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1. Claudia
Vision for the Future of Nursing
When exploring the vision for the future of nursing, pause to reflect on your why. Doing so will allow an opportunity to revisit your purpose. It is important to think of which aspects of nursing we are passionate about in order to discuss how to make an impact on specific patient populations. The art of Nursing is the way in which the profession becomes manifest in the pragmatic care. Nurses need to attend to the patients’ needs in a manner that depicts a good level of academic excellence.
In 2010 the Institute of Medicine (IOM) and Robert Woods Johnson Foundation (RWJF) published a report indicating recommendations that could help better nursing as a profession. Some of these primary issues addressed in the IOM report state that the nurse should practice to full potentiality and to the level of their training and education. It is important for nurses to attain higher levels of training and various education via the upgraded education forums that tends to promote academic advancement. Therefore, improving the education system is imperative in ensuring that the delivery of health care will be safe, quality, patient-oriented, and touched in all areas more so on the issue of primary care and overall public health. The main purpose is to make sure that all Americans can access much-needed health care services. To ensure that these objectives have been met, nurses need to be at the forefront in contributing and ensuring the maximization of all opportunities that can guarantee better health care to the citizens (Dobbins, 2016), Nurses are required to fully partner with physicians and other health professionals that reside in the United States. It is clear that not all nurses start their profession with the intention of being a leader (Dobbins, 2016). However, the strongest leaders are needed to transform the US health care system. The transformation will ensure that the nurses can adapt and take new roles in the new setting hence the need to incorporate leaders with indispensable characteristics.
In execution and laying strategies to implement these recommendations, there is a need to implement certain elements in an organization for anticipated change to take hold. Therefore, having a shared vision is imperative to executive change and fit in one direction with regards to the practice ahead. They need a vision statement that depicts the seriousness in implementing some of these recommendations (National academic, 2016). Vision statements act as a reminder to the practitioner now and then hence ensuring the objective laid have to be followed; hence success is realized. On the other hand, there is a need to have an effective leadership type, which is now in charge of ensuring shared visions. Effective leadership ensures that success is realized as early as possible. There also comes in the aspect of organizational culture supporting change and creating readiness to change. In implementing these recommendations, there comes the need to accommodate change and get ready for unprecedented changes. Therefore, in the overall implementation of these changes, it is important to underhand that change will always be there giving room for improvement.
References
Dobbins, E. H. (2016). Improving end-of-life care: Recommendations from the IOM. The Nurse Practitioner, 41(9), 26-34.
National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. National Academies Press.
2.Tania
Healthcare in the United States is transitioning to offer high-quality healthcare services to each patient. The increase in patients seeking medical services is evidence of the steps the healthcare system is taking. There are challenges that the nursing profession is facing as the practitioners seek to provide quality care (Grossman, 2016). The nursing career requires restructuring to cater to the demands of the diverse patient population (Hassmiller, 2015). Nurses are essential personnel who are part of the healing process. The technological advancements and new treatment methods available have proven the responsibility of nurses to become more critical. The future of nursing is expected to change and continue to grow as healthcare needs are continuously evolving.
My vision for the future of nursing is an adequate nursing staff to guarantee the safety of the patients. Inadequate staffing negatively affects the healthcare institution, nurses, and the patients outcomes. The healthcare institutions need to have adequate staff to ensure the nurses are satisfied with their work, not suffering from burnouts, and avoid adverse events on towards the patients (Hassmiller, 2015). The second vision is to create leadership in the nursing profession, which works to have strategies to direct the nurses (Grossman, 2016). Healthcare institutions and organizations will help in the creation and implementation of these strategies. The nurse’s responsibility will include leadership, and their primary role will be providing high-quality patient-centered care (Grossman, 2016). Thus, the nurses will work towards supporting the healthcare institutions in implementing the strategies.
My third vision is the contribution of nurses towards providing quality care to patients. The nurses have access to healthcare resources and should properly utilize them for the benefit of the patients (Hassmiller, 2015). The nurses who play a big role in the healthcare sector create the image and influence the system. Thus, the delivery of high-quality care will positively influence patients to restore health quickly. The fourth vision has a nursing culture that defines the profession. A nursing culture does not necessarily only include patient care. Nurses can find satisfaction in their profession, acquire education and training, improve the image and standards of the practice (Grossman, 2016). The power and ability to promote the nursing profession lies within the nurses by embracing the values of the profession, the society will change their views towards the nurses.
