Recent Trends in Nursing Care Essay

Introduction The discipline of nursing has witnessed several innovations and advancements in the last couple of decades that have greatly improved on the nurse efficacy and efficiency. Simpson (2000) for instance, argued that the last 25years have seen abundant and numerous positive innovations. The author attributed some of these advances to nursing advocacy, which for example has contributed to the introduction of such innovation as single room maternity care, and especially for this purpose, family centered care for clients and their families. Corroborating this stance, Schoot et al (2006) post that away from the â€Å"technologically-driven, prescriptive, and outcomes-oriented approach aimed at solving people’s health problems† (Jonsdottir et al, 2004 p.241), recent trend in nursing practice is now towards family centered, client centered care, where practice is determined by the needs of the client (Schoot et al., 2006 p.232). Furthering this line of argument, Simpson (2000), contend that perinatal nursing which involves care for both the child and the parent, which in this case is the stay at home father, consists of a whole of complex clinical interventions, intensive patient and family education, empathetic support and evaluation of family dynamics and a wide range of opportunities to make a difference in the lives of the whole family. This situation is further compounded considering the fact that in practice, patients are often erroneously seen as problems to be corrected, instead of being seen as mysteries to behold and attend to. Jonsdottir and others (2004) were of the view that the diminishing ‘humanness’ applied to nursing care and practice further makes family centered care a difficulty. However, the purpose of this paper is to look at examine the recent trends in nursing practice and the implications that these holds for family centered nursing care, especially for stay at home fathers, who in most cases, need personalized/individualized care. As argued Jonsdottir and his colleagues rightly argued, the increasing technological approach to nursing care and the standardization of healthcare is placing more emphasis on what the authors called â€Å"fast-paced, fast-talking health care provision† (2006 p.242) thereby moving nurses’ attention away from relating to patients in a caring manner, which has been shown to be an important aspect of care; towards cost effective service delivery. One of the implications of this trend is that living with complex health circumstances, such as that faced by a stay at home fathers, is considered more of a private affair, which the client must handle alone. These authors argue that, though the necessity of medical treatment is not under contention, however, the standardizing of healthcare procedures with disregard for people’s experiences and peculiar situation was a serious issue to look into. Simpson (2000) identified two major issues/problems that have contributed to this reduced relational care between nurses and patient. First, the authors argue that over the last decades, the cost of care has steadily increased; this has led to several cuts in the number of nurses attending to patients. Unlike the one-to-one nursing care that used to be the case, the reducing numbers of nurses that have to attend to a number of patients have meant that nurses cannot find the time to adequately relate to their patients. This fact is aptly conveyed in this statement ‘Nurses don’t have the time to do nursing; they can’t even get to know the people they are working with’ (Fieldhouse, pers. comm., 28 January 2003 Quoted in Jonsdottir, 2004). On the other hand, the increasing use of technology such as monitors, mean that several patients can be monitored remotely without the need to personally get in contact with the patients. Fortunately, more recent literatures report that recent trends in nursing practice is now towards client centered care, instead of the professionally centered approach highlighted above. Researching nurse’s perception with respect to client centered care, Schoot and colleagues (2006), suggest that individualized/client centered care is gradually gaining prominence in healthcare delivery and has become a topical issue for nurse practice in most western countries. The authors posit that this nursing innovation places the autonomy as the starting point for care. Under this care settings, rather than the professional taking all the decisions and approaching the client as a problem that must be solved, client centered care involves collaborative effort of both the nurse professional and the client, which is directed towards achieving care that meets the client’s peculiar needs, wishes and expectations, while at the same time, in line with professional standards. As a result, this approach to nurse care is centered on client autonomy, improved patient participation and shared decision making. One interesting intervention in the direction of client centered care is what Limacher and Wright (2006) referred to as ‘commendation’. Reporting a qualitative research involving several clients and their nurses, these authors suggest that verbal acknowledgement of the strengths and competencies of the client brings feelings of goodness, optimism and hope which could greatly help the client emotionally. It is argued that care for patients such as stay at home fathers goes beyond physical or medical treatment, empathetic support and acknowledgement could greatly improve the healing process. The result of the qualitative research shows that patients need the medical treatment as much as they need the emotional support, thus such intervention is of great importance. Another important and striking innovation or advancement in nursing care is the increased autonomy that nurses enjoy today. Some decades back, nursing was more often seen as professional that only carry out the prescriptions, recommendation or instructions of the physician. In such a scenario, there was little or nothing that the nurse could contribute to the care of a stay at home father, except for prescriptions of the physician. However, in recent times, nurses are more innovative and able to take on tasks and responsibilities. Explaining this development with respect to perinatal nursing, Simpson (2000) assert that â€Å"in many institutions, it is often the nurse who titrates oxytocin for induction or augmentation of labor, the nurse who decides when contraction or fetal heart patterns are within normal limits, the nurse who manages the second stage of labor, and the nurse who suggests the timing for regional