Table of Contents
Nursing Theory
The most influential nursing theory that has had a significant effect on my practice is the nursing need theory that Virginia Henderson developed. The main concepts of the theory emphasized empowering a patient by carefully meeting his or her needs. Virginia Henderson had the conviction that nurses must recognize various human needs and strive to meet them successfully. Giving attention to the 14 components that Henderson highlighted helps nurses to register positive patient outcomes. The theory emphasizes the need to identify and meet different human needs that are biological, sociological, psychological, or spiritual (Meleis, 2011). Henderson outlined 14 components based on human needs that allow nurses to embrace a holistic approach when delivering care to patients. Focusing on the 14 components helps the patients to become independent so that they can register a faster progress to healing even after hospitalization.
The nursing needs theory is of great relevance to my professional practice. Notably, the theory encourages me and serves as a framework that enables me to deliver holistic care to all the patients. Many of the patients I attend to register various needs. Based on the theory, I take the time to assess the psychological, spiritual, sociological, as well as biological needs of patients before I can develop an effective plan of care (Meleis, 2011). Particularly, the theory is effective when dealing with the elderly group, which is highly vulnerable. The need theory has presented me with a realistic approach that helps me to register positive patient outcomes. I can assess and strive to meet the needs of the patients to ensure that they make good progress towards recovery.
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Two Historical Nursing Figures
The most influential figures to my nursing practice include Helen Fair Child and Margaret Sanger. Helen Fair Child served as a nurse during the First World War. She took the responsibility of providing quality care to the victims of the war. She was able to highlight the adverse effects of the war as she made efforts of attending to the injured soldiers. She volunteered to move abroad where she served the American Base Hospital. Her main determination was to register a positive impact on the lives of the injured individuals. She relentlessly highlighted the physical and emotional needs of those participating in the First World War (Meleis, 2011). She highlighted the environmental conditions that made life difficult for the soldiers in the First World War. Despite the difficult situations, Helen remained a significant contributor to promote the health of the soldiers who had sustained injuries. She eventually succumbed to the disease, leaving a strong legacy of her selfless service.
On the other hand, Margaret Sanger developed a remarkable nursing career and registered a significant impact on women. She focused on identifying the needs for contraceptives in a poor neighborhood in New York. She took note of the existing disparities in the provision of health care. She became a writer who enlightened women on birth control options to control the increasing rate of unwanted pregnancies and numerous abortions among young women. She established the National Birth Control League as a way of creating a larger platform for women to receive knowledge and contraceptives (Meleis, 2011). Margaret Sanger published numerous letters that she had received from different women, as a way of demonstrating that there was an evident need for contraceptives. She faced litigation at different points due to her relentless spirit of advocating for women to have access to birth control measures.
Helen Fair Child serves as a great influence on my nursing practice. Her commitment to meet the needs of injured soldiers despite the difficult situations of the war is inspiring. The nursing practice may present different barriers. However, Fair Child’s experiences motivate me to focus on meeting the needs of the patient and promoting the emotional stability of the patients. On the other hand, Margaret Sanger left behind a strong legacy that motivates me to attend to the needs of the less privileged in the society (Meleis, 2011). In my daily practice, I have the privilege of serving women who have unique needs but who do not access to the resources they require. My focus is to ensure that I empower such patients with knowledge and information and I provide quality health care that could benefit them in the future. I also help patients gain access to community resources that can meet their unique needs.
State Board of Nursing and American Nurses Association
There is a significant functional difference between the State Board of Nursing and the American Nurses Association. The State Boards of Nursing play a critical role in establishing the rules and regulations that govern the nursing practice in each specific state. Moreover, the State Boards of Nursing take charge of accrediting nursing programs and providing licenses to nursing graduates (American Nurses Association, 2015). The State Boards set the specific requirements that nurses must meet in their daily practice. They also establish professional standards that govern the daily practice. State Boards of Nursing promote compliance with the existing regulations through different disciplinary actions. On the other hand, the American Nursing Association plays an important role in advocating for nurses. The professional organization serves as the voice of all the individuals in the nursing profession. It seeks to improve the quality of care while ensuring that nurses operate under favorable conditions.
The California State Board of nursing influences my practice directly because it determines the expected professional standards that I must maintain. Moreover, the California State Board of Nursing has provided me with my nursing license and has developed all the relevant regulations that govern the nursing practice. The American Nurses Association has established a code of ethics that governs the nursing profession and it ensures the voicing out of my needs as a nurse (American Nurses Association, 2015). The American Nurses Association has established a platform that advocates for quality training and improved nurse practice standards that assure me of a favorable working environment.
