The transcultural nursing theory by Madeleine Leininger influences my practice because the approach considers the elements of culture in translating the variating views of health care. My rationale is based on the growing need of understanding cultural diversity due to the inevitable cultural diversity of patients (Alligood & Fawcett, 2017). The model encourages intercultural competence in nursing so as to work within those frameworks in improving the delivery patient care. Cultural congruence is beneficial because it incorporates the lifestyle, values, and beliefs of the patient when administering care. By adopting the transcultural approach, my career advancement is limitless with increased opportunity of global scale travel to offer health care interventions.
Application of the Transcultural Nursing Theory to Practice
Nurses often focus on patient-centered care when applying the transcultural model to improve the quality of practice (Alligood & Fawcett, 2017). In a demographically sensitive population, nurses are one of the largest group of caregivers that have to develop cultural-understanding. Therefore, many nursing academic institutions incorporate cultural sensitivity training in their courses so as to produce culturally adaptive professionals that comprehend the variances of care in practice. Furthermore, health care institutions offer mandatory and periodic on the job training for nurses so as to accommodate the increasingly diversified client population. Discrepancies on cultural matters reduce the tolerance level of the individual therefore presenting challenging contexts that jeopardize the quality of care.
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The transcultural nursing model fits in to my practice because it offers a solution to the lack of preparedness from experience, contexts, and education. By being a transcultural practitioner, I can suit the role of opening communicative networks between patients and physicians where some westernized health practices are culturally appalling to the patient. Intercultural misunderstanding reduces the quality of patient care because it raises cultural stressors that influence some patients to seek alternative medicine. Therefore, trans-culturalism shall ensure that I meet the special needs of patients through accommodating their nonconventional requests while also discarding offending practices.
The Relevance of Historical Figures in the Professional Nursing
Sister Callista Roy developed the adaptation nursing model of 1976 that views an individual as a composition of interrelated systems that work in collaboration to sustain overall health. Today’s practitioner uses the adaptation model to explain the maintenance of balance in human physiological system as significant in ensuring the social, biological, and psychological satisfaction (Crihfield & Grace, 2011). Another historical figure is Hildegard Peplau who used the interpersonal approach to define the relationship between patients and nurses as having a profound effect on the healthcare outcome. Through orientation, then identification, exploitation, and resolution, interpersonal relationships strengthen the nursing expertise of an individual.
While Roy focuses on the environmental aspect that perpetuates the individual wellbeing, Peplau defines the relationship of the nurse and patient as improvements to health care outcomes. Roys model appeals to the multiagency approach of nursing, while Peplau’s contributes to the interpersonal bonds as a method of maturing the nursing profession (Crihfield & Grace, 2011). Both models are applicable in the use of culturally sensitive methods of dealing with patient care in a diverse population.
Roys adaptive approach resonates with my transcultural model because it addresses the patients’ needs in regards to their changing environment. The environment influences the person’s interdependence level, role functions, physiological aspect, and self-concept. By assessing the interrelationship between the behavior that heavily relies on culture and stimuli, I can evaluate and intervene on the effective method that shall restore their wellbeing. Similarly, the interpersonal theory of Peplau has similar elements with trans-culturalism which redefines the relationship between the patient and the nurse. Patients often develop trust for practitioners that are culturally competent and increase their perception on the credibility of their diagnosis and instructions increasing my level of nursing maturity.
State Board of Nursing and the American Nurses Association (ANA).
The State Board of Nursing is a regulatory and state-specific licensing body that defines the standards of safe patient care. By evaluating various qualifications presented by individuals, the body issues licenses within its state jurisdictions. On the other hand, the American Nurses Association advances individual and organizational nursing professions by playing an advocacy role (Bull et al., 2017). ANA sets the credentialing bar for nurses by offering valid certification to practitioners.
ANA is a representative of registered nurses in the 54 of the United States while different SBNs represent each state. ANA aims at improving patient care by optimizing, protecting, and promoting effective diagnosis and treatment of populations so as to alleviate human suffering (Strong, 2011). The ANA and the SBN are therefore important to my nursing practice because the ANA protects my rights and advocates my needs at the Congress as a registered nurse, while the SBN shall provide the license as a RN so that I can apply my training.
In order to be given licensure as a professional registered nurse in Utah, one must have completed a minimum of four hundred hours of practice. The other option is to participate in licensed practice of two hundred hours plus an additional fifteen hours and or thirty hours of continued education an approved higher learning institution. Failure to maintain license requirements in Utah include deterrence from renewal after the certification expires. The individual will need to participate in a reentry program and verify that they practiced as a nurse for five to ten continuous years.
It is advisable to use nursing licensure of registered nurses in compact states which multistate thereby allowing physical and or electronic practice across the member states while non compact states forbids multistate practice (Strong, 2011). Only members of the Nurse Licensure Compact are eligible based on their primary state of residence. Non compact state licensure limits the extent to which an individual can practice.