How does your vision fit with the recommendations in the IOM report?
The ability to participate in strategies that improve the quality of care by nurses is supported by the recommendation that calls for the nurses to exercise according to their extent (Altman, 2016). My vision to create leadership and the contribution of nurses to providing healthcare align with the recommendations since there are several limiting factors (Grossman, 2016). The vision focusing on the nurses contribution fits with the recommendation since it promotes the use of the healthcare resources to provide high-quality care. The second recommendation calls for acquiring high levels of training and education to ensure the nurses can deliver quality and safe patient care to each patient they encounter (Altman, 2016).
The creation of policies and workforce planning is a recommendation that focuses on the importance of having data on the workforce and contributions of the various professionals in a healthcare institution (Grossman, 2016). The recommendation calls for data regarding the staffing of the health professionals, hence supporting my vision towards adequate staffing to provide quality healthcare. The nurses are supported to lead changes in the healthcare sector through these recommendations (Hassmiller, 2015). The recommendation aligns with my vision to create leadership in the nursing profession; thus, the nursing education institutions should facilitate leadership programs for the nurses to exercise their skills.
What two action steps do you plan to take to promote this vision?
To promote the vision that I have for nursing, I will take the responsibility of continuing my education and seeking leadership skills to develop opportunities. I will have the ability to make decisions as I provide care to my patients. Continuing education and training enable a nurse to contribute to making policies in the healthcare system (Grossman, 2016). Participating in research is a crucial way of learning about teamwork, leadership, and data collection, thus improving nurses’ competence (Hassmiller, 2015). It is a project that I will join since it will assist in developing skills and knowledge to utilize research and academic knowledge. The research enables a nurse to utilize the healthcare system’s resources and assures the provision of quality care to patients.
References
Altman, S. H., Butler, A. S., Shern, L., & National Academies of Sciences, Engineering, and Medicine. (2016). Achieving Higher Levels of Education. In Assessing Progress on the Institute of Medicine Report The Future of Nursing. National Academies Press (US).
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. FA Davis.
Hassmiller, S. B., & Reinhard, S. C. (2015). A bold new vision for America’s health care system: The Future of Nursing report becomes a catalyst for change. Nursing outlook, 63(1), 41-47.
3. Barbara
Asian cultures are very family oriented. The worldview of Asian cultures is collectivist. When healthcare decisions need to be made it is usually perceived to be the responsibility of the oldest male in the family. Nurses should respect the patient’s beliefs and culture but remain ethical. This can be a difficult position if family members do not wish to tell an ill family member about their condition.
The nurse should assess the patient’s beliefs and perceptions of their health condition. It is important for the nurse to develop a relationship and trust with the patient individually without involving the family. This may be the only opportunity for the patient to express their true healthcare wishes and it is the duty of a nurse to advocate those wishes. Not doing so is an ethical breach. Although there is a great variety of beliefs, Asians often do not like to tell a person who is ill of impending death, and many believe even speaking of it may bring bad luck or a poor outcome (Ritter, 2017). If the patient wishes to know and is receptive, asks questions and wants to know their condition, by all means the nurse is obligated to tell the patient despite the families wishes. After all, the patient is the nurse’s number one priority.
Asian culture may influence telling a patient their true prognosis. Family members often believe in using life prolonging measures and do not believe in autopsies (Ritter, 2017). It is imperative that the nurse evaluates the patient’s personal perception and to fulfill their healthcare wishes should they differ from the traditional family views. The nurse should evaluate aspects such as pain and mood. Many Asian cultures do not believe in complaining or expressing negative emotions such as pain. It is the nurse’s responsibility to make the patient aware that they do not need to suffer and that the decision is ultimately their own. Each patient has the right to make their own decisions based on their own beliefs and values. This is known as autonomy. A patient’s need for autonomy may conflict with care guidelines or suggestions that nurses or other healthcare workers believe is best. A person has a right to refuse medications, treatment, surgery, or other medical interventions regardless of what benefit may come from it (Haddad, Geiger, 2020).
