The art and Science of Nursing and Discuss the Implementation and Influences of the Concepts in the Health Care Environment

Introduction

Nursing is an occupation within the healthcare sector based on the care of individuals, families, and communities for maintaining and attaining best of health conditions. Nurses differ from other healthcare organizers. by the way, they tackle the patients, their training, and area of practice. The profession of nursing is unique in its way, they first develop a plan for taking care of the patients, and they work collaboratively with doctors and sort out a polite way of dealing with patient’s family. They are a bridge of communication between the physicians and the patient’s health. The profession of nursing is as old as 5th century BC and is continued till now. It can be considered a business of great responsibility as well as mechanisms for public liability. Nurses must have one or more qualifications to be a member of nursing staff. A practical nurse and a registered nurse are at the same level. Nurses blend the art and science of nursing and give fuel to the advancements in their profession. This paper will define the art and science of nursing and discuss the implementation and influences of the concepts in the health care environment.
Definition of the Art & Science of Nursing

The American Nurses Association (2017) is the organization which sets the standards of the profession. It defines nursing in two ways. The first one is to optimized the health and provide the patients with diagnosis and treatment and second one is to prevent the injury and illness by advocating the people. Patients and their families rely on nurses. Therefore, the standards of nursing require that they must be certified and equipped with professional knowledge. If we talk about nursing, we will talk about standards which govern nursing and its scope. It describes the answer of nursing practice in term of five Ws, Who, When, Where, What, Why and How. The answers to all these questions provide a complete understanding of the complexity of this profession, its boundaries, and membership. Experience, role, education, and the population served to determine the total scope of nursing practice. It is compulsory to set some standards for Professional Nursing; these standards dictate the duties that are obligatory for all registered nurses in spite of their role, specialty, the total population it is requisite to perform proficiently. The nursing process is a process that relies on bi-directional feedback from each working component that includes, diagnosis, assessment, and detection of outcomes, planning, Implementation, and finally the evaluation.

Polas discussed the importance and implications of the profession of nursing. He emphasized that this is a job where the professional plays with the lives of the patients so there is no room for a mistake. Each of the nurses must be aware of the medicinal technologies and skilled at a clinical experience. Theoretical and Evidence-based information about human experiences and reactions are used by the nurses to corporate with healthcare customers for assessing and identifying the results of concern. Interventions are intended to manufacture favorable consequences that do no harm to anyone. It’s an ethical duty for the nurses to sustain healthcare practice environment that is conducive to promote quality health care. Studies show that demoralizing and unsafe conditions provoke medical errors and infectivity of the worker. It increases the chances of conflicts and tension among the health professionals. (Polas,2014)

A Graduate nurse has some qualities which include the Use of systems, community resources and organizations to lead successful change and a nurse should apply quality ideology while communicating methods, tools, etc. One must express leadership skills that provide supplementary impending and possible solutions. These are the part of the profession, and it defines the art of the professional. (Palos,2014) However, the care and compassion that is demanded by this profession cannot be quantified, but nurses are supposed to satisfy their patients. The satisfaction of the patient’s acts as driving force for them and their better services will benefit the people.
How the Art & Science of Nursing Influences Current Practice

Lust and Fater (2013) stated that nursing is a holistic practice, and that “human caring involves values, a will, a commitment to care, knowledge, caring action and consequences” (p. 90). Lust and Fater (2013) also described that the caring in nursing is related to intersubjective human responses to health-illness conditions.

Lust and Fater worked in this demanding profession and came up with the conclusion that states nurses must provide the patients with patient-centered care (PCC). PCC will ensure that patients are getting the good quality care. (Lust & Fater, 2013).PCC is a way to improve the quality of their profession. Nurses must meet the standards of nursing to become a highly skilled professional and expert at PCC. Standards are always necessary if we want any organization to work in its best condition and produce the best results. They outline of expectation from the profession and guide the nursing practice which is essential for self-analysis. It also helps in the development of better understanding of the different roles that a nurse has. They provide a mean for evaluation for all nurses to ensure clinical aptitude and protection and hence provide a framework for increasing clinical ability checklists. As well as for identifying areas of enhancement in the clinic, and also improves patient and workplace safety. (Lust & Fater, 2013) Professional nursing promotes the friendly relationship between the patient and nurse. As a patient needs more attention and wants to be taken care of therefore politeness is the key to the quick recovery of the patient which relies on the relationship of nurse and the patient. The nurse automatically promotes self-care and a concept of humbleness in society. The concept of care for the environment, its society and people. However, PCC is not limited to nursing only, but yes, it helps to define nursing in a much better and easier way. (Lust & Fater, 2013)
How the Art & Science of Nursing Influences My Personal Nursing Practice

Nursing is a profession, but it comes from the soul. Each nurse must put her best efforts to cure people. It is inclusive of the knowledge and care. For advanced practice registered nurse, there are additional obligations that one must follow it includes the offering of clinical solutions, evidence-based pharmacological agents, and treatments, therapies, and referrals. For getting registered as a nurse, there are multiple educational courses that qualify a candidate to sit in licensure examination in the United States. Registered nurses possess the information, talent, judgment, can manipulate and are creative.

