Reading And Journal Of Nursing Management

Question: Discuss about the Reading and Journal of Nursing Management. Answer: Introduction The current assignment focuses on the concept of aged care nursing. It is a multispecialty area where individual patient needs or requirements vary. Therefore, the nurses involved in aged care need to develop requisite skills for catering to the patient requirements. This involves developing knowledge regarding the evidence based methods and practices. Additionally, the nursing care policies and regulations are also important in provision of effective care to the patients. In this respect, the education and training of the nursing staff governs the success of the care plans and intervention methods. Additionally, application of the speciality nursing competencies and skills may help in empowering the patients by means of implementing a patient centred approach. Education And Training Required To Move From Novice To Expert In Aged Care Nursing The education and training of the nurses during the transitory phase from novice to expert can be explained with the help of a simple theory. The theory was proposed by Dr. Benner which emphasizes that skills and understanding of a nurse develops over time through sound education and a multitude of experiences. She further suggested that the development of the skills is dependent upon an extension of practical knowledge. The transitions from novice to expert consist of 5 stages as follows – novice, advanced beginner, competent, proficient, expert. In the novice stage one is totally dependent upon the mentor for getting specific set of instructions which would be simply followed by the preceptored nurse. As commented by Phelan & McCormack (2016), the behaviour of an individual is limited and flexible at this stage. On the contrary, at an advanced beginner stage an individual has prior experience in handling similar situations. In competent stage a nurse has already developed 2-3 years of expertise within the same area of nursing care and can handle emergency situations. At this stage the nursing staffs are able to plan their own actions based on abstract and analytical thinking. In the proficient stage a holistic understanding is established to facilitate decision making. As commented by Willetts et al. (2017), at the expert stage a nurse develops intuitive grasp of clinical situations. The training and education needs vary in each stage of nursing care from novice to expert care. In this stage certain features of the task which are the very basic of nursing care are taught to the students such as measuring weight of the patients, temperature and blood pressure monitoring. As commented by Surr et al. (2017), at the novice stage one is unable to use judgement or discretionary powers. In the advanced beginner stage a nurse is able to form effective relationship with the patients and give detailed instructions based on recurrent meaningful patterns learnt in the clinical trial sessions (Lewis et al., 2015). As mentioned by Cashin et al. (2017), the use of therapeutic communication approaches for understanding the needs and requirements of the patients is emphasized at the advance beginner’s stage. In the competent stage, the nurse has developed sufficient ideas to manage clinical risks based on analytical skills. At the competent stage of clinical practice the nurses are made to undergo clinical simulation games to develop their decision making skills which will them in coordinating complex multiple patient needs and demands (Houser, 2016). In the competent stage, the nurse should be consciously made aware of the long term goals and should be able to differentiate between the emergency and later concerns. As mentioned by Willetts et al. (2017), emphasizing upon evidence based practices can help in providing effective care to the patients. For example in dealing aged patients suffering from rheumatoid arthritis, the nurses should be trained upon the implementation and inculcation of light stretches and exercises within the daily care routine of the patients. Maxims are used to guide the nurses at proficient stage and consists of standard code of conduct which is applied within particular scenarios. The proficient performers are taught with the help of case studies, which helps them in developing the required intuitions for analysing a similar clinical situation (Chenoweth et al., 2014). At the expert stage a nurse has developed sufficient clinical judgement and ability. As argued by Cashin et al. (2015), the expert nursing code of practice is holistic in nature rather than procedural. The expert nurses are supposed to show increased control, understanding in dealing with the grievances of the patient. NMBA Standards Of Nursing Related To Aged Care Nursing The Aged care is one of the complex areas of nursing care which requires sufficient skills along with formal education. As commented by Huang et al. (2014), the aged care nurses are required to develop leadership