Professional Accountability in Nursing

Nursing Theory

Explanation

From assessing the patient to set goals and interventions for them, the care environment should only allow for the best approaches intended to predict crucial nursing steps and facilitate the care provision process. This is why I am picking Sister Callista Roy’s Adaptation Model of Nursing as the key element of a thorough care environment where patient values are respected, and provider needs are met as well. According to Russo et al. (2019), constant assessments give nurses all the necessary data and create opportunities for them to adapt to the conditions instead of looking for innovative solutions. When a patient experiences pain, for example, the Adaptation Model can be utilized to determine their essential needs and aid care providers in establishing the required conditions to preserve their comfort (Russo et al., 2019). Therefore, an essential task for care providers that can be achieved with the help of the Adaptation Model is to reduce patient pain and promote positive thinking. Excellent nursing practice may be easier to achieve under the condition where the effectiveness of different care approaches and medications can be assessed through adaptation to the patient situation.

Discussion

The Adaptation Model of Nursing proposed by Sister Callista Roy may be aligned against professional nursing practice perfectly since it contributes to the development of critical thinking. The central focus is to ensure that every patient gets the best and the safest care, so my intentions mostly revolve around reducing the deficit in patients and generating the most appropriate environment for all types of individuals entering the hospital. The Adaptation Model also allows me to make sure that there is a positive relationship between patients and me, as it influences their perception of the care setting and often speeds up the process of recovery. An exceptional idea that also has to be mentioned in the case of the Adaptation Model is that positive care experiences are much easier to achieve in the case where care providers and patients have similar objectives and tend to join their efforts to attain them. Overall, I consider the Adaptation Model of Nursing proposed by Sister Callista Roy to be a perfect choice for my professional practice.

Contributions of Historical Nursing Figures

Comparing the Differences

The two historical figures that can be pointed out as essential contributors to healthcare are Clara Barton and Dorothea Dix. The former was a nurse that cared for injured soldiers during the Civil War, and the latter represented one of the biggest advocates for the healthcare rights of prisoners and mentally ill individuals (Strickler, 2018). Both these professionals were devoted to contributing to the field of nursing and preventing the threatening effects of natural disasters and other negative events. Clara Barton provided the ones in need with all the required resources, from food and clothes to medical supplies and emotional support, while Dorothea Dix was a powerful advocate for patient rights across all spheres of care (Strickler & Farmer, 2019). Nevertheless, both of them could be seen as creating opportunities for the development of a caring environment where better treatment could be achieved with no limitations. It was because of these two care professionals that other providers started fighting for better care conditions and patient protection against misjudgment and bias.

Describing the Influence of Historical Figures on Professional Practice

The biggest influence on my professional practice is Clara Barton. One of the main reasons why this historical figure appeals to me is the fact that the State of Tennessee is often affected by natural disasters, so I am always on the verge of volunteering activities. I am always trying to remain effective for the local community and make sure that a hypothetical disaster relief process is going to be deployed as smoothly as possible. Despite Tennessee not being a high-risk disaster zone, the local population still requires an emergency action plan and supply donations in the case of unexpected events. Another important area of my nursing activities is the promotion and protection of patient rights. This is why the second historical figure that I picked for this assignment was Dorothea Dix. I cannot afford for patients to be mistreated, so I am trying to do everything in my power to push for the best policies and advocate for those who do not have a loud voice in the healthcare segment. Dix’s efforts motivate me to move forward and help every patient to attain positive health outcomes and preserve essential rights.

Functional Differences

Defining the State Board of Nursing and the American Nurses Association

The State Board of Nursing can be defined as a regulatory body within every specific state that is required to remain responsible for administering the most appropriate practices across the given state (Tennessee Department of Health, n.d.). The American Nurses Association, it is a professional organization that is aimed at a proper representation of registered nurses to promote high-quality care and adherence to all-state regulations (American Nurses Association, n.d.). The biggest difference that can be highlighted when looking at the two healthcare bodies is that the State Board of Nursing is only a statewide regulatory organization, while the American Nurses Association covers the needs and aspirations of practically every American registered nurse.

