When I think of nursing theory the first person that comes to mind is Florence Nightingale. She is well known for her environmental adaptation theory. In her theory she discusses ventilation and warming, noise, variety, diet, light, cleanliness, and chattering hopes and advices. I feel that her theory influences my values and goals. Her theory is also used every day in the hospital facility I work in (Cherry and Jacob, 2017).
Nightingales theory has influenced my nursing values by ensuring that I provide a safe environment for my patients. Patient rooms should be clean, well lit, and free of clutter to implement non-maleficence. Her theory has influenced my values such as altruism and dignity. I provide individualized care to my patients while respecting their morals. Every person is different and their care needs to be catered to their needs. As a nurse I am always concerned with the patient’s altruism. Safety is key and the driver in everything I do as a nurse. If safety is not up held then everything else fails. Nursing experience
Nurses apply Florence Nightingales theories in their practice to promote excellent nursing practices in many ways. There are restricted visitor’s hours to promote rest and reduce noise. Patients are put on specific diets depending on their health history to promote healing and further harm. For example, Nurses monitor the amount of fluids that patients take in that are admitted for Congestive Heart Failure to ensure they do not further complicate their disease process. In the morning nurses raise the blinds to let in the natural light so patients are aware that is a day time and time to be up and not sleeping. This helps to combat delirium in patients and helps them get the proper rest. Nurses also ensure the rooms are clean, linens are changed daily, patients are bathed daily and as needed, and housekeeping tends to the patient rooms every day. Not only does cleanliness apply to the patients but it also applies to the nurses. In current practice nurses must wash their hands with antimicrobial soap before entering and after leaving a room. To combat boredom of patients and have a variety of activities nurses can offer art therapy, music therapy, or pet therapy. There are many other things that nurses can do for patients in their nursing practice that are influenced by Florence Nightingales nursing theory. Nursing experience
Currently in my professional practice I also do many of the mentioned things above that align with Florence Nightingales nursing theory. When I bathe my patients I implement the use of CHG wipes that not only clean the patient but also provide cleanliness to help prevent infections. I also wash my hands prior to entering a room, assessing a patient, and upon exiting a room. While in a patient room I try to limit noise and distractions to help promote rest and healing. At the facility I work at we do not have strict visiting hours but we do have quiet time where we dim the lights and try to limit visitors to advocate rest. I am upfront with my patients about their care but at the same time am respectful of their feelings. I do not fill them with false hopes or tell them things that are untrue about their care or diagnosis. Everything that I do in my practice relates to Florence Nightingales nursing theory in some sort of way. Nursing experience
There were many influential nurses in the nineteenth and twentieth century. The two that I would like to discuss are Linda Richards and Lillian Wald. Linda Richards was born in 1841. Richards was America’s first trained nurse in 1900. She is known for creating the first system of keeping written medical records. Prior to her creating individualized written records nurses were expected to report important facts orally from memory. Richards contribution helped to change the process of giving report and keeping medical records. By keeping written records nurses are now able to keep an accurate history on the patient. When information is given by mouth facts can be misconstrued or completely left out. Richards contributions differ from Wald’s because Richards changed the process of nursing. Wald’s contribution recognized the need to expand nursing to a more in need population. Both women made drastic changes for the nursing community (Campbell, n.d.). Nursing experience
Lillian Wald was born in 1867. Wald is considered to be the founder of public health nursing. Wald recognized that poverties areas needed access to affordable healthcare. Patients were charged based on a fee sliding scale. She also started the first American public school of nursing in New York City and founded the Henry Street Settlement. The Henry Street Settlement was known for its large playground in the lower east side. The Settlement opened more branches in New York to provide services such as health care, community programs, and employment to everyone. She was recognized in the New York Times as “one of the 12 greatest living American women” and received the Lincoln Medallion for being an “Outstanding Citizen of New York” (Hansan, 2018)
The works of these two ladies influence my professional nursing practice in many ways. Richards introduction of charting patient information helps with effective communication skills. With the help of my charting I am able to effectively communicate the patients care to the oncoming nurse and members of the healthcare team accurate information. By charting the information items are not as easily missed and I am able to look back throughout my shift to ensure I didn’t miss anything. Charting is used in the court of law as proof to what did and did not happen. The rule of thumb in nursing is “if it wasn’t charted, it didn’t happen”. Having the ability to chart patient information also allows for implementation, interventions, and evaluations. I am able to see what the Doctors chart and view their orders which allows me to implement their plan of care and provide interventions that align with the plan of care. I am also able to evaluate things that have happened on different shifts like when wound care was last done and when it needs to be redone. Nursing experience
Wald’s recognition of the need for public health nursing and providing care to everyone in a community has changed nursing in a drastic way. By providing extended care to everyone in my practice I am able to provide nursing care to everyone in my community. Due to the diversity of my community I am able to care for people from all different walks of life and see a variety of different disease processes. I am also able to provide care to people who may not have received care before if it wasn’t for Wald. As a nurse I also volunteer in my community for a variety of things that offer public health nursing to members of my community. By doing this I am able to implement education to these individuals that they may not have ordinarily received (Hansan, 2018). Nursing experience
The State Board of Nursing and the American Nurses Association (ANA) differ in various ways. The State Board of Nursing is state specific. It is a regulatory body that sets the standards for safe nursing care, decides the scope of practice for nurses in its jurisdiction, and issues licenses to qualified candidates. The State Board of Nursing covers issues such as public health, safety and welfare, and help to develop nursing licensure exams (“What is a State Board of Nursing?”, 2018). While the ANA is a professional organization that represents the entire RN population. The ANA requires RN to pay a fee to become a member. The ANA helps to advance nursing and be the “voice” of its members. Once a member of the ANA you are given resources to further your career, access to journals, discounts on certification exams, discounts on personal benefits, ANA meetings and conferences, live webinars, and many other benefits. The ANA is a nationwide organization (“About ANA”, n.d.).
