Nursing Skill Mix - Report Example

Running Head: Nursing Skill Mix and How it Impacts on Contemporary Practice in Australia Nursing Skill Mix and How it Impacts on Contemporary Practice in Australia [Writer’s Name] [Institute’s Name] Nursing Skill Mix and How it Impacts on Contemporary Practice in Australia Abstract An important contribution that can be made to the efficient healthcare management system is the skill mix and the changes associated with the skill mix. Skill mix is the demarcation of the rules and responsibilities that have been distributed within the staff members of health care workforce. The skill mix can help in the development of healthcare staff by introducing developments that make sure that the skills within the staff are enhanced. An improved strategy in the skill mix of the health care workforce can be better understood when it is realized that what are the impacts of improving skill mix on nursing and the other related health care issues. Introduction Nursing in Australia: An outlook These are the days when it has been realized by the health care workers in Australia that Australia is lagging behind in the health care workers especially in the case of nurses in the nursing stations. It has been said that the Australian health workforce has been the one department on which the government has invested a lesser amount of money as had been needed. It has been estimated by the Australian Medical Workforce Advisory Committee that since the year of 2000 there has been a shortage in the healthcare workforce especially in case of nurses in Australia. In the year if 2004, it had been realized that the self sufficiency has to be obtained in the nursing workforce by the implementation of many rules in the National Health Workforce Strategic Framework. As the commission says all the ethical protocols shall be used to train and to achieve the best level nursing workforce by making the best possible utilization of the nursing skill mix. As Zimmermann (2002) says, skill mix in the scenario of the workforce in healthcare profession can be assumed to be a much broader term. In this case it is an interrelated mix of the staff as well as the contrast of the rules as well as the duties and obligations and the activities among the staff that belongs to various different categories. There have been many policies that have paid attention to the skill mixes as it has been realized that the skill mix can be the one factor that can make better changes in the future in health care. The main point in the skill mix has been the mix of the activities of the physicians and nurses. Carey, Saunders, and Royal College of Nursing (Great Britain) (2000) have discussed that skill mix can result in an enhancement in the skills of various people within the staff including nurses as well as physicians. It might be leading to substitutions that take place between different groups, including the mixing of the delegations higher or lower to their criteria that leads to the changes and innovation in roles being played by different people in health care. Skill mix in Australia Zuzelo (2007) has said that skill mix has been identified and defined in many ways in the literature as has been said that there are four main models of skill mix between a physician and a nurse. Skill mix and its importance has been more than just realized in Australia and the healthcare management in Australia. Halcomb, Patterson, Davidson (2006) say that two other skill mix models that have been included are the contemporary practitioner and the needs led practitioner. These two models are the ones that can effectively explain the main roles being played by nurses in healthcare management. These also provide an important and a classifiable philosophy of healthcare and this philosophy focus on proper health care being delivered to the patient thus focusing on what the user needs. Therefore if nursing is viewed rather in detail from this very perspective than it can be seen that services being given by nurses are the ones representing the medical needs of a community and a welfare rather than the number of enlisted medical health care services that can be possibly provided to the needy ones. Bushy (2002) says there have been some frameworks that have been advised so as to define a way to look at the doctor nurse skill mix. Framework includes enhancement as a first and foremost point that says that roles and responsibilities that are given to a particular group of workers in health care management should be extended. This can be helpful in enhancing skills of the workers in healthcare management especially the nurses. Jones, and Cheek, (2003) say that another part of framework includes substitutions as creating possibilities for working across the professional levels so as one worker from one professional level is replaced by another so as an intermixing of responsibilities can be created in the workforce. Stephanie, and Evelyn (2002) say that delegation is a framework model that positively says that the movement and an intermixing of tasks should be done in the uni-disciplinary ladder within a health care work environment. Innovation and the changes in healthcare management are introduced by making possibility an availability of newer jobs so that the changes are to be felt in health care systems. Skill mix has been discussed in many cases in relation to the nurses in Australian healthcare professions at the levels of advanced practiced nurses or the nurse practitioners including the specialist nurses. Mahon, (1996) say that in the limelight of skill mix, the roles and responsibilities that have been assigned to the advanced practiced nurse in Australia has been categorized in one too many ways. At one place by the International Council of Nurses says that Nurse Practitioner or in other words, an advanced Practice Nurse is a registered nurse who has successfully gained the knowledge base that is required by any nurse at this renowned position. The nurse is equipped with skills as complex decision making, health care management at tougher times, enhancing the knowledge by using all the possible research capabilities as well as the clinical and medical competencies for more advanced nursing practice. Davidson, and Elliott, (2006) have said that in addition to this a fact that has been realized and is reflective on various healthcare policies being designed by the nursing authorities in Australia is that these are the skills that are enhanced as well as polished when skill mix occurs between healthcare professional from higher as well as lower ladders of delegations. The mixing of knowledge occurs providing