"Nursing / Doctor / Physician" Essays

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Postoperative Pain Management Assessment Research Proposal

Research Proposal  |  4 pages (1,391 words)
Bibliography Sources: 8


The study revealed that nurses' poor communication with parents and the nurses' deficient knowledge about pain and its management were the obstacles to its effective management. Better education in the nurses and open communication with parents would eliminate these obstacles (Simons and Roberson). And Yuceer (2011) stresses the holistic approach to postoperative care by nurses in improving the efficiency of pain management. This approach includes insuring the most appropriate evidence-based assessment and treatment; monitoring of pain and its complications; education of the patient and his family; documentation of the steps of pain management and fulfilling the recognized standards of postoperative care (Yuceer).

Regular updates by refresher courses, sustained pain education, continuing evidence-based educational programs, more accurate pain assessment, opinion leaders and other change agents, better nurse education plus improved communication with parents, and a holistic approach can make postoperative pain management more adequate.

Conceptual Framework

This consists of nurses' knowledge and attitude towards pain management and the theory of Brenda Conrad. This combination is grounded on the belief that the nurse stands at a unique and pivotal point in supporting and promoting the highest possible health level in the patient and in providing him with quality life. It shapes all the goals of nurse assistance towards patient recovery, independence, adjustment and treatment. In meeting the patient's needs, the nurse must possess adequate knowledge and skills in pain assessment and management and supportive attitude to complement it. Underlying nursing care is a solid knowledge base from which is drawn genuine care and concern for the patient's welfare holistically. These are the components of the quality improvement program on postoperative pain management. The program is directly aimed at upgrading nurses' knowledge and skills in managing postoperative pain. It assumes that regular or constant upgrading of nurse education will make postoperative pain management more adequate.

Methods and Procedures

This study will use the acute pain service or APS in evaluating the quality improvement program in a 1000-bed hospital, especially through the nursing, anesthesia, and surgery departments. It will establish quality indicators and use quality tools, conduct nurses' knowledge about postoperative pain and use a visual analog scale or VAS in assessing pain intensity. It will involve both nurses and physicians who have some familiarity with evidence-based guidelines on postoperative pain. Three consecutive surveys will be conducted to monitor the entire activity. It will also involve 2,589 surgical inpatients.


The acute pain service improved the level and quality of postoperative pain relief. The service included pain assessment by a visual analog scale or APS, a standard multimodal pain treatment, and continuous quality evaluation. It involved a required team of surgeons, anesthesiologists, and nurses.


Carlson, C.L. (2009). Use of three evidence-based postoperative pain assessment practices by registered nurses. Vol. 10 # 4, Pain Management Nursing: Medscape.

Retrieved on April 11, 2014 from http://www.medscape.com/viewarticle/715639

Guardini, I.., et al. (2008). The effectiveness of continuing education in postoperative pain management: results from a follow-up study. Vol. 39 # 6, Journal of Continuing

Education in Nursing: PubMed… [read more]

Professional Nursing Associations: Benefits and Rationale Term Paper

Term Paper  |  4 pages (1,309 words)
Bibliography Sources: 5


Today, the number of nursing professional associations in the U.S. alone exceeds one hundred. To this end, one may ask; is it necessary to have all these? Wouldn't one organization acting as the voice of the entire nursing fraternity be sufficient? The subsequent subsections attempt to explain why an umbrella organization would not adequately meet the purpose of a professional association.

Unity in Advocacy: it is important to note that each of these associations "speaks for nurses and nursing based on their mission and vision statements that are specific to the specialty's interests, goals, and purposes" (Matthews, 2012). Moreover, the different specialty groups educate healthcare administrators, policy makers, and the public on different issues (Matthews, 2012). When they collaborate, they put the healthcare sector in a better position to advance knowledge to the different stakeholders on almost all aspects of healthcare (Mason, Leavitt & Chafee, 2013). If this were to be left to one organization, some crucial aspects would be neglected.

Membership Value: professional associations are able to further enhance communication with members. This is "one of the many benefits of involving a variety of organizations in collaborative efforts" (Matthews, 2012). One of the most important rewards for professional association membership is the privilege to participate in association advocacy (Porter-O'Grady, 2011). Moreover, the value of membership increases with the provision of an increasingly secure intra-member communication network (Porter-O'Grady, 2011). Both the privilege to participate in advocacy and the capacity to secure the association's information decreases with increasing membership, which implies that one large organization would be less effective than many small associations working towards a common goal (Porter-O'Grady, 2011).

Professional Development: besides enhanced communication with members, professional associations usually "solicit scholarly manuscripts of relevance to members and publish the latest advanced knowledge in a specialty area" (Matthews, 2012). Having a single organization would imply having a larger membership, spread out across diverse specialties. Owing to the high degree of specialty diversity, it would be difficult for the organization to focus on a particular specialty and work towards professionally developing the proportion of its membership that aligns with that particular specialty, and then do the same for all other specialties (Matthews, 2012).


There is power in numbers; when people and associations collaborate in one voice, they put themselves in a better position to advance stronger and more powerful ideas, and can then advance their causes better than they would have done in their individual capacities. It is this ideology forms the basis of professional associations. Nursing has, over the years, evolved from being just a study course, to being a profession characterized by numerous professional associations on the national, as well as the international scale. Such associations are, in their numbers, important not only because of the benefits they bestow upon their members, but also because of the education and knowledge they advance to policymakers, healthcare practitioners, and the public, regarding their respective specialties. There is need, therefore, for every licensed practical nurse to join a professional nursing organization.

On… [read more]

Family Centered Nursing Care Term Paper

Term Paper  |  3 pages (1,027 words)
Bibliography Sources: 2


Because nurses understand the value of patients and their uniqueness and individuality, providing informational support to their family members also helps to honor those patients and give them the best opportunity for a successful outcome for their disease or condition. Honoring a patient and his or her wishes is vitally important at a part of Provision One, as well. Patients who are capable of stating their wishes should be allowed to do so, and those wishes should be respected. Nurses who treat patients and who hold to Provision One properly know that every patient should be treated with all of the respect and care that any human being would want and deserve.

Another study done on a similar issue was based on describing the experiences of families who were providing care on a physical level to relatives who were critically ill and receiving the support of bedside nurses (Mitchell & Chaboyer, 2010). This study shows another sub-issue of the Provision, in that nurses are duty-bound to treat patients and their families with care and respect, regardless of the medical problems of the patient. The study involved 10 family members, phone interviews, and a research design that was qualitative in nature, in order to determine whether those who had to care for sick family members with the help of a nurse felt they were getting the information they needed from that nurse (Mitchell & Chaboyer, 2010).


Overall, it can be seen that family-centered care is an excellent way for nurses to become better focused on the ideas behind Provision One of the Code of Ethics. Having respect for human dignity and creating good relationships with their patients (and those patients' families) are very important aspects of nursing. Regardless of the nature of the patients' health problems, they all deserve to be treated fairly. Additionally, they should all have the opportunity to determine what kind of treatment they want and when they decide that they have had enough treatment if there is nothing else that can be done to help them. These kinds of issues should be decided by the patient and respected, both by the nurses and by the patient's family. When the nurse has a good relationship with colleagues, the patient, and the patient's family, that patient is going to get the best care possible.


Bailey, J.J., Sabbagh, M., Loiselle, C.G., Boileau, J., & McVey, L. (2010). Supporting families in the ICU: A descriptive correlational study of informational support, anxiety, and satisfaction with care. Intensive and Critical Care Nursing, 26: 114-122.

Mitchell, M.L. & Chaboyer, W. (2010). Family Centred care -- A way to connect patients, families and nurses in critical care: A qualitative study using telephone interviews. Intensive and Critical Care Nursing, 26: 154-160.

The Guide to the Code of Ethics for Nurses: Interpretation and…… [read more]

Nursing Time Management Strategies Term Paper

Term Paper  |  4 pages (1,238 words)
Bibliography Sources: 3


However, this sense of attending to physical nursing needs is only one component of providing effective patient care. While nurses must attend to patients' physical needs, they must also be mindful that they need to address patients' psychological components and make that time spent with patients seem meaningful, even if it is briefer than they would like. "Psychological nursing time is conceived as that internal to providers and recipients of nursing care. It is subjective, perceptual, and elastic. Psychological nursing time is influenced by the history, experience and expectations of the participants. It is what participants experience as nursing and how they experience it" (Jones 2012). Physical and psychological nursing time are interrelated -- on one hand, patients often feel as if they are receiving better-quality care if the nursing staff maintains a physical presence near them but if their needs are not met, additional bedside time alone will not rectify this issue.

Sociological measures of nursing time reflect the fact that even nurses with superior time management skills are still heavily influenced by the assumptions and standards of the environments in which they practice. "Examples of time structures that influence nursing care include established work shifts, standardized medication times, standardized procedure sequences, and hours of operation for ancillary departments" (Jones 2012). No matter how well-organized she may be, every nurse has a finite allotment of how much time she can allocate to different duties. Thus, physical, psychological, and sociological time senses are always continually interacting.

These articles provide useful guidelines in nursing practice in terms of how they define what is and what is not within every nurses' scope of control. Teaching time management techniques to recent hires seems to be a valuable investment, given the substantial impact time allotment can have upon patient care. Simply because a nurse has technical skills does not necessarily mean that she knows how to prioritize tasks. Also, every institution has different standardized operating procedures which may require shifts in nursing techniques. A large hospital may have the luxury of greater specialization for nurses regarding care while a small practice may require nurses to assume a far wider range of duties, which means that they have no one to defer to when dealing with an urgent case.

Nurses must also understand the different factors which must be balanced when evaluating their use of time. Spending actual physical time with the patient cannot be ignored or underestimated. However, given that nurses' time is not unlimited, stressing the need for 'quality' of interactions is also vital. And patients must feel as if psychologically, the nurse is emotionally present, available, and meeting their needs. Finally, nurses must be realistic about the extent to which they can be an ideal nurse, given the sociological constraints which affect them. Communicating to nurses the different dimensions of 'nursing time' can better enable then to allocate their time and use effective time management strategies.

A final lesson from these articles is the need for nurses to take the time to… [read more]

Nursing Burnout Research Paper

Research Paper  |  4 pages (1,661 words)
Bibliography Sources: 3


The correlation between long shifts and development of burnout among nurses has been clearly highlighted in the article therefore patient care can only be improved if nurses are allowed better working conditions such as being allowed to go immediately their shifts are over, being allowed off days and given vacations and working normal shifts without unnecessary overtimes.

The article can be applied to individual nursing experiences in various ways first of all it can be used as a guide to a nurse on how the length of their shift can adversely affect their performance. Therefore after reading this article a nurse can be able to understand how long shifts can affect them and their work thus make sure that they work shorter shifts. Secondly the article can be applied by a nurse on how they are supposed to that patient who is in their care. This is because it highlights how it can affect their communication with the patients and care they give them. Therefore it can help them see the importance of working shifts of appropriate hours and hence will be better off handling and giving care to patients. Finally the article is useful as it highlights proper conditions that nursing leaders should put in place for nurses. This will guide a nurse on what conditions they know are appropriate and those that will not lead to development of burnout.

The article has clearly brought out the correlation between longer working hours and development of burnout among nurses. This has been achieved through examples of research that has been carried out on the topic.it has also laid out the appropriate working environment that nursing leaders should strive to create in order to prevent burnout among nurses.


Polikandrioti M., ( 2009). Burnout Syndrome. Retrieved March 24, from 2014 http://www.hsj.gr/volume3/issue4/340.pdf

ScienceDaily, LLC., (2012). Long shifts lead to nurse burnout and dissatisfied patients. Retrieved March 24, from http://www.sciencedaily.com/releases/2012/11/121106114046.htm

Helpguide.org, (2010). Preventing Burnout. Retrieved March 24, from 2014 http://www.helpguide.org/mental/burnout_signs_symptoms.htm… [read more]

Lean Nursing for Work-Life Balance Research Paper

Research Paper  |  4 pages (1,349 words)
Bibliography Sources: 4


There is evidence in the nursing literature that roughly 25% of practitioners' time is wasted because of systematic inefficiencies. Nurses report having to look for missing equipment or medication, having difficulties deciphering the handwriting of doctors, being asked by doctors and others to find charts, being distracted while administering medications, and putting up with numerous, unnecessary interruptions during their shift. Informed by this body of research, my initiative to improve the work-life balance of nurses will include efforts increase efficiencies in the workplace. This is counterpoint to examining timesheets and looking for time management issues with individual practicing nurses -- that would be treating the symptoms instead of causes. It is critical to my efforts to ensure that systematic issues do not pull down the performance and efficiency of nursing staff.

Informational Expert

I conducted an email (telephone) interview with Steven Spear, a senior fellow at the Institute for Healthcare Improvement in Cambridge, Massachusetts. Spear is the co-author (with H. Kent Bowen) of "Decoding the DNA of the Toyota Production System" (Harvard Business Review, 1999, September -- October), and the author of "Learning to Lead at Toyota" (Harvard Business Review, 2004, May). Spears served as my informational expert for both of my SMART goals since his work on lean healthcare organizations encompasses communication (SMART Goal 1) and leadership (SMART Goal 2). I believe that Spears approach to improving efficiency, effectiveness, and safety in hospitals has direct application on my initiative to secure a reasonable work-life balance for nurses at my facility.

Spears (2005) asserts that reform is within the sphere of control of nurses and other practitioners: What I'm talking about here are opportunities that will not require any legislation or market reconfiguration, that will need little or no capital investment in most cases, and -- perhaps most important -- that can be started today and realized in the near-term by the nurses, doctors, administrators, and technicians who are already at work. (webpage 1)

At the suggestion of my Spears, I will pursue more information about the lean system employed by Toyota, and learn more about the quality organizations that are at work in hospitals and healthcare systems throughout the U.S. And Canada. The following website was suggested, as it is specifically geared to healthcare and includes numerous lean tools, including the 5S Program Audit Scorecard that I will use to kick off my initiative.


The Lean Healthcare Exchange. Retrieved http://www.leanhealthcareexchange.com/


I will pursue a series of self-guided course to develop and refine my informatics competencies. I see this facet of my action plan as dovetailing nicely with my concerns about time management. Indeed, when I review Spears admonishment (below), I consider that my original tack may have been too narrow. I wish to emphasize nurses as part of a larger and holistic system, not simply as individual practitioners in need of remediation in the area of time management.

Spears (2005) summarized the challenge: The problem stems partly from the system's complexity, which creates many opportunities for ambiguity… [read more]

Holistic Nursing Term Paper

Term Paper  |  8 pages (2,429 words)
Bibliography Sources: 6


The assumptions will also need development (Selandars, 2010).

Environmental Theory and Hand Hygiene

Effectiveness of hand washing in reducing infections

Hospital acquired infections are significant health issues in the globe. Even though there is a lot of innovation in the medical field, the chemical solutions of killing microorganisms that cause infections are not effective (Chen et al., 2011). Therefore, there… [read more]

Reality Shock and Nursing Research Paper

Research Paper  |  3 pages (1,000 words)
Bibliography Sources: 5


In general, the ideas of utilitarianism and deontology may be used as a paradigm for the issue of reality shock for nurses. Deontology says that we cannot make the determination about actions only by looking at the result. To make this affective, the individual should find the motives that allow us to translate actions from simply the philosophical idea into reality. Utilitarianism is an outcome-based theory, focusing primarily on the results of an action. In this theory, an action is ethical if it produces the most good and the least harm for everyone affected by the action ("the greatest good for the greatest number."). Stated another way, an action is ethical if more of society benefits; the social benefits for society are the positives less the social costs. There are several important issues surrounding this theory. This view tends to place the onus of responsibility solely in terms of the result produced by any action. It looks only at the conclusion, not the means to get there. Second, the benefits and costs include any kind of good or harm, including things (such as the value of a human life) that may be difficult to value in precise noncontroversial ways. Third, the benefits and costs include those that happen now and those that will happen in the future; future benefits and costs must be discounted to present value. Fourth, to be considered ethical, it is not enough that the action does more good than harm; the action must do the most good and the least harm to be judged ethical (MacIntyre, 2006).

Using deontology as a personal model though, it is not just the outcome of patient care and service to the profession that is paramount, but the manner and way of modeling the appropriate behaviors in order to help the greatest number. The means to the end has already been established -- X amount of dollars and time should, in theory, not only result in a career that provides personal satisfaction and actualization, but actually helps people. Overall, the utility of this is helping the greatest number of people in the least amount of time in the most effective way. However, when dealing with the reality shock of modern nursing, it is the manner in which the nurse transitions from student to actual clinician, caregiver and above all, patient-advocate. For me, understanding that it is the long-game, the notion of the overall nursing paradigm has a profound ethical proponent that will allow one to minimize the tactical frustration in favor of the strategic outcome.


Bonis, S. (2009). Knowing in Nursing: A Concept Analysis. Journal of Advanced Nursing, 65(6), 1328-41. doi:10.1111/j.1365-2648

Kajander, S., et al. (2013, August). Self-Assessed level of competence of graduating nursing students and factors relating to it. Retrieved from Nurseeducationtoday.com: http://www.nurseeducationtoday.com/article/S0260-6917(13)00300-6/abstract

MacIntyre, A. (2006). A Short History of Ethics. New York: Routledge.

Marquis, B., et al. (2009). Leadership Roles and Management Functions in Nursing. Philadelphia, PA: Wolters Kluwer.… [read more]

Nursing Should Be Classified Essay

Essay  |  2 pages (772 words)
Bibliography Sources: 2


Some argue that nursing should not be classified as a profession as it does not require the same level of education and training as a doctor or other "professional" occupations. This perspective is limited because it only takes into account the amount of time to get certification, not the fact that nurses need to continue with training and furthering their education for their rest of their careers.

One of the most important components of nursing, as with many professions, is the code of ethics inherent to the occupation. According to the American Nurses Association (2014), "The ANA believes the Code for Nurses is nonnegotiable and that each nurse has an obligation to uphold and adhere to the code of ethics." When a person becomes a nurse, they are pledging not only that they have the education, but that they have the temperament, the personality, and the mental ability to do the right thing for the patient at all times. The nurse, even more so than the doctors, must be the advocate for the patients because they have more direct interaction with them. The nurse will be the one to closely read the case file and therefore know the medications the patient is on, their allergies, their conditions, and to have to comfort the patient and their loved ones. Therefore a nurse must be skilled technician, medical expert, and warm presence. All of these components contribute to the nurses' code of ethics.

