Competencies in Nursing, and Quality Leadership - Essay Example

mреtеnсiеs, Sсоре of Рrасtiсе in Disasters Student’s Name Institutional Affiliation Table of Contents Table of Contents 2 Introduction 3 Competencies in Nursing Practice 3 General Competencies in Nursing 3 Competencies in Disaster Nursing 4 Importance of Competencies in Disaster Nursing 7 Scope of Nurses during Disaster 8 Benefits of Expanded Scope in Nursing 11 Nurses’ Ability to Respond During Disasters 11 Ethical and legal Issues in Disaster Response for Nurses 14 Conclusion 16 References 17 Introduction Nursing competencies are the key requirements needed in nursing professionals’’ behavior or conduct in order to provide quality care in the practice. On the other hand, disasters are events that bring significant damages to life and property as well as overwhelming the community’s resources. (Veenema, 2013). Therefore, in order to offer credible and high quality services, educational institutions for nurses should emphasize the need to embrace key competencies and applying them in when practicing nursing (Ranse & Royal College of Nursing, 2010). The following paper intends to provide a critical analysis of the competencies that nurses need to apply during disasters. It also discusses the scope, roles, and responsibilities of nurses during disasters. Further, nurses’ ability to respond in disaster settings as well the legal and ethical considerations have been provided in this work. The paper will show that as nurses do what it takes during disasters, there is need to have more legislative provisions that will protect nurses in disasters circumstances. Competencies in Nursing Practice General Competencies in Nursing Nursing competencies are the basic requirements needed in nursing professionals’ behavior or conduct in order to provide quality healthcare services (Davies & Janosik, 2012). They may vary from one country to another but some of the general nursing competencies include: Patient-Centered Care Evidence-Based Practice Leadership Professionalism Patient-Centered Care Informatics and Technology Communication Quality Improvement Teamwork and Collaboration Safety Systems-Based Practice Competencies in Disaster Nursing The complexities and scope of disaster demand nurses to have a standard set of skills that should guide their operations before, during, and after disasters (Reilly & Markenson, 2011). In a global point of view, few models have been developed focusing on the catastrophe in nursing. However, nurses need to work internationally, and different settings with health care providers and nurses from other parts of the world. Therefore, to ensure that there is the typical response to disasters globally, availability of competencies is necessary (Couig & Kelley, 2012). It is critical to note that in competency-based practice, nurses may find it challenging to choose the set of competencies applies. The correct choice of competencies is crucial since they are instrumental in informing the actions to be taken in the practice, the standards to be set, and the needs required. However, the identification of competencies requires the use of nursing literature as well as the application of nursing theories. In addition, nurses should ensure that they understand the existing competencies and their areas of application. At the same time, they need to synthesize the new competencies in their field’s expertise and the objective of every competency. The following section discusses the four main competencies, which span through the phases in preparedness, response, and recovery. Model leadership As one of the four competencies, model guidance aims at ensuring that nurses can solve problems that occur during disaster or under emergency conditions (Couig & Kelley, 2012). The nurse should be in a position to quickly find a solution of an urgent situation where solution requires critical thinking. On the other hand, under the model leadership, a nurse is supposed to ensure that emotional behaviors that come from a given disaster are managed from both within and in others (Finkelman & Kenner, 2010). It is instrumental in providing the suitable environment in solving disaster or urgent situations during emergencies. It also helps the nurse to serve the victims soberly. Model leadership also requires that a nurse be in a position to manage response mechanisms with internal and external partners. It is crucial as the collaboration in disasters helps to ensure that all goes as planned. Additionally, it is through leadership that one can ensure that all parties are respected regardless of their cultures or social background. However a nursed is expected to act within the law in other to show model leadership traits. Communicating and Managing Information In any disaster situation, poor communication is another crisis altogether. The collaborative and efficient management of disasters cannot be achieved when nurses are not able to communicate with the rest of the team (Howard et al., 2010). The first role under this competency is ensuring that the information during the disaster is management properly. The confidential information should not be allowed to leak unnecessarily during disasters as it can harm the process. In order to ensure that information is properly managed, nurses should apply the principles of risk and crisis communication, which include timely delivery of information and confidentiality, among others. Further, if a