Patient Turnover And Relationship System In Nursing Practice

Meaning of the term caring

Discuss about the Patient Turnover and Relationship System.

According to Adam (2016), philosophy of caring is the basic pillar of nursing profession. However, Adams (2016, pp: 01) have opined that, “The attribute of caring is no longer a central theme to the nursing profession and has become only second nature to the busy, overworked nurse in a technologically dominated setting”. The following essay aims to analyse to what extent this statement holds significance in nursing profession. Analysis of the validity of the statement will be done under the light of the Professional Code of Conduct of Nursing and Midwifery Board of Australia (2017) along with detailed examination of related concept of care and importance of care in nursing profession and present day scenario. Towards the end the essay with put forward the conclusion stating to what extent the writer agrees or digresses with the above mentioned statement.

The profession of nursing is the key healthcare profession. It has principal contribution towards the overall health and wellbeing of the patients. The concept of care in nursing profession generally deals with holistic care to the patients for fast recovery of the mental and physical health (Bodner et al., 2015). According to Oosterom-Calo Vice and Breslow (2015), apart from providing the medical care, it is also the duty of the nurse to make sure that the surrounding environment is suitable for fulfilling the comprehensive requirement of the patients thereby leading towards the physical wellbeing and mental satisfaction. Oosterom-Calo et al. (2015) further opined that the patients who are suffering from the prolong disease like cancer, demands certain level of emotional and spiritual support and it is the duty of the nurse to fulfil the spiritual requirement of the patients in order to promote speedy mental recovery which in turn positively impacts the physical health. Ramezani et al. (2014) has also spiritual care mode as one of the related concept of care in nursing profession. Spiritual care is regarded as a critical aspect of nursing care. This is because, the patients project nurses as the valuable source of the spiritual information and it is the duty of the nurse to be able to fulfil the spiritual requirement of the patients. However, in spite of increasing importance of spiritual care in the recent times, at present there are still certain level of ambiguities about in the nature and the associated components of the spiritual care (Ramezani et al. 2014). According to Lusk and Fater (2013), in order to optimally fulfill the physical, mental and spiritual requirement of the patients, it is the duty of the nurses to abide by person or patient centered care model. This care plan varies from person to person and is now gradually evolving as the principal mode of care plan among the nurses.

Overworked nurse in technologically dominated settings

According to Adams (2016) the concept of caring varies from individual to individual. Adams (2016) have further defined the concept of caring as an altruistic act of feeling concerned for another person. Caring is the fundamental principal of the nursing profession as introduced by the Florence Nightingale. The caring in nursing profession has two main domains one act as a noun and other domain act as the verb that signifies the act of caring for unknown person when he or she is unable to take care for them (Adams 2016). Via procuring care, a nurse employs a genuine and authentic practice that is comprehensive and meaningful to both the patient and their family of cares (Adams 2016). This authentic practice is mainly based on the nurse knowledge base and the knowledge that arose from the interpersonal relationship between the nurse and patients. The concept propose by the Adams (2016) aligns with the Code of Ethics for Nurses in Australia. According to the code of ethics nurse must value quality nurse care for all the patients irrespective of the diversity. Here quality nursing is acknowledged as accepting the accountability of the standards of the nursing care and taking reasonable actions as per the requirement.

