Abstract This paper discusses how the nursing shortage and repercussions in nursing attrition and compromised patient care led to numerous attempts at forcing mandatory nurse-patient ratio legislation in California until finally, the bill was signed into law in 1999. This paper reviews the bill including the history and ramifications of the legislation and focuses on implications for the nursing profession and others.
From the Paper "In 1999, California became the first state in the union to impose mandatory nurse-patient ratios (Sabin, 2004; Wilson, 2004; Dumpel, 2005; Gedhill, 2005; "Hospitals struggle," 2005; Evans, 2006). The legislation requires that med-surg nurses would no longer be responsible for more than five or six patients each, during the phased in approach to the bill. According to research, the bill required that as of January 1, 2004, no more than six patients per nurse be assigned and that by January 1, 2005 the number be reduced to the assignment of no more than five patients per nurse (Sabin, 2004; Gedhill, 2005; "Hospitals struggle," 2005; Evans, 2006). Governor Gray Davis signed the California Staffing Ratio Law, AB 394 into law on October 10, 1999, although attempts to pass such legislation dated back to 1193 with the introduction of AB 1445 that was defeated (Dumpel, 2005). "
Abstract This paper discusses the importance of the nurse-patient relationship in the care of the patient. The paper then aims to determine if there is an impact on nurses as professionals or patients regarding the nurse-patient relationship, when a nurse is a patient within the health care facility. The paper looks at the possible impact such a change in the nurse-patient dynamic might have on future health care.
Table of Contents:
Background and Significance
Purpose
Theoretical Conceptual Framework
Review of Literature
Research Question
Sample and Setting
Research Design
Measurement
Reliability and Validity
Data Analysis
Limitations of the Study
Implications for Nursing Conclusion
From the Paper "Over the past decade professional nurses have sought to alter their work within the field in numerous ways. As many nurses begin to retire as part of the baby boomer generation it is apparent that they will require additional health care services in the decades to come. While it has been established that there is a need for nurses to focus on nurse-patient relationships in health care, there has not been research to date that explores how that relationship may be altered if the patient is a nurse. Therefore, an exploration of this issue should be accomplished to determine if there is need for new training, a shift in policies or awareness of the issue for the future of the nursing and health care community."
Abstract This paper discusses relational work beyond the nurse - patient dyad and how this affects professional relationships and provision of care. It explains that the primary duty of the nurse to put the needs of the patient first and foremost. The paper also looks at how collaboration and leadership are roles that transcend the nurse-patient dyad and are subject to different dynamics in that the nurse deals with peers and other professional that are, unlike the patient, transient in the hospital setting. The paper shows that from the ill-perceived role of the nurse performing mundane tasks for physicians more than half a century ago, the establishment of nursing as a distinct pillar in the health care system to the hybridization of the practice of both nursing and medicine, it is still to be determined what non-clinical roles may arise in the future health care system.
Outline:
Introduction
Conclusion
From the Paper "The different duties and responsibilities of the nurse are impossible to relegate to any one role. She may collaborate with an attending physician one moment and be expected to comfort a patient and family the next. One particular set of roles involve relating to colleagues and other health care professionals. These roles are different from nurse-patient roles in that they involve unique social dynamics inherent to any health care system."
Tags:nursing, health, care, professional, teamwork, leadership, collaboration
Abstract Interpersonal Aspects of Nursing is an important theory that strives to bring the focus of nursing back to therapeutic means of treatment. While the science of nursing has much to do with the quality of patient recovery, Joyce Travelbee's theory suggests that a positive nurse-patient relationship can bring about a favorable patient outcome. The paper presents an overview and critique of the theory and discusses how the theory can be used in professional practice.
From the Paper "Development of ideas should be logical and consistent throughout so thoughts can be interpreted appropriately (Parker, 2006). Regarding clarity, Travelbee's theory is not entirely understandable because major concepts are defined by various means. While Travelbee herself develops some concepts, others are taken from Webster's dictionary and the World Health Organization. I found definitions throughout interpersonal aspects of nursing to be clearly defined, but found inconsistencies in meanings on occasion. Travelbee states the definitions of concepts and then goes on to explain the definition, however, she does had a tendency to use the same definition for different terms."
Abstract This paper offers a review of the factors that may contribute to the chronically ill person maintaining or not maintaining adherence to prescibed treatment. Chronic mentally ill clients exert considerable energy avoiding loss of control. Both the therapeutic environment and the nurse-patient relationship are contextual factors furthering this goal. The paper looks at the important role played by the nurse in building a strong and reliable relationship with the mentally ill patient, in order to better adminster treatment.
From the Paper "In the last several years, there has been a growing concern for the plight of family caregivers of persons with chronic disease and disability. This focus arose primarily from recognition that chronic disease is becoming a greater problem in our society. In part, this problem is due to the advances in medical science and technology that have prolonged the lives of many chronically ill persons."