nurse have any information that could reduce the impact of a disaster he is expected to report such information through the chain of command for the action to be taken (Jones et al., 2006). In most cases, during disasters, nurses are expected to collect and compile data for future reference. It also helpful when giving emergency services to the victims of a catastrophe. However, nurses should ensure that the collection, recording, and management of information are done by a professional, which involves following the protocol. Plan For and Improve Practice This is the third competency that includes ensuring that a nurse contributes in making disasters management better and more successful (In Veenema, 2013). The expertise that a nurse has acquired in the practice and training is expected to apply to the victims and in many situations is creative. Further, a nurse needs to contribute to the analysis of vulnerability at the community or individual levels. The contribution is critical in enhancing the response mechanisms during disasters. This should also be the case during the development of emergency plans. Generally, a nurse needs to play a role and participate in the promotion of the organizational capacity such as the development of programs, policies, procedures, and the training of the workforce (Finkelman & Kenner, 2010). This is crucial in ensuring the organization is strong enough in the application of preparation, response, and recovery mechanisms during disasters. However, in situations where an issued is beyond nurse’s legal mandate, the matter should be referred to the relevant personnel for action. Protection of Health and Life of People The key concern during disasters is to save the life of people at whatever cost, which should be the priority of nurses (In Veenema, 2013). Therefore, a nurse needs to be competent enough in a given field to save lives effectively. In this connection, a nurse is expected to maintain emergency plans and understand the immediate actions that should be applied during special dusters. In such situations, a nurse should employ protective behaviors such as ensuring that proper wear is worn to avoid or prevent infections. Following the chain of command, a nurse should report any unresolved threats to mental or physical health in order to reduce the impact. Importance of Competencies in Disaster Nursing Competencies in Disaster nursing play a critical role in supporting learning and assessment of organizational capabilities in disaster management (McSherry et al., 2012). They serve as guidelines or as the resource for the development of curriculum and review, a continuation of nursing education, and training programs. In this way, they help in encouraging consistency in what skills and knowledge are taught and expected in the nursing practice. Further, individual skills and knowledge are assessed including the identification of training needs that should be applied. It is critically important to have the ability to identify gaps during disasters since it provides an opportunity for improvement in disaster management. Organizations and health professionals should ensure that there is a systematic application of competencies in order to reduce the risks that are related to disaster response. In addition, competencies act as the foundation through which evidenced-based practice, standards, research models are developed (Nygaard, 2007). As noted above, disaster management in nursing is a complex process that calls for partnership among various players. Therefore, having common competencies that provide the basis through which standards of practice during disasters can be formulated. In this respect, it becomes less challenging to deploy nurses globally where disasters occur since the same competencies are used worldwide. Competencies are also critical in building confidence among nurses and health practitioners (Veenema, 2009). They provide the reference through which a nurse can counter-check regularly or at any time especially during disasters. As noted above, since the profession uses the same competencies worldwide, any nurse is confident in any part of the world that disaster has taken place. The courage and confidence in nurses play a critical role in providing professional services standard approaches to disaster management. Scope of Nurses during Disaster During disasters, nurses have the core task of ensuring that the health and life of the populations are protected by using the knowledge gotten from the training as well as the accumulated experience in practice (Bridges & TriService Nursing Research Program, 2009). It is important to note that during disasters, nurses are expected to provide their services to individuals, community or in a given population. The aim is to promote the health and prevent diseases or the impact of disasters on the victims. Therefore, nurses bring critical expertise to every stage of disaster cycle including preparedness, response, and recovery. Nurses have specialized skills and ability of linking systems that are important in the continuum of disasters. Special skills for nurses include but not limited to emergency medical care, surveillance, health and disease investigation, rapid needs assessment, case finding, collaboration techniques, prophylaxis and treatment methods, teaching in health and education, referral and outreach services, organization of partners or victims during disasters , among others McSherry