Professional Standards of Nursing



Professional Standards of NursingJean HarkenFerris State UniversityProfessional Standards of NursingNurses have many roles and provide care to numerous people each day. The purpose of this paper is to identify the current scope of practice that I utilize in my everyday job (Singleterry & Eisen, 2013). By doing this, I will better be able to compare and contrast the difference in roles as this writer transitions into the BSN role (Singleterry & Eisen, 2013). Implementing the new knowledge that is learned in these courses is very important to growing and expanding as a baccalaureate prepared nurse. Although the current job that one holds may now change, it is important that the new knowledge is carried out and provides new strengths to the nurse in every day practice (Singleterry & Eisen, 2013). Due to everyone coming into this program with different experiences, it is important to recognize where you came from and where you are going with the new found knowledge.Professional Identity To start off, what is a profession? Merriam-Webster states a profession is “a type of job that requires special education, training, or skill” (Merriam-Webster, 2014). With just that definition alone, I would say nursing qualifies as a profession. According to the American Journal of Nursing “A profession utilizes in its practice a well-defined and well-organized body of specialized knowledge which is on the intellectual level of the higher learning” (Bixler & Bixler, 1959, p. 1). This is a statement made several years ago, and was only a starting point from what nursing has become. There is a lot of time, dedication and education that goes into being a nurse. Nursing as a “job” requires a minimum of two years of education and schooling as well as some specialty classes. This in the least amount of education required to qualify for an entry level position in this field. Throughout your career more education, specialty classes, and a large amount of on the job training required to advance in this profession.Since a profession seems to be described by tacit knowledge, by many nursing organizations, it seems only natural that nursing would qualify as a profession. This is a perfect example that what is leaned in nursing school is only a beginning to the extensive amount of knowledge that will be learned on the job. To make better nurses it is necessary to have effective role models, role reputation and interactions with a professional group to help with the ongoing educational progress (Olsson & Gullberg, 1991).As I look back and reflect on my years of nursing, what I learned in nursing school is only a beginning of the knowledge I have obtained. In this profession, one is always trying to better themselves and on the job learning, conferences and additional courses are just a few ways to do so. The way that nurses represent themselves also help to prove what an important profession nursing is. The more put together, and confident a nurse is in their skills the safer a patient feels, and the more respect nurses receive as a profession. There have been many years of struggling, battling for legislations that protect nurses, advocating for patients and educating ourselves and the public to get where we are today (Rowell, 2003). It is important that nurses remember that and represent the profession in a positive way while implementing the standards of nursing.Scope of PracticeScope of practice is what nursing bases their profession on. Scope of practice is basically the “law of nursing”. It defines action, and procedures that are permitted or not permitted and the specific requirements of education needed to perform a specific task (Anderson, 2014). These practice standards advise us as nurses how to practice medicine, where we are able to apply our nursing skills and in what fashion we can do this. Each area of nursing may have slightly different standards depending on what specialty they deal with, but all nursing in general has a scope of practice that must be followed and then can be elaborated in each specialty area. The scope of practice is broken down into six nursing standards that go more detail into the roles and responsibilities of the registered nurse.AssessmentAssessment is one of the six standards of nursing. To me, this may be the most important one. Assessment is the basis of all treatment that is done on patients. It is extremely important to learn and practice good assessment skills. Assessment is the foundation to all further care, whether it be preventative care, management of care or for actual treatment (Olsen, 2012). Nurses are the eyes of the doctor when they are not there. Nurses spend more time with their patients than any other healthcare provider. With that being said, it is not surprising that nurses often are the first ones to pick up any change in a patient’s condition. This is a reason that assessment skills must be utilized, practiced and held to a high standard (Olsen, 2012). The nurse should then be able to process and priority the assessment information that was obtained and be able to make any further treatment decision or the need to call a physician based on this.In the critical care setting especially these skills must be fine-tuned and able to pick up on even the littlest change in a patient. These fine-tuned assessment skills could literally mean the different between life and death of a patient. If a critical complication of a patient is noticed in a timely manner by a nurse, the problem can often times be addressed before further damage can be done. In critical care there are full body assessments done a minimal of every two hours, with quick assessments always being done. Any time you look at your patient, whether you realize it or not, you are doing some sort of assessment on a patient. One case that I can think of that fine-tuned assessment skills helped with a patient is on a neuro patient that was recovering from a stroke. In the morning her pupils were equal and reactive, two hours later they were unequal and one was not reactive. We were able to get a computed tomography (CT) scan and treat the problem before it became worse. Had this particular nurse not had good assessment skills, this could have been missed and a much different outcome could have happened. PlanningPlanning is also an essential part of the nursing process and scope of practice. A plan must be develop by the nurses