Nursing Professional Boundaries Essay

Pages: 8 (2992 words)  ·  Style: Harvard  ·  Bibliography Sources: 20  ·  Level: College Senior  ·  Topic: Health - Nursing

SAMPLE EXCERPT:

[. . .] Role Development and Role Boundaries

The nurse leaders draw professionals from the best utilizing the most appropriate management theories to develop an individual management style and performance. In addition, the nurse leader will act with the assumption that nurses and other professionals wish to attain competence, which if they receive the motivation, they will achieve it, in addition to higher performance levels (Huey, 1994). Advanced nursing practice is applicable to various specialized sectors of clinical nursing, nurse-midwives and nurse practitioners. Another role development option for nurses includes nursing administration and education roles. However, in role development, it is also to keep in mind the professional working limits in order to achieve quality healthcare services.

Dynamic Professional Boundaries

The past century has witnessed the growth and transformation of the current professions and the introduction of new professionals. The changes result from advancing technology, education, and research empirical evidence. In addition, professional boundaries have come under pressure because of shortages in the nursing practitioners (Nancarrow and Borthwick, 2005). The changes have resulted to numerous implications for traditional nursing boundaries. For instance, unskilled healthcare practitioners are assuming roles, which professionals previously performed. However, there is no theory that offers an explanation to the witnessed changes in the nursing practice. It is important to note that concepts of proletarianisation, de-professionalism, and post-professionalism have attempted to explain the issues to traditional authority (Nancarrow and Borthwick, 2005).

Inter-professional Relationships between nurse and doctor

Deficiencies in the collaboration and relationships between nurses and doctors have a negative effect in the provision of healthcare and on the general outcomes of the patient (Hoskins, 2012). The consequences will further lead to stress and frustration levels experienced by the two types of professionals; they can bring about medication errors and personal harm. However, improved relationships between healthcare professionals as outlined by the professional boundaries are an influential aspect in maintaining working relationships (Rosenstein and O'Daniel, 2005). This calls for maintaining of these boundaries; therefore, the professionals should avoid having sexual relationships, or any other form of relationship that may undermine their professional requirements (Rushmer and Palis, 2003).

Implementation of new roles

The nurse practitioner (NP) is a role, which has existed over the past four decades. Globally there is a lack of a universal way of defining, introducing or implementing nurse practitioner roles. In addition, this has contributed to the varying understanding of what comprises nursing roles and the complication of developing best practices in order to implement new roles (Sangster-Gormley et al., 2011). Some of the factors that influence successful implementation of new nursing roles include lack of laws and authority for the role, diverging role definitions, insufficient organization care, opposition from healthcare professionals and inadequate educational requirements (Sangster-Gormley et al., 2011).

Inter-professional working and blurred boundaries

Inter-professional working greatly depends on the relationship between the healthcare professionals. However, existence of barriers or violation of professional boundaries will contribute to bad relationships (Rushmer and Palis, 2003), which will compromise inter-professional boundaries. Some of the blurs to inter-professional working include lack of awareness of the abilities and efforts, and rivalries and resentments, among the professionals concerning limits (Hoskins, 2012). Some prior studies suggest that the professionals spend a lot of time in emphasizing their differences than sharing knowledge, which they perceive as a threat rather than an advantage. Into the bargain, the healthcare field has aired concerns over the issue of task substitution and true inter-professionalism, suggesting that doctors should maintain their core role (Hoskins, 2012).

Malaysian Nursing Code of Conduct

The Malaysian government recognizes the contribution of the nurses towards the provision of quality healthcare. The nurses do this through protection, restoration of health and promotion. In addition, they help in illness prevention and elimination of suffering in the care of individuals (Chong, Sellick and Francis, 2011). In performing their roles, the nursing practice endeavors to protect the interest of the society by making sure its nurses abide by a code of conduct. Therefore, every registered nurse has a moral obligation to abide to a professional code of conduct. The Malaysian nursing conduct offers guidelines for professional behavior and practice; therefore, the code serves as a standard against that considers complaints of professional violations. In addition, it supplements the Nurses' Act of Malaysia.

NMC Nursing Code of Conduct

The Nursing and Midwifery Council (NMC) code of conduct refers to the principles and expectations considered binding to any individual who is a member of a specific group. People perceive it as an efficient tool to reinforce a specific model of behavior. The code has a good logical structure and covers a wide range of factors of nursing, providing clear formulations in practice. In addition, the code provides comprehensive guidance concerning a broad range of significant issues (Williams, Firn and Wharne, 2011). Some of the professional conducts designed for nurses and midwife are among the effective approaches available along with various industries.

