Future of Registered Nursing in Perioperative Environment - Essay Example

FUTURE OF REGISTERED NURSING IN PERIOPERATIVE ENVIRONMENT Name Class Instructor Institution City State Date FUTURE OF REGISTERED NURSING IN PERIOPERATIVE ENVIRONMENT With the advancement of surgical care, the roles of the nurses are also advancing. The perioperative nurses role is crucial because of their critical thinking, professional judgments and their close working relationship with the surgical patient. The current trends in health care, legal and ethical issues, financial, human factors and factors influencing professional practice will all determine the future of perioperative nursing in the country. The nurses in a perioperative setting give nursing care services for the patients going through a surgical procedure (Hamlin, Davis & Rchardson-Tench, 2009). The nurse works in close collaboration with the surgeon together with other healthcare specialists to plan the best care for the patients (Rothrock, 2003). The nurse in the perioperative environment is accountable to their patients. That is achieved by the use of best practices, standards, clinical guidelines and improvement activities. The perioperative nurses are committed to the development and improvement of their professional skills (Rothrock, 2003). There are three stages in a surgical experience, and they include preoperative, intraoperative and postoperative. Depending on the kind of facility, that the nurse is working, the responsibility of the perioperative nurse will involve providing care to the patients in one or more of these stages. In a perioperative nursing environment, there are ethical and legal issues that the nurses face on a daily basis. The nurses must also be in a position to accurately identify any ethical or legal issues about the perioperative environment. After identifying these issues, the nurses must then take appropriate actions to safeguard the rights of the sick. In the context of ethical issues, some of them involve the ability to make swift decisions under considerable stress. In Australia, the regulatory authority is held by NRA. Time is an important aspect of the provision of care. Therefore, the nurses might find it hard to ascertain the ethical and legal aspects within set time limits. When such ethical and legal issues are not handled appropriately within a given time limit, the patients and members of their families may experience suffering and pain. Additionally, there might be expensive legal cases that the health institution may have to deal with. The patients and the families of the patients may choose to institute legal proceeding for mishandling and wrong treatment of the patients. However, understanding the roles and the responsibilities that come with the perioperative environment can help the nurses avoid any legal and ethical dilemmas. Many nurses are exposed to clinical negligence claims and, therefore, should take care in their professional practice. All health professional are required by law to maintain a duty of care towards their patients. In the context of perioperative nursing, the nurses should take sensible care to prevent any omissions or acts that they can reasonably anticipate. Therefore, they should use their best judgement to ensure that they do not do any harm to the patients. The duty of care is not only required of one individual to others, but also individuals are needed to maintain a duty of care towards themselves. That perspective would be taken in cases where a patient would seek to claim damages from the medical institution or a professional. The patient must do as they are instructed to attain their health. Therefore, just like other nurses in other areas, perioperative nurses are required to maintain a duty of care where they ensure that they do not do any harm to the patients and instances of legal claims are avoided. Another factor that would determine the future of perioperative nursing is financial factors. In most places globally, healthcare is stratified, and there are healthcare facilities for the ‘haves’ and the ‘have-nots’. Additionally, in many work settings, financial incentives are employed to direct the efforts of workers towards a common goal. Even in healthcare, the situation is the same, and many professionals prefer those jobs that have financial incentives. The future of perioperative nursing environment will also significantly be determined by economic factors. In every society, there are those individuals that lack appropriate access to healthy foods, adequate housing and safe working conditions and that can lead to adverse effects on their health (World Health Organization, 2007). As well, these individuals can face both life and financial stress that can also have negative health impact in the long run. In that context, economic influences in the healthcare play a significant role. According to Schulz (2005), healthcare expenditure by most governments is as a result of supply and demand factors. Other factors are economic conditions and political conditions. Certain factors such as ageing are relevant to the enlargement of health expenditure. Therefore, any expenditure by the government in terms of health will be determined by the forces of supply and demand. In the context of perioperative care, the services are expected to be in high demand over the coming years. Therefore, the government could be forced to incentivize such services so that they will be available to all individuals in the country. The Victorian government has also chosen to support the perioperative services through their support of research activities. The government is working towards the improvement of perioperative activities (Hamlin, Richardson-Tench & Davies, 2011). The government through ACORN ensures that professional competence and patient care are of the highest standard. Therefore, the government in Australia is committed to the improvement and growth of perioperative professionals. The government through ACORN ensures that the perioperative setting is kept at the highest level possible. In the finance perspective, perioperative nursing has a future and is set to grow through the support of the government. The safety of the patient in a perioperative setting is determined by a number of factors. These factors include psychological safety, good team work, good communications and reliable systems among others (Reid & Catchpole, 2011). Nightingale noted that the greatest threat to the safety of the patients was the infirmities of the human