Task 1
Article 1
This 5-page article is titled “Nursing Knowledge: Defining New Boundaries.” It first discussed four types of nursing knowledge, namely aesthetic knowledge, empirical knowledge, personal knowledge, and ethical knowledge. These types of nursing knowledge are generated through research in the nursing field through such approaches as quantitative and qualitative research. The paradigms or methods that are used to generate nursing knowledge include (a) scientific knowledge/positivism, reductionism, and (b) philosophical or naturalistic enquiry. Performing research and doing it into practice are not enough. There must be critiquing of the research before it can be trusted and considered reliable. However, the generation of knowledge has become more complex. There has been an increasing emphasis on postmodernism, shifting away from the usual modernism. The reason for this shift is said to be due to the increasing complexity of scientific methodologies coupled with the nurses’ lack of ability to express scientific knowledge in any other way aside from complex research methodologies.
Thus the nurse has to go farther than understanding nursing in the traditional way in order to redefine nursing knowledge. Those with power are the ones who decide what and which information counts as knowledge. This includes funding bodies. However, using science through research is not sufficient to generate the needed nursing knowledge. The practical application of science has its own boundaries and sometimes even has its own failure in promoting effective practice. On its own, science cannot solve all the problems that the nursing profession faces. Nursing therefore needs to be the one to describe their own perspective and their own idea of what constitutes knowledge. In practice, the nurse only uses technological hardware and scientific knowledge as simply tools which they combine with the element of nursing, interpersonal skills, and manual dexterity so as to create it into what is called nursing. Nurses need to look for new ways by which nursing knowledge can be generated.
This article concluded that a postmodern identity is needed for nursing in order to be able to come up with new knowledge that will enhance the nursing practice. Nursing knowledge is considered evolving and thus whatever improves or updates nursing practice can be justifiably identified as a unique body of knowledge for nursing.
Article 2
“Deconstructing Nursing: From Theory to Practice” is the title of this second article. In this article, it has been emphasized that many people think nursing is an easy profession. But what we see and know of the nursing profession is just the tip of the iceberg. In this article, three nurses were asked about their observations of other nurses and of the nursing profession as a whole. These three nurses are Stephen Wright, David Benton, and Dame June Clark.
Stephen Wright is a professor and in this article is observing Kerri Tweddle, an E grade staff nurse. According to Wright, Kerri is fully attentive, tuned in, and focused. Kerri is acting out her nursing duties in an effortless manner. She does the right things as a result of experience and knowledge about the nursing profession. She is able to make the right decisions on situations at a speed that would sometimes leave people wondering how she did that. This ability is not out of accident or chance but rather because of education and training as a nurse. In Kerri’s case, there is an integration of skill and knowledge which in turn transforms the work at hand from a limited task to a complicated craft which is being dealt upon in a very effortless manner.
The next nurse observer, David Benton, is a nurse director and observed a theatre staff nurse named Janet Mitchell. Janet’s case shows an understanding and awareness into the complicated nature of the specialist area and how education is able to support nursing practice, where breaks in education lie, and how they might be acted upon. Theatre nursing practice involves the use of intense, complex, and sophisticated knowledge and skills by the practitioners.
Dame June Clark is a former RCN president and emeritus professor of nursing; she spent one day observing a district nurse. Her observations focus more on a nurse’s autonomy to do what he or she thinks best for the patient. For a nurse, the decision has to be made hastily or else the life of the patient would be the one in danger. District nurses face this issue of autonomy day to day which could be scary, considering that the life of the patient all but rests on the decision of the nurse. If the nurse is not able to make the right decision, chances are that the patients as well as other health care professionals will lose trust in her and that would be a very hard thing to build up once again.
Task 2
The article is titled “Nursing in Hong Kong: Issues and Challenges” by . Nursing as a science means that it is a body of knowledge systematically organized, and like all bodies of knowledge is dynamic and subject to change. New perspectives in health and illness appear. Nursing as an art pertains to the aspects of knowing in nursing that are not discovered by scientific investigation. Nursing is thus considered as both a science and an art.
The purpose of this article is to provide a discussion on the challenges and issues that are being faced by nurses and the whole nursing profession in Hong Kong. Nurses face a continuing variety of dilemmas which involves clients, family members of the client, health care professionals, and other nurses. every one of the situations that nurses face pose new experiences and problems involving the care of the client, the variety of approaches to decide and settle problems, and different outcomes as to whether approaches provide significant achievements. Four specific issues that were tackled in the article are workforce issues, educational issues, practice issues, and leadership issues.
