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NRS 430 Week 1 Contemporary Nursing Practice Assignment

NRS 430 Week 1 Contemporary Nursing Practice Assignment

Scope of Practice and Differentiated Practice Competencies: Contemporary Nursing

Nursing practice has changed over the decades from when nurses had minimal education to having complex nursing training programs and when nurses provided basic care to performing complex medical and nursing procedures. Nursing was initially a woman’s work where women cared for the sick at home in the era where there were no hospitals (Egenes, 2017). Modern nursing is attributed to Florence Nightingale, who developed nursing practices that created new standards for nursing practice.  In this regard, this paper will discuss the evolution of nursing practice, the differences between ADN and BSN nurses, and the significance of evidence-based practice in nursing.

Evolution of Nursing Practice

Nurses were formerly not provided formal nursing education but were instead given on-job training on how to provide basic care such as clean and dress wounds. They did not have autonomy and received instructions from physicians. As the nursing practice evolved and more hospitals were established, women began receiving nursing training in small to medium-size hospital systems (Egenes, 2017). However, the training was observation-based, taking two to three years, and the scientific rationale for interventions was not emphasized.

Advances in medicine and technology created a need for complex and specialized nursing education. As a result, nursing training shifted from hospital observation to the classroom.  Certification programs have been created, changing the scope of nursing practice (Egenes, 2017). Nurses also have Master’s and Doctorate levels, which increase a nurse’s scope of practice to include duties similar to physicians such as taking history and physical exams, making diagnoses, interpreting diagnostic results, and initiating treatment plans.  Furthermore, standards of nursing practice have been created to ensure quality nursing care, and nurses are educated on ethical practice and providing culturally sensitive care.

Practice Competencies between an Associate and Baccalaureate Education in Nursing

Nurses with an Associate Degree in Nursing (ADN) and with a Baccalaureate Degree (BSN) are both registered nurses (RNs). Both

NRS 430 Week 1 Contemporary Nursing Practice Assignment

NRS 430 Week 1 Contemporary Nursing Practice Assignment

BSN and ADN programs prepare nursing students to deliver patient care that meets the set standards. Besides, both programs equip the future RN with nursing skills and ensure they attain the clinical practice competencies necessary for nursing practice (Northrup-Snyder et al., 2017). However, the BSN program emphasizes more on areas of informatics and research. It also has courses not offered in the ADN program, such as nursing theories, social sciences, public health, leadership, and management. The differences in the ADN and BSN training result in differences in the scope of practice. ADN RNs are generally more focused on technical, clinical duties and everyday direct patient care, including monitoring patients, administering treatment, performing basic nursing procedures, and updating charts (Ghaffari, 2017). On the other hand, the scope of BSN nurses includes nursing educator, research, public health, administrative, leadership, management roles, and direct patient care.

Approaches to Decision-Making in a Patient Care Situation of a BSN vs.ADN

Approaches to decision‐making would differ in a BSN and ADN nurse caring for a diabetic patient with uncontrolled sugars and a worsening foot ulcer.  An ADN nurse will care for the patient by providing basic care such as dressing the wound, administering insulin or hypoglycemics, and monitoring blood sugar levels. Conversely, the BSN nurse will perform these tasks but get concerned about the uncontrolled sugars and delayed wound healing. As a result, the BSN will assess the patient’s diet and exercise patterns and educate the patient on the needed changes to promote optimal glycemic levels. Besides, the nurse will apply evidence-based interventions to promote healing of the ulcer and educate the patient on foot care.

Applying Evidence‐Based Practice to Nursing Care

In the past decades, evidence-based practice (EBP) has become a key element of excellent patient care. EBP is applied in various aspects of nursing as it offers valuable insight into clinical care approaches backed by evidence to address issues in direct patient care, infection control, and patient workflow (Mackey & Bassendowski, 2017). It enables nurses to apply the latest research methods in the patient care setting, including direct patient care. It focuses on established outcomes, thus promoting enhanced patient care. The BSN program equips students with knowledge and skills on EBP, which helps to analyze patient care approaches that can improve health outcomes (Mackey & Bassendowski, 2017). Students are trained on scientific research, gathering, and analyzing evidence, which they apply to establish the best patient care interventions.

