The challenges facing nurses during care delivery.
INTRODUCTION
Several qualities and challenges characterize the nursing profession. The organizations that lead such a profession to ensure that working conditions and work ethics are maintained to create an efficient team in the medical industry. By ensuring that nurses are contented with their jobs and that they work as per the provided work ethics, the satisfaction of both the nurses and the society is likely assured.
The challenges facing nurses during care delivery.
Nursing is one of the high-pressure jobs in the health care sector. Nurses are faced with a lot of responsibilities that they have to fulfill in their line of duty—for instance, helping patients, acting as advocates, updating paperwork, and aiding in the procedures. Nurses are faced with some challenges day in day out. Three significant challenges that nurses are facing today include; work violence, long working hours, and job hazards.
- Workplace Violence
Nurses face bullying and harassment at their workplace from patients and colleagues. The Medscape medical news poll showed that approximately 71 percent of nurses confirmed to have been harassed by patients. In contrast, a survey by the RNnetwork, an employment agency, showed that their colleagues had harassed roughly 45 percent of nurses. Harassment was defined as either patient pestering, persistent attempts at communication, social media stalking or verbal harassment, and bullying by colleagues.
Therefore, healthcare institutions should take up measures to ensure staff safety at work. Health organizations should also put in place policies such as screening for weapons and firearms, lockdown procedures, adequate security, and training medical staff on ways to keep themselves safe to ensure staff safety.
- Long working hours
Nurses also experience long working hours that are characterized by fatigue and possible medical errors. These nurses often come to work after a short nap and work when called in no matter the hour. With such work habits, these nurses sometimes come to their cognitive decline due to fatigue and stress from work, thus, affecting their productivity at work.
Therefore, organizations should ensure that they employ sufficient nurses that could be enough even during crisis and busy days. By hiring enough nurses, the organization can arrange for shift changes for the nurses so that they can have sufficient rest to be able to work efficiently (Kelly, 2018). Changing work shifts for nurses improves morale, and helps them to work as they are well rested for the job.
- Job hazard
Nurses also experience various job hazards that include sharp needle and razor injuries, bloodborne viruses, cold and flu germs, slippery hospital floor, and airborne viruses (Erica, 2017). These conditions put the nurse’s health at risk and their families as well as these airborne infections are prone to affecting more people due to contact with an infected person.
Health organizations must put staff health as their priority. Providing staff with sufficient and safe working equipment, regular health checkups, and training to help during surgery situations would go a long way in ensuring that nurses are reliable and contended with their working conditions.
Key messages from the IOM’s future of nursing report.
In this report made in 2010, the committee made four key messages that would help transform the nursing profession in three crucial fields of practice, education, and leadership. These key messages include; nurses should practice to the full extent of their education and training, nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression, nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States and that effective workforce planning and policymaking require better data collection and improved information infrastructure. The discussion below will dwell on the second key message, which is the transformation of the nursing profession through education.
Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Ideally, nurses choose to advance their education to improve their living standards in terms of career development, knowledge, and suitability of their job conditions. Nurses who develop their career aim at attaining better jobs, good salaries, vast expertise in their field of profession, career advancement, and better working conditions.
On the other hand, the US has registered an enormous number of students who are qualified for studying for nursing but are rejected each year because of the limited resources in the nursing faculties in schools. There has been a high interest in the field of nursing over the past years. Thus, the committee found it reasonable to address the issue of quality education for nurses. Nursing schools must provide quality education for healthcare givers as they play an essential role in ensuring that the health of patients is well taken care of. With the high rise in research and technology, more advanced techniques have been introduced into the education system, making it different from the nursing techniques used in the early years of caregiving training.
With the above under consideration, the committee pointed out that the nursing education system should provide nurses with essential basic elements of nursing education such as ethics, integrity, and holistic, compassionate patient care knowledge to help nurses perform effectively in their job. With the dynamic change in technology, science, and population constitution, the education system should be able to produce nurses that can adapt to these changes effectively and ensuring effective care delivery. The profession should ensure there are continuous and progressive learning and training of nurses to be able to provide these nurses with primary education, residency programs, and continued competencies in their field. Training should happen across the nursing profession; for those at the entry-level and those who are already old in the job.
Nurses who advance their education should have a more profound understanding of the areas of care delivery, quality improvement, reducing patient risk, care management, and advancement in authority and responsibility. Nurses must keep getting the training, which will aid them in doing their jobs better; this will also mean that they can deliver well and improve the quality of healthcare. Also, there must be interprofessional training of physicians, nurses, and other healthcare providers from when they are students and throughout their careers to enable them to work together efficiently without conflict of interest and authority. Organizations that accredit and certify nursing professionals should ensure that there is a complete demonstration of mastery of healthcare skills, management capabilities, and professional advancements in all levels of education to supplement the written board examinations and accomplishment of degree programs.
By enabling an improved system of education in the nursing profession, nurses can work well with other jobs in patient care delivery, adapt to changes in science and technology, and advance their knowledge in healthcare providence. Progressive learning helps nurses develop effortlessly to higher education levels; thus, they can refill the nursing department. An advancement in nursing provides knowledge on the providence of safe patient care, provide leadership skills relevant in their field, engage in healthcare decision-making procedures, and provide conversant services with ease (IOM, 2011).
Five core competencies in nursing.
The Institute of Medicine, 2001, came up with guidelines with which medical professionals should carry out their clinical tasks. These competencies engage all clinicians, irrespective of their discipline, and include; providing patient-centered care, employing evidence-based practice, working in interdisciplinary teams, applying quality improvement, and utilizing informatics.
