Being A Professional Nurse Or Midwife: Skills And Theoretical Principles

This unit will contribute to completion of course level outcomes, Western Sydney University graduate attributes and the Nursing and Midwifery Board of Australia Registered Nurse Standards for Practice. Course level learning outcomes can be accessed on your Unit vUWS Home Page.

The Being a Professional Nurse or Midwife unit is part of Bachelor of Nursing or Bachelor of Midwifery course. The unit provides the foundation for developing comprehensive, coherent and connected knowledge in the nursing and midwifery disciplines and introduces and develops interaction skills which will be required by graduates in their work environments.

Learning outcomes for the unit are outlined below.

1 Appraise theoretical perspectives that inform and enhance graduate practice.

2 Evaluate the relevant professional regulatory frameworks and their relationship to competent professional practice

3 Analyse the lifelong learning approach as it applies to continuing professional development and maintaining professional currency

4 Evaluate a professional portfolio that meets registration requirements

5 Reflect on readiness for practice through self-review and group reflection and feedback

6 Evaluate processes relevant to WH&S issues to provide safe, quality care within the scope of practice

7 Reflect on and set personal goals for career development in relation to primary health care and identify potential professional mentoring opportunities

Students are to draw on the National Safety and Quality Health Service Standards and the NMBA professional practice documents to develop critical responses to the clinical incident. The following questions are required to be answered for this assessment:

1. What happened in this clinical incident?
2. What activities did the nurse or midwife need to complete in the immediate situation?
3. What professional behaviours may have made a difference in this situation?
4. What do you learn from this case study about your own preparedness for professional practice?

Support your answers with reference to the relevant clinical and professional standards that apply to professional practice.

– The marking criteria and standards have been developed to guide you through the assessment process. Please read the criteria and standards carefully.

– The paper must include in-text references and a reference list at the end of the paper in the APA style 6th edition (available on vUWS) for all resources used.

The journey of transition of nurses towards a field of professionalism is often daunting, with newly enrolled nurses overcome by self-demeaning emotions. While the current educational aspects of the nursing curriculum aim to adequately equip newly enrolled nurses with effective information, knowledge and patient-handling capabilities, the sudden shift to an environment over-filled with critical, medical emergency situations often leave nurses unequipped and overcome with feelings of discouragement and unpreparedness (Laschinger et al., 2016).

It is worthwhile to mention that the acquisition of appropriate nursing skills along with due consideration of professional nursing models, often prove to be helpful. Hence, the following paragraphs of this essay aims to critically analyze the various clinical and non-clinical skills required along with a detailed discussion on the various theoretical models to be considered for novel professional nurses. Lastly, the essay ends on a reflective note considering my own efforts during my transition to professional practice.

The field of nursing involves activities and functions beyond the mere treatment and eradication of somatic symptoms in patients. As rightly stated by Wilson, Harwood and Oudshoom (2015), nursing is undergoing constant dynamic transformations through the utilization of various multidisciplinary approaches along with considering the ethical needs and values of the concerned patient. Hence, nurses transitioning from educational fields to various professional and clinical settings, will be required to acquire various skills at the clinical as well as non-clinical levels, in order to result in a smooth occupational journey (Wilson, Harwood & Oudshoom, 2015).

During the first years of education, a practicing nurse is relatively a novice in the clinical field. Hence, outlining the usage of the Dreyfus model for skill acquisition for future transitions, Benner (2004), states that the novice nurse will be required to acquire clinical skills outlining basic medication mechanisms as well as mode of administration, along with additional possession of clinical skills concerning the appropriate procedures of treatment for the patient, concerning the alleviation of his somatic symptoms (Benner, 2004). Hence, such skills can be acquired through adequate practicing on dummy models or mannequins, where the nurse educators must engage in critical questioning concerning individual patient needs and symptoms, thus paving the way for acquisition of non-clinical skills concerning the communication (Cant & Cooper, 2017). Benner (2004) also stressed that novice nurses must now engage in critical skills of communication where they must engage in effectively reassuring patients who are overcome by feelings of distress and anxiety. The concerned nurse educators must actively engaging in adequate training of such nurses concerning recognition of changes in the patient condition, the prevalence signs and symptoms along with identification of vital signs (Benner, 2004). As opined by Bowen and Prentice (2016), the acquisition of such skills will aid in the adjustment of nurses new to the clinical environment, since this will not only aid in effective symptom and treatment recognition, but also in the establishment of effective communicative strategies with the patient (Bowen & Prentice, 2016).