According to Adams (2016, pp: 01), “The attribute of caring is no longer a central theme to the nursing profession and has become only second nature to the busy, overworked nurse in a technologically dominated setting”. However, Entwistle and Watt (2013) is of the opinion that caring is an important aspect of nursing because it helps to improve the overall experience of patient in the process of delivering healthcare. The concept of caring, helps in the framing of the patient centred care plan. According to Kitson et al. (2013), patient centred care plan is one of the crucial parameter behind improvement of patient’s health and wellbeing.  This again goes with the Code of Professional Conduct for Nurses in Australia (2017) which vouches in favour of health and wellbeing of the patient. According to Rathert, Wyrwich and Boren (2013), patient centred care plan is a modified version behind the concept of nursing care and must be placed as the first preference in the nursing profession. The importance of the patient centred care plan is, it covers eight different aspects of patient’s care plan and this include respect towards patient’s preference, integration and co-ordination of care, education and information, optimal physical comfort, proper emotional support, adequate of the family members, friends and family in the decision making process, proper access to care and continuity and transition (Rathert, Wyrwich and Boren 2013). Moreover, optimal nursing care is also significant in the present day culturally diverse healthcare environment of Australia. According to Renzaho et al. (2013), culturally competent health care model promotes increase rate of awareness cultural awareness under the linguistically diverse environment and thereby preventing compromised patient-provider relationships which increasing patient’s health outcomes. This culturally competent care model again inclines with the Code of Professional Conduct for Nurses in Australia (2017) which emphasize the importance of nursing practise in a culturally competent manner with due respect towards the cultural and ethnic values of the Aboriginal and Torres Strait Islanders (indigenous population in Australia)

According to Shanafelt et al. (2012) and Shanafelt et al. (2015) the majority of the nursing professionals are now suffering from burnout in comparison to any other profession in world. Shanafelt et al. (2012) have highlighted both the individual along with organizational factor as the reason behind this burnout. According to O’Malley et al. (2010) and Holden (2011), the nurses are of the opinion that documentation of the patient information through computerized entry is the leading cause of the work overload leading to concentration distraction along with the decrease in compassionate care. Zhou et al. (2010) have opined that the concept of technological advancement in health care like application of the electronic health records have been introduced in the health care system has been introduced increase the quality of care along with patient safety. However, implementation of electronic health records has increased the clerical burden over the nursing and other health care professionals and thus decreasing the quality of care. Active workload generated due to high requirement of data documentation has decreased the nurse-patient interaction along with potential distraction of the nursing professional from the quality medical practice. Dyrbye et al. (2012) have opined that this distraction is affecting the individualized quality of care (both emotional, spiritual and medical) that the nurses used to take in order to address the patient concerns. The majority of the hospitals are now using computerized transcription services in order to document patients’ notes and this have further increased the eel of burnout among the nursing professionals (Shanafelt et al., 2013). Shanafeltet al. (2016) have opined that implementation of the computerized documentations have forced the healthcare professionals to devote more time in clerical documentation in comparison to the critically analysis of the patients. According to Entwistle and Watt (2013), critical analysis of a patient is an important factor for stringently designing the person centred care plan. Person centred care plan is important crucial for improving the overall patient outcome as it is based on 8 crucial principles like respect of patient’s choices, proper co-ordination and integration of care, proper information and education about the patient, providing the patients physical comfort along with emotional support, encouraging active involvement of family in the patient care plan, continuity and transition of care and proper access to care (Entwistle and Watt 2013). The study conducted by Shultz and Holmstrom (2015) reported that technological advancement in the healthcare profession though has helped to increase the hourly volume of the patients attended but have decreased the quality of personalized care.

According to Benner (2012), proper education and updated knowledge among the nursing professionals pave towards radical transformation. Benner (2012) further opined effective knowledge and nursing skills helps the nurses to practice in accordance with the prevailing health care standards while abiding by the health care policies. According to Nursing and Midwifery Board of Australia (NMBA) (2017), it is the duty of the nurse to practice in accordance with the relevant laws of nursing profession. Moreover, proper education and training among the nursing professionals help in the improvement of the quality of care via decreasing the incidences of medication error and drug errors (Adhikari et al., 2014). Adhikari et al. (2014) is of the opinion that this nursing education and skills training must be undertaken under a multidisciplinary approach so that the nurses gets a diverse exposure in the different aspects of patient care plan like correct patient, right amount of drug, right percentage of dose, right span of time and right mode of administration. According to Park et al. (2012) Apart from patient care approach, nursing education also includes ethics education and this domain is highlight significant under the NMBA code of conduct (2017) which proposes nursing practice under proper reflective exposure undertaken through ethically sound framework

