This paper is an extended annotated bibliography consisting of different articles on modern nursing. The first article discusses the Gibbs reflective cycle in light of a specific case study; the second article discusses encouraging nurses to specialize in geriatric care; the third discusses how negative media images of nurses affect nurse recruitment; the final article addresses delegation on the nursing ward.
¶ … Burzotta, L. & Noble, H. (2011). The dimensions of interprofessional practice. British Journal of Nursing, 2011, 20(5): 310.
This article uses the Gibbs reflective cycle to analyze a specific case confronted by a nurse in the field of practice. The cycle includes "description of the event, feelings encountered, the positive and negative aspects of the experience, an analysis of the event, and a conclusion of the overall experience" (Burzotta & Noble 2011: 310). The Gibbs reflective cycle is intended for both nurses and patients to understand the full social and emotional implications of healthcare decisions that are made. The subject of the article, Mrs. Jones, was diagnosed with late-stage breast cancer and was entering into the palliative care process. Mrs. Jones had a small child as well. Despite the severity of her diagnosis, the treatment team focused on addressing Mrs. Jones' psychological, social, and physical needs in a holistic fashion, striving to maintain her independence for as long as possible. The family's needs were addressed by a 'care team' as a whole as well as Mrs. Jones' needs. Interprofessional or interdisciplinary care was vital in treating Mrs. Jones.
Mrs. Jones needed assistance because of her impaired mobility and difficulties with attending to the acts of daily life, but she also required emotional support given the challenges both she and her family were facing. Patients must have advocates within the healthcare system in the form of nurses and other professionals and these advocates must be able to facilitate communication between the patient and outside providers, commensurate with the principles outlined in Gibbs. Interprofessional efforts also require workers to be good communicators with one another (one problem with Jones' treatment team was a lack of follow-up and collaboration of the social worker assigned to her case).
Carrigan, Kate. (2009). Coming of age: The challenges of nursing an aging population.
Australian Nursing Journal, 16 (6): 23.
As the population of Australia ages and the need for nurses to staff aged facilities increases, there remains a notable gap between the wages of nurses in geriatric care and in other fields of medicine in Australia. Given that the medical system in Australia is government-run, much criticism has been directed against the government for this discrepancy in funding. Using non-nurses will not solve the problem: workers in aged care facilities must have comparable educations to nurses in other care settings yet the wage gap results in deficits in education and training amongst aged care staff. Personal care assistants cannot be interchangeably inserted into the roles whereby a fully-fledged nurse is required.
Even retaining adequately-qualified nurses is challenging. Staff attrition at care facilities is high -- many nurses move in and out of the required positions -- and having a mix of skills of amongst nursing employees is difficult to maintain on a regular basis on-site. Yet GPs are not interested in spending much time in this sphere of medicine (also due to the low pay), so attracting more NPs is essential in the long-term. Sign-in bonuses, allowing nurses to work as specialists in two facilities at the same time to increase their income, and allowing nurses to charge more are all possible solutions to the problem of low levels of incentives for staff to specialize in this area of medicine. Given that numbers of geriatric patients will be increasing, it is essential that the government address this problem sooner rather than later and fundamental structural changes are enacted so that the current ineffective pattern does not continue unabated.
Morris-Thompson, T., Shepherd, J., Plata, R. & Marks-Marand. (2011). Diversity, fulfillment and privilege: the image of nursing. Journal of Nursing Management 19, 683 -- 692.
The way that nursing is viewed by the general public and by nurses themselves is often very paradoxical. While nurses describe their profession as extremely fulfilling on a personal level, members of the public often say that they would not recommend nursing as a viable career choice and tend not to have a positive view of the function nurses hold in society. The media still tends to portray nurses as the 'helpmates' of doctors, rather than as having unique roles as caregivers that are essential for patients. There is also the common stereotype of figures such as the 'naughty nurse' that bears no relationship to what nurses actually do in their day-to-day lives. The methodology deployed in this article was that of a qualitative study, interviewing both nurses and members of the public in a relatively open-ended fashion. An extensive literature review was conducted before the study was embarked upon to contextualize the attitudes expressed by patients. The authors note that such assessment of impressions of the nursing profession is essential, given that it will likely affect whether students in the future are willing to enter its rapidly dwindling numbers. Even nurses themselves are shying away from entering fields such as primary care and providing for the elderly and are instead focusing on more respected, specialized high-technology fields.
Focus groups were used for the qualitative portion of the actual research, to mine more rich impressions than could be given from a purely data-driven questionnaire. Non-nursing participants included parents, children, members of the media, teachers, and mature career-switchers. The general consensus was that nursing was a 'nasty' job but was necessary and that nurses were poorly-paid and put upon. This was in stark contrast to the participant-nurses who often described their careers as fulfilling both in financial and emotional terms. It is suggested that this discrepancy of perception vs. reality must be addressed to encourage more people to enter into the various capacities of the nursing profession.
Schluter, J., Seaton, P., Chaboyer, W. (2011). Understanding nursing scope of practice: A
qualitative study. International Journal of Nursing Studies, 48: 1211 -- 1222.
This research study specifically deploys a qualitative research format to grapple with the question of how nurses' scope of practice has changed. Because of changes in the healthcare system and changes in patterns of patient's needs, nursing roles are in a constant state of flux. The study consisted of interviews with RNs and ENs and specifically focused upon the issue of delegation. Professional nurses are increasingly called upon to delegate critical matters to non-nurses functioning in the field of care. Because of the expansion of stressors placed upon the healthcare system, nurses find themselves overburdened by the demands of more and more patients, requiring others to step into the breach, including unlicensed healthcare workers even in acute care settings.
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