Nursing Theory
Florence Nightingale was a revolutionary nurse of her time who is mostly remembered as the initiator of contemporary nursing and a reformer of hospital nursing sanitation methods. Nightingale’s life achievements were so powerful considering many Victorian women of her age group never pursued professional careers. Nightingale was serving as a healthcare leader and caregiver during the Crimean War when she noticed that there was a connection between the patients who died and their environmental conditions. Her descriptions of health, nursing, environment, and humankind are remarkable even to this day. She published many health-related books and pamphlets which came to be known as Nightingale’s environmental theory. Nightingale’s nursing theory has influenced many people’s values and goals in terms of nursing, including my own.
Health is a shared responsibility in today’s society and the World Health Organization (WHO) serves as the authority that oversees and coordinates health in the United Nations. WHO has identified multiple areas of focus to mitigate disease and mortality globally, including poor ambient and indoor air quality, vector-borne diseases, poor water quality, sanitation and availability, global environmental change, as well as toxic substances. These areas align with the canons of Nightingale’s environmental theory which include light, ventilation, variety in the environment, noise, air, bed and beddings, nutrition, personal cleanliness, and chattering hopes (George, 2014). Nightingale's theory emphasizes changing a patient’s environment in order to positively impact their health. With the advent of technology and with its globalization, numerous environmental threats have emerged such as vanity, air pollution, industrial noise, global warming, and fad diets. According to WHO (2018), roughly 1.7 million people die annually from consuming unsafe water while another 1.6 million die from inhaling indoor smoke. It is evident that there is a huge correlation between health and the environment and observing this relationship has influenced my goals and values towards the nursing profession.
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According to Nightingale’s environmental theory, it is up to a nurse to design appropriate environmental settings that can ensure that a patient’s health is restored gradually. Environmental factors affect every patient in unique ways depending on their illness or situation. Hence, nurses must address the canons of this theory depending on the patient so that changes are made in a way that best satisfies a particular patient’s needs. The environmental theory has a broad range of applications and it can be implemented at a work site, hospital, the home, or the community at large. Nurses apply this theory every day by changing their patient's sheets and linens, ensuring that the patient maintains personal cleanliness, and providing them with adequate and appropriate nutrition. Indoor air quality is crucial in a medical environment. Therefore, nurses usually ensure that the hospital has adequate ventilation. Nightingale claimed that patients should be provided with sufficient light, especially natural light. Therefore, most hospital beds are placed in such a way that a patient can see the sunlight directly through a window. Nurses also do their best to reduce noise-making activities, such as loud conversations and clanking which can interrupt a patient’s sleep or lead to poor communication and pain perception among patients. Some nurses often place elements like plants and flowers in a patient’s room in order to make a patient concentrate on something else other than the pain he or she is experiencing.
Nightingale’s theory fits with my professional practice in that my perception of health is the ability to change a patient’s surroundings to the best of my ability. To me, nursing is the act of utilizing a patient’s environment so as to help the patient during their recovery process. The fact is, many external factors can cause an individual's health to deteriorate. Therefore, inciting a holistic environment around a patient can facilitate a more optimal recovery for a sick person.
Historical Contributors.
There have been numerous remarkable people who have made great contributions to the field of nursing throughout history. Some made huge differences in the everyday lives of their patients while others made vast differences in improving the work of nursing. Two notable individuals who made exceptional contributions to the nursing profession are Mary Seacole and Clara Barton. Both of these nurses dedicated their entire life to helping others.
The legacy of Mary Seacole serves as an inspiration to current and future nurses yet history does not remember her as vividly as it does other pioneers of nursing. Being a black woman and a nurse, Seacole was a controversial figure who had to endure a lot of social burdens imposed on her by Victorian society. However, by force of character, conviction, and ability Seacole managed to leave a mark on the practice of healing. She served the soldiers of the Crimean war by providing them with supplies and medicine despite being denied the Crimean fund to travel Crimea. Seacole also brought care to yellow fever and cholera-ravaged prospectors in Panama. She recognized her mother for being the most influential person in her passion for nursing
Clara Barton is mostly remembered for founding the American Red Cross as well as her work as a nurse during the Civil War. Barton proved that women could be just good as men at working in extreme condition. During the battle of Antietam, she was able to outlast many surgeons, assistant surgeons, and hospital stewards all the while suffering from symptoms of typhoid fever. Note, this was her first experience working in the heat of battle.
Clara Barton and Mary Seacole both struggled with the propriety of a woman assisting unrelated men. However, they still saw the needs that had to be fulfilled and set forth to accomplish them no matter what it took. Both of these women also served in raging wars despite the dangers they faced. Barton also served the victims of war and famine in foreign countries. These two women both found their true calling in tending to the needs of the people in different nations.
Barton and Seacole are both influential to me. Barton chose to serve communities that were usually forgotten like developing countries. Access to healthcare is crucial to good health, yet rural residents face a variety of health care barriers such as few doctors, hospitals and healthcare resources. Approximately 19.3 percent of people in the US are living in rural areas (United States Census Bureau, 2016). My wish is to follow in Clara Barton’s footsteps by serving the areas of the country that are lagging behind in terms of healthcare resources for one reason or another. Seacole always remembered her mother as the most influential person in her life. Similarly, I recognize my grandmother for giving me the will to practice nursing. I identify with both of these women for their passion to move forward in the face of terror to help others.
