Introduction
The nursing career is critical to the health and wellness of society. Given the sensitive nature of their profession, it is integral that the services offered are of high quality. Accountability ensures that nurses work in the best interest of the patients and carry out their duties competently while continually growing in the field. There should be evidence of working knowledge of the concepts, uses, and levels of most theories and evidence-based discoveries to integrate into the daily routine. In addition, nursing principles and ethics are necessary tools for enhancing professionalism. Therefore, to maintain the integrity of the healthcare system, it is crucial to integrate theories, maintain ethical standards, and remain accountable.
Nursing Theory
There are a variety of nursing theories that students, clinical researchers, and practicing professionals can use to enhance their learning and practice. There are several models that have impacted my values and goals, including the nursing process theory. Ida Jean Orlando introduced the theory because she felt a dissatisfaction with the assumption that the motivation for nurses to act was receiving orders from physicians, institution policies, and other reasons (Abyu, 2019). Her belief in doing research which would later provide consistent findings for the theory was that nursing actions should be based on the need to meet the needs of the patients. Thus, nurses use the theory in establishing good relationships with their clients.
The theory outlines the five core stages in patient care from the time of their admission to the hospital to restoration of health. The steps include assessment, diagnosis, treatment plan, and evaluation of progress (Toney-Butler & Thayer, 2022). Noteworthy, the goal is to alleviate patients’ distress and observe a positive change in behavior.
Nurses apply Orlando’s theory to create rapport with clients and advocate for a patient-centered management plan. Thus, by integrating the theory into practice, the nurses achieve excellence since their motivation is to care for the patient until they regain wellness.
Nursing process theory fits my professional practice as it complements patient-centered care throughout the care continuum. Particularly, it provides suggestions during assessment, diagnosis, creating a treatment plan, and evaluating the patient to assess progress. The theory shows nursing as a distinct profession with specific functions and outcomes (Abyu, 2019). Therefore, it helps me in practice to be conscious of what is expected as a professional in the medical field. Moreover, the theory advocates for the uniqueness of every patient’s needs and ways I can relieve their distress.
Historical Nursing Figures
The reforms and growth in the nursing field are largely attributed to key personalities whose works were a milestone of discoveries from continued research and experience. Some of the renowned icons in the 19th century include Florence Nightingale and Dorothea Dix (“Three historic” 2019). The two dedicated their lives to advocating for better nursing practices that alleviate the suffering of people. Their contributions were the foundation of modern medicine which takes into account the holistic wellness of patients.
In comparing their difference, Nightingale was the founder of modern nursing recognized for providing guidance for professional practice. Particularly, in 1859 she published her book, Notes on Nursing, which provides an overview of the essentials of contemporary nursing and sanitary medical practice (Nightingale, 2020). In addition, she contributed to statistics by carefully writing notes for the Casualties of the Crimean War (“Three historic”, 2019). Conversely, Dix’s contribution was mostly in the mental-health sector and establishing prison reforms. Noteworthy, Dix was a teacher who suffered from physical and mental illness and received overseas treatment before returning to the United States and volunteering to teach inmates on Sundays (“Three historic”, 2019). She was moved by the conditions of prisoners and aggressively started writing to the congress and state legislatures to expand medical care to inmates and persons with mental problems.
The contributions from Nightingale positively influences my nursing practice by encouraging me to engage in sanitary medical care. Observing hygiene measures such as washing hands frequently, wearing gloves, and ensuring that the patients are clean helps to reduce the spread of germs. Moreover, her work of record keeping inspires me to keep records for statistical analysis. Equally important, the work of Dix shows the value of humans regardless of whether they have a mental illness or are serving a jail term. It helps me to redefine healthcare holistically giving relevance to the psychiatric health as much as physical health.
State Board of Nursing and the American Nurses Association
A state board of nursing (SBN) is the regulatory and licensing body whose scope of practice is limited to its jurisdiction. Its roles include setting the standards for safe nursing care, handling disciplinary actions, and issuing licenses (Jacobs, 2022). The American Nurses Association (ANA) is an affiliate partner organization that represents the interests of all the registered nurses. Its core goal since its foundation in 1896 is to enhance the quality of healthcare (“About ANA”, n.d). Its roles include fostering high standards, promoting a safe working environment, bolstering the wellness of nurses and advocating on healthcare issues. Failure to maintain licensure can result in temporary or permanent revocation, loss of credential and certifications, criminal charges and prosecution. Comparison of the difference between the two agencies reveal that the ANA lacks the legal authority given by the SBN. The two organizations influence my nursing practice by setting the standards for professionalism and ethical care. In addition, they ensure the holistic wellness of nurses at their workplace.
In the state of Maryland, the licensed practical nurse, nurse technician, and registered nurse can renew their licensure online. The main requirement is proof of continuing education and evidence of active practice hours in nursing (“Renew or reactivate”, 2023). All the registered nurses in the state must renew licenses every year before birthday. Noteworthy, there is a difference in license renewal between nurses in a compact and non-compact state (Curtis, 2021). Specifically, the licensed practical nurses and the registered nurses in compact states can work across multiple member states without completing the licensure process each time unlike those in non-compact.
FDA and CMS
The food and drug administration (FDA) and the center for Medicare and Medicaid services (CMS) are significant agencies in the development and consumption of new medical technologies. Their functional difference is that the FDA approves drugs and medical devices upon sufficient evidence that the product is safe and effective (“U.S. Food and Drug Administration”, 2022). Conversely, the CMS main role is coverage and evaluating if the product is necessary and reasonable (Centers for Medicare & Medicaid Services, 2023). The two agencies are essential in my healthcare professional practice as they ensure that the product I give to the people are not only safe but relevant to the patients and general population. Therefore, they maintain the integrity of nursing practice and earn the trust of people to purchase medicine.
