Nursing: Today And Beyond
Nurses play a central role in medical institutions across the globe. Other than providing therapeutic services to patients, nurses fit in the leadership positions in hospitals. Initially, nursing began as a home-based activity where people offered car services to patients. Such people comprised of women that took care of the sick family members at home before the 1800s. Eventually, Florence Nightingale developed new approaches that could extend care services beyond the home. Some of the previous authorities, such as the British government, helped in strengthening nursing, especially during the period of the Crimean War. A few people volunteered to provide first aid services to the soldiers at their respective units. The new care approaches that Nightingale fashioned led to professional nursing that is carried out. Today, nurses across the globe have bodies that govern them. Some of those bodies include the American Nurses Association that looks at the affairs, recruitment, remuneration and other matters that pertain nurses. Hence, this paper has analytically outlined factors like challenges, concepts of the Institute of Medicine (IOM), and finally, the competencies of the IOM.
Challenges nurses face today in care delivery and ways to overcome them. (Can be ethical, legal, financial, or social).
The first challenge that nurses experience in care delivery regards compensation. Nurses are compensated differently based on the working environment and the region of work. Statistics from the Association of the perioperative Registered Nurses depicts that the nature of the U.S. nurses vary per the regions and states where they work. Compensation is a challenge in this profession since some health workers are given little reparations as compare to professionals in other states. A variance in benefits in nursing is likely to lower the working moral. Today, Nurses that accomplish their therapeutic duties in the East South Central region earn $4,300 below the average wage of nurses (National Academies of Sciences, Engineering, and Medicine, 2016). The situation is devastating because nurses in the Mid-Atlantic districts earn $14,800 more than the typical wage that they are paid. Variations in wage and compensation rates lead to complaints as nurses receive the same training in various medical institutions. Secondly, the idea of workplace violence poses challenges in a nursing career. Violence is seen by other nurses, leaders, or patients. The period of 2012 and 2014 recorded more cases of workplace violence in the U.S. (National Academies of Sciences, Engineering, and Medicine, 2016). Nursing was the most affected career as these cases had doubled those of other occupations. Out of the 14 American states, there were more than 12 health units that reported instances of workplace violence among the nurses. According to the research of the Occupational Safety and Health Administration (2015), the total workplace violence was between January 1st 2012 and September 30th 2014, in the 14 American states were 10,680.
Third, nurses are faced with a staffing dilemma. A dramatic shortage in staffing in recent years has posed personal and professional uncertainty in nursing. The problem of staffing is among the key reasons that trigger nurses to quit a healthcare facility or the job. This is because fewer nurses that are available in a medical facility are exposed to more workloads, a situation that causes frequent exhaustion or post-traumatic stress disorders. American Bureau of Labor Statistics approximates a shortage of more than 1 million R.N. by 2022 (Rollins, 2016). Also, fewer nurses in the U.S. hospitals deny these health specialists an opportunity to offer the care they believe is vital for patients and their respective households. Finally, nurses are exposed to long working hours in numerous health units. Health professionals are usually necessitated to work on prolonged shifts or what they regard as “back-to-back shifts.” Exposure of nursing to longer working hours can cause more medical risks that are harmful to patients and nurses. Here, Rollins (2016) states that exhaustion that is caused by long working hors can result in inappropriate medication, untimely injection, more burnouts, or failure to attend to patients. Any work that is done for more than eight hours is strenuous and can cause adverse impacts in an organization.
While looking at the predicament of low compensation among the nurses, it is necessary for the U.S. Labor of Bureau Statistics to formulate an average wage and benefit that nurses ought to get. Since some private health organizations might take advantage of vulnerable nurses, it is vital to implement ad monitor the wage regulations in all the American states. Also, the challenge of workplace violence can be tackled by ratifying stringent rules against the perpetrators. This includes fining or terminating the contract of those that partake in gross misconduct at work. For the case of patients, it is vital to inform them about the institutional policies before the process of hospitalization is done (National Academies of Sciences, Engineering, and Medicine, 2016). Carolina has taken a standpoint against workplace violence among nurses. Other states like Massachusetts are in the process of enacting the bill into practice. The issue of shortage of registered nurses can be solved by hiring more health workers in all the U.S. states. At some point, it is vital to lower the entry points for a nursing career so that many people can enrol and specialize in this course. More hiring will ultimately solve the pandemic of long working hours among healthcare specialists.
Explanation of one message in the Institute of Medicine’s 2010 Future of Nursing report and why it is essential to the nursing profession.
The 2010 IOM report has a significant impact at a personal, institutional, and also policy levels. The 2010 groundbreaking report by IOM on the “Future of Nursing” targeted at enhancing the care as well as outcomes of all the ethnic groups in the country. Therefore, the critical message that is outlined in this analysis is: “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (Institute of Medicine, 2015). It is the second message that is outlined in the 2010 IOM report. Based on this message, the nursing career is improving in terms of competencies, performance, and technology. This is because nurses are attending to patients that have complex ailments that require both theoretical and techno-how prowess. Having a complex structure in nursing necessitates one to have acquired a properly structured education that can meet the emerging demands of the medical institutions. Based on the given report, the programs that are vital for an active nursing career includes the RN-BSN or MSN related programs.