Nursing meets the definitions of a profession as illustrated. To be a nurse, a person must have a lot of education and specialized training. They must also possess a specific set of skills that allow them to be successful in that occupation. Even more than this, they meet the less formal definition of a profession which is an occupation that requires a person be dedicated to their work so that their own sense of ethics and their adherence to the code of ethics as prescribed by their job description is beyond reproach.

Works Cited

American Nurses Association (2014). American Nurses Association Inc.: Silver Springs, MD. Retrieved from http://www.nursingworld.org/nursingstandards

Board of Registered Nursing (2013). Department of Consumer Affairs. State of California.

Retrieved from http://www.rn.ca.gov/about_us/whatisbrn.shtml… [read more]

Reason I Selected the University Admission Essay

Admission Essay  |  3 pages (1,061 words)
Style: APA  |  Bibliography Sources: 5


Reading, conducting, and utilizing research within the field is one of the most vital components of any MSN program in contemporary times. Therefore, one of the most prudent applications of earning such a degree is to utilize this methodology to obtain new knowledge in this field today in order to administer more efficacious care to individuals and collectives.

I have extensive professional experience relevant to my future career goals and specialty selections at this educational institution, which are (respectively) to operate as a Family Nurse Practitioner locally while organizing medical mission trips and practice abroad, and family primary care and adult gerontology primary care. That experience includes working as a Registered Nurse at UF Health Jacksonville, Brooks Rehabilitation Hospital, and St. Vincent's Medical Center in Jacksonville, Florida. At UF Health I worked with post-intensive medical and surgical patients in the capacity as a trauma and surgery progressive care facilitator, at Brooks I worked with post-surgical and medically complex cardiac and stroke patients in a rehabilitative environment in the capacity as an administering medication and educating patients regarding medical issues, and at St. Vincent's I worked with pre- and post-surgical and medically complex GI/telemetry patients in the capacity of assessing and educating patients about surgical care while also administering it to them.

The Family Nurse Practitioner nursing specialty certainly has a need for nurses with master's degrees, due in part to the growth of patients as denoted by several implications of the Affordable Care Act. There are a considerable number of responsibilities these professionals must handle, including the need to "obtain and assess health histories and physical examination data, order and interpret common diagnostic tests, identify actual and potential health problems, and formulate with the client family a comprehensive plan of therapeutic measures" (UAB, 2013). This degree of authority is best exercised by nurses with master's degree. The same sentiment applies to the nurses in the field of gerontology, in which "emphasis is placed on putting prevention into practice, involving adults in decision making as…responsible health…consumers; educating consumers, decreasing health complications…and recognizing the importance of the community in primary care" (UAB, 2013). These duties are best performed by master's degree holding individuals who are utilizing evidence-based practices.


Egenes, K.J. (2012). The nursing shortage in the U.S.: a historical perspective. Chart. 110(4), 18-22.

Harper, D.C. (No date). About our school. www.uab.edu. Retrieved from http://www.uab.edu/nursing/home/about

Marelli, T.M. (2013). The good, the bad and the ugly in the changing healthcare landscape: the role of nurse practitioners in meeting increasing demand for primary care (the good), CMS and contractor oversight of home health agencies (the bad), and the sad demise of the Medicaid hospice benefit in Louisiana (the ugly). Home Health Care Nurse. 31(3), 121-123.

UAB Nursing. (2013). Nurse practitioner family primary care. www.uab.edu. Retrieved from http://www.uab.edu/nursing/home/images/stories/info_sa/MSN_Flyer_NP_Family.pdf

UAB Nursing. (2013). Nurse practitioner adult gerontology primary care. www.uab.edu. Retrieved from http://www.uab.edu/nursing/home/images/stories/info_sa/MSN_Flyer_NP_Adult_Primary_Care.pdf… [read more]

Nurse Perspective the Profession Essay

Essay  |  3 pages (1,107 words)
Style: APA  |  Bibliography Sources: 3


The many different job opportunities for nurses shows that in this career there is much variety. Nurses are needed everywhere and this career allows its members to choose from many different options in many different types of settings as well.

The nursing work day is another positive aspect about this career that I feel has drawn me towards this profession. I appreciate the ability to work long or short shifts, or working on weekends or weekdays. Nursing shifts are often long and hard, but this is the type of workplace scenario that I am most comfortable working within. Since people need healthcare everywhere there are people, I know that I am always needed somewhere as well. Hospitals are just one place where nursing occurs but all around the world caring and healing are desperately needed.

Nursing Perspectives

I love the idea of becoming a nurse. Nursing is everything that my heart desires. My limitations for caring, healing and compassion are endless. A caring and compassionate nurse is considered as a guardian angel by patients. This appears to be a very satisfying and gratifying career for me. Nurses advise people about how to live life in a clean environment. Nurses educate people in poor localities and also work with the homeless, bringing sanitation and wellness into people's lives.

Nursing is not just a job. It is taking the trust and faith that a complete stranger has put into you and bringing it out to its fullest potential. It is about showing love and compassion for another's needs above your own. Nurses are blessed with the ability to touch people's lives throughout every age and stage of life. Nurses listen when you are feeling low. They do not hide from the problem, but rather stand up for those in need and heal as much as possible.

Becoming a professional nurse means so very much to me and my family. There is so much that goes along with the definition of what a nurse is, that everyone has their own views. Being a nurse to me is being someone that can take care of people. Caring for people to me is the purpose of nursing, but you also have to do your job and do it right as you are doing this. We care for patients they are our responsibility and why we are there. We have to know the difference between right and wrong, be a critical thinker as well as an interpreters of information, and someone who is filled with the skills and heart to really care and heal another human being and provide joy to their life.


I am very grateful for my educational and professional opportunities that have been presented to me throughout my life. I feel that nursing is the right thing for me to do and will benefit my family and my community as well.


Courchane, C. (2011). With nurse shortage looming, America needs shot in the arm. The Washington Times, 6 June 2011. Retrieved… [read more]

Beyond the Critical Incident Itself Essay

Essay  |  8 pages (2,649 words)
Style: Harvard  |  Bibliography Sources: 13


Reflexivity, the final dimension, has many salient questions. These questions include how current experiences dovetail and mesh with prior experiences, how prior situations could/should have been handled better, what would be the consequences of alternatives for the patient/others/self, how one feels NOW about the experience, whether one can support one's self and others better as a result of the new… [read more]

Nurse Eduactor Strategic Plan Essay

Essay  |  3 pages (1,008 words)
Bibliography Sources: 1+


Education is always a 'two-way street:' a student learns from professionals but can also learn from teaching others.

While I did complete a curriculum development course, I still feel that my knowledge of learning theory and different learning types and styles is lacking. Within the next year, I will strive to more specifically learn about different pedagogical strategies and different learning theories, such as the concept of multiple intelligences and multicultural approaches to learning. Over the course of my current framework of experiences, I have grown appreciative of the fact that not all people are the same, and an instructional strategy that works well with one student or patient may not be universally applicable. I feel that I am cognizant of how I learn on a personal level but my understanding of how others learn has to be deepened and challenged.

To achieve this objective of gaining competency teaching people different from myself, I intend to read Howard Gardner's book on his theory of multiple intelligences within the year. I am also interested in the theory of emotional intelligence, given that I believe that nursing requires intensive interpersonal skills, not merely the competencies that can be measured in a technical fashion. As well as being a more mindful practitioner in the field about my own learning style and interactions with others, I will read books, professional journals, and websites on nursing theory and human psychology that discuss ways to transmit education more effectively in a manner to enhance my emotional intelligence. I will also do all that I can to learn about different health philosophies within a variety of different cultures, asking questions of patients and professors over the course of my entire life as a nurse educator.

The greatest weakness I identified as a nurse educator is my fear of speaking to large groups of people in public. Oddly enough, on a one-on-one and small group basis, I have few problems in speaking my mind. However, in large group settings, I often feel uncomfortable and self-conscious. This will be the biggest challenge: over the course of the next three years, I would like to take a class in public speaking. This will give me experience and confidence in being able to organize my thoughts before others and decrease my anxiety with practice. I also find myself challenged by multitasking and tend to have trouble prioritizing tasks. I intend to read a book and perhaps take an online course in time management strategies, such as the 7 habits of highly effective people to improve in this capacity as well.


Covey, S. (2012). 7 habits of highly effective people. Franklin Covey.

Gardner, H. (2007). Frames of mind: The theory of multiple intelligences. New York: Basic


Professional Nurse Educator's Group. (2013). Official Website. Retrieved from:


National League of Nursing (2013). Official Website. Retrieved from:

http://dev.nln.org/aboutnln/info-history.htm… [read more]

Hospice Utilization: Survey Findings Data Analysis Chapter

Data Analysis Chapter  |  7 pages (1,883 words)
Bibliography Sources: 4


A glaring gap in the survey is the absence of any questions querying respondents about frequency of hospice referrals made and how often patient's took advantage of hospice services. Future improvements would be to fill this gap and flesh out the factors contributing to physician/NP, patient/family, and administrative/clinical workflow barriers to hospice care underutilization.


Christakis, Nicholas A. And Lamont, Elizabeth B. (2000). Extent and determinants of error in physicians' prognosis in terminally ill patients: Prospective cohort study. BMJ, 320, 469-473.

McGorty, E.K. And Bornstein, B.H. (2003). Barriers to physicians' decisions to discuss hospice: Insights gained from the United States hospice model. Journal of Evaluation in Clinical Practice, 9(3), 363-372.

McNeilly, D.P. And Hillary, K. (1997). The hospice decision: Psychological facilitators and barriers. Omega, 35, 193-197.

Temel, Jennifer S., Greer, Joseph A., Musikansky, Alona, Gallagher, Emily R., Admane, sonal, Jackson, Vicki A. et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363, 733-742.

Weckmann, Michelle T. (2008). The role of the family physician in the referral and management of hospice patients. American Family Physician, 77(6), 807-812.

Appendix A

Barriers to Hospice Utilization

1. I Have ____ years of Nursing experience

____16 or more

2. . I have ____ helped patients and their families plan for end of life care as a nursing professional





3. I have ____ years of hospice care experience.

____9 or more

4. During end of life how often have you interacted directly with patients and their family members ____ of the time






5. . Based on my knowledge with end of life care planning and/or hospice care, hospice care is underutilized.

____ strongly agree

____ agree

____ disagree

____ strongly disagree

6. Based on your knowledge, are patients, physicians, or administrative hurdles the primary barrier preventing the use of hospice care? Number the following answers in order of importance, with 1 being most important and 3 the least.


____ Physicians

____ Administrative hurdles

____ N/A





7. When physicians appear resistant to recommending hospice care, which of the following is most prevalent. Use 1 to…… [read more]

Nursing and the Calling Term Paper

Term Paper  |  4 pages (1,385 words)
Bibliography Sources: 2


However, Makanya had an open mind and viewed many of the developments generated by European culture as positive, although she believed firmly in her own sense of equality. "You can't be a proper nurse," she was told, "the nursing schools here are only for white girls. If you go to work at a hospital, you will really be just a servant, mopping floors and cleaning up after the Europeans" (McCord 26). However, Makanya resisted such conventional wisdom and ultimately strived to persevere to realize her dreams. She worked with a white physicians for most of her life, despite the notion that black women could not be 'proper nurses' and despite her own bristling resentment at the racism she felt.

African-Americans were regarded as drudges in Makanya's South Africa -- ironically, much how nurses were regarded in Nightingale's time, before Nightingale begin to establish the respectability of the profession through her dissemination of knowledge. Makanya came to embrace Christianity and grew to admire many aspects of modern medicine -- the kind that was located in urban centers of development. Although she occasionally experienced internal conflict between the two worlds and worldviews she inhabited, the fact not all whites -- particularly those within the profession of medicine -- endorsed such prejudices regarding black inferiority heartened her and enabled her to believe she had a future within the medical profession and that Western medicine was a good thing. As one black woman said who was able to study medicine: "in my medical school we have learned about pigmentation, the blackness in our skins which God has given us to protect us from the sun…White people cannot stay too long in my country else they shrivel up and die. Poor things they don't have that special blackness to protect them from the sun" (McCord 53).

Makanya did not despise the ways of her non-Christian ancestors but she also did not feel a need to reject Christian civilization and aspects of the industrial world wholeheartedly, although it clearly may have been tempting to do so, given the way she was often treated. Despite her many gifts, she was limited to a great degree in her ability to gain full medical credentials on par with a white women, but her efforts to make the most of her life within the constraints in which she operated demonstrated that she did not allow herself to become embittered. Makanya's struggles thus indicate ambiguity about life in the countryside: on one hand, she perceives the superiority of modern medicine over folk medicine and prefers the organized religion of Christianity over native faiths which she regards as superstition, but she does so with a clear-eyed view that many of the persons who support the cultural ideals of Europe regard her as innately inferior.

Nightingale's more dismissive attitude towards urban life is to some degree understandable, given the original intention of the publication of Notes on Nursing. Notes on Nursing was intended to be an instructive work, not an autobiographical musing on… [read more]

Nursing Advanced Practice Role 5901 Term Paper

Term Paper  |  10 pages (3,354 words)
Bibliography Sources: 10


Certification Requirements

The nurses require some capabilities and competencies to get a nursing job in a registered institute. The nurses require having different certifications to prove their knowledge, skills and capabilities. These certifications are requirements of state as well as the country. Some of these certifications include following:

Associate of Applied Science

Acute Care Nurse Practitioner-Board Certified

Adult Nurse Practitioner-Board… [read more]

Regulation in Nursing Regulatory Essay

Essay  |  3 pages (935 words)
Bibliography Sources: 2


The need for accreditation is technically voluntary, unlike the need to receive a license. "Most accreditation programs testify to the institution's achievement, rather than merely guaranteeing safety [like licensure]. Accreditation, like nurse certification, is voluntary -- but not quite" (Barnum 1997). Few students will want to attend a non-accredited institution and spend their money on a degree which could severely compromise their employment prospects. Also, "in nursing master's education, most programs will not admit a nurse who graduated from an unaccredited program, even if the program was licensed by the state" (Barnum 1997). An autonomous national accrediting agency, "officially recognized by the U.S. Secretary of Education" called the Commission on Collegiate Nursing Education (CCNE) was created to ensure "the quality and integrity of baccalaureate, graduate, and residency programs in nursing" (CCNE Accreditation, 2013, CCNE). Students looking to pursue a degree within the field can look for CCNE accreditation a guarantee of the legitimacy of their degree.

The difference between regulation and accreditation

At its most basic level, regulation restricts the actions of individuals while accreditation requires institutions to meet certain standards. However, as a practical matter, the need for accreditation, particularly for smaller schools seeking legitimacy can be vital. The pressures of accreditation means that a school is limited in terms of how it structures its syllabus and meets particular standards set by the accrediting agency, just as nurses must meet specific standards to be licensed to practice. Unlike an institution which can still technically remain 'open' even though unaccredited, however, a nurse cannot practice without a license.

Standards for nurses according to current regulations and accreditation requirements have become increasingly uniform in recent decades. However, while the ability for nurses to practice autonomously has grown, the accreditation process, it is argued, has limited many institutions in terms of creativity and scope. It can also be financially draining: "state evaluation for nursing programs, general collegiate evaluation, and NLN evaluation together consume a heavy dose of scarce time of deans and faculties. Cost and time are big factors in an era of down-sizing -- a phenomenon that education has not escaped" (Barnum 1997).


Barnum, B. (1997). Licensure, certification, and accreditation. Online Journal of Issues in Nursing Available 2(3)1. Retrieved: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol21997/No3Aug97/LicensureCertificationandAccreditation.html

CCNE Accreditation. (2013). CCNE. Retrieved:


FAQ. (2013). AAAC. Retrieved:


Warburton, R. (2009). Accreditation and regulation: Can they help improve patient safety?

AHRQ. Retrieved: http://webmm.ahrq.gov/perspective.aspx?perspectiveID=74… [read more]

Nursing Metaparadigm Is a Declaration Term Paper

Term Paper  |  4 pages (1,252 words)
Bibliography Sources: 4


d.). As receivers of nursing care, nursing clients have an agreement with the harmonic environment.


The third concept of the nursing metaparadigm is health, which is a dynamic process that incorporates the combination of well-being and illness and is described as the awareness of the nursing client throughout his/her life span. This perspective focuses on the whole nature of the recipient of care based on the physical, aesthetic, social, and moral realms since health is not only contextual but also relational. Wellness or well-being is viewed as lived experience of similarity between a person's possibilities and realities and is centered on caring and feeling cared for. On the other hand, illness is described as lived experience of any dysfunction or loss that can be intervened through caring relationships. Notably, the level or extent of an individual's health is a demonstration of the mutual interactive process between a person and his/her environment.


As a discipline and practice profession, nursing is the science and art of complete health care that is directed by several values such as choice, human freedom, and responsibility. As a concept of nursing metaparadigm, nursing can be regarded both as a profession and practice. As a profession or discipline, nursing is a body of knowledge developed through theoretical development, logical evaluation or analysis, and research.

As a practice, nursing is realized through therapeutic nursing interventions that depend on the creative use of body of knowledge in providing nursing care. The therapeutic nursing interventions are based on theories, which guide and enhance the nursing practice. When providing the interventions, professionals in this field use critical thinking and clinical judgment to provide evidence-based care to nursing clients. The interventions are usually geared towards achieving helping the community to achieve an optimal level of wellness and well-being in different nursing contexts or settings. One of the most important aspects of providing nursing care is clinical judgment skills because of their essence in professional nursing practice.

The nursing profession basically focuses on helping nursing clients and communities achieve the optimal level of wellness and health. Therefore, the moral ideal and central focus of this discipline is human caring, which is a process involving a commitment to the lived experience of the client and community. Since it also incorporates concern and empathy, the individual nurse is involved with clients throughout life as an active partner in human care relationships and transactions.

As evident in this discussion, metaparadigm in nursing plays a crucial role in the realization of the goals of this profession. As suggested by Fawcett, the entire nursing discipline is based on concern and emphasis on these four concepts (Basford & Slevin, 2003, p.275). These four concepts should not only be considered in the study of nursing but should also be considered in nursing practice.