changes in the knowledge base of the healthcare workers so as to push the limits in the better service provision to the needy ones in a community and welfare. Henery, (2003) says that contemporary nursing is the one matter that needs to be focused by the policy makers in Australia. These days are focusing on an enhancement of knowledge by an implementation of higher researching skills so as en enhancement in the knowledge basis can lead to better changes in nursing and service provision to the community. Nurses whether they are advanced practiced nurses or the Nurse Practitioner, seems to be anticipated, in these days, to be utilizing more of the research capabilities with a healthcare environment so as to make possible an enhancement in the knowledge base. Bushy, (2002) says that this is the knowledge base than can be shared with the people belonging to the staff who may be higher or lower in rank. Here again the skill mix seems to work as the mixing of the staff can be able to increase a knowledge base that has been anticipated by the higher authorities as International Council of Nurses. The nurses are the healthcare workers who are being anticipated to manage the health care profession in such a way that it leads to the better quality service provision. Davidson, and Elliott, (2006) say that demands from the nurses are increasing on a daily basis and it is to be seen that these demands are fulfilled by making sure that the Australian nursing authorities design the policies that can allow the skill mix in the healthcare environments. Halcomb, Patterson, and Davidson, (2006) argue that contemporary nursing in Australia is focusing on the advanced practiced burse. It has been said that the term Advanced practice nurse is much of a broader term and this covers a variety of nursing roles that are inclusive of the nurse practitioner as well as that of a nurse specialist. As is bring expected by the nursing authorities at Australia, the nurse practitioner comes in with a higher education and a much stronger knowledge base. Knowledge base that a nurse practitioner has will be emphasizing on the medical conditions as well as the patient care and management provision to the needy ones. Sarah, and Wendy, (2002) say that the responsibilities that the nurse practitioners are given include the patient care in primary as well as the hospitals. In comparison there has been an outline sketched by the Australian authorities that can truly define the responsibilities of a nurse specialist. In this case a set of responsibilities given to a nurse specialist are lesser but still holding an importance as compared to that of a nurse practitioner. Stephanie, and Evelyn, (2002) say that a nurse specialist is a one who deals with only one specialty in terms of healthcare and these can be inclusive of oncology or even pediatrics. In some cases there may be an intermix that is noticed in the responsibilities of a nurse practitioner as well as a nurse specialist as there can be no distinct line that divided their roles in healthcare. These are the main definitions of a nurse practitioner and nurse specialist that are found to more confused in case of function equality in the countries as USA and Australia. Nursing policies and skill mix Different health sectors, different countries as well as different policy makers have different sets of view point when it comes to policy making by keeping in mind the main factor of nursing skill mix. Main issues that need to be seen by the policy makers are the healthcare issues as well as health care management issues. Jones, and Cheek, (2003) argue that in the case of Australia, there are some factors that have to be seen when skill mix in nursing is to be kept in mind. These factors include an availability of all the possible resources, the regulatory environment, culture of Australia, customs and practice being followed in healthcare in Australia that will help in defining roles in healthcare. These are the factors that can also help in determining the levels and limits of the skill mix in health care profession. Halcomb, Patterson, and Davidson, (2006) argue that these are the factors, as has to be realized, that have their effects on the skill mix as well. It has to be realized that if there is a variation in these factors, even in any one of these than the changes can be seen to be implemented on skill mixes in healthcare profession. In case of skill mixes, there are distinctive variations that are seen in between different regions as well as different countries as well as different healthcare occupations. In another way it can be said that the patients’ illnesses were much lesser when they has been treated by nurse practitioners as compared to the ones treated by the physicians or doctors. Mahon, (1996) says that there are many studies that have been done for studying the outcomes of skill mixes occurring between the nurses and physicians or doctors. The skill mixes as has been shown have shown much positive outcomes as the nurses are the ones treating the patients much better as compared to the physician as an intermixing of knowledge has occurred in this skill mix and this is the learning that has made the contemporary nurse learn much more. The ladder of roles and responsibilities is widely different between a nurse practitioner and a doctor still as a result of skill mixing the nurses have managed to learn practices being implemented by the physicians in treating the patients. Table 1: New roles and skill-mix: drivers, issues and possible interventions in Australian nursing systems (Davidson, and Elliott, 2006) Mahon (1996) says that there has been an increasing evidence that shows that modern day have tried to use the skill mix in such a way that they have been accepting the roles and responsibilities that had been once limited to physicians. This has been noticed in case of many countries as USA and Australia. It has been noticed in some cases that the anticipated benefits for skill mix has not been achieved in many cases however the analysis has revealed that the methods have been inclusive of financing primary care in healthcare occupations. Jones, and Cheek, (2003) argue that important and distinctive roles have been played by primary healthcare financing. As in this case it has been primarily noticed that the transferring of roles and responsibilities within the primary healthcare has been much accepted as a part of skill mix. This raises the possibility of transfer of the responsibilities as well as competencies from one professional level to another. Nursing global recruitment practices and nursing ethics National Health Workforce