Nursing is one among the oldest and most noble profession in the world (Basavanthappa, B. T., 2004). It is one of the professions that hold a very unique place in the world’s health care system. Currently, millions of nurses work in diverse settings and fields as frontline workers providing critical and essential services to the various populations they work in. Working either independently or with other health care professionals, nurses promote the health of communities, families and people (Kemppainen, et al., 2013). Millions of people all over the world always turn to nurses for delivery of primary health care services, health care education and health advice and counseling (Hutchison, B. et al, 2011).
Nurses are critical links in maintaining a cutting-edge health care system. Nursing keeps on being a fundamental support of the world’s populace. Whereas most people think of a nurse as someone who basically deals with hospitalized patients to mitigate their misery, nurses also fill a lot of positions in health care in many varied settings, working both cooperatively and freely with other health care experts (Irvine, D. et al, 1998).
Nursing Influence on Patient Outcomes
The quality and type of care professionals in nursing offer is a core part in the eventual success of health care delivery globally. Nurses play an integral role in making sure the needs of patients being attended to at home, and in hospital are met. These types of needs will range from lifesaving, such as, resuscitation after a heart attack, or high dependency and intensive care units (Blegen, M. A., 2013).
Furthermore, it may also involve helping patients living with chronic illness such as renal failure or diabetes. Other than that, it may also taking care of sick pediatric patients, the geriatric, homeless persons and mentally ill patients. In all the above cases, nurses must be able to combine technical skills acquired during their training, with compassion and caring. All over the world today, nurses spend a lot of time with patients and they have a major impact on patient experiences and outcomes (Eaton-Spiva, L., 2010).
Patient-centered type of health care system is a core professional standard and competency for all nursing practice (American Nurses Association, 2010). Nurses are influential at countless points throughout the process of caring for patients, from performing bedside procedures to providing thorough instructions on medications. Some of the main elements that improve patient outcomes include; clinically competent nurses, existing and collaborative working relationships, adequate staffing, control over nursing practice, managerial support and patient-centered culture.
On the other hand, several inhibiting factors, such as, harsh working environments, cost-effectiveness policy and poor staff appraisal may hinder quality outcomes (Kieft R A. et al, 2014). A patient receiving care from a qualified nurse without job burnout is likely to have better outcomes as compared to one suffering from work overload and harsh working conditions. There is therefore a direct correlation between nursing and patient outcomes.
Registered Nurse Role and Responsibility
A registered nurse in simple terms is a clinician who has completed at least an associate degree in nursing or a hospital-based diploma program and passed a national licensure examination (American Nurses Association, 2010). These nurses care for a wide range of patients, from newborns to teens to adults.
Registered nurses coordinate and provide patient care, they also play a role in educating patients and the public about different health diagnoses, and provide emotional support and advice to patients and their family members (Smolowitz, J., 2015). Some of the roles and responsibilities of the registered nurses include the following:
- Perform physical examinations
- Make tentative diagnoses
- Treat patients en route to hospitals or at disaster site triage centers.
- Conduct specified laboratory tests.
- Hand items to surgeons during operations.
- Prepare rooms, sterile instruments, equipment and supplies, and make sure that stock of supplies is maintained.
- Instruct individuals, families and other groups on topics such as health education, disease prevention and childbirth, and develop health improvement programs.
Registered nurses work in hospitals, and nursing care facilities. They also work in correctional facilities, summer camps, schools, and with the police and military departments. The backbone of health care provision in the United States is the registered nurses (American Nurses Association, 2010). Registered nurses are responsible for provision critical health care to the public when and wherever it is needed.
Adapting to Health Changes and Meeting the Needs of Patients
The health care system is very diverse in nature (Blendon, R. J., 2003). The nature of needs and services do vary greatly. Transformations have been taking place in nursing and nursing education. These changes have been driven by major socioeconomic factors, as well as by developments in health care delivery and professional issues unique to nursing.
Among the trends unique to health care include; changing demographics and increasing diversity, technological explosion, globalization of world’s economy and society, the advent of the educated consumer, alternative therapies and genomics, and palliative care, the shift to population-based care and the increasing complexity of patient care (Heller, Barbara R., et al., 2000).
Other trends include; significant advances in nursing science and research and the current nursing shortage. These trends in health care will require that individuals or professionals to adapt to the changes. So how does one adapt to these changes. Continuous medical education is one very adequate field that is very helpful in addressing the shortages of adaptation. In order to achieve positive and quality patient outcomes, care givers and nurses have to adapt new technology and adapt to utilization of latest devices (Zeiger, R. F., 2005).
Even as the nursing profession positions itself to meet today’s challenges and tomorrow’s, the key towards unlocking and achieving the goals lies in the thorough understanding of the drivers affecting nursing. To quote Peter Drucker in work Managing for the Future, ‘It is not necessary to be clairvoyant to know the future; it is only necessary to clearly interpret what has already happened and then project forward the likely consequences of those happenings’ (Truman Talley Books, 1992).
Consumers are slowly becoming highly interested and knowledgeable about disease prevention and health promotion, and there is a generally increased demand and acceptance for complementary and alternative health options (Werner, R. M., 2012). Consumers are having an increased power in the patient-provider relationship (Morse, J. M., 1991).
This creates a high level demand for greater levels of patients’ participation in majority of clinical decisions and comprehensive techniques in health education. Nurses are therefore to be prepared to have a deeper understanding of the changed relationship and be more competent in alleviating patients’ conditions as well as their families. Adapting to changing health care trends is thus crucial in achieving quality health care and meeting patients’ needs (Gillick, M. R., 2004).
