Today and Beyond
Nurses play an important in care delivery within the healthcare industry. Nursing is an incredibly rewarding career, and most nurses receive good salaries at the end of the month. However, every job has its obstacles, and so does nursing, which makes it one of the most demanding professions globally (Buerhaus et al. 2017). The primary objective for nurses is to deliver quality health care to vulnerable patients while offering them moral support (Buerhaus et al. 2017). Nonetheless, nurses are also human beings, and they need a lot of help to enable them to carry on with their tasks effectively
Question One: Challenges Nurses face in Care Delivery.
As much as nurses play an essential role in our lives, they face many challenges when trying to accomplish their goals; therefore, we will explore some challenges they face and how to overcome them.
One of the challenges they face is getting overworked and underpaid. Most nurses feel that they get underpaid because they get overworked (Buerhaus et al. 2017). Nurses tend to find themselves in situations where they single-handedly work longer than they are supposed to, and the pay is too low. This can affect the way they deliver healthcare to their patients and puts patients’ health at risk because exhaustion in nurses starts to set in (Buerhaus, 2017). most nurses complain of having a patient load where one nurse is required to tend to more than ten patients in a shift. The nursing profession has seen an increase in patients’ numbers due to the emergence of more complex diseases (Buerhaus et al. 2017). The rise of chronic diseases has led to more complex health needs of patients, and it is so overwhelming for nurses to have to deal with many patients all at once. Low staffing, getting overworked, and patient load has led to nurses feeling like they are unable to deliver quality care for their patients as it is required of them.
Another challenge nurses face workplace violence, which is considered to be a social issue affecting the profession. Workplace violence is considered to be any threat of harassment, physical abuse, or any disruptive behavior that often occurs in workplaces (Hackethall, 2016). Research shows that nurses are highly assaulted more than police officers or security guards. Nurses face threats from some of their patients, especially those who are addicted to abusing substances or suffering from mental health problems (Hackethall, 2016). Additionally, nurses that are stationed in the maternity wing are often assaulted by women who have labor contractions. Nurses face harassment from patients or visitors who are in the queue waiting to see a doctor; some people harass nurses upon receiving bad news. Studies show that many of these nurses do not report these incidences due to fear that they will be laid off from their jobs (Hackethall, 2016). The government is implementing strategies that will require hospitals to develop workplace violence prevention plans (Stempniak, 2017). According to Stempniak (2017), the Council of Nurses has come up with a zero-tolerance policy on workplace violence to help make nurses feel comfortable carrying out their daily tasks.
Work compensation poses as a common challenge to most nurses nowadays. Regional differences highly contribute to nursing compensation based on the cost of living from where one comes from (Gooch, 2015). Nurses that reside in the Pacific region make $20,000 more than an average staff nurse. Studies reveal that in America, nurses from the South East Central region make $4500 below average (Gooch, 2015). Apart from regional differences in pay, gender disparities also exist in the payroll. Male nurses earn $16000 more than female, registered nurses; however, in the orthopedics section, the discrepancies do not exist (Gooch, 2015). Gender differences and regional differences affect how nurses perform when delivering quality health care to patients. In partnership with the Council of Nurses in America, the government should come up with ways to fill in these gaps. For instance, ensuring that they pay all genders equally, and when it comes to regional differences, the gap should be reduced to a reasonable payroll difference.
Question Two: Institute of Medicine’s 2010 Future of Nursing Report message
The main objective of the IOM Future of Nursing is to provide a strategy for nurses to ensure the nation’s change from clinic-based services to a system prompting on prevention and wellness in the society. The committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine came up with a vision for a more reformed health care system (IOM, 2011). The committee laid these reforms intending to have a future system that makes quality healthcare reachable to all diverse populace of the U.S. ensures disease prevention and improves health outcomes (IOM, 2011). The four key messages in the report include; Nurses should practice to the full extent of their education and training. The second one is nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression (IOM, 2011). The third one is, nurses should be full partners with clinicians and other health workers in reforming health care in America (IOM, 2011). The last key message is having a productive workforce planning and strategy formulation, which requires upgraded means of data collection and advanced information infrastructure (IOM, 2011). My main focus will be on the first message: Nurses should practice the full extent of their education and training.