For me, patient safety comes first. Our profession is accused of causing deaths of many people due to some mistakes in treating them. Any overdosage of a drug or not giving enough medicine to the patient can result in a permanent loss. (Wolf,2014) Therefore, nurses have to take great care of the medication. Wolf blamed the nurses for such mistakes and stated that the cause of these blunders is the lack of knowledge which he stated as “inappropriate medication for the patient)” (p. 103). Therefore, I plan to work on evidence-based practice. The technological advancements in medications have helped nurses to perform their duties well and do the right thing at the right time. (Wolf, 2014)

Nurses are not only responsible for taking care of their medication, but they also have to act as a psychomotor. Nurses must take care that their patients suffer the least. The pain of medication must be decreased with psychological techniques and friendly relations. If the nurse has good interpersonal skills, she can become friends with the patient and thus, the medication is well done. (Wolf, 2014). It is an art to convince the patients to take medicines which cause pain, but nurses have to master that art. (Wolf,2014)

Now, we are convinced that science and art of nursing go hand in hand. We cannot miss any of these. If there is a deficiency in science, I may commit any medication error, but if the art of nursing is not understood, the patients may not feel comfortable with me, and their comfort is my priority. To be the best nurse, I will always strive hard to keep the balance between art and science by updating myself with the Scope and Standards of Nursing and augmenting good relations with the patients so that I can assess their needs.
The Perceived Major Influences on the Changing Health Care Environment

In any healthcare center, patients are depressed due to their bad health. The interaction of nurses with the patients helps in reviving their hopes. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey shows that when the nurses are granted incentives and Value-Based Purchasing (VBP) scores, they work even better to improve the experience of the patients. This was explained in the Patient Protection and Affordable Care Act (Dempsey, Reilly, & Buhlman, 2014). As it is proved that communication with the nursing staff has positive results in the patients’ care, therefore, hospitals strive to improve the quality and give a better experience to their patients,

The healthcare environment has changed due to the introduction of bedside shift report. This report gives the patient an authority to take his care and be a participant in his treatment which makes him comfortable at first place and also, the patient starts trusting the Institute and the fear of being in a hospital are gone. (Dempsey et al., 2014). Patients can decide the nurse who will be visiting him and this way he will feel better. (Dempsey et al., 2014, pp.149). Patients are also given the authority to question the staff, and the caregivers can also use this method to decide on matters of discharging the patient. (Dempsey et al., 2014).

Dempsey et al. wrote the analysis in the year 2013, which stated that VBP program influenced the performance and efficiency of the healthcare providers and the risk. Centers for Medicare & Medicaid Services (CMS) provide initiatives for the performance programs particularly in the Readmissions Reduction Program (RRP) and the Hospital-Acquired Condition (HAC) Reduction Program. In both of these programs, hospitals are accused of poor performance, and they have to pay the fine.

Hospital-acquired urinary tract infections (CAUTI) is another major issue which is one of the major hospital-acquired infections (HAIs). It is almost 40% of the HAIs. Nurses are required to analyze the need of suing a Foley Catheter. (Quinn, 2015). The implementation of this plan reduced the HAI by 50 % in White Plains Hospital in New York (Quinn, 2015). The hospital has criteria which are called Question the Foley. Nurses evaluate the patients who have Foley Catheter and decide if the catheters should be continued or discontinued. The use evidence-based criteria to decide about the catheter and change the name of their policy so that they may assess the Foley.
How My Practice Has Changed in the Last Five Years

I had an experience of sitting with the patients and interacting with on the same grounds which was a big treat for me. In Mission Hospital at Mission Viejo, the authorities organized a program called “2 minutes sitting and talking time” for the patients and nursing staff. Therefore, we sat with them and had the conversation. It was a pleasure to understand their needs and study their verbal and nonverbal cues. I enjoy such sessions, and in routine, I try to do this in my shifts. This is the only way I make my patient comfortable and develop a bond with them. A friendly interaction gives them a wave of trust, and they cooperate with us in all matters. When the patients are satisfied by our services, they enjoy a good experience, and this is the goal of the healthcare institute.