Interdisciplinary Communication and Collaboration in Nursing Practice

Nurses today are part of the interdisciplinary teams and play a major role in developing patients’ care plans. Nurses communicate with the interdisciplinary teams using CUS and SBAR protocols. CUS is an acronym for Concerned, Uncomfortable, and Safety. It is a communication tool used by nurses to express concerns to the interdisciplinary team about changes in a patient’s health status respectfully and professionally. The SBAR protocol representing situation, background, assessment, and recommendations is used by nurses when having a clinical problem that needs to be conveyed to the team (Müller et al., 2018). Communication using the SBAR protocol is usually purposive, straight, and prepared and promotes information exchange between the nurse and the team. The CUS and SBAR protocols foster quality and safe patient care since patient information is communicated through an efficient and well-organized format.

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Conclusion

Unlike in the past, where nurses conducted similar tasks, nurses’ scope today is determined by their level of education and the specialized courses they have undertaken. Both BSN and ADN nurses have the same licensing level; however, some of their roles are different. ADNs focus on technical, clinical duties, while BSNs focuses on research, management, leadership, and informatics.  Nurses need to communicate accurately, succinctly, and purposeful with the interdisciplinary teams to promote collaborative care.

Also Read: NURS 8302 Discussion Strategies for Building Effective Teams

References

Egenes, K. J. (2017). History of nursing. Issues and trends in nursing: Essential knowledge for today and tomorrow, 1-26.

Ghaffari, M. (2017). Preparing Nurses for Community Health Care: A Comparative Study of the ADN and BSN Programs. International Journal5(2), 32-45. https://doi.org/10.18488/journal.9.2018.52.32.45

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing33(1), 51-55. https://doi.org/10.1016/j.profnurs.2016.05.009

Northrup-Snyder, K., Menkens, R. M., & Dean, M. (2017). Student competency perceptions from associate degree to bachelor degree completion. Journal of Nursing Education56(10), 581-590. https://doi.org/10.3928/01484834-20170918-02

Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ open8(8), e022202. https://doi.org/10.1136/bmjopen-2018-022202

Description:

The field of nursing has changed over time. In a 7501,000 word paper, discuss nursing practice today by addressing the following:

1. Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
2. Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.
3. Identify a patient care situation and describe how nursing care, or approaches to decisionmaking, differ between the BSNprepared nurse and the ADN nurse.
4. Discuss the significance of applying evidencebased practice to nursing care and explain how the academic preparation of the RNBSN nurse supports its application.
5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

Since the early days of Florence Nightingale, the nursing profession has developed over time. Utilized nursing theories, practice models, and scientific frameworks have advanced as well. The demand for quality and greater access to treatment has altered the training and education of nurses over time. Diverse cadres of nurses with distinct scopes of practice have been generated by nursing education. Evidence-based practice has superseded traditional decision-making models in nursing practice, resulting in new decision-making models in nursing. The requirement for nurses to connect with other nurses and other professionals has led to advancements in nursing communication and cooperation tactics and techniques. Consequently, the purpose of this paper is to describe the evolution of nursing, compare associate (ADN) and baccalaureate (BSN) education in nursing competencies, illustrate how decision-making differs between ADN and BSN nurses, discuss the importance of applying evidence-based practice, and describe the current nursing collaboration and communication strategies.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to theLopesWrite Technical Support articles for assistance.

Topic 2 DQ 1

Description:

Define critical thinking and evidence-based practice. Discuss what critical thinking in nursing practice entails and explain why it is important. Discuss the role of critical thinking and evidence-based practice as they relate to patient outcomes.