et al., (2012). Therefore, nurses are expected to apply these skills and ability to disasters in order to save the life of people and protect their health. However, the following roles of nurses in the community during disasters are instrumental in the management of the crisis. In any disaster, the community is affected in one way or the other, thus promoting the role of nurses in such situations. The disruptions that come to the community due to the impact of hazardous events have varying effects on nursing as well the provision of healthcare. Consequences of disasters to the commonwealth may be long term or short term, depending on the magnitude of the destruction as well as the ability to the community and the available resources to address and meet the immediate health care needs of the community without the addition of more resources (McSherry et al., 2012).. However, as noted above, the objective of nursing is to ensure that the highest level of healthcare is given to the community by identifying, advocating, and caring for the affected in all phases of the disaster. The process also includes participating in the every level of planning as well as preparedness. However, it is important that during medical disasters nurses should be aware of the most probable hindrances that they may encounter when providing healthcare as well as noting the best modification in service delivery. Further, it is the responsibility of nurses to understand that whether the disaster is relatively small and multi-casualty incident or a disastrous event, the provision of health care can become overwhelming (In Veenema, 2013). In such circumstances, nurses may be required or called upon to provide health services for a large number of people at a rapid pace. Therefore, nurses need to prepare and have proper planning to prevent chaotic scenarios that might lead to poor care delivery. In order to minimize occurrences of chaotic scenes during disasters, there should be an appropriate distribution of nursing staff to ensure maximization of care delivery. This is because nurses are expected to triage properly patients during disasters, which also depends upon effective coordination among stakeholders, distribution of essential equipment and supplies as well as their placement. In case there are limited resources during a medical a disaster, regional plans should be made to provide the most basic care and stabilize the victim’s health conditions. However, it is hard to provide the usual standard of care when the healthcare resources are overwhelmed in a disaster scenario. It also recommended that nurses should have and understand the accepted standards that constitute reasonable care for a give jurisdiction. This will be instrumental in determining resource usage during disasters. Additionally, during disasters, nurses need to work together with other agencies and disciplines within the system of healthcare in order to provide effective services and maintain the functionality of a healthcare facility. One of the important roles of nurses during disasters is overseeing the process of transferring patients to other regional hospitals for health services especially those located away from the area where disaster has taken place (Kim, 2015). At the same time, nurses are supposed to assign supplemental healthcare workers as well as obtaining needed supplies. Therefore, in order to ensure that such roles are achieved, coordination with other healthcare providers including hospitals is essential. The scope of health care service by nurses during disasters can be extended based on the kind of disaster. For example, depending on the magnitude of the disaster, the community affected may need water, food or shelter as their immediate requirements. In such circumstances, public health nurses or nurses that are not routinely involved in meeting the basic survival needs of a community may be required to due to the severity of the situation or because normal health operations have been damaged. Further, nurses may as well be required to provide their services outside a health facility as the first respondents for venerable communities during a disaster, which requires quick adjustment to the environment. Benefits of Expanded Scope in Nursing It is critical to note that expanded scope in nursing helps health professionals in gaining more experience while applying their skills in practice. Further, expanded scope enables a nurse to become more creative in solving problems in the society as well as exercising leadership roles and other competencies. Evidently, it is clear that ineffective nurses’ response to a disaster can negatively affect the community’s outcome from the hazardous event especially when resources fail to match with the needs. Therefore, nurses need to be well equipped not only with resources but also with enough skills and knowledge in order to overcome disaster-induced adversities. Finally, nurses should understand different roles that they need to play in order to deliver effectively quality services to the community affected in a disaster setting. Nurses’ Ability to Respond During Disasters The ability of nurses to respond during disasters entirely depends on the preparations made at individual and institutional levels (Kim, 2015). The fiat steps that in health institutions should do in order to ensure adequate response to disaster is to establish a disaster management plan. Having disaster management plans