Nurses have an ethical and professional responsibility to safeguard the interests of the patients while ensuring that all the treatment plan improve their wellness. As an advocate, I track medical errors, protect the patients from misconduct and incompetence of the healthcare team members, and offer relevant information for the clients to make informed decisions when they request for alternative therapy (Abbasinia et al., 2019). The nurses also spearhead social justice by providing information that protects their patients from infectious diseases as they champion for new reforms (Huynh & Haddad, 2022). Thus, nurses are the voices of their patients as they understand their needs and have their best interests at heart.
Nurse Practice Act and RN Practice
The Nursing Practice Act (NPA) defines the laws that every US state and territory set to govern the nursing practice. Each state is then required to interpret them into regulations for nursing care practice and power for law enforcement (Huynh & Haddadl, 2022). The Maryland state uses NPA is as reference and benchmark when establishing regulations. The NPA influences my professional practice by ensuring there is a well-defined scope of practice. The nurses can understand the requirements, policies, and rules so that they remain accountable for every work.
The scope of practice for registered nurses (RN) in my state of Maryland include assessing and identifying the needs of the patients. They implement and monitor the management plan of the hospitalized individuals (“Become an RN”, 2021). In addition, they make sure that the policies and standards of the organization are observed in the treatment of individuals. Nurse delegation is a program that permits the nursing assistants in Maryland to work in certain settings and perform assigned tasks. Some of the roles that the nurse assistance is given include blood glucose testing and administration of prescription medication (“Nurse delegation”, 2023). Noteworthy, a registered nurse must be present to teach, guide, and supervise the assistant and assess the progress of the patient.
Application of Professional Practice
Professional nursing practice has many applications, all aimed at providing the optimal care to patients. As a scientist, I engage in scientific inquiry that informs evidence-based healthcare decisions. The nursing profession mandates continuous evaluation of new data, its dissemination, and the implementation of good practices, first on a trial basis and then a wide-scale adoption. Moreover, nurses use translation science to provide resources that help decision-making in healthcare. Thus, nursing is a scientific discipline and requires professionals to have high objectivity and accountability to the seniors.
In my professional role as detectives in carrying out their work to carefully evaluate and determine what is causing ill health and the available options for restoring health. Notably, the nurse utilizes clinical imagination and nursing science to assess the patient while taking note of any deviations from the norm (Burton & Ormrod, 2020). For instance, when a patient has hypothermia, they think of different diagnoses that could be causing the anomaly. Hence, the nurse is able to prevent and control adverse outcomes.
As a manager of healing who creates, advocates and promotes health and holistic wellness of the people, I do my work while affirming the dignity of their patients to preserve their emotional and psychological peace. Furthermore, nurses are encouraged to have multicultural competencies for the population that they serve (Burton & Ormrod, 2020). The implication is that they can provide culturally appropriate and quality healthcare to each patient regardless of their background. Therefore, they manage the patient by providing an initial assessment, conceptualizing the issues, and monitoring and evaluating the treatment plan until they achieve the desired outcome.
American Nurses Association Code of Ethics
The American Nurses Association (ANA) sets standards of ethics that ensure nurses are professional in their practice. There are a total of nine provisions and their interpretations provided by the ANA. The first requires that nurses practice “with compassion and respect for the inherent dignity, worth, and unique attributes of every person” (American Nurses Association, 2015, p.1). The second provision is that their primary commitment is to the patients, who can be one person, a group of people, a family, or an entire community (American Nurses Association, 2015). The provision influences my nursing professional practice by reminding nurses to remain empathetic to their patients and practice patient centered care, respectively.
Several errors may occur in nursing practice, including those relating to medication which are common in clinical setting and those for documentations mostly at the lab and during simulation. Medication errors can occur in many ways such as under dosing, overdosing, and providing patients with the wrong medication (Escrivá et al., 2019). With documentation, mistakes occur when there is a mismatch in patients’ background information, failure to keep records of lab results, and breach of privacy in simulation, and lost information (Eltaybani et al., 2018). The ANA provision can be applied in minimizing medication and documentation errors as it gives emphasis on respect and compassion. The implication is that the nurse is likely to be more careful not to commit a mistake that can be fatal to their patients.
Leadership Qualities and Nursing Environment
There are many qualities that a nurse leader should have, including good communication skills, project management, integrity, and dedication to excellence. The nurse leader should assume clinical expertise and collaborate with the team of professionals to implement best practices (Heinen et al., 2019). The significance of communication skills at the bedside is to enhance hand-over practices while within an interdisciplinary team is to enhance collaboration without role clash. Project management skill in the bedside is important following milestones of the treatment plans and in interdisciplinary team for disseminating tasks. The quality integrity is significant at the bedside as it ensures the leader is trusted by the patient while for an interdisciplinary team it helps to depict consistent in speech and action. Importantly, dedication to excellences is relevant in eliminating errors at the bedside and promoting a good culture among members of the multidisciplinary team.
Work environment affects delivery of care either positively or negatively depending on the organization. It affects nursing leadership by determining the structure of management and flow of command. For example, if the administrators are dictatorial, it may discourage nurses from giving ideas to the leaders. The environment affects decision making by giving policies and standards of practice which the medical team must follow. Moreover, it has an impact on professional development depending on the available resources and support from the employers for the workers to advance their academics and careers.
Conclusion
In summary, the nursing profession is a critical discipline that directly influences the health of the nation. Nurses are aware that their practice is relevant in ensuring that patients get well within the shortest time possible. They apply theories and get inspirations from key historic figures whose work led to major reforms and modernized nursing as a profession. In addition, the ethics code of conduct and other professional standards provides nurses with guidance for practice. The leaders are expected to have various qualities and create a positive environment for holistic growth.
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