Topic 2 DQ 2

Description:

Describe how the nursing profession is viewed by the general public. Discuss factors that influence the public’s perception of nursing? Describe ways to educate the general public on the professional nurse’s role and scope of nursing within a changing health care system.

Topic 2 Participation

Description:

Read Chapter 3 in Dynamics in Nursing: Art and Science of Professional Practice.

Creating a More Highly Qualified Nursing Workforce

Description:

Read “Creating a More Highly Qualified Nursing Workforce,” by Rosseter (2015), located on the American Association of Colleges of Nursing (AACN) website.

The Impact of Education on Nursing Practice

Description:

Read “The Impact of Education on Nursing Practice,” by Rosseter (2017), located on the American Association of Colleges of Nursing (AACN) website.

Topic 2 DQ 2

Apr 11-15, 2022

Describe how the nursing profession is viewed by the general public. Discuss factors that influence the public’s perception of nursing? Describe ways to educate the general public on the professional nurse’s role and scope of nursing within a changing health care system.

REPLY TO DISCUSSION

BG

Billie Gabbard

Posted Date

Apr 15, 2022, 4:28 AM

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Replies to Billie Gabbard

Good morning, everyone,

In your opinion, how has COVID changed the perception of nurses? There have been many ups and downs in the last 2 years in the perception that the public has of nurses.

Billie

  • CW

Cassidy Wright

replied toBillie Gabbard

Apr 15, 2022, 11:48 AM

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Replies to Billie Gabbard

Hello Billie,

In my opinion I have found working as a ER nurse throughout COVID that people and the general public are very thankful for nurses and their everyday work. I think COVID has opened the eye of the general public about what nurses do and what our day to day work is. I think people were able to see just how real COVID was based off of the news and information they learned throughout the COVID pandemic. I have found that overall people are grateful and I have even earned a couple of “front line worker” discounts in my day to take life which is pleasant. I think that COVID was a window for the public to see what its like to care for somebody that is ill or dying. I found that the public had a new appreciation for what we do.

 

-Cassidy

  • BG

Billie Gabbard

replied toCassidy Wright

Apr 17, 2022, 3:26 PM

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Replies to Cassidy Wright

Hi Cassidy,

Thank you for sharing your experience which honor the nurse. I believe that nurses rose to the occasion during a time of uncertainty.

Billie

  • RF

Rose Francis

replied toBillie Gabbard

Apr 15, 2022, 1:32 PM

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Replies to Billie Gabbard

In my opinion, COVID has changed the perception of nurses. There were many situations where nurses had to endure up to 24 hours of continuous work while the general public were not allowed to be in contact with the patient due to fear of transmission and death. Nurses contributed much more in caring for the sick compared to other professions. Some nurses remained at the hospital for several days to avoid spreading the virus to their family members. In many countries, nurses were considered essential front-line workers. Some were awarded for their dedicated services by higher authorities.

  • BG

Billie Gabbard

replied toRose Francis

Apr 17, 2022, 3:33 PM

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Replies to Rose Francis

Thank you, Rose. Nurses did give of self, risked infecting self and family, but continued to work along side patients. Nurses are amazing peoples.

Billie

  • CW

Carly Wallmeyer

replied toBillie Gabbard

Apr 15, 2022, 3:40 PM

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Replies to Billie Gabbard

I think that COVID has increased the awareness of importance of nurses and health care in general. The impact the virus has had would have been so much worse if the healthcare system, including nurses, didn’t react the way we did. Being flexible, dedicated and simply showing up for our patients in a time of such uncertainty, while managing life in a pandemic, shows how strong and essential nurses are. One out of every 100 people in the United States is a nurse adding up to over 4 million nurses nation wide (American Nurses Association, 2022). Since nurses are so common in our communities, I think our friends, family and neighbors were able to see how the nurses role changed and became so important when visitations became minimal. Nurses because not only the eyes and ears for the doctors, but for the patient and their loved ones as well. Although I do think the community values and appreciates nurses a bit more due to the pandemic, I don’t think they understand the impact the pandemic had on nurses mentally, emotionally and physically.