Failure to maintain my licensure requirements would lead to serious consequences. The California State Board of Nursing would pursue disciplinary actions that may include revoking my license (California Board of Nursing, 2016). The Board is very specific that I must meet all the requirements outlined in the licensure application and exhibit compliance with all the nursing standards. As a result, I must practice nursing within the legal scope highlighted to protect my professional license.
There are certain differences associated with a person’s practice depending on the license requirements in a compact state or a non-compact state. Nurses who have the Nurse Licensure Compact (NLC) have the freedom to practice in different states that are members to the licensure compact. Particularly, nurses registered in the licensure compact may serve in 25 different states without the requirement of any other license when they move from one state to the other (California Board of Nursing, 2016). A non-compact state license allows a nurse to serve in a specific state with the mandatory requirement for obtaining another license if the individual moves to a new state.
The Effect of Regulatory Agencies on My Role of Patient Advocacy and Patient Safety
Patient advocacy has become a critical issue in nursing. Particularly, patient advocacy allows the nurse to serve as the voice of patients to meet their unique needs. The nurse is in a position to act on behalf of the patient and work with different stakeholders with the core objective of registering positive outcomes. Regulatory agencies set out the limits of patient advocacy and outlined the necessary framework that I should follow when advocating for different patients (Cherry & Jacob, 2008). Based on these frameworks, it is easier for me to carry out patient advocacy in compliance with the existing regulations. Additionally, regulatory agencies emphasize the patient safety as the most critical aspect in the delivery of health care. These agencies provide guidelines that I can follow to promote patient safety. For instance, the American Nurses Association provides me with guidelines on how to improve patient safety (American Nurses Association, 2015). The Quality and Safety Education for Nurses also empowers me to implement evidence-based practice as I strive to register high levels of patient safety.
Alternative therapies have become a common concept in the modern day. These therapies have the potential to register positive outcomes, especially for patients with chronic illnesses. However, regulatory bodies such as the Food and Drug Administration (FDA) provide guidelines that I can use when advising patients on the recommended alternative therapies. Particularly, the FDA ensures that the alternative therapies do not pose any harm to the health of patients. Other regulatory bodies such as the Center for Medical Aid and Medical Services also provide additional guidelines on substances that patients cannot use due to their adverse effects (Cherry & Jacob, 2008). Based on the guidelines from these two agencies, it is easier for me to recommend the best alternative therapies for patients who make such requests.
Comparison of Nurse Practice Acts
Texas and California are two states that exhibit significant differences and similarities in their Nurse Practice Act. In Texas, it is mandatory for individuals to undertake and pass a “Nursing Jurisprudence Exam”, which is a precondition for licensing. Based on the Texas Nursing Practice Act, individuals must meet a requirement of continued education of up to a minimum of 24 hours (Texas Board of Nursing, 2016). On the contrary, California does not have a mandatory Nursing Jurisprudence Exam. The California Nursing Practice Act makes it clear that individuals must meet a minimum of 30 hours of continued education (California Board of Nursing, 2016). However, both the California and Texas Nursing Practice Acts share similarities in the description of the role they play and the outlines duties and responsibilities of registered nurses.
Both states have similar standards and scope of practice for registered nurses, licensed vocational nurses (LVN), and unlicensed assistive personnel (UAP). The two states define explicit duties and responsibilities for registered nurses and outline a scope of practice that includes the administration of medications through different routes. Moreover, registered nurses in both states can participate in carrying out invasive procedures, parental and tube feedings, patient assessment, as well as the provision of education and counseling to families and patients (Texas Board of Nursing, 2016). On the other hand, the two states are clear on the fact that licensed vocational nurses can participate in the different functions that registered nurses carry out, but under the direct supervision of either a licensed physician or a registered nurse. UAPs in both states take up roles such as making beds, bathing patients, and ambulating based on their experience. The two states do not give a specific scope of practice for the UAPs.
California and Texas have similar rules of delegation. The delegating health care provider should use sound judgment to determine the tasks that a UAP can carry out depending on the circumstances, specific needs of the patient, available supervision, and evaluation, as well as the provision of the necessary directions and communications. Texas and California are keen on promoting safe practice through the establishment of the stringent rules that govern safe practice (Texas Board of Nursing, 2016). Both states have a joint commission that sets the standards and determines the level of compliance. The two states also take into consideration the National Patient Safety Act that outlines the safety framework for the nursing practice. The states are keen to ensure that nurses receive quality and safety education and increase their competencies in registering higher levels of safety.
