Table of Contents
Nursing Theory
Among the most common theories in nursing is Jean Watson’s theory of human caring. This theory has played a major role in the positive values and goals it has brought on nursing practice. Jean Watson in this theory focuses on promoting health through enhancing the existing relationships between nurses and their patients (Cherry & Jacob, 2016). The theory is built on the concept that nursing the primary role of nursing itself is the promotion of health, the prevention of illnesses, restoration of health and most of all caring for the sick. The primary assumption in jean Watsons is caring as one of the modalities of promoting healthcare.
Nursing Practices
Nurses that implement carative factors is the primary facilitator in enhancing better health. The major concepts in this theory include health, nursing, human beings, and the society. In most cases, nurses apply this theory in their day-to-day activities. Each time nurses provides sufficient care to their patients then they use the Jean Watson’s theory. A primary concern for nurses in implementing the human care theory is the provision of care to their patients. This care may include the integration of humanistic altruistic values, the instilling of hope to patients, the cultivation of sensitivity to patients and the promotion and acceptance of positive feelings. Jean Watson’s theory is essential for the promotion of nurse-patient relationship (Cherry & Jacob, 2016).
Nursing Theories and Professional Practices
This theory is essential in the whole concept of nursing practice. The theory fits nursing practice, as nursing itself is built on caring for the sick and promotion of health. Through the theory, nurses can deliver proper care to their patients through compassion and respect which are important in the recovery process. Through this theory, harmony and wellness prevails while illness is altered and eliminated
Historical Figures during the 19th and 20th Century
Different historical figures had different contributions in the nursing profession. Each of this contribution since Nightingale’s era has positively impacted on the nursing practice. An example of these figures includes Madeline Leininger and Patricia Brenner. Leininger is among the most popular theorists in nursing commonly known for her cultural care diversity and universality theory. In nursing, it is important to understand that care is provided to people from different diverse cultures (Cherry & Jacob, 2016). Even with this, it is important for nurses to consider the different cultures of their patients when providing healthcare to their patients. An important factor in relation to the diversity of cultures is the fact that cultures impact on the delivery of care. For example, some cultures may force patients resist specific forms of treatments, which in turn affects the whole process.
Patricia Brenner on the other hand, through her theory primacy of caring calls for professionalism in the delivery of healthcare. The theory argues that professionalism in nursing depends on the experience absorbed through the engagement of areas such as novice, competent, proficient, and expert within the domains of the nursing practice. Even with this however, it is important to be professional in all the level of engagement. This professionalism enhances the end results of the whole process of nursing practice (Cherry & Jacob, 2016)
Differences in Contributions
Both figures, among others have played a crucial role in the nursing profession. Care is the dominant factor in the entire practice of nursing. Care however cannot be delivered without the consideration of other factors such as the diversity of cultures of the patients and even the levels of professionalism. The proper understanding of cultures and the proper understanding of the nursing professionalism are important in the effective delivery of healthcare.
Influences of the Contributions on Nursing
In each and every day’s practice nurses encounters several factors that tend to affect the quality of the healthcare delivered. Among the most common factors is the integration of the diversity of cultures in the delivery of healthcare. Theories from Leininger and Brenner have over the years played a crucial role in the nursing profession. Brenner’s theory has impacted on the way nurses view care and the role it has in their everyday practice. With this theory, nurses now understand that their entire profession calls revolve around the quality of care they provide to their patients. Even with these, however, this care cannot be effective without the consideration of several factors. Some of these factors include those discussed in Leininger theory. In today’s nursing practices, it is important to consider the different cultures of the patients. This revolves around the fact that different cultures influence how different patients view specific forms of treatment (Cherry & Jacob, 2016). Consideration of cultural diversity helps nurses ensure that the different modes of communication do not violate specific beliefs and also ensure effective communication with patients.