American Nurses Association (2022). What is Nursing? https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/

Description:

Read “Scope of Practice,” located on the American Nurses Association (ANA) website.

Initial Course Survey

Description:

In an effort for continuous improvement, Grand Canyon University would like you to take this opportunity to provide feedback about your experience with the university. Your participation is appreciated.

What Is Nursing?

Description:

Read “What is Nursing,” located on the American Nurses Association (ANA) website.

Contemporary Nursing Practice SAMPLE

            Nursing practice involve wide range of health care activities. This paper seeks advance various key areas of contemporary nursing practice. In particular, the paper will discuss the evolution of nursing practice overtime, comparison and contrast of the differentiated practice competencies between an associate and baccalaureate education in nursing, identify a patient care situation that portrays how nursing care differs between the BSN prepared nurse and the ADN nurse, discussion of the essence of applying evidence-based practice to nursing and how RNBSN supports its application, and illustration of interdisciplinary team collaboration and communication among nurses and how it supports patient outcomes.

Evolution of Nursing Practice

Nursing practice has gradually changed overtime. According to Ranard, (2015), nursing was initiated when it did not require formal medical training but it was based on the gender and eagerness for the job. At that time, women would learn medical skills from their mothers or other women in nursing. Women were regarded as caretakers and nursing was perceived as extension of their job as care takers. Nurses used to deal with minor ailments and help patients who were unable to perform activities of daily living. However, the nursing profession started changing after the creation of council of nurses in different countries which brought the rules, standards, and regulations which turned the nursing into a profession (Ranard, 2015). Today, nursing profession has drastically changed and is characterized by extensive training programs, more responsibilities, better hospitals, focus on patient care, and more diversified staff. Moreover, the current nurses are more about leading change, promoting teamwork and consistency, prioritizing, and organizing, which have in turn changed the scope of practice and approach to treat an individual by increasing efficiency in health care, saved lives, and led to generations of devoted medical professionals.  Essentially, the current nurses act as bridge that binds team of health care professionals and other disciplines together.

Compare and Contrast the Differentiated Practice Competencies between an Associate and Baccalaureate Education in Nursing

Nurses with Associate Degree in Nursing (ADN) and Bachelor of Science in Nursing (BSN) both practice as registered nurses. However, their competencies in practice vary significantly depending the variation in nursing education. The education of ADN takes a period of three years and it’s mostly technical. Moreover, it focuses on the clinical skills intended to enhance patient health status. The ADN scope of practice is usually task oriented and nurses are held responsible for their actions. ADNs are expected to have the ability of evaluating, planning, and executing proper patient care from the time patient visits to the triage until admission or discharge. On the other hand, BSN connotes a four-year program that involves various nursing issues such as nursing roles, critical thinking, patient care, supervision, management, and community health. Regarding the scope of practice, BSN nurses should portray independent decision-making and ability of problem solving. The scope of practice also involves integration of intellectual, emotional, physical, and social competencies to improve patient outcomes (Rosseter, 2014). Overall, BSN-prepared nurses provide more holistic care as opposed to ADN-prepared nurses because they take care of patients in the entire time of patient care, which begins from pre-admission to post-discharge.

Identification of a Patient Care Situation that Highlights the Difference in Nursing Care between the BSN Prepared Nurse and the ADN Nurse

In patient care situations, there are fundamental differences in approaches to decision-making between BSN-prepared nurses and ADN-prepared nurses. For instance, in a patient c are situation where the patient needs intubation in emergency room, the ADNs and BSN nurses are likely to portray differences in decision making approaches. The BSNs approach to decision is likely to be anchored on the management of the patient after intubation while ADNs approach to decision is directly focused on patient treatment since they have authority to intubate the patient and prescribe drugs to the patient. Likewise, in the decision making approaches involving end of life care, the BSNs will focus on various aspects such as the rights of the patient, legal, and palliative aspects, which the ADNs are not trained to focus on (Loversidge et al., 2018).