Differences of the Advocacy of Registered Nurses, LVN, and UAP
Registered nurses exhibit remarkable competencies of patient advocacy because they have received training on how to carry out patient advocacy. As a result, registered nurses are the most competent in patient advocacy. Licensed vocational nurses, participate greatly in the delivery of quality healthcare, but they must follow the existing chain of command when carrying out patient advocacy (Cherry & Jacob, 2008). When serving as a detective, the registered nurse utilizes clinical imagination and creates links between science and other observed patterns to improve patient outcomes. The licensed vocational nurses engage in active patient assessment by asking open and closed-ended questions as detectives. The UAPs have a limited role in carrying out the role of a detective. As a result, they only report unique developments to the registered nurses.
As scientists, registered nurses compile the available evidence and rely on evidence-based practice with the core objective of promoting positive patient outcomes. LVNs can actively participate in the gathering of evidence conducted by registered nurses. The UAPs have a limited role in promoting patient advocacy as scientists (Cherry & Jacob, 2008). Moreover, registered nurses have the capability to serve as masters of the healing environment by critically analyzing the existing health policies, and regulations, as well as, and make the necessary recommendations. LVNs participate in the provision of patient education and promote the optimum conditions for the healing process in their role of healing environment managers. UAPs participate in the role of ambulating, the provision of clean linen and bathing patients as their contribution in the role of healing environment managers.
Provisions from the American Nurses Association Code of Ethics
Two of the most significant provisions of the American Nurses Association Code of Ethics include:
- The nurse’s primary commitment is to the patient, whether an individual, family, group or community or population
- The nurse, in every professional affiliation, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by consideration of social or economic status, personal attributes or the nature of health problems
The first provision listed above is of great influence to my nursing practice because it outlines the need for me to show compassion, respecting, and promote the dignity of every patient. Based on this provision, I understand the need of respecting the worth and uniqueness of each patient irrespective of social or economic statuses (American Nurses Association, 2015). I strive to ensure that I depict high levels of respect to every patient despite their unique health problems. The second provision influences me to remember that I should give priority to patient needs at all times. For this reason, I ensure that I assess and meet the needs of patients, their families, and communities.
In a recent scenario, I was developing a treatment plan for one of my patients. However, I failed to consult and inform the patient and her family on the available options for care. I only realized my mistake when one of the family members made a complaint that the family did not know the available care options. It was explicit that I did not give attention to the significance of communicating and consulting with patients and their families. The first provision stated above is highly relevant to the scenario that happened recently. Due to my busy schedule, I forgot to exhibit the primary commitment to the patient and her family by communicating effectively with them regarding the available treatment and care options. The second provision is also relevant because my behavior did not exhibit the required levels of respect for the unique needs of the patient and the freedom to choose from different care options.
Leadership Qualities that Represent Excellence in Nursing
The four critical leadership qualities that exhibit excellence in nursing include relationship management, self-awareness, accountability, and integrity.
The four leadership qualities mentioned above are of great significance as I play the role of a leader at the bedside. Relationship management can help me in establishing an effective relationship with the patient and other assistance with the focus of delivering quality healthcare. Integrity and accountability are also critical as they will empower me to make informed decisions that promote the needs of the patients and that enhance patient safety (Kelly, 2012). Self-awareness will enable me to understand how my emotions can affect those of the patient and exhibit emotional intelligence. Within the nursing team, self-awareness and relationship management will empower me to establish successful relationships with team members and foster effective collaboration.
Accountability and integrity will help me to make better decisions and to carry out my delegated duties with expected levels of professionalism. Similarly, when working within the interdisciplinary team, relationship management will help me to foster successful interactions with other healthcare professionals (Kelly, 2012). Self-awareness will enable me to exhibit the relevant interpersonal skills and emotional intelligence as I interact with other professionals. Integrity and accountability will help me contribute significantly with emphasis on evidence-based practice to foster patient safety and positive outcomes.
Organizational structures have a significant impact on nursing leadership, decision-making, and professional development. The existing structures empower me to become a servant leader who focuses on registering positive patient outcomes. The organization emphasizes the need for participative decision-making that helps me to consult with other health care professionals before making important decisions regarding patient care (Kelly, 2012). The organization offers different training programs that can assist me in pursuing personal and professional development. These programs can empower me to develop new competencies and skills and deliver quality healthcare.
- American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: American Nurses Association.
- California Board of Nursing. (2016). Nursing Practice Act. Retrieved on 15th August 2017 from
- Cherry, B., & Jacob, S. R. (2008). Contemporary nursing: Issues, trends & management (5th ed.).St.Louis, MO: Mosby/Elsevier.
- Kelly, P. (2012). Nursing leadership & management. Clifton Park, NY: Cengage Learning.
- Meleis, A. I. (2011). Theoretical nursing: Development and progress. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
- Texas Board of Nursing. (2016). Licensure.