Influence of the Organizations on Professional Nursing Practice

The impact of the two regulatory bodies on professional nursing practice may be perceived as different as well because the Tennessee Board of Nursing is mostly responsible for activities associated with nursing licenses and the promotion of healthcare competencies. The American Nurse Association strives for all-around improvements that go beyond Tennessee and have a positive effect on all American states. Such advancements are necessary because they enhance ethics and promote the value of a safe care environment (Tennessee Department of Health, n.d.). Advocacy efforts may also become easier to accomplish under the condition where the public is involved together with healthcare specialists.

Requirements for Professional License Renewal in the State of Tennessee

The Tennessee State Board of Nursing requires registered nurses to go through an employer evaluation bi-annually. This assessment may include a combination of two methods of evaluation that can be combined in any form that is convenient for the respective nurse. Some of the activities and requirements include the following: evidence of national certification, satisfactory employer evaluation, a letter from a patient (or patient family) evidencing a satisfactory patient-provider relationship, written self-evaluation, or a letter from an agency where the given nurse served as a volunteer (Tennessee Department of Health, n.d.). Additional license renewal materials could include published articles, nursing credit transcripts, and letters of satisfactory completion of orientation programs and refresher courses.

Differences between Compact and Non-Compact States

The key difference between compact and non-compact states is that a license obtained in compact states allows registered nurses to practice in different states. A multistate license can be obtained by the given registered nurse after completing the required application process and meeting the requirements established by the National Council of State Boards of Nursing (National Council of State Boards of Nursing, n.d.). As for the non-compact state licenses, registered nurses will only have a chance to practice in their home state with no exceptions.

Comparing the Food and Drug Administration and the Center for Medicare and Medicaid Services

Impact of the Agencies on Professional Nursing Practice

One of the main reasons why the Food and Drug Administration impacts professional nursing practice is that it requires constant clinical trials to be conducted in order to make treatments available for public use (Fain et al., 2017). The Centers for Medicare and Medicaid Services, are responsible for the cost and coverage that can be achieved by patients (Wang et al., 2016). Therefore, all the respective therapies and reimbursements are regulated by these two agencies to a certain extent so that patients can benefit from the most appropriate prices and services.

Speaking of the role of a patient advocate within the framework of providing a patient with an alternative therapy, one of my essential tasks would be to ensure that none of the regulatory agencies described above either prohibit or limit the implementation of such. The regulations provided by the Food and Drug Administration are rather beneficial for patients and care providers because the agency supports alternative medicine efforts and regulates the market of respective drugs (Fain et al., 2017; Wang et al., 2016). As for the Centers for Medicare and Medicaid Services, there are not as impactful since they do not cover experimental treatments and mostly support conventional methods.

The Nurse Practice Act and Its Impact on Professional Practice

The Scope of Practice for a Registered Nurse in the State of Tennessee

The scope of practice in the State of Tennessee includes a professional capability of counseling or educating patients, administering proper medication, delegating medical acts to other healthcare providers, and establishing the right means of treatment (Tennessee Department of Health, n.d.). The authorizations covered by the scope of practice allow for the delegation of medical activities, too. However, the law does not specify the healthcare professionals that can engage in the delegation process and the types of services or tasks that could be delegated. There are no medical activities included in the list of tasks prohibited from delegation to other healthcare professionals (Tennessee Department of Health, n.d.). Also, supervision is not required when a healthcare professional delegates certain tasks to other healthcare specialists.

Delegation for the RN as Defined in the State of Tennessee

Despite the lack of limitations included in the delegation laws of the State of Tennessee, it is not possible for registered nurse to delegate their responsibilities or assignments at any time. The scope of practice of a registered nurse from Tennessee requires licensed personnel to be proactive and delegate tasks only in the case where it could contribute to the effectiveness and cost-quality ratio of care provision (Tennessee Department of Health, n.d.). The existence of high educational standards across Tennessee also contributes to the ability of the state examiners to ensure that applicants follow the requirements and possess all the relevant knowledge.