already in place is critical is the simplifying response to emergencies for nurses. For example in Australia, all hospitals are required to have developed disaster management plans already in place (In Keeling & in Wall, 2015). The strategies put across in these plans should be well outlined and understood by all stakeholders in the institutions. Additionally, the roles and responsibilities of various partners in times of disasters need to be well stipulated. The key element in disasters management is how communication process will take place and the channels through which stakeholders will be required to use during and after disasters (Watson, 2015).. At the same time, training of employees including nurses is emphasized so that effective coordination of activities is ensured when a disaster strikes. The study has shown that in some health institutions, disaster programs do not meet the needs of the community, employees or other vital stakeholders, which leads to the poor response to disasters (Kim, 2015). Further, it is not enough to have a response plan to disasters, but it is advisable to formulate a committee that consists of medical professions, administrative and security officers. The committee is instrumental in steering the process of disaster management (McSherry, W., McSherry, R., & Watson, R. 2012).The representation in the committee should be from various departments to provide several inputs in the disaster prevention. At the same time, nurses should be allowed to present their views as the committee reviews on the available strategies in disaster management. However, one of the responsibilities of the committee is to ensure that the coordination between various stakeholders in the management of a disaster is effectively done. This involves scanning the area affected by a disaster and guide the nurses and agencies concerned. For example, the committee could be involved in the determining presence of generators or air handlers in a given disaster setting. Additionally, the committee handles reviewing and establishing new strategies on disaster management. However, the committee is expected to consult relevant authorities when introducing new laws in the institutional policies on the handling of disasters management. The distribution and roles played by all parties involved in managing crisis should be addressed by the court (Couig, M. P., & Kelley, 2012). Additionally, ability to respond also involves conducting drills, which prepare nurses in advance. Conducting practice drills should be done on a regular basis to ensure that health professionals including nurses are updated on the changing environment and techniques in disaster management. Therefore, exercises need to be part of the training process that encompasses the roles and responsibilities that nurses should play during disasters. On the other hand, the guidelines on what is expected during disasters need to be simple and clear to all stakeholders (Brebbia & International Conference on Disaster Management and Human Health, 2013). This is instrumental in facilitating efficient delivery of services. In this connection, health care institutional should provide checklists in order to ease the understanding of the guidelines of training (Royal Australian Nursing Federation & Australian Nursing Federation, 2010). The application of theoretical knowledge in a disaster setting becomes easier to nurses if the guidelines such as competencies are also made simpler. However, it must be agreed that it also depends on the style of training nurses are taken through for them to remember the guidelines and apply them appropriately (Couig, M. P., & Kelley, 2012). Finally, equipping health facilities with necessary resources that are required during disaster is instrumental in ensuring that nurses play their roles appropriately (Locklyn, 2006). The regular check of the facilities needs to be conducted so as their applicability in times of disasters can be effective. Some of the requirements include protective gear, vehicles such as ambulances, and enough first aid kits among others. Ethical and legal Issues in Disaster Response for Nurses Several legal and ethical issues face nurses when practicing on disasters. Nurses are expected to deliver in varying circumstances that call for their creativity in decision-making. In some instance, the response efforts may be areas that nurses are not licensed to operate. In such circumstances, a nurse is expected to consider the legal and ethical application of the creativity before acting. In many jurisdictions, nurses find themselves unable to act even when the victims need their service. One of the main components in ethical considerations in disaster settings is saving of life and protection of people’s health. However, the application of this code of conduct becomes complicated to nurses if the circumstances might result in loss of life or deterioration of a victim's health conditions (Nygaard, 2007). It is such considerations that a nurses will be reluctant to offer health services especially in the jurisdiction where there are no legal protection for nurses or health professionals when helping during disasters. The above circumstances are mostly experiencing by registered nurses who are supposed to follow a given code of conduct ad protocol when offering their services (Nygaard, 2007). The circumstances become worse when nurses who are not assigned to responding to emergencies in a health