that has strategies and alternative to achieve outcomes (Matthews, 2012). Planning comes after the assessment, diagnosis occur, planning progression of care is essential to safe and efficient recovery. Planning must have an appropriate, organized and systematic plan to work properly, it must be individualized to work properly (Matthews, 2012).Education to the patient on the plan is essential to the plan working properly and all disciplines should be included for the best care of the patient. I will be the first to admit, that while in nursing school, I thought that care plans were the biggest waste of time. I couldn’t see how all this work spent on something would actually prove to be useful. I have quickly found that while working in the real world, not only are they helpful for a patient, they care also be helpful for nurses. These plans are customized for each patient to aid in the progression of care. A nurse should evaluate this plans minimally each shift in a hospital setting. You should clearly be able to see the progression or lack of progression from the documentation and make changes as necessary to the plan to better suit the patient. In one instance a properly documented and executed care plan saved several nurses and a hospital from a lawsuit. The care plan was carefully drawn up for the patient. It was very well documented that the patient was refusing care and actually doing anything but what was recommended in the care plan. This care plan had even been edited to better accommodate the needs and wishes of the patient and still showed non-compliance from this particular patient. This documentation was able to prove that actions were taken on multiple levels from the nursing staff and cleared them from a lawsuit. While maybe not as important as the assessment phase, planning rates as one of the priorities in my book.TransitionAlthough the job that one does may not change, the knowledge, skills and attitude that one possesses after completing the bachelors program has many changes. The bachelors prepared nurse has a greater focus on quality measures and evidence based practice (American Association of Colleges of Nursing - QSEN, 2012). After completing the bachelors program, the nurse is better prepared when it comes to researching and coming up with and practicing best practices. There is much more attention put on community nursing and the importance that it plays in the society that we live in. There is a lot more emphasis placed on teamwork, being a leader of a team and working effectively as a team (American Association of Colleges of Nursing - QSEN, 2012).There is much more emphasis on active listening as well as leading a conversation. More skills are developed to effectively form a plan of care, follow out the plan, evaluate and make changes to the plan as needed. While these skills are learned in nursing school, they are known leaned more in depth and with a better understanding of the importance of an effective plan of care. The emphasis placed on assessing a patient’s needs and coming up with a plan that also involves the family or support system to become successful (American Association of Colleges of Nursing - QSEN, 2012). The skills that are added in the bachelors program are invaluable and while the day to day job may not change, the additional skills and knowledge brought to the job is invaluable. The attitude of the bachelor prepared nurse changes as well. You are taught the values of what you are learning. One is taught why evidence based practice is as important to patient care and to the nursing field as a whole. The bachelors prepared nurse is taught to appreciate and value the contributions of a team and how important team work is (American Association of Colleges of Nursing - QSEN, 2012). After completing this program, you are able to be a clinical instructor in many nursing programs. It is so important to have a positive attitude and to share your knowledge and experiences to help mold new nursing minds. Preceptors can make all the difference to a brand new nursing student. Having pride and respect in the nursing career is essential.KnowledgeThe key to a successful nurse is to never stop learning. When the learning stops, the nurse should be done practicing. Education is very important to the nursing career and the nurse should continually be challenged. Credits are required to maintain a nursing license which is a testament to how important education is to maintaining and expanding knowledge. The nurse can utilize the credits that are obtained while completing the bachelorette degree as some of the credits needed. The demands of nurses today are high as well as the critical thinking skills required to be an effective nurse. Education at the bachelor’s level provides nurses with these necessary skills to be successful in today’s world of nursing (American Association of Colleges of Nursing, 2014). The education that is learned in the bachelors program, especially related to community nursing, management and research in invaluable to the nurses of this day in age (American Association of Colleges of Nursing, 2014). With the decline in healthy people across America and the poverty levels rising, nurses that can focus on the needs of a community is a huge win for all parties involved. Research in the way of the world. With all the advancements in medicine and nursing practice, the skills that are learned in the bachelors program on research could help to change medicine for many people.SkillsWith the many skills that nurses obtain over the years, it is important for nurses to acquire and maintain these skill. There are many areas that skills are needed and many ways to obtain these skills. Collegiality and the adaptions into nursing practice is a great place to start with exchanging skills (Conqdon & French, 1995). Not only job oriented and physical skills are important to the nursing field. Communication skills are also extremely important. While there is only so much that can be taught, it is important for bachelors prepared nurses to have very effective communication skills. Communication is a major component of providing great care. Collaboration as a team is also a skill that is emphasized in the bachelors program. Through many group assignments and projects, students learn very quickly the importance of team work. With the courses in this program being on-line courses, students are taught how important