Professionalism in Nursing Study Guide Part 6

General scope of practice for nurses in Kenya  Diagnosing, treating, evaluating and managing acute and chronic illness  Obtaining medical histories and conducting physical examinations  Providing information to include all aspects of sexual and reproductive health  Ensuring infection prevention and control while carrying out nursing procedures  Providing care to patients in emergency setting  Providing prenatal care and family planning  Proving well-child care including screening and immunizations  Counselling and educating patients on healthy behaviors, self-care skills and treatment options  Advocating for patient to obtain optimum health  Developing appropriate health messages for clients in different settings  Utilizing research findings to improve care  Caring for dying patient and care of recently diseased. You will now look at professional nursing which will start with the disciplines of nursing in Kenya. The disciplines of nursing include: • General Nursing • Midwifery • Community Health Nursing • Mental Health and Psychiatric Nursing • Nurse Anesthetist • Ophthalmic Nursing Levels of nursing preparation in Kenya Basic Programs 1.cetificate in nursing In this program, the nurse is prepared at certificate level to provide promotive, preventive, curative, rehabilitative and palliative nursing care to the individual, family and community. she/he functions under the direction of the registered nurse The only certificate nursing program that is currently in place is the Kenya Enrolled Community Health Nursing which is being conducted by government, mission and private institutions. the All these programs are tailored in such a way that there is an integration of general nursing, midwifery, community health nursing, mental health and psychiatric nursing. 2 Basic diplomas in nursing [KRCHN] The nurse is prepared at diploma level in clinical practice, management, clinical teaching, counselling and research. she/he is registered to function at operational and managerial level There are two basic Diploma programs in Kenya: the Kenya Registered Nursing (KRN) and Kenya Registered Community Health Nursing (KRCHN). KRN is being conducted at the Nairobi Hospital and Mater hospital in Nairobi. KRCHN is being conducted by many schools of nursing sponsored by the government, mission and private organizations 3.Post basic diploma: In this program, a nurse has a post basic diploma in a branch of nursing such as midwifery, accident and emergency, pediatrics, community health, critical care, anesthesia, perioperative and neonatal nursing. 4.Diploma in advanced nursing This is a nurse who has gone through a higher diploma program in nursing in a recognized university with more in-depth scientific base including nursing management, community health, teaching and research 5.Bachelor’s degree in nursing [BScN] The nurse is prepared at a degree level as a clinical practitioner, nurse educator, manager, counselor and researcher.is capable f providing leadership in major fields of nursing. He/she is a registered nurse. having been prepared in a program with more depth scientific base The BScN nurse should be in a position to apply critical thinking in solving patients’ problems 6.Master’s degree in nursing Nurse prepared at master’s level with specialization in one field of nursing. this is a nurse specialist who can engage, in advanced nurse practice 7.Doctorate or PhD in nursing This is the highest academic level of preparation of the nurse .it enables him to assume status of academia, research and consultancy. Emerging issues in nursing  Increasing stress related to personal and professional responsibility  Expectations of personal freedom of choice have led to ethical issues related to abortion, right to die, and lifestyle preferences  Political and economic influences on health and healthcare competency and performance-based evaluation are more strengthened to safeguard nurses and employers.  Rapid development of knowledge and information .in speciality of education  Home based care and self care is increasing in popilarityis increasing in popularity  Technology  Nursing advocacy and actions  Looming nursing shortage  Rise of hospice care  1.Factors influencing nursing education globally and locally 2.Adaptations to innovation in nursing practice 3.Emerging issues and trends in nursing. 4.proffessional nurse positive attitudes towards nursing as a profession. Community based /public health nursing Community health nursing, public health nursing and home-based care nursing may be discussed together The idea of community-oriented nursing practice is that nursing intervention can promote wellness, reduce spread of illness and improve the health status of groups of citizens or the community at large Its emphasis is on primary, secondary and tertiary prevention. Nurses in these settings traditionally focused on maternal health and chronic care. Community based nursing occurs in a variety of settings including home settings. These patients usually have identified needs which usually relate to illness, injury or disability. Community based programs and agencies for specific populations e.g., elderly as well as hospices, and independent professional nursing practices provide home health care services .Hospice care is the kind of care that focuses on the quality of life for people and caregivers who are experiencing life limiting illness. With shorter hospital stays and increased use of outpatient care services, nurses have a choice of practicing in a variety of healthcare delivery settings. Community nursing centers are nurse managed and provide primary care such as immunizations, health assessment and screening services, patient and family education and counselling etc. Various agencies provide care at home and in the community to meet needs of patients who are discharged from acute care institutions to their homes still in their recovery process. Many of these patients are elderly, and many have multiple medical and nursing diagnoses and problems e.g., those that require intensive nursing care, ventilatory support, intravenous nutrition and medication etc. As a result, there are many opportunities for employment in the community and home care settings .it requires high -level assessment skills, critical thinking and decision making because, you will be working in a setting where other medical staff are not there to validate observations and decisions In addition, nurses in community-based nursing they are responsible for patient and family teaching and for contacting community resources and coordinating continuing care of patients. Therefore, for these reasons, the scope of practice not only includes the care of patients within a hospital ,but also the care in the home and community. Expanded nursing roles Professional nursing is adapting to meet changing health needs and expectations. the role of the nurse has expanded to improve the distribution of healthcare services and also to decrease the cost of healthcare. Nurses may receive advanced education in different specialties such as family care, oncology, intensive care etc. Where they can get titles such as nurse practitioner, clinical nurse specialist or even advanced practice nurse. Nurses who function in these roles provide direct care to patients through independent practice within a hospital or in collaboration with a physician. Specialization in nursing has evolved in recent years Most states require NP’s and CNS to have a graduate level education where they provide direct healthcare to patients and collaborate with other health professionals In developed states, nurse practitioners have prescriptive authority. they also engage in management, education, consultation and research. With advanced practice roles, professional organizations continue to clearly define the scope of practice for nurses. To give them the authority to perform activities that were previously restricted to the practice of medicine. These functions include diagnosis, treatment and performance of certain invasive procedures and also prescription of medication. The board of nursing in each state stipulates regulations regarding these functions. There is increasing evidence that Nurses have also have engaged in organizational structures to collaboratively make clinical decisions.