Abstract This paper explains that the health care field has developed collaborative practice in which each member of various professions within the health care field, including physicians, nurses, ancillary departments, patients and patient families, works together by sharing knowledge and insights on how to deliver high-quality patient care. The author points out that nursing diagnosis is classified as a language for nursing to standardize its practice, which allows nurses to work towards patient care in a uniform pattern by providing the nurse with a plan and interventions. The paper stresses that the primary difference between nursing diagnosis and collaborative care is that nursing diagnosis is intended for the nursing community solely; whereas, all healthcare fields work together in collaborative care.
Table of Content
Case Study
Collaborative Practice
Obstetric Physician and Nurse Neonatal Intensive Care Nurse Patient and Family
Social Worker
Nursing Diagnoses and Collaborative Problems
Nursing Diagnosis
Collaborative Problems
Potential Barriers to Successful Collaboration
Conclusion
From the Paper "Due to the fact that meconium was noted in the amniotic fluid, the LD nurse will collaborate with the NICU nurse at the onset of delivery. The NICU is extensively experienced with more critical issues concerning newborns. Therefore, the NICU nurse will take the first look at the newborn to make sure there are not any indications requiring more specialized care. If needed, the NICU nurse will transport the newborn quickly to the NICU unit. Even though in this situation the presence of the NICU nurse is more precautionary, her presence is important for the safety of the newborn."
Abstract This paper shows how mental health nurses talk extensively about the relationship between the nurse and the patient and the use of this relationship. It is suggested that this relationship is a therapeutic one and this term is often used in the patients? care planning. The paper quesions what exactly nurses want to achieve in this nurse-patient relationship. The author of the paper suggests that one of the primary goals of this relationship should be to move power and control to the patient. Perhaps this could be seen as the objective or end goal of the relationship. The writer also suggests that mental health nurses often inadvertently remove control and power from the patient through the inappropriate use of this relationship. Several power theories, put forth by experts in the field such as Barnett and Hildegard Peplau, are discussed in relation to the writer's developing philosophy of nursing and own practice as a psychiatric nurse.
From the Paper "Taking the time to know the patient is part of enabling empowerment and this is shown in the nurse-patient relationship through Peplau's (1997) theory of interpersonal relations. Peplau discusses the nurse-patient relationship as requiring three phases to achieve a therapeutic value. This involves an interpersonal knowing between the nurse and the patient. There are three phases to Peplau's framework: orientation, working, and termination phases. This writer suggests that in order to move the relationship from the orientation phase to the working phase, the nurse must identify issues of power and control in the relationship. Forchuk et al (1998) cites the relationship as powerful when moving through this transition to the working phase. This involves the nurse being consistent, available and valuing trust in the relationship."
Tags: institutionalization, orientation, communication
Abstract In this work, the role of the nurse as the patient advocate in the field of psychology treatment is explored through two seminal works on the role of the nurse as advocate for the mentally ill patient. After reviewing these two works, Hummelvoll's "The Nurse-Client Alliance Model" and Vuckovich's ?The Ethics of Involuntary Procedures", the paper concludes that the role of the nursepatient advocate in psychiatric nursing is crucial to the well-being of the patient, and though it evolves with the differences in care and the level of self-advocacy, a patient can provide it is a major part of the care process.
From the Paper "The issue of ethics is central to the nurses ability to provide services for a client as his or her advocate and in one article the psych nurse's ability to base decisions on ethical grounds for the greater goods of the client is explored, and within the work the role of nurse as patient advocate is explored, though secondarily through the language of the article. Though issues become much more complicated when involuntary procedures are concerned nurses rely on experience, not excluding the experience with the patients themselves as a guide. Without the role of advocate these decisions would be much harder to make."
Abstract The paper presents a nursing situation that demonstrates the role and responsibility of nurses as advocates of patient safety and quality of care. The paper discusses the issues raised in this particular situation such as lack of time for nurses to offer even basic care to their patients, harm caused to patients because of not getting basic care, the patient's and family's right to know, how the truth should be told, and the problems connected with whistle-blowing. The paper then looks at possible options and resolutions for dealing with the issues.
Outline:
Introduction
Core Issues in the Situation
Potential Options
Analysis of Each Option
Theoretically Defensible Position
What Made the Situation Challenging?
Conclusion
From the Paper "refers to adhering to high moral principles or professional standards.
In this series on the heart of nursing, the role of integrity in nursing practice merits a mention. Every year, market researchers conduct a poll in various countries to find out how the population surveyed rate a range of professions and occupations in relation to honesty and ethical standards. In Australia, the UK and the United States, nurses are frequently ranked number one, or pretty close to it. In the US, nurses have been ranked top for 'honesty and integrity' every year since 1999, except 2001, when they were ranked second.
"Being honest is at the heart of our work. That is why the charge nurse is still upset about the part he played in Meg's care, and why nurses often go home troubled because they have not, in their own eyes, been able to maintain integrity in their practice."
