Introduction
Nursing is an occupation within the healthcare sector based on the care of individuals, families, and communities to maintain and attain the best health conditions. Nurses differ from other healthcare professionals in the way they care for patients, their training, and their area of practice. The profession of nursing is unique in its way; nurses first develop a plan for taking care of patients, work collaboratively with doctors, and find a polite way of dealing with patients’ families. They are a bridge of communication between physicians and patients regarding their health. The profession of nursing is as old as the 5th century BC and has continued until now. It can be considered a profession of great responsibility as well as a mechanism for public accountability. Nurses must have one or more qualifications to be members of the nursing staff. A practical nurse and a registered nurse are at the same level. Nurses blend the art and science of nursing and fuel advancements in their profession. This paper will define the art and science of nursing and discuss the implementation and influences of these concepts in the healthcare environment.
Definition Of The Art & Science Of Nursing
The American Nurses Association (2017) is the organization that sets the standards of the profession. It defines nursing in two ways. The first is to optimize health and provide patients with diagnosis and treatment, and the second is to prevent injury and illness by advocating for people. Patients and their families rely on nurses. Therefore, the standards of nursing require that nurses be certified and equipped with professional knowledge. If we talk about nursing, we will talk about standards that govern nursing and its scope. They describe nursing practice in terms 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 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, irrespective of their role, specialty, or the total population they serve, to perform proficiently. The nursing process relies on bi-directional feedback from each working component, including diagnosis, assessment, detection of outcomes, planning, implementation, and finally evaluation.
Palos discussed the importance and implications of the profession of nursing. He emphasized that this is a job where professionals deal with the lives of patients, so there is no room for mistakes. Each nurse must be aware of medicinal technologies and skilled in clinical practice. Theoretical and evidence-based information about human experiences and reactions is used by nurses to cooperate with healthcare consumers in assessing and identifying outcomes of concern. Interventions are intended to produce favorable consequences that do no harm to anyone. It’s an ethical duty for nurses to sustain a healthcare practice environment that is conducive to promoting quality health care. Studies show that demoralizing and unsafe conditions provoke medical errors and infections among workers. They increase the chances of conflicts and tension among health professionals (Palos, 2014).
A graduate nurse has some qualities that include the use of systems, community resources, and organizations to lead successful change, and a nurse should apply quality principles while communicating methods, tools, etc. One must demonstrate leadership skills that provide additional insight and possible solutions. These are part of the profession, and they define the art of the profession (Palos, 2014). However, the care and compassion demanded by this profession cannot be quantified, but nurses are supposed to satisfy their patients. Patient satisfaction acts as a driving force for nurses, and their better services will benefit people.
How The Art & Science Of Nursing Influences Current Practice
Lusk 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). Lusk and Fater (2013) also described caring in nursing as related to intersubjective human responses to health-illness conditions.
Lusk and Fater worked in this demanding profession and concluded that nurses must provide patients with patient-centered care (PCC). PCC will ensure that patients are getting good-quality care (Lusk & Fater, 2013). PCC is a way to improve the quality of the profession. Nurses must meet the standards of nursing to become highly skilled professionals and experts at PCC. Standards are always necessary if we want any organization to work in its best condition and produce the best results. They outline expectations of the profession and guide nursing practice, which is essential for self-analysis. They also help in the development of a better understanding of the different roles that a nurse has. They provide a means of evaluation for all nurses to ensure clinical aptitude and protection and hence provide a framework for developing clinical ability checklists, as well as identifying areas of improvement in the clinic and improving patient and workplace safety (Lusk & Fater, 2013). Professional nursing promotes a friendly relationship between the patient and nurse. As a patient needs more attention and wants to be taken care of, politeness is the key to the patient’s quick recovery, which relies on the relationship between the nurse and the patient. The nurse automatically promotes self-care and a concept of humbleness in society, as well as care for the environment, society, and people. However, PCC is not limited to nursing only, but it helps define nursing in a much better and easier way (Lusk & 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 forth her best efforts to care for people. It includes knowledge and care. For an advanced practice registered nurse, there are additional obligations that one must follow, including offering clinical solutions, evidence-based pharmacological agents, treatments, therapies, and referrals. To become registered as a nurse, there are multiple educational courses that qualify a candidate to sit for the licensure examination in the United States. Registered nurses possess knowledge, talent, judgment, and creativity.
For me, patient safety comes first. Our profession is accused of causing the deaths of many people due to mistakes in treating them. Any overdose of a drug or failure to give enough medicine to a patient can result in permanent loss (Wolf, 2014). Therefore, nurses have to take great care with medication. Wolf blamed nurses for such mistakes and stated that the cause of these blunders is a lack of knowledge, which he described as “inappropriate medication for the patient” (p. 103). Therefore, I plan to work on evidence-based practice. Technological advancements in medications have helped nurses perform their duties well and do the right thing at the right time (Wolf, 2014).
Nurses are not only responsible for taking care with medication, but they also have to use psychomotor skills. Nurses must ensure that their patients suffer as little as possible. The pain of medication must be decreased with psychological techniques and friendly relationships. If the nurse has good interpersonal skills, she can become friendly with the patient, and thus, medication administration is improved (Wolf, 2014). It is an art to convince patients to take medicines that cause pain, but nurses have to master that art (Wolf, 2014).