Applying Different Roles to Professional Practice

Scientist

The role of a scientist presupposes that professional practice should be based on advocacy activities and vigorous participation in patient assessment. Registered nurses have to collect as much data as possible in order to be able to provide adequate care and ensure that all tools and services are in place (Carter et al., 2020). Attention to detail and the ability to introduce required changes quickly also represent two essential qualities of a registered nurse-scientist. The whole team can be moved by a nurse-scientist looking to collaborate and advocate for various patients.

Detective

In the role of a detective, a registered nurse will be required to evaluate different trends in order to come up with proactive mediation strategies and help other care providers adapt to the upcoming changes. As the team is going to go through the process of investigation, all sources of information will be analyzed in detail in order to assist the personnel in identifying bottlenecks and dilemmas that are yet to be resolved (Carter et al., 2020). Therefore, numerous interviews have to be conducted in order to make patient records as complete as possible and propose certain treatments based on confirmed findings.

Manager of a Healing Environment

The role of a manager of a healing environment requires a registered nurse to develop a setting where patient safety is going to remain the priority irrespective of external and internal events. For instance, certain patients sharing a room could be separated in order not to cause confusion and make sure that an optimal care environment is created where both patients will reach positive health outcomes quicker (Carter et al., 2020). Closer observation is necessary to make sure that advocacy is possible and registered nurses develop a connection with patients, which allows them to make informed decisions quicker.

Provisions from the Code of Ethics

Analysis of the Impact of Provisions on Professional Practice

Provision Three and Provision Six included in the American Nurses Association’s Code of Ethics stand out to me the most because they show that patient advocacy and a thorough focus on ethical decision-making could lead to positive health outcomes. The ability to protect patient rights and safety while also engaging in collective efforts to make ethically sound decisions is what many registered nurses are looking for when trying to provide optimal care (Olson & Stokes, 2016). Provision Three, to my mind, also makes nurses obliged to attain the most appropriate care methods and advocate for every patient irrespective of their personal characteristics. Provision Six is just as important for professional practice because it shows how any registered nurse could generate positive patient outcomes by maintaining patient safety and privacy at all times (Olson & Stokes, 2016). The clinical environment should be synonymous with safety, and Provision Six requires registered nurses to ensure that ethics maintain equal access to all services.

Describing a Nursing Error

One particular nursing error that can be associated with Provision Six from the Code of Ethics is the inability to preserve patients’ confidentiality and share their personal information with someone else, even if those are family members. The idea is that the patient should always remain the first figure to learn the results of all assessments and see if they want to share that data with someone else. While the patient’s family could be educated on certain topics related to the patient’s condition, the nurse should never be in the right to share personalized insights with other people, even if it feels as if it could contribute to the patient’s health in a positive manner. Accordingly, Provision Six has to be respected when nurses are approaching patients’ personal requests and thoughts because a practitioner could easily violate one’s rights by simply disrespecting their right to privacy. In order to fulfill Provision Six, nurses may be required to communicate their expectations regarding ethical standards and adapt their behaviors to the existing state of affairs.

The application of Provision Three can be supported by the fact that patient confidentiality and advocacy are two of the biggest challenges of the 21st century. Patients should remain the ones sharing vital insights regarding their health with family members unless there is no other person except the nurse to convey the message. Even the best intentions may cause damage to a patient’s health, so it should be crucial not to overstep the existing ethical boundaries set by Provision Three. In order to attain Provision Three, nurses may be required to review their values and ideals in order to remain congruent and follow all necessary policies. At all times, patients should be able to rely on the condition that nurses adhere to the ethical provisions and are not going to interfere with any of the regulations established in the Code of Ethics and other regulatory documents.

