Future Roles in Nursing Essay
Future Roles in Nursing Essay
Future Roles in Nursing Paper
As an accelerated Nursing student who will be taking both undergraduate and graduate-level classes over the course of your program, it is expected that you possess solid academic/scholarly writing skills. To demonstrate this proficiency, you are required to write and submit a paper in this course.
Below is a description of this assignment. Future Roles in Nursing Essay
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• Investigate a future role in nursing that is interesting to you. Write a two-three page paper, plus title and reference pages, describing your topic.
• Provide some discussion/analysis/context of why this role is of interest to you.
• Please format paper per APA guidelines for formatting and citation of sources as failure to do so will strongly impact your grade. Papers containing excessive formatting, organizational or grammatical errors will be given an unsatisfactory grade (<73%) and students will be referred to the GWU Academic Writing Center for writing assistance. Proof of a meeting with the Writing Center will allow the student (with an unsatisfactory grade) to earn 5 additional points on the paper grade.
• First-person Point of View (POV) is acceptable as long as the tone is scholarly vs. conversational. Remember to follow grammatical rules for paragraph structure, spelling, and punctuation.
• Include at least three current, peer-reviewed scholarly references FROM THE NURSING LITERATURE in your paper (no older than five years).
• Remember to include a title and reference page per APA guidelines.
• Papers must be submitted in MS-Word format, NOT PDF.
Examples of Nursing specialties are listed below. Pick one of these roles in nursing that interest for your future role in nursing paper.
• Adult Medical Surgical,
• Intensive Care Unit (ICU),
Emergency Department (ED, Operating Room (OR),
• Labor and Delivery,
• Psychiatric Unit,
• Pediatric Medical-Surgical,
• Pediatric Intensive Care Unit (PICU)Future Roles in Nursing Essay
For the purpose of this assignment the author will provide an example of a patient; referring to her as Mrs. A, as the NMC states that we must respect peoples right to confidentiality (Nursing and Midwifery council 2008). Mrs. A is an elderly patient who has recently received a diagnosis of vascular dementia.
Mrs. A is a 65 year old lady that lives with her 68 year old sister. Mrs. A is a widow and has no parents or children of her own, leaving her sister as her only immediate family. Over the last 30 years, Mrs. A co-owns and works in a successful card shop in town with her sister. Ever since she was diagnosed with vascular dementia 3 months ago, Mrs. A begun noticing that her memory was deteriorating and she was beginning to lose interest in activities she had once loved. Because of this, she cut down her hours at the shop from 5 days a week to 6 hours split over 2 days. Mrs A found this particularly difficult as she had worked in that shop for over 30 years. Mrs A was previously a very independent woman and took pride in her independence. Previous to her diagnosis, Mrs. A had a good social life, with friends and colleagues a major focus in her life, but due to her deteriorating memory and mood swings, Mrs. A has found maintaining these fundamental relationships more and more difficult. Mrs. A was referred to a district nurse after her sister brought her into their GP surgery following a first-degree burn to her hand. Mrs. A’s medical history included a long history of hypertension due to 20+ years of being a heavy smoker and one previous Transient ischaemic attacks (TIAs’). Prior to her visit to the GP, Mrs. A had been receiving minimal support regarding her vascular dementia diagnosis as it was considered to be in the “early stages”.Future Roles in Nursing Essay
Dementia is the term used to define a number of symptoms that alter the way the brain functions. These symptoms include, memory loss, problems with communication, compromised reasoning and difficulties with performing day-to-day activities. Dementia affects the way somebody’s mind works, therefore resulting in behaviour which can hinder their ability to live independently and can also affect social relationships (Martin 2006).
