Continuing Competence in Nursing Practice

Nursing is a sphere that requires both professional knowledge concerning the right way to conduct necessary medical manipulations and the knowledge of psychology that helps nursing professionals to understand the needs of their patients and address possible communication problems before they occur. Nowadays, there is a range of nursing theories that are successfully implemented by nursing practitioners in different countries. Among them, there is the theory of bureaucratic caring and the theory of successful aging that encourage nurses to utilize a patient-centered approach discussed in AACN Masters Essentials.

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The theory of bureaucratic caring that relates to the eighth essential proposed by AACN was proposed by Ray can be listed among concepts that are widely implemented in nursing practice. Unlike other theories, it utilizes a systemic approach when describing the nature of the nursing process. According to the theory, there is a clear connection between two parts of the nursing process (those related to nurse-patient communication and bureaucratic cultures) (Johnson, 2015). The concept of caring that was developed by the researcher includes many dimensions that should be taken into account to meet the needs of a patient. As is clear from the basic notions used in the theory, a nursing specialist should be able to provide spiritual and ethical caring that is based on key values such as diversity, justice, and professional integrity. In the theory, a great deal of attention is paid to patient education, taking care of the physical and mental state of a patient, the readiness to respect patients’ cultural values and provide them with an opportunity to express themselves freely if it helps them to recover.

One of the primary values that lie at the basis of the bureaucratic nursing theory is love that encourages nursing specialists to utilize a range of tools that can improve patients’ well-being. Continuing on the topic of bureaucratic caring, it is important to note that the theory highlights the importance of a holistic approach to nursing care. Unlike many theorists who tend to focus on particular aspects of nursing and, therefore, design theories that have a more restricted application, Ray emphasizes that nursing care cannot be analyzed out of context as she believes that this approach is ineffective in terms of patient outcomes. Understanding the great role of the organizational structures of healthcare institutions, the author pays focused attention to the difference that exists between the approaches of various healthcare specialists to work. Even though there are a large number of advanced nursing roles, the ultimate goal of each healthcare specialist is to establish the conditions under which patients will be happier. At the same time, the range of working practices that specialists use to achieve this goal is enormous. The theory of bureaucratic nursing developed by Ray encourages nursing specialists to perceive different approaches to patient care as an entity and always take into consideration global problems that this system has when deciding on the ways to improve the quality of care (Glasser, 2014).

Another theory that is to be analyzed within the frame of the assignment touches upon an essential biological process that causes numerous psychological concerns – aging. The theory of successful aging that was proposed by Flood at the beginning of the twenty-first century can be listed among the theoretical approaches that analyze the impact of aging on all spheres of life (Staples, 2014). Having studied the impact that the process of aging has on physical and mental needs, views of life, and self-image of any patient, the theorist has managed to formulate the key principles of work with older adults. Among these principles, there is the necessity to take into account the perceptions of aging and associated difficulties that patients demonstrate in order to provide a high quality care that would enable senior patients to see their health situation as it is and stop thinking that aging is the worst experience in their life. In other words, nurses should do their best to make patients accept the process of aging and stay self-confident.

Speaking about the link that exists between the chosen theories and the AACN Masters Essentials 2011, it needs to be said that both theories are inextricably connected with the eighth essential that refers to the ability of professional nurses to use client-centered approach to improve the quality of service that their patients get. (American Association of Colleges of Nursing, 2011). As a future advanced practice nurse, I am planning to integrate both theories and the essential into working practice. In particular, I will focus on using an approach to care, involving a thorough analysis of my patients’ situation. Keeping in mind that the spiritual needs of patients are as important as physical ones, I will demonstrate the readiness to discuss any problems of my patients. Importantly, I will do my best to show that the information on my patients’ personal problems will never be used inappropriately. In addition, I will try to make any patient feel that his or her cultural values and age are respected. There are different ways to support patients; sometimes, it is enough to initiate a conversation to discuss similar cases and dispel patients’ worries. Taking care of senior patients who often have a communication deficit, I will try to improve their perceptions of aging, distracting their attention from physiological changes.

In conclusion, the discussed theories and essentials can help to guide a future advanced practice nurse. The key concepts emphasized by the theorists promote the use of a patient-centered approach that ensures a high quality of service. Using theoretical materials mentioned above, I am planning to create my own strategy based on effective nurse-patient communication and a cohesive approach to care.


American Association of Colleges of Nursing. (2011). The essentials of master’s education in nursing. Web.

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Glasser, J. (2014). Continuing competency in nursing practice: Enhanced standards for complex environments. International Journal for Human Caring, 18(2), 71-75.

Johnson, P. V. (2015). Ray’s theory of bureaucratic caring: A conceptual framework for APRN primary care providers and the homebound population. International Journal for Human Caring, 19(2), 41-44.

Staples, J. (2014). Successful aging from the viewpoint of older adults. Research and Theory for Nursing Practice, 28(1), 87.

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