it is to have a team leader and a plan to follow. Collaboration became very important while trying to put the final project or paper together. It was very apparent that if even one person of the team fell behind, it was much more challenging to keep on the task at hand. You also quickly learned that other members would pick up the slack to provide the best outcome for the group. If nurses on a floor or in a unit worked even half as well as the groups in school, there would be some very well taken care of patients.AttitudeWhen it comes to attitude, the first place a nurse need to look is at themselves. A nurse needs to have respect for themselves, their patients and the career. This positive attitude can be reflected though a performance appraisal. It is important for the nurse to examine themselves and the way that they practice, what they are successful with and the areas that can use some improvement (Kimmel, 2007). This also leads into ethics and making the proper decision for the patients. The bachelors prepared nurse is taught the critical evaluation skills and is able to evaluate the ethical aspects of the career at a higher level. After even a couple semesters in this program, I find myself looking at situations experienced on my unit very differently than ever before. I find it easier to help families deal with the difficult situations that they may be faced with. As a bachelors prepared nurse there is a commitment to higher accountability and critical thinking. The bachelor prepared nurse often holds leadership roles and should lead by positive example and commit to a higher quality of care. There should be a commitment made by the bachelor prepared nurse to be a mentor and role model (American Association of Colleges of Nursing - QSEN, 2012). Too often nurses are stressed in their jobs and less than acceptable attitudes are displayed. While humans and making errors and not always being the person that we want to be, as a nurse we have a responsibility. As a bachelors prepared nurse I feel that we have a greater responsibility to take control of a situation, even one that is less desirable and make it into something positive.SignificanceThere is often a debate of bachelor’s prepared nurses as opposed to those with an associate’s degree or those from long ago with the diploma program. The AND nurses with often tell you that are better prepared clinically than those BSN nurses and they could be right (Ellis, n.d.). While only having my AND, I would have been one of those nurses that defended myself that I can do the same job as a BSN prepared nurse and could often provide better assessment coming right out of nursing school. What I lacked was looking at the big picture, neither of us was “better” than the other one, the education was just slightly different. The nursing profession is a complex one, and I found that I was lacking some of the knowledge needed to make more decisions on my own, the skills needed to help with critical thinking. These would be the skills that my BSN could help me to obtain. With the needs of patients changing, nursing must also be flexible and able to change to meet these needs, this is what BSN training will help provide (Ellis, n.d.). The main difference with ADN nurses and BSN nurses is that there is more leadership, management and community nursing that is emphasized with the bachelors prepared nurse (Ellis, n.d.). This fits into the scope of practice in every way that it is written. The nurse should continue to educate themselves in order to better suit the needs of their patients. This does not mean that every nurse should obtain their Bachelor’s degree or they will not be able to manage their patients. Remember in the big scope of things, there is a lot of leaning that can be done on the job and from one another. This will have to be a personal decision for each individual person. One can continue to learn and expand their knowledge without obtaining a bachelor’s degree, but there are more options once this degree is obtained.In these changing on complex times, hospital especially are looking for nurses with a BSN to work in emergency and critical care units. This is mainly due to the more developed critical thinking skills, the ability to make decisions and the more well-rounded education that they are received. By obtaining a bachelor’s degree, you are also have more opportunity to grow. Many places will not even look at you for a manager position or coordinator position without this degree. This is also a stepping stone if you are planning on an advanced practice degree at some point in time. The bachelor’s degree provides some education in management, and leadership, also expanding on the scope of practice. Ultimately obtaining a bachelor’s degree has to be an individual choice, but the opportunities one could have with the degree are essentially endless.ReferencesAmerican Association of Colleges of Nursing - QSEN (2012). Graduate - Level QSEN Competencies. Retrieved from Association of Colleges of Nursing (2014). The Impact of Education on Nursing. Retrieved fromAnderson, L., (2014). Understanding the Different Scopes of Nursing Practice. Retrieved from , G. K., & Bixler, R. W. (1959, August). The Professional Status of Nursing. The American Journal of Nursing, 59(8). Retrieved from , G., & French, P. (1995, April 21). Collegiality, adaption and nursing faculty. Journal of Advance Nursing, 4, 748-758. Retrieved from , S. (n.d.). To BSN of not to BSN -That is the Nurse’s Question. Retrieved from , N. (2007). The Standards of Professional Performance for Nursing. Retrieved from , J. (2012). Standard 4. Planning. In K. M. White, & A. O’Sullivan (Eds.), The Essential Guide to Nursing Practice (pp. 75-85). Silver Spring, MD: / American Nurses Association.Olsen, S. J. (2012). Standard 1. Assessment. In K. M. White, & A. O’Sullivan (Eds.), the Essential Guide to Nursing Practice, pp. 35-44). Silver Spring, MD: / American Nurses Association.Olsson, H. M., & Gullberg, M. T. (1991). Nursing education and definition of the professional nurse role. Expectation and knowledge of the nurse role. Retrieved from , P. A. (2003). The Professional Nursing Association’s Role in Patient Safety. Retrieved from , L., & Eisen, G. (2013). NURS 324 Transition into Professional Practice [Couse Syllabus]. Retrieved from Ferris State University MyFSU ................
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