condition. These frailties include unconscious behaviours and complacent attitudes. According to Reid and Catchpole (2011), human beings are not capable of following rules in a consistent manner. The conclusion by the House of Commons (2009) was that patient safety failures were due to lack of synergy and contradiction in the development of policies. They routinely change their behaviour from the set procedure to creatively manage current situations they are facing. Amalberti et al. (2006) contends that such deviations from the standard procedures should be encouraged so that organizational efficiencies can be achieved. Despite these frailties, the human factor in the perioperative environment is crucial. Numerous publications on human error in the provision of healthcare have been printed highlighting the importance of patient safety. As a result of such publicity, patient safety has always emerged as an important factor in the making of health care policy. A number of changes have always been proposed which include maintaining minimum nurse-to-patient ratios (Sevdalis, Hull & Birnbach, 2012). That is also the case in perioperative nursing. The nurse to patient ratio must be maintained to ensure that adequate care is provided. The perioperative setting is currently hit by a shortage of nurses. Therefore, the demand for qualified registered nurses will be great in future. The current trend in technological advancement will not completely replace the human aspect because nurses are critical in providing personalized care to the patients. Globally, perioperative has been evolving for years. Surgical care is transitioning at an elevated rate from inpatient to outpatient surgery. At a global scale, perioperative nurses are broadening their roles and responsibilities to encompass preparation and education of the patient, preoperative assessment, intraoperative activities that include assisting the surging, recovery and the evaluation of the whole operative process and the discharge planning (Bacon, 2006). In Australia, there is a growing trend where perioperative nurses are undertaking the role of the surgeon’s first assistant (Gillespie, Chaboyer, Wallis, Chang & Werder, 2009). In terms of destination for the migration nurses, the trend between Canada and Australia is almost the same. Both countries according to Gillespie, Chaboyer, Wallis, Chang and Werder (2009) are some of the preferred destination for registered nurses. However, the countries have been exacerbated by the nursing skills shortage because most of the registered nurses in the countries have migrated to work in other countries. Therefore, the need for perioperative nurses to take up the role of first assistant. Dumchin (2010) contends that the current preoperative nursing environment is getting practiced in a technologically advanced setting. Therefore, it is becoming imperative that registered nurses continually update their knowledge and skills. The use of advanced preoperative technology has meant that few nurses are qualified enough to work effectively in such an environment. According to Dumchin, this shortage can be addressed through expanding nursing education by using web-based applications. Using online applications is suitable and efficient especially for adult learners. Many countries including Australia are moving towards a full integration of technology in the perioperative environment. In that regard, it will also be crucial in the coming years that perioperative registered nurses are competent to use such technology. According to Corbin (2008), care is a fundamental factor of the nursing practice. However, there are a number of factors that influence my professional practice as a recovery nurse. It is almost not possible to think that a registered nurse would not want to be compassionate, but several factors may stand in the way of the professional practice. These factors can be categorized as cultural, professional and personal. In terms of cultural factors, it is unclear why the nurses are expected to be compassionate at all times. However, according to Woodward (1997), it might be linked to its religious origins. Patients always assume that they will receive compassion from the nurses. However, it goes on to be a risk when it becomes a norm leading to its devaluation. Compassion is always in danger of getting institutionalized and ultimately becoming something that is worthless. Also, the cultural changes can affect the profession in a significant manner. The vocabulary that is often employed in nursing care can also get outdated. For example, the word compassion, vocation and care among others can change over time. Compassion was used by the early professionals as a necessary quality that nurses should possess (Schantz, 2007). The advancement in terms of technology and science has been linked to the deteriorating caring nature of some of the nurses. Sometimes the nurses may be more concerned about applying their skills to the systems in place and the machines rather than on patients. Many times I have found myself giving too much importance to gaining competence in the use of technology rather than concentrating on patient care. Even the whole system seems to be leaning towards achieving science and technology competence at the expense of showing compassion and care. According to Castledine (2004), it is more likely that personal beliefs have an impact on the professional practice of individual nurses. Sometimes many of the nurses believe that by obtaining medical skills should come before compassion and caring. Just like other specializations, surgery is undergoing profound developments. The introduction of new technology and increasing specialization has contributed to radical changes in the provision of care. The financial pressures to enhance throughput and diminish waiting times are other factors that have contributed to the changes in the landscape of care. Many of the current perioperative roles are being altered in response to these radical shifts in surgery. The traditional primary role of perioperative nurses is to take care of the patients in the ward after they have undergone a surgical procedure rather than on the operating theatre. The recovery nurses also do These roles. They also integrate both the postoperative and preoperative roles, offering care before and after surgery. The nurse is also an important member of the surgical team and works closely with the consultant. They also provide continuity in the operating theatre as the junior medical workers