Dementia is one of the most common neurological conditions among the elderly in the western world. It is estimated that in the UK alone, there are 820,000 people living with a diagnosis of dementia, with the average age of onset being over the age of 65years. However, it can also develop in younger people where it is known as young – onset dementia (Alzheimer’s Research Trust, 2010).Future Roles in Nursing Essay
The type of dementia that will be discussed in this assignment is vascular dementia. Researchers have found that vascular dementia is the second most common form of dementia after Alzheimer’s disease, accounting for 20 to 30 per cent of cases. Vascular dementia is defined as a “disease with a cognitive impairment resulting from cerebrovascular disease and ischemic or haemorrhagic brain injury” (Nazarko 2011). According to the Department of Health (2009), vascular dementia is the term used to describe a number of symptoms that lead to a progressive decline in cognitive and memory function.Future Roles in Nursing Essay
The brain requires a sufficient amount of blood in order for it to function properly (Beart 2007). Vascular dementia develops when the blood supply that transports oxygen and nutrients to the brain is “damaged by a blocked or diseased vascular system” (Salma 2008). This damage happens when cells die due to the fact that the blood no longer has the ability to reach the brain cells proficiently. If there is an interference of the blood supply to the brain, for even the shortest period of time, the distinctive functioning of the cortex – (which is the site in the brain responsible for language, memory and learning) will be impaired. (Thomas 2001). The effects and the speed of progression in vascular dementia vary from one individual to the next. Usually, symptoms associated with vascular dementia begin suddenly, for example after a stroke. Vascular dementia is dissimilar to other forms of dementia due to the fact that it “often follows a stepped progression”, with symptoms remaining the same for a certain period of time and then gradually getting worse (Ouldred 2010). According to Stacpole (2011), the following symptoms are typically linked to vascular dementia: visual mistakes and misperceptions, seizure, periods of acute confusion, problems with continence and psychological symptoms such as apathy. A number of medical professionals prefer the term “vascular cognitive impairment (VCI)” to vascular dementia because it is more precise in explaining the fact that vascular thinking changes can range from mild to severe. (Bamford 2010) .Future Roles in Nursing Essay
The two main types of vascular dementia are multi-infarct dementia and subcortical dementia. Subcortical VaD occurs due to small vessel disease “causing lesions in the deep white matter of the brain and where the cortex of the brain is usually well preserved”. Multi-infarct dementia (MID) is the most common type of vascular dementia. MID is caused by a series of “mini-strokes” – also known as Transient Ischaemic attacks (TIA’s). (McKeith 2005).
TIA’s are known to occur when the blood flow to a particular part of the brain stops for a brief period of time. Transient ischaemic attacks are caused by a temporary loss of blood flow (ischemia) to the brain as well as momentary impairments of consciousness or sight; TIAs share the same underlying aetiology as strokes: a disruption of cerebral blood flow but without actually causing any acute tissue death like that found in a stroke. (Bamford et al. 2004).Future Roles in Nursing Essay
A single transient attack or stroke episode does not necessarily mean the individual will go on to develop vascular dementia. However, if the individual has or has had more than one stroke, transient ischemic attack, or has been diagnosed with small vessel disease, then they may have an increased risk of developing vascular dementia. (Bryans et al 2003).
Risk factors of vascular dementia may include hypertension, atrial fibrillation, hypercholesterolemia, smoking and diabetes (Jolley 2009).Future Roles in Nursing Essay
Although vascular dementia is one of the most common neurological conditions among the elderly in the western world, the exact cause still remains unclear. Vascular dementia is a disorder that cannot be reversed, the progression of the disorder, can however be slowed. Using drugs, along with lifestyle changes to prevent more strokes from occurring, can be an effective way of slowing the progression of vascular dementia. (Knapp and Prince; 2007).
The symptoms of vascular dementia are individual to each person, thus highlighting the necessity for holistic nursing assessment, care and management. These symptoms can vary from; loss of memory; poor judgment and reasoning; apathy, confusion and mood disturbances. (Judd et al; 2004).Future Roles in Nursing Essay
There are major impacts on the person due to vascular dementia; because vascular dementia cannot be cured, it is considered a long-term neurological condition in which the person and family have to come to terms with the initial diagnosis, which can be devastating. Living with a long-term condition has a significant impact on a person’s quality of life and poses particular challenges for the individuals’ family members and health-care providers. (Carers UK 2007).
