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ANSWERED!! Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.

The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing practice today by addressing the following:

1.  Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.

2.  Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.

3.  Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.

4.  Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.

5.  Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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SUGGESTED ANSWER

Contemporary Nursing Practice

The position occupied by the nursing profession in the delivery of healthcare in all setups world over is not only vital but one that cannot be done without. It is critical to appreciate that nurses are the heartbeat of patient care as they form the link between diagnoses made by doctors or themselves and implementation of the same to the patient. Hence, it is the joy of a nurse that the patient is cared for appropriately during their lowest moments in illness. Akin to other components of healthcare, nursing too has undergone evolution, not by choice, but informed by need and other advancements. As such, patient care has only improved over the evolutionary timeframe, which is as remarkable. Subsequently, the evolutionary process will be specifically expounded on, as well as some categories of care provision, role and impact of evidence-based therapy (EBP) in today’s care practice and collaboration modalities used by nurses.

Evolution of Nursing and Impact on the Scope of Practice

In medieval times, nursing was viewed as an act of charity (Cherry & Jacob, 2016). Nurses were seen as low-life individuals whose only respite in terms of giving back to the society was derived through caring for others in times of war, famine or disease outbreaks. The provision of patient care was heavily reliant on home-made remedies that provided timely relief for the patients. The risk of adverse reactions was thus very high. Additionally, there were no hospitals at the time and hence health care provision was done at individuals’ homes. Florence Nightingale, revered as the mother of contemporary nursing, then sought to change this through her redescription of the profession and its aspects for it to be more appreciated and beneficial to the society.

The effect of Nightingale’s infusion of new concepts into the profession was remarkable, far-reaching, as well as lasting. The most overt was the new appreciation of nursing as a much-needed profession in healthcare and not just a life-saving engagement for lowlifes (Smith & Parker, 2015). Most of it is attributable to one of her famed texts known as ‘Notes of Nursing.’ Due to this professionalization, the demand for nurses rose and hence led to the setting up of nursing schools, as well as professional nursing organizations and regulatory agencies (Cherry & Jacob, 2016). The markers for professional growth of nursing were there, and it was not stopping. Through the establishment of nursing specializations, nursing research has enabled create a new pool of information essential for improved patient care. Nurses are currently bound by codes of ethics and form the bulk of primary care providers in the current dispensation.

Practice Competencies between Associate and Baccalaureate Nurses

As alluded to above, nursing roles have changed and been fine-tuned overtime to meet patient needs. This has brought with it a host of specialties, all aimed at ensuring maximal comfortable patient-centred care. ADNs and BSNs are some of the few, and describing them sheds more on their commonality as well as differences regarding service provision.

ADNs are viewed more as technical nurses as they spend most time training on the skills of care provision. These nurses form the bulk of nursing professionals in health facilities. Their role in ensuring continuous and direct care provision to patients and their families is thus very vital (Tyndall & Scott, 2017). Effectively, to ensure proper functionality, they major on providing the most basic of nursing care as well as having attendant leadership skills to get activities going. Having appropriate communication skills is also important.

BSNs, conversely, are regarded as professional nurses. These are the nurses whose training involves specific aspects of critical thinking, research and evidence-based practice (Northrup-Snyder, Menkens & Dean, 2017). BSNs are thus more theoretically grounded and thus form the pool from which nurses specialize into higher cadres of nursing practice. Armed with that, they exhibit wholesome patient care and manage the patient’s physical, psychological and social welfares from the time they set foot in the hospital until their exit (Northrup-Snyder, Menkens & Dean, 2017). This group of nurses can work as nursing managers, care providers or nursing teachers. Hence, they are usually based in hospitals or nursing schools.

The difference between the two competencies is thus stark. This is occasioned by the difference in qualifications, the varying amounts of time they take in school, employment avenues and scope of practice.

Differences in Patient Care Approaches between BSNs and ADNs

The example provided is hinged on the basic technical versus professional differences between the two groups. A patient presents with convulsions in a care facility having both a BSN and an ADN. The AND nurse would immediately provide the appropriate anticonvulsant to stem the problem and as well assess the vital signs to have an idea about the patient stability. A BSN, on top of that, would do an assessment of the neurological function of the patient as well as check organ systems that could cause neurological problems such as liver, kidneys, heart and lungs. After having an idea of the probable aetiology of the patient’s presentation, they go ahead to inform the doctor for further management.

Evidence-based Practice in Nursing Care

Science itself is premised on evidence to drive specific theories forward. Evidence-based practice (EBP) is the equivalent of that in healthcare, where patient care approaches are not whimsical activities but tried and tested modalities. EBP is thus premised on having the best-researched patient management guidelines implemented for better outcomes (Ellis, 2019). The results have been remarkable, and over the years, the concept has only strengthened.

Indeed, the role of EBP is more than just that which meets the eye. It lends itself well to the longstanding principle that the practice of healthcare provision is both an art and a science. In that regard, EBP traverses and links both components. While it is anchored on the concept of relating the normal physiological state of the human body and pathological states in order to derive a much-needed balance that is critical for recovery and regaining of function, EBP has its full realization upon its application in nursing interventions (Ellis, 2019). It creates a dispensation where ideas are constantly appraised and only those with proven positive end results are implemented. An example is the prevention of bedsores using the regular turning of patients’ approach, to relieve pressure on bony prominences.

Effectively, BSNs, who were described as more theoretically oriented in critical thought and research practices, play a massive role. They engage in the appraisal of patient management modalities to assess the best ones. Moreover, through research, they expound the understanding of newer concepts of nursing in patient care.

Interdisciplinary Communication and Collaboration in Nursing Care

Healthcare is vast and fluid, both in its composition as well as functioning. There are a host of role players, stakeholders and eventual health managers. The aim is to ensure proper and satisfactory service dispensation to a patient (House & Havens, 2017). Some of the mechanisms employed to ensure this is realized include social events for workers, interdisciplinary education sessions or even faculty appointments in a joint fashion. These enhance harmony and interdisciplinary understanding as well as collaboration. Communication is best achieved through having well set out channels and hierarchy, which include notice boards or announcement sessions (House & Havens, 2017). Use of formal language should also be encouraged in the premises to avoid instances of miscommunication. Perhaps more useful would be to drill into one’s mind the repercussions of miscommunication, which range from minor mishaps to patient death.

Conclusion

Nursing is, therefore, a critical component in healthcare. Increased appreciation of the profession has coincided with good outcomes in the health fraternity. Eventually, it remains to be seen what the future holds for the profession, even with further evolution and newer specialties.

References

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Ellis, P. (2019). Evidence-based practice in nursing. Learning Matters

House, S., & Havens, D. (2017). Nurses’ and physicians’ perceptions of nurse-physician collaboration: a systematic review. Journal of Nursing Administration, 47(3), 165-171.

Northrup-Snyder, K., Menkens, R. M., & Dean, M. (2017). Student Competency Perceptions From Associate Degree to Bachelor Degree Completion. Journal of Nursing Education56(10), 581-590.

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.

Tyndall, D. E., & Scott, E. S. (2017). Writing development in associate degree in nursing-to-baccalaureate degree in nursing students: Moving out of the comfort zone. Journal of Nursing Education56(3), 182-185.

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