Significance of EBP to Nursing and How Academic Preparation of the RNBSN Nurse Supports EBP Application

Evidence-based practice (EBP) in nursing connotes application of best available evidence, patient inclinations, and clinical expertise to clinical practice. EBP is important in the nursing practice of care because it avails scientific research to nurses to guide their decision. Moreover, EBP helps nurses to be updated about the new medical guidelines for patient care. By relying on the best current documented interventions that matches the health care needs of the patients, nurses tend to increase recovery chances for the patients (Dang &Dearholt,2017). Overall, the implementation of EBP in health care is associated with better patient-outcomes, which can ultimately reduce the demand for health care resources. The EBP models of care are applied in healthcare organizations in a bid to standardize and deliver more reliable and quality patient care. On the other hand, the academic preparation of the RNBSN nurse supports EBP application because it sharpens RNBSN nurses’ skills on research. RNBSN nurse students learn how to incorporate nursing evidence, theories, clinical judgment, and patient preferences. As health care is increasingly becoming complex, EBP knowledge of EBP is crucial for the success of nurses. RNBSN-prepared nurses know how and where to pursue evidence-based guidelines and the manner of executing such guidelines in the routine nursing practice.

Interdisciplinary Team Collaboration and Communication among Nurses and How it Supports Safe and Effective Patient Outcomes

Multidisciplinary teams connote health care team members drawn from different areas of specialty with complementary skills, experience, and profession. For patients to receive better health care under the interdisciplinary team, nurses should communicate with pertinent experts concerning the treatment plan for their patient while acknowledging the responsibilities of each team member. Mostly, nurses serve a bridge between the health care organization, physicians, and patients. As such teamwork is crucial for nursing role. Therefore, it is imperative to facilitate open communication. Effective communication in multidisciplinary team ensures safe and more effective patient outcomes by ensuring quality patient-oriented care. It also ensures reduction in medical errors and enhances patient experience with health care. Ultimately, this will reduce the health care cost (American Association of Colleges of Nursing, 2015).

Conclusion

The nursing profession has evolved from a situation where it did not require formal medical training to the present practice where nursing is considered as a valuable profession extensive training programs and more patient health care responsibilities. On the other hand, the practice competencies between ADN and BSN prepared nurses varies significantly. BSN-prepared nurses provide more holistic care as opposed to ADN-prepared nurses because they take care of patients in the entire time of patient care, which begins from pre-admission to post-discharge. It has also been established that the implementation of EBP in health care is associated with better patient-outcomes. Finally, interdisciplinary team collaboration is crucial in ensuring safe and effective health care services, which leads to positive patient outcomes and satisfaction with health care services.

References

American Association of Colleges of Nursing. (2015). Creating a more highly qualified nursing workforce. Retrieved September, 30.

Dang, D., &Dearholt, S. L. (2017). Johns Hopkins nursing evidence-based practice: Model and guidelines. Sigma Theta Tau.

Loversidge, J., Yen, P. Y., Chipps, E., Gallagher-Ford, L., Genter, L., & Buck, J. (2018). Top-of-license nursing practice, part 2: differentiating BSN and ADN perceptions of top-of-license activities. JONA: The Journal of Nursing Administration, 48(6), 329-334.

Ranard, C. (2015). How Nursing Has Changed Over Time – Minority Nurse. Minority Nurse. Retrieved 29 September 2020, from https://minoritynurse.com/how-nursing-has-changed-over-time/.

Rosseter, R. J. (2014). The impact of education on nursing practice. American Association of Colleges of Nursing Fact Sheet.

NRS-430V NRS-430V-O503 Contemporary Nursing Practice 150.0

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