With regards to Mrs. A, the district nurse that took over her care found that the diagnosis of vascular dementia had caused her to feel as though she had no sense of self-worth, her self-identity had been taken away from her and from here on out there would need to be major lifestyle changes that Mrs. A, her sister and friends would need to adhere to. Therefore in order for Mrs. A to achieve levels of recovery; and to live well in the presence or absence of her symptoms; the nurse had to provide a major supportive role in the care of the lady with vascular dementia throughout this process to optimise her and her families’ quality of life. (Keady 2004).Future Roles in Nursing Essay
Dementia is a life changing diagnosis, and the person and family should be supported as holistically as possible by the nurse and healthcare providers at the time of diagnosis. (Barber and Murphy 2011 ). Mrs. As’ sister and close friends found it very difficult to accept this life changing diagnosis especially in regards to her sister, as it proved to cause significant changes in their relationship; research shows the role of “informal carer” is rarely chosen, but thrust upon family members such as Mrs. A’s sister as a consequence of incapacitating illness. (NICE 2006). However due to the bond between the two sisters, they managed to adapt with the support of the nurse and the healthcare team, and eventually came to terms with the altered circumstances. This lady and her family were supported in this transition by a referral to relevant agencies for counselling and other suitable support services.Future Roles in Nursing Essay
This was useful for Mrs. A’s sister as she was not experienced in regular caring duties, and was used to her sister being a strong independent and self-reliant woman. The nurse in charge of Mrs. A’s care recognised this and saw that the sister required guidance and education to provide this care, which in turn assisted in reducing any stressors for Mrs. A and her sister, as well as a care of package being put in place for Mrs. A. (Nain 2006). If they both had not been supported at an early stage, and not been provided with the access to information and support, there could have been consequences of ill health, and stress for Mrs. A’s sister, as well as generating more ill health for Mrs. A herself (Pews 2005).Future Roles in Nursing Essay
The nurse also made a referral to local support groups so that Mrs. A’s sister could have other people who were going through the same feelings and changes in their lives to talk to. These groups aim to support people living with dementia and those who care for them. By referring her to these support groups, the nurse aided in helping Mrs. A’s sister to maintain some form of independence and time away from her caring duties , as recent research shows that family members tend to neglect their own social life and health, once they become carers (Beart 2008). The nurse worked closely and monitored the lady with vascular dementia, and her family to provide a support network, and treat them holistically, thus encouraging an optimum environment for the acceptance of the diagnosis (Roy and Gillespie 2011).Future Roles in Nursing Essay
There were also financial implications on the family, because of loss of earnings due to changes in the Mrs. A’s health. Her sister had to reduce her hours working in their shop dramatically, in order to become a part-time carer. The nurse was supportive, as this had a major impact on the family as the sister begun to have bouts of anxiety and stress within this period of change. The nurse assisted in these matters by referring them to the social work department for advice and guidance on welfare benefits and financial matters; this was a great relief for the two sisters and reduced the amount of financial pressure brought by the dementia diagnosis (Manthorpe and Iliffe 2007).Future Roles in Nursing Essay
Mrs. A was given a clear and concise explanation of vascular dementia, enabling her to preserve some independence and empower her to make informed decisions concerning her care, where possible. By providing her with access to relevant information, both at the time of diagnosis and throughout the course of the disease, Mrs. A and her family (/friends) felt as though they were understood and valued, this in turn significantly improved the quality of life for Mrs. A, throughout providing her choices regarding her own care (Pinner and Bouman, 2003).Future Roles in Nursing Essay