rotate. Other responsibilities include assessment of the patient before the operation, asking for and interpreting the clinical tests and holding discussions with the patients and members of their family on effects of a surgical procedure. They are also responsible for patient’s pain control and managing some of the common postoperative procedures. As a recovery nurse, most of these roles have been encountered. The primary role of the recovery nurses is to provide care for the patients immediately after a surgical or anaesthetic procedure. Some of the most important roles of the recovery nurse is the assessment of the airway. As a recovery nurse, I also take note of observations and chart them appropriately. Other roles that I have done are providing relief from pain and nausea in addition to correcting any postoperative complications. While most of the roles played as a recovery nurse are postoperative, other roles that perioperative nurses play have been done. Postoperative roles are more challenging than the roles played by perioperative nurses before a surgical procedure. Therefore, as a recovery nurse, I am competent to play the role of the perioperative nurse. With my current education and skills as a recovery nurse, I am in a good position to acquire the required skills to perform the perioperative nurse roles. In the coming years, perioperative nurses will be in high demand, and that will attract both financial and stature of specialists in the medical field. As a recovery nurse, I am in the process of acquiring a general nursing experience that is crucial for entry into the perioperative nursing specialty area. Postoperative care of the patients has provided a fast-paced environment that has often been stressful and where lifesaving decisions has to be made. Throughout the contact I have with the patients, I have ensured that they are getting quality care as required by the nursing council of Australia (2008). As a nurse, I have had to come across other sick and suffering individuals and in need of compassion and which I have shown genuinely to them. The nursing professional is required to show genuine compassion and care for the patients so that they can adequately provide the required care. Patients that have been cared for have come from different economic, social, racial and cultural backgrounds, and I have come to understand the value of embracing the diversity of individuals. Some of the skills that I have acquired as a recovery nurse include the exercise of accountability and autonomy. As a nurse, I have come to understand the importance of taking responsibility for own standards of practice. From the context of which I had offered care, both accountability and autonomy were enhanced. Holland Wade (1999) contended that job satisfaction and commitment can be attained through autonomy and practice of accountability. Additionally, I have also provided care legally and ethically in order to avoid legal risks. As a recovery nurse, I have had to come across individuals approaching their end of life. The experience has often led to the raising of questions regarding the meaning of life. Such questions have often resulted in the intersection of personal feelings with the provision of care to the patients. Therefore, I have had to learn how to contain some of the powerful emotions so that the appropriate care and support to the patients and colleagues would be offered. However, I believe that I have to continually keep learning even after completion of my current studies so that I can achieve competency in the nursing profession that would offer appropriate care to patients. There are significant radical shifts in surgery and perioperative nursing highlighting the need for the nursing professionals to keep abreast with the latest technology, science and developments in the field. Perioperative professionals are in demand not only in Australia, but also around the world. Therefore, the current trend indicates that the demand for perioperative professionals are going to rise, and that will lead to the elevation of the profession. The future of the perioperative professional is bleak and as a recovery nurse, I am in the process of becoming a perioperative nurse. The skills, experience, values learnt together with education put me in a good position to be a perioperative nurse. References Amalberti R, Vincent C, Auroy Y and de Saint Maurice G. (2006). Violations and migrations in health care: A framework for understanding and management. Quality and Safety in Health Care 15(Suppl. 1): i66–i71. Bacon, D. (2006). Results of the 2006 AORN salary survey: trends for perioperative nursing. AORN journal, 84(6), 952-963. Corbin, J. (2008) Is caring a lost art in nursing? International Journal of Nursing Studies; 45, 163–165. Dumchin, M. (2010). Redefining the future of perioperative nursing education: A conceptual framework. AORN journal, 92(1), 87-100. Gillespie, B. M., Chaboyer, W., Wallis, M., Chang, H. Y. A., & Werder, H. (2009). Operating theatre nurses’ perceptions of competence: a focus group study. Journal of advanced nursing, 65(5), 1019-1028. Hamlin, Davies, M., & Richardson-Tench, M. (2009). Perioperative nursing: an introductory text. Chatswood, N.S.W., Elsevier Australia. House of Commons All Party Health Committee Patient Safety Report of Session (2008–09). HC 151-I. Available at: http://www.publications.parliament.uk/pa/cm200809/ cmselect/cmhealth/151. Nursing, Australian, and Midwifery Counci. (2008). Codes of Professional Conduct & Ethics for Nurses & Midwives, 2008. Australian Nursing and Midwifery Council. Reid, J., & Catchpole, K. (2011). Patient safety: a core value of nursing-so why is achieving it so difficult?. Journal of Research in Nursing, 16(3), 209-223. Rothrock, J. C. (2003). Alexander's care of the patient in surgery Mosby, St.Louis (MO). Schantz, M. (2007) Compassion: a concept analysis. Nursing Forum; 42: 2, 48–55. Schulz, E. (2005). The influence of supply and demand factors on aggregate health care expenditure with a specific focus on age composition. ENEPRI Research Reports, (16). Sevdalis, N., Hull, L., & Birnbach, D. J. (2012). Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress. British journal of anaesthesia, 109(suppl 1), i3-i16. Woodward, V.M. (1997) Professional caring: a contradiction in terms? Journal of Advanced Nursing; 26: 999–1004. World Health Organization. (2007). Achieving health equity: from root causes to fair outcomes. Interim Statement. Commission on Social Determinants of Health. Read More