Taskforce (2009) has reported that on a global level there have been many events that have had an effect on the nursing workforce resulting in a shortage of the nurses in Australia. There has been a commitment in the reform package in nursing totaling $1.6 billion so as to hire more nurses. Here the main goal that needs to be accomplished is that the reformation in the health care system through the proper changes in the nursing workforce. Global financial crisis has been one of the main impacts that has been seen on the nursing workforce in Australia. There has been a decline in the value of the Australian dollar that means that the Australian nursing workforce is lesser attractive to the world. This has also increases the employment rates in Australia casing an increase in the employment pool. In addition to this it has been seen that the nurses and the nurse practitioners because of the unemployment are going to the other countries to get the employment and this has made the National Health Workforce Agency to make sure that they start hiring nurses from the different states and the territories. It has been said that to increase the workforce in the nursing stations, an amount of $63 million will be given so as to advertise the nursing station vacancies in the next few years. Moreover the overseas recruited nurses will be tarried in such a manner that they are aware of the nursing registration requirements. Treatment modalities, technologies and most of all the nursing skill mix are the factors that contribute to the service delivery from the nurses to the needy ones. In addition to this it has been seen that the pressure of the acute healthcare has increase in the healthcare facilities and there is a need to hire the acute healthcare workforce in the nursing stations. This relates to the expectations that are changing for the nursing workforce as has been in the case of the hours that they spend with the patients at the health care facilities and the dedication and the quality of the service that they are providing to the patients. Halcomb, Patterson, and Davidson, (2006) say that sacrifice, human devotion and faith is what defines nursing as a vocation. Nightingale system of nursing had been based on female values and displacement as well as discipline of men. Still these are the main historical factors that have affected nursing in many ways in third world countries. For nurses to be able to fulfill their responsibilities, the professional code of conduct and ethics must be compensated. Stephanie, and Evelyn, (2002) have argued that gender has been a main issue in nursing workforce in third world countries as it has been seen as a female only occupation. This has caused the self esteem of the nurses to suffer the most as well as there is a lack of belief that is associated with nursing. The operating room nurses were the ones being treated as handmaidens for male surgeons. Thereby nurses have not been treated as managers or healthcare partners but as a workforce under the male surgeons. Position that the modern day nurse holds in developed countries is very different to that of the typical imagery that has been associated with the nurse in a third world country. In this case a nurse is still considered to be a domestic duty worker. Political intervention Carver, (2008) says that it has been seen that the nursing homes are the ones that need attention at the priority level and thereby it has been said by the Australian Nursing Federation (ANF) that from the government there is a serious priority that has to be taken at the end of the nursing homes in Australia. the nursing workforce in the old nursing home shave been seen to be declining because of the factors that have been stated above and there have been some complaints that have been lodged to the Department of Health and Ageing's Complaints Investigation Scheme (CIS). Thereby it has been realized by the nursing homes that in addition to the nursing workforce the skill mix is a need as well. Enhanced salary systems for the nurses who are aged and they should be paid more than the others, introduction of national level licensing system so that there is a through recognition of professionalism as well as the skill mix in nursing. Conclusion There have been developments in ways that nurses need to evolve and one in much way this includes an importance is skill mix. Still mix can make possible an innovation in the nursing roles by an intermixing of the practices being observed by physicians and nurses. Still in the age of contemporary nursing there are countries that are stuck the female only ideology of nursing as this is a well needed change. References Journal articles (2009). Health Workforce in Australia and Factors for Current Shortages. National Health Workforce Taskforce. Bushy, Angeline. (2002). International perspectives on rural nursing: Australia, Canada, USA. Australian Journal of Rural Health. 10(2):104-111. Carver, Peter. (2008). Self Sufficiency and International Medical Graduates – Australia. National Health Workforce Taskforce. Davidson, P. M., and Elliott, D. (2006). Clinical leadership in contemporary clinical practice: implications for nursing in Australia. Journal of Nursing Management. Issues in Collaboration in Nursing Management. 14(3):180-187. Halcomb, Elizabeth., Patterson, Elizabeth., and Davidson, Patricia. (2006). Evolution of practice nursing in Australia. Nursing and healthcare management and policy. Journal of Advanced Nursing. 55(3):376-388. Henery, Neil. (2003). Constructions of spirituality in contemporary nursing theory. Nursing theory and concept development or analysis. Journal of Advanced Nursing. 42(6):550-557. Jones, Jacqueline., and Cheek, Julianne. (2003). The scope of nursing in Australia: a snapshot of the challenges and skills needed. Journal of Nursing Management. 11(2):121-129. Mahon, Pamela, Young. (1996). An analysis of the concept 'patient satisfaction' as it relates to contemporary nursing care. Journal of Advanced Nursing. 24(6):1241-1248. Sarah, Winch,Debra Creedy., and Wendy, Chaboyer. (2002). Governing nursing conduct: the rise of evidence-based practice. Nursing Inquiry. 9(3): 156–161. Stephanie, D., and Evelyn, Sharman. (2002). The Nursing Struggle in Australia. Journal of Nursing Scholarship. 19(4): 197 – 200. Bibliography Carey, Lynda., Saunders, B, W., and Royal College of Nursing (Great Britain). (2000). Practice nursing. Elsevier Health Sciences. Zimmermann, Gerber, Polly. (2002). Nursing management secrets. Elsevier Health Sciences. Zuzelo, Rager, Patti. (2007). The clinical nurse specialist handbook. Jones & Bartlett Publishers. Read More