Once the nurse makes the proper evaluation of the patient’s perception and healthcare wishes, the nurse has done their part and has a duty to respect those choices. This may mean the patient states to do whatever the eldest male says and has little involvement in their care. If this is their traditional belief then the nurse should avoid bias because of his or her own beliefs. This can be a difficult ethical challenge to accept. In this case it is best for the nurse to respect the family’s cultural beliefs on healthcare and to ensure the nurse has made clear communication with the patient. All the nurse can do in this case is offer the patient education and information, assess their perception, and provide quality nursing care.
Coburn, C. L., & Weismuller, P. C. (2012). Asian motivators for health promotion. Journal of transcultural nursing : official journal of the Transcultural Nursing Society, 23(2), 205214. https://doi.org/10.1177/1043659611433869
(Links to an external site.)
Haddad L.M, Geiger, R.A., (2020). Nursing Ethical Considerations. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526054/
Ritter, L. A. (2016). Multicultural Health. [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781284121605/
4. Lameness
Nursing Ethics in Care: Prognosis
Cultural practices are strong influencers in healthcare because they influence the social aspect of a patients health. Social well-being is an integral aspect of health as per the World Health Organization. Admittedly, however, there are certain social practices that do harm to the mental and physical well-being which are the two other aspects of health (Price, Williamson, McCandless, Mueller, Gregoski, Brunner-Jackson 2013). By not telling a patient of their prognosis I would be respecting their rights but compromising on their physical health. Such a scenario would be a catch 22 where I am ethically required to be exclusive in patient care while the same ethics expect me to respect the patients wishes (Price et al., 2013). Regardless of the professional ethical constraints that push me to tell the client of their prognosis, the patient still retains the power to give directions on how they want to be managed. As such, I would respect the patients request not to be informed of their prognosis.
Considering they are terminally ill the risk of not telling them of their prognosis is considerably reduced and therefore refraining from telling them does moderately low harm. By telling the patient of their prognosis I would be serving my interests to not violate any ethical practices (Price et al., 2013). However, I would be in violation of my own oath of putting my patients first because I would be going against their wishes and beliefs and hence cause harm. I regard truthfulness to my Hippocratic Oath as the reason for refraining from telling my patient of their prognosis. I would however, Attempt to convince them that it is important to know the prognosis. If my attempts were futile, I would respect their wishes and hold my tongue regarding the prognosis.
Healthcare providers can navigate the challenges presented by such enigmas and land on a solution that delivers equilibrium. However, such solutions are situational and hence cannot be reapplied in a different scenario. For instance, Asian culture requires that terminally ill patients are not told of their prognosis. Such a scenario can be escaped through telling the patient of the possible care options available. A known terminal cancer patient may be told that chemotherapy is still an option but the odds of success are immeasurably minute. As such, the patient will have known of their likely prognosis without a family conference being called to the same end. No ethical barriers will have been broken yet all ethical requirements will have been met. Healthcare providers could identify the barrier causing the ethical conflict and indulge it in healthcare provision (Price et al., 2013).
As observed most of the ethical concerns arise from cultural or religious beliefs. However, the indulgence of cultural or religious heads such as community elders and religious leaders can health navigate the ethical challenges in place. For instance, if someone does not want to be told their prognosis because it violates their culture, a cultural leader like a priest or elder can be sought to help in the dispensation of healthcare. When information is not fully disclosed it could be considered an ethical breach (Price et al., 2013). However, the confines of the non-disclosure are crudely sketched. When information is not disclosed due to a signed legal document serving as the restraining order then there are not ethical violations. The patients should provide bearing for the clinicians management and violating their will would be unethical. However, if the patient wants to know the information but healthcare providers hold it from the patient, then there is without a doubt a breach of ethics.
References
Price, M., Williamson, D., McCandless, R., Mueller, M., Gregoski, M., Brunner-Jackson, B, et al. (2013). Hispanic migrant farm workers attitudes toward mobile phone-based telehealth for management of chronic health conditions. Journal of Medical Internet Research, 15(4), e76. http://doi.org/10.2196/jmir.250
