The nursing profession and practice have undergone an evolution since become a vital part of care delivery in the late 19th century. Theories have helped shape nursing practice into a discipline that is flexible and adaptable to serve any role within the healthcare system. Nurses serve numerous roles and are recognized as the backbone of the industry. The approach and attitudes of nurses have developed to ensure the optimal practices are implemented which lead to positive patient outcomes.
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Evolution of Nursing Practice
The scope of nursing practice has evolved along with the population’s healthcare needs and the availability of knowledge about correct approaches to treatment. While first nurses served as helping hands, modern nurses are required to be highly educated, maintaining up-to-date qualifications, and critical thinkers which enable them to perform and participate in complex clinical treatments. The evolution took time, requiring a change in both education curriculums and attitudes.
The evolution of medical technology has contributed to the growth of nursing practice as it eliminates certain barriers such as paternalism and provides an opportunity for approaches to care such as long-distance telemedicine. Nurses are expanding into the community as health ambassadors and more roles are available outside acute hospital settings (Johnson, 2015). Meanwhile, care delivery has shifted to becoming more service-centered in considering the needs of the patient and communicating with them. If before, patients simply received medical care, current practice guidelines enable nurses to involve patients and their families in the care and decision-making processes.
Associate degrees in nursing (ADN) and a Bachelor of Science in Nursing (BSN) maintain vital differences in terms of practice competencies. Individuals with either degree are able to be licensed and practice as a registered nurse after graduation and completing the NCLEX exam. Both perform standard nursing duties such as essential care, a collection of medical history, physical examinations, and patient education.
However, a BSN is often considered more qualified and competent by nursing leaders and physicians due to the more advanced education. A BSN offers the opportunity for more complex procedures, leadership roles, and often higher pay. It is also required to progress from a registered nurse into roles such as nurse educator, public health, and other specialties which require at least a BSN, and a master’s degree which cannot be obtained without a BSN. AND nurses are more technical nursing roles, limited to repetitive and routine situations in bedside care that limited the scope of skilled techniques and decision-making. BSN standards are stricter, requiring more clinical hours and expertise, creating more competent professionals (Matthias, 2015).
A standard care situation may consist of a patient admitted into the emergency room with a complaint about pains in the chest. The role of the ADN would be to approach the patient and conduct the first contact by collecting essential information and the complaint, assessing the severity of the condition. An ADN nurse may measure vital signs and begin basic emergency room procedures. Collection of medical history and communication with the patient can also be included in the responsibilities.
ADN nurses can administer medicine under the supervision of a BSN nurse. Furthermore, they can monitor the patient, keep the chart updated, and discharge the patient. Meanwhile, a BSN nurse has the capabilities to do all the above and begin the process of treatment. BSN nurses can decide to run diagnostic tests if necessary. BSN nurses will often double-check patient assessments and possess enhanced decision-making and more competence in complex situations. A BSN nurse has increased responsibility in providing treatment and medication to an emergency room patient without the presence of a physician.
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Evidence-based practice has been the core concept of nursing practice and evolution in recent years. It helps to develop guidelines and procedures that ensure that decision-making and treatments achieve optimal results in patient care and outcomes. It eliminates uncertainty, promotes high quality in the healthcare market dynamic, and prevents errors (which is an ethics issue). Evidence-based practice helps to achieve both industry and regulatory standards for quality of care. A BSN-RN degree ultimately aids to transition and integrate research into practice. BSN programs prepare nurses for competent research methods and the ability to evaluate information.
As the nursing role becomes complex with more technology and responsibilities, national nursing organizations have set goals of upward of 80% of nurses achieving a BSN by 2020 (University of North Florida, 2016). This is done to ensure the general competency of the field as advanced education translates into the ability to research, synthesize, and integrate information into practice in professional, competent, and ethical methods.
Modern healthcare requires collaboration within interdisciplinary teams. Efficient and timely communication is vital to achieving a high quality of health care. Positive interdisciplinary communication is linked to increased job satisfaction. Registered nurses must work with frontline staff, therapists, assistants, social workers, physicians, and specialists amongst others. Interdisciplinary team approaches help improve patient care by increasing standards, gathering various perspectives on treatment, and maintaining a safe hospital environment.
Interdisciplinary teams are linked to a number of positive patient outcomes such as reduced falls and improved treatment rates. Interdisciplinary communication for nurses can occur during specially structured communications such as interdisciplinary bedside rounds (SIBR) or exchange of information via standard charts or patient records (Gausvik, Lautar, Miller, Pallerla, & Schlaudecker, 2015).
The nursing profession has evolved significantly over time, growing to encompass the demands of the healthcare system and patient needs. Nurses are becoming highly qualified and trained professionals able to perform various medical interventions. The education level is significant with ADN nurses only performing basic and routine tasks, BSN nurses are inherently able and tasked with more complex duties inpatient care. The process of healthcare is an interdisciplinary process requiring communication and competency.
Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare, 8, 33-7. Web.
Johnson, S. (2015). How has nursing changed and what does the future hold? The Guardian. Web.
Matthias, A. D. (2015). Making the case for differentiation of registered nurse practice: Historical perspectives meet contemporary efforts. Journal of Nursing Education and Practice, 5(4), 108-114. Web.
University of North Florida. (2016). The importance of evidence-based practice in nursing. Web.