Imbalance Of Power In Nursing

Nursing is known to be one of the most challenging careers, owing to the tough responsibilities that nurse practitioners are charged with and the immense sensitivity of their role (Li, 2013). Both Registered nurses and nurse practitioners work together monitoring a range of patients’ health and providing them with adapt care needed within their scope of practice. However, the roles and the responsibilities they bestowed are different. Creating a balance between a tough job and the extremely sensitive wellbeing of a patient, which lies in the decisions that a nurse practitioner makes, does surely propel one to the pinnacle of clinical nursing. As they carry out this sensitive role, they are also expected to be active in a wide range of other areas, including research, education, policy, and clinical governance. It is true that the working environment in which they work, to a considerable extent, does not provide the flexibility needed by nurse practitioners in an effort to carry out these complex roles, but they somehow have shown they are able to achieve this (Fleming & Carberry, 2011). This essay looks to justify the claim that nurse practitioners are the pinnacle of clinical nursing drawn from evidence from existing literature. It will demonstrate the roles and responsibilities a nursing practitioner holds a higher expectation than a registered nurse. It is also argued though that there is immense pressure on registered nurse, making the nurse practitioners role not as

Nurses actively preserve the dignity of people through practiced kindness and respect for the vulnerability and powerlessness of people in their care… This vulnerability creates a power differential in the relationship between nurses and persons in their care that must be recognised and managed.7 A diagram representing a continuum of professional behaviour provides a picture of therapeutic versus non-therapeutic behaviour in the relationship between the nurse and the persons in their care.8

As nurses we accept the responsibility of caring for the patient therefore, we have to be hold accountable for the care that we provide. It is important for nurses to use their own judgement in accepting responsibility, when to seek consultation and when and what to delegate to others. According to Battie & Steelam (2014), “a prospective nurse should hold themselves accountable for patient advocacy, continuity of care, lifelong learning, to colleagues, the nursing profession, and their organization”.

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

As a patient advocate, the nurse should engage in multidisciplinary support to help family understand the legal aspects and obligation of the power of attorney in making life end decisions and the legal obligations of the Advance Directives. Nurse must be firm in stressing these considerations to family so they may realize the full legal and ethical implications of their decisions.

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

Power as defined by Kelly & Crawford (2008) is the ability to achieve one’s goals by creating, acquiring and using resources to do so. Nurses over time - whether learned, cultural or related to gender-specific characteristics, have not embraced power (Kelly & Crawford, 2008). The public view of nurses as subordinates to physicians, simply “trained” to follow doctors’ orders, an overall lack of understanding as to the level of education and the kind of work nurses actually do (Sullivan, 2004) has lent to this perception. Sullivan (2004) writes about telling

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

Patient-Centered Care: Patients should have control over the care they receive. By involving patients and family members in their care it will result in better health outcomes. “The response of health care professionals to patients’ questions, concerns, and feedback directly influences how comfortable patients are with speaking up” (Spath, 2011, p. 236). As nurses we need to respect our patients’ wishes and give each

Nurses find themselves in the middle of a complex health care system between the financial side and patient safety. A professional nurse’s goal is to provide safe, quality, patient care. However, nurses often fail to meet this goal due to the variability in patient acuity, the unpredictable workload of nurses, and institutional budget constraints (ANA, 2014). According to the American Nurses Association (2014) research shows that lower staffing levels of registered nurses correlate with poor patient outcomes, as well as negative nurse outcomes, such as physical injury and ‘burnout.’

Patients, in any healthcare setting, deserve respect and care that is centered on their unique needs. Nurses and health care are required to assist them to achieve this goal. Changing the health care system will require us to reestablish our

Through experience, it is recognizable that the focus of nursing is shifting as a result of cost-efficient care approach, increased workload, and time consumed by performing technical skills. As a consequence, research has shown poor patient outcomes as nurses are faced with decreased amount time to connect with their patients (Canadian Federation of Nurses Union [CFNU], 2012). Despite the tasks at hand, the nursing scope of practice (College of Registered Nurse British Columbia[CRNBC], 2016) is to support patients through all aspects of their health challenges. This means that nurses need to attend to any aspects such as

I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.

Nurses play a very important roles in patient care. They have the power to improve the quality of care, thus improving patient outcomes. According to Fackler, Chambers, and Bourbonniere (2015), the phenomenon, which is stated in this study, is that the concept of power is usually viewed by nurses ' perception of their work environment; the environment that allows them to take proper care of their patients. Furthermore, based on the social theory that power is defined as the capacity to achieve goals, the authors believe that if the nurses ' capacity to achieve goals for themselves and their patients culminates in a positive conclusion, then power becomes an essential phenomenon to explore (Fackler et al., 2015).