Workforce issues focus specifically on the changing roles of the nurses, as well as the need for a nursing workforce that possess competence to be able to deliver the best possible quality of care for the patient. Self awareness and personal growth of practicing nurses’ are considered the basic building blocks for their assurance as a nurse. By way of this improvement, nurses learn to inquire and develop proficiency regarding situations that they encounter during their work. To help solve the problem in Hong Kong, an option would be to allow Hong Kong nurses to work with international nurses. Through this way, the nurses are exposed to new ways of working and as a result would expand the nurses’ personal growth, experience, and knowledge. Working with nurses from other countries can also help in client care issues or ethical considerations, which are often embedded in various cultures (2003). Nursing shortage is another problem faced by the nursing population in Hong Kong. With this shortage, delegation of tasks became affected and even the quality of care can show negative effects.
Nursing practice can now be found in multiple care settings, including health care institutions and foundations, the community, and the home. In addition, nurses are active in political and lobbying groups, social and not-for-profit agencies, and work on establishing social health care policies. These activities increase nursing’s public viability and, at the same time, increase the public’s awareness of professional nursing (2004). These multiple roles can create more workforce issues in the field of nursing.
Educational issues about nursing in Hong Kong include schools being too theoretical, use of research and continuing education. Reflective and lifelong learning are two very important aspects of professional nursing practice ( 2003). As a nurse, it helps to think back on a client situation, to make sense of the experience, and to therefore gain insight as to the meaning of the situation that the nurse has been in. With reflection, the nurse seeks to understand the relationships between concepts.
Time deficiencies are a reason as to why some nurses are not able to continually learn, and is referred as a common reason for not executing or retrieving clinical supervision ( 1999). The nurses are often expected to study and enrich their learning at their own pace and time. This is in contradiction to the encouragement that organizations must be a learning institution. However, given the many tasks that are being delegated to the nurses, they are not able to study on their own. Additionally, because there is no funding that is allocated to this, the problem is compounded on how such lifelong learning can be promoted and implemented in a system that lacks both staff and funds ( 2003).
Assessing and adapting educational information and approaches to the needs and preferences of the health care support workers enhances the success of educational efforts. Not all individuals are comfortable in class settings or in support groups. Educational programs that use these methods should have other educational opportunities available to the health care support workers that needed to be educated. Nurses must at all time also remain creative and responsive to other health care workers when providing education.
When it comes to practice issues, each clinical situation that nurses face everyday requires thorough decision-making and critical analysis in order to provide correct and logical clinical decisions and plans to be developed for each client.
It could be argued that critical thinking is indeed an essential part of the nursing profession. It is not enough that a nurse has abstract knowledge; he or she also has to develop the intellectual capacity to contextualize and to adjust what he/she knows in particular cases. Every clinical experience becomes a lesson which will serve as a guide and information for the nurse.
Nurses are responsible for making accurate and appropriate clinical decisions. Critical thinking is very important as no two clients have the same needs. The nurse after assessment and diagnosis has to employ critical thinking skills for a client’s particular condition.
A nurse is always challenged to observe each of his or her clients closely, search for and examine ideas and judgments about the problems that the clients face. Additionally the nurse has to consider scientific principles that he/she have learned and relate this to the clients’ problem, recognize the problems, and develop the right approach to nursing care as appropriate to the situation and problem of the client. Nurses must not make snap judgments just by their intuition alone when at practice. This could jeopardize the client’s situation and perhaps affect the nursing quality of care for the patient.
There are also other issues that nurses face in their clinical practice. This includes differences in the client’s culture, structure of the health care system, and even the growing shortage of nurses can affect clinical practice of the nurses.
Hong Kong nurses face the issue of the need for strong visible leadership. Effective leadership style is a significant aspect of the creation of an environment that promotes the holistic development of nurses. (1997) defines leadership as “a process of social influence in which one person is able to enlist the aid and support of others in the accomplishment of a common task.”
Leadership and planning are two very important points when providing quality care to the clients. Nurse leaders must create a work culture that supports continuous quality improvement beliefs and practice in the nursing profession. in nursing care areas, home care sections, or clinics, a nurse manager who serves as the leader is responsible for supporting a program. The individual staff are also responsible for monitoring practice, making decisions about ways to improve practice, and evaluating results. This mirrors the definition above that leadership is a collaborative activity ( 1997).
On the other hand, individuals who help the nurses can also restrict practice and provide a form of control over nurses. It is plausible to infer from this that power is being exerted over nurses and by nurses in many situations. Thus representation has now become a key issue for the status and future of the nursing profession.
The article also points out that the Hong Kong population deserves the best quality nurses and nursing care. However, this is not easily done. The issues that have been mentioned here in the article have to be resolved first if the nursing profession as well as Hong Kong’s health care system is to advance. To achieve this, collaboration among key stakeholders is needed.
Credit:ivythesis.typepad.com
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