Task 1 C304 Professional Roles and Values: Professional Accountability

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Task 1 C304 Professional Roles and Values: Professional Accountability

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Student Name College of Health Professions, Western Governors University Professor Name Date Due

Nursing Theory

As a nurse working at the Postpartum Unit, a nursing theory that deeply resonates within me is Dorothea Orem’s Self-care theory of nursing. The self-care theory of Orem’s is broadly defined as assisting others in the provision and management of self-care to maintain or improve human functioning (Miller, 2021). I believe that if my patient were to perform self-care as much as possible, then they’ll recover quicker. I am adamant about utilizing this nursing theory to carry out effective nursing practices in my career as a NICU nurse.

Excellent Nursing Practices

Nursing within this model is limited to only upkeep the patient’s self-care regimen when the patient reaches a point when they are unable to. It is imperative to promote independence of the patient from medical staff when they can. There are three sections of Orem’s self-care theory: the theory of self-care, the theory of self-care deficit, and the theory of nursing system (Miller, 2021). The theory of self-care focuses on the performance of activities conducted by individuals themselves. These activities focus on maintaining the individual’s health on their own. The theory of self-care deficit is when a nurse should step in if their patient is limited or incapable of self-care and needs the help. The theory of nursing systems pertains to the focus “on the relationship between a nurse and their patient and the wholly or partially compensatory nursing system and supportive-educative system that takes place between the nurse and a person” (Miller, 2021). This describes how the self-care of the patient will be met by the nurse and/or the patient.

This theory model showcases five methods of helping patients. These methods include acting for and doing for others, guiding others, supporting another, providing an environment promoting personal development in relation to meet future demands, and teaching another

It became Nightingale’s mission to improve the sanitary condition of the hospital she worked at due to the unsanitary state and the cholera outbreak in the early 1850s. It was in the Crimean War of October 1853. Her experiences at the Crimean War greatly influenced her as a nurse and her views on sanitation. When she arrived with a team of thirty-four nurses, she saw how truly inhuman, disgusting conditions the wounded British soldiers were being subjected to. The water was contaminated, patients sat on their own feces, rodents and bug scurried about, basic supplies were scarce, and more soldiers were dying from infections rather than battle injuries (A&E Television Networks, 2009)

So, Nightingale set to work by cleaning the hospital with the abled soldiers. She would make evening rounds throughout the hospital offering routine care to the hospital’s many patients. She reduced the death rate by two-thirds at this site. She also created many patient services to improve the quality of the patients’ stay at the hospital. This includes the creation of the invalid’s kitchen that would assemble appealing food within the dietary requirements of their patients. She established a laundry for clean linens and instituted a classroom/library for patient’s intellectual stimulation and entertainment. She even wrote a Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army that later established the healthcare system in the military (A&E Television Networks, 2009).

Later in life, Nightingale funded the St. Thomas’ Hospital and established the Nightingale Training School for Nurses within it. She changed the playing field for women in the nursing occupation that many women of various financial backgrounds aspired to become nurses like Nightingale. Nursing was viewed in a more positive outlook by the upper echelon as well. Even if she was bedridden for life by the “Crimean fever” she still advocated for healthcare reform and even published a work that focused on how to run civilian hospitals properly. She consulted

many about the best methods to manage field hospitals in the Civil War and served as an authority on public sanitation in India (A&E Television Networks, 2009).

Clarissa, better known as Clara, was a nurse helping in the Civil War. She found it best to help support the troops by going to the battlefield in person. After her service, she traveled to Switzerland to provide care to the injured and ill during wartime and for the formation of national societies to provide neutral voluntary aid. It was on her return to home in 1881when she established the American Red Cross (American Red Cross, n.). Her experiences throughout her life as a wartime nurse taught her how necessary it is to provide quality care, emotional support, and supplies to those on and off the battlefield. With the American Red Cross foundation, she was able to provide food, clothing, and even shelter. As well as, providing medical supplies and assistance with evacuation efforts of the wounded. These services eventually became core services bestowed from her organization (Clara Barton’s Missing Soldiers Office Museum, 2020).

Differences in Contributions Although both historical founding mothers share vast similarities, they do have their differences. Throughout her career, Nightingale’s sole focus was on the importance of environmental health of a healthcare facility. She aspired to become a nurse due to faith, believing that her calling as a nurse came from God (A&E Television Networks, 2009). Clara was inspired into nursing when her older brother fell ill. She cared for her older brother at the age of eleven for two years until his full recovery and developed skill that helped her later in the Civil War (Clara Barton’s Missing Soldiers Office Museum, 2020). Despite their amazing contributions to the nursing community, Nightingale worked with teams, Barton often worked independently in her field.

