Professional Roles and Values

2 C304: Task 1 A. Nursing Theory There are many nursing theories that have influenced my practice but one that I reflect on the most would be Jean Watson’s Theory of Human Caring. I feel that that I align with this theory because it shifts the focus from solely completing tasks to caring for the patient’s physical, mental, and emotional needs as a whole. Cherry and Jacob (2019) state that the expectation is that the client will experience balance and harmony in mind, body, and soul (pg 85). I use this in my own professional practice by focusing on all needs, stated and nonverbal of my patients. This holistic approach is critical to positive patient outcomes. B. Contributions of Historical Nursing Figures The two historical figures that I will discuss are. They are described by Cherry and Jacob (2019) on page 9. The first nurse I will discuss is Sojourner Truth. She was a nurse during the American Civil War and was observant of the sanitary conditions of her patients. Sojourner recognized the importance of cleanliness for her patients to heal. The second nurse that I will discuss is Lillian Wald. Her primary focus was on public health and disease prevention. I find practices that Truth and Ward both implemented in their practices still present in my own. I practice Truth’s focus on cleanliness and sanitation by keeping my work area and the patient’s room neat and tidy with no excess supplies out and bedside table always cleared of waste. I practice Ward’ focus on public health by vaccinating my patients prior to discharge. I also assist in occupational health at my facility by administering COVID-19 vaccines to staff and the public, as well. 3 C. State Board of Nursing The State Board of Nursing and the American Nurses Association (ANA) both benefit nurses, though their functions are very different. A state’s board of nursing sets parameters and scope of practice for medical workers. A state board is more like a governing or ruling body. The American Nurses Association a national organization, rather than a state organization. ANA contributes to more education and research for nurses. It also aids in nursing licensure standards (Cherry and Jacob, 2019, pg. 65). These two entities influence my nursing practice daily. Both are wonderful sources of data, ANA regarding research and evidence-based practice and a bord of nursing regarding my scope of practice as a registered nurse. As a resident of Indiana, I live in a state that is part of the NLC. The requirements for compart licensure are stated on Final Rules found on NCSBN website. They are as follows: the nurse’s name, jurisdiction of licensure, license expiration date, licensure classification, license number and status, public emergency and final disciplinary actions, as defined by the contributing state authority, a change in the status of a disciplinary action or licensure encumbrance, status of multistate licensure privileges, current participation by the nurse in an alternative program, information that is required to be expunged by the laws of a party state, the applicant or nurse’s United States social security number, current significant investigative information, and a correction to a licensee’s data. This list of requirements is substantially longer than that of Illinois, where I was previously licensed. Illinois is not part of the nursing licensure compact and only require the applicant’s basic information and previous licensure information. Failure to maintain licensure in my practicing state would result a lapse in my license and inability to practice nursing. 4 D. FDA and Center for Medicare and Medicaid Services In this section, I will discuss the functional differences between the Food and Drug Administration and the Center for Medicare and Medicaid Services. The FDA Mission statement describes their function as being “responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation”. (fda.org, 2018) They refer repeatedly to national safety and the safety of all in relation to products that we consume or what is around us. The Center for Medicare and Medicaid Services focus more directly on the patient and their care. They are concerned more with health care costs and how they are covered. The FDA and CMS influence my nursing practice in two completely different ways. I notice the FDA affecting my practice primarily in medication. FDA is always trialing and approving new drugs for different disease processes. The also control safe medication handling and disposal. I do not notice the functions of CMS as frequently as the FDA. I am aware of other departments such as social work and case management working more closely with this entity. I have delt with CMS in cases involving patient placement to skilled nursing facilities and rehabilitation facilities My primary role for each patient that I care for is that of their advocate. I am responsible for their health but also their safety and wellbeing. If a patient requests alternative therapies, advocates should speak up for the patient and their wishes. Advocates should always make sure that providers are aware of patient’s alternative request. E. Nurse Practice Act According to Cherry and Jacob (2019), a nurse practice act is comprised of statements that refer to protecting the health and safety of the citizens in the jurisdiction and it describes the qualifications and responsibilities of those individuals covered by the regulations (pg 66). I 5 reside in the state of Indian. Our nurse practice act is similar as to what is described above and can be found through the NCSBN website. The Indiana General Assembly spells out the roles and scope of practice of each type of nurse in the state of Indiana. It also discusses tasks appropriate to delegate. For example, as a registered nurse I can complete tasks including assessments and