A. Identify a nursing theory that has influenced your values and goals.
Nightingale Environmental theory
1. Explain how nurses apply the identified approach from part A to implement excellent nursing practices.
Florence Nightingale’s theory talks about how the environment can promote healthcare. In her theory, Nightingale advocated for aspects such as cleanliness, proper ventilation, light, noise reduction and proper nutrition. The aspects of Nightingale’s theory make the nurse to work efficiently by utilizing their intuition about environmental modification and patient care (Rahim, 2013). The theory encourages nurses to modify patient environment to provide comfort during disease period.
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2. Discuss how the identified theory from part A fits your professional practice.
A few years back, I came across the worst depressing situation in my nursing profession. I was working in a surgical unit of one of the local hospitals as a volunteer. When I entered the surgical unit ward, I felt a very irritating odor. I took rounds in the ward to search the origin of the smell. Everyone in the ward was disturbed by the smell. As I got into the second room of the unit, the intensity of the smell increased. I spotted a middle-aged man sleeping on dirty bed sheet stained with his urine. A dust bin full of dirty swabs, bed pan and urinal were under his bed. His food was also not covered. To reduce the smell, I decided to empty the dustbin and opened windows for ventilation. I advised the patient not to use the urinals and bed pan to avoid many health problems. The place was cleaned and the patient was given clean bedding and the condition of the surgical unit immediately improved.
B. Identify the contributions of two historical nursing figures in the nineteenth or twentieth century.
Florence Nightingale (1860)
Florence Nightingale focused on environmental effects on healing. According to Nightingale, the health outcomes of patient can be improved by having good ventilation and warming, clean beds and bedding, observing room cleanliness and chattering hopes and advises.
Merle Mishel (1981)
Merle Mishel strives to improve patient care and outcome during uncertainty by determining the uncertainties and addressing them. In her theory, Mishel directed positive outcomes, developed nurses’ framework, initiated coping skills and adaptability and appraised the situation.
1. Compare the differences in contributions of the two historical figures identified in part B
Nightingale focused on environmental influences on healing. Nightingale believed that positive patient health outcomes can be achieved by transforming stressors around the patient that include reducing unnecessary noises, developing variety, comfort and warmth (Hegg, 2013). On the other hand, Mishel’s theory direct nurses in providing patient care. Nurses have to evaluate different situation, establish an adaptable plan and initiate skills to assist patients in coping with various illness.
2. Describe how the contributions of the two historical figures influence your professional nursing practice.
Nightingale and Mishel contributions have positively affected the nursing profession immensely. Mishel’s theory developed my nurse care plans that include problems evaluation, plan development as well as meeting nursing goals. On the other hand, the theory of Nightingale helped me to develop a better environment to promote healing.
C. Explain the functional differences between the State Board of Nursing and the American Nurses Association (ANA).
The State Board of Nursing sets safe nursing care standards and decides nurses’ scope of practice while the ANA is an organization that advances and safeguards nursing profession.
1. Define the roles of these two organizations.
The State Board of Nursing critical role is regulating registered nurses, providing licenses, renewing them and taking disciplinary action ( NCSBN, 2015 ). On the other hand, the American Nurses Association offers public safety and enhances nurses’ mobility in institutions. The ANA protects nursing profession by developing standards, advancing nurses welfare and their rights (American Nurses Association, 2011).
2. Explain how these two organizations influence your nursing practice .
The State of Board nursing ensures that I acquire a license and conduct my activities within the scope of nursing. The organization also helps me to advance my education to be relevant to the ever-changing field of nursing. Besides, ANA ensures that I conduct my duties effectively in an ethical manner.
3. Explain the requirements for professional license renewal in your state.
According to the New York Board of Nursing, nurses are required to renew their license after three years. The nurse ought to apply for license renewal five months prior to the license expiry date. The nurse should also complete child abuse reporting test.
a. Discuss the consequences of failure to maintain license requirements in your state.
Practicing without renewing a license in New York State can result in a fine of more than 1000 dollars or revocation of the license.
4. Compare the differences between registered nursing license requirements in a compact state versus a non-compact state.