In conclusion, nursing metaparadigm is based on four concepts or elements that define nursing both as a profession and practice. Person, environment, health, and nursing mark the bounds of the nursing discipline while determining the… [read more]

Competency Although Both Nurse Practitioners Term Paper

Term Paper  |  3 pages (1,017 words)
Bibliography Sources: 3


In teaching, scholarship calls that knowledge of subjects and their communication ability. Real scholarship is portrayed in the knowledge depth and breadth of the nurse educator in a required area. The skills of educators in mentoring subjects and the ability of educators to demonstrate proficiency in standards of scholarly writing is a prerequisite competency. Nurse educators must meet five distinctive standards including relevance, clarity, intellectual diversity, originality, and accuracy. These are helpful in the dissemination of information to other best practices in research, healthcare, and education (Nagelkerk, 2009).

Nurse administrators make meaningful contributions to knowledge development in practice through integration, scholarship of discovery and knowledge application. Nursing administrators help subjects discover new knowledge through conducting real research by interpreting, reading and applying existing knowledge in creative and new ways. In most cases, nurse educators are required to collaborate, design, and utilize research in their practice and education. This helps learners to pursue opportunities for intra-disciplinary and interdisciplinary research (Utley, 2011). Learners are able to remain abreast of current industry requirements and knowledge. This enables them to integrate scholarly and research findings in the practice of nursing. Scholars have challenged nursing education leaders to collaborate with emerging systems of health care. Collaborations with students, peers, administrators, communities and groups are crucial for the maximum expression of the role of nurse educators. The successful education of the future generation of nurses depends on the ability of nurse educators to interact with diverse constituencies. Nurse educators use skills and knowledge related to collaboration to enhance and enact the best practices for the scholar and teacher roles.

Similarity and differences

Various elements influence the development of nursing practitioner and nurse educator programs. They include are the increasing sophistication of inpatient care, government regulations limiting physicians' working hours and technology. Nursing practitioners have established themselves in critical and specialty care practice compared to nursing administrators. On the other hand, nursing administrators focus on system redesign and quality improvement in care delivery facilities (Wittmann-Price, 2013).

Both nursing practitioners and nurse educators have relatively short history in the system of health care delivery. However, in the short period, they acquire the intended respect of most patients and other healthcare professionals. Recently, mainstream media have featured the nursing practitioners and educators by highlighting their significant contributions in improving health care conditions (Nagelkerk, 2009). New programs of nursing administrator education and new areas of nursing practitioner continue to emerge. Mostly, nursing practitioners and administrators have been successful aim caring for people in the city, rural areas, and vulnerable groups. It is evident that nurse practitioners and nursing administrators have an integral role in the health care system.


Mirr, J.M.P., & Zwygart-Stauffacher, M. (2010). Advanced practice nursing: Core concepts for professional role development. New York, NY: Springer.

Nagelkerk, J.M. (2009). Starting your practice: A survival guide for nurse practitioners. St. Louis, Mo: Mosby Elsevier.

Utley, R.A. (2011). Theory and research for academic nurse educators: Application to practice. Sudbury, Mass: Jones and Bartlett Publishers.

Wittmann-Price, R. (2013). Certified…… [read more]

BSN Degree: Pathway to Professional Research Paper

Research Paper  |  5 pages (1,795 words)
Bibliography Sources: 1+


In light of the small difference in starting salaries, it is hard to justify the large difference in the cost between the two degrees. The cost of a BSN at a public university, in tuition and fees, averages about $28,080, but an associate degree at a community college averages only $6,120 (Ashford, 2011). The choice seems clear for any prospective nurse who is unsure if they want to pursue a professional career in nursing, may only be interested in patient care, or might not have the financial resources to fund four years of college. In addition, with the proliferation of RN to BSN programs, choosing to become a professional nurse need not be made at the beginning of a nursing career.


Ashford, Ellie. (2011, Mar. 28). Data show value of associate degree RN programs. CommunityCollegeTimes.com. Retrieved 12 Sep. 2013 from http://www.communitycollegetimes.com/Pages/Workforce-Development/Federal-data-demonstrate-value-of-associate-degree-RN-programs.aspx.

Blegen, Mary A., Vaughn, Thomas E., and Goode, Colleen J. (2001). Nurse experience and education: Effects on quality of care. Journal of Nursing Administration, 31(1), 33-39.

Chang, Yun-Kyung and Mark, Barbara A. (2009). Antecedents of severe and nonsevere medication errors. Journal of Nursing Scholarship, 41(1), 70-78.

Donley, Rosemary and Flaherty, Mary Jean. (2002). Revisiting the American Nurses Association's first position on education for nurses. Online Journal of Issues in Nursing, 7(2). Retrieved 11 Sep. 2013 from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/RevisingPostiononEducation.aspx.

IOM (Institute of Medicine). (2010). The future of nursing: Focus on education. Institute of Medicine. Retrieved 12 Sep. 2013 from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health/Report-Brief-Education.aspx.

Kingkade, Tyler. (2013, Jan. 9). Two-year degrees vs. four-year degrees: Sometimes associate's beats bachelor's in earning potential. Huffington Post. Retrieved 12 Sep. 2013 from http://www.huffingtonpost.com/2013/01/09/two-year-degrees-vs.-four-year-degrees_n_2439934.html.

Raines, C. Fay and Taglaireni, M. Elaine.…… [read more]

Nursing Metaparadigms and Practice-Specific Concepts Research Paper

Research Paper  |  7 pages (1,957 words)
Bibliography Sources: 4


The argument can be made that all of the foregoing modes involve developing an effective therapeutic relationship and that the better the relationship the better the clinical outcomes. For instance, according to Masters, "The nurse using Leininger's theory plans and makes decisions with clients with respect to these three modes of action. All three care modalities require coparticipation of the nurse and client working together to identify, plan, implement, and evaluate nursing care with respect to the cultural congruence of the care" (2012, p. 69).

In increasingly multicultural treatment settings, Leininger's three basic modalities provide a valuable framework wherein nursing professionals can explore the potential effects of cross-cultural differences on the therapeutic relationship. In this regard, Masters points out that, "Leininger developed the sunrise model, which she revised in 2004. She labeled this model as 'an enabler,' to clarify that although it depicts the essential components of the Cultural Diversity and Universality Theory, it is a visual guide for exploration of cultures" (2012, p. 69).

Nurses can integrate the relevant nursing philosophy from Watson and Leininger by drawing on the language that is used by these two nursing theorists to promote improved practice-specific outcomes (Ondrejka & Barnard, 2011). According to Ondrejka and Barnard (2011), "This development involves clarifying terms and looking at the three large domains within the nursing philosophy: advocacy through caring, quality, and nursing practice" (p. 140).

List of Propositions

A numbered list of at five propositions or assumption statements connecting the concepts described above is provided below.

1. The four metaparadigms of nursing provide a useful framework in which individual nursing practitioners can develop their own personal model of care.

2. Each nursing scenario must take all four concepts of nursing into account.

3. Every nursing situation is unique.

4. Every patient is unique.

5. Cross-cultural competence is recognized as an important part of the skill set needed by nurses today.


The research showed that metaparadigm is the widest perspective that is available for discipline to shape and guide real-world practice. The metaparadigm serves as an overall framework in which more elaborate structures develop. The research also showed that the central concepts of the nursing discipline are person, environment, health and nursing. Two nursing theorists who developed models of care based on these metaparadigms are Jean Watson and her Philosophy and Science of Care and Madeleine Leininger and her Cultural Diversity and Universality Theory. Although these theorists differed with respect to the conceptualization of each of the central concepts of person, environment, health and nursing, they both agreed that patient-centered practice is an essential ingredient…… [read more]

Theory Practice Professional Socialization Research Paper

Research Paper  |  3 pages (984 words)
Bibliography Sources: 3


This change theory has however some weaknesses too. It changes the system externally and not internally. Thus it does not offer due consideration to the issue that what level of resistance is anticipated against the change management. It does not tell how long it can take to change the system and what will be the role of new entrants in the system. Will they be bullied or supported by the seniors etc. Therefore, the change theory should not be blindly followed without taking measures to face the agitation in the system against the freshly introduced policies (Butts and Rich, 2011). The internal support will be critical to make the changes practical.

Question 3: Applicability of role theory

In the interventions to bring change in a system, role theory can serve an effective role. The interventions need that everyone in the system should play a role in the different activities they perform (Green, 2000). A person has a role in form of education, training, practice and management. In Nursing Practice, the nurse has an individual as well as a social role. The change management should focus is efforts to ensure that every nurse understands her role and is capable to perform her based on her Nursing Education. Once the nurse qualifies for the job, she or he should not rely of the education once attained. The Nursing research should be a continuous process in the system. At the clinic, every nurse should know about the ongoing nursing research in the industry so that she does not lack knowledge and information about the contemporary nursing issues and practices. The role theory will ensure here that every nurse understands his/her part in all these aspects and to keep in touch and updated to perform the job better.

The nursing practice that is backed by education and latest research is expected to serve the patients and the clinic in the best manner. The change agent therefore should not neglect the role theory and rather offer consultancy to the nurses so that they adhere to the needs of changing system and face the challenges. The role theory tries to understand the problems at a micro level. Also does it try to offer solutions at micro level that at the end influence the overall performance of the individual as well as the system. It motivates the nursing research and education for the purpose of improvement and growth even if everything seems alright at the moment. If there are any shortcomings in the theory or its applications, they can be removed from time to time with experience and opportunities.


Butts, J.B. And Rich, K.L., (2011), "Philosophies and Theories for Advanced Nursing Practice,"

ISBN-13: 9780763779863

Green, J., (2000), "The role of theory in evidence-based health promotion practice," Health

Education Research, 15(2), pp. 125-129.

Lai, P.K., and Lim, P.H., (2012), "Concept of…… [read more]

Theory Gap Theory-Practice Gap Nursing Research Paper

Research Paper  |  2 pages (670 words)
Bibliography Sources: 2


Barriers to nursing

There are various challenges that the nursing fraternity faces on a daily basis ranging from the job requirements, the financial aspect, the cultural aspect, the patient-nurse relation, bureaucracies and much more of that. One of the most neglected and ignored barriers however is the gender aspect that, though is outstanding and is experienced in the daily practice, the gender parity and discriminatory perspectives in nursing are usually ignored.

There are real and perceived barriers that men face when they want to join the nursing profession. Apparently, the nursing profession was not gender selective before the 1800s, this changed significantly with the emergence of Florence Nightingale who had no place for men in the nursing sector except where physical strength was needed. Nightingale focused on the innate characteristics of the female gender as being compassionate, caring and loyal and also the fact that most have undergone motherhood, and she treated these are the prerequisites of nursing. She even went further to indicate the age at which the females should consider becoming nurses (Margaret G.A.,2013). It was at this stage that the perspective of nursing to be a female domain took root.

This perception has in the long run made many people view the nursing as a female domain and making many shun the profession. This has led to the global shortage of nurses as many males would rather get into the medical field but go for being a doctor or other related fields and not being a nurse. There is no ground or proof that males cannot make good nurses since the innate characteristics are in existence in both males and females and the training helps to bring this out in both gender.


Margaret G.A., (2013). Florence Nightingale's Influence on Nursing. Retrieved September 7, 2013 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805929/

Scully, (2011). The theory-practice gap and skill acquisition: an issue for nursing education. Retrieved September 7, 2013

http://www.ncbi.nlm.nih.gov/pubmed/21706997… [read more]

Apns Competency Course Competencies Research Paper

Research Paper  |  3 pages (1,037 words)
Bibliography Sources: 3


"Sixty-nine studies published between 1990 and 2008 were analyzed and 28 outcomes were summarized for nurses practicing in APRN roles. The results indicated that APRNs provide safe, effective, quality care and play a significant role in promoting health and health care" (Patient Protection and Affordable Care Act; Program Integrity, 2013, ANA). Using APNs for roles once fulfilled by physicians promote patient wellness. APNs can provide accessible, personalized, and high-quality service.

However, because of the ambiguity of their roles, APNs may be called upon to perform multiple functions in a diverse healthcare environment. APNs often must "use their technical knowledge and skills to provide support and teaching, particularly to nurses and junior doctors when they first started on the wards and were unfamiliar with the organization" (Williamson 2012). APNs act as teachers and mentors; facilitators and delegators as well as offer care to patients. Regardless of whether the profession was intended to assume an educational and directive role, it has in many contexts for both specialists and generalists.

It has also been observed that having an APN on a ward often results in a transfer of responsibility to the APN, particularly if doctors are not available, which can result in an shift in responsibility and power in favor of the APN away from those of less credentialed nurses in a process known as 'deskilling.' Combined with the blurred roles for APNs, one study noted that frequently "APNs perceived that they were part of neither the medical nor the nursing team, yet had to meet competing demands and, in some cases, overcome the antagonism of colleagues" (Williamson 2012). There may also be antagonism between APNs in various specialties and clinical nurse practitioners who have areas of personal expertise but lack advanced degrees.

The creation of healthcare exchanges as part of the Affordable Care Act is seen as a critical time for APNs, enabling nursing professionals to advocate for the elimination of existing barriers to APNs providing primary care in some states and an end to "traditional private health insurer practices that prohibit APRN participation in private health insurance networks" (Patient Protection and Affordable Care Act; Program Integrity, 2013, ANA). The American Nurses Association has called for mandating that all participant insurers allow APNs to exercise the full scope of their training, both as a way of containing costs and also in recognition of the high-quality care the evidence shows that APNs can provide. Although defining the profession may still be a struggle within both academia and on the wards, the vitality of the debate indicates that the role of APNs is likely to be expanded still further and that the demand to obtain an advanced degree in nursing will rise in coming decades.


Hanson, C. & Hamric, A.B. (2003) Reflections on the continuing evolution of advanced practice nursing. Nursing Outlook, 51:203-211. Retrieved from:


Patient Protection and Affordable Care Act; Program Integrity. (2013). ANA. Retrieved:


Williamson S. et al. (2012) The role and benefits of ward-based advanced nurse practitioners.

Nursing… [read more]

Advanced Practice Roles Research Paper

Research Paper  |  3 pages (1,091 words)
Bibliography Sources: 3


APNs in more conventional practice settings may feel threatened by specialties that treat population groups and place more of an emphasis on group-based rather than individually-based nursing. However, "statements that distinguish rather than disparage selected APN groups are necessary to build the internal cohesion needed to promote advanced practice nursing to the public and other healthcare providers" (Hanson & Harnric 2003: 206). In fact, there is a great deal of overlap given that so many individualized problems in primary care such as chronic diseases related to obesity have their roots in larger societal issues, such as a lack of healthy food and exercise.


Hanson, C. & Hamric, A.B. (2003) Reflections on the continuing evolution of Advanced Practice

Nursing. Nursing Outlook, 51:203-211. Retrieved from:


Question 3: The ANA Scope and Standards of Practice document identifies specialty nursing practice and advanced practice nursing behaviors

Although specialty nurses and APNs both operate within the general nursing paradigm, there are a number of critical differences between the two. First and foremost, while specialty nurses focus on a single field of practice or patient population (such as family practice, pediatrics, gerontology, and psychiatric care), general APNs have a more broad-based framework of knowledge and operate in more varied practice settings. Much like physicians, whose roles they are increasingly subsuming, "advanced practice nurses must be grounded in theory and research as guides to their clinical practice. While they work in collegial capacities with physicians, they must be prepared to diagnose and treat patients with acute and chronic illnesses and to prescribe medications" (What is APN, 2013, Vanderbilt University). They can refer patients to specialty providers; organize research studies; interpret lab results; and perform a more wide range of "psychosocial, functional, and developmental assessment" functions (What is APN, 2013, Vanderbilt University). The scope and knowledge base of a general APN more completely mirrors that of a physician.

In terms of regulating credentials "most APRNs possess a master's or doctoral degree in nursing and may also have passed additional certification examination. APRNs are regulated as a separate group by 52 boards of nursing" (Kenward 2007: 4). The ability of APNs to perform specific services is also defined separately from those of nurse specialists. For example, "in at least 45 states, advanced practice nurses are allowed to prescribe medications, while 16 states have granted APRNs authority to practice independently without physician collaboration or supervision" in contrast to RNs (Kenward 2007:4). For nurse specialists, regulatory oversight "is mostly done by the state boards of nursing…Other oversight bodies include advanced practice nursing board, department of health and board of advanced registered nurse practice" (Kenward 2007:5).


Hamric, A.B., Spross, J.A., & Hanson, C.M. (2009). Advanced practice nursing: an integrative

approach (4 ed.).

Kenward, K. (2007). Report of findings from the role delineation study of nurse practitioners and clinical nurse specialists. Special report: National Council of State Boards of Nursing, Inc. (NCSBN), 30. Retrieved from:


What is APN? (2013). Vanderbilt University. Retrieved from:

http://www.nursing.vanderbilt.edu/msn/whatisapn.html… [read more]

Collaborative Nursing Term Paper

Term Paper  |  4 pages (1,177 words)
Bibliography Sources: 3


Collaborative Nursing: Evidence and Expert Interview

As I continue to advance in my career development, I continue to take steps toward reaching the two SMART goals identified in the previous section of this project. These goals, to become a nurse educator and to become a Unit Nurse Educator at Emory Healthcare, both require an extensive body of experience, knowledge and continuing career development education. The discussion presented below gives consideration to these requirements by using data drawn from both literature and professional interviews. This qualitative data is considered here and provides fresh insight into how I might best achieve both of my SMART goals.


Though nothing can replace the value of the actual, hands-on practice of medicine, it is important for a nursing professional to have a firm grounding in the theoretical dimensions of care-giving as well. This is why texts such as that by Motacki & Burke (2011) are so valuable. The text in question provides considerable detail on the actual demands that will come with everyday work not just as a nurse but specifically as a nurse educator. As the text demonstrates, nurse education is an essential everyday part of care management. According to the text, "the process of patient care management includes skills such as delegation, patient assignment, coordination, collaboration, communication and outcome monitoring. This process occurs in an interdisciplinary work environment, and skill in working in such environments is necessary." (Motacki & Burke, p. 1)

This helps to elucidate the skills that I must hone to be an effective nurse educator. Working in a collaborative environment, the text shows, requires exceptional skills in communication, leadership and grace under duress. Another important aspect of the working environment is the impact of its administrative leadership. Such is to say that as nursing professionals, we must contend with the difficulties that often come with working in a bureaucracy or an organization that is otherwise insensitive to the needs of patients and caregivers. As the a Unit Nurse Educator, that target position of my second SMART goal, I recognize that I will be in a position of leadership. In such a position, I will be more likely to face those bureaucratic obstacles head on. As the text by Kramer et al. (2009) contributes to this discussion, it will be incumbent upon me to find balance between respecting the administrative authority of my healthcare institution and creating a positive environment for treatment. As Kramer et al. warn, "Nurses cannot control practice or engage in activities related to a patient-centered culture at the unit level unless parallel sanction and endorsement for these activities exist at the organizational level." (p. 77)

I recognize that an important part of my aspiration to this second SMART goal is learning to lead within limitations. In addition to this resolution, the literature helps to make me more fully aware of the massive challenges that lay ahead for any nurse educator. Today, perhaps more than ever before, there is a growing deficit between the treatment challenges facing… [read more]

Function of Theory in Nursing Practice Annotated Bibliography

Annotated Bibliography  |  8 pages (2,840 words)
Bibliography Sources: 8


¶ … function of theory in nursing practice.