Journal, 2021b). Evaluating licensure applications are to confirm that the nursing applicants have the appropriate education, passed the NCLEX-RN, and background checks completed. Issuing licenses is just that and maintaining a list of licensed nurses that is available to both healthcare providers and the public. For renewing licenses, the State Board of Nursing requires nurses to participate in continued career education in good standing. Finally, disciplinary actions require the Board to investigate nurses that are suspected of violating laws or nursing regulations. A consequence to this would be the reprimanding or even loss of a nursing license (Nurse Journal, 2021b).

The ANA is a professional nursing organization that advocates for nurses. According to their website, the ANA exists only to advance the nursing profession by fostering high standards of nursing practices, promoting a safe and ethical work environment, supporting the health and wellbeing of nurses, advocating healthcare issues that affect the public and nurses (American Nurses Association, n.). The ANA was designed specifically to support all registered nurses with the United States and all U. territories.

Influence of the State Board of Nursing and ANA The impact of both organizations has greatly influenced my nursing career. Due to the State Board of Nursing, I was able to gain my nursing license through intense examination testing and renew it every two years to continue my professional career as a registered nurse. The ANA has allowed me to voice my beliefs and feelings during my time as a nurse that could potentially aid other nurses.

Requirements for Professional License Renewal In terms of renewal for a professional nursing license, the state of California requires that those who want to maintain an active license must complete thirty contact hours of continuing

education (California Board of Nursing, n.d). A full set of fingerprints must be submitted to the DOJ and FBI for renewal licensure. The renewal applicant needs to disclose any discipline issues or if they have been convicted by a crime (Nurse Journal, 2021a). It is important to know that your first license acquired will expire in two birthdays, not years. So, when the month of your birthday ends, every renewal after will need to renew every two years. There will be renewal notices approximately three months before the expiration date (California Board of Nursing, n.d).

Failure to Maintain License Requirements Consequences on failing to maintain license requirements vary depending on its severity and the number of factors included to determine the disciplinary penalty. These factors include the severity and recency of offense, rehabilitation evidence, current ability to practice safely, mitigating factor, and past disciplinary history (California Board of Nursing, n.d). If your license has been lapsed for more than eight years, you must submit a delinquent renewal fee, thirty hours of continuing education, and proof of competency to practice by either retaking the license exam or verification of a current active license in the United States or U. territory (California Board of Nursing, n.d).

Compact Versus Non-Compact State States under the Nursing Licensure Compact (NLC) allow nurses with one license the ability to practice in other states under the same agreement. (Gaines, 2021). The NLC has eleven requirements for multistate licensing. Nurses must meet the requirement for a license in their state of residency, must graduate from an education program approved by the board or from an international education program, pass the English proficiency exam, pass the NCLEX-RN or NCLEX-PN or predecessor exam. The applicant must be eligible for or hold an active

Nurse’s Role as a Patient Advocate As a nurse, I am the first to know about my patient’s wants and needs for quality healthcare as I am the one who interacts with the patient directly and often. If a patient of mine expresses their want for an alternative therapy, I must make sure that their request is heard, researched, and addressed. This means that I got to make the patient’s physician aware of this request. It is also imperative to have a discussion with the physician about if the alternative therapy is safe for the patient. If it is safe, then a set action must be followed. For starters, the physician must have a dialogue with the patient regarding their request and send out orders for the patient to be given the alternate therapy. However, if the alternate therapy is proven to be unsafe, the physician will still need to have a conversation with the patient why that is so and recommend other safe therapies.

Purposes of the Nurse Practice Act The purpose of the Nurse Practice Act (NPA) is to mandate a scope of practice and responsibilities for RNs in California (California Board of Registered Nursing, n.d). It allows nurses to practice within a safe guideline set by the state of California. This mandate is in the California Business and Professions Code starting within Section 2700 (California Board of Registered Nursing, n.d).

Scope of Practice For California, this state’s scope of practice for RNs is to perform all the tasks in the CNA and LVN scope of practice. RNs also have the responsibility to such tasks as the administration of intravenous medications. In California, RNs are independent practitioners. Supervision is not required if the RN work within their scope of practice. The expansion of a scope of practice due to standardized procedures may allow the RN to perform tasks, usually

reserved for physicians, such as refilling medications dictated by specific criteria (Nursing Explorer, n.).

Rules for Effective Delegation In the state of California, it is important for RNs to delegate successfully based on the care the patient needs. Delegation for a RN is divided up in five sections: the right person, the right task, the right circumstances, the correct directions, and the right supervision/evaluation (RegisteredNursing, 2021). RNs, when delegating tasks, must listen to any doubts or hesitations of their subordination or else the delegated tasks could have dire consequences for the patient. Subordinates must be competent enough to carry out their assignments as not all licensed subordinates have the experience or the education as their more experienced co-workers (California Board of Registered Nursing, n.d).