anesthesia, thus playing an pivotal role in the ultimate outcome of labor† (Simpson, 2000 p.301). It can be asserted that improved nurse autonomy can impact positively on nurse patient relationship and more importantly on patient outcomes. As a fallout of the improved autonomy enjoyed by nurses in recent times, there is an increasing trend towards evidence based nursing. Simpson argues that twenty five years ago, it was almost impossible to hear nurses discussing about evidence based care, he posited that then, such practices as heavy narcotics for use in labor were not only rarely questioned or frowned at, they were almost seen as the norm. Also, nurses were more preoccupied with carrying out orders and prescriptions, than worrying about evidence or rationale for any particular intervention. Fortunately, today the story is drastically different. Jonsdottir and others are of the opinion that through continuous research and knowledge development, nurses have come to realize the importance of research to practice (Jonsdottir et al., 2004). This fact is further buttressed by Fawcett (1999), who argued that nurses have come to realize that the nursing profession is both an educational and professional discipline, and as such, basic, applied, and clinical types of research are required to direct practice in the right direction. Simpson further posit that rather than just taking orders and carrying out tasks, nurses can now question traditional practice and also examine literatures for evidence in support or against â€Å"the way things have been done† (2000 p.303). While Fawcett (1999) contend that nurse clinicians now practice nursing in an increasingly thoughtful manner; by continually contemplating situations and stretching their minds towards insight into nursing practice to better help people improve their health, Simpson (2000) on the other hand suggest that the majority of today’s nurses have the skills and knowledge to search through computer databases for important literature and to critically evaluate the combined weight of facts gathered from such literatures to influence decision on the right intervention. The ability to collaborate with the physician also enables the nurse to provide better evidenced based care to the stay at home father. For instance, nurses are becoming more aware that as an autonomous healthcare provider, they are responsible for their actions and inactions. As a result, the average nurse has the right to critically evaluate every intervention prescribed by a physician for compliance with standards and recent evidence. With such knowledge, the nurse can better collaborate with the physician in the best interest of the patient. Although, Simpson (2000) regret that less than 50% of the registered nursing population in the United States have a 4year college degree. Positing that a baccalaureate degree greatly influences the ability to adequately understand research methods and design, which is pertinent for effective research critique; the author suggest that the minimal nursing qualification should be re-considered. This is more important, considering the fact that the ability to critically evaluate evidences presented in literatures for validity and reliability and to be able to present credible recommendations or inform practice based on such research evidence, nurses need better knowledge about the research process and design, on which the ability to effectively critique a research work is founded. With everything said so far, it is important to examine how the knowledge gained so far can influence nursing practice. To start with, the increasing nurse autonomy holds grave implications – positive and negative, for the practicing nurse that requires serious considerations. It is a know fact that every right comes with a duty. Autonomy of the nurse means that the average nurse has the right to decide what intervention is right at every instance. The nurse also has the right to correct or challenge a colleague, when he/she realizes that the right procedure has not being followed in attending to a patient. With the same gravity, the nurse has to be accountable for every action and inaction, decision and indecision. However, for a nurse caring for a stay at home father, autonomy has more advantages, as with every other care that requires an emotional relationship between the nurse and the client. In this circumstance, the nurse can adequately care for the patient without necessarily worrying about strict regulations. The nurse can provide a client centered care for a patient when he/she is able to make decisions, collaboratively with the patient on the best and most suitable approach without the restrictions of standardizations. Also the resort to evidence based practice means that the nurse practitioner has a guiding knowledge base to help make the right care decisions as at when due. Evidence based care ensures that only the best known procedures are employed in caring for patients. In the same light, the trend towards relational care i.e. personalized care to meet the needs of individuals, to help them live with the complex health and emotional issues that most patients live though ensures better quality of life for patients. The understanding and empathetic relationship established between the nurse and the patient ensures that the patient is not only ‘treated’ but cared for in a manner that brings solace and comfort from the several discomfort that comes with illness. In conclusion, it is a fact established over the centuries that nursing is influences people’s lives, not only in illness, but in health as well. As better innovations and nurse interventions are developed and researched, the nursing profession becomes better and more effective in its role as the ‘carer’ for the society. References Fawcett, Jacqueline (1999). The State of Nursing Science: Hallmarks of the 20th and 21st Centuries. Nursing Science Quarterly, 12(4):311-318. Jonsdottir, Helga, Merian Litchfield, Margaret Dexheimer Pharris (2004).Issues And Innovations In Nursing Practice: The relational core of nursing practice as partnership. Journal of Advanced Nursing, 47(3):241–250. Limacher, Lori Houger and Lorraine M. Wright (2006). Journal of Family Nursing, 12(3):307-331. Schoot, Tineke, Ireen Proot, Marja Legius, Ruud ter Meulen, Luc de Witte (2006). Client-Centered Home Care Balancing Between Competing Responsibilities. Clinical Nursing Research, 15(4):231-254. Simpson, Kathleen (2000). A critical evaluation of the past 25 years of perinatal nursing practice: Opportunities for improvement. The American Journal of Maternal Child Nursing (MCN), 25(6):300-304.