Clinical and non-clinical skills for newly enrolled nurses and midwives

Upon undergoing new graduation, nurses who are advanced beginners will now be required to engage in a variety of additional clinical and non-clinical skills required for transitioning to professional practice. This nursing stage, according to Heyes and Thachuk (2015), presents a key transitional process since nurses for the first time are fully engaged in being completely being responsible for the patient, in professional, legal and administrative terms (Heyes & Thachuk, 2015). This new responsibility will require the nurse to engage in clinical skills of increased attentiveness and patient follow-up, resulting in close inspection and monitoring of the personalized treatment needs of the patients, along with assessment of symptom improvement and relapsing. Attard, Baldacchino and Camilleri (2014), stressed the importance of another critical, non-clinical skill which is required by the nurse is usage of patient-centered or family-centered approaches requiring interpersonal skills. The nurse must now, not only be critical to the various clinical changes in a patient, but must also engage in effective cooperative and collaborative skills resulting in involvement of patient’s family in the treatment process. Acquisition of such skills will lead to newly enrolled nurses to not just feel comfortable in the individual management of patients, but also acquire confidence in communicating with related patient parties (Attard, Baldacchino & Camilleri, 2014).

For the smooth transition of nurses towards the field of professional practice, there is a need to succinctly consider various theoretical principles in addition to the acquisition of various clinical and non-clinical skill sets (Marañón & Pera, 2015).  Hence, newly enrolled nurses can choose to adopt, implement and execute the following theories, in order to face a smooth professional life.

One of the key theories which can be adopted by newly practicing nurses is the ‘Need Theory’ which had been formulated by ‘the Nightingale of Nursing’, Virginia Henderson. This theory emphasized the need to grant the concerned patients to engage in the determination of their treatment plan, which will result in long term positive health outcomes, even after treatment. Hence, this theory will aid the new nurse in engaging in a smooth and comfortable communication with the patient, which will further pave the way for optimum professional practice (Ahtisham & Jacoline, 2015).

The next theory which can prove to be beneficial in nursing professional practice is that of ‘Unitary Human Beings’ by Martha Rogers, which emphasizes upon the interplay of environmental factors in the treatment and improvement of patient health. Hence this theory will guide the nurse in remembering to consider aspects of hygiene, food and nutrition while treating patients, resulting in confident transition to professional practice, during individual patient management (Dunn, Price & Roger, 2016).

Theoretical principles for transitioning to professional practice

The ‘Self Care Theory’ by Dorothea E. Orem, focuses on adoption of a holistic approach for patient treatment with consideration of their psychological, developmental, social, interpersonal as well as functional aspects. Hence, new nurses must remember to engage in provision of a multidisciplinary approach which will help in smooth transition to professionalism through facilitation of communication with other departments (Mohammadpour et al., 2015).

One of the most influential and effective theories to be considered by nurses transitioning to professional practice, would be the ‘From Novice to Expert’ by Patricia Benner. This theory emphasizes on nurses to focus on abstract concepts of information, along with association with past experiences. Hence, nurses who are new, must always considering relating their theoretical knowledge along with their experiences, since experiences in nursing, leads one to learn from previous patient examples to be incorporated saliently in present treatment of illnesses (Benner, 2004).

In addition to the above, new nurses must also be open to usage of ‘Transcultural Theory’ by Madeleine Leininger, which will empower them to consider the ethical and cultural needs of a patient, during treatment planning and intervention (Shen, 2015).