Application of Nursing Roles As a scientist, I am constantly collecting data of my patients in the Postpartum Unit. This research would include lab work, basic information of the patient’s past pregnancies, miscarriages, and other basic medical information pertaining to their past/current pregnancy. After I collected every possible information I could gather, I then hypothesized the current situation and what they need healthcare wise. All of this is then presented to the patient’s physician for resolution. In other ways, I can be considered as a detective in my career. Like a detective, I need to really dig deep to reach the root cause of what is really going on. This provides context to my patient’s circumstances so that I can better provide the best quality of healthcare for my patient. As a manager of the healing environment, it is important to be there for your patient especially in the Postpartum Unit. I have seen so many unfortunate situations happen to the mothers in my unit. It really helps the patient emotionally and mentally to be there

a culture of safety. Incompetence, unethical, illegal, or inappropriate practice need proper actions from the nurse, so the patient’s best interest is not jeopardized. When potential harm can be done by impaired actions, the nurse ought to protect the patient, public and the profession (Ovid, n.).

Analysis of Provisions The two provisions mentioned above have greatly influenced the way I practice nursing. It is my job to hear my patient out, I strongly believe in my patient’s autonomy. Whatever the patient wants within their healthcare plan, whether it be an alternative therapy or medicine, it is my job to make sure that they are heard. No one has the right to take that away from a patient, be it their family, friends, or a caregiver. My priority is my patient, their safety, and their privacy relating to healthcare. Each patient is a unique individual with different needs in their care plan, their needs, safety, emotional stability, rights, and culture will be respected.

Clinical Practice Error There is a multitude of ways that nursing errors can occur. By not checking the uterus frequently after birth, it can lead to a hemorrhage. Clearing clots and checking uterine blood flow so that you can miss the hemorrhage. If you leave the patient uncheck for so long, placental abruption, placenta previa, an over distended uterus, high blood pressure disorders of pregnancy, prolonged labor, infection, and so much more (Stanford Children’s Health – Lucile Packard Children’s Hospital Stanford, n.).

Application of ANA Provisions Provision two and three apply to the situation mentioned above. In provision two, the nurse’s primary commitment is to the patient. If the nurse is not committing to the patient, then a new one should be established to avoid further repercussions. Provision three requires that the nurse should protect the health, safety, and rights of the patient. It is our job as nurses in the

Postpartum Unit to maintain the health of our patients. No matter how busy we are with charting, we still need to perform our routine checkup on patients. Not doing so can be detrimental to our patients.

Leadership Qualities or Traits There are quite several essential leadership attributes for quality nursing. I believe that four leadership traits that represent excellence in nursing would be emotional intelligence, critical thinking, communication skills, and respect. It is paramount that nurses develop these qualities for their career to provide exceptional quality care and to become a functioning, reliable teammate.

Demonstration of Nursing Leadership Qualities of Traits It is critical to practice these four traits as a leader at the bedside. A good sense of emotional intelligence can help alleviate emotional distress from a patient. Approaching the situation without so much as a thought to how the patient feels would raise tension and dampen the patient’s experience at the hospital. You need to gage the emotional well being of your patient to approach the situation correctly and with the best outcome. Respect plays a big role as well. Respect goes both ways. When you respect your patient, they feel a sense of trust and compassion. It makes it easier to engage with them. Skillful communication plays a significant role in patient healthcare. You need to clearly state what needs to be done, how and when to deviate from any misunderstandings that could lead to potential difficulties. Critical thinking allows you to make quick decisions about various factors within your patient’s care.

It works about the same with these qualities when you are under a nursing or interdisciplinary team. However, just because you are on a team does not mean that you can lay

unit-based counsel committee meeting. Decision making by the team needs to be timely and exceptional as the patient’s time runs by. We need to be prepared as time is of the essence and so much can happen in so little time. Professional development allows our nurses to want to strive and continue to grow. It helps a nurse want to be more and provide better healthcare. If an organization does not put into their nurse what they want out of them, failure is imminent. We nurses are the heartbeat of the hospital. By being a member of the unit-based counsel, has given me outstanding communication skills and has shown me a growth of my professional development not only in the Mother-baby Unit, but has opened doors to be a member of the Unit-based Counsel. Where decisions are made not only on a unit level but a district level. As a nurse, the opportunity for professional development is an individual opportunity. It is up to the individual nurse to grow professional if they so choose. As some nurses are content with continuing as a bed-side nurse for their career.

References

A&E Television Networks. (2009, November 9). Florence Nightingale. History. Retrieved October 2, 2021, from history/topics/womens-history/florence- nightingale-1.

American Nurses Association. (n.). About Ana: Ana Enterprise. Nursingworld. Retrieved October 2, 2021, from nursingworld/ana/about-ana/.