and management skills. The comprehensive aged care underlines ethical and professional understanding of clinical practise which results in improved patient outcome (Willetts et al., 2017). In this respect, the Nursing and Midwifery Board of Australia (NMBA) has stated a number of professional codes of conducts. A few of them have been discussed over here with respect to aged care. The first objective states that the nurses should practice in a safe and competent manner (“Nursing and Midwifery Board of Australia – Endorsement as a nurse practitioner”, 2018). Under this the nurses should not undertake practices which may compromise the safety of the patients, such as while designing the care plans for the aged patient affected with diabetes neuropathy and restricted movement, the nurse should not suggest strenuous exercises to them which may result in serious injuries (“Nursing and Midwifery Board of Australia – Endorsement as a nurse practitioner”, 2018). The second objective states that the nurses should act in accordance with the standards of their profession and broader health system (Meißner & Schnepp, 2014). Under this the nurses can intervene to safeguard the basic good will and interest of the aged people under care. This is particularly true with regards to the patients suffering from dementia, as their reasoning and decision making skills are affected. As per the objective number 4, the nurse should respect the basic dignity, culture, ethnicity, values of the patient. This is particularly true in case of respecting the autonomy and self sufficiency in the patients. A patient with Alzheimer’s may have restricted decision making skills. This could lead to the development of clinical disputes where the practising nurse limits the freedom and autonomy of the patients owing to their safety concerns. This may be a breach of the Mental health capacity act, 2005, as per which the patient should be given sufficient freedom to participate in care planning and decision making. Conclusion Education and training of the nurse forms an important component of patient care. In the present scenario the aspects of aged care have been highlighted as well as the development of a nurse from novice to expert have been highlighted. There are various aspects of education and training provision in nursing care based upon practical experiences, case studies as well as maxims. An individual enters into nursing practice with little or no knowledge and is mostly dependent upon instructions from seniors regarding practice methods or procedures to be applied. However, there is a gradual shifting from novice to expert based upon the application of NMBA standards of nursing. This forms the core of nursing practices enlisting the various regulations of patient care. The implication of the NMBA standards also helps in maintaining the core ethics of nursing care. References Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., … & Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37. Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., … & Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266. Chenoweth, L., Merlyn, T., Jeon, Y. H., Tait, F., & Duffield, C. (2014). Attracting and retaining qualified nurses in aged and dementia care: Outcomes from an Australian study. Journal of Nursing Management, 22(2), 234-247. Houser, J. (2016). Nursing research: Reading, using and creating evidence. Massachusetts :Jones & Bartlett Learning, 256-354. Huang, H. C., Huang, Y. T., Lin, K. C., & Kuo, Y. F. (2014). Risk factors associated with physical restraints in residential aged care facilities: a community?based epidemiological survey in Taiwan. Journal of advanced nursing, 70(1), 130-143. Lewis, A., Wallace, J., Deutsch, A., & King, P. (2015). Improving the oral health of frail and functionally dependent elderly. Australian dental journal, 60(S1), 95-105. Meißner, A., & Schnepp, W. (2014). Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research. BMC medical informatics and decision making, 14(1), 54. Nursing and Midwifery Board of Australia – Endorsement as a nurse practitioner. (2018). Nursingmidwiferyboard.gov.au. Retrieved 13 January 2018, from https://www.nursingmidwiferyboard.gov.au/Registration-Standards/Endorsement-as-a-nurse-practitioner.aspx Phelan, A., & McCormack, B. (2016). Exploring nursing expertise in residential care for older people: a mixed method study. Journal of advanced nursing, 72(10), 2524-2535. Surr, C. A., Gates, C., Irving, D., Oyebode, J., Smith, S. J., Parveen, S., … & Dennison, A. (2017). Effective dementia education and training for the health and social care workforce: a systematic review of the literature. Review of educational research, 87(5), 966-1002. Willetts, G., Aberdeen, S., Hood, K., & Cross, W. (2017). The dynamic role of the graduate nurse in aged care: An Australian experience of delivering an aged care graduate nurse program. Collegian, 24(4), 397-402.

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