I realize that despite adequate education, I am still overcome my fear and lack of confidence when met with the thought that shortly I will be engaging in real life clinical situations. Considering the transition which I will be encountering shortly resulting in my shift to professional practice, I feel that I should consider using and implementing above theories and skill sets which will aid in my preparation and progress of professional practice. For this, I must set certain personal goals. One of my key goals which will require fulfillment would be acquiring adequate knowledge considering the various treatment and care procedure required by a patient. Despite already engaging in the above, since I am required to adhere to my nursing curriculum, I must continuously engage in further research in order to acquire adequate clinical and scientific evident, which will help me treat my patients during professional practice. An additional skill set which I must consider, would be the usage of appropriate communication skills (Hagemeier et al., 2014). Considering the needs of the patient, along with involvement of their family during treatment selection is of utmost importance for the maintenance of professional, high quality nursing practices, which can only be utilized through effective communication strategies. For tracking my progress as well as preparing my future transition to future nursing practice, I believe adoption of Benner’s theory of skill acquisition would be highly appropriate. This will require of me to constantly consider my previous as well as present experiences, while treating patients as this will encourage me to be more receptive to patient symptom changes as well as associating the same with past experiences and theoretical knowledge (Benner, 2004). For further smoothening my process of transition, I must remember to engage in appropriate teamwork as well as exhibit communication skills which will not only help me accustom to the new surroundings but also aid in the understanding of appropriate delegation, leadership and team collaboration in clinical settings. Further, I believe that training myself in the usage of ‘Need theory’ would direct me appropriately to consider individualized patient decision, while ‘Transcultural Theory’ will sufficiently help me to be consider the ethical and cultural patient needs(Keyko et al., 2016). Usage of such theories will help me to progress successful into a professional nurse with due reduction of feelings of distress and anxiety.

Considering cultural and ethical needs of patients

Conclusion

Hence, it can be concluded that the field of nursing requires due consideration of various theoretical principles as well as acquisition of various clinical and non-clinical skills which will not only broaden nursing knowledge, but will also aid in the proper transition towards nursing professional practice. Hence, the new nurse must engage in acquisition of clinical skills of symptom management, vital sign recognition and treatment provision along with non-clinical skills of communication, interpersonal relationships, feedback, follow up and team collaboration. Further, usage of experience is a key determinant which will not allow new nurses to assess the patient’s condition effectively, but will also familiarize her with the occupational surroundings. Hence, to conclude, usage of appropriate theoretical frameworks, along with skill acquisition will launch a budding nursing successfully into the fields of professional practice.

References

Ahtisham, Y., & Jacoline, S. (2015). Integrating Nursing Theory and Process into Practice; Virginia's Henderson Need Theory. International Journal of Caring Sciences, 8(2). 443-450.

Attard, J., Baldacchino, D. R., & Camilleri, L. (2014). Nurses' and midwives' acquisition of competency in spiritual care: A focus on education. Nurse Education Today, 34(12), 1460-1466.

Benner, P. (2004). Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgment in nursing practice and education. Bulletin of science, technology & society, 24(3), 188-199.

Bowen, K., & Prentice, D. (2016). Are Benner's expert nurses near extinction?. Nursing Philosophy, 17(2), 144-148.

Cant, R. P., & Cooper, S. J. (2017). Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse education today, 49, 63-71.

Dunn, D. J., Price, D., & Neder, S. (2016). Rural Caregivers of Persons with Dementia: Review of the Literature Guided by Rogers' Science of Unitary Human Beings. Visions: The Journal of Rogerian Nursing Science, 22(2). 16-24.

Hagemeier, N. E., Hess Jr, R., Hagen, K. S., & Sorah, E. L. (2014). Impact of an interprofessional communication course on nursing, medical, and pharmacy students’ communication skill self-efficacy beliefs. American Journal of Pharmaceutical Education, 78(10), 186.

Heyes, C. J., & Thachuk, A. (2015). Queering know-how: Clinical skill acquisition as ethical practice. Journal of bioethical inquiry, 12(2), 331-341.

Keyko, K., Cummings, G. G., Yonge, O., & Wong, C. A. (2016). Work engagement in professional nursing practice: A systematic review. International Journal of Nursing Studies, 61, 142-164.

Laschinger, H. K. S., Cummings, G., Leiter, M., Wong, C., MacPhee, M., Ritchie, J., ... & Young-Ritchie, C. (2016). Starting Out: A time-lagged study of new graduate nurses’ transition to practice. International Journal of Nursing Studies, 57, 82-95.

Marañón, A. A., & Pera, M. P. I. (2015). Theory and practice in the construction of professional identity in nursing students: a qualitative study. Nurse Education Today, 35(7), 859-863.

Mohammadpour, A., Rahmati Sharghi, N., Khosravan, S., Alami, A., & Akhond, M. (2015). The effect of a supportive educational intervention developed based on the Orem's self?care theory on the self?care ability of patients with myocardial infarction: a randomised controlled trial. Journal of clinical nursing, 24(11-12), 1686-1692.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.

Wilson, B., Harwood, L., & Oudshoorn, A. (2015). Understanding skill acquisition among registered nurses: the ‘perpetual novice’phenomenon. Journal of clinical nursing, 24(23-24), 3564-3575.