Now, we are convinced that the science and art of nursing go hand in hand. We cannot miss either of these. If there is a deficiency in science, I may commit a medication error, but if the art of nursing is not understood, 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 relationships with 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 poor health. The interaction of nurses with patients helps revive their hopes. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey shows that when nurses are granted incentives and Value-Based Purchasing (VBP) scores, they work even better to improve patients’ experiences. This was explained in the Patient Protection and Affordable Care Act (Dempsey, Reilly, & Buhlman, 2014). As it is proven that communication with nursing staff has positive results in patient care, hospitals therefore strive to improve quality and provide a better experience to their patients.
The healthcare environment has changed due to the introduction of bedside shift reports. This report gives the patient authority to participate in his care and treatment, which makes him comfortable in the first place, and the patient starts trusting the institution, reducing the fear of being in a hospital (Dempsey et al., 2014). Patients can decide which nurse will be visiting them, and in this way, they will feel better (Dempsey et al., 2014, p. 149). Patients are also given the authority to question the staff, and 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 2013, stating that the VBP program influenced the performance and efficiency of healthcare providers and related risks. The Centers for Medicare & Medicaid Services (CMS) provide initiatives for performance programs, particularly the Readmissions Reduction Program (RRP) and the Hospital-Acquired Condition (HAC) Reduction Program. In both of these programs, hospitals are penalized for poor performance and have to pay fines.
Hospital-acquired urinary tract infections (CAUTIs) are another major issue and are among the major hospital-acquired infections (HAIs). They account for almost 40% of HAIs. Nurses are required to analyze the need for using a Foley catheter (Quinn, 2015). The implementation of this plan reduced HAIs by 50% in White Plains Hospital in New York (Quinn, 2015). The hospital has criteria called Question the Foley. Nurses evaluate patients who have Foley catheters and decide if the catheters should be continued or discontinued. They 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 the experience of sitting with patients and interacting with them on the same grounds, which was a big opportunity for me. At Mission Hospital in Mission Viejo, the authorities organized a program called “2 minutes sitting and talking time” for patients and nursing staff. Therefore, we sat with them and had conversations. It was a pleasure to understand their needs and study their verbal and nonverbal cues. I enjoy such sessions, and routinely, I try to do this during my shifts. This is the only way I make my patients comfortable and develop a bond with them. A friendly interaction gives them a sense of trust, and they cooperate with us in all matters. When patients are satisfied with our services, they enjoy a good experience, and this is the goal of the healthcare institution.
Moreover, I have done hourly rounding to help them with toileting and guide them regarding comfort and positioning. I used to do two-hour rounding before, but now, the head tells us to make an hourly round during huddle time and report it in a chart on the computer. Patients who are rounded on 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 as frequently, 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 knowledge so that I can give evidence-based care. I plan to update my skills by participating in every new certification and educating myself about the latest advancements. The Academy of Medical-Surgical Nurses (AMSN) is my next plan because it offers training in the Scope and Standards of Nursing. Those measures include quality of care, performance appraisal, collegiality, education, research, ethics, communication with family members, leadership, and collaboration with the client, significant others, and healthcare providers, which are very helpful for nurses. I will also work on my skills, abilities, and knowledge to become an expert in the medical-surgical setting. Therefore, I will strive hard to become an expert in procedures and practices by becoming a part of AMSN. Technological advancement and training in using new diagnostic equipment and machines will also be lessons to learn. After getting certified in all these areas, I will become a member of the Emergency Nurses Association.
To become a good evidence-based caregiver, I need a mentor, so I will look for an evidence-based practice (EBP) mentor. EBP is believed to play an integral part in reducing costs and improving the quality of healthcare. It gives better outcomes, and there are fewer variations in care (Fineout-Overholt, Gallagher-Ford, & Kaplan, 2012). Nurses not only gain good knowledge and skills in nursing, but they also become experts in organizational behavior and strategies in an organization. Master’s-degree nurses have knowledge about EBP, and they can easily tackle the complications of EBP, but a nurse without a master’s degree cannot do this (Melnyk et al., 2012). Therefore, to be a good evidence-based caregiver, I will pursue my education and obtain a Master of Science in Nursing (MSN) degree.
SMART Goals For My Future As A BSN
As soon as I graduate with a 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 in 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 to a school or college to become a Master of Science in Nursing (MSN). To make enough money, I will work as a Family Nurse Practitioner (FNP) and Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) until May 2018 so that I can complete my applications within the given timeframe. After doing all this, I will be able to start my FNP, AGACNP, and MSN programs 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 an EBP manner and with more confidence.
Conclusion
Technological advancements and research in nursing education have augmented the importance and respect of professionals. Nurses not only give us medicinal treatments but also give us emotional support in our hour of need. Therefore, nursing is treated as both art and science. The profession of nursing is a very honorable and dedicated career; one needs to strive hard to sustain difficult circumstances. To fulfill the demands of QI and flourish 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 that need improvement and develop an action plan to work on them instead of only accommodating QI activities. Every patient has a different mindset. Some demand science only in the form of medicines, but others demand humanistic care and flexibility. Therefore, nurses have to master both areas. These efforts will result in regaining the true essence of this profession and providing the best quality of care.
References
The American Nurses Association. (2017). What is nursing? Retrieved from https://www.nursingworld.org/EspeciallyForYou/What-is-Nursing
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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