facility find themselves in situations where they are called upon to attend to casualties. The risk of infection when attending to a mass of victims during for such nurses is also high. The compassionate nature of registered nurses forces them to respond and offer their help while others find themselves struggling to provide assistance when situations are worse. The question of the role of registered nurses in responding to emergencies and disasters remains unanswered in many countries, especially if they are called to offer services in nontraditional areas. Nurses registered or unregistered have a sole obligation of saving the life. As nurses think about ethics, an eminent danger exists in situations where infection could occur (Jevon et al., 2008). In such circumstances, nurses find themselves unable to balance the ethical obligation while at the same time protecting their health and life as well. On the same note, nurses find it challenging in attending to patients when there are no enough resources to protect their life or health and that of other people, which calls for adequate legislative provision that would protect nurses in such situations. At the same time, health institutions should ensure enough facilities are provided to nurses during emergencies especially where their lives are at risks. As indicated above legal considerations also puts nurses in confusion especially during disasters. The legal implications if nurses are involved in areas beyond his jurisdiction make nurses reluctant in offering services to people (Adelman & Legg, 2009). Some of the questions include if there is a law protecting or compelling a nurse to respond, whether nurse’s license is protected and if the nurse is assured that he will not become the target for lawsuits for malpractice or negligence. The study indicates that there are no enough legal provisions that provide protection of nurses when involving themselves in disaster response processes. Conclusion Disaster nursing is one of the essential elements of nursing practice as it plays an instrumental role in equipping nurses with relevant skills and knowledge in disaster management. However, nurses need to ensure they appropriately apply guidelines and competencies when delivering services to the public. Further, nurses should understand their roles, scope, and responsibilities in disasters, which ensure smooth coordination. Finally, ethical and legal considerations need to be balanced by enacting legislative provisions in order to protect nurses during disasters. References Adelman, D. S., & Legg, T. J. (2009). Disaster nursing: A handbook for practice. Sudbury, Mass: Jones and Bartlett Publishers. Brebbia, C. A., & International Conference on Disaster Management and Human Health. (2013). Disaster management and human health risk III: Reducing risk, improving outcomes. Southampton: WIT Press. Bridges, E. J., & TriService Nursing Research Program. (2009). Battlefield and disaster nursing pocket guide. Sudbury, Mass: Jones and Bartlett Publishers. Couig, M. P., & Kelley, P. W. (2012). Annual review of nursing research: Volume 30, 2012. New York: Springer Pub. Co. Davies, J. L., & Janosik, E. H. (2012). Mental health and psychiatric nursing: A caring approach. Boston: Jones and Bartlett Publishers. Finkelman, A. W., & Kenner, C. (2010). Professional nursing concepts: Competencies for quality leadership. Sudbury, Mass: Jones and Bartlett Publishers. Howard, P. K., Steinmann, R. A., Sheehy, S. B., & Emergency Nurses Association. (2010). Sheehy's emergency nursing: Principles and practice. St. Louis, Mo: Mosby Elsevier. Jevon, P., Ewens, B., & Humphreys, M. (2008). Nursing medical emergency patients. Oxford: Wiley-Blackwell Pub. Jones, G. J., Endacott, R., & Crouch, R. (2006). Emergency nursing care: Principles and practice. London: Greenwich Medical Media. InVeenema, T. G. (2013). Disaster nursing and emergency preparedness for chemical, biological, and radiological terrorism and other hazards. In Keeling, A. W., & In Wall, B. M. (2015). Nurses and disasters: Global, historical case studies. Kim, H. S. (2015). The essence of nursing practice: Philosophy and perspective. Locklyn, B. (2006). The nursing practice. Collegeville, Minn: Royal Australian Nursing Federation. McSherry, W., McSherry, R., & Watson, R. (2012). Care in nursing: Principles, values and skills. Oxford: Oxford University Press. Nygaard, G. G. (2007). Disaster nursing: The primary care challenge. Ranse, J., & Royal College of Nursing, Australia. (2010). Inspiring, progressing and promoting the profession of nursing in disaster health. Brisbane: Royal College of Nursing, Australia Reilly, M. J., & Markenson, D. S. (2011). Health care emergency management: Principles and practice. Sudbury, Mass: Jones and Bartlett Learning. Royal Australian Nursing Federation., & Australian Nursing Federation. (2010). The Australian journal of advanced nursing: A quarterly publication of the Royal Australian Nursing Federation. South Melbourne, Vic., Australia: Royal Australian Nursing Federation. Riky K.N., (2012). A practice guide in nursing. Pine Forge Press. Veenema, T. G. (2013). Disaster nursing and emergency preparedness for chemical, biological,and radiological terrorism and other hazards. Veenema, T. G. (2009). ReadyRN: Handbook for disaster nursing and emergency preparedness. Watson, R. (2015). Competencies in nursing: Oxford: Oxford University Press. Top of Form Bottom of Form Read More