Evolving Practice of Nursing and Patient Care Models

Evolving Practice of Nursing and Patient Care Models

Evolving Practice of Nursing and Patient Care Models

Nursing care is one of the greatest pillars in the healthcare delivery system of the United States and all over the world. In most hospitals, the role of the nursing team is strictly respected and cannot be undermined by any means. Most of the care given to the patient from the doctor is given through the nursing team. The welfare of the patient is taken care of by the nurses among other several reasons. Because of this, nurses are needed in very high demand for a facility to function properly and for a patient to receive maximum care. In the recent past, both in America and other countries as well, there has been an upward rise in the number of chronic diseases such as diabetes mellitus, hypertension, arthritis, cardiovascular diseases, mental and degenerative diseases.

This has in turn increased the demand of nurses since these patient usually require a lifelong care and monitoring system. A rise of this has been attributed to the rampant change in the lifestyle and increased consumption of processed foods. With these on the rise, there is a looming shortage of nursing personnel evident in the near future since the causative agents are here to stay. Nursing care provides health services from disease prevention to disease cure, palliation and chronic home care if needed. The demand of the services of the nurses will always be high in as long as the diseases still exist. The practice of nursing is expected to evolve in the near future. As diseases change, innovations and researches done, the nursing care program is bound to change as well. To begin with, the number of nurses will have to be improved drastically over the years. This can either be done by increasing the number of medical schools or by increasing the number of nurses trained per class in a given year. This will ensure that by the time the demand is extremely high, there are sufficient nurses to fill the defect.

Also, the nurses available will have to undergo either further training or specializations if possible. The training can be achieved either through continuous medical evaluation or through individual training programs. This is because, in this era and in the near future there has been a tendency to practice evidence based medicine. Medicine is practiced on the basis that it has been tested and confirmed by a given group of people that managing a condition in a certain way leads to better prognosis and therefore, treatment schedules are given in a specific manner for a given reason. For this to be possible, the nursing team has to be at par with the recent studies and the latest journals and information regarding almost all diseases since one can never decide which cases to receive when in hospital and which ones not to, unless following a specialization.

Third is the current influence by medical technology. Technology has extremely involved in the recent past since the advent of computers. This has greatly aided different fields of technology including the medical field. Several innovations have been made in the healthcare delivery system and these will only increase in the future. Because of this, the nursing team has to be on toes with newer technologies and newer developments in the technological sector. Several tools have been implemented secondary to technology such as electronic medical records are very important especially in service delivery. Therefore in this era and in the near future, all the nurses will be expected to have had basic computer knowledge and basic health care management technological tools to be at par with everyone else in the world.

The continuum of care is a patient care system that covers the wellness of an individual throughout his whole life. It is comprised of both services and mechanisms that follows up patients through their health, wellness, mental health and social issues during all levels of healthcare. It is composed of several services which include, immediate acute care following an illness, hospital care following an admission, outpatient care, ambulatory care, wellness programs and home based care such as in palliative care patients. Nurses play a huge role in this continuum of care since they take care of the patient wholesomely. With evolving and emerging trends, more nurses, as already stated, will be needed to ensure this continuum of care is upheld. There are four mechanisms that have been proposed that will aid in the integration of the continuum of care. These include, community based services whereby home based nurses conduct home visits to patient to assess their progress and advise accordingly.

Recently, with the development of telemedicine, community based services have been made especially easier as the nurse and their patient can communicate remotely. The next mechanism is the disease management programs development. This is whereby, patients suffering from specific chronic diseases are brought together and educated on their disease and given a platform to inquire more about their condition from the nurses. This definitely will improve their outcome since it will enable them to know more about their condition and thus manage it better by their own. Third is the formation of an organized health information and finally the improvement of case management systems.

