Professional Nursing Work Environment Analysis

Developing a personal philosophy of nursing and patient care is essential to the development of every nurse. The development of a personal philosophy begins in nursing school. Nurses incorporate our personal beliefs within our nursing practice and as we grow and mature as nurses and human beings our philosophy changes. Exposure to new beliefs, cultural differences, and researching the views of a variety of nursing theorists assist nurses in developing an expanding their own philosophy with the culture of care.

Professional nursing practice has been developing for several centuries. Nursing as a profession can be traced back to the early Christian era. Since then the perception of nursing practice has changed significantly. “Nursing is caring, commitment, and dedication to meeting the functional health needs of all people” (Craven &

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster

Philosophy of nursing is an intricate framework based on the nurse’s views, ideas, practice, beliefs, and ethics that give guidance and meaning to the care, treatment, and research of the nursing profession. (What is a Philosophy of Nursing, n.d.) “Most would agree then that nursing is increasingly recognized as a ‘multi-paradigm discipline’” (Powers & Knapp, 2011, p. 129).

Registered nurses are an integral part of the healthcare system, and make up the largest number of healthcare professionals. According to the Bureau of Labor Statistics (2015) “The employment rate for registered nurses is expected to grow by 16% between 2014 and 2024”. This is more than double the average rate of growth for a profession. The rapid growth rate can be attributed in part to better management of chronic diseases and the baby boomer generation. The growth in the nursing profession is paramount, however the demographics of the nursing population does not mirror the demographics of the population served.

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

The national shortage of Registered Nurses (RNs) has helped generate formidable interest in the nursing profession among people entering the workforce and those pursuing a career change. According to a report issued by the U.S. Department of Health and Human Service in 2002, the national population is continuing to grow and age and medical services continue to advance, so the need for nurses will continue to increase. They report from 2000 to 2020 the predicted shortage of nurses is expected to grow to 29 percent, compared to a 6 percent shortage in 2000. With the projected supply, demand, and shortage of registered nurses and nursing salaries ever-increasing, the nursing profession can offer countless opportunities. But first one must

Historically, the nursing field is one that has consistent positive job outlooks, as there is typically a continued shortage. Healthcare is the backbone of most communities, not just for its services, but also for the jobs it provides and the economy stimulation. Jill Bernstein, author for “Changes in Health Care Financing and Organization” states, “The health care industry is a critical component of the national, and most regional and local economies of the United States” (4). The nursing field has suffered challenges due to the economic, social, and the political downturn of the U.S. Nevertheless, there is still some noticeable growth taking place and opportunities available. This shows encouraging signs for new nursing graduates.

A nursing philosophy is concepts or values that a nurse embraces within his/her practice and allows these concepts and values to shape the way he/she practices nursing and drives the purpose of their nursing care. It is important for each nurse to develop his/her philosophy of nursing to be a purpose driven nurse. Each nurse will have his/her own nurse philosophy because each believes differently. Nursing philosophies might come from different understandings but still point to one thing. They point towards the benefit and for the good of the client. Nursing philosophies can have several key concepts that are used in nursing models that include: client, health, environment and nursing.

Professional practice models can help guides nursing practice in any healthcare setting. Nursing care models are commonly adopted by Magnet organizations because they promote staff autonomy, shared decision making, patient-centeredness, and quality care. Nurses most often develop PPMs which reflect not only nursing values but the organization’s values as well. This paper will explore several elements of the Brigham and Women’s Hospital’s (BWH) Professional Practice Model (PPM). First, the model’s fundamental nursing framework will be identified. Next, a brief discussion on how the model promotes patient-centeredness, evidence-based practice, and interdisciplinary collaboration will be presented. Lastly, a summary of how the model fosters quality, safety, informatics, shared governance and leadership will be reviewed.

Many healthcare organizations worldwide are striving to achieve magnet designation. Having the magnet title is essential because it recognizes healthcare organizations that act as a “magnet” for excellence by establishing a work environment that identifies, rewards, and promotes professional nursing (ANCC Magnet Designation, 2012). A magnet hospital is considered to be one where nursing provides excellent patient care, where nurses have a high level of job satisfaction, and where there is a low staff

In the early 1980s it came to light that while the supply of nurses had reached a record high, only 80% of hospitals nationwide had adequate nurse staffing levels (American Nurse Credentialing Center, 2011, p. 8). To address this issue a taskforce was formed within the American Academy of Nursing (AAN). Through an initial study of 165 hospitals, the AAN determined the characteristics of healthcare organizations that were magnetically attracting and retaining nurses as employees (American Nurse Credentialing Center, p. 9). In this study the AAN found “Forces of Magnetism” that contributed to the high level of job satisfaction amongst nurses, superior quality of care, low job turnover, and high level of nurse involvement in leadership, decision-making, and research. In the early 1990s, catapulted by the findings of this initial study, the American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program. The intention of the ANCC’s Magnet Recognition Program was threefold: To reward hospitals that demonstrated “excellence in the delivery of nursing services to patients;” to encourage quality in the nursing work environment to support practicing professional nurses; and to guide navigation for the dissemination of evidenced-based clinical nursing practice (American Nurse Credentialing Center, 2011, p. 14).

Magnet hospitals are named for their potential to attract and retain qualified nurses. Magnet hospitals are facilities that have been certified by the American Nurses Credentialing Center for promoting positive patient outcomes through best practices in nursing (Upenieks, 2003). The Magnet environment fosters autonomy and professional nursing practice. Research shows that Magnet hospitals have better work environments, a more highly educated nursing workforce, superior nurse-to-patient staffing ratios, and higher nurse satisfaction than non-Magnet hospitals (Aiken, Kelly, & McHugh, 2011). Implementation of that environment requires the ability to create trust, accountability, and open communication in changing times.

In the early 1980s there was a significant nursing shortage and high turnover at hospitals. Research by the American Academy of Nursing recognized forty-one hospitals that attracted nurses to work at their location because of their more collaborative and supportive work environments. These hospitals were more effective with filling nursing job vacancies compared with similar hospitals. The American Nurse’s Credentialing Center (ANCC), an organization of American Nurses Association developed a voluntary recognition program to formally credential Magnet hospitals, and the first Magnet hospital was credentialed in 1994 (Kelly, 2011). ANCC review certain criteria that are design to measure the quality and strength of nursing practice at the hospital. Nurses who work at these Magnet hospitals have higher job satisfaction and reports that they have better communication between the nurses and other healthcare team. Most importantly, Magnet hospitals have high quality nursing care, better patient outcomes, and high patient satisfaction.