Factors Influencing Nurses - Essay Example

Factors Influencing Nurses providing Quality Care to Clients within Peri- Anesthetic Environment Introduction Accountability has become a major factor in the health care industry because consumers have become more sensitized and expect quality services that provide value for their money. Consumers are continuously getting involved in the process of health care provision and in most instances require to be informed about the various decisions made regarding their health. The provision of quality care in nursing is mandatory if the fraternity is to achieve its objectives. Quality care is not a new thing in nursing and began with the efforts by Florence Nightingale to provide care to solders. Nightingale was successful from the beginning because she was able to establish standards that acted as guidelines. The standards she set were the first guidelines on quality care in nursing to be documented. Nursing therefore has been established as a profession with a wide store of knowledge and with specialization dividing it into various fields which include surgical nursing peri- anesthetic and post anesthetic nursing among others. However some scholars like Cantor (1983) are still of the idea that nurses seldom get involved with the whole aspect of delivering health care to patients or the provision of quality services to patients. Cantor argues that nurses have traditionally limited themselves to taking care of patients, disregarding important factors such as whether the care they are providing is satisfactory to the patients or whether the resources available, however scarce are being utilized maximally to ensure that that the patient recovers in a conducive environment. However it is also important to avoid the blame game and critically look at the factors that influence the quality of care to the patients including aspects such as the quality of training given to nurses and the availability of facilities. This paper will analyze some of these factors with reference to peri-anesthetic nursing. (Brubaker, T. 1987). Professional Development Before a particular surgery is carried out nurses have the important obligation of obtaining consent from the patient. ( Margaret F., Alexander, Josephine N., Fawcett, Phyllis, J. 2008). This important because nurses play the role of ensuring that the patient is fully aware of all the procedures, the risks involved and this information will help the patient in making the appropriate decision. The information obtained by the nurse will also help the surgical team to be aware of any special needs or requirements as stated by the patient. Nurses therefore provide a very important link between the doctors and the patient contrary to the general misinformation where many people assume that doctors are the ones who obtain consent from patients. Due to the increasingly complex needs of the patients it is important that nurses are constantly equipped to obtain the important information from the patient and advise the patient accordingly before requesting for consent. It is therefore a prerequisite that the nurses who obtain consent from patients undergo complete training in line with the requirements of medical standards of care. Research has established that most nurses are not thoroughly trained in their initial course to deal with such challenges and this is a problem that can be solved by implementation continuous professional development to periodically equip nurses with the experience to deal with the ever changing challenges. Professional development has been a major concern in the nursing field and it is constantly being evolved in line with the patient’s requirements so that nurses can be equipped with the expertise to deliver quality services. Learning opportunities are constantly being created and they also include emphasis on the learner’s critical thinking and self reflection skills in order to constantly evaluate the process of self development. According to Jacqueline Fawcett (2004) there seems to be a general agreement in literature that continuous professional development in surgery the nursing field is important for the delivery of quality services. The need for continual professional development is arising to the changes observed in health care. Paxton (1996) emphasizes that the clinical role of nurses is exponentially expanding and that the expansion requires that changes be made in both the health care and the nurse education perspectives. The continuous development of new knowledge and skills makes it necessary for nurses to continually evaluate their professional experience in order to provide quality services to patients. Professional development is also important because it helps nurses in identifying the limitations of their previously acquired knowledge and skills and they therefore have the opportunity to fill the gaps. The continual professional development can also help in boosting the confidence and the esteem of nurses who feel that they did not do their best in school and therefore consider it as an opportunity. Continuous professional development can also be used as a tool for evaluation and upgrading. The major challenges in nursing have become the attainment of professional development, the maintenance of professional development and the advancement of professional development. However, most nurses find it hard to engage in continual professional development because of lack of funds and/ or time and this fact has become a major limiting factor. According to Kemp (2003) professional development takes place where the professionals have realized the need to upgrade their skills with the objective of improving the quality of their performance. According to Mackereth most nurses are diligent on issues concerning the art and science of nursing; furthermore nurses have continuously sought for continual professional development in order to maintain their daily activities. Most nurses however complain that that the major drawbacks in the pursuit for continuous professional development include, lack of funds, lack of time, lack of professional support, lack of courses that efficiently cover relevant areas and lack of inspiration. Motivations to engage in continuous professional development comes from the fact that nurses constantly encounter challenges in their working environments and they are therefore compelled to seek for additional knowledge and experience so that they can become better equipped. Some of the challenges experienced are limited to a particular area while some are more distributed. It is therefore important that nurses engage in continuous professional development so that they can be able to learn from each other’s challenges and even share knowledge. The knowledge required for nurses when dealing with patients and doctors should be continually expanded especially due to the changes observed in general climate of health care. Nurses should be constantly aware of the needs of the rights and needs of their patients because legal and ethical matters are fast becoming an important factor. The social atmosphere requires that