Excellence in Clinical Nursing

¶ … clinical nursing professionals require self knowledge as well as expertise in order to be successful in their field using Patricia Benner's book as a background. It has one source.

Clinical professions today require experts. In a clinical setting both nurses and doctor are equipped with information which will validate their presence for patient care. A critical understanding of the processes of diagnosis, treatment and monitoring of the patient is imperative as they are responsible for the patient care outcomes. Nurses today are playing a critical role as intermediaries, more knowledgeable than an attendant but with less expertise than the physicians themselves. Nursing is no longer a comparatively inferior career but a highly sophisticated field requiring clinical expert skills to carry out patient care duties. They are responsible for making on the spot decisions; act as coaches for aspiring nurses; specialize in certain areas such as rehabilitation, injuries, administrative nurses etc. And they are also to assist their peers in patient care and clinical practices. The complex environment in which nurses work is even further made challenging with the introduction of technology. Operations theaters, equipments, emergency care units and at times paramedic services all demand nurses play an extra role apart from attendance. In fact in dire emergency situations they are required to take initiatives in making quick decisions and implement them. Thus nurses in today's environment are required to have an all-encompassing role in which they are the decision makers, the mentor, the expert as well as the supporters for clinical patient care outcomes.

Studies indicate that [Benner 1984] the path to achieving excellence in nursing is filled with barriers and difficulties. The effectiveness of nurses' patient care outcome is never immediate because patients take a long time to develop a trust with their medical assistants; doctors are critical of the role of nurses in medical care and administrators are not enthusiastic about support staff even though they realize that nurses play crucial roles in critical care situations.

Whether one is a registered nurse or general one, nurses are required to support their peers and at the same time expected to understand the sufferings of their patients. Mandates like being on time, on location, performing group duties and performing interoperative tasks etc. are rudimentary. They are required to act as padding support for their peers while on the other hand, patients expect nurses to inform them of the nature of their illness may it be a severed spinal condition, head tumor operation outcome or the duration of rehabilitation in a clinic; they expect their nurses to act as mentor and be empathetic towards them to the extent of treating nurses as friends. They share their personal experiences and expect to share their beliefs as well. Thus the holistic nature of the field of nursing has put tremendous pressure on the nursing professionals.

Patricia Benner in this regard has very eloquently outlined the importance and the nature of nursing care. In her book she illustrates that a novice nurse begins with learning and learning develops when the theoretical framework is put to practice. Skills, practical abilities as well as dexterity all counts when a nurse is engaged in performing the clinical duties. Yet success however does not come in application only but rather on how the nurse utilizes external knowledge from the surrounding to polish their skills. Senior nurses for example are required to demonstrate competencies in the areas of organization, coordination, team arrangements as well as monitoring the process of care. They may take a leadership role and thereby give support to the health care institutions. To even further, their careers these nurses can even become specialized in certain clinical areas through advance studies and research. The concept of holistic nursing for example has become an extension of the nursing field as a result of intuitive nursing knowledge and skill development. From a personal experience, I feel that excellence in nursing has not been achieved as there are still more areas to explore especially in clinical practices that are outside the organization such as home care delivery, managed care etc. As a nurse at a rehabilitation clinic I personally have experienced that patient care is more effective at patients' own home as they are more relaxed, psychologically at peace and are not forced to be vigilant of the medical practitioners who are treating them. The role of the nurse is enhanced because s/he would be acting as the friend, mentor and medical assistant by making appropriate and knowledgeable decisions for them. Thus excellence in nursing practice still has a long way to go and practitioners can be expected to explore, exploit and specialize in their field.