State Board of Nursing and the American Nurses Association
Definitions
The state board of nursing, also known as the national council of state boards of nursing is a non-profit organization responsible for bringing together the nursing boards and counsels on specific matters of concern and interests. This revolves around all the matters affecting health and safety. The board is also responsible for the development of licensure examinations in the nursing profession. The American nurses association, on the other hand, is a professional organization develop to protect the nurse’s profession. The ANA provides that the functions of nursing are to ensure that there exists protection, promotion, prevention of illness, the optimization of health, and the alleviation of pain.
Influence on Nursing Practices
Through this, the organization is able to develop the most effective standards of practice and the promotion of rights and welfare of the nurses. These two organizations have played a crucial role in the nursing profession. The State board of nursing has been responsible for the licensing of nurse while the ANA has been responsible for the protection of nurses
Requirements for License Renewal in Hawaii
Different states have different license renewal requirements. Northern Marianas/Saipan Island board of nursing is responsible for licensing in the Commonwealth of Northern Marianas Islands (CNMI). The license renewal, in this case, is after every two years. For advanced practice nurses, the renewal period should be after every two years, but on odd-numbered years. All national certifications should be renewed as per the requirements set by the certification companies (Hawaii Nursing License, 2017). This means that the verification fees may vary depending on the different states in CNMI. In cases of advanced practice nurses, no educational units are required. They, however, must complete a five-hour pharmacology coursework during the renewal period. The renewal fees also vary with the different nursing levels.
The failure to meet the entire license requirement in the CNMI calls for an administrative suspension. The licensing board has the right to revoke the licenses of nurses that do not comply with the laws set by the state. Misconduct in practice may also result in the revocation of licenses based on the broken laws (Hawaii Nursing License, 2017).
Differences between Compact and Non-compact State Licensing
Nurse licensing varies between compact and non-compact state. Compact states, in this case, are the states that have adopted the NLC while the non-compact states are those that have not adopted the Licensure compact. The licensure compact allows nurses at all levels to have a single license in their individual resident state. Those with a compact license can also practice nursing in other compact states regardless of the location. Even with this, however, the nurses must follow the practice act of the state (varies from one state to another). In cases of misconduct in practices, compact license nurses are legible for the consequences within that state (Hawaii Nursing License, 2017). Compact states licenses allow practice in all the NLC states unless the nurse is under disciplinary audit.
For non-compact states, nurses are only allowed to practice in that state. In case they move to other states nurses are required to apply for practice licenses based on the state’s requirements. Each state, as mentioned has different requirements; this means that for a non-compact license, the nurse has to meet the requirements for the state (Cherry & Jacob, 2016).
Functional Differences of the FDA and the CMS
The food and drug administration is a United States federal agency under the department of health and human services responsible for the protection and the promotion of the health of the public. The FDA protects public health through regularly controlling and supervising the safety of food consumed in the United States, dietary supplement, medications, medical devices, tobacco products, vaccines, and even animal foods. All these responsibilities revolve around protecting the health safety of the Americans. Another important responsibility of the FDA is the speeding up of the advancements in public health so as to ensure that the medical products are safe, effective, and more affordable to the general public. The organization is also responsible for enhancing the nation’s counterterrorism capabilities (Cherry & Jacob, 2016).
Previously known as the health care financing administration the center for Medicare services is a department under the Department of Health and Human Services in the united states responsible for administering Medicare programs that collaborate with the federal governments in the administration of Medicaid services, health insurance for children and insurance portability standards.
The influences of the FDA and the CMS on nursing profession revolves around their policies and how they guidance to the nursing profession. Both organization through their regulations and legislations essentially focus on the promotion of patient health and the effective delivery of services. The FDA in relation to this is responsible for the promotion of the safe use of the existing medical services. As mentioned, care is the primary role of the nursing practice. Through ensuring there exists safety in the food consumed, the instances of illness are reduced and controlled within the society. The CMS on the other hand advocates for patient safety through providing standards and enacting programs that enhance health in the society.