Margaret Newman and the non-nursing theory of James Fowler, which has been adopted in approaches and teachings in nursing.

Margaret Newman

Theory of Health as Expanded Consciousness (HEC)

Understanding the consciousness of patients

View of patients as a connected to universal energy

Understanding differing concepts of time, space, and reality

Interjecting caring… [read more]

Nursing According to the Systems Research Paper

Research Paper  |  3 pages (1,270 words)
Bibliography Sources: 2


Kaminski indicates that "the Diffusion of Innovation theory is often regarded as a valuable change model for guiding technological innovation where the innovation itself is modified and presented in ways that meet the needs across all levels of adopters." (p. 1)

This is critical because our healthcare technologies are only as good as the nurses who will be end users. It is critical that innovation be proliferated in a way that incorporates the needs, expectations and experience of those who must ultimately use this technology to accommodate patient needs.

Search Strategies:

The search strategy which located articles by Brookes et al. (2007) and by Romano (1990) was initiated using the EBSO CINAHL Database. This approach yielded two useful articles but required some parsing through various journals. By contrast, the Google search which yielded articles by Kaminski (2011) and by Clancy et al. (2008) was more precise, focused efficient. The professional database proved more cumbersome where the search process was concerned.

Annotated Bibliography:

Brookes, K; Davidson, P.M.; Daly, J. & Halcomb, E.J. (2007). Role Theory: A Framework to Investigate the Community Nurse Role in Contemporary Healthcare Systems. Contemporary Nurse, 25(1-2), 146-155.

The study by Brookes et al. (2007) is especially critical to our discussion for its focus on the role of nurses through a systems theory lens. The article contributes the understanding to our research that nursing roles are defined by a host of overlapping demands both internal and external to a given care context. This denotes that the systems theory is appropriate for measuring the impact that these forces have separately and collectively on nursing orientation.

Clancy, T.R.; Effken, J.A. & Pesut, D. (2008). Applications of Complex Systems Theory in Nursing Education, Research, and Practice. Nursing Outlook, 56(5), 248-256.

Clancy et al. acknowledge through their article that the nature of the healthcare industry is an increasingly complex one today. The combination of ever-advancing informatics, electronic health record technologies, treatment options, regulatory conditions and bureaucratic imperatives has produced a 'complex system.' It is for this reason, the article contributes to our overall study, that the systems theory is appropriate to the industry. Said theory is aimed at helping to understand the interdependence of these overlapping conditions.

Kaminski, J. (2011). Diffusion of Innovation Theory. Canadian Journal of Nursing Informatics, 6(2).

Kaminski (2011) provides the present research with a detailed history of the Diffusion of Innovation Theory. The article is intended to offer both an overview of the theoretical model and a discussion of its relevance to the nursing profession in its current state of evolution. Identifying the stages of diffusion through its participants, Kaminski introduces the concept of innovators, early adopters, early majority, late majority and laggards to help us understand the natural progression of the uptake of innovation in the field.

Romano, C.A. (1990). Diffusion of Technology Innovation. Advances in Nursing Science, 13(2), 11-21.

Published in 1990, the article by Romano is notably prescient for its recognition of nursing informatics as a rapidly evolving area of the practice. This discussion on… [read more]

Registered Nursing Essay

Essay  |  2 pages (550 words)
Bibliography Sources: 1


Registered Nursing

Registered nurses are medical practitioners who offer and coordinate patient care in addition to advising and providing emotional support to patients and their families. These professionals work in diverse health care settings including home healthcare services, hospitals, nursing care centers, and physician's offices. Moreover, registered nurses work in schools, with the military, correctional facilities, and summer camps. Since these medical professionals work in different settings, they have three education paths i.e. diplomas from authorized nursing programs, an associate nursing degree, and a bachelor's in nursing. In addition to either of these education paths, registered nurses must be licensed through passing a national licensing exam.

As part of their initiatives to provide and coordinate patient care, registered nurses carry out several duties including recording patients' symptoms and medical histories, giving medicines and treatments, and developing patients' care plans. They also observe patients, record their observations, consult with other healthcare practitioners, manage and supervise medical equipment, and help conduct diagnostic tests and evaluate results. With regards to advising patients' families, they teach patients and their families on management of diseases or injuries and explain necessary procedures after treatment ("Registered Nurses," 2012). In some cases, these professionals are mandated with the task of supervising licensed practical nurses, home care aides, and nursing aides.

The duties and titles of registered nurses is usually dependent on their work settings and their patients since they can focus on several specialties like a specific health condition, a particular body part, a certain group of people, and a specific working environment. While some of them combine two or more of these specialties, there are several possibilities for specializing.

In the current…… [read more]

Collaborative Nursing the Two Smart Term Paper

Term Paper  |  3 pages (1,136 words)
Bibliography Sources: 3



Goal 2: Nursing Mentoring

The authors of a peer-reviewed article in Nursing Education Perspectives (Cottingham, et al., 2011) assert that in addition to the critical shortage of nurses, there is also a growing number of nurses who will be leaving their positions because of: a) a lack of appreciation from their superiors; b) a "diminished sense of value within the organization"; and c) a "lack of professional stimulation" (Cottingham, 250). The problem related to a lack of stimulation could be (and should be) remedied with ongoing and inspirational mentoring programs. Nurses should be incorporated "…at all levels in the mentoring process," Cottingham concludes (255).

Credible Website: The Truckee Meadows Community College Website (www.tmcc.edu) presents thorough details on the mentoring program that is available to nursing students at the college. As part of the education of nursing students, Truckee Meadows recruits experienced nurse practitioners who are "enthusiastic, friendly…caring and understanding…" to mentor beginning students. One whole component of the nursing program at TMCC revolves around learning to be "…an effective mentor" in the field of nursing. This is a worthy Website.

Informational Expert: Eileen also alluded to the importance of mentoring at her workplace. "In addition to classes on ethics all nurses at the facility are required to set aside time for mentoring newer nurses that come on the floor. We have huge turnover because of the violent nature of some of our patients, and each time a nurse is hired -- whether she has had experience in this kind of facility or not -- that nurse receives serious mentoring from several of us on the floor." What specific kinds of issues are covered in the mentoring? "We go over the ethical standards we all are expected to adhere to; we have a checklist that we review with the newly hired nurse; we answer questions and we emphasize the need to stay calm and collected whenever possible because the patients sense when a nurse is afraid, and they take advantage."


The SMART goals in this paper -- ethical leadership and nurse mentoring -- have been explained and through the peer-reviewed articles presented, solid, helpful information has been provided. According to the Storch article, ethics is not sufficiently emphasized in the literature and moreover, some nurses feel that they do not have the support of their superiors in terms of ethical leadership and behavior. And in the mentoring article, along with the acute shortage of nurses, it is reported that there are many nurses who will not stay in the industry because they are not stimulated and they apparently have a "diminished sense of value" in the field. Mentoring could and should remedy that situation.

Works Cited

Cottingham, S., DiBartolo, M.C., Battistoni, S., and Brown, T. (2011). Partners in Nursing: A

Mentoring Initiative to Enhance Nurse Retention. Nursing Education Perspectives, 32(4),


Eileen. (2013). "Ethical leadership and mentoring are an important part of nurses in the psychiatric facility where I work."

Ghebrehiwet, T. (2013). Doing what's right: The ethics of… [read more]

Role of APN Research Paper

Research Paper  |  10 pages (3,411 words)
Style: APA  |  Bibliography Sources: 7


Role of an advanced practice nurse (APN) has changed and evolved over the years to the point where an APN has more authority, more respect and more responsibility -- and this paper delves into those responsibilities. The paper also reviews the intelligent use of the APRN (or APN) and the not-so-intelligent use of these well-trained healthcare professionals.

The prescriptive authority… [read more]

Multisystem Failure in a Geriatric Term Paper

Term Paper  |  7 pages (2,043 words)
Bibliography Sources: 7


However, in order to quantify the changes, nurses must follow the required measures after administering the sedatives. In order to know whether the pain management is successful, the level of pain after administering palliative should be lower in comparison to the level of pain before administering palliative (Rosenthal & Kavic, 2004).

2. Discuss what you learned regarding assessment of the geriatric patient.

Through the effective treatment administered to Mrs. Elli Baker, I realize that it is very difficult to administer any form of treatment to geriatric patients in comparison to other groups of people. Geriatric patients might be unwilling to respond to any medical questions and disclose information regarding their health status.

F. Identify the collaborative team members pertinent to the care of the geriatric patient in the scenario, including the emergency room nurse's response to changes in the level of consciousness and increasing respiratory distress.

Numerous collaborative team members play a larger role in caring and managing the geriatric patient. For example, in this scenario, the community health workers as well as the primary care nurses play a significant role in health assessment process in times of emergencies. For example, when Mrs. Baker was on her phone she seemed confused, and some minutes later, she collapsed in her backyard. If there were a community health worker or a primary care nurse, he/she would identify the signs in Mrs. Baker and control them before worsening.

In addition, in the ER, nurses and doctors play a significant role similar with the collaborative team members in caring and managing geriatric patients. In the ER, nurses should be very careful when inserting the chest tubes. As well, in case the level of respiratory distress elevates, nurse ought to have the capacity to utilize the required diagnostic devices to assess patients facing such conditions. They should utilize diagnostic tools, such as good medical history, comprehensive physician examinations, and good chest auscultations (Rosenthal & Kavic, 2004).


Esteban, A., Anzueto, A., Frutos-Vivar, F., Alia, I., Ely, E.W., Brochard, L., et al. (2004).

Outcome of older patients receiving mechanical ventilation. Intensive Care

Medicine, 30(4), 639 -- 646. Evidence Level IV: Nonexperimental Study.

Happ, M.B., Baumann, B.M., Sawicki, J., Tate, J.A., George, E.L., & Barnato, A.E. (2010).

SPEACS-2: Intensive care unit "communication rounds" with speech language pathology. Geriatric Nursing, 31(3), 170-177. Evidence Level III.

Kane, R.L., Ouslander, J.G., & Abrams, I.B. (2004). Essentials of Clinical Geriatrics (5th

Ed.). New York: McGraw-Hill. Evidence Level VI: Expert Opinion

Mick, D.J., & Ackerman, M.H. (2004). Critical care nursing for older adults:

Pathophysiological and functional considerations. Nursing Clinics of North

America, 39(3), 473 -- 493. Evidence Level VI: Expert Opinion.

Marik, P.E. (2006). Management of the critically ill geriatric patient. Critical Care

Medicine, 34(9 Suppl.), S176-S182. Evidence Level VI.

Pisani, M.A., Inouye, S.K., McNicoll, L., & Redlich, C.A. (2003). Screening for preexisting cognitive impairment in older intensive care unit patients: Use of proxy assessment. Journal of the American Geriatrics Society, 51(5), 689 -- 693.

Evidence Level IV: No experimental Study

Rosenthal,… [read more]

Critical Care Nursing Case Study

Case Study  |  12 pages (4,512 words)
Bibliography Sources: 20


¶ … care needs, concerns and treatment strategies for Mrs. Margaret Cronin, an elderly patient admitted to HDU following assessment in DEM. This paper will first examine her necessities of care while determining the impact of all biopsychosocial and pathophysiological responses of the client. Given the melee of Margaret's symptoms, along with her medical history -- hypertension, pneumonia, and extreme… [read more]

Application of Nursing Theory Term Paper

Term Paper  |  7 pages (2,277 words)
Bibliography Sources: 7


¶ … nursing Theory

Middle range theory

The Middle range theory is one of the critical and functional theories relating to the management of nursing principles and practices in the society. According to this theory, there is a close relationship between nursing theory and practices while carrying out nursing principles and activities. The theory proposes the importance of having nursing… [read more]

Patricia Benner: Nursing Philosophy Research Paper

Research Paper  |  5 pages (1,571 words)
Bibliography Sources: 4


It can be said that the practitioners can take appropriate action to modify their plans for obtaining the most efficient results. For this purpose, the nurses can identify the unusualness of the situation while considering the effects before the implementation of the plans. It is further said that the nurses are required to have the efficient holistic understanding of the situation to provide the most effective healthcare to the patient (Benner, Tanner, & Chesla, 2009; Sitzman & Eichelberger, 2010).


It can be concluded from the paper that the nurses can assist their patients to come out of negative mentality and attitude caused due to the healthcare issues. It is also found that the Benner's theory has provided that the nurses can offer words of comfort to patients while refreshing their confidence. It can be said that the role of nurse can be defined as a facilitating role to assist a patient for obtaining the higher level of consciousness. It is found in the paper that the nurses are required to offer services to patients that are based on cure. A nurse can develop a care fellowship with patient while helping him to find the hidden healing that is inside him (Benner, Tanner, & Chesla, 2009; Basford & Slevin, 2003).


Basford, L., & Slevin, O. (2003). Theory and Practice of Nursing: An Integrated Approach to Caring Practice. Nelson Thornes.

Benner, P.E., Tanner, C.A., & Chesla, C.A. (2009). Expertise in Nursing Practice: Caring, Clinical Judgment & Ethics. Springer Publishing Company.

Finkelman, A.W., & Kenner,…… [read more]

Nursing Ethics Essay

Essay  |  2 pages (580 words)
Bibliography Sources: 5


, 2009).

A Code of Ethics is in place so that professionals have a clear and unambiguous way to help make decisions. With the six fundamental principles of ethics combined with the principles of informatics ethics, we find that there is a duty that is expected of the nurse to provide privacy, openness, security, and support the patient's wishes. In this sense, ethics and legality do not mesh. In the case of euthanasia, for instance, a patient may have the appropriate documentation legally signed (no intrusive measures, etc.), and the nurse must be responsible for maintaining those wishes and keeping the records private. They also have the moral duty of allowing the individual the moral right to choose what is best for them as an extension of the basis on national rights. For the nurse, every Code of Ethics says that suffering and lengthy pain are not moral. Making it easier for the patient to be comfortable when there is no hope for recover is kinder than heroic medical measures that may prolong pain and suffering (IMIA; Information for Research on Euthanasia, 2009).

This is certainly a quandary for legal scholars, moral philosophers, healthcare professionals, and anyone who has a loved one in an untenable terminal and painful, condition. We then have the trend in medical ethics in the 21st century that not seems to focus on deontology more than utilitarianism (the means are more important than the results). But, the combination of care and virtue ethics also means that besides medical ethics, we must also look at the overall benefit to society. Within medical ethics,…… [read more]

Illness Modern Nursing Is Extremely Complex Essay

Essay  |  2 pages (723 words)
Bibliography Sources: 2


¶ … Illness

Modern nursing is extremely complex and much more patient oriented than ever before. Nursing theories abound, and are all useful in providing a toolbox of resources for the modern nurse. Theories are useful when usable, and when there are concepts that are part of the dynamic relationship in caring and advocacy that are some of the primary expectations of the modern nurse (Alligood, 2010). Because patients are often frightened and uncertain, one of the theories that can be used in both analysis and tactical application is Mishel's Uncertainty of Illness Theory. This theory is comprehensive and can be applied to any number of patient populations with divergent demographic characteristics, varying health concerns, and has no limits on age and ethnicity. Mishel tells us that interventions by the nurse can help calm the patient through gestures, words, symbolic references, behaviors, and empathy. The theory has many similarities to Watson's Theory of Caring, in that during uncertain times, empathy and care from the nurse can have a positive and proactive effect upon patient health, expectations, and ability to understand medical procedures. Indeed, clinical evidence supports that uncertainty in illness often increases fear to the point that it can make decisions about care and treatment options difficult for patients to make due to increased anxiety and a lack of ability to understand the decision making process (Mishel and Clayton, 2003).

Mishel's theoretical construct and quantitative scale may be used quite well during period of uncertainty, particularly when there is a potential life-threatening illness. For example, in a recent study focusing on the diagnosis of meningioma, researchers found that the patients' combined understanding of the illness along with a nursing intervention using Michel had considerable positive effects in helping women make informed decisions regarding treatment options, interventions, and procedures. Using this theory, nurses are able to be in a unique and powerful position to influence the process of understanding, informed decision-making, and ultimately, a co-role in support for patient's who face life-changing decisions (Guadalupe, 2010).

In the case of meningioma, age and gender are important variables: the illness tends to strike females older than 70 almost four times more than those younger.…… [read more]

Self-Confidence in Licensed Practice Nursing Students Introduction Chapter

Introduction Chapter  |  12 pages (4,199 words)
Bibliography Sources: 8


¶ … self-confidence in licensed practice nursing students. Nurses are important personnel in the hospital or any medical setting. Despite the training and teaching strategies used in their curriculum, many nurses complain of lack of confidence when it comes to applying their practical knowledge. This research will look into experience of licensed nursing students in order to find a positive… [read more]

Nursing Informatics Pioneers Essay

Essay  |  3 pages (1,034 words)
Bibliography Sources: 5


Abbott made her most significant contribution to the field by serving as the director of graduate programs in Nursing Informatics at the University of Maryland, where she quickly steered the program into becoming the largest such nursing informatics educational outlet in the world. One critical component of Dr. Abbott's approach to teaching nursing informatics has been based on her own introduction to the field from an independent, three credit course. Rather than limit the role of informatics to one niche of a nurse's overall education, Dr. Abbott has advocated for an innovative and inclusive approach, stating that "it should be woven into every single class that we teach, that every basic essential core competency in nursing has a data or an informatics components to it" (AMIA, 2008). As she stated with such humility in her AMIA interview, "I like to think that I played just a small role in creating this third-, fourth-, fifth generation of nurse informaticians that are now out in practice" (2008), and after learning more about Dr. Abbott's work, it is safe to say that her impact on my chosen profession has been profound.