Moreover, I have done a 1-hour rounding to help them in toileting and guide them to the comfort and positions, I used to do a 2-hour rounding before, but now, the head tells us to make a one hour round in huddle time and report it in a chart on the computer. Patients who were rounded upon frequently have a better experience and relationship with the hospital and staff. (Dempsey et al. 2014) Similarly, patients who are visited every hour do not use the call light, and they are more satisfied.
How I Incorporate the Art & Science into My Practice

There is always room at the top, and I want to conquer that top. I want to train myself and educate my brain with the knowledge so that I can give evidence-based care. I plan to update my skills by participating in every new certification and educate myself about the latest advancements. Academy of Medical-Surgical Nurses (AMSN) is my next plan because they offer the training in the Scope and Standards of Nursing. Those measures include quality of performance appraisal, care, performance appraisal, collegiality, education, research, ethics, family members communication, leadership, and collaboration with the client, significant others, and health care providers, which are very helpful for the Nurses (AMSN, 2012). I will also work on my skills, abilities, and knowledge to become an expert in the medical-surgical setting. (AMSN,2012). Therefore, I will strive hard to become an expert in procedures and practices by becoming a part of AMSN. Technological advancement and the training on using the new diagnostic equipment and machines will also be a lesson to learn. After getting certified in all these things, I will become a member of Emergency Nurses Association.

To become a good evidence-based caretaker, I need a mentor so that I will look for an evidence-based practice (EBP) mentor.EBP is believed to play an integral part in reducing the cost and improving the quality of healthcare. It gives a better outcome, and there are no variations in care. (Fineout-Overholt, Gallagher-Ford, and Kaplan 2012). The nurses not only get the good knowledge and skills in nursing but they also become the expert in organizational behavior and the strategies in an organization. Masters’ degree nurses have knowledge about EBP, and they can easily tackle the complications of EBP, but an on master’s degree nurse cannot do this. (Melnyk et al. 2012), Therefore, to be a good evidence-based caretaker; I will pursue my education and get a degree of Master of Science in Nursing (MSN).
SMART goals for My Future as a BSN

As soon as I graduate with Bachelor of Science in Nursing (BSN) at California State University, Fullerton in December 2017, I will get a full-time job as a trauma emergency room RN in a magnet hospital by May 2018. By April 2018, I will get the certificate Trauma Nursing Core Course (TNCC) and become a Certified Emergency Nurse (CEN). To become an expert in EBP, I will pursue education and get admission in a school or college to become a Master of Science in Nursing (MSN). To make enough money, I will work as Family Nurse Practitioner (FNP) and Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) till May 2018 so that I can complete my complete my applications within the given timeframe. After doing all this, I will be able to start my FNP, AGACNP, and MSN in August 2019. These programs will end in May 2022, and then, I will have more knowledge, skills, and abilities to deal with my patients in EBP manner and with more confidence.
Conclusion

Technological advancements and the researchers in the nursing education has augmented the importance and respect of the professionals. Nurses not only give us the medicinal treatments but they also give us emotional support in the hour of need. Therefore, it treated as both, the Art and the Science. The profession of nursing is a very honorable and dedicate career; one need to strive hard for sustaining the terrible circumstances. For fulfilling the demands of QI and flourishing in the profession, nurses are required to exhibit professional morals. They are also supposed to fulfill their ethical and legal responsibilities. They should point out the areas which need improvements and an action plan to work on it instead of only accommodating the QI activities. Every patient has a different mindset. Some demand the Science only; in the form of medicines but others demand humanistic care and flexibility. Therefore, nurses have to master both the departments. These efforts will result in regaining their true essence of this profession and in providing the best care quality.
References

The American Nurses Association. (2017). What is nursing? Retrieved from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing

Academy of Medical-Surgical Nurses. (2012). Scope and standards of medical-surgical nursing practice 5th edition. Retrieved from https://www.amsn.org/sites/default/files/documents/practice-resources/scope-and-standards/AMSN-Scope-Standards-MS-Nursing.pdf

Dempsey, C., Reilly, B, & Buhlman, N. (2014). Improving the patient experience: Real-world strategies for engaging nurses. The Journal of Nursing Administration, 44(3), 142-151. doi:10.1097/NNA.0000000000000042

Lusk, J. M., & Fater, K. (2013). A concept analysis of patient-centered care. Nursing Forum, 48(2), 89-98. doi:10.1111/nuf.12019

Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: Critical implications for nurse leaders and educators. The Journal of Nursing Administration, 42(9), 410-417.

Palos, G. R. (2014). Care, compassion, and communication in professional nursing: Art, science, or both. Clinical Journal of Oncology Nursing, 18(2), 247-248.

Quinn, P. (2015). Chasing zero: A nurse-driven process for catheter-associated urinary tract infection reduction in a community hospital. Nursing Economic$, 33(6), 320-325.

Wolf, Z. (2014). Exploring rituals in nursing: Joining art and science. New York, NY: Springer Publishing Company.

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