Still, this message stipulated vital recommendations that are associated with nursing and their academic qualifications. One of those recommendations is that the U.S. health facilities should have more nurses with bachelors of Science in Nursing (BSN). The approximate figure in this massage is 80%, and this needs to be more than that of nurses with doctorates (Samur & Intepeler, 2019). The other recommendation that is evident in the message entails a structuring a competency-based schooling system that is grounded on collaboration and teamwork. Having health care professionals that have diversity skills is vital as it enhances inclusivity in care delivery. Here, inclusivity entails employing nurses that are of different gender and ethnic groups into the nursing career. As a way of strengthening inclusivity, the message on educating more nurses set up more educational gateway for the health officers that had graduated from a non-BSN R.N. plan and eventually hired on a non-RN program (Institute of Medicine, 2015). Nurses that are hired on a non-RN project must enrol for BSN within their first five years of employment to be fully qualified.
Much of the discussion in the message is also put on the entry-level among the health officers. Here, nurses must fulfil all the required qualifications to become one of the healthcare specialists. Therefore, emphasis on meritocracy is vital as it ensures that qualified professionals attend patients. For example, the American Nursing Association and other bodies that advocate for the plight of nurses have agreed on BSN as an entry-level for the healthcare providers in the country (Rollins, 2016). The skills needed ere are vital as they make an individual go past the traditional curriculum and was less involving. Also, more training among the nurses is vital as it increases competencies of caregivers. Based on the message in this analysis, agreeing on BSN as a primary entry-level was agreed to become effective in 2016.
Explain each of the Institute of Medicine’s five core competencies and describe ways in which nursing practice can meet each of these. Identify at least one obstacle for each and explain in detail how it can be overcome.
IOM has five key competencies that are known among the health officers. One of those competencies entails offering patient-centered care services to those that seek medical services. During the provision of patient-centered care, nurses ought to deliver quality care, identify, respect, and also establish needs, differences, and values of all patients. The reason is that patients have varied values and beliefs that cannot apply to others. In this case, nurses meet the competency of patient-centeredness through their collaboration with the families, clients, and other health officers that know the needs of patients (Occupational Safety and Health Administration, 2015). Still, nurses make frequent communication with these groups to adhere to this competency. Having a mutual relation between nurses and patients helps in the provision of an effective continuum care. Nonetheless, the competency of client-centeredness is faced with a problem of enhancing effective communication. This is because not all patients can communicate properly due to the varied cultural backgrounds and communication disabilities that they experience (Samur & Intepeler, 2019). The competency can be curbed when health officers incorporate interpretive devices in a healthcare setting. Communication devices will help nurses identify the phonologies that are used by various patients since their languages are translated to a common dialect.
Also, IOM has outlined accomplishing duties as an interdisciplinary team as a second competency in nursing. Since provision of healthcare needs a collaborative approach, there is a necessity to work as a team to offer the best services. Nurses can work as a team if there are proper structures that are initiated to govern employees. Although working guidelines are vital in an institution, the same rules should not interfere with the normal working environment of nurses. Working as an interdisciplinary team can be attained through the provision of continuum education and training among the nurses. Training will offer nurses with skills that are needed to work as a team (Samur & Intepeler, 2019). However, an interdisciplinary team is faced with the dynamic of having varied viewpoints in healthcare. This dilemma can be handled by advocating for oneness and corporation among the nursing interdisciplinary teams.
Third, it is vital to use evidence-based practice in a nursing setting. This approach is vital in handling the ever-growing nursing demands. Here, expansive knowledge is needed to solve the existing dynamics. Availability of evidence-based practice (EBP) is needed to introduce new skills to nurses. This can be achieved by restructuring the nursing fraternity as a whole. The introduction of EBP is devastating to some nurse since they view it as an devastating activity as they do not readily adapt to changes (Rollins, 2016). Before the EBP is introduced, it is vital to identify the abilities of nurses and how they can adapt to the new structures.
Fourth, IOM advocates for the application of quality improvement in nursing. Quality improvement allow nurses to recognize errors that happen during their role accomplishment. Here, quality care is given to the patients when this competency is applied in nursing. Still, this competency targets at rejuvenating nurses after post-hospitalization. Quality improvement is achieved by acquiring nursing skills through surveys that deals with quality care (Occupational Safety and Health Administration, 2015). The problem of this competency is lack of enough resources that can enhance proper care. The competency can be solved through equitable distribution of care resources to hospitals.
Utilization of the nursing informatics is the final competency that is outlined by IOM. Informatics in healthcare is achieved through the use of improved technology. Proper technology helps in solving dilemmas that face patients (Institute of Medicine, 2015). Still, this type of informatics helps to find the outcome of patients, analyze health trends, and also evaluate existing health interventions. This competency is faced with a problem of limited skills among the nurses. Some nurses are not acquainted with the technological knowledge, hence making it tough to work properly. The solution to this competency is by training workers, especially nurses on the use of technology.
Conclusion
Overall, nurses re attempting to curb numerous challenges that they face using multiple means. Such means are incorporating the IOM 2010 nursing competencies. Still, it is vital to adhere to the IOM messages that were outlined to help in nursing career. Seamless working in care units is vital as the process helps in enhancing care services.
References
Institute of Medicine (2015). Health professions education: A bridge to quality. Washington, DC: National Academies Press.
National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. National Academies Press.
Occupational Safety and Health Administration. (2015). Workplace violence in healthcare: understanding the challenge. Occupational Safety and Health Administration.
Rollins, J. A. (2016). Assessing Progress on ‘The Future of Nursing’. Pediatric Nursing, 42(1), 6-35.
Samur, M., & Seren Intepeler, S. (2019). Nurses’ view of their work environment, health and safety: A qualitative study. Journal of nursing management, 27(7), 1400-1408.