Leadership Qualities as Predictors of Excellence in Nursing

Significance of Leadership Qualities

The vital leadership qualities that have to be preserved in order to contribute to the development of an excellent care environment are:

  • patience,
  • effective communication,
  • time management,
  • confidence.

From discussing treatment plans with patients and family members to promoting interdisciplinary treatment approaches, leadership is everywhere because it can improve one’s understanding of their role in the process (Sherrod et al., 2020). Therefore, healthcare team members have to remain interconnected to provide patients with care and related information.

As a leader at the bedside, a registered nurse should pay more attention to leadership in order to help team members gain confidence and make informed decisions. When a nurse is confident enough, they have the opportunity to establish a trusting relationship with the patient and manage the team better. The majority of nursing activities also correlate to the need to advocate for patients and their needs, so the key to being a leader at the bedside is to ensure that patients are not overwhelmed by providers’ decisions.

Leadership within a nursing team or an interdisciplinary team will have to be achieved through the interface of addressing patient concerns and making them comfortable with the existing care environment. Time management and patience are going to be helpful in this case since an excessive workload can damage the workforce’s productivity and hinder the team’s relationships with patients. Therefore, team-building activities should be held to facilitate communication and reduce the burden of work-related stress.

Impact on the Work Environment

The most important idea about leadership is that the majority of factors related to nursing leadership, decision-making, and professional development cannot be assessed separately. For instance, a positive care environment may only be achieved in the case where various healthcare stakeholders join their efforts in an attempt to attain high-quality care. They would deploy personalized treatment plans that adhere to patients’ needs and address essential concerns at the same time (Sherrod et al., 2020). Therefore, the strength of decision-making initiatives is going to increase because providers would start paying more attention to secondary factors and the presence of alternative solutions. Ultimately, leadership is the key to professional development because patient satisfaction is a vital metric that can be utilized to motivate employees to improve their proficiency and ensure that the organization is innovative enough to resort to groundbreaking solutions from time to time.

References

American Nurses Association. (n.d.). ANA enterprise. ANA. Web.

Carter, E. J., Hessels, A., Cato, K., Sun, C., Cohen, B., Rivera, R. R., & Larson, E. (2020). Evaluation of the joint nurse scientist role across academia and practice. Nursing Outlook, 68(3), 261-269. Web.

Fain, K. M., Castillo-Salgado, C., Dore, D. D., Segal, J. B., Zullo, A. R., & Alexander, G. C. (2017). Inappropriate fentanyl prescribing among nursing home residents in the United States. Journal of the American Medical Directors Association, 18(2), 138-144. Web.

National Council of State Boards of Nursing. (n.d.). Nursing regulation. NCSBN. Web.

Olson, L. L., & Stokes, F. (2016). The ANA code of ethics for nurses with interpretive statements: Resource for nursing regulation. Journal of Nursing Regulation, 7(2), 9-20. Web.

Russo, S., Baumann, S. L., Velasco-Whetsell, M., & Roy, C. (2019). A comparison of two case studies using the Roy adaptation model: Parents of opioid-dependent adults and bariatric surgery. Nursing Science Quarterly, 32(1), 61-67. Web.

Sherrod, D., Holland, C., & Battle, L. H. (2020). Nurse preceptors: A valuable resource for adapting staff to change. Nursing Management, 51(3), 50-53. Web.

Strickler, J. (2018). Clara Barton: Angel of the battlefield. Nursing2020, 48(3), 43-45. Web.

Strickler, J., & Farmer, T. (2019). Dorothea Dix: Crusader for patients with mental illness. Nursing2021, 49(1), 49-51. Web.

Tennessee Department of Health. (n.d.). About. Tn.gov. Web.

Wang, D. E., Tsugawa, Y., Figueroa, J. F., & Jha, A. K. (2016). Association between the Centers for Medicare and Medicaid Services hospital star rating and patient outcomes. JAMA Internal Medicine, 176(6), 848-850. Web.

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