Introduction
Patients should be targeted to their specific requirements, not those of the healthcare workers who are providing it. An overhaul of the healthcare sector is necessary to accomplish this. Health care reform will necessitate a significant change in the duties of many health workers, especially nurses. When it comes to health care reform, nurses can play a pivotal role in creating a more patient-friendly atmosphere that is more accessible to those who need it. However, today’s nurses encounter a wide range of social, financial, legal, and ethical issues. Nurses’ jobs and patient outcomes are impacted by the constraints they experience.
Challenges Faced by Nurses
Ethical issues, such as patient confidentiality, are a significant concern for nurses today. Doctors and nurses enjoy a high level of patient confidence because of this trust. This is a duty that nurses have to uphold to defend the patients’ rights. No other professional should know anything about a patient’s medical history unless the patient’s doctor has given permission to do so. Nurses are often put in a difficult situation when they must withhold crucial information from those who would care, yet the patients have told them not to (Albert et al., 2020). Even the patient’s wife, for example, can be told to keep their private information to themselves. This is a possibility, and the patient may be having limited time left. The nurse must deal with this situation since the patients’ rights are crucial and safeguarded.
In addition, nurses encounter an ethical issue in establishing limits with their patient populations. Nurses commit their professions to ensure that patients get the medical support they require, making establishing professional boundaries typically challenging (Albert et al., 2020). Nurse supervisors have the authority to intervene when patients or nurses violate professional and ethical boundaries. While nurses have a high capacity for empathy, it may help them to set ethical limits with clients early in their professions. Furthermore, nurses can profit from surrounding themselves with experienced nurses and skilled nurse supervisors. Nurse leaders can establish learning cultures in which they constantly debate ethical concerns with the caregivers in their departments.
Another concern that nurses are facing right now is compensation. It is a financial concern that nurses across the country face — regional discrepancies in living costs result in regional disparities in compensation. Nurses who work in various parts of the country earn more money than other nurses. For example, nurse practitioners in the Pacific territory earn more than nurses in the mid-Atlantic area (Bisco et al., 2017). Beyond regional differences, the gender pay gap continues to be an issue.
In most cases, male nurses frequently earn more than female nurses. Over the years, the standard of living has risen dramatically. Paying male nurses more than female nurses demonstrates discrimination, which the constitution prohibits. Prior to starting a new job as a nurse, it is essential to negotiate a salary with the company. Nurses should not downplay themselves because subsequent promotions will be dependent on a proportion of the nurse’s starting wage.
Legal issues, such as negligence and malpractice, are also a problem for today’s nurses. Unintentional harm to the patient is a common cause of medical negligence. For instance, negligence can be charged if a nurse delivers the wrong medication to a patient or fail to document the patient’s nursing observations. Procedures performed outside of one’s area of expertise or failure to closely follow a doctor’s patient-monitoring instructions are examples of medical malpractice. To overcome negligence and malpractices, nurses should adequately document all activities done to the patient, including procedures done and a list of medications the patient is receiving.
Institute of Medicine’s 2010 Future of Nursing report Key Message
The Need to Transform Education
Nursing education in the United States must undergo significant revisions in light of the country’s rapidly evolving healthcare delivery system and work setting. The present and future generation of nurses must be prepared to provide safe, high-quality, patient-centered care in all contexts, particularly in primary care and public and social health (Bergren et al., 2021). An education system should provide nurses with the necessary skills to assess and enhance their quality of patient care and safety standards while keeping the essential features of nursing education. Health care delivery systems, quality control, effective care delivery models, and patient risk reduction, need to be taught in nursing education at all levels to prepare nurses for their new roles (Bergren et al., 2021). Constant learning in the nursing field must encompass basic education and residency courses as well as continuing competencies.
There is a critical need for more nurses to acquire comprehensive training in managing complex conditions and coordinating treatment across various healthcare providers. A systems approach, quality management, patient care, and basic knowledge of health policies and research are required competencies for those who wish to work in health care (Bergren et al., 2021). Clinical abilities, administrative competencies, and professional development must be proved at all levels by accreditation and certification organizations, in addition to degree courses and written board tests (Bergren et al., 2021). As students, health care professionals should begin to learn about interprofessional teamwork as early as possible and continue throughout their professions. Committed cooperation across professions is the only way to accomplish an interprofessional education.
Nurses should progress quickly through the educational system to pursue advanced degrees, including doctoral degrees. Nurses with graduate programs will reinforce the nursing schools and add value to the body of knowledge regarding how nurses can deliver current patient safety; engage in health care decision-making, and facilitate leadership skills. Moreover, beyond the facility, nurses provide treatment in the community and schools, expanding access for individuals who are unable or unwilling to visit a hospital.
Institute of Medicine’s Five Core Competencies
Patient-Centered Care
As a whole, patient-focused care covers the ideas, abilities, and attitudes that foster increased patient empowerment, accountability, and prioritizing patients’ overall needs and experiences in shaping healthcare delivery. As part of a patient-centered approach, care is tailored to each patient’s specific needs, and participation is encouraged. Cultural awareness, patient participation, and access to care are essential components of patient-centered healthcare that emphasizes patient encounter (Sherwood et al., 2021). Providing care that is solely oriented on treating an illness and disregarding the patient’s requirements puts patients at a disadvantage in a world where their needs are constantly evolving. Therefore, treatment strategies are becoming increasingly popular, targeting patients’ tastes and views and appreciating their surroundings, including their home, work, and social and cultural background.