create nursing diagnoses. According to the Indiana General Assembly, registered nurses can “delegate tasks which assist in implementing the nursing, medical, or dental regimen; or perform acts which are approved by the board or by the board in collaboration with the medical licensing board of Indiana”. My role differs from that of an advanced practice registered nurses in a few ways including the writing of scripts under an authorizing provider. (Indiana General Assembly) F. Nursing Roles As a nurse I feel that we wear many different hats. I can see myself in each role listed. Nurses act as scientists by using evidence-based practice in our daily practice. We use research and statistic based on patient outcomes to improve overall care. Nurses act as detectives by assessing patients and collecting data to relay to providers and other staff. We can piece together this data and put together the “puzzle” or diagnosis. Nurses act as a manager of the healing environment by planning the patient’s day that is individualized to each patient. As the primary nurse, I schedule my treatments and medications around when the patient will be off the unit. For example, I manage my patient’s care by holding all medications prior to hemodialysis as they will all be dialyzed off and have no effect on my patient. I administer them after the treatment is complete. I can also manage the environment by performing tasks that facilitate communication like muting the patient’s television while asking admission questions, educating the patient or their family on new medications and their effects, or preforming my assessment. 6 G. American Nurses Association The two provisions that I will discuss are found in the code of ethics. They are stated by Cherry and Jacob (2019) as follows: “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care." (pg 163) These influence my nursing practice daily by reminding me that my duty is first to the patient and their safety. The decisions that I make through critical thinking directly influence the patient and their outcomes. A nursing error that I will discuss is a medication error. This could occur in any area including the clinical setting, skills lab, or simulation if the proper steps are not followed by the nurse or student nurse. We are taught in nursing school about the six rights of medication administration and the three checks done prior to administration. These six rights include right patient, right medication, right dose, right time, right route, and right documentation. These steps are in place to ensure patient safety. The two provisions that I chose directly correlate with patient safety. They state that the nurse must advocate for the rights and health of the patient. The administration of a medication violating any of the rights listed above could put the patient’s safety or even life in jeopardy. It is personally important to mention that nurses must act as well. Not only should we monitor ourselves when administering medications, but we should also be conscious of those around us and the decisions they are making. I am not only responsible for the patients under my direct care, but all the patients around me and their wellbeing. 7 H. Leadership Four leadership qualities that I feel are important aspects of nursing are being a team player, contributing to a health work environment, knowing one’s strengths and weaknesses, and being respectful to myself and my team. Firstly, I will touch on being a team player I feel that this is vital at the bedside. My most recent evaluation from management stated that “Jayci is always willing to lend a helping hand”. This is also important regarding the interdisciplinary team. For example, there are a few therapy staff members that are always available to jump in and assist with a difficult transfer even if the patient is not on their treatment list. I feel that it is important to help your coworkers because they will also be there for you when in a pinch. I am a member of my unit’s healthy work environment committee. We organize things such as unit outings or food and sock drives for local missions. Healthy work environment is important to the nursing team because it assists with team building and unit morale. Another leadership quality that I feel is important is knowing your strengths and weakness. This not only benefits my coworkers but also the patients under my care. If there is a skill that I feel unfamiliar with, I know that I have coworkers to turn to and ask for assistance. This is an important aspect of management and team leaders because it can make evaluations more efficient and meaningful. Lastly, being respectful of your team members is another important leadership quality. The way in which one staff member speaks to another can set the tone for their whole day and even relationship. This quality is important to the interdisciplinary team because we are exchanging ideas and solutions to aid in patient outcomes. Respectful conversations between team members can still relay issues and statements but in a better way. 8 Work Environment I feel that my work environment directly correlates with how my day will flow. If my unit is very hectic, with multiple heart catheterization scheduled for example, I know that my day is going to be very fast paced and busy. This directly effects my decision making as I am making decisions regarding patient planning and tasks related to the schedule and pace of the day. Thankfully, my nursing leadership is also directly affected. Fast paced days feel like all hands are on deck. Other nurses are quick to step in and step up to our challenging cases. Our team leaders and management are very present of hectic days. They are by your side when faced with a critical patient. This positively effects my professional development as they are amazing role models in these situations.