Registered nurses in compact states are allowed to conduct their duties only in their home state. However, they can only be allowed to practice in states that are part of the licensure compact. To practice in other compact state, compact nurse should pass NCLEX, not in any disciplinary case with the compact state, pass education and criminal record checks and possess a legit social security number ( De Pasquale & Stange, 2014 ). On the other hand, nurses in non-compact state are restricted to only in states they got their license. If non-compact nurses relocate to another state, they have to apply for another license in the state and should meet state requirement before being given the license. The nurse checks with the board of nursing from the state she wants to work in, check the requirement and then apply for licensure with the state.
D. Discuss the functional differences between the Food and Drug Administration (FDA) and the Centres for Medicare and Medicaid Services (see the web links below).
The FDA safeguards people’s health by ensuring that human and veterinary drugs, biological products and medical devices are secure, safe and efficient (FDA, 2018). On the other hand, the Center for Medicare and Medicaid Services supervises health programs and offers information to patients to collaborate with physicians and make appropriate decisions about health care ( Unroe et al., 2015 ).
1. Discuss how the two regulatory agencies influence your professional nursing practice.
The FDA ensures medical devices as well as medications I utilize go through rigorous tests to ensure safety during administration and use. On the other hand, the Center for Medicare and Medicaid Services (CMS) avails information to me to make informed decisions about patients’ health. Through the CMS, I can get information to educate patients about the importance of health care.
a. Describe your role as a patient advocate in promoting safety when a patient has requested to use an alternative therapy.
As patient advocate, I am required to direct and give patient information about the therapy they want. I will also provide the information needed for patients that need an alternative treatment to make appropriate decisions. I will educate patients on medication safety.
E. Discuss the purposes of the Nurse Practice Act in your state and its impact on your professional practice.
The New York Nurse Practice Act protects people who need nursing care (Downing, 2012). The act makes sure that the nurses’ conducts are developed in line with professional experience behaviors that are mandatory for public protection. The act guides me on what I should do as a nurse and authorizes me to report to the board.
1. Discuss the scope of practice for an RN in your state.
A New York State registered nurse should foster patients’ safety by determining practice decisions accountability, educate, inform and communicate with care professionals. The nurse collects data, analyze, develop goals and ensure that any activity or intervention prevail the standards of nursing.
2. Discuss how your state defines delegation for the RN.
The duties and responsibilities of nurses In New York is based on
Patient’s need and condition
The ability of the RN to evaluate patient potential harm
Predictability of the outcomes
Task complexity
F. Apply each of the following roles to your professional practice:
A scientist- Since nursing is majorly based on science, I will act a scientist by utilizing the knowledge of science to comprehend patient healthcare.
A detective- as a nurse, it is important to act as a detective because in some cases you need to study broadly to connect with what the patient is experiencing. A nurse can assume the role of a detective when he or she researches the patient background to understand and evaluate what is going on with patients’ health.
A manager of the healing environment- in my case, I will assume the role of a manager of the healing environment when I teach and direct patients on their health and the care they need when leaving the hospital.
G. Identify two provisions from the American Nurses Association (ANA) Code of Ethics (see weblink below).
The first and the fifth provisions are provisions that stand out among the ANA provisions. The first provision requires nurses to conduct their duties by showing compassion and respect for the ingrained worth, dignity and distinct attributes of every individual ( Milton, 2013 ).
The fifth provision is another ANA provision that stands out. The provision requires nurses to not only provide health and safety to their patients but also do so themselves as well as preserve character and integrity wholeness, perpetuate individual and professional development and maintain their competence.
1. Analyze how the two provisions identified in part G influence your professional nursing practice.
The 1 st provision helps me to show compassion and respect to patients by preserving patient worth and dignity in any delicate situation they may feel they are in. It is important for nurses to strive with compassion and respect but sometimes it is difficult to respect an individual if we disagree with their life choices.
The fifth provision is another ANA provision that stands out. The provision requires nurses to not only provide health and safety to their patients but also do so themselves as well as preserve character and integrity wholeness, perpetuate individual and professional development and maintain their competence (American Nurses Association, 2011). The provision reminds nurses to take care of themselves regardless of the busy schedule they have. If nurses take care of themselves, they will promote health for patients effectively.