Patient advocates play a crucial role in protecting the patient’s rights, patient representation especially in cases the patients cannot communicate with themselves and even in offering support and education to their patients. In cases where a patient requests to use alternative therapies, the role as a nurse revolves around the core values that guide patient advocacy. An important element in this if the protection of the patients choice to use the alternative therapy (Cherry & Jacob, 2016). Depending on the type of therapy chosen, the basic responsibilities should revolve educating the patient on the basis of the therapy including the complications that may arise from the chosen therapy and acting as a caregiver
Purpose of the Nurses Practices Act
NPA plays a crucial role in ensuring there exists effective nursing in all states. In Hawaii, the act ensures that there exists professionalism in nursing practice. Nurses, in this case, are supposed to comply with specific regulations for guidance. The mandated laws set the scope for practice and the responsibilities of registered nurses (Nurse Practice Acts Guide and Govern Nursing Practice, 2017).
Scope of practices for RN’s in Hawaii
In Hawaii, the state policies on nursing govern the scope of practice. The registered nurses, in this case, practice independently from other medical practitioners such as physicians. The practice is governed by the state’s board of nursing. Registered nurses are authorized to conduct diagnosis and also provide specific services without any collaborative agreements and supervision (Nurse Practice Acts Guide and Govern Nursing Practice, 2017). Even with this, however, Registered nurses are supposed to practices under the standards of the board and as guided by the state laws. The board has the responsibility to grant authority to all qualified nursed. Registered nurses in Hawaii are recognized as the primary care providers (Hawaii Scope of Practice Policy: State Profile, 2017).
Delegation for RN’s in Hawaii
Delegating as provided by Hawaiian nursing laws revolve around allowing the delegate perform certain nursing activities and procedures. This has provided, however, only applied to licensed nurses. Regardless of their roles, either RN, LPN or even VN’s the delegate should have obtained training and education and also validated competence in performing delegated and care responsibilities. The processes and contexts, in this case, vary with the specific activities. Competency validation as defined by the state should be comply with specific skills and knowledge needed to perform specific responsibilities (Nurse Practice Acts Guide and Govern Nursing Practice, 2017)
Application of Nursing Roles
Nurses have different roles, which vary depending on the functions of the roles. These roles vary from scientists, detectives, and managers of the healing environment. Each of these responsibilities in nursing have a major impact on the delivery of healthcare services. Nurse scientist are mostly nurses with advances preparations in nursing and other related fields. A nurse scientist has expert content knowledge and knowledge in specific principles of research and methodology in a specific clinical area. The primary roles of nurse scientists vary from the provision of leadership in the development, coordination, and the management of research in medical fields, and the provision of mentorship to other nurses in research. Nurse scientists also play a crucial role in the literature relating to health sciences.
Nurse detectives, on the other hand, are nurse professionals, which conduct investigations on specific issues that impact on healthcare and even nursing profession itself. The most important guiding principles for nurse detectives in effective communication and listening. Both these principles act as agents of gathering the required information from either the patients or even nurses themselves. An important role of nurse detective is the provision of solutions to some of the existing issues in healthcare (Cherry & Jacob, 2016).
Managers of healing environments play a crucial role in the delivery of proper healthcare. In nursing, managers of the healing environment should have enough experience in both creative leadership and in program development. These managers possess strong collaboration and communication skills, which enable and enhance partnership with other medical practitioners (Frankel & PGCMS, 2008). They should also possess high level of knowledge in specific areas so as to meet the specific goals of the organization
Provisions under the ANA Code of Ethics
Ethical conduct is an important element in the effective delivery of services to all professionals. An appropriate ethical conduct plays a crucial role in helping professionals carry out their tasks in a manner that is consistent with achieving quality. The nursing profession is guided by the ANA code of ethics, which comprises of nine ethical conducts (Zahedi, Sanjari, Aala, & PeyMani, 2013). These ethical codes play a crucial role in guiding the specific practices of nursing. They aim at ensuring that there exists quality in the services delivered by nurses. This section analyses two ethical codes, which are the respect for human dignity and the relationships with patients.