American Red Cross. (n.). Clara Barton. Redcross. Retrieved October 2, 2021, from redcross/about-us/who-we-are/history/clara-barton.html.

California Board of Registered Nursing. (n.d). Disciplinary Actions and Reinstatements. Rn.ca. Retrieved October 3, 2021, from rn.ca/enforcement/dispaction.shtml.

California Board of Registered Nursing. (n.d). License/Certificate Renewal. rn.ca. Retrieved October 2, 2021, from rn.ca/licensees/lic-renewal.shtml.

California Board of Registered Nursing. (n.d). Nursing Practice Act. Rn.ca. Retrieved October 5, 2021, from rn.ca/practice/npa.shtml.

California Board of Registered Nursing. (n.d). The RN as Supervisor – California Board of Registered Nursing. Rn.ca. Retrieved October 5, 2021, from rn.ca/pdfs/regulations/npr-i-12.pdf.

Centers for Medicare and Medicaid Services. (n.). History. Cms. Retrieved October 5, 2021, from cms/about-cms/agency-information/history.

Nursing Theory. (2020, July 19). Orem’s Self-care Deficit Nursing Theory. Nursing-theory. Retrieved October 2, 2021, from nursing-theory/theories-and-models/orem- self-care-deficit-theory#:~:text=The%20theory%20identifies%20five %20methods,future%20demands%3B%20and%20teaching%20another.

Ovid. (n.). Code of Ethics for Nurses with Interpretive Statements. Ovidsp-dc2-ovid- com.wgu.idm.oclc. Retrieved October 5, 2021, from https://ovidsp-dc2-ovid- com.wgu.idm.oclc.org/ovid-a/ovidweb? QS2=434f4e1a73d37e8cff7fb618affc25b1096bacdd874d081b5671bf8d6b04570f0f458d e9ef534ec549ec2a5e3484d04b47862717ede774c4e21ff7d6e344ab56424f543a11261bd0e 0f8069ddd4aed44671c11b3b6fcba6b2c4400435ed29ca33c7f989c791526effdf8a39a003b c22793d98f45e9dff7e863f012fea609709faabf566840a9ff0edb337b144f3ce420f3d3629c dbda0a8bbcdd27593fed2ad0cf1288c6faa2a359177a9b0b08b250ebbf6645018be0ca21ccf 651129702799143e76a7caa48c8f7f05daa51992123921234ffff7ea0df71736b83e442c91a 1346de5e9226ca36d119804c40ddd090fa2a91bd23c0a38ac0d99d8ba14f95cfb0d219d1a e36e2c5b1eead6d71a84a8f10622f1cd46a5ef1844c54e2dbdacfbb23752a4cb8c855.

RegisteredNursing. (2021, August 1). Assignment, Delegation and Supervision: NCLEX-RN. RegisteredNursing. Retrieved October 5, 2021, from registerednursing/nclex/assignment-delegation-supervision/.

Stanford Children’s Health – Lucile Packard Children’s Hospital Stanford. (n.). Postpartum Hemorrhage. Stanfordchildrens. Retrieved October 6, 2021, from stanfordchildrens/en/topic/default?id=postpartum-hemorrhage-90- P02486.
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Nursing Theory
As a nurse working at the Postpartum Unit, a nursing theory that deeply resonates within
me is Dorothea Orem’s Self-care theory of nursing. The self-care theory of Orem’s is broadly
defined as assisting others in the provision and management of self-care to maintain or improve
human functioning (Miller, 2021). I believe that if my patient were to perform self-care as much
as possible, then they’ll recover quicker. I am adamant about utilizing this nursing theory to carry
out effective nursing practices in my career as a NICU nurse.
Excellent Nursing Practices
Nursing within this model is limited to only upkeep the patient’s self-care regimen when
the patient reaches a point when they are unable to. It is imperative to promote independence of
the patient from medical staff when they can. There are three sections of Orem’s self-care theory:
the theory of self-care, the theory of self-care deficit, and the theory of nursing system (Miller,
2021). The theory of self-care focuses on the performance of activities conducted by individuals
themselves. These activities focus on maintaining the individual’s health on their own. The
theory of self-care deficit is when a nurse should step in if their patient is limited or incapable of
self-care and needs the help. The theory of nursing systems pertains to the focus “on the
relationship between a nurse and their patient and the wholly or partially compensatory nursing
system and supportive-educative system that takes place between the nurse and a person”
(Miller, 2021). This describes how the self-care of the patient will be met by the nurse and/or the
patient.
This theory model showcases five methods of helping patients. These methods include
acting for and doing for others, guiding others, supporting another, providing an environment
promoting personal development in relation to meet future demands, and teaching another
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