Dr. Betty L. Chang, DNSc, RN, FNP-C, FAAN also became inspired to integrate the precepts of nursing informatics into her own career after observing the subpar care and treatment afforded to the nation's elderly patients. Beginning her career at the University of California, Los Angeles (UCLA), Dr. Chang immediately began to notice that, while computerization was being used to improve operations in billing, pharmaceutical administration, and laboratory testing, the techniques were not being readily adopted by working nurses. When her studies revealed that clinical nursing specialists (CNSs) under her supervision were developing inconsistent diagnoses upon being given the same set of symptoms and etiologies, Dr. Chang found "an impetus to work toward an expert system to provide decision support for nurses in deciding upon nursing diagnoses" (AMIA, 2008). Dr. Chang cites this novel approach to quantifying the efficacy of nursing diagnostics as her most lasting contribution to the field of nursing informatics, telling the AMIA that she is most proud of "drawing attention and awareness of nurses to the use of decision support in making nursing diagnoses and subsequently in selecting nursing interventions, and finally, in the evaluation of care" (2008).


Abbott, P. (2008, November 19). [Video Tape Recording]. Nursing informatics pioneer interview. American Medical Informatics Association Nursing Informatics History Project, Bethesda, MD., Retrieved from http://www.amia.org/sites/amia.org/files/Patricia-Abbot-NIWG.pdf

Chang, B. (2008, June 07). [Video Tape Recording]. Nursing informatics pioneer interview. American Medical Informatics Association Nursing Informatics History Project, Bethesda, MD., Retrieved from http://www.amia.org/sites/amia.org/files/Betty-Chang- NIWG.pdf

McLane, S., & Turley, J.P. (2011). Informaticians: How they may benefit your healthcare organization. Journal of Nursing Administration, 41(1), 29-34.

Nightingale, F. (1860). Notes on nursing: What it is and what it is not. New York: D. Appleton and Company.

Travers, D., & Mandelkehr, L. (2008). The emerging field of informatics. North Carolina Medical Journal, 69(2), 127-131. Retrieved from http://www.ncmedicaljournal.com/wp- content/uploads/NCMJ/mar-apr-08/travers.pdf… [read more]

Nursing: Nursing Theorist Madeleine Leininger Term Paper

Term Paper  |  4 pages (978 words)
Bibliography Sources: 4


The attainment of those goals are impacted by roles, stress, time, and space. King held that nursing is a focus on the care of a human being and nursing goals is the health care of individual patients and groups of patients. From King's view, human beings are open systems that interact with their environment constantly. The basic assumption in the goal attainment theory is that the client and nurse relate information and set mutual goals taking action to achieve those goals. This is also held to be the primary assumption of the nursing process. King stated "Each human being perceives the world as a total person in making transactions with individuals and things in the environment." (Nursing Theories, 2012, p.1) Also stated by King is that "transaction represents a life situation in which perceiver & thing perceived are encountered and in which person enters the situation as an active participant and each is changed in the process of these experiences." (Nursing Theories, 2012, p.1) The major concepts of King's nursing theory include the following interacting systems:

(1) social;

(2) interpersonal; and (3) personal. (Nursing Theories, 2012, p.1 )

The concepts for the personal system include perception, self, growth & development, body image, space and time. The interpersonal system concepts include those of interaction, communication, transaction, role, and stress. Social system concepts include the elements of organizations, authority, power, status, and decision-making. King proposed in her theory that if the nurse-client interactions are perceptual interactions that transaction will occur and that if the nurse and client make the transaction the goal will be achieved. (Nursing Theories, 2012, paraphrased) Where transactions are made in the interactions between the patient and nurse, growth and development will be enhanced. However, where there is a role conflict on the part of the nurse or the patient there will be stress. However, where the nurse has special knowledge and is able to effectively communicate that information to the client, there will be a mutual setting of goals and goal achievement will result.

Summary and Conclusion

The nursing theories of Leininger and King have been reviewed and while there are differences in these theories, there are similarities as well. Both theories acknowledge that patient-nurse interaction is critical in attaining a positive health status for the patient. Both theories also acknowledge the importance of the patient as a whole person.


Imogene King's Theory of Goal Attainment (2012) Nursing Theories. Retrieved from: http://currentnursing.com/nursing_theory/goal_attainment_theory.html

Leininger, M (1996) Culture Care Theory: Research and Practice. Nursing Science Quarterly 9(2) 72-75.

Tourville, C. And Ingalls, K. (2003) The Living Tree of Nursing Theories. Nursing Forum, Vol. 38, No.3 July-Sept 2003. Retrieved from: http://www.snjourney.com/ClinicalInfo/NgTheory/Nursing-Theory-Tree.pdf

Williams, Leigh Ann (2001) Imogene Kings' Interacting Systems Theory: Application in Emergency and Rural Nursing. Online Journal of Rural Nursing and Health Care,…… [read more]

Nursing Conceptual Model Essay

Essay  |  3 pages (1,005 words)
Bibliography Sources: 4


¶ … nursing Conceptual Model

Overview of Madeline Leininger's Theory of Culture care Diversity and Universality

Madeline Leiningers was a famous nursing theorist who studied nursing as a profession. She developed several nursing details and theories that are used up to today in the nursing profession. She based her theory on the notion of trans-cultural nursing. The theory involved a discussion of the meaning and intention of care in nursing. It is a common feature to encounter the term care in all fields that involve nursing and nursing professionals. Through many studies and exemplifications related to nursing, Madeline Leiningers developed a theory called a transcultural theory (Reynolds & Reynolds, 1993).

The aim of Madeline Leiningers trans-cultural theory is based at establishing a congruent nursing care through cognitive-based assistance. The theory makes use of facilitative, supportive, and enabling actions that make one is in a position of fostering equitable management of the available health care within the nursing profession. The measures of providing support and care are tailor-made and fit individuals, groups, beliefs, cultural values, lifestyles, and many other characteristics of people in the society. The intention behind the provision of health care among the patients is directed at establishing the best possible avenues of development and influence in the society. The main aim of Madeline Leiningers was to foster an equitable nursing care. The nursing care would involve all the people no matter the culture and society with other orientations that make up patients in the health centre.

The theory has a number of components that ensured that it lived in accordance to the provisions of health in the society. The theory considers communication and language as a basic fact that brings about success in the delivery of health care to patients. Through language and communication, nursing professionals are able to reach many cultures and diversity among the clients. The theory considers gender as one of the main factors of a successful multicultural nursing profession. Through gender, the theory considers its diversity in a bid to diversify the provision of health services to the people. Sexual orientations make up part of the changes and entities that dictate the nature of providing health to the people. Moreover, the notion of having a stable ground of performance is directed at the disability/ability orientations among all the people. The theory fosters for a universal provision of health services to the people involved. This does not depend on the states of occupation, age, socioeconomic orientations, and appearance or dresses people have.

Madeline Leiningers' theory makes considerations of making it possible for people to access nursing services. Patients are able to access services without having to provide their basement of food and use of space. The theory reiterates the importance of providing a unified mode of nursing health services in order to foster interpersonal relationships between the nursing services and all the people concerned. The state of providing the health services is directed at the nature of meals and preparations together with related lifestyles among… [read more]

Nurse Barriers Nursing Care Essay

Essay  |  2 pages (640 words)
Bibliography Sources: 2


Nurse Barriers

Nursing Care and Barriers to Evidence-Based Practice

In a recent and rather typical nursing setting, I was tasked with delivering care -- including the provision of advice -- to a patient with Type II diabetes. The care provided was very standard and straightforward, as the patient was present in the medical office for a check-up/monitoring of her condition and not due to any new or recently aggravated symptoms or other complaints or concerns. Insulin and fasting glucose were tested and assessed in accordance with established guidelines, dietary records were taken as reported by the patient, and dietary choices were discussed in light of the patient's reported eating habits and history of insulin needs as well as other parameters of her condition. All of this was accomplished in keeping with evidence-based practice, as far as this nurse is aware, and yet this really is the crux of the issue (Polit & Beck, 2012). The degree of standardization and established practice guidelines for such check-ups is assumed by the nurse to be in keeping with research and thus to constitute evidence-based practice, and yet the regularity of the interpretation of results and of the advice given does not appear to be individually customizable nor has this nurse been able to independently verify the recommendations made for practice and care delivery.

The primary barrier to delivering, or more correctly to confirming the delivery of, evidence-based care, is a lack of time available to the nurse to engage in reading the relevant research (Zeitz & McCutcheon, 2003). Especially in a general practice setting where no real specialization exists, nursing staff are not only expected but required (due to a variety of ethical, medical, personal, and legal constraints) to provide care along established guidelines and to make significant adjustments to care only after lengthy discussions with nursing leaders and/or physicians, and must be able to do so for a variety of patients in…… [read more]

Self-Esteem and Nursing Essay

Essay  |  5 pages (1,656 words)
Bibliography Sources: 1+


A nurse with low self-esteem cannot do this. Nurses who spread themselves too thin and never take the time to nurture themselves become less, rather than more caring towards their patients. This is why it is so important that nurses take time to 'have a life.' "Hobbies and activities have been known to boost peoples' self-esteems, so it would be beneficial to do something meaningful on one's spare time. Enroll in an exercise class, learn a new art or craft, travel, join an organization, or become good at something unrelated to the job. Keep in mind that professional counseling may be needed for the most chronic problems with self-worth" (Nurses with low self-esteem please seek help, 2012, All Nurses). This is why it is so valuable for hospitals and other healthcare institutions to offer on-site counseling for nurses who must often deal daily with death, sickness, and other problems which may cause them to question their sense of self-worth.

Creating a cohesive environment in which colleagues are encouraged to support one another, including young nurses, is an important first step in fostering nurses' self-esteem. It has often been observed that older nurses tend to 'haze' younger nurses (in a phrase often called 'eating their young') and this hazing can cause a blow to younger nurses' self-esteem from which they never fully recover. This ultimately has a negative effect on the profession as a whole, given that it creates higher levels of attrition and in-fighting. Nurses must be resilient to deal with the challenges they face as healthcare professionals, and resiliency is impossible without high self-esteem.


Chapter 15: Self-image. (n.d.). Cengage Learning. Retrieved:


Moody, R.C., & Pesut, D.J. (2006). The motivation to care: Application and extension of motivation theory to professional nursing work. Journal of Health Organization and Management, 20(1), 15-48

Nurses with low self-esteem please seek help. (2012). All Nurses. Retrieved:

http://allnurses.com/nurse-colleague-patient/nurses-low-self-751537.html… [read more]

Evidence-Based Practice (EBP) Essay

Essay  |  3 pages (895 words)
Bibliography Sources: 6


This is good not only for her esteem but also for the quality of her general practice.

EBP, according Sackett (2009) is linked to five main ideas which are:

That application of epidemiological, economic and biostatistical principles as well pathophysiology and personal experience be integrated in one's practice,

That clinical and health-based decision should be formulated on the most authoritative evidence available.

That the nature and source of the evidence should be linked to the congruent and applicable clinical population.

That appraisal and review of the information be integrated in one's practice, and that,

There should be consistent monitoring of one's performance.

EBP to has its disadvantages. They include the following:

Evidence-base d practice has been said to be a program that is not only time-consuming to implement but also takes certain skills to master it. Nonetheless, given its importance, this may be a questionable disadvantage since anything worthwhile is time-consuming.

More significantly, Straus and McAlister (2000) claim that EBP lacks sufficient evidence to confirm its advantages as a nursing program / theory. It also reduces the client's choice in matter and form of treatment as well as other variables of treatment, aside from which EBP overlooks the client who has atypical needs and is different form the norm. (Research, generally deals with the norm).

Evidence-based practice too suppresses creativity as well as suppressing autonomy since it enjoins nurse to follow scientific literature research rather than her own intuitions or higher judgment.

Evidence-based practice too influenced legal proceedings whilst sometimes a more intuitionist approach may be needed. Finally, Straus and McAlister (2000) claim that EBP has its own hierarchies of research that it authorizes with some research that may be completely helpful and reliable, being buried at the bottom of the totem pole.

At the end of the day, practitioners have to realize that they do not know everything and that for this reason they turn to scientific sources to help them. Recognizing their shortfalls and the shortfalls of literature research can also correct for some of the limitations of EBP.


Cluett, ER Evidence-based practice http://www.elsevierhealth.co.uk/media/us/samplechapters/9780443101946/9780443101946.pdf

Sackett DL, Rosenberg WMC, Gray JAM et al. (1996) Evidence-based medicine: what it is and what it isn't. British Medical Journal. 312;169 -- 171

Sackett DL, Straus SE, Richardson WS et al. (2000) Evidence-based medicine. How to practice and teach EBM, 2nd edn. Churchill Livingstone, Edinburgh

Scott, M., & McSherry, R. (2009). Evidence-based nursing: clarifying the concepts for nurses in practice, Journal of Clinical Nursing, 18,1085-1095

Straus SE, McAlister FA (2000 Evidence-based medicine: a commentary on common criticisms. Canadian…… [read more]

Community Health Nursing the Scope Term Paper

Term Paper  |  2 pages (718 words)
Bibliography Sources: 2


FIVE: The data that should be collected and presented to appropriate authorities includes specific abandoned buildings (addresses of the buildings and digital photos), potential activities of children that could mean they are getting exposed (for example, children playing in the dirt near where a factory was located, or where a gasoline station existed when lead was an ingredient in gasoline; lead remains in the soil for many years). Also, any evidence that children are being exposed to lead poisoning should be presented.

SIX: The criteria needing to be developed include a screening program for children once a year. Children in low-income or run-down neighborhoods should be screened once a year for possible lead in their bloodstream. Children living in houses that were built before 1978, and where paint is peeling, should be screened. And the Centers for Disease Control recommend "…all children Medicaid-elgible are categorized as a 'vulnerable population' because they are more likely to live in lead-contaminated housing" (Goodwin, 2009).

SEVEN: The nurses association in the community can show leadership in this matter. The nurse has credibility, and after doing the research, nurses can enlist doctors, other healthcare individuals, parent-teacher associations and elected officials as a powerful coalition.

EIGHT: As pointed out in SEVEN, nurses have a tremendous amount of credibility and clout when they form coalitions with other credible citizen organizations. Implementing change means getting the word out, enlisting Rotary, Lions, Kiwanis, the University Women's group, parents, businesses, and others, and organizing media coverage of events that are planned in order to focus on children's health.

Works Cited

Goodwin, Hilary A. (2009). Lead Exposure and Poisoning in Children. UCLA Institute of the Environment and Sustainability. Retrieved January 30, 2013, from http://www.environment.ucla.edu.

Hitchcock, Janice E, Schubert, Phyllis E., and Thomas, Sue A. (2003). Community Health

Nursing: Caring in Action. Independence, KY: Cengage Learning.

Lundy, Karen Saucier, and Janes, Sharyn. (2009). Community Health Nursing: Caring for the Public's Health. Burlington, MA: Jones & Bartlett Learning.

Union-Tribune. (2013). Nurse's Vision Yields Beds for Homeless after…… [read more]

Delirium in Nursing: Comparing Article Review

Article Review  |  2 pages (679 words)
Bibliography Sources: 1+


The first article is moderately short; therefore, the demand for attention is not as high. Both sets of authors from each article agree that there is a substantial lack of attention and research regarding delirium. Both articles serve to inform and motivate further research on this topic. The 2010 article is an example of an experiment in the intervention of delirium while the 2001 article is an example of a summary of the information available and current perspective on this medical condition.


Both articles advocate for change regarding the perception and treatment of delirium. Both articles contend for measurable testing and results. Both articles furthermore understand the vital role that nurses serve in the treatment of delirious patients. Nurses will often spend quite a deal more time with patients than physicians generally; therefore, dealing with patients who are delirious, or may be becoming delirious is a relevant issue in modern nursing. Medical advances of the modern day are such that patients may survive procedures and conditions that people died from in previous generations. Though these patients may survive, the recovery of such medical conditions may be for an extended period of time. This is one reason why understanding and being trained to observe delirium is critical in the medical profession. Moreover, there is a growing consensus regarding the connection between psychological, emotional, and physical health. When a patient's mental or physical health is in danger, these and other risk factors, directly contribute to the onset of delirium, which will likely further hinder recovery, as a common result of prolonged delirium is death.


Ramaswamy, MD, R., Dix, PharmD, E.F., Drew, J.E., Diamond, PhD, J.J., Inouye, MD, S.K., Roehl, MD, B.J.O. (2010) Beyond Grand Rounds: A Comprehensive and Sequential Intervention to Improve Identification of Delirium. The Gerontologist, 51(1), 122 -- 131.

Schuurmans, Phd, M.J., Duurmas, MD, PhD, S.A., & Shortridge-Baggett, EdD. (2001). Early recognition of delirium: review of the literature. Journal…… [read more]

Nursing Is in a Unique Essay

Essay  |  2 pages (635 words)
Bibliography Sources: 2


Other people can become ill because of potential communal dangers such as environmental hazards or other dangers. The major difference, according to the ANA, is the "focus of care" (Definitions 2012). Those concerned with public care have a larger focus and extends further than the margins of the community in which the nurse serves. Nursing within the community requires a larger scope than those in acute care settings because within an acute setting, there is a more narrow focus on the individuals under the nurse's care.

4. Give examples of the application of the Quad Council Competencies and the Scope and Standards of Public Health Nursing as they apply to staff level and specialist level community nursing practice.

The Quad Council Competencies and the Scope and Standards of Public Health Nursing explain how several groups determined a universal understanding of what they believed as a profession was the responsibility of a nurse (ASTDN 2003). Specific examples of how these should be applied detail the competencies which should be utilized by nurses. One of the most important of these applications is understanding which criterion should be performed by nurses and if a nurse or series of nurses should refuse to commit to these restrictions, or if they are unable to do so, then they do not belong on a hospital staff.

Works Cited:

ASTDN (2003). Quad council PHN competencies.