Analysis of Provisions
As identified the primary function of nursing as a profession is the provision of care to patients. This care, however, cannot be delivered without the respect for human dignity and enhancing the nurse-patient relationship. Respect for human dignity, which is the first provision of the American nurses association code of ethics provides that as a provision each nurse should respect the inherent dignity, the worthiness, the unique attributes and all the human rights for their patients. These revolve around the fact that healthcare is a universal component that transcends all the individual differences. Each human being has a right to proper and equal healthcare. This healthcare, however, cannot be delivered without the general respect of human dignity. Nurses, in this case, should consider all the needs of the patients and also respect their values (Zahedi, Sanjari, Aala, & PeyMani, 2013).
Provision two, which is closely related to provision one, is also an important provision in the delivery of quality healthcare. Theorists, scholars and nursing professionals have insisted on the importance of developing a proper relationship with the patient. Nurses should establish close relationships, built on trust with their patients. These relationships should be determined by the needs, and even the cultural believes of their patients. Important elements of this provision include cultures, religious beliefs, value systems, social support systems, language, and even sexual orientation (Sorrell, 2012). These elements are important when developing the relationships between nurses and their patients. This importance revolves around the fact the consideration of these elements helps promote wellness and general health and address the existing issues.
`Provision one is closely related to provision two as to develop a strong relationship with an individual should begin with respect. The relationship developed should include the respect for the decisions made by the patients. In cases where patient choices increase the risks, then the relationship developed should help the nurse intervene and help the patients understand the risks associated with their choices.
Clinical Practice Errors
Severally, errors have occurred in the delivery of care. A common error in the nursing practice includes the medical error. Nurses play an important role in caring for their patient including ensuring they consume specific medications accordingly. In most cases, medical errors are closely associated with incompetence and negligence of the healthcare professional. Even with this, however, medical errors are also closely related to the proper breakdown of the processes that guide the delivery of care, poor understanding of the different cultures, believes, and even the lack of respect for human dignity. Even the most competent and careful nurses may cause a medical error, especially in cases where specific beliefs, have influenced the decisions made by the patients (Sorrell, 2012).
The first and the second provisions play a crucial role in the prevention of medical errors. These provisions comprise of specific components the rights to self-determination and autonomy, which play a crucial role in helping nurses appreciate the patient’s rights. Any complication that may arise on the decisions made by patients may result in medical errors. The respect for human dignity and the development of proper relationships helps nurse consider the decisions from patients before administering specific treatments and implementing specific care modalities (Sorrell, 2012). An important component of the two provisions is trust, which is an important component in delivering of proper healthcare.
These provisions in relation to medical errors also help the effective disclosure of the relevant information. Healthcare providers have a responsibility of providing the most relevant information to the patients. Relationships between the nurses and the patients help the nurses understand the specific beliefs of patients before providing care. These relationships enhance the communication between the nurses and the patients. Through this, patients can disclose even the most private information that may help them receive treatment. The primary role of the provisions is to ensure delivery of quality healthcare (Sorrell, 2012). This means that it is important to implement all the nine ethical codes of conduct when providing health care. This would help ensure that there exists maximum quality in delivering quality care.
Leadership Qualities in Nursing
Effective leadership is mandatory for success in all professions. Effective leadership conjures a variety of reflections, thoughts and images that may include, influence, power, dynamic personality, goals, charisma, autocratic behaviors, innovation, kindness, and even influence. In nursing leadership is an important component for all levels of nursing. While leadership is understood as an important component for those in managerial positions, nurses at all levels have the responsibility to lead in each action they engage in. Some of the most effective leadership qualities include, kindness and compassion, accountability, advocacy and critical thinking. Each of these traits plays an important role in the whole process of nursing practice (Frankel & PGCMS, 2008).