Sharing responsibility and control with patients and families can help nurses provide patient-centered care. A continuing discussion with patients should be established to promote mutual trust, appreciation, and cooperation in pursuing similar goals and developing corresponding treatment plans (Sherwood et al., 2021). Furthermore, patients’ loved ones, such as relatives, should be included in the decision-making process and supported as caregivers. Nurses should make them feel comfortable in the care delivery context, and their demands and efforts should be recognized.
Even though patient-centered care has been shown to improve health outcomes for patients, it has also been met with several difficulties. A gold standard for measuring patient-centeredness does not yet exist (Sherwood et al., 2021). It has been difficult to consistently measure the impact of patient-centered care interventions because of a lack of proper, suitable, and reliable tools. Another difficulty has been linked with the definition of terminology relevant to this competency. For effective research to be carried out, more effort needs to be conducted on defining standard terminology and words relating to patient-centered care.
Evidence-Based Practice
Healthcare providers may continually advocate optimal approaches and prevent underuse, misuse, and exploitation with the increased evidence-based practice. According to the concept of evidence-based practice, clinical competence and patient values should be considered when making judgments on personalized patient care (Melnyk et al., 2018). Finding and sharing excellent clinical practice research findings such as journals has made significant progress in recent years. For effective use of research in practice, nurses must identify and access the best available sources of information. Additionally, they should seek relevant facts from the best available sources of evidence, especially those that review or assess the evidence’s validity and relevance for a given patient or population.
While the clinical evidence for medicine is substantial and growing, the scientific basis for nursing is deficient. Nursing interventions are not documented in medical files, which serve as the foundation for the research studies that comprise the evidence base (Melnyk et al., 2018. For instance, critical nursing practice concerns such as patient distress, dehydration, skin damage, lifestyle changes, knowledge gaps, noncompliance with treatments, and coping skills are largely unrecorded clinical institutional data systems.
Nursing experts should advocate for standardizing research and integrating it with other data sources to obtain the best attainable patient outcomes and increase the evidence base through new randomized trials. Organizers at the summit emphasized that concentrating on the core bodies of information and having a shared language and terminology between professions are also critical components of implementing an evidence-based approach in health care. Therefore, hospital librarians must aid clinicians in phrasing clinical inquiries and discovering pertinent material.
Interdisciplinary Teamwork
Multidisciplinary power relates to multiple professions working together to meet patient requirements. The teams are crucial in coordinating and managing multiple patient requirements, keeping up with new technologies, meeting payer demands, and delivering treatment across places (Roberts, 2016). Due to the members’ different academic and professional experiences, teams tend to avoid unnecessary or duplicate services and offer more innovative solutions to complicated challenges. Nonetheless, it has been shown that effective teamwork needs healthcare workers to learn about their co-workers’ competence, background, understanding, and values. The ability to communicate, negotiate, delegate, manage time, and analyze group dynamics are all examples of basic group skills that they should demonstrate. High levels of collaboration and communication are essential to guaranteeing quality, continuity, efficiency, and reliability in healthcare. Finally, health workers need to perceive themselves as a crew that is part of a broader system.
Quality Improvement
The extent to which health care services for people increase the likelihood of intended health outcomes is referred to as quality improvement. Poorly constructed care systems have led to wasteful duplication of services, excessive long waits and delays, and reduced safety and quality of care, culminating in preventable errors and patient injury (Roberts, 2016). The health sector is afflicted by expense and inefficiency, and an intolerable amount of mistakes. Excessive and unnecessary testing are examples of wasteful use of assets. Due to inefficiency, patients wait longer for both procedures and test results. Health care agencies are progressively implementing strategies and procedures derived from total quality management to reduce waste, reduce errors, improve productivity, and eventually enhance care delivery. More precisely, nurses must be educated to discover flaws and risks in care and comprehend and apply basic safety design guidelines such as quality control.
Utilization of Informatics
Numerous benefits of informatics have been attributed to its application to administrative activities, the proliferation of health-related data available to consumers, and increased ease of access to research services for scholars and patients alike. Information technology will improve the efficiency with which health care providers can do four critical tasks: eliminate errors, manage information and expertise, make choices, and communicate (Roberts, 2016). Nurses can enjoy informatics services through word processing, description, and data interpretation software. However, before the general use of informatics, several legal and regulatory difficulties must be addressed. Rules regarding the use of e-mail with clients are intended to ensure the confidentiality and privacy of patient health records. Compliance with such requirements, primarily for healthcare practitioners, requires education and training of future and present health professionals on technologies that secure access to provider-patient interactions.
Conclusion
Nurses today face significant challenges ranging from social, financial, legal, and ethical problems. Problem-solving abilities are critical in nursing, as nurses spend most of their time with clients and are frequently responsible for most care decisions. Furthermore, nurses should boost their degree of education since it gives them the required ability to analyze and improve patient care and safety requirements. Interdisciplinary teamwork, patient-centered care, evidence-based practice, quality improvement, and utilization of informatics are all elements that nurses should incorporate to enhance quality care to the patients.
References
Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students’ ethical dilemmas regarding patient care: An integrative review. Nurse Education Today, 88, 1-8. Web.
Bisco, J. M., Cole, C., & Karl, J. B. (2017). The effect of government-run healthcare on the salaries of nursing professionals in the US. Journal of Insurance Issues, 40(2), 215-246. Web.
Bergren, M. D., & Maughan, E. D. (2021). The future of nursing 2020–2030: School nursing research. The Journal of School Nursing, 37(5), 321–322. Web.
Sherwood, G., & Barnsteiner, J. (2021). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.
Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The first US study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence‐Based Nursing, 15(1), 16-25. Web.
Roberts, B. (2016). Relationship-based care: The Institute of Medicine’s core competencies in action. Creative Nursing, 22(2), 92-96. Web.