In order to provide Mrs. A with optimum care the nurse observed that providing continuity of care would be of great benefit to her. Continuity of care provides a patient with a level of trust and understanding, as well as reduction of medical errors and negligence (Freemon et al; 2003). Mrs. A found that, having different nurses/ carers and other health care professionals coming in and out extremely distressing, in the community setting. Seeing the same doctor, nurse or carer on each visit can increase patient satisfaction, but however in reality in any clinical practice or area, any nurse or healthcare practitioner will find that this may not be feasible at all times and prove to be very challenging. This may be due to a number of reasons such as staffing levels, sickness or holidays (Hope 2009). The nurse in charge of Mrs. A’s care assisted in the continuity of care to the best of her ability, by effective case management of the lady and delegating the caseload effectively, and optimum communication with the nurses, social work and family (Benison 2009).Future Roles in Nursing Essay
Once the nurse had overcome the challenges of diagnosis and continuity of Mrs. A’s care, the nurse begun to notice that at each visit Mrs. A seemed uninterested in anything that was being said or that was happening around her. When the nurse had raised these concerns to her sister and received confirmation that in-fact Mrs. A had lost interest in most things over the last few weeks; the nurse observed this symptom as apathy in vascular dementia.Future Roles in Nursing Essay
Some of the ways that the nurse treated apathy in vascular dementia was to actively involve Mrs.A, her family, and carers in the treatment process; this helped to lessen the misconception of lack of interest in any activities proposed to Mrs. A. The nurse also made the decision to educate Mrs. A’s family and carer’s about apathy; this helped them understand that apathy is not just “laziness” s or Mrs. A being difficult, but that the symptom was in fact a part of vascular dementia (Levy et al; 1998). The nurse also ensured that other factors that would influence apathy such as; pain, insufficient sleep, disrupted sleep patterns, and fatigue were managed effectively through the use of appropriate medication and/or therapy. (Braine 2010).Future Roles in Nursing Essay
In conclusion, this essay has provided an insight into the aetiology and pathophysiology of vascular dementia, and has defined the two main types of vascular dementia, as well as explaining how vascular dementia is a neurodegenerative diseases that unlike most forms of dementia, follows a stepped progression, with symptoms remaining the same for a certain period of time and then gradually deteriorating. This essay also shows that vascular dementia, can be a devastating and overwhelming experience, to the individual and their family, and how it impacts the quality of life for the family, and not just the individual with vascular dementia. Examples on what type of implications having a “carer” role thrust upon a family member, has on the family member’s self-worth and self-identity are also discussed by the author. This essay highlights the importance of caring and supporting the family, and not just the individual, as a whole, and explains how this can be an incessant challenge.Future Roles in Nursing Essay
One recommendation for future nursing practice is for all dementia training/ education to be implicated universally; this training should not be limited to solely mental health nurses as dementia is becoming more prevalent in the western world. This education/ training should convey an emphasis on the importance for the nurse to have tangible interpersonal skills, constantly incorporating compassion during challenging times such as; throughout diagnosis, providing continuity of care and throughout the numerous signs and symptoms vascular dementia presents. The nurse should promote patient and family empowerment and act as an advocate for them both as the NMC code (2009) states that nurses have a great responsibility and a duty of care; In the course of learning all the above skills, nurses should be taught that providing care to an individual with dementia is very different from giving personal care to an elderly person who has all their cognition and understands what you are trying to say or do. Future Roles in Nursing Essay The intersection of dementia makes even the simplest task a challenge. Dementia care is not just “personal/social care” only; or attending to hygiene and feeding requirements. Because in reality it is not comfort but growth that makes life worth living and people with dementia have the ability to grow too, given the right care and conditions. Therefore, one of the main focuses in dementia care should be to promote an enhanced quality of life for the individual with dementia.Future Roles in Nursing Essay