Nursing professional highlights holistic care to the overall health of the patients. This overall health of the patients encompasses both mental and physical health. Speedy recovery among the patients demands spiritual and emotional support from nurses and this support come in form of empathy and compassion (Jason, 2014). According to McCaffrey and McConnell (2015), compassion is a form of human experience and is of deep significance towards nursing care as its aims towards understanding the context of the healthcare environments which is ruled by rationalisation and efficiency. However, Bramley and Matiti (2014) are of the opinion that compassion in nursing is included with the actions of care which at times takes time. However, this domain needs to be fleeting in order to strengthen compassionate connection. In spite of urgent calls for high focus in the all domains of nursing education and teaching, the opinion of the patient was divided on whether compassion can be taught or remains a moral value. Gaining a proper understanding of the effect of uncompassionate actions in nursing care lays an opportunity to revamp both cultural and individual behaviours (Bramley and Matiti 2014).

As per the NMBA code of conduct (2017), nurses are required to remain accountable and responsible for their actions. According to Battié and Steelman (2014), accountability or staying responsible for actions is an essential component of nursing care as it increases the level of patient safety. Oyetunde and Brown (2012) further opined that the primary healthcare nurses who are indulged directly with public are required to be cognizant about their public stand-point along with the level of accountability and responsibility on professional grounds.

All these five domains fall under the domain of safe and culturally competent nursing while valuing the diversity of the people and respecting their confidentiality (NMBA Code of Conduct, 2017). Here respect meaning respecting the dignity and the consent of the patients and this in turns goes with the concept of the informed decision-making. According to Barry and Edgman-Levitan (2012), informed decision-making is an important aspect of nursing care as it increases the involvement of the patient into the care plan and thereby increasing the level of outcomes. Moreover, informed decision-making is a pinnacle of patient centered care, which also helps in reducing the overall cost of care (Oshima and Emanuel, 2013). Trustworthiness increases the level of trust among the client-nurse relationship and thereby improving overall patient outcome (Park et al., 2012). According to Ramezani et al. (2014), non-judgmental and unconditional acceptance in nursing care helps in the improvement of spiritual care in the nursing practice. Furthermore, spiritual care is dynamic and subjective concept. Ramezani et al. (2014) has defined this as unique aspect of care that incorporates all the other aspects of the care model. This concept has emerged under the context of nursing awareness of the transcendent dimensions of life and then critically reflects on reality of the patient. The provision for spiritual care leads towards the generation of positive consequences in patient’s health like healing for patients along with increase in the domain of spiritual awareness for nursing professional (Ramezani et al., 2014).

Critical thinking and problem solving is an important aspect of nursing profession as it helps to improve the decision making skills along with the leadership quality among the nursing professionals and thereby increasing the quality of care. According to Chan (2013), concepts of critical thinking changes, from time to time and thus there is an urgent need to clarify the perspective of the educators towards critical thinking and problem solving skills. There is also an urgent requirement to evaluate the new strategies towards the improvement of the critical thinking. With better understanding about the nursing education, educators along with nursing teachers are required to frame refine strategies towards enhancing critical thinking skills and in turn making them ready for clinical practice (Chan, 2013). According to Lee et al. (2013) application of the concept map helps in the overall improvement of the critical thinking skills among the nursing professionals and thereby helping to refine their problem solving skills and taking prompt actions. Mulnix (2012) further opined that evidence based practice among the nursing professionals help in the improvement of the critical thinking skills among the nursing professionals and thereby making them more proficient in the domain of active actions during emergencies.

Conclusion

Thus from the above discussion it can be concluded that caring is an important aspect of nursing profession. Caring does not only centres on providing quality health care for improvement of the patient’s physical health but also encompass proper assessment of mental health of the patients. Care in the domain of mental support deals generally deals emphasizes compassion and empathy along with exercising trustworthy and health relationship with the client. For drafting a comprehensive care plan, nurses must work on their critical think, problem-solving skills along with generating awareness under the domain of culturally competent care. However, increase in the application of technology-based documentation is creating a barrier towards the nursing professional to indulge in quality relationship with their client via practicing communication and intra-personal skills. This increase in the documentation is increasing extra clerical work load of the healthcare professionals thereby shifting the focus of the healthcare professionals from the care plan drafting towards technology based applications.

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