In the healthcare environment, it describes what the professionals should do and behave. The code has four main principles including:

a. Taking care of individuals, treating the individual independently and always respecting their dignity

b. Protect and promote healthcare services and well-being for concerned individuals and the wider society by working with others

c. Providing nursing practice and healthcare services of high standards during all times

d. To operate openly and honestly to uphold the good reputation of the profession

Implications of Changing Roles of Nurses and the Impact on patient care

Nurses play an important role in the quality of patient care. Most of their roles, though not as technical compared to the roles of physicians, their skills in those roles play an important role in the care delivery. Therefore, when the roles suddenly change, it means that the patient will not access someone to talk to immediately (Cohn, 2009). This means that when the patient feels a change in their health condition, they will not get immediate check up. In addition, the patients will not have an opportunity for effective assessment in their treatment process. If the roles change and a nurse assume a physician's responsibility, it is likely that they will not deliver the required help to the patient, citing under-qualification and experience.

The change of roles will lead to the change of most of the traditional caring role. In addition, this will lead to increased clinical knowledge, which might lead the nurses back to school. This also means that the increased reliance of technology might lead to some nurses losing their jobs. However, the change in roles will greatly influence the patient outcome. This is because the patients might become sicker and may end up requiring higher dependency (Cohn, 2009). In addition, the changing roles will complicate disease management and finding the patients will become difficult because they will no longer stay in their beds.

Bibliography

Avis, W.S., Drysdale, P.D., Gregg, R.J., Neufeldt, V.E., & Scargill, M.H. (1983). Gage Canadian Toronto, ON. Canada Publishing Corporation: Gage Educational Publishing Company.

Chong, C.M., Sellick, K., & Francis, K. (2011). What influences Malaysian nurses to participate in continuing professional education activities? Asian nursing research, 5(1), 38-47.

Cohn, K.H. (2009). Changing physician behavior through involvement and collaboration. J Health Manage, 54, 80 -- 6.

Goolsby, M.J. (2004). American Academy of Nurse Practitioners National Nurse Practitioner Sample Survey, Part 1: an Overview. J Am Acad Nurs Pract, 17(9), pp. 337 -- 341.

Hoskins, R. (2005). Inter-professional working or role substitution? A discussion of the emerging roles in emergency care. Journal of advanced nursing, 68(8), pp. 1894-1903.

Huey, J. (1994). The leadership industry. Fortune, pp. 54-56.

Hung, J.H. (1999). Professional boundaries in the doctor-patient relationship. Minnesota Board of Medical Practice Update. Fall, 2 -- 5.

Justice, M. (1995). Can We Care Too Much? Therapeutic nurse-patient relationships. Creative Nursing, 10-12.

Kagle, J.D., & Giebelhausen, P.N. (1994). Dual Relationships and Professional Boundaries. Social Work, 39(2), pp. 213-220.

Megginson, L.C., Mosley, D.C., & Pietri, P.H., Jr. (1996). Management: leadership in action (5th ed). New York: Harper & Row.

Nancarrow, A.S., & Borthwick, M.A. (2005). Dynamic professional boundaries in healthcare workforce. Sociology of health & illness, 27(7), pp. 897-919.

Offredy, M. (2000) Advanced nursing practice: the case of nurse practitioners in three Australian states. Journal of Advanced Nursing, 31, pp. 274 -- 281.

Puteri, K.J.N. (2009). Challenges for the nursing profession in Malaysia: Evolving legal and ethical standards. Journal of nursing law, 13(2), pp. 54-62.

Rushmer, R., & Pallis, G. (2003). Inter-Professional Working: The Wisdom of Integrated Working and The Disaster of Blurred Boundaries. Public Money and Management, 23, pp. 59-66.

Rosenstein, A.H., & O'Daniel, M. (2005). Disruptive behavior and clinical outcomes: perceptions of nurses and physicians. Am J. Nurs, 105(1), pp. 54 -- 64.

Sangster-Gormley, E., Martin-Misener, R., Downe-Wambodlt, B., & DiCenso, A. (2011). Factors affecting nurse practitioner role implementation in Canadian practice settings: An integrative review. Journal of advanced nursing, 67(6), pp. 1178-1190.

Steff, B.D., & Grimes, A.J. (1986). A critical theory of organizational science. Academy of management review, 11, pp. 322-336.

Watson, J.,… [END OF PREVIEW]

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