Functions of the Food and Drug Administration and the Center for Medicare and Medicaid Services
The Food and Drug Administration protects the health of the citizens by ensuring that there is efficacy, safety, and security of the food and drugs that humans consume (Enwerem & Okunji, 2017). Therefore, the FDA regulates the production and distribution of biological products, human and veterinary drugs, cosmetics and radioactive products. Furthermore, it increases awareness on evidence-based information of medical products that are safe, affordable, and effective. On the other hand, the Center for Medicare and Medicaid Services, is responsible for the creation of awareness on the quality and cost of health care products so as to create affordable, innovative, accessible, and quality health models (Bull et al, 2017).
The American Nursing Association requires that nurses use FDA compliant medical practices that ensure patient safety. As a registered nurse, the FDA requires me to gather information on any faulty patterns of drug interactions or medical device fault so as to increase their efforts in ensuring that health products consumed by citizens are safe (Enwerem & Okunji, 2017). Furthermore, I am required to use only FDA approved products so as to increase the credibility of my practice. The CMS also ensures that I use safe modern health intervention technologies such as the electronic health records system that safely store patient data that aids in the prognosis of health problems.
As a patient advocate that promotes safety when faced with a patient that chooses alternative therapy, I would evaluate the efficacy and the safety of the remedy. By holding a formal discussion with the patient, I shall address their expectations and preferences so as to monitor any potentially harmful situation. I will let the patient know that most of these alternative methods have no guarantee of safety but through documentation of the progress and the specific type of therapy, I shall make a shared decision making session that makes the patient feel respected in the outcome.
Purposes and Impact of the Nurse Practice Act
The Nurse Practice Act mandates nursing boards to lay out the practice scope of registered nurses depending on the state. The scope of the practice consists of the education, competences and authorities attached to RN performance guided by nursing values. The registered nurse has the duty to protect a patient’s right at the expense of the health institution if following the institutions codes places the patient at a risk of harm.
In Utah, the registered nurse of required by law to produce all patient information before major surgical operations so as to ensure that health interventions are effective. The Act specific the duty to care as flexible in regards to different contexts. The law prohibits the registered nurses from exercising duty that is beyond their care. For example, a nurse that decides to conduct an emergency operation on a patient because the main physician is absent violates the requirement of the Nursing Act. The nurse should always subject the patient to treatment that protects their dignity and not discriminate against them based on their race, religion or socioeconomic background.
Under the Act, registered nurses grant the public the right to sanction them from service delivery if they actions put the community at risks. Conscious disregard for the compliance guidelines are evidence of negligence which is subject to punitive actions admissible in a court of law. To avoid violation, the nurse should ensure that they do not directly or indirectly cause harm to a patient by either offering misleading or inaccurate information on their health that may place them at risk of injury or even death (Paschke, (2017)
In my state, a registered nurse is delegated with the duty of maintaining the optimal health of individuals within the society. Therefore, in order to practice, one must be licensed and specialized in skills and judgment to promote a conducive environment, perform delegated procedures, and provide accurate patient health information. RNS assess health care needs, lay outline care plan strategies, and implement safe and effective nursing interventions. Other delegations include supervision of the practice, teaching, and monitoring intervention progress.
Professional Roles
As a scientist, a registered nurse uses evidence based scientific methods to address patient problems. The scientific role derives its nature from extensive research on the nursing intervention methods and teaching these courses to students. Application of the empirical results of nursing studies conducted ensure that the patient care improves significantly. I can use a multidisciplinary approach in solving complex health problems. Drawing from the field of psychology, biology, and chemistry, I can suggest health interventions that compliment my culturally sensitive approach to nursing interventions (Paschke, 2017).
As a detective, a registered nurse makes an accurate observation on the patient’s general health condition which remains a mystery. They, therefore probe in to the issue by asking relevant questions out of knowledge based on former similar signs and symptoms that create illness complications. They have the detective eye for detail where they make observations from the patient’s cultural environment and how the context is affecting their health. RNS can also read the body language of patients to know any detectable lie that can be dealt with by using culturally sensitive cues. Through the patient charts, they search for information that affirms their suspicions on specific existing medical conditions and document their findings for future reference and make recommendations.
As a manager of the healing environment, a registered nurse provides high-quality healh delivery because they are accountable for the patients’ health. They also take care of the day to day operations in the absence of the physicians. Their roles in managing patient chronic conditions place them at a leadership role because institutions rely on their authoritative decision making skills. Through a leadership framework, the RN collaborates with other healthcare professionals in providing a multiagency approach to care.
Provisions of the American Nurses Association (ANA) Code of Ethics
The American Nurses Association Code of Ethics states that the RN has the obligation of providing optimal care to the patient using their competence (Pearce, 2018). The RN therefore should always practice their responsibility, accountability, and authority during their decision making. Furthermore, they should advance their profession so as to improve the health and nursing policy. They should therefore partake in scholarly inquiry and extensive research so as to advance their ability in their professional roles.
A nursing error may occur when a physician is away and the nurse goes beyond their competence level to perform unauthorized surgical operation on an individual to save their life. With most physicians attending to different health institutions due to the minimal number of specialty experts, nurses may be faced with the dilemma of adhering to the code of ethics that only allows them to act within their competence levels. Regardless, the RN is still required to put the patient’s interest as paramount and may frisk their licensure to act out of conduct.
