As a nurse, one must follow a scope of practice, what is expected of them within their role of the nursing profession. These guidelines shape the responsibility of the professional nursing organization and serve to protect the public. According to, Nursing’s Social Policy Statement: The Essence of the Profession (American Nurses Association, 2010, p. ) defines contemporary nursing: “Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. ” I believe my role, as a nurse is consistent with the scope of practice outlined by ANA and the contemporary definition cited. As a nurse, I strive to be clinically competent and aware of the constant challenges that one faces on a daily basis.
Being well informed promotes health and prevents further illness and injuries. One goal I try to set aside every week is to attend a weekly ground rounds meeting, where additional education is provided on a specific case study. This opportunity allows me to stay current and up to date on new medications available, research findings and team collaboration feedback from staff on effective treatment options for optimal patient outcome.
In addition, completing required competencies and being a member of Oncology Nursing Society also strengthens my knowledge and skill in providing the best evidence based practice to an individual and their families. Being a resource nurse for my unit allows me the opportunity to share my knowledge with the staff and actively participate in mentoring young nurses build a strong foundation and develop critical thinking skills. Education is critical in the nursing profession. Lifelong learning must be an ongoing process due to the rapidly growing population and technology advancements in our society today.
I believe it is the responsibility of the nurse to facilitate this process and collaborate with other nurses in their field to continue to work together to strengthen the role of the nurse in an environment that requires continuous education and competencies. “Registered nurses must continually reassess their competencies and identify needs for additional knowledge, skills, personal growth, and integrative learning experiences” (American Nurses Association, 2010 p. 13). State legal regulations and professional standards of nursing The Ohio Board of Nursing defines nursing and the scope of nursing practice.
Rules and regulations are in place to determine compliance set in motion by the Nurse Practice Act. Responsibility is outlined by establishing standards for nursing education programs, eligibility to sit for the state licensure exam, renewal criteria of that license, and setting standards for continuing education to meet renewal criteria. The Board is also responsible for defining the standards of delivering safe nursing care for registered nurses and protecting the community with these standards.
Another role the Board is responsible for is reviewing and investigating violations of this Nurse Practice Act and determining if a nurses license is to be denied, revoked, suspended, or restricted in any way (Ohio Nurses Association). It is essential that nurses maintain an understanding of the legal regulations within their nursing practice. The Ohio Board of Nursing requires all Ohio nurses to have continuing education on Ohio law with a total of 24 continuing education hours every two years for license renewal (Ohio Board of Nursing).
As a professional, I feel it is my primary responsibility to understand the law and regulations defined before me, this knowledge allows me to safely practice nursing care and deliver the best care to my community. I have worked in other states as well, and of those states I have worked, Ohio is the only one requiring a continuing education credit with a focus on state law and regulations. I feel every state should have continuing education credit requirements for renewal and at least one of the required credits have a focus on law. It is important as a professional to have knowledge of this.
To have a check and balance system in place to make sure one is justly maintaining these standards and expectations in delivering a safe competent nurse to our community is vital to the population as a whole. Provisions 7, 8 and 9 “Provision 8 describes the nurse’s moral obligation to society. Provision 9 describes the responsibilities of the nursing profession to both the individual nurse and society in general. Provision 7 provides the necessary linkage between individual competence and evolving professional standards of practice, in addition to giving nurses a responsive and collaborative role n health policy for the overall advancement of the profession” (Fowler & Association, 2010, p. 91).
Initially, these Provisions were never intended to be carved out of stone, but historically, they have been a guide and continue to be a guiding force of moral and ethical standards to follow. I pride myself on working for a hospital that fosters an environment on ethical integrity and professionalism. Because of this strong thread, it motivates me to do more, achieve more, and be more than I am today. I want my patients and my community to feel that they are receiving the best nursing care.
An example I recently explored was implementing a grid to follow based on patient’s diagnosis and treatment pathway prior to admission to the floor. I work in the hospital’s rapid admissions unit. My goal is to have the patient to their room in 30 minutes or less. Of recent, we have received a lot of admissions for pancreatitis, however, I have noticed that the patient arrives to my unit without pain management options, i. e. PCA pump. This has delayed the patient’s comfort and care prior to arrival to HRAU leaving me scrambling to get pain orders, equipment and recover any customer service issues.
This grid allows a framework to use as a guide of anticipated orders and outcomes. I presented this grid to my nursing manager, our staff and the ER manager and charge nurses for their collaborative input and suggestions. So far it has been effective, and we are working on additional areas to cover as well. Nursing is continually evolving and as a professional it is our job to facilitate education within our community of nurses so we can better serve our patient population. Philosophical forces influencing practice
Philosophy is an attitude toward life and that attitude evolves from every nurses belief system. One’s attitudes are shaped by their environment and an accumulation of life experiences, I define nursing as a way to give back. Giving good nursing care doesn’t stop at being knowledgeable about medicine and having the very best in technology. It goes beyond, by reaching that individual on a spiritual level and connecting with them. I have always believed that one cannot be taught how to show compassion, an individual either possesses that ability or they do not.