In attempting to analyze the myriad changes expected over the next fifteen years, an explicit review of the numerous variable and dynamics of time are essential and crucial. This will provide an ideal platform for drawing a practical, accurate and clear inference on what is actually expected. Variables such as dependent, independent and interdependent must be quantified it the outcome is to be reliable. Essentially, I intend to reflect on the changes that have been witnessed in the healthcare sector aimed at quality assurance and reduced costs. Some of the direct steps include downsizing, rightsizing, restructuring, and re-engineering which were widely incorporated in the health sector. Research suggests that over the last decade, system reforms have concentrated on structuring and restructuring. For instance, the Sinclair restructuring commission and Community Care Action Centre have been restructured to accommodate the ever-increasing population. In addition, at the community level, consumer expectations and knowledge have experienced metamorphosis following the improved technological know how, which eventually has outpaced social morals, values and norms. In the early 90s, Registered Nurses Association of Ontario pushed for revised educational qualifications, specialization, and professionalism code of conduct, professional rights and personnel adequacy within the nursing profession. In essence, this research paper aims to highlight the changes or developments expected in the nursing practice in the next fifteen years. Some of the changes are associated with nursing specialties to be introduced, culture and practical nursing profession, and suitability of community health care on the elderly.Future Roles in Nursing Essay
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CHANGES EXPECTED IN THE NURSING PROFESSION
In the next decade, the provision of healthcare services will be dictated by economic efficiency majorly due to the ever-changing economic condition. Though predicted by the Canadian Nurses Association back in 1981, changes in the practice of nursing will be necessitated by the persistent need for efficient and affordable but quality healthcare services (Kalisch, 2004). In response to such demands, the nursing profession will opt for optimal specialized utilization of the healthcare personnel by developing competitive new entry points into the healthcare system. In the next ten years or more, greater changes are expected in provision of healthcare from the expensive treatment procedure to long-term campaigns promoting preventive approaches and healthy living (American Nurses Association, 2001).Future Roles in Nursing Essay
Additionally, as the world experiences technological transformation, communication and health provision facilities are also improving. Equipments used by the nursing personnel are also being revolutionized. These modifications or developments in the materials and nursing equipments are expected to simplify and efficiently boost the practice of nursing. Besides, the advancements in communication and management systems are expected to completely change nursing human resources issues, work environment quality, information and services access, therefore, improving care delivery efficiency (Chikky& Black, 2007).
Presently, a considerable number of the patients in various health facilities exhibit disgust, hostility and disillusionment, especially about the services that they receive. As a result, many nurses constantly complain of dissatisfaction and burnout, which directly affect the quality of services that they give the patients. It is very clear that the affected nurses have been active in open forums incorporating and advancing the views of their colleagues with the aim of finding a solution to these persistent challenges.Future Roles in Nursing Essay There is no doubt that the solution to these challenges lie deeply in the provision of holistic nursing care (Kalisch, 2004). Though still underdeveloped, this approach may yield positive results in the next fifteen years as it incorporates the provision of psychological and physical care to patients rather than managing a particular condition or disease. Consequently, cases of burnout and frustrations will be minimized, as the nursing personnel will be equipped with the holistic nursing skills necessary for giving optimal care comfort to their patients (Hayakawa, Ogasawara & Katz, 2007).