Center for Disease Control (2012). Core functions of public health and how they relate to the 10

essential services. CDC: Atlanta, GA. Retrieved from http://www.cdc.gov/nceh/ehs/ephli/core_ess.htm

Definitions for population-based health care vs. community-based health care (2012). Retrieved

from http://www2.kumc.edu/instruction/nursing/nurs430/unit2/Popvscom.htm… [read more]

Disaster in Franklin County Emergency Term Paper

Term Paper  |  4 pages (1,309 words)
Bibliography Sources: 1+


Actions During Interviews

In the scenario, the actions of the nurse during interviews varied. It was, however, more focused on quickly assessing the situation for severity of injury, patients at risk, or needed supplies for marginalized populations (children, geriatric patients, or patients with special needs. The nurse in the scenario had to deal with interpretive issues (language), social and behavioral situations (e.g. people are under great stress and may not be acting rationally, and most of all, finding a solution that met the needs of the individuals in duress. The nurse in the simulation also did an excellent job in educating individuals so that they can take some responsibility for their own health and care. This follows the medical paradigm of nursing's responsibilities and responses to emergency situation. Most scholarship in nursing sees the nurse's role as one of leadership; the physicians are tasked with triage and emergency care management, but the nurse needs to advocate for communities, vulnerable populations, and have the competencies to proactively assist in emergency management situations (health promotion, risk reduction, disease prevention and illness and disease management). To do this, however, nurses need to both define their role and function within the emergency management paradigm and prepare ahead for intervention.

Post-Disaster Actions

This scenario outlined the importance that nurses should actively participate in emergency management drills and practices as much as time, and policy allow, but at least annually. Within the emergency management community, there are of course, several local, state, regional and national agencies. Two of these agencies, FEMA, noted above, and the Nursing Emergency Preparedness Education Coalition (NEPEC), formed a protocol in conjunction with Vanderbilt University that coordinates emergency preparedness with nursing organizations. The goals of NEPEC are in direct relation to the nurse participating in emergency management practices but incorporating the more global recommendations into local programs. There are four major goals: 1) increase the awareness and knowledge to all nurses about mass casualty incidents; 2) provide guidance and research to individual nursing and hospital programs that will help train for mass casualty events; 3) monitor and advocate for legislation that is support of such efforts; and 4) increase the effectiveness of all nurses responding to mass casualty incidents by instituting regular and robust training programs that nurses can easily incorporate into their own schedules, but have macro and micro meaning for their overall emergency preparedness (Veenema).

Nursing Personnel

Nurses must maintain current knowledge of emergency plans and procedures, and to maximize effectiveness under crisis situations. The key to the nurse's ability to maintain current knowledge of emergency plans and procedures and to maximize their effectiveness is knowledge and a continual positive liaison relationship with the appropriate emergency management agencies within the community. Most community and regional services actively seek out the expertise of qualified nurses, realizing that they are at the crux of the healthcare pyramid. Because low-frequency events are actually a high risk for potential problems, preliminary training and education are vital for a nurse to be effective with those… [read more]

Nursing the Nevada Nurse Practice Term Paper

Term Paper  |  5 pages (1,444 words)
Bibliography Sources: 2


080. The Indiana State Board of Nursing also allows for ad hoc committees, but no specific committee creation is mandated.

In addition to their duties as board members, Nevada members of the State Board establish regulations for their profession; prepare examinations, investigate and verify applicant qualifications, and set fee schedules for licensure. The State Board of Nursing in Indiana has… [read more]

Nursing the Beginning: Nightingale Term Paper

Term Paper  |  2 pages (638 words)
Bibliography Sources: 1


In 1920, nurses serving in a military capacity for the United States Army received relative rank. This began a chain reaction of recognition of nurses as military officers. By 1938, a section of the Arlington National Cemetery, for distinguished veterans, was dedicated to nurses. The Army-Navy Nurses' Act of 1947 solidified the position of nurses in the military, offering greater job security, equitable pay, and responsibilities.

Nursing in the Heart of the 20th Century

In 1923, Mary Breckenridge recognized the importance of nursing in rural communities and made great inroads ensuring that rural Kentuckians received health care services. African-Americans made great progress during the middle of the 20th century nursing profession after the National Association for Colored Graduate Nurses merged with the American Nurse Association. Increasing numbers of males also started to join the profession.

Advancements in mental health care also transformed the practice and the profession. Mental health specialists were able to provide their patients with drugs to ease their suffering, as advanced understanding of mental illness emerged. Thus, nursing became more of a cross-disciplinary profession that took into account cultural diversity via the understanding of anthropology. Nurses who preferred to work in a religious organization understood the role of spirituality in patient care.

Theory and the Impact on the Present

The Nurse Training Act of 1964 diverted federal funds to the betterment of the practice, which was beginning to see its first Masters and PhD programs at esteemed colleges and universities around the world. These programs helped to distinguish nursing science from nursing practice, while also merging the two into evidence-based practice. Finally, nursing philosophies became more articulated as the profession deepened. Henderson's Need Theory, Peplau's theory of interpersonal relations, and Roger's science of unitary beings are among many nursing theories that are used to guide nursing practice and education.


Penn Nursing Science (2012). History of nursing timeline. Retrieved online:…… [read more]

Nursing a Gap Between Theory Term Paper

Term Paper  |  3 pages (966 words)
Bibliography Sources: 5


1550). Major changes to the structure and form of nursing education have been promoting such changes. Nursing education is in a transitional stage, in part because of the strong need to generate more nursing staff and facilitate the graduation of nurses worldwide. Yet at the same time, nurse education is being bogged down by the types of theory that Silva (1999) criticizes as being detrimental to genuine professional growth. The growth of individuals and the profession as a whole depends on rethinking nurse education. Education of nurses can and should parallel the education of physicians, which address a far more practice-oriented curricula than nurses have come to expect (Landers, 2008).

The nurse educator can therefore become the ironic bridge between theory and practice. As the nurse educator holds the keys to communicating nurse theory and practice to students, that role is among the most important in healthcare now. Education is one of the four main pillars of nursing: the other three are management, practice, and research (Upton, 1999). The concept of evidence-based practice has blossomed in recent years as an attempt to fuse all four of these pillars, while at the same time enabling the individual independent growth of these sectors. While these pillars all draw from theory for their success, theory needs to be put firmly in its place. Theory also needs to reflect each individual scenario and cannot be rigid. Rather, nursing theory is inherently flexible and loose (Rolfe, 2007).

Nursing theory is unlike philosophical theory in that it is theory-in-action (Rolfe, 2007). Nursing practice is the act of treating patients with care and kindness, using the latest scientifically proven tools, technologies, and techniques. The theory of nursing has been philosophically established; there is no great need to further the investigation of nursing philosophy because of the uselessness of such an endeavor. It is the core of the practice that must take center stage in the 21st century. In all countries, a nursing shortage has highlighted the pressing need for a greater number of trained practitioners who are not concentrating on theoretical development but on how practice reflects the scientific evidence that preceded it. All nursing practice should be based on evidence; evidence trumps theory. Evidence-based practice is the blending of theory and practice. Therefore, evidence-based practice should be viewed as the main bridge between theory and practice in nursing today.


Landers, M.G. (2000), The theory -- practice gap in nursing: the role of the nurse teacher. Journal of Advanced Nursing, 32: 1550 -- 1556. doi: 10.1046/j.1365-2648.2000.01605.x

Rolfe, G. (1993). Closing the theory-practice gap: a model of nursing praxis. Journal of Clinical Nursing, 2, 173-177.

Sellman, D. (2010). Mind the gap: philosophy, theory, and practice. Nursing Philosophy, 11, 85 -- 87.

Silva, M.C. (1999). The state of nursing science: reconceptualizing for the 21st century. Nursing Science Quarterly, 12(3), 221-226.

Upton, D.J. (1999), How can we achieve…… [read more]

Nursing Research and Evp Research Paper

Research Paper  |  3 pages (766 words)
Bibliography Sources: 3


(Bauer, 2010, p.3) Steps of the Iowa model are reported to be the formulation of a question.

III. Steps Used for Research and Evidence-Based Practice

Steps used for research and evidence-based practice under the Iowa Model include the following steps:

(1) Step One - Bauer (2010) states that the question asked in a PICO format is more effective for use rather than searching the literature. The PICO format uses the method as follows in framing the question:

P = Population of Interest

I= Intervention

C= Comparison of what you will do

O= Outcome (Bauer, 2010, p.3)

(2) Step Two -- "Determination of the relevance of the question to organizational priorities." (Bauer, 2010, p.3) This involves the discovery if "improved recovery or decreased hospital time post treatment was an organizational priority."

(3) Step-Three -- determination of whether the evidence answer the question. (Bauer, 2010, p.3) If a systematic review exists to answer the clinical question, it will be located in databases including those of CINAHL, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews. (Bauer, 2010, paraphrased)

Stated as critical questions that should be asked when evidence is being appraised are those stated as follows:

(1) What were the study results?

(2) Are the study result valid in nature?

(3) Will the study results assist the nursing professional in caring for their patients? (Bauer, 2010, paraphrased)

Following the gathering of evidence and upon the evidence being evaluated and synthesized, it is necessary to determine is enough evidence exists to support a change in practice. If a problem triggered the search the question of whether "other levels of evidence be considered or a research study instituted must be answered. Upon the practice change, implementation of a timeline should exist for evaluated of the change in practice. The final step in the process is sharing the outcomes of the change in practice with other practitioners "in the form of an article or poster." (Bauer, 2010, p.3)


Bauer, C. (2010) Evidence-Based Practice: Demystifying the Iowa Model. Oncology Nursing Society. Metro Detroit Chapter. Vol. XXV. Issue 2. Spring 2010. Retrieved from: http://metrodetroit.vc.ons.org/file_depot/0-10000000/0-10000/8013/folder/62252/Spring%202010%20Volume%20XXV%20Issue%202.pdf

Evidence-Based Nursing (nd) Nurse Groups. Retrieved from: http://i.nursegroups.com/nursing-article/evidence-based-nursing.html

Evidence-Based Nursing Position Statement (2012) Sigma Theta Tau…… [read more]

Nursing Roles for the Elderly Essay

Essay  |  3 pages (901 words)
Bibliography Sources: 0


Nursing professionals possess sufficient knowledge of these issues and can educate family members on how to look after the needs of the elderly patient. Nurses also act as counselors for elderly patients and their family members. They can assist elderly patients in interpreting life stage issues as well as health issues so that they may deal with their psychological anxieties. Nurses are capable of performing this role effectively since they assist and directly witness their patients dealing with the challenges of their physical condition.

Nurses as Advocates for the Elderly

In addition to performing functions of caregiver and information provider, nursing professionals also act as advocates of their patients, particularly of the elderly, because of their greater vulnerability and general lack of social awareness about their peculiar problems. There exists a lack of information or sensitivity to the problems of the elderly among people that nursing professionals can help to address. Prejudices and negative stereotypes against the elderly take the form of ageism in the public health care systems as well as in society at large. These attitudes prevent the sharing of knowledge about the health concerns and needs of the elderly. Moreover, the perceived dependence of the elderly on the public health care system and the welfare system discourages investment of economic resources into care for the elderly. The result is that mediocre human resources are allocated to elderly health care. Nursing for the elderly seems less attractive as a career option in comparison to nursing for other patient groups. This directly affects the well-being of the elderly. Similarly, there is a need to increase resources for research into finding cures for diseases of the elderly. Nurses can act as advocates for the elderly by bringing these issues into the public discourse in professional as well as regulatory circles.

Lobbying Needs of Nursing Professionals

Nursing professionals in the United States experience several challenges and issues that adversely affect their professional development as well as their social well-being. The AARP, being one of the most influential lobbies in the United States, can play a significant role in improving the working conditions for nursing professionals by supporting specific legislation. For instance, there has been legislation in the state of California to specify the minimum nurse-patient ratio at healthcare institutions. Some other states have also enacted similar legislation to improve the productivity of nursing professionals. The AARP can help nurses by supporting this legislation in other states because this would help to increase the number of nurses so that the workload of nurses would be reduced to tolerable levels and they would be able to discharge their duties towards patients without unnecessary stress.… [read more]

Philosophy of Nursing Leadership Today Creative Writing

Creative Writing  |  5 pages (1,806 words)
Bibliography Sources: 3



Fortunately, these learning these transcultural needs in healthcare settings can be facilitated through mentors and older colleagues who can provide the empirical observations and anecdotal accounts that help inform best practices today. Mentors and seasoned practitioners can help newcomers "learn the ropes" and understand what transcultural nursing skills are most salient in a given healthcare setting (Wilson & Sanner, 2010). From a personal perspective, my supervisor has played an important role as my selfless mentor. After she hired me, my supervisor always encouraged me to go back to school and finish my higher education. Indeed, she follows up with me about my progress in school and has offered help with any assignments I may have to this day, and her assistance has been inspirational and essential to my progress.


Nursing professionals today are faced with a number of challenges to the provision of high-quality healthcare services, most especially an increasingly diverse client base. Transcultural differences can adversely affect the ability of even the most dedicated healthcare professionals to provide the clinical interventions needed, but the research showed that Madeleine Leininger's "Theory of Culture Care Diversity and Universality" provides a useful framework that can help nurses understand the unique needs of people from diverse cultures and backgrounds. Finally, the research also showed that mentors and others who have tenure in the workplace are valuable resources that can help inform best practices for newcomers.


Daly, J., Speedy, S., Jackson, D., Lambert, V.A. & Lambert, C.E. (2005). Professional nursing:

Concepts, issues, and challenges. New York: Springer.

Leininger, M.M. (1991). Culture care diversity and universality: A theory of nursing. New York: National League for Nursing.

Leininger, M. & McFarland, M. (2004). Transcultural nursing: Concepts, theories, research, and practice (pp. 169 -- 177). New York: McGraw-Hill.

Jeffreys, M.R. (2006).…… [read more]

Iconic Nursing Leader and Theorist Essay

Essay  |  6 pages (2,048 words)
Style: APA  |  Bibliography Sources: 7


He had a forlorn expression on his face so I sat down next to him and let me say what was on his mind. You could say this was absolutely a caring moment -- and the husband opened up to me about the sixty years he and his wife have been married. He also said the two had never been apart except for the time when he served in World War II.

As he covered some of the good times he and his wife had shared together, tears were trickling down his face. At that point I touched his hand and I began to shed some tears as well. His opinion was quite different than the daughter and her fiance. He wanted his wife to be at peace, to remove the pain from her body and to basically allow her to pass. No one had asked him his opinion in the earlier meeting and it was clear his daughter didn't really know where he stood in the matter. I spoke to my instructor and the attending RN about this matter; we called the doctor in and the husband authorized (for his wife) a Comfort Measures Only policy. The daughter was not happed with this and vigorously stated her position. Her father told her it was his wish (based on what he knew his wife also wanted) to have his wife be allowed to die in dignity. The daughter (after a conversation with a pastor) agreed that aggressively treating the cancer would only make her suffer more.

What did I learn about myself? I learned that a caring moment can do more than just offer a time of reflection -- it can be a moment when a solution is found to a problem that otherwise might not be resolved. I learned that being a good listener is absolutely vital to the success of a caring moment and that older people sometimes don't open up when younger people are dominating the conversation with their points-of-view. I also learned that I am an ideal person for the field of nursing and that I am very moved and touched by the writings and theories of Jean Watson. The patient's husband was willing to open up to me because he could see I really did care about his and his wife's situation. There was nothing more I could do beyond what I did (bring a pastor and a doctor into the situation to help the husband achieve the goal he sought).

Works Cited

Cohen, Judith A. (1991). Two portraits of caring: a comparison of the artists, Leininger and Watson. Journal of Advanced Nursing, 16(8), 899-909.

Suliman, Wafika A., Welmann, Elizabeth, Omer, Tagwa, and Thomas, Laisamma. (2009).

Applying Watson's Nursing Theory to Assess Patient Perceptions of Being Cared for in a Multicultural Environment. Journal of Nursing Research, 17(4), 293-300.

Watson, Jean. (2009). Caring Science and Human Caring Theory: Transforming Personal and Professional Practices of Nursing and Health Care. Journal of Health & Human Services

Administration, 31(4),… [read more]

Nursing Grand Theory Research Paper

Research Paper  |  7 pages (2,325 words)
Style: APA  |  Bibliography Sources: 3


She stated that it is not merely the periods of health or illness. She defined the role of nurses as to guide individuals and their families into uncovering meaning and planning for changes in the health using their own personal definitions of health Melnechenko, 1995()

Martha Roger's Science of Unitary Human Beings

Marta Roger's theory provides a wide body of… [read more]

Role of Nurses Roles Essay

Essay  |  4 pages (1,236 words)
Bibliography Sources: 1+


For example, if a particular demographic struggles with healthy eating and has an obesity problem, then educating the community on nutrition and responsible nourishment would be a foremost priority. Before implementation can be enacted, it is imperative that the community health nurse have a strong awareness of the salient characteristics associated with their given setting.

After the community health nurse has familiarized himself with their environment, the next step involves implementing their courses of action. These actions should be tailored specifically to the needs of the community; for example, if the local schoolchildren do not receive sufficient exercise, it would be productive for the community health nurse to promote physical exertion. If there were a sports team in the area, the community health nurse could arrange for a collection of the athletes to discuss the virtues of exercise, thereby providing the kids with tangible role models. If obesity were prevalent amongst the population, they could provide a community-wide lunch involving nutritious foods. In each of these examples, the focus is not so much on curing a particular individual, but rather on educating a community so that they can successfully take care of themselves.

Common procedures implemented by the community health nurse include providing the area schools with health services (these include issuing standardized medical tests, lice examinations, tobacco education, hygiene education, nutritional information, blood pressure tests), providing postpartum visits, and prenatal risk assessments. The community health nurse should be sensitive to any trends that may be taking place within their particular community; for example, if there has recently been a rash of teen pregnancies, then it would be prudent to provide sexual education services.

It is prudent that a community health nurse be well-respected within the community. They are not only a member of the community but also the health representative for the entire population. Accordingly, it is crucial that they maintain a friendly, open demeanor, so that if anyone has a health-related concern, they feel as though they will receive honest, reasoned advice. In this regard, the community health nurse is not only a physician but also a therapist and a teammate within their community. While it is important to respond to health trends within the community, the emphasis of the nurse should be on prevention. A skilled community health nurse should exhibit great foresight and be able to anticipate problems before they develop. For example, if there is no initiative educating people on how to prevent obesity, then the fact that there is a high percentage of obese individuals would reflect negatively on the health care of the population, regardless of whether there are competent doctors within the community.

Although doctors continue to provide valuable surgical and diagnostic services, the varied nature of a population necessitates the existence of the more active position of the community health nurse. Although access to health care has increased, many members within a population are unable to visit an institutional practice and so the nurse represents a valuable presence within the community.… [read more]

Nursing Research How Data Collection Essay

Essay  |  3 pages (898 words)
Bibliography Sources: 3


2524). Nurse practitioners in Oncology can benefit from this study because the carefully collected, examined and interpreted data will give them greater understanding and deal with their breast cancer patients' distress issues and effects.

