Knowledge for Nursing Practice- a Narrative

Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

The five fundamental patterns of knowing are empirical, aesthetical, personal, ethical and sociopolitical. The patterns or ways of knowing help with the development and application of nursing knowledge. Empirical knowing embodies “factual and publicly verifiable descriptions, empiricism and theoretical explanations or predictions” (Carper, 2012 p.25). In my Oncology setting the science of nursing is very relevant to practice. I use science daily in calculating body surface area for chemotherapy drugs, chemotherapy protocols and febrile-neutropenia protocols with the initiation of specific antibiotics are some examples. Empirical knowing provides facts from empirical research for nursing care and interventions. Aesthetical knowing is known as the “art and act” of nursing, it highlights empathy. This pattern of knowing recognizes the nurse’s perception of what is significant in an individual patient’s behaviour (Carper, 2012). I utilize the art of nursing by acknowledging the patient’s feelings and being present for them during a difficult time and the ability to establish a meaningful connection with the patient.

Giving myself time to read up on nursing experiences, attending more clinical practice labs, participating and watching these duties in the health care setting will allow me to develop a secure level of confidence the next time that this type of situation may occur. Staying in the room allowed me to experience the feeling of support while looking past social norms and how they are challenged. I met my personal values, and I believe that one should respect another person`s privacy. This understanding allowed me to be there to support the resident during her time of need. In the article `starting out` by Jane Schulz, a nursing student shares her experience of helping her colleague assist an elderly patient with daily care. Observing the compassion and care between nurse and patient from fundamental tasks, she took away a valued lesson of how our support and caring methods affect an individual. My relation to this story allowed me to reflect on the effects my care and supporting actions had on our patient.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

nurse staffing ensures quality nursing care for patients and can be a challenge for nurse

When people think about nurses, many ideas come to mind. They think of the hideous old starched, white uniforms, a doctor’s handmaiden, the sexy or naughty nurse, or a torturer. The media and society have manipulated the identity and role of nurses. None of these ideas truly portray nurses and what they do. Nurses are with the patients more than the doctors. People do not realize how little they will encounter the doctor in the hospital until they are actually in the hospital. People quickly realize how important nurses are. Because nurses interact with their patients constantly, nurses are the ones who know the patients best.

In order to develop nursing knowledge and establish evidence-based practice (EBP) in nursing, there needs to be a "concept model, one or more theories and one or more empirical indicators" (Fawcett & DeSanto-Madeya, 2013, p. 26). The theoretical framework can be advantageous in guiding and supporting the design and execution of an EBP change. Using a conceptual model (C) theory (T) and empirical research (E) provides the foundation for an intervention to an identified clinical problem. Known as C-T-E structure, the application of this system in nursing practice involves an elevated level of critical reasoning, which assists in knowing what data is important and how it relates to practice change (Chinn & Kramer, 2011; Fawcett & DeSanto-Madeya, 2013; Mazurek Melnyk & Fineout-Overholt, 2015). The doctoral level of nursing necessitates the need to combine the understanding and knowledge gained from using the C-T-E structure, and then integrate the concepts and theories into daily practice.

Stanton, M. R. (2004, March). Hospital Nurse Staffing and Quality of Care. Research in Action. Rockville, MD, USA: Agency for Healthcare Research and Quality.

AACN Standards for Establishing and Sustaining Healthy Work Environments comprise skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership (AACN, 2005). These standards are in line with the work life factors identified by Lake (2002) as characteristics of effective professional nursing practice environments (effective nursing leadership, staff participation in organizational affairs, adequate staffing for quality care, support for a nursing model of patient care, and effective nurse/physician relationships) that play an important role in the quality of nurses’ working lives and patient safety (Laschinger & Leiter, 2006). Establishing and sustaining healthy work

The profession of nursing is usually described as high-demand job, as well as stressful. The American Association of Critical-Care Nurses believes that nurses can empower their work environments and truly make a difference (AACN, 2016). Although nurses have the ability to join committees and help make changes slowly, there are many factors in the nursing that cannot be changed by nurses. “The global increase in the aged population, the intensity of health care problems, the incidence of chronic illnesses and advanced technology, nurses are faced with a variety of work-related stressors” (Lambert & Lambert, 2008, p. 38). Regardless of nursing communication and social aspects of units, nurses need to accept some stressors as they are and

For this assignment, I was tasked with reading the article: Fundamental Patterns of Knowing in Nursing by Barbara A. Carper, R.N., Ed. D. The article was about how knowledge, and its patterns, can shape the way we act and care as nurses. It also goes in to detail about how there are four distinct patterns of knowing in nursing. They are: empirics, esthetics, personal knowledge and ethics. By using the structure of the aforementioned four patterns and applying them to the first statement on how they can shape how we act as nurses, Dr. Carper explores how understanding these patterns and their meaning can lead to better nurses and ultimately, better care.

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

In the medical fraternity, nurses make up the largest healthcare profession. The care of patients depends on the well-being of the nurses, and issues affecting them may affect patients, directly or indirectly. As a profession, nursing, can be both an extremely rewarding and challenging activity. A number of problems exist, and most are becoming worse because of lack of lack of mechanisms to address these issues. The three greatest issues affecting nursing today include improving health education, lack of respect for nurses and cost cutting. Although these problems are not clinical, they influence the efficiency of the performance of nurses in their delivery of services.

The ability to be aware of something either by observation, getting information or through inquiry enable us to know. Knowledge is acquired when one is informed about an object or subject. However in Nursing knowledge is acquired either through scientific or Research (Explicit) and Tacit or Experience (Synthesis of Information)