Burnout may be defined as a specific kind of stress reaction seen among human service professions such as nursing. It is characterized by feeling of emotional exhaustion, depersonalization and reduced personal accomplishment (Shahnazdoust, 2012). Several studies have shown that new graduates’ working conditions are stressful and have resulted in increased levels of burnout (Cho et al. 2006, Gustavsson et al., 2010).
Evidence suggest that the first two years of practice influences new nurses’ desire to leave the profession due to burnout (Beecroft et al., 2008). Burnout in nursing is of both organizational and individual concern with consequences for well‐being, absenteeism, turnover and job burnout. Burnout is rarely assessed as part of a comprehensive model of occupational stress (Kilfedder, C. J., Power, K. G., & Wells, T. J., 2001).
Recent study of 309 new nurses in Quebec found that 43% reported a high level of psychological distress. The same study revealed that 62% of respondents intended to quit their present jobs for other jobs in nursing, and 13% intended to leave the profession entirely (Lavoie-Tremblay, O’Brien-Pallas, Desforges & Marchionni, 2008)
Diagnostic and Statistical Manual of Mental Disorders DSM-IV describes burnout as a mental adjustment disorder that are characterized by, “the development of clinically significant emotional or behavioral symptoms in response to an identifiable psychosocial stressor or stressors”. The two definitions provide three hallmarks of burnout, which are; Mental Exhaustion, Depersonalization and Lack of Career accomplishment (Schaufeli & Enzman, 1998). Some of the main causes of burnout include; conflict with patients, long working hours, deaths of patients, high stress environments and large workloads.
The nursing shortage has many undesired consequences on patient safety and quality of care (Aiken, et al., 2002). Numerous studies have demonstrated that the shortage of nurses often leads to burnout with consequent effects which include: On Nurses; decreased quality of care, inadequate staffing and continuous overtime for nurses, and the risk of errors in medication (Oulton, J. A., 2006).
On Patients effects could include patient mortality, drug adverse reactions, increased patients neglect, cross infections, patient dissatisfaction and other complications (Buerhaus et al., 2007). On the side of Management the effects may include; absenteeism due to clinical symptoms of diseases, high rates of employee turnover, increases lawsuits for the management, and it also creates a hostile and toxic work environments.
Bullying and lateral violence is commonly experienced in the nursing profession. Lateral violence is a deliberate and harmful behavior or actions demonstrated in workplace by one employee to another (W Christie, 2012). Lateral violence is a significant problem in the nursing profession. Some Literature define Lateral Violence as nurses overtly or covertly directing their dissatisfaction inward toward: those less powerful than themselves, themselves, and each other (Griffin, 2004).
Lateral violence has a lot of effects on nurses. Griffin, (2004) observed that one in three nurses will leave their position because of lateral violence. Bartholomew, (2006) also concluded from his studies that 60% of fresh graduates in nursing leave their positions within 6 months partly as a direct result of bullying and lateral violence. Lateral violence can have undesired psychological effects for example, sleeping disorders, irritability, low morale, apathy and absenteeism.
It could also cause physical effects like, angina, headaches weight loss, hypertension, and eating disorders. Therefore, there is need for concerted effort to rid out lateral violence in workplaces to mitigate such undesired effects on central persons involved in health care delivery.
Nursing as profession demands that its practitioners must be highly skilled at what they do and is committed to maintaining high and acceptable quality levels of care (Jourdain, G., & Chênevert, D., 2010). Continuing education of health workers includes the experiences after initial training which help health care personnel to maintain and improve existing, and acquire new competencies relevant to the performance of their responsibilities.
Appropriate continuing education should reflect the needs of the community in health and subsequently lead to planned improvements in the health of the community (Griscti, O., & Jacono, J., 2006). Continuing education in nursing consists of well planned, organized learning experiences designed to augment the skills, attitudes, and knowledge of registered nurses for the enhancement of nursing practice, education, administration, and research aimed towards achieving better patient outcomes and improvement of health care (Knowles, M. S., 1985).
Life-long learning in nursing relates not only to professional practice but also to the development of the person as an individual and as a responsible citizen (Charles Judd, 1928). Patients are never comfortable being treated by health practitioners who have not kept up to date. The health care institutions and professions have mounted massive programs of continuing professional education; as a matter of fact, it is one of the fastest‐growing aspect of all of education. Internationally, the standard best practice has been to continually train nurses to keep up with emerging trends in healthcare. This is part of continuing education. It is very crucial as it helps in improvement of patient outcomes and generally the whole health sector.
Nursing remains one of the critical most links towards achieving universal health coverage for any nation (Ikegami, N., 2011). The profession is so critical that were it to dysfunction in a day then humanity would be at risk of total collapse. Much as the profession is nobble, nurses face a lot of challenges ranging from those of psychological nature and physical (Thompson, P. A., 2008). These issues need to be addressed wholesomely in order to have a vibrant and well-functioning health work force. Occupational support needs to be developed to avoid burnout. Continuous nursing education should also be fostered and promoted to achieve desirable outcomes.
Nursing has a bright future and will continue being the cornerstone of the health care system of any nation. With the increasing clinical complexity in many patient care settings, rapidly evolving technology, the emergence of new diseases and constant advances in treatment there is dire need for a strong emphasis on lifelong learning and critical thinking among healthcare professionals Heller, Barbara R., et al., 2000). The future of nursing also lies in research, adaptation to changing trends and constant recruitment and appraisal of the nurses. This will be the only way to safeguard health care and vast humanity.