I have always believed that that is one of my strongest qualities, and this has been reconfirmed back to me by my patients through the years. To truly interact with a person you need to gain their trust, once that has been achieved through a therapeutic environment, healing is then possible. Ethical principles influencing practice There are standards in place to dictate the need to protect patient’s values, beliefs, culture and safety. It is difficult at times, when dealing with challenging patients and having to handle the stress of our jobs to remain open and unbiased.
It is nice to have a reminder that our patient’s values come first and respect their choices. Our role is to educate them about their treatment plan and make sure they are well informed, while letting go of our own attitudes. Determining, nursing practice are essential for dealing with day-to-day ethical issues (Jormsri, Kunaviktikul, Ketefian & Chaowalit, 2005). I recently had an Asian woman who presented with abdominal pain and requested to have cupping performed by a healer specialized in the field. I was initially at a loss, how was I going to find someone to perform cupping.
I wanted to help this woman and when I asked my colleagues and manager they had no suggestions. So I contacted the department that handles cultural awareness and was able to get a lead on whom to call. After, two hours of my day spent looking for someone to call, I finally had my answer. I came back to give my patient an update on the progress and she was so relieved. It was like you could see the anxiety drain out of her. By the end of the day, the therapist arrived to do cupping with her and she was relaxed and expressed that she truly felt like I heard her.
It was not easy and I did find myself getting frustrated with the process of trying to make something work that I knew very little about. I’m happy I followed through with it, because in the end every patient has a right to believe what they believe, even though her values and attitude toward medicine is very different than my own, I was able to put aside my own views and attitude and really help someone else. Conclusion Many might say nursing is a science and some might say nursing is an art.
I believe it is both. To be a successful nurse one must have the passion to continue their education and apply their knowledge through the science of nursing, and have the efficacy and compassion to provide the art of caring. Without caring the nurse is unable to connect with the patient and if the nurse cannot connect, trust will not develop between the nurse and the patient. I have always believed nursing is a calling and it is one of the most challenging jobs to have, but by far it has been the most rewarding.
At first glance, there may seem to be little difference between registered nurses, or RNs, and licensed practical nurses, or LPNs. Both administer medications, change dressings or insert catheters. Either may work in a hospital, clinic or doctors’ office. However, there are significant differences related to critical thinking skills, care planning, nursing scope of practice, education and overall responsibilities. RNs are independent in many areas, while LPNs -- also known as licensed vocational nurses -- must work under the supervision of an RN or physician and cannot practice independently.
Scope of Practice
Scope of practice defines the specific tasks a nurse is allowed to perform in a given state. Each state has a board of nursing; some states combine RNs and LPNs in the same board, while others have two separate boards. The board determines which tasks fall under the RN license and which can be performed by an LPN. The RN scope generally includes more complex and potentially dangerous tasks, such as titrating or adjusting a dose of medication based on a patient’s condition; invasive procedures, such as inserting a central venous catheter; or giving intravenous chemotherapy.
The nursing process consists of four steps: assessment, planning, implementation and evaluation. The LPN has a limited role in each of those steps but cannot perform any of them completely or independently. The RN generally performs the initial physical assessment of a newly admitted patient and may also perform a daily assessment. An LPN might take the patient’s blood pressure and pulse, but she would report her findings to the RN, who would determine how those readings fit into the clinical picture for the individual patient and whether any changes should be made to the plan of care.
The Care Plan
Implementation of the care plan includes performing the daily care of the patient. For example, the RN would determine that the patient will benefit from walking at least three times a day and include that as an intervention on the care plan, while the LPN would actually help the patient walk. At the end of each shift, the RN evaluates the patient’s progress toward specific goals that will promote recovery and adjusts the plan as necessary, depending on the patient’s progress.
Only RNs can develop the care plan and make changes, although LPNs can contribute suggestions. Care planning and evaluation require critical thinking skills, including the ability to analyze information, consider underlying medical conditions and integrate that information into the overall picture of the patient’s health status. All of these skills are taught in nursing school but are not included in the LPN curriculum, which is focused on bedside tasks. The RN must always see the big picture for each patient.
About the Author
Beth Greenwood is an RN and has been a writer since 2010. She specializes in medical and health topics, as well as career articles about health care professions. Greenwood holds an Associate of Science in nursing from Shasta College.
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