Accountable care organizations refers to a group of medical personnel including doctors, nurses, consultants and other physicians that come together as one unit to take care of a given set of patients. This is the most recent trend seen worldwide. Most healthcare practitioners come together to tackle said conditions. This has great future prospects since it prevents burn out of the workers and ensures that each condition is handled to the best of their capacity. A medical has is also known as a patient centered healthcare home. It is a partnership between a patient and their family together with the clinician to form an easily accessible, coordinated, and compassionate and a culturally effective family centered home for the patient. This has been show to improve patient outcomes markedly. The first medical home was in 1967 by the American academy of pediatrics and was centered on children with specialized health needs. The outcome was favorable and since then this has been an area of interest.

Nurse managed health clinics are most often at the primary healthcare level. Most of the time, they are community based and are often led by a nurse who has been in practice for a long period of time and has thus a huge amount of experience, most often, this nurse also has undergone vigorous training and is most often than not at the pinnacle of her studies. Their main function is usually promotion of health, prevention of diseases and health education to avert the acquisition of diseases. Most of these are usually nonprofit based and their prices low enough to ensure that those who cannot afford quality healthcare are served as well. In the near future, several of these will of high essence. This is because, in as much as the world is developing, there will always be a group of people who will not be able to access good healthcare because of their low socioeconomic status and therefore, centers as these will aid to ensure their health is preserved as well to facilitate ultimate eradication of disease.

Several nurses in the department were in agreement with the findings of this research. The first one stated that her best reform that would ever happen is the increase in the number of nurses in their facility. She categorically stated that most of the time they are overworked and they end up getting back to their homes extremely tired. This thus affects their families negatively and brews hostility among them, this is particularly worsened by the fact that on the following day they have to wake up and go and attend to patients happily and satisfactorily yet themselves they cannot handle their own homes. This has led to depression among several nurses and even the resignation of others which is a very undesirable outcome. Also the extreme fatigue leads to a bad attitude towards an innocent patient at other times which then prevents good management of the patient which would have occurred had there be enough nurses to assist. At other instances they get overworked and have to recruit non-qualified nursing and medical students to assist them which is currently not allowed in the healthcare delivery system of the United States. This also brews resentment among colleagues as they cannot work peacefully together. Like in all facilities, there are malingerers even in the nursing care department. These particularly lead to the burn out of the very hardworking and down to earth nurses leading to sub optimal patient assessment, monitoring and management.

The second nurse stated that great benefit would be obtained from providing them with continuous medical education either through trainings or short courses. She stated that sometimes they get stranded in the middle of a course of treatment and have to seek foe a second opinion or even look for a book to refer then proceed to the next step of management as per their consult. She mentioned that this has once led to the death of her patient since she did not act in time and as expected and thus lost the patient. If there had been a series of trainings or even simulations on the same, she wouldn’t have made that mistake she did that day and that mortality is forever imprinted in her mind. Currently she is back on a specialization program and urges all the nurses both current and those soon to be that they need to undergo continuous training to avoid forgetting some of the basic key management protocols both in the emergency, inpatient and the outpatient set up.

The final interviewee was a male nurse in his mid-fifties. He was particularly worried about the decrease in number of nurse managed health clinics. His country home is one of those of a low socioeconomic status and therefore most people cannot receive quality healthcare. He noted that in the recent past, there has been a steady decline in these facilities and his main urge was to the willing nurses to set up more of these facilities in the needy areas as this is their future. This is their only hope and this is all they can afford. Even as healthcare evolves, the healthcare providers with the help of the government and other well-wishers, must not forget about the less fortunate in the society.

References

Allen, D. (2014). The Changing Shape of Nursing Practice:The Role of Nurses in the Hospital Division of Labour. Psychology Press.

Andersen, R. M., Rice, T. H., & Kominski, G. F. (2011). Changing the U.S Healthcare System:Key Issues in Health Services Policy and Management. John Wiley and Sons.

Medicine, C. o. (2011). The Future of Nursing:Leading Change,Advancing health. National Academies Press.