Nursing is an ever-changing and growing profession. Tools such as, the scope and standards for nursing, state nursing legal regulations, code of ethics, and general principles of philosophy are used to set standards and promote growth within the profession. I use these principles and standards daily in my career as a registered nurse (RN). In this paper I will discuss the importance of these factors in my career, and how they all contribute to making outcomes successful for all involved. American Nurses Association Scope of Practice
There are six set standards of the nursing practice; assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ANA, 2010; pp. 9-10). Throughout a typical shift on the unit I work for, I have set tasks I am expected to complete in order to progress the patient’s care, and to keep the patient safe. I begin my shift by completing my initial assessment on my patient.
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During this time, I am getting to know my patient and assessing if there are any new issues that need my immediate intervention. From here, I am able to discuss appropriate goals for the day with my patient. This may come in the form of increasing mobility, by walking around the unit, decreasing pain, or simply taking a bath.
Next, I plan when and how these tasks will be able to be performed and coordinate care with the appropriate members of the team; such as nursing assistants and physical therapists. Evaluating the patient after any intervention assists in discovering what works and what does not for the individual. “The nursing process in practice is not linear as often conceptualized, with a feedback loop from evaluation to assessment. Rather, it relies heavily on the bi-directional feedback loops from each component” (ANA, 2013; p.3).
Specific State Legal Regulations The Ohio Nurses Association (ONA), has set up legal regulations for those who practice nursing. “The regulation of nursing practice is essential to the protection of public health and welfare” (ONA, 2012; p.1). These regulations set up the standards for becoming an RN. One of the first standards is that an RN will be licensed only after completing an “educational program approved by the state board of nursing and pass a licensing examination before a license to practice is granted” (ONA, 2012; p.1). To become an RN, I completed my associate degree in nursing (ADN) at Columbus State Community College. I then passed the National Council Licensure Examination (NCLEX) to receive my license. Provisions 7, 8, & 9
“Provision 7 challenges the nurse to participate in the profession’s contributions to society by being actively engaged with its progress and development” (Fowler, 2010; p. 91). Education is a constant element in my career as a nurse. At the state level, I am required to have a set amount of continuing education hours every two years to carry a valid nursing license.
Through my hospital, I must be current with my cardiopulmonary resuscitation (CPR), be familiar with changes in policies and procedures, and be familiar with the different diagnoses on my unit; such as ischemic strokes and subarachnoid hemorrhages. I am also continuing my education by taking classes to earn my bachelor of science in nursing (BSN). It is not only my responsibility to further my education, but it is also important for me to help others continue their education as well. I have done this on my unit by orienting new nurses. This is important because not only does it educate others, but it also helps reinforce what I have learned during my time as an RN.
In the hospital that I work at I am in continuous contact with different cultures and ethnic groups. Without utilizing provision 8, my care for patients would significantly suffer. By having a genuine respect for my patient’s culture and values, a new level of trust can be made. Having trust in the medical field is a must, especially for an ethnic group that may be a minority in the community. “Provision 8 emphasizes culturally diverse worldwide populations, respect for persons and their ways of life, and cultural values, imposition, sensitivity, and competence” (Fowler, 2010; p.114).
Social ethics are the primary focus of provision 9. “There are three major functions of social ethics, all which fall within the legitimate, if not essential sphere of the professional nursing association: reform of the profession, epidictic discourse (which is a type of public values-based speaking), and social reform” (Fowler, 2010; p.123). Learning about this provision has made me realize that I need to become more involved in social matters relating healthcare. An example of a nurse, who fought for social change, is Margaret Higgins Sanger. According to (Fowler, 2010; p.130), Sanger fought for women’s right to use contraception. She fought by educating other women through her publication The Woman Rebel. There have been many other nurses that have shaped the profession of nursing, healthcare, and social issues. Philosophical Forces
In my personal and professional life I strive to do the ‘right’ thing. Before making a big decision I try to outweigh the good and the bad. “Moral philosophy is the philosophical discussion of what is considered good or bad, right or wrong, in terms or moral issues. Moral issues are those which are essential, basic, or important. They deal with important social values or norms, such as respect for life, freedom, and love; issues that provoke the conscience or such feelings as guilt, shame, self-esteem, courage or hope” (Burkhardt & Nathanial, 2008; p. 29). As a nurse, I feel that I need to have a strong moral philosophy that I will not walk away from in order to protect my patients. My personal moral philosophy is to do what is best for the patient, by keeping them free from harm, and respecting the individual’s values and wishes. Ethical Principles and Theories
Ethical principles and values influence my practice in nursing. The ethical standards beneficence, respect for human dignity, justice, and autonomy help to keep the patient free from harm (Noble-Adams, 1999). During bedside procedures, for instance central line placement, these standards should always be in place. As a nurse, I must make sure that the procedure would in fact benefit the patient and that the patient is free from harm. Before even beginning the procedure, informed consent must be signed by the patient. If the patient is unable to do so the patient’s power of attorney must be informed and sign. While the central line is being placed I must make sure that the patient privacy is being achieved, and that the proper techniques are being used to keep the patient free of infection. This is just one example of how ethical principles and theories are used on my nursing unit.
Without these principles and guidelines, I am not able to grow as a nurse. Everyday decisions about the care I give to my patients will be guided by basic philosophy and ethical standards. I feel that in my four years of nursing, my practice has been consistent with these standards. As an RN, I feel it is important to always seek improvement in all aspects of my career. Taking a step back and self-reflecting will allow me to find areas of improvement necessary to improve the care that I give to my patients.