2. Describe a nursing error that may occur in clinical practice (e.g., clinical setting, skills lab, or simulation).
Not checking the patient’s allergies in the operating room and providing inappropriate medication is one of the errors that can occur.
a. Explain how the ANA provisions identified in part G can be applied to the error discussed in part G2.
The ANA first provision requires the nurse to practice with respect and compassion for the ingrained worth, dignity and distinct attributes of every individual.
As leaders, nurses should lead by showing compassion and providing feedback to the patient. Nurses should follow this provision by doing proper patient checks and rechecking procedures before giving out medications to their patients. Adhering to the provision allows nurses offer the best medication at the right time to the right individual. If nurses follow the ANA provisions, they will understand nurse commitment and values.
After nurses failing to check patient allergies and providing inappropriate medication, I noticed how significant provision five is to providing care. In many cases, nurses are taught to give patient safety a priority. However, they should also hold their safety at the same level of priority as that of the patient. In this case, nurses could have checked patient allergies and offer appropriate medication. If a nurse follows the fifth provisions, medication errors such as in the above mentioned case could be prevented.
H. Identify four leadership qualities or traits that represent excellence in nursing .
Ability to cope with stress
Integrity
Critical thinking
Initiative
1. Discuss the significance of the four leadership qualities identified in part H in the nurse’s role as each of the following:
• A leader at the bedside
This leader needs critical thinking to get their nursing job conducted safely and efficiently for the patient, initiative to get the nursing job carried out, integrity to gain trust from their patients and ability to cope with stress in demanding situations.
• Within a nursing team or interdisciplinary team
In the multidisciplinary team, the leader needs the initiative to collaborate effectively and get work done in a team environment, integrity to gain trust among workers, ability to cope with the stress that may accompany the team environment and critical thinking to collaborate with team members effectively.
2. Identify how your work environment impacts the following:
• Nursing leadership
Leadership requires a unified work environment to achieve a common goal. The work environment should give the nurse necessary assistance and the tools that they need to do their job. Therefore, the work environment ought to give nurses assistance and tools to assist them in performing their duties.
• Decision making
The work environment immensely affects how decisions are made. If the work environment fosters safety in patient care, then decision making will reflect safety in patient care.
• Professional development
The work environment that promotes right moral and security enables employees to reflect the same. The type of work environment influences professional development by establishing the stage of what is significant for its employees.
References
American Nurses Association. (2011). Code of ethics for nurses with interpretive statements. Nursesbooks. org. Retrieved from http://www.nursingworld.org/FunctionalMenuCategories/AboutANA
De Pasquale, C., & Stange, K. (2014). State regulation and the mobility of nurses: An examination of the Nurse Licensure Compact. Emory Univ., Department of Economics.
Downing, A. S. (2012). The New York Nurse Practice Act and Its Administration. The American Journal of Nursing, 12(3), 185-197.
Hegge, M. (2013). Nightingale’s environmental theory. Nursing science quarterly, 26(3), 211-219.
Milton, C. L. (2013). The American Nurses Association Code of Ethics: A reflection on the ethics of respect and human dignity with nurse as expert. Nursing Science Quarterly , 16 (4), 301-304.
National Council of State Boards of Nursing – NCSBN (2015). What You Need to Know
About Nursing Licensure and Boards of Nursing. Retrieved from https://www.ncsbn.org/Nursing_Licensure.pdf
Rahim, S. (2013). Clinical application of Nightingale’s environmental theory. i-manager’s Journal on Nursing , 3 (1), 43.
Unroe, K. T., Nazir, A., Holtz, L. R., Maurer, H., Miller, E., Hickman, S. E., ... & Sachs, G. A. (2015). The optimizing patient transfers, impacting medical quality, and improving symptoms: transforming institutional care approach: preliminary data from the implementation of a centers for Medicare and Medicaid services nursing facility demonstration project. Journal of the American Geriatrics Society , 63 (1), 165-169.
U.S. Food and Drug Administration (2018). FDA Fundamentals. Retrieved from www.fda.gov/about-fda/fda-basics/fda-fundamentals on September 25, 2020