Module 8: One Clinical Use of Research Results in Advanced Nursing Roles of Practitioner, Educator, or Administrator

Are older patients comfortable discussing sexual health with nurses? (Farrell & Belza, Jan-Feb 2012) provides research results that can be used by a nurse practitioner, educator and administrator. The study was designed to determine barriers to discussing sexual health with older patients and whether older patients: have questions about their sexual health that have not been answered; are asked about their sexual health; want a health care provider to ask about their sexual health; would feel comfortable discussing the issues with a nurse. The quantitative design of the study was reportedly a quantitative cross-section using a 24-item survey distributed to older adults who reside in retirement communities and/or took fitness classes in the geographical area of Puget Sound, Washington. With 101 completed surveys, the researchers collected, examined, interpreted and reported the results. Two of several conclusions reached by the study were: nurse practitioners often simply do not ask about their older patients' sexual health; some older patients are uncomfortable discussing their sexual health (Farrell & Belza, Jan-Feb 2012, pp. 54-55). A nurse practitioner can clinically use these results to better understand how older patients feel about the issues, how this practitioner has perhaps been remiss in asking his/her older patients about their sexual health, and develop a method for broaching the topic in ways more comfortable for the older patients. An educator can use the study results to inform and teach his/her students about older patients' sexual health issues, about caregivers' tendency to overlook/avoid asking older patients about their sexual health, and about developing methods for his/her students' handling of these issues. An administrator can use the study results by understanding the gap in treatment and developing procedures for nursing staff to broach the topic of sexual health with older patients in ways that are more comfortable for older patients.

Works Cited

Anonymous. (2011, March 14). Breast cancer; Research from M. Montgomery and co-authors provides new data about breast cancer. Health & Medicine Week, p. 2524.

Farrell, J., & Belza, B. (Jan-Feb 2012). Are older patients comfortable discussing sexual health with nurses? Nursing Research, 61(1), 51-57.

Polit, D.F., & Beck, C.T. (2008). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Purssell, E., & While,…… [read more]

Nursing Researchers This Is a Pilot Study Term Paper

Term Paper  |  5 pages (1,733 words)
Style: APA  |  Bibliography Sources: 7


¶ … Nursing Researchers

This is a pilot study intended for forming a test on the larger and more rigorous study of the experiences of nursing researchers. Reliability is the measure of consistency and accuracy within research methods for measuring research variables in a study. Reliability helps in the interpretation of statistical analysis results to find out the reliability of… [read more]

Evidence-Based Nursing Practice Allows Essay

Essay  |  5 pages (1,709 words)
Style: APA  |  Bibliography Sources: 5


All information must always be communicated to participants stating their participatory positions in the research, goals of the study, required data and collection methods and the amount of commitment required from the participants.

Ethics in research also demand for the deliberation of the sponsorship of a study, criteria for participants' selection, risks and benefits of the study and any available alternatives for the research (Williams, & Wilkins, 2008). Every research study requires adherence to confidentiality of information from participants and participants must always participate voluntarily will full rights of withdrawal or withholding information during the research. Lastly, research requires the availability of researchers' contacts to all participants with full observation of the discussed ethical practices even for vulnerable participants like children, pregnant women and the ill (Polit, & Beck, 2008).


American Psychological Association. (2009). Publication manual of the American Psychological Association (6th Ed.). Washington, D.C

Cronin, P., Coughlan, M., & Ryan, F. (2007). Step-by step guide to critiquing research. Part 1: quantitative research. Mark Allen Publishing Ltd. British Journal of Nursing, Vol. 16, No 11

Griffin, R.A., Polit, D. R, & Byrne, M.W. (2007). Nurse characteristics and inferences about children's pain. Manuscript submitted for publication.

Williams, L. & Wilkins. (2008). Wolters Kluwer…… [read more]

Nursing What Effect Does Simulation Lab Literature Review Chapter

Literature Review Chapter  |  13 pages (4,035 words)
Bibliography Sources: 10



What Effect Does Simulation Lab have on the Confidence and Critical Thinking of Nursing Students as Licensed Practical Nurses?

Nursing graduates must have self-confidence and critical thinking capabilities in order to resolve multifaceted patient care issues. The use of human patient simulators to supplement teaching in schools of nursing is rising; however, further research is needed in order to… [read more]

Nursing Organizations the Purpose, Mission Research Paper

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Bibliography Sources: 2


It focuses on childbirth, rather than on all pediatric specialties. It also focuses on nurse-midwives and not all midwives are nurses. While NAPNAP's inception is relatively recent (1973), the ACNM is "the oldest women's healthcare organization in the United States" ("About ACNM," ACNM, 2012). The core functions it serves are similar to that of NAPAP. It supports the continuing education of members and sets ethical standards for the profession to increase the sense of professionalism and regard the population feels for midwives. It also has a political arm, in its creation of "liaisons with state and federal agencies and members of Congress ("About ACNM," ACNM, 2012).

ACNM is committed to creating the impression of professionalism for the profession of midwifery and strongly supports the certification of this 'caring' profession. Some people still view midwives as folk medicine practitioners, and the ACNM works to create an evidence medicine-based image for midwives, as well as to establish the unique value they offer to women and children ("What is a midwife," American Pregnancy Association, 2012). "ACNM evaluates, publishes, and showcases scientific evidence to improve professional practice. We are committed to upholding the most rigorous clinical practice standards in the midwifery profession and applying this knowledge and clinical expertise to help women make the best health decisions. We strongly support the use of quality measurement to improve care" ("About ACNM," ACNM, 2012).

However, while the organization does support professional standards, it also notes that it is an advocate of woman-centered care that encompasses women's social and human needs during pregnancy, childbirth, and childcare and supports those who enter the profession through nontraditional means. "ACNM celebrates and supports a diverse midwifery profession. ACNM embraces those prepared dually in nursing and midwifery and those prepared directly in midwifery" ("About ACNM," ACNM, 2012). Like NAPNAP, ACNM offers continuing education certification options, but it also provides more general information about becoming a midwife, even for individuals who currently do not have a degree in nursing, but are seeking to transition into the profession through educational 'bridge' programs ("Become a midwife," ACNM, 2012).

For an advanced practice nurse with a general interest in pediatrics, or a specific interest in pediatrics beyond the field of childbirth NAPNAP would be more suitable. For a nurse-midwife, or a midwife contemplating gaining professional certification after entering the profession through nontraditional means, ACNM would be a better choice. Both organizations offer continuing education and benefits to members as advocacy groups and sources of networking and communication.

Works Cited

"About ACNM." American College of Nurse Midwives. [23 May 2012]


"About us." National Association of Pediatric Nurse Practitioners. [23 May 2012]


"Become a midwife." American College of Nurse Midwives [23 May 2012]


DeNoon, Daniel. "Baby milk recommendations changed." Web MD. 2008. [23 May 2012]


"Home." National Association of Pediatric Nurse Practitioners. [23 May 2012]


"NAPNAP continuing education center." National Association of Pediatric Nurse Practitioners.

[23 May 2012] http://www.napnap.org/PNPResources/Education.aspx

"What is a midwife?" American Pregnancy Association. [23 May 2012]

http://www.americanpregnancy.org/labornbirth/midwives.html… [read more]

Safe Patient Positioning Article

Article  |  3 pages (1,101 words)
Bibliography Sources: 5


Set the room's temperature for typical OBCAB at 72 degrees Fahrenheit and prepare heater blankets. For valves, set the room's temperature at 65 to 68 degrees Fahrenheit with heater blankets available for warming after the pump run. The patient should be secured in supine position with proper cushioning of pressure points. A lower extremity sleigh should be used to support patient laterally. Once successful intubation with a double lumen-tube endo-tracheal tube is accomplished, place a central venous pressure or pulmonary artery catheter and arterial blood pressure line. A Foley catheter and a nasogastric tube are inserted after the patient receives anesthesia. Finally, carefully place the R2 external defibrillator pads on the patient's chest before positioning the patient for the procedure.

Patient Positioning

Align the patient's left chest with the edge of the operating room table for a TECAB'S/Lima take down's. This allows the left arm to hang down and remain clear of the instruments when working on anterior chest wall. For all other cardiac procedures, align the right chest with the edge of the operating room table and let the right arm hang down supported with gel pads and tucked with half a sheet. Both arms need to be adducted, supported, and padded appropriately. Be mindful of digits being free hanging and verify that there are no pressure points. Place a small 6-8" positioning roll, gel pad, or inflated pressure cuff under the left mid-thorax for TECAB's/lima take downs (right mid-thorax for all other cardiac procedures) caudal of scapula to lift thorax and drop shoulder and allow scapula uninhibited movement. Place the left arm for TECAB's/lima take downs or right arm for other cardiac procedures alongside the patient below table level and pad appropriately; do not elevate the shoulder. Secure and pad the head/neck of patient level with the anesthesiologist for monitoring. Prepare patient with betadine/chlohexidine for CABG and potential saphenous vein harvesting. Lower extremities need to be in a slight or full frog leg supported position. Patient needs to be secured to the OR table with safety strap.


Crucial issues related to patient safety during robotic surgery include anesthesia along with the nuances and complications that are related to patient positioning. Robotic surgery presents the operating room team with significant challenges that require careful patient screening and intraoperative management to assure patient safety. Anesthesiogists and surgeons depend on clear communication between all attendant staff so that no mistakes are made during any point of the procedure. Teamwork is essential to the success of a robotics program at any institution.

Perioperative nurses must be informed and prepared to safely position patients for robotic surgical procedures. As patient advocates, perioperative nurses are responsible for ensuring that the surgical patient is safe from harm and that everyone on the surgical team is doing his or her part.


Ballantyne, G.H. (2002). Robotic surgery, telerobotic surgery, telepresence, and telementoring. Surgical Endoscopy, 16(10): 1389-1402.

Barbash G, Glied S (2010). New Technology and Health Care Costs- The Case of Robot-Assisted Surgery. The New England… [read more]

Nursing Ethics Ethical Behavior Term Paper

Term Paper  |  2 pages (619 words)
Bibliography Sources: 3


Another study determined that "ethical problems occur because of conflicts in a society's moral principles, values and laws" (Runde, 2007, p. 2). A nurse must therefore know and understand exactly what he or she is dealing with when it comes to treating people of any faith, including Jehovah's Witnesses. Consideration should be taken regarding those beliefs even at the risk of the patient's life. Ultimately, it is up to the patient to make the choice as to what specific care or treatment should or should not take place. If a patient believes in a particular manner, that patient has the right to refuse treatments that go against those beliefs.

One could surmise that human dignity is worth more and encompasses more than its share of components, some of which include the patient's beliefs and belief system. The values held by the patient may not coincide with the values held by the nurse. In that case, the nurse does not have the right to use measures or treatments that go against what the patient believes, even if the nurse believes in an entirely different manner. The patient's beliefs and values should be considered at placed as the highest priority.


American Nurses Association (2012) Nursing world, accessed on May 6, 2012 at: http://www.nursingworld.org/codeofethics

Badzek, L.A., Mitchell, K., Marra, S.E., Bower, M.M., (1998) Administrative Ethics and Confidentiality/Privacy Issues, ANA Periodicals, Vol. 3, No. 3

New York Organ Donors Network (2012) Religious viewpoints, accessed on May 6, 2012 at: http://www.donatelifeny.org/just-for-you/religious-leaders-amp-clergy/religious-viewpoints/?gclid=CIfroauh7K8CFbMEQAodzQ4c0Q

Runde, M.; (2007) End of life decision making, Sault Area Hospital, accessed on May 6, 2012, at: www.health.gov.on.ca/english/providers/.../ccs.../sah_eol_learn.pdf… [read more]

Effects of Nursing Shortage on Nurse Retention and Patient Care Delivery Term Paper

Term Paper  |  2 pages (724 words)
Bibliography Sources: 3


Nurse Summaries

Effects of Nursing Shortage on Nurse Retention and Patient Care Delivery: A Review of Current Literature

Hayes, B. & Bonnet, a. (2010). Job satisfaction, stress and burnout associated with haemodialysis nursing: a review of literature. Journal of Renal Care 36(4): 174-9.

This study consisted of a meta analysis of nine primary studies conducted in the area of nephrology/renal-specialized nursing that focused on factors of job perception, performance, and burnout amongst nurses. While not focused on the precise question of the nursing shortage that is guiding this review, it is significant that this research noted a strong correlation between job stress/burnout and lower levels of quality in care provision, suggesting that anything that leads to decreased nursing satisfaction would contribute to a decrease in the quality of care provided. A nursing shortage adds to both the workload of nurses -- an identified factor in the creation of job stress -- and also increases overall organizational strain, which further degrades nursing job satisfaction and contributes to job stress, according to the study. It is not clear that any practical decisions leading to evidence-based change can be made based on these research findings; certainly organizations would be advised to avoid nursing shortages in order to mitigate the risks to nursing satisfaction and job stress, however the essential problem of the nursing shortage is that there simply aren't enough nurses in the industry as a whole, rendering individual organizations helpless.

Buerhaus, P., Donelan, K., Ulrich, B., Norman, L., DesRoches, C. & Dittus, R. (2007).

Impact of the Nurse Shortage on Hospital Patient Care: Comparative

Perspectives. Health Affairs 26(3): 853-62.

A national survey and analysis of responses was conducted by the authors in this direct qualitative analysis, measuring the perceptions of the degree of the nursing shortage facing the United States, the effects of this nursing shortage as they are predicted to occur by various stakeholders, and the effects of the nursing shortage as they currently exist and as it is currently being experienced. This directly addressed the research question identified as the primary focus of the present review, examining the effects of the nursing shortage on both nursing retention and patient care in terms…… [read more]

Nursing Phil Throughout My Life Admission Essay

Admission Essay  |  4 pages (1,349 words)
Bibliography Sources: 0


I did not need to talk about Christ to the residents. It was just in my attitude and approach that I developed a sense of maturity that was beyond my years. Perhaps it was being around people who were genuinely mature, that caused me to feel emotionally strong and connected. Whatever it was, it was during my work at the senior center that I became clear and determined to become a nurse.

The volunteer work I did at the senior center has continued ever since my first day at the institution. Since then, I have lost one of my beloved grandparents. It was the first time I was faced with the death of a loved one. Dealing with this tragedy involved the invocation of any and all coping mechanism I knew. I went to Church more often, and prayed twice as hard. I spoke to my pastor, and cried to my family members. The trauma deepened my personal connection with God and the source of all life. I believe that my having dealt with death has made me not only a better person but also a better nurse. Because I got a paying job after high school, I volunteer much less at the senior assisted living facility. Now I work there about once every two weeks. My paying job is at a local hospital, as a nurse assistant. I am learning about how healthcare centers are organized, and how they are structured in terms of the organizational hierarchy and human resources. I am learning the process of intake, and how patients are screened and asked about their insurance and medication history. Likewise, I see how patients leave the hospital and the discharge procedures that follow. I have learned a little about the information technology used in the hospital, although I am not allowed to actually use the system myself.

My work at the hospital has only made me want to be a nurse more. I want to have an expansive nursing career, too, one that is not constrained by culture, time, or place. For example, I see myself working in various Christian health missions around the world, in different countries and in different times of the year. I bring a great sense of enthusiasm to the Mark and Huldah Buntain School of Nursing. I am sure my classmates will share this enthusiasm as we together embark on the incredible journey of education, self-development, and professional development. In addition to my enthusiasm, I bring an unwavering faith and commitment. My Christian faith is always strong, and has never been doubted. The only kind of doubt I ever experience is doubt related to myself. Self-doubt and low self-esteem are problems that I believe will vanish as I become more aware of my boundaries and limitations and know how to work within them. I intend to do this while in the Bachelor's program.

My sense of loyalty and commitment ensures that I finish what I start, and I am responsible for my own… [read more]

Nursing Shortage on Nurse Retention Article Review

Article Review  |  3 pages (886 words)
Bibliography Sources: 2


The reason for the study was the shortage of nursing staff in hospitals and identification of elements in the work setting that conflict with the views of nursing staff in regards to their idea of the most conducive work environment. The study used a descriptive survey design and a convenience sample of 385 nurses on five inpatient units.

The work environment scale (WES) was used to measure the perceived work environment in this study. The WES was developed in 1994 by Moos and enables individuals to report on their perceptions of their real (R) current and ideal (I) or desired work setting. The survey is comprised by two forms (R and I) both of which contain 90 questions each and 10 subscales. The subscales include: (1) relationship; (2) personal growth; and (3) system maintenance with change. (Kotzer and Arellana, 2008) A two-point scoring of true or false is used and questions are designed so that they represent a 50/50 ratio of negative and positive aspects of the work setting. (Kotzer and Arellana, 2008, paraphrased)

The findings in the study state that a highly positive work environment was confirmed by staff on their units however there were areas that did not fit the nurse's ideal of a preferred work environment and these areas were focused on for change. The literature reviewed in this study notes that the work environment of the professional nurse is "a multidimensional phenomenon" and that this is inclusive of various elements that support the nursing practice and provide the staff "with a sense of contribution and personal satisfaction." (Kotzer and Arellana, 2006) The authors of the report states that employees who "believe their work environment provides access to these structures [access to information, support and resources to get the work done and continuous opportunities for employee development not only feel empowered and experience increased levels of autonomy and self-efficacy, but ultimately demonstrate a greater commitment to the organization." (Kotzer and Arellana, 2008)

Conclusions stated by Kotzer and Arellana (2008) include that there is a challenge in the nursing profession to create environments that "enhance productivity, professionalism and quality outcomes in patient care." In addition, it is reported that the AACN Standards for Establishing and Sustaining Healthy Work Environments "asserts that every nurse is accountable for contributing to a supportive, healthy, and safe work environment that need improvement and involving staff in making and evaluating change, supports an evidence-based work environment to attract and retain qualified nursing staff." (Kotzer and Arellana, 2008)


Kotzer, Anne Marie and Arellana, Kerry (2008) Defining and Evidence -- Based Work Environment for Nursing in…… [read more]

Search, and Evaluation Task Essay

Essay  |  3 pages (845 words)
Bibliography Sources: 3


Of the several attributes that were associated with hospital climate, the one standout was having the opportunity for professional development. Some of the job dissatisfaction was expressed by CNAs and LPNs who do not experience many opportunities or avenues for professional betterment. An important aside was that registered nurses often expressed dissatisfaction with not being able to spend more time caring for patients, while the LPNs and the CNAs felt they were spending too much time on patient care with very few other alternatives, particularly opportunities for staff development. .