The Federal government needs to ensure that they standardize the scope of practice rules and regulations for all nurses in America. This will ensure that all Americans have access to quality health care, and the nurses’ contribution to the health care team is maximized (IOM, 2011). The nursing profession’s possibility to help shape up the U.S healthcare system will be highly limited because nurses believe that their future is bestowed upon being confined in acute care settings like the inpatient hospitals (IOM, 2011). As mentioned earlier, the future f healthcare is likely to shift from being hospital-based to community-based, yet most of the nurses are confined in acute care settings (IOM, 2011). Therefore, nurses must find a way to invent and disseminate reconceptualized roles to fill in gaps between coverage and access to health care. More nurses need to become primary health care providers, health coaches, and health team leaders in various health care settings (IOM, 2011). In doing so, it will assist in putting back the nursing profession where it belonged in the early 20th century. In addition to that, advanced technologies are pushing nurses farther away from their patients. Studies reveal that most nurses spend 44% of their time with their patients. Less than 20 % of nursing practice time was devoted to patient care activities; the rest was consumed by medicine administration, documentation on a patient’s health progress, and communication regarding the patient (IOM, 2011). Some health care organizations have come up with a Proclamation for Change, which aims at addressing deficiencies in hospital designs, organization, and advanced technology (IOM, 2011). The organizations also ensure nurses have a conducive working environment and rally for the promotion of vendor partnerships in health care settings.
Question three: Institute of Medicine’s five core competencies
The Institute of Medicine suggests that health workers should have a set of simple core competencies regardless of their discipline at work to enable them to meet the requirements of the 21st-century health care system. The first one is the provision of patient-centered care, where nurses are urged to identify, respect, and care about patients’ values, preferences, distinctions, and expressed needs (IOM, 2003). Nurses need to listen to, clearly communicate with patients, and educate them on various ways of preventing a specific disease from evading their bodies (IOM, 2003). They should also consider advocating for healthy lifestyles in patients and focus on population health (IOM, 2003).
The second core competency is working as an interdisciplinary team. Nurses should cooperate, collaborate, communicate, and integrate health care in teams to ensure that health care delivery is continuous and reliable (IOM, 2003). Employing evidence-based practice is the third core competency a nurse should possess. It involves integrating best research skills with clinical expertise and patient values for optimum care, and getting involved in learning and research activities is feasible (IOM, 2003). The fourth one is applying quality improvement, where nurses identify errors and hazards in health care and designate necessary safety procedures. In addition to that, nurses should test and design interventions to change processes and systems of care to improve health quality (IOM, 2003). The last one is utilizing informatics, where nurses should communicate, manage, mitigate errors, and support decision making using information technology (IOM, 2003).
Nurses need to implement these five key competencies to ensure that quality health care is provided to all patients. To put patient-centered care into practice, a nurse can decide to have health care professionals come to the patient instead of moving the patient from one room to another. To employ evidence-based practice, nurses need to find out where and how to find the best possible sources of evidence (IOM, 2003). They should also know how to come up with detailed clinical questions and search for relevant answers and determine how to integrate these new findings into practice (IOM, 2003). Some obstacles in employing evidence-based practice include difficulty in getting their research findings to doctors in an appropriate format. Some nurses proposed that socially trained clinical librarians should assist health practitioners in formulating clinical questions and recognizing the relevant literature (IOM, 2003). In applying quality improvement, nurses must continually understand and quantify the quality of care, interactions between doctors and patients, and health status concerning a patient and community needs (IOM, 2003). The major obstacle in this is that applying quality improvement methods mitigate errors, inefficiency, and delay. Nurses need to know how to employ word processing, data presentation, and analysis software; they also need to know how to search, retrieve, manage and make wise decisions using electronic data from various databases on the internet (IOM, 2003). They also need to know how to communicate using e-mails and file transfers, and lastly, they should enhance education and access to reliable health information for all patients.
References
Buerhaus P., Skinner L. E., Auerbach D.I & Douglas S. O (2017). Four Challenges Facing the Nursing Workforce in the United States; Journal of Nursing Regulation 8(2), 40-46
Gooch, K. (2015). 5 of the Biggest Issues Nurses Face Today; Becker’s Hospital Review. Retrieved from: https://www.beckershospitalreview.com/human-resources/5-of-the-biggest-issues-nurses-face-today.html Accessed on May 15, 2020
Hackethall, V. (2016). Workplace violence rampant in health care; Medscape. Retrieved from: https:www.medscape.com/viewarticle/862562 Accessed on May 15, 2020
Institute of Medicine (IOM, 2003). THE Core Competencies Needed for Health Care Professionals; Health Professionals Education. The National Academies Press.
Institute of Medicine (IOM, 2011). Key Messages of the Report; the Future of Nursing; Leading Change, Advancing Health. The National Academies Press. Doi:10.17226/12956
Stempniak, M. (2017). Violence Prevention in Hospitals; hospitals &Health Networks. 3-37