State Board of Nursing Vs. The American Nursing Association
The State Board of Nursing (SBN) and the America Nurses Association (ANA) are both nursing regulatory bodies though they have significant functional differences. ANA is the official spokesman of nurses. It furthers the nursing profession by advocating for the rights of nurses in the workplace, fostering high-quality nursing care, influencing Congress and regulatory agencies on health-related issues impacting the public and nurses. On the other hand, SBN protects the health and safety of the community by developing standards of practice, issuing licenses and certifications to qualified applicants, endorsing nursing education programs, and disciplining unlicensed persons and licensee for violating the rules and regulations of nursing. Furthermore, the State Board of Nursing operates within a particular state.
The Florida Board of Nursing influences my nursing practice by describing licensing requirements that I must meet as well as the roles and expectations I should conserve within the profession. The board will ensure that I am competent enough to practice as a nurse in Florida by the successful completion of an exam. Licensees planning to renew their license must comply with certain continuing education requirement. This condition impacts my career in that I will have to continue enriching my nursing knowledge and keep up with the latest healthcare trends in order to keep on practicing as a nurse. The body also sets ethical standards for daily practice and leadership skills that I must adhere to. The American Nurses Association provides resources and support for nurses. Hence by joining the ANA, I will always be sure that I have a voice championing for my needs as a nurse.
Licensing requirements in Florida
A nurse in Florida has to renew his or her license biennially in order to continue practicing nursing. Nurses also have to pay additional fees and comply with certain continuing education requirements before their license can be renewed. A continuing education requirement in Florida is a total of twenty-four-course hours on preventing medical errors, domestic violence, HIV/AIDS, Florida Nurse practice rules and regulations, and human trafficking. Of this 24 hours, two hours should be related to prevention of medical errors while another two hours must be related to laws and rules in nursing. A nurse in Florida who fails to renew their expired license within four years may have to sit for a special purpose examination or complete other reactivation requirements in order to prove that they still have the competency to resume active practice.
Florida is a compact state which means that nurses can practice in other states provided it is also considered a compact state. Licenses from non-compact states restrict a nurse from working in any other states. A nurse who lives in non-compact states must apply for a new license to qualify for travel nursing jobs. If the nurse wishes to practice in a compact state, he or she will be issued with a single state license, meaning that the license is valid only in that member state.
Food and Drug Administration Vs. the Center for Medicare and Medicaid Services
The Center for Medicare and Medicaid Services and Food and Drug Administration are both departments under Health and Human Services. Although, the two departments have very different functions. The FDA serves to safeguard the people by guaranteeing the safety, efficacy, of veterinary and human drugs, medical devices, radiation-emitting products, and biological products. The CMS administers the Medicaid program which provides health overage to millions of people in the United States.
The CMS and FDA have both influenced my clinical practice in the past. I once worked on a clinical research that involved testing a new drug. The FDA demanded we register the clinical trial and submit the results to them. After lengthy trials and phases, the drug had to be sent to the FDA for approval. It would then analyze the drug and establish whether it was better than the standard drug. The patients in the trial had to receive medication and services which were forwarded to the CMS for reimbursement of services. It was difficult watching terminally ill patients getting turned away because they did not meet the criteria for the study or other insurance guidelines.
Nursing Practice Act
The Nursing Practice Act is a protection law that ensures people without minimum competency do not practice nursing in Florida. This act affects my professional practice since it provides guidelines that I must follow for me to become a licensed nurse in Florida. As a nurse practicing in Florida, I have to be familiar with the definitions set forth by the Nurse Practice Act so that I can know the limits of what I can do legally. In Florida, the terms “registered nurse” and “professional nurse” are usually used interchangeably. The scope of practice for registered nurses includes administering medications and treatments authorized by a duly licensed practitioner and observing, assessing, diagnosing and planning interventions (George, 2014). A RN is also responsible for supervising and teaching other personnel on their nursing practices. The Nurse Practice Act does not define the delegation for registered nurses. However, the state defines specific licensing requirements that must be maintained before duties are delegated to the RN nurse.
Professional Roles
Nurses have to assume the role of detective every day of their professional life. A nurse has to use their clinical imaginations along with nursing science to identify small changes and deviations in the patient’s condition in order to avoid and control detrimental outcomes. They also determine the consequence of certain subtle variations. A nurse must determine areas of concern in the environment. I have acted as a detective in my nursing practice in that I entered a patient’s room and observed that the patient looked uncomfortable. I then approached the patient and carried out a physical examination. I used a stethoscope to listen to the action of the patient’s heart and breathing and noticed that his heart rate was irregular which meant that the patient was presenting signs of arrhythmia. I was able to take the necessary steps early enough and prevented any adverse outcomes.