The State Board of Nursing is in every state and each state has its own individual set of rules. These rules are established by the Nursing Practice Acts (NPAs). The NPA set rules and regulations into place that establish the qualifications for state licensure. The State Board of Nursing is responsible for issuing and renewing nursing licenses, reviewing applications for nurse applicants, and enforcing disciplinary action (“What is State Board of Nursing?”, 2018). Nursing experience
The ANA is a membership only professional organization. It prides itself in improving the quality of healthcare for all. It currently has members in all 50 states and U.S. territories. The ANA has two types of membership. The lowest type of membership has limited access. The ANA collaborates with other nursing organizations to address and solve issues that affect the nursing profession. The ANA recognizes problems within the nursing profession and finds solutions to improve the practice. They also offer many benefits to their members (“The History of the American Nurses Association”, n.d.). Nursing experience
Both of these organizations influence my nursing practice. The ANA helps to make changes to better nursing. The changes that they make allow me to practice safely and have adequate resources in my nursing practice. I am actually a member of the ANA. By being an ANA member I received a discount on the CMSRN exam. I am now a CMSRN. I frequently receive education opportunities from the ANA which allow me to have advanced knowledge in specific areas. They also send me CEU opportunities at a discounted rate which I need to maintain my RN license. The State Board of Nursing (BON) helps my nursing practice by requiring education to maintain my license. This education helps to ensure I am up to date with the frequent changes in healthcare. BON is also responsible for allowing me to renew my license which I need in order to practice as an RN.
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I live in the state of Virginia. In the state of Virginia you are required to have continued competency hours which must include 15 contact hours and 640 practice hours or 30 contact hours. Licensure is required to be renewed every 2 years. In order to renew a fee is applied. If license requirements are not maintained then disciplinary action such as probation or loss of license can occur (Kluwer, 2018). Nursing experience
In the United States there are compact and non-compact states. Compact states allow you to practice in other compact states without having to obtain an additional license, but your original residence needs to be located in a compact state (Douglas, n.d.). If you reside in a non-compact state, then you are not able to practice in any other state. In order to practice in other states then you have to obtain a separate license for that state. You are allowed to obtain as many single state licensures as you want. You are required to adhere to the rules and regulations in the state that you are working (Papandrea, 2016). Nursing experience
The Food and Drug Administration (FDA) and the Center for Medicare and Medicaid Services (CMS) both play vital roles in the healthcare system, but they do differ. The FDA is responsible for making sure that drugs and devices are safe and effective. The FDA monitors things such as medications, vaccines, medical devise, and blood products. CMS is responsible for deciding if the product is needed for the condition of the patient or can improve function to the patient. CMS is also responsible for determining the amount that healthcare providers get reimbursed (Richardson, 2015).
The FDA influences my clinical practice by the types of medications I administer to patients. The medications I administer have to be approved by the FDA. They also decide what medical devices are safe and effective for patients. Their determinations play a factor in what I have available to adequately care for my patients. If a patient is on a medication that has been taken off of the market by the FDA it is my responsibility to inform the doctors that the patient is taking this medication. Which means that is up to me to be aware of medications that I administer. Nursing experience
The CMS is the main decider in determining if patients qualify for certain medications and equipment. This plays a role in my clinical practice when it comes to safely discharging a patient. There are times when a patient needs certain medications or equipment in order to be discharged but CMS doesn’t feel it is necessary, so the patient gets denied. This then can possibly make the discharge unsafe. It is then up to me to work with the medical team and social worker to troubleshoot how we can get the patient the things that they need in order to be discharged safely. This also comes in to play when a patient needs physical therapy services at discharge, but CMS doesn’t approve them because they are out if rehab days or don’t feel it is necessary. It again is up to the whole medical team including myself to figure out how we can get the patient what they need to have a safe discharge. This plays a large part in my advocacy for my patients Nursing experience.
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