- Providing patient-centered care
Patient-centered care involves recognizing and respecting the patient’s differences in terms of values, preferences, and articulated needs. A health care provider should help the patient relieve ache and anguish, provide regular care, listen to the patient’s needs, provide information to the patient, and improve the patient in decision making. It is the duty of a medical practitioner to promote illness prevention, fitness regardless of the population constitution. Nurses should ensure that they care for patients without favoring them based on their differences. A nurse provides patient-centered care by providing timely and effective medication as prescribed and continues taking care of the patient. It is crucial that the nurse listens to the patient’s needs and attends to them. By providing advice to patients and educating them regarding their conditions, patients can make the right decisions regarding their health.
However, some patients become abusive to nurses due to various reasons. Such harassment lowers the morale of the nurse, thus, affecting their work concerning these particular patients. Health institutions should provide nurses with training on how to deal with such situations. Such training helps nurses deal with bullying patients, and they can provide satisfying care to these patients.
- Working in interdisciplinary teams.
An interdisciplinary team consists of members from various professions who have diverse and focussed knowledge, skills, and techniques. The team members assimilate their observations, concepts of expertise, and scopes of decision making to organize, cooperate, and communicate with each other to improve care for a patient. These teams can reduce redundancy in services as each expert incorporates their efforts to ensure that patients are well taken care of. Nurses working in such groups can learn new concepts in the field of medicine, ensure timely and accurate communication of information, and provide efficient care services for patients. Nurses can give patients guided information with the help of other experts.
However, interdisciplinary teams are faced with constant conflicts that arise due to the difference in knowledge and values. Some experts may have a conflict of interest and authority, which may affect the delivery of care to patients. In this case, the team needs to find a mechanism under which disputes will be resolved to ensure that such conflicts do not affect the performance of the group. By resolving disputes, members can work in unison again and avoid interpersonal conflicts.
- Employing evidence-based practice.
The concept of evidence-based practice refers to the combination of productive research evidence, expertise, and patient’s values and customs in making decisions about the care of a particular patient. Evidence-based practice enables clinicians to determine where to find information, how to deal with the data obtained concerning the delivery of care to the patient, and to learn how and when to incorporate these findings into the clinical practice. With relevant evidence and information, clinicians can best care for the patient. Nurses who implement this practice are more likely to advance their knowledge as well as help the patient understand their illness, its effects on them and the society, how to prevent and cure it and make informed decisions about their health.
However, sometimes, the evidence-based practice may be time-consuming for nurses who have busy scheduled. Such nurses are not able to get informed evidence of the medical questions posed to them; thus, they end up giving general knowledge that is not efficient in the decision-making process. Health centers and clinicians must be in contact with clinical librarians who will help them find sufficient evidence to base their reports on; thus, saving time and solving the problem all at once.
- Applying quality improvement
According to the Institute of Medicine, quality improvement is the “degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Institute of Medicine, 1990). Quality may be improved in healthcare by assessing existing practices in comparison to the traditions from other places. Thus, to identify the best way to deal with patients, planning and testing new methods relevant to the care of patients to best improve quality of service, progressively identifying and correcting errors in the care of patients and incorporating other disciplines in the management of patients’ care. Nurses should be able to integrate other clinicians to learn new ways of taking care of patients and improve their knowledge and skillset.
However, lack of support and leadership may significantly hinder the improvement of services offered by nurses. Nurses need help from management to implement changes that would effectively improve the quality of care given to patients. The management of health centers should provide room for nurses to implement change that will help improve the delivery of services to patients.
- Utilizing informatics
Healthcare informatics is the information technology under which health care services are based. This information helps in financial and administrative systems, record entry and retrieval, decision support systems, and in emails. The committee realized that informatics would help in reducing errors, the management of knowledge and information, decision making, and communications. Nurses may implement informatics when recording and retrieving medical reports of patients, prescription decisions, sending reports to other relevant physicians and patients, and managing health records. Informatics may also be used to develop new practices based on past information researched to provide excellent services.
However, some informatics may be regulated to support confidentiality. Thus, breach of such regulations may lead to the invalidation of one’s license of nursing. One must familiarize himself with the Health Insurance Portability and Accountability Act to achieve compliance with such standards regarding patients’ records (Greiner and Knebel, 2003).
Conclusion
Challenges in the nursing discipline must be dealt with to create ethical working standards for nurses. Dealing with nursing challenges, improving the education system of nursing, and creating competent nursing professionals has been the most crucial duty of the Institute of Medicine; thus, ensuring that all issues regarding the field of medicine have been addressed to create a productive industry.
References
Kelly Gooch, Becker’s Hospital Review.5 of the most significant issues nurses face today, June 15, 2018. Retrieved from https://www.beckershospitalreview.com/workforce/5-of-the-biggest-issues-nurses-face-todayjune15.html
Erica Bettencourt, DiversityNursing blog. 5 problems nurses face today, September 19, 2017. Retrieved from http://blog.diversitynursing.com/blog/5-problems-nurses-face-today
Institute of Medicine, 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press, 29-32.
Institute of Medicine. 1990. Medicare: A Strategy for Quality Assurance: Executive Summary IOM Committee to Design a Strategy for Quality Review and Assurance in Medicare. Washington: National Academy Press.
Institute of Medicine (US) Committee on the Health Professions Education Summit; Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US); 2003. Chapter 3, The Core Competencies Needed for Health Care Professionals. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221519/