Contemporary Analysis of Personal Nursing Practices

In a profession filled with standards and broad responsibilities, patients expect real human care that makes them feel not only healthier but also truly cared for. After a thorough review of the selected reading material, I have furthered my resolve for effective care within my work setting. Within the American Nurses Association (ANA) scope of practice, I recognize I have ground to gain in focusing on the needs of each patient in their current situation for an individualized experience, in spite of the rush so characteristic of the emergency room. My practice, furthermore, is consistent with codes of ethics respecting patient autonomy to make important decisions. In learning the nuances controlling regulations for out-of-state practitioners, I have gained a further appreciation for the legal structures shaping my profession. The following pages will serve as a summary and guideline for the professional standards I aim to implement in the workplace on a daily basis.

Personal Practice as Compared With ANA Scope of Practice

The ANA scope of practice focuses on five tenets for effective nursing care. These tenets include an emphasis on individualized healthcare (O'Sullivan, 2010, p. 4). Nursing practitioners are expected to respect the nuances of a situation and adjust to the unique demands of the situation. Secondly, nurses must create partnerships for organizing the implementation of care (O'Sullivan, 2010, p. 4). This includes family members and friends as well as professional healthcare providers via electronic and personal communication strategies. Thirdly, through interpersonal communication and concrete acts of service, caring plays a central role in the work of a registered nurse (O'Sullivan, 2010, p. 4). These professionals are expected to engage in a benevolent role that works toward the recuperation of the patient. Fourthly, in providing customized care to the patient, nurses must take initiative to apply "theoretical and evidence-based knowledge" of the situation to create a basis for operation (O'Sullivan, 2010, p. 4). The nursing process of assessment, diagnosis, outcomes identification, planning, implementation, and evaluation should be applied in all situations (O'Sullivan, 2010, p. 3). Lastly, registered nurses will take responsibility for creating a professional environment where optimal solutions may be implemented (O'Sullivan, 2010, p. 4). "Negative, demoralizing, and unsafe" work environments will not be tolerated. These five standards play an important role in daily practice.

The ANA scope of practice especially applies to my work ensuring that the environment is at all times safe for work. Unclean work surfaces and reckless behavior cannot be tolerated, and this standard is mirrored in my daily professional development. In spite of the busyness of my job, I endeavor to provide a supportive role that truly leaves people feeling valued and cared for.

Personal Practice as Compared With PA Regulations and Professional Standards

In the "Responsibilities of the Registered Nurse", as outlined by the Pennsylvania State Board of Nursing, six broad standards must be applied in practitioner situations. In my work, I strive to employ such standards in the emergency room. These standards include a focus on an ongoing gathering of data to have the most complete information for assessing patient needs (Fry, 2014, p. 13). In addition, I work to relate current patient status with normal behaviors as I make needs-based decisions (Fry, 2014, p. 13). While acting to implement a wellness plan in the midst of a fast-paced environment, I act in a capacity determined to restore and promote the wellbeing of my patients (Fry 2014, p. 13). All of these standards come under an overarching bent on analysis of the current situation; if an outcome is not functioning properly, it is my responsibility to correct the matter (Fry 2014, p. 13). Finally, my work centers on a fundamental acceptance of responsibility for my client; as such, I abstain from engaging in specialized practices outside of the scope of my experiences (Fry 2014, p. 13). Together, these objectives drive my work to provide the most effective service that I am capable of.

Provision 7, 8, and 9 Growth Objectives

Provisions 7, 8, and 9 address matters of the social conscience. Here, we find that the nurse carries a responsibility to the public to create educational initiatives promoting positive life habits in tandem with other health professionals (Fowler, 2010, p. 89, 103, 121). In Provision 7, for example, it is my responsibility to seek opportunities where I can develop policy within my particular work arena in the emergency room (Fowler, 2010, p. 89). If there is a procedure delaying the efficient measurements of a patient's vital signs, I must take the opportunity to propose a better method. In the case of Provision 8, my work could be positively humanitarian by taking some time off to volunteer abroad in programs like Nurses Without Borders, especially in places recently struck by natural disaster imposing an urgent environment similar to my current setting (Fowler, 2010, p. 103). Finally, my work centers on a full-fledged dedication to the integrity of this honorable profession (Fowler, 2010, p. 121). As one of the oldest professions in existence, I realize that my work contributes to a national standard for healthcare. As lives literally depend on my ability to effectively perform my job responsibilities, I realize this commitment cannot be taken lightly.

Philosophical Forces Influencing Personal Practice

Nursing practices remain in a constant state of flux. As technology advances and treatment methods shift due to current research advancing our understanding of the human body, one of my fundamental philosophies in the emergency room is the word, "change." In my job, I anticipate its arrival, look for chances to implement it, and seek to engender it in others as we evolve our working methods. For example, as HIPPA regulations become more vigilant, I recognize I have an unprecedented responsibility to patient confidentiality. While change alone does not necessarily bring about a greater good, once integrated into the system, an educated and inquisitive nurse must remain open to new ways in which to improve current practice.

In addition, I remain on the lookout for opportunities to teach and be taught by my peers. As my coworkers each bring unique work experiences and skillsets to the professional environment, I recognize that a great opportunity exists for us to gain from one another. In one case where a coworker was struggling to establish the urgency of a set of patients in the ER, I took the opportunity to review with them the procedures for establishing triage priorities. In doing so, I sought to understand what their frame of reference was and correlate it to current ER procedures in my workplace.

Ethical Theories, Principles, and Values Influencing Personal Practice

Within the Pennsylvania State professional nursing laws, established principles have been set. They do not, however, block the care of the sick in connection with religious organizations nor in the case of home care (Law, 2007, p. 6). In addition, externally licensed nursing practitioners outside of the Pennsylvania commonwealth benefit from six months duration in which they may legally work within the state (Law, 2007, p. 6). Some ethical theories related to my ER work environment within the state involve effective communication. In my work, I must ensure that the patient and family members appreciate the benefits and risks of potential procedures so that they can make informed decisions, all within the context of a broad understanding that there are no guaranteed success rates. As such, I maintain patient autonomy.

The proper resolution of ethical dilemmas, however, remains complex as these problems often have no clear solutions. If a patient refuses care in spite of urgent need, for example, it is my job to make sure that they have all the relevant information pertaining to their situation in order to make an informed decision. At a minimum, I will facilitate the guidance of clear-decision making.

References

Burkhardt, M., & Nathaniel, A. (2008). Ethics & issues in contemporary nursing (4th ed.). Clifton Park, NJ: Delmar.

Fowler, M. D. (2010). Guide to the code of ethics for nurses: interpretation and application. Silver Spring, MD: American Nurses Association. (Original work published 2008)

Fry, C. (2014, January 11). State board of nursing. The Pennsylvania Code. Retrieved from http://www.pacode.com/secure/data/049/chapter21/chap21toc.html

Law, P. (2007). The professional nursing law. General assembly of the commonwealth of Pennsylvania, 317(69), 1-23.

O'Sullivan, A. (2010). Nursing: scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Association.