Tags: Care, nurses, patients, medication, treatment, doctor
Abstract Identifies the difficulties in this nurse-patient relationship and attempts to describe how any understanding of the psychological and/or sociological concepts contained in this unit could have helped to interact more successfully and therapeutically with this client.This paper cites a case study presented from the point of view of a nurse who had to take care of a 'difficult' patient. Through her experience the reader is made to understand that the nurse-patient relationship should be understood to be therapeutic and only then can it actually come to a realization of true care giving.
Abstract This paper addresses the problem of finding a reliable means of predicting the need for nursing care of patients in the intensive care unit (ICU). It looks at present systems devised by nurses to establish nurse-patient ratios and explores these strategies and systems, as well as alternatives. The paper concludes that the preferable course will be a system designed by nurses; without that, legislation will be the only alternative. The paper also looks at the writer's point of view and the relevance of the issue to him.
Table of Contents:
Introduction
Personal Relevance
Relevance to Nursing The Issue: Nurse-Staff Ratios
Analysis
Alternatives: Staffing Models
Legislation
Recommendations
Conclusion
From the Paper "Another system for determining nurse-patient ratios is of more interest to the health organization and the government. The diagnostic related groups system is primarily based on the principal diagnosis. Comorbidities and other factors such as length of hospital stay allow outcomes to be costed. The diagnostic related groups are used as a means to calculate costs as well as a system to estimate the cost of nursing care. The problem with the diagnostic related groups system is that, although it is comprised of 475 diagnostic categories, they have never been evaluated in terms of the nursing workload linked with them (Adomat & Hewison, 2004). In general, no patient classification or dependency system that currently is in use is completely effective for determining nurse-patient ratios in the ICU. The problem is found in the variable nature of the ICU so that a set of circumstances cannot be projected onto even the immediate future."
Abstract This paper discusses computerization of the nursing professing, as it pertains to the documentation of patient information. The paper describes the process involved and why health care documentation is an important aspect of nurse care of the patient. The paper also looks at why computer-based data collection is more productive that other means.
Abstract The paper discusses Imogene King's general systems framework theory of nursing that emphasizes the importance of the interaction between nurses and patients. The paper looks at how other theorists have adapted King's model to specific uses and focuses on Margaret Newman's conception of health that can be seen as supporting King's approach. The paper suggests that the application of King's approach could be demonstrated with a skit showing the interaction between nurse and patient.
From the Paper "King attained a diploma from St. John's Hospital School of Nursing in St. Louis, Missouri in 1945 and a BS in Nursing Education at St. Louis University in 1948. she also acquired a degree as Doctor of Education from Teachers College, Columbia University in 1961 and an Honorary PhD from Southern Illinois University in 1980. She started her professional career at St. Louis University and spent several years at Loyola University in Chicago before moving to the University of South Florida. Her system model depicts three interacting systems: personal, interpersonal, and social."
Abstract This paper examines nurse burnout as a prevalent problem in many institutions. The paper explains that nurse burnout can be attributable to inadequate staffing and points out that the consequences of under-staffing are observed in terms of the decline in overall well-being of the nursing staff: staff exhaustion leading to high levels of stress and burnout, nurse dissatisfaction, absenteeism, and higher risk for disfranchisement from the profession. The paper then looks at the common method for calculating the nursing workload internally - the nurse-patient ratio. The paper concludes that while the evidence cited in the paper reflects different institutions, the extent to which burnout is seen should be assessed, as well as evaluated, to help find the possible contributing factors, both within and outside the hospital setting.
Outline:
Identification of Clinical Problem
Review of Literature
Research Critique
Conclusion
From the Paper "Managers have attempted to adapt to the situation by maintaining flexibility in staff schedules depending on changing unit demands which are constantly changing. When a patient is so seriously ill that one nurse cannot perform care, one or more other nurses are needed for a limited time. At other times, such is not the case. However, the central problem in staffing is not attaining staff flexibility congruent to the unit's needs. The reality that it is not recognized by higher management, nor is it under the control of nurses further complicates the problem."
Tags:patient, critical, care, intensive, mortality, hospital
Abstract This paper examines collaborative efforts in the field of nursing. The paper takes a particular case study and identifies which clinical and social groups would be involved in a collaborative effort. Following this, the paper discusses nursing diagnosis and collaborative care and ways of differentiating between the two before identifying potential barriers to collaborative practice.
Outline:
Case Study
Collaborative Practice
Obstetric Physician and Nurse Neonatal Intensive Care Nurse Patient and Family
Nursing Diagnoses and Collaborative Problems
Nursing Diagnosis
Collaborative Problems
Potential Barriers to Successful Collaboration
Conclusion
References
From the Paper "In addition to nurses and physicians collaborating with each other to supply quality care, the patient and her family also play a large role. Patients and healthcare providers work together to make decisions concerning the patient's care (Blais et al, 2006). The LD nurse will collaborate with the patient and her family concerning care throughout the birth process. For example, the LD nurse will clearly explain the options available for pain management. The client and her family together in turn discuss these measures and decide what is best for the client. The LD nurse does not tell the patient and her family what to do for pain management, but instead relays the proper information to the patient and her family in order to allow for patient and family participation (Blais et al, 2006)."