patients become part of the whole process of treatment and recovery. For instance consent is defined as the agreement by the patient to obtain professional care. It may sound simple and even vague but can be violated by just an instance of touching the patient and it can lead to a legal tussle. Communication Nurses provide an important link between the patient and the doctor especially during the administering of anesthesia and in ensuring that procedures such as peri- anesthetic fasting is carried out accordingly. It has been observed that patients are always reluctant to provide information to the consultants especially when they are surrounded by interns doing their rounds. Therefore the patient may withhold some important information or history which might be fundamental during the surgery. The nurse therefore has the obligation of extracting information from the patient in a more private setting and communicating the information to the surgical team. Patients and mostly older patients and the very ill sometimes tend to be confused and anxious and it is upon the nurses to provide comfort to such patients by communicating the relevant information to such patients to get rid of the anxiety. When such patients are not comforted they may decline to undergo and important surgical procedure that could have saved their lives. Family members also need advice on how to handle their loved ones before an operation and to provide the much needed support and encouragement, while at the same time candidly ensuring that they are duly aware of the underlying risks. A situation may arise where a patient has undergone a surgical procedure that causes temporary memory loss or loss of some important organ such as the leg o the arms. Since family members are the ones closest to the patients they should be prepared to handle the patient with love and care so as to hasten the recovery and therefore improve on the quality of the services provided. There should also be proper and effective channels of communication between the nurses and the doctors for a particular surgery to be carried out successfully. Nurses should be aware of the patient’s general history to avoid the use of procedures or medicines that can be harmful to the patient. Effective and efficient communication within the hospital is generally and important factor that should be extrapolated to other areas apart from just the peri- anesthetics. Work Load The historical basis of nursing has always been to take care of patients most importantly against the nosocomial infections. However Nursing has faced dynamic changes since its inception in terms of responsibility and in terms of job description. However the most challenging perspective of nurses is that they carry the responsibility of service in the hospital, they are at the service of both the patients and the doctor. There are always patients in the hospital with different kinds of complication and nurses are the ones who are always the first to respond. For instance patients who have been prepared to receive general anesthesia and heavy sedation are at risk of developing aspiration pneumonia. This is because a patient under an anesthesia or is generally unconscious lacks the reflexes needed for swallowing. Therefore the contents of the stomach may be refluxed and be inhaled via the open larynx to the lungs. These contents are capable of causing chest infection or even pneumonitis. The risk of complications increases with increase with age because the ability of the body to fight such infections decreases with increase in age. The situation therefore requires that the working environment should therefore be equipped with the relevant facilities and procedures to prevent the occurrence of such infection and to treat the infections in case they occur. Such infections require that nurses be constantly on the watch and while at the same time addressing the new cases being reported. The workload is tremendous considering that nurses are already understaffed and in most instances they do not really get the appreciation they deserve. Nurses should have their job description clearly defined so that they can be able to understand what is expected of them to avoid any unnecessary workload. Furthermore Brubaker (1987) emphasizes the need for hospitals to continually keep up with the increasing technology and with the advancing technology and skills. This fact dictates that the surgical wards and particularly the nurses to be continually equipped with the necessary facilities, knowledge and skills to tackle the special cases they encounter within the limited time frame in order to maintain the high quality standards required in the field. Staff relationship It is important that proper communication be maintained between nurses and the surgeon team to ensure the well being of the patient. Communications are better put across when there is harmony in relationship. The staff relationship in any hospital involves all the employees. However in this case the paper will concentrate on the relationship between the nursing staff and the surgical team. The foremost important aspect in relationship is mutual respect and appreciation; this therefore nurtures good relations which further lead to good communication. Nurses hold a significant amount of information considering that in some instances they obtain consent from the patient and in the process obtain important aspects of the patient’s history. It is therefore imperative that relationships between nurses and the surgical team be harmonious. Conclusion Although getting sick is mostly an unavoidable occurrence, the decision by a given patient to seek help from a given hospital or facility is determined by factors such as previous experience, social context and whether the treatment will be beneficial. These factors can be summarized as the quality of care provided. The quality of the care provided will depend on the level of experience of the nurses which further depends on how often they seek continuous professional development in order to keep up with the dynamics experience. Nurses provide an important link between the surgical team and the patient in the surgical wards. It is therefore an important factor that the communication is relayed effectively and in a timely manner to avoid complications. The surgical wards should also be equipped with the relevant skills and equipment to prevent and treat complications in case they occur. Lastly the wards should also be able to cater for the special needs of patients. References Brubaker T (1987). Aging, health, and family: long-term care. Sage, 1987. Colin A. Pinnock, Ted Lin, Tim Smith. (2003). Fundamentals of Anesthesia. 2nd Edition, Cambridge University Press, 2003. David E. Longnecker, David L. Brown, Mark F. Newman, Warren M. Zapol (2007), Anesthesiology. McGraw-Hill Professional, 2007. Jacqueline F (2004) Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing models and theories. McGraw Hill. Margaret F. Alexander, Josephine N. Fawcett. (2000). Nursing Practice: Hospital and Home: The Adult, 3rd Edition, Elsevier Health Sciences, 2006. Read More