The current healthcare industry is experiencing various issues and challenges such as staff or personnel shortage, operational deficits and credentialing. Even though the prospects for future of nursing may be unclear, current proposals of the Health Care Scheme may yield positive results. By increasing the number of nurses, the risks and workload on nursing care will be minimized to a manageable level (Mahaffey, 2004). Coupled with the possible specialization criteria, definite care provision will guarantee quality assurance. As the role of nurses is transformed from actual caring for the patient to coordinating care provision with families of the patient, more time will be allocated to serious care cases rather than the minor cases, which can be handled by family members in a home care setting (Chikky & Black, 2007). As care provision complexity reduces, nurses will only have to educate the patient’s family members on the basics of healthcare and save time on non-nursing roles.Future Roles in Nursing Essay
EXPECTED NURSING SPECIALTIES IN THE NEXT DECADE
Nursing education has no limits. Certified nursing is critical in maintaining high quality of healthcare provision to clients. To improve quality of care, specialization is necessary. In the next decade, Holistic Nursing will be a necessity in understanding the physical and psychological care for clients. Rather than just concentrating on the ailment care, the attention is also given to psychological and social interfaces of condition of a client (Hayakawa, Ogasawara & Katz, 2007). Further, Domestic Animals Nursing care specialty will certainly surface due to the current influx of pet diseases and ailments. This group of nurses will concentrate on the provision of home care education to pet owners and care to be applied on a sick pet and post treatment recovery program. In addition, due to the prevalent rates of cancer infections, nursing specialty in Cancer Care Nursing “Oncology Nursing” will surface to help in the management of many patients who have been diagnosed with cancerous ailments (Chikky & Black, 2007). As specialization is made necessary, the above specialties will only deal with the care for these ailments, which are very common in different communities.Future Roles in Nursing Essay
CULTURALLY RELEVANT HEALTHCARE
There is no doubt that practicing as a nurse in the town of San Antonio, Texas, it is crucial and important for one to understand the culture of the Hispanic population who are the majority residence in order to give culturally relevant care. Hispanics are very sensitive on issues related to moral values, tradition, Spanish language, and religion. To understand this community, serious commitment to multiplicity on language issues is very necessary. To avoid or avert the chances of language barrier, this group requires additional interpretation services for clarity (Chikky & Black, 2007). In addition, since this group forms the minority clique in America, they tend to share strong community bonds on inter and intra personality interactions. To win their trust, it is vital to develop culture specific informal and formal networks as a means of balancing sensitivity and culture in the provision of healthcare services. Besides, this community consists of a large number of those who dropped out of schools and colleges. Therefore, apart from the verbal communication, non-verbal communication strategies such as gestures, demonstration, symbolism, written translations and pictures may be vitally important (American Nurses Association, 2001).Future Roles in Nursing Essay
REFORM ON COMMUNITY HEALTHCARE TO FIT THE OLDER CLIENTS
In order to satisfy the healthcare needs of the elderly, the community healthcare system will have to be transformed to be in line with the special needs of this particular group. To begin with, this group requires interpretation and refined non-verbal communication tools. Besides, they are sensitive to care issues surrounding culture, norms and religion. Consequently, the community healthcare system should be restructured to accommodate the behavioral aspects related to tradition, especially on dieting (American Nurses Association, 2001). The objective is to increase the choices available for adequate and optimal care. However, fear and lack of experience are serious barriers to properly handling older clients. To reverse this, the community healthcare system should foster creativity and proper adult care training to equip the nurses with these special skills unique to old clients. In fact, to achieve this, mobile technology should be applied to provide culturally and timely information on health to old in their homes (Chikky & Black, 2007).Future Roles in Nursing Essay
In my work place, at a nursing and rehabilitation facility in San Antonio, Texas, majority of my fellow staff members are Hispanic and Black Americans. In fact, only thirteen white and non-Hispanic people form part of the entire personnel. Therefore, being part of the thirteen, we form the minority group. San Antonio is widely dominated by the Hispanic population and this is reflected in the fact that many of my co-workers speak English with the Latin ascent. Nearly fifty five percent of all the staff is of Latin origin, thirty percent black Americans and the rest white non- Hispanic. The Hispanics are very social but conservative on the topics or issues of culture, norms and religious view. Intrestingly, nearly all of them are Catholics. On the other hand, the black Americans prefer unique communication technique comprising of coded language sounding explicit on the first impressing. Due to minority issue, the white non-Hispanic nurses have learnt to co-exist with others in an interactive and open manner (Mahaffey, 2004).Future Roles in Nursing Essay
In sum, to realize the much-needed reforms in the provision of healthcare, meaningful application of modern technology, technical assistance, and awareness campaigns are necessary and crucial. Besides, cultural relevance and knowledge encourages quality service provision. Moreover, structural reforms, specialization, holistic nursing, partnerships with players in the care provision are essential in transforming nursing career into a noble profession. Future Roles in Nursing Essay