Experience with emergency room nursing care and the accuracy of concomitant work expectations led to higher job satisfaction. In other words, nurses who did not have accurate ideas about what emergency room nursing entailed were more likely to be dissatisfied with their jobs and to experience lower morale.

D. Explain how resource availability and selection limited the scope of your research topic.

Much of the research on job satisfaction of medical personnel focused on long-term care situations such as dialysis or acute care such as oncology. A body of research was also available on violence against nursing staff. One theme that was prevalent in the job satisfaction literature for hospital staff was shortages of staff and of beds. This theme did cross over into the emergency room nursing category since emergency rooms in some locations tend to be over-utilized by marginalized people who do not have medical insurance. The overarching problem was a dearth of literature specific to job satisfaction and morale in emergency room nursing staff.

E. Discuss how performing a literature review affects nursing practice in an emergency room setting.

The primary benefit to be derived from conducting a literature review of emergency room nursing care is that facets of the issue are made salient in the literature that were not initially viewed as contributing factors by the researcher. The result was a broader and deeper perspective about variables that impact job satisfaction and morale, and that have the potential to indirectly impact the quality of patient care Importantly, the process of doing a literature review can lead to discovery of new lines of research or perspectives that are wholly different from those of the researcher. Further, as the literature review is conducted, the relationship between the various studies becomes increasingly apparent. These insights would not be so readily available to the researcher were he or she not engaged in the process of considering each article against the other and…… [read more]

Healthcare Practices and History Research Paper

Research Paper  |  3 pages (913 words)
Bibliography Sources: 2


Relates how the Jewish culture has or could potentially influence world nursing culture and American culture, supported by the chosen transcultural model. (Leininger)

The Jewish culture is noted by several scholars to have a very strong influence on the nursing as well as American culture. This is due to the manner in which several nursing practices, ethics in nursing and pioneers of these practices subscribe to the Jewish way of life.

A review of statistics on medical practitioner's achievements reveals that Jews are prominent medical practitioners, teachers as well as researchers. This is supported by the fact that close to 28% of the Nobel Prize Winners for Medicine/Physiology is Jewish, a number that constitutes 40% of the American winners (Temple Shalom,2011). These statistics clearly indicates the strong influence that the Jewish culture has in the nursing and American culture as a whole. The fact that the Jewish nursing/medical culture can find a place in the global nursing/medical practice is a true example of how transcultural nursing can be put in action and practice. This is an envisioned in the Culture Care Theory, where Leininger noted that caring is the real essence of the nursing profession and is in itself unique to the concept of nursing (Leininger,1991;Reynolds,1995).

Draws conclusions about the overall role the Jewish culture has had, or could have, in the future of nursing as a profession.

The overall role that the Jewish culture could have in the medical profession is evident from their heavy influence of modern medical discoveries as well as medical ethics. This means that the nursing profession will in the future rely on several methods and practices that are pegged on the Jewish way of life.


Gesundheit, B., Hada, E (2005).Maimonides (1138-1204): Rabbi, Physician and Philosopher*. IMAJ 2005;7:547-553

Illievitz, AB (1935).Maimonides the Physician. Can Med Assoc J. 1935 April; 32(4): 440-442.

Leininger MM (1997) Overview and Reflection of the Theory of Culture Care and the Ethnonursing Method. Journal of Transcultural Nursing, 8:2, 32.52.

Leininger MM (1991) Culture Care Diversity and Universality: A Theory of Nursing. National League for Nursing Press, New York.

MyJewishLerning (2011).Jewish Health & Healing Practices.Available online at http://www.myjewishlearning.com/practices/Ethics/Our_Bodies/Health_and_Healing.shtml. Accessed on 15/4/2012

Reynolds C. (1995) The Theory of Culture Care: Implications for Nursing. In: Metzger McQuiston C. & Webb AA (eds) Foundations of Nursing Theory. Contributions of 12 Key Theorists, 369.414. Sage Publications, Thousand Oaks, California

Shalom Temple (2011). President's Message.Bulletin of Shalom Temple. Available online at http://www.newjewishcongregation.org/Shalom%20June%202011.pdf Accessed on 15/4/2012… [read more]

Autonomy and Nursing Essay

Essay  |  2 pages (931 words)
Bibliography Sources: 4


Autonomy and Nursing

One of the more important parts of contemporary nursing revolves around the philosophical combination of ethical behavior and patient advocacy in a busy healthcare environment. We know there is a shortage of trained nurses and sometimes even physicians; we know that there are rising costs both internally and externally for healthcare organizations; and we know that a great number of Americans are under insured, or not insured at all. Still, we are in nursing because we wish to be a part of a caring profession; one that makes a real difference in a person's life and contributes to the overall welfare of society.

It seems, in fact, that due to a number of social and cultural factors within our society, the role of the modern nurse has become increasingly complex, often requiring the help of the philosophical discipline of ethics. Nursing ethics, while similar to medical ethics, seems also to take on more of a predominance of relationships, maintaining patient dignity, advocating for the patient, and collaborative care. In essence, nursing ethics uses the model of caring rather than curing, and surrounds the relationship between the client and the nurse (Galadher, 2003).

The overall trend in nursing ethics is more of one that asks that the means to the end are just as important, if not more important, than the results. This is quite apparent in the ethical maxim of autonomy. This is a moral and bioethical idea that indicates a rational individual (client) should be allowed to make un-coerced and informed decisions on their one. An individual must be responsible for their own actions, and their decisions on healthcare must reflect that they are a partner in their healing program, as well as any decisions made about their help. In the modern world, this is really exemplified by the process of patient consent; but instead of simply asking for permission to perform x, y or z, the healthcare professional must ensure that the patient has a complete understanding of the tests, the drugs, and even the procedures that the physician feels are in the best interest of the patient. This also includes a patient refusing treatment if they are cogent and informed; the physician may disagree, but the issues of quality of life or decisions about the side-effects or potential consequences of treatment must, in the long run, be decided by the patient (Rai, 2009).

Part 2 -- One superb example of a nursing theorist who epitomizes both human caring and autonomy is Jean Watson in her Theory of Human Caring. For Watson, one cannot view nursing as just a science, but a combination of art and science that uses the process of caring to increase the ability of the healthcare profession to understand and mitigate disease. Caring, though, is really…… [read more]

Burns and Grove ) Capstone Project

Capstone Project  |  4 pages (1,455 words)
Bibliography Sources: 4


Compassion enables one to empathize with the sick that need care. Human beings are sensitive by nature and need care especially in time of pain and suffering. Nursing is all about caring for someone and being there for them at such times. The author believes that compassion is what makes a nurse. It is essential especially when caring for patients… [read more]

Men in Nursing the History Term Paper

Term Paper  |  5 pages (1,704 words)
Bibliography Sources: 4


In the present, discrimination against men in nursing exists in more subtle forms. Biased language is one type of discrimination, as the use of the female pronoun in nursing texts and the distinction of "male nurse" assumes that men in nursing is not normal (Wolfenden, 2011). Gender assumptions and stereotypes suggest that only females have the ability to empathize and be nurturing enough to serve patients (Meadus, 2000). The combination of gender assumptions, role strain, and gender bias language has culminated in recruitment barriers for men into the nursing field. The failure to recruit men into nursing only perpetuates the cycle and sustains nursing as a single-sex occupation. Recruiting high school males into baccalaureate programs has the potential to adjust stereotypes and address a forthcoming nursing shortage that would eventually compromise the quality of patient care.


Brown, B. (2009). Men in nursing: Re-evaluating masculinities, re-evaluating gender. Contemporary Nurse, 33(2), 120-129. Retrieved from https://www.dora.dmu.ac.uk/bitstream/handle/2086/3029/men in nursing.pdf?sequence=4

Meadus, R. (2000). Men in nursing: Barriers to recruitment. Nursing Forum, 35(3), 5-12. Retrieved from: http://folk.uio.no/olegmo/Men in Nursing/Meadus, R.J. 2000.pdf

O'Lynn, C., & Tranbarger, R. (2007). Men in nursing history, challenges, and opportunities. (1st ed.). New York, NY: Springer Publishing Company.…… [read more]

Professional Development Assessment Principal Duties Research Paper

Research Paper  |  2 pages (541 words)
Bibliography Sources: 0


Music selection, conversation, and a level-headed demeanor are the ways, small and large, in which I create an optimal working environment.

Collaborates with other professionals and directs nonprofessional nursing personnel in maintaining recognized standards

Teaching and orienting new permanent senior and temporary staff members is one of my greatest joys. It is always gratifying seeing a new recruit gradually become an old and trusted associate over time, and to feel proud of the role I had in mentoring his or her career. Also in my 'teaching' capacity, I developed the nursing manuals for the staff for minimally invasive procedures. I act as the primary resource nurse in these areas: the robotics program, ventricular devices, ECMO, the TAVI program and VATS.

My desire to give back to my professional community also manifests itself in my membership on the Collaborative Governance Committee, PPI Committee, and/or Practice Committee. Informally, I regularly offer input to my team leader and director regarding unit needs. I am an AORN member and special assembly member of the MIS/Robotics Unit for AORN.

I have chosen to participate in these unit, departmental, and national organizations so I can have a critical role in the development of new and existing nursing and hospital policies and procedures and improve patient care.

On a personal level, I have striven to maintain and update my clinical knowledge and skills based on current nursing education practice and AORN standards and recommended practices. I am eagerly anticipating returning to school to enhance my credentials by taking a CNOR certification course this spring.… [read more]

Life Dilemmas in Nursing End Research Paper

Research Paper  |  3 pages (1,446 words)
Bibliography Sources: 3


Subsequent research has supported these findings (e.g., De Beer, Gastmans, & Dierckx de Casterle', 2004).

The principle beneficence, nonmaleficence, and veracity are directly applied by the ANA ethics codes in this case. The notions of doing good and doing no harm can become confused by personal feelings regarding the cessation of suffering in a person. The nurse's function is to… [read more]

Nursing Law Dissertation

Dissertation  |  30 pages (9,400 words)
Bibliography Sources: 1+


Critical Care Nursing

Regarding Legal Liability

the critical care nursing regarding legal liability issues

Definition of key concepts

Introduction to the history of forensic nursing

Interaction with patients with legal liability issues

The critical care unit as forensic domain

Recognizing patients with legal liability issues

Wound characteristics

Recognition of evidence

Evidence collection and preservation

Integrating ethical and medico-legal considerations

Negligence… [read more]

Nursing Ethics Ethical Dilemma Essay

Essay  |  3 pages (865 words)
Bibliography Sources: 3


The potential problem with this solution may be that the supervisor does nothing, does not want to fire a good nurse in a short-staffed ward, or does not believe the accuser. Then, a great deal of damage has been done, given that the offending nurse still can continue stealing, but the nurse manager will lack support for her actions and may be questioned in any of the decisions she makes, because she has made what seems like a baseless accusation.

Acceptable consequences

None of the consequences are really 'acceptable' in the above-cited scenarios. However, clearly the least acceptable consequences are to do nothing. Patients should not have to come to the hospital and worry that their valuable possessions are being stolen. All nurses have an ethical obligation to put their patient's rights and needs first and foremost, and to promote a safe, healthy, and trusting environment. With a thief on the ward, this is impossible.

As the team gradually becomes aware of the fact that there is a thief in their midst, they will be unwilling to trust one another in the day-to-day duties they perform together on the ward. For nursing to be effective, it must take place in an environment of trust and support.

Thus, the most acceptable action seems to be to report the nurse, using the factual evidence at the nurse-manager's disposal. Confronting the nurse would put the hospital in legal jeopardy and would not give the nurse-manager adequate protections to deal with the personal fallout that would ensure, when the crime was revealed. Going through the necessary authorities makes the actions of the nurse-manager seem less personal, and more objective.

Ethical decision

Report the suspected crimes, with the stated evidence, to a supervisor: either to an upper-level nurse manager, or to a member of the HR staff in charge of disciplinary and mediation matters. If available, going to HR or someone outside of the nursing hierarchy who would allow the nurse-manager to remain anonymous while the crime was being investigated would be preferable. HR would also know how much evidence, legally speaking, would be required to allow for the termination of the thieving nurse.

Dilemma resolution

The nurse manager went to HR, and reported the evidence. The hospital investigated the crime and confronted the nurse. She was angry, did not confess, and approached a lawyer to bring suit against the hospital. However, given the evidence against her, the case was dropped.


Blais, Kathleen K. & Janis S. Hayes. (2011). Professional nursing practice: Concepts and perspectives.…… [read more]

Florence Nightingale -- Nurse Theorist Research Paper

Research Paper  |  2 pages (695 words)
Bibliography Sources: 2


Florence Nightingale -- Nurse Theorist

The nurse theorist that likely had the most influence on the institution of nursing was Florence Nightingale. This paper reviews her nursing innovations and points to her viewpoints and definitions as well.


Nightingale struggled to get into the career she desired against her wealthy parents, who believed she should do what upper class women were typically supposed to do in the 19th century, stay at home, marry, and have children while keeping the house neat and clean. But Nightingale dove into health issues notwithstanding her parents' wishes -- against "strenuous family opposition," is how Alex Attewell explained it in a UNESCO article.

Nightingale's view of humanity is to be found in the approach she took to her work and her passion to contribute to the health of those who were sick. "Trials must be made, efforts ventured -- some bodies must fall in the breach for others to step upon," she wrote in 1846, to her father. Clearly she was seeing that new theories must be applied and new procedures must be embraced for healthcare to advance beyond the primitive state that it was in at that time (Attewell, 1998, p. 3). Women long for an education, Nightingale explained, in her chapter "Cassandra" (1860); women long for "…education to teach them to teach, to teach them the laws of the human mind and how to apply them," Attewell quotes from Nightingale's book.

Nightingale believed that God created "miasmatic disease in order that Man should learn its causes through observation," Attewell explains; and after Man learns was causes disease, Man should then "prevent its recurrence through management of the environment" (Attewell, 4). The way that God had set about to help humanity, Nightingale believed, was that nurses, with their obligation to understand and carry through procedures that promote hygiene, "…had a unique opportunity for spiritual advancement" (Attewell, 4). Nurses could then discover "the nature of God by learning his 'laws of health'" she wrote in 1873 (quoted by Attewell, 4).

So it is clear that Nightingale's views of man, the environment, health…… [read more]

Chief Nursing Officer Term Paper

Term Paper  |  5 pages (1,695 words)
Bibliography Sources: 5


In other words, the CNO is not stuck in an office glued to paperwork, he or she is making rounds, serving, as Mastal writes, as a "role model of professional nursing and nursing quality" (324). If the CNO provides "elevating" or "inspiring" leadership -- in effect "raising the level of human conduct as well as the aspirations of all involved" -- that CNO is promoting a cohesive environment.

Moreover, Mastal insists that although hospital board members are not always fully aware of what goes on in the workplace they oversee, the CNO can help produce a positive, uplifting environment by helping to educate board members with quality and safety issues. The more the board knows and understands, the less time the CNO has to spend educating the board and hence the more time he or she spends working to inspire staff. The CNO can also use "evidence-based, nursing-sensitive quality measure" that fully reveal the value that nursing offers society (Mastal, 325).

In conclusion, the role of the CNO is vitally important even though hospital bureaucracies are not up to speed on the value of a CNO. Also, the turnover of CNOs, and the rate of dissatisfaction found in the field, is disturbing and must be addressed by the competent and responsible oversight organizations. It is known that nurses and other staff serving under the CNO prefer that person embrace the transformational leadership style, and so there should be emphasis place on transformational leadership during the training period that a CNO goes through in order to achieve that level of nursing leadership.

Works Cited

Casida, Jesus M. (2007). The Relationship of Nurse Managers' Leadership Styles and Nursing

Unit Organizational Culture in Acute Care Hospitals in New Jersey. Dissertation for Doctor of Philosophy in Health Sciences, Seton Hall University. Retrieved December 5,

2011, from http://domapp01.shu.edu.

Jones, Cheryl B., Havens, Donna S., and Thompson, Pamela A. (2008). Chief Nursing Officer

Retention and Turnover: A Crisis Brewing? Results of a National Survey. Journal of Healthcare Management, 53(2), 89-104.

Mastal, Margaret Fisk, Joshi, Maulik, and Schulke, Kathryn. (2007). Nursing Leadership:

Championing Quality and Patient Safety in the Boardroom.…… [read more]

Nursing Shortage Issues Surrounding Research Paper

Research Paper  |  8 pages (2,586 words)
Bibliography Sources: 4


Present Impact

Baccalaureate programs are offered at approximately 606 four-year colleges and universities. The Bachelor of Science Nursing (BSN) program prepares graduates to practice across all healthcare setting and take on the widest assortment of healthcare roles. BSN programs include all of the course work taught in ADN and diploma programs plus a more in-depth treatment of the physical and… [read more]

Future of Nursing Essay

Essay  |  2 pages (647 words)
Bibliography Sources: 2



Future of Nursing

From reading the Report Brief which one of the 4 key messages speak to you and WHY?

The key message that I see as being very important is that of nurses being full partners, with physicians and other health care professionals, in redesigning health care in the United States. I believe that when redesigning any business process it is very important to include those who work on the front line and truly understand what is needed in order to be successful. When looking to redesign health care, who better to ask what works and what doesn't than those nurses who work with the patients on a daily basis. It is these people who are closely attuned with what it takes to get the job done and these are the being that need to be contributing the most.

From Chapter 3: Transforming Practice, list one of the Barriers to Transforming Practice as identified in the reading.

One barrier that is listed in the Barrier to Transforming Practice is that of an aging workforce.

3. After identifying the one Barrier, describe a strategy, that you have seen implemented in your work setting or you have seen implemented in the media, to address your identified Barrier.

By the year 2020 there is expected to be more than one billion people who are aged sixty or older in the world. Within the nursing professing it is believed that over the next ten to fifteen years there will be a large exit of nurses from the nursing workforce as they retire just at a time when demand for nursing and health care is going to be on the rise due to the ever ageing population. Older nurses are a rich source of valuable information. Their early or compulsory exit from the workforce means a loss of many desirable and experienced nurses to care for patients. When they retire, their knowledge, understanding and clinical know-how…… [read more]

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