The RN may cite the provision of using optimal resources in delivering services that are outside their competence levels (Pearce, 2018). By acting on the patient’s best interest, the board of ethics may place the nurse on a periodical suspension as a punitive measure against future misconduct. Depending in the outcome of the procedure, the pending deliberations by the board may include revocation of licensure or placing a cautionary principle on the practitioner.
The ANA provisions identified can be applied to the error stated above. For the provision of ensuring there is responsibility, accountability, and authority during their decision making, the RN could be held responsible for the commission of the error as they have signed to follow the virtues stipulated. Before making any decisions, the RN should be careful not to commit any error and cause the patient to die or put them in a difficult situation. The RN should partake in scholarly inquiry and extensive research always in order to avoid errors, which can be caused by commission of omission. Extensive research will help to uncover problems that would have been leeway for an error like the one given above.
Leadership in Nursing
Developing leadership traits in healthcare provision enables a registered nurse to influence other health professionals in the patient care industry. Confidence is an important trait that creates authority that healthcare professionals need when deliberating decisions on the best nursing interventions that impact on optimal health care provision. Responsibility is also another admirable leadership trait that makes RNs show accountability for their decisions in affecting outcomes. It also means that the RN can provide guidance and collaborative efforts with other RNs so as to help the community wellbeing.
Another leadership trait is problem solving with resonates well with the nursing profession. In an industry that faces complex and challenging health problems depending on the individuality of a patient, a RN needs to be quick in identifying problems area related solutions so as to provide quick and convenient intervention methods. Additionally, RNs need to be passionate of their profession so as to be well equipped with extensive information on the practice and hold to the nursing principles.
A passionate leader at the bedside of a patient applies a multi-disciplinary approach that offers the patient a culturally sensitive care system that ensures that they transition well during the process of healing. The passion will drive the registered nurse in researching on the chronic health condition so that they can decide to place them in hospice care where they are surrounded by the family and friends. Patients with chronic life ending ailments often need the company of people that they love and show concern for them which leads to the improvement of their painful symptoms.
Within a nursing team of interdisciplinary practitioners, a problem solver often develops a holistic approach in implementing health care solutions. For patients undergoing chronic ailments, they may need the services of a counsellor who address their mental health when dealing with the probability of death. The competent nurse creates a conducive environment for the psychologist so that their mitigation plans maintain the patient dignity during treatment. Some intrusive surgeries often need psychiatric preparation so that to ensure that te method is not culturally offensive to the individual.
Impacts of the Working Environment
Working in a multidisciplinary environment increases the prospect for nursing leadership. This is because it gives chance to the registered nurse to establish the relevance of the nursing practice in offering patient care. Through showing responsibility and accountability for respecting the patient’s culture in health interventions, other professionals can learn from the nursing practice. Environments that support the nursing practice often value the input of confident, passionate, and ethical individuals who do what is right in accordance with the code of ethics.
The process of decision making variates with health care institutions with some having simplistic channels with others having a complex mechanism. In a simple context, it is fast and easy to make a decision that shall contribute ti improving health care outcomes. However, complex systems offer cases of liability where a nurse may be charged with negligence if they make prompt decisions that negatively impact on their duties. Therefore, it is important to adapt to complex systems because by following the set procedure, the institution codes, and adhering to personal decisions, a RN will make information based decisions that do not increase liability.
Working environments offer a trajectory for professional development because of the interpersonal relationships that offers hand on experience. Nurses using the transcultural model often forge a nurse patient relationship that offers them with insights to the practice that cannot even be trained. Many registered nurses that embrace the cultural diversity of the health institutions diverse environment gain nursing maturity through experiences that make them improve their approached to dealing with the practice’s complexity.
References
Alligood, M. R., & Fawcett, J. (2017). The theory of the art of nursing and the practice of human care quality. Visions: The Journal of Rogerian Nursing Science , 23(1), 4–12
Bull, J., Kamal, A. H., Harker, M., Bonsignore, L., Morris, J., Massie, L., & Taylor, D. (2017). Tracking patients in community-based palliative care through the Centers for Medicare & Medicaid services healthcare innovation project. Journal of Palliative Medicine , 20(11), 1231–1236
Crihfield, C., & Grace, T. W. (2011). The history of college health nursing. Journal of American College Health , 59(6), 470.
Enwerem, N. M., & Okunji, P. O. (2017). Knowledge of food and drug interactions among nurses: Assessment strategy for continuing education. International Journal of Higher Education , 6(1), 122–130.
Paschke, S. M. (2017). American academy of ambulatory care nursing position paper: The role of the registered nurse in ambulatory care. Nursing Economic$, 35(1), 39–47.
Pearce, P. F. (2018). The value of nurse staffing: ANA principles redevelopment and direction for the future. Nursing Economic$, 36(4), 169–176
Strong, D. E. (2011). Access to enforcement and disciplinary data: information practices of state health professional regulatory boards of dentistry, medicine and nursing. Journal of Health & Human Services Administration, 33 (4), 534–570.