We can do it today.
Application of leadership Qualities
Nursing, regardless of which section of the organization calls for critical thinking in all practices. Bedside leadership varies with specific reasons such as the administration of drugs, counseling, to even recording the progress of the patient. Critical thinking is effective for all these functions. Compassion becomes an important element in counseling and even when communicating with the patient. As provided in the ANA code of conduct, the relationship between the nurses and patients are important in the delivery of healthcare (Cherry & Jacob, 2016). This relationship may be demonstrated through compassion. Compassion is also an important element in ensuring quicker recovery of the patients. Each and every nurse has a responsibility to his or her patient. Accountability, in this case, is a major component of the nursing profession. Nurses as care providers are accountable for their own patients. This accountability should include all the activities undertaken by the nurses and also the patient. It is also important to understand that each nurse is an advocate for his or her own patient.
Specific leadership qualities also play a crucial role in an interdisciplinary team. As identified, critical thinking is important in all the activities undertaken by nurses. Accountability is also an important trait within the interdisciplinary team. Each nurse should understand that he or she is responsible for his or her actions. This should apply in cases of success and even in cases of crisis. This should also apply in interdisciplinary teams. Accountability should also apply in cases where nurses fight for their individual rights. Advocacy should also apply in cases where nurses have to represent their patients in the interdisciplinary team (Frankel & PGCMS, 2008).
Impacts of Work Environments on Practice
Work environments play a crucial role in the ability to deliver proper and quality health care to patients. The proper atmosphere is efficient in the proper and the normal functioning of the organization. This revolves around the fact that it impacts on each and every aspect of the facility. This ranges from the safety of the patients and nurses to even job satisfaction. Several studies have identified how some work environment issues such as staffing contribute to the outcomes of the facility and patient outcomes (Cherry & Jacob, 2016). The American nursing association in collaboration with other facilities and stakeholders support the need for a healthy work environment for both nurses and patients.
Nursing leadership calls for a healthy work environment. Most decisions within the facilities are made depending on the situations of both the patients and caregivers. Poor work environments divert the core principles of leaders, in that leaders have to make decisions to manage the environments rather than decisions to provide quality healthcare. Work environments also impact on the decision-making within healthcare facilities. For example, in facilities with fewer hospital beds, decision-makers have to make extra decisions such as sharing of beds, which impacts negatively on the quality of care. Professional development is also negatively impacted by poor work environments. This is evident in cases where there is overstaffing, forcing nurses to work excessively. A common element in this is fatigue, which as identified has negative impacts on the delivery of healthcare (Purdy, Laschinger, & Finegan, 2010).
- Cherry, B., & Jacob, S. (2016). Contemporary Nursing: Issues, Trends, & Management (7 ed.). Mosby.
- Frankel, A., & PGCMS. (2008). What leadership styles should senior nurses develop. Nursing Times, 23-24.
- Hawaii Nursing License. (2017). Retrieved from Nursing License Map: Nursing Licensure Made Simple: https://nursinglicensemap.com/advanced-practice-nursing/hawaii-nursing-license/
- Hawaii Scope of Practice Policy: State Profile. (2017). Retrieved from Scope of Practice Policy: http://scopeofpracticepolicy.org/states/hi/
- Nurse Practice Acts Guide and Govern Nursing Practice. (2017). Retrieved from Nurse Practice Act, Rules & Regulations: https://www.ncsbn.org/nurse-practice-act.htm
- Purdy, N., Laschinger, S., & Finegan, K. (2010). Effects of work environments on nurse and patient outcomes. Journal of nursing management, 901-913.
- Sorrell, J. M. (2012). Ethical Issues with Medical Errors: Shaping a Culture of Safety in Healthcare. OJIN: The Online Journal of Issues in Nursing.
- Zahedi, F., Sanjari, M., Aala, M., & PeyMani, K. (2013). The code of ethics for nurses. . Iranian journal of public health.