Nurses take on the role of a scientist by uncovering new ways to treat complications. Nurses are often encouraged to use evidence-based practices to determine the best approach to take when dealing with a particular condition or situation. A nurse can also take part in scientific probes to contribute to healthcare decisions or implement, disseminate, and critique evidence to impact practice. Being a prelicensure clinical nursing student, I have not had the opportunity to take part in an evidence-based practice program. Although, I have still come across situations that demanded me to apply what I have learnt so far. I once walked in on an elderly woman who was having congestive heart failure and in fluid overload. The patient was also dyspneic. I had previously learned that the most appropriate was to relieve fluid was by using a diuretic and hence I asked the head doctor whether I could give furosemide to the patient. Turns out I was right.
A nurse acts as a manager of the healing environment by practicing holistic medicine. The healing environment is global in nature and one has to consider the healthcare policies, regulations, and finance. By realizing this, a nurse can establish, coordinate, and champion for a respectful multifaceted environment that fosters optimal well-being and guarantees the dignity of the patients. The nursing environment is also characterized by political, cultural, economic, and social influences. A nurse can, therefore, address such issues by influencing public policy and promoting equality and justice in the human heal experience. A nurse also monitors the cleanliness of the hospital environment for the well-being of the patients. I have acted as manager of the healing environment by managing a patient's environment. I normally record medical records which include the patient's treatment plan, medication list, condition, and symptoms. I also ensure that a patient’s needs are met including giving them the appropriate medication at the required time.
Provisions of the American Nurses Association (ANA) Code of Ethics
Every profession must have a code of ethics to help professionals to navigate ethical and value conflicts. The American Nurses Association Code of Ethics defines nine provisions. These provisions act as a blueprint for the roles and responsibilities of nurses. The first provision identifies the ethics associated with health, human dignity, relationships, self-determination, and relationships. This provision claims that a nurse has to practice with compassion and respect the immanent dignity, worth, and individual qualities of each patient (Indest, & Patrou, 2008). The eighth provision defines the right to health, human rights, and obligations. It demands nurses to cooperate with the public and other healthcare professionals to diminish health disparities, encourage health diplomacy, and protect human rights (Indest & Patrou, 2008).
These provisions influence my professional nursing practice since they outline how I should treat patients. Provision one states that I must treat every patient with dignity and respect their unique attributes. This provision ensures that a patient consents to the treatment and medication provided. Provision eight ascertains that health care professionals collaborate in promoting medicine and reducing disparities. Healthcare professionals also collaborate in research to bring new advancements to the public which is part of this provision. Healthcare can only move forward if there is collaboration among the individuals in this field.
Denying a patient the right to self-determination of care is a common error that might occur in a clinical setting. Patients have the right to refuse healthcare. This is why a nurse has to acquire a patient’s consent before preparing them for any surgical procedure. Education becomes crucial in a situation where a patient refuses care. A nurse will have to equip the patient with relevant information regarding the treatment and how it will benefit them so that he or she can make an informed decision. Provision one can be applied by respecting the patient’s right of self-determination. Therefore, the nurse should support a patient’s wishes if they refuse to undergo treatment. Provision eight can be applied through collaborating with charge nurses and doctors to identify an alternative course of treatment that can be administered to the patient.
Leadership Qualities in Nursing
Self-confidence, dependable, cooperative, and energetic are among the most important leadership qualities that aid in delivering excellence in nursing (Persily, 2013). These qualities facilitate teamwork in the hospitals and assists individuals towards achieving a hospital's goal. These traits can help a nurse become a leader in the bedside by giving him or her the self-confidence to perform their role efficiently. Low self-confidence can jeopardize a patient's life, especially during high-pressure situations. A nurse should also cooperate with patients to create a good nurse-patient relationship. Leadership qualities can be used within an interdisciplinary team to enhance working conditions. A nurse's energy can be contagious and it can assist others if it is very positive. A nurse's self-confidence can enhance the kind of trust the team has on the nurse. When a nurse is dependable, the other members of the team can count on and put their trust on her. Cooperative qualities can foster a positive working environment and decrease workplace stress.
The condition of a work environment can determine how a person feels about going to work. I have witnessed nursing leaders implement new strategies that are meant to increase the energy levels within the environment. However, some nurses opposed these strategies and for a while the hospital environment was unkind. In this case, decisions were made without considering the needs of other people working in the hospital, so things were bound to get tense. A smoother transition could have been achieved if the hospital leaders made people feel like they had a voice. Professional development is normally accomplished by an energetic and confident leadership. Changes in the work environment cannot be achieved without these components.
References
George, J. B. (2014). Nursing theories: The base for professional nursing practice . Harlow: Pearson Education.
Indest, G. F., & Patrou, J. (2008). The Florida nursing law manual . Altamonte Springs, Fla: Nursing Law Manual.
Persily, A. C. (2013). Team leadership and partnering in nursing and healthcare. New York: Springer Publishing Company
United States Census Bureau. (2016, December 08). United States Census Bureau . Retrieved from New Census Data Show Differences Between Urban and Rural Populations: https://www.census.gov/newsroom/press-releases/2016/cb16-210.html.
World Health Organization (2018). Health & Environment . Retrieved from http://www.who.int/heli/publications/helirevbrochure.pdf?ua=1
