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12. trends and issues in nursing
by Ram Sharan Mehta, Ph.D. on Jul 03, 2012
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12. trends and issues in nursing
Document Transcript
1. TRENDS AND ISSUES IN NURSING Ram Sharan Mehta, Associate Professor B.P. Koira
la Institute of Health Sciences Email: ramsharanmehta@hotmail.comNursing has bee
n called the oldest of the art, and the youngest of the profession. As such, it
hasgone through many stages and has been an integral part of social movements. N
ursing has beeninvolved in the existing culture, shaped by it and yet being to d
evelop it. The trend analysis andfuture scenarios provide a basis for sound deci
sion making through mapping of possible futuresand aiming to create preferred fu
tures.The future will see great advantages in prevention, diagnosis and treatmen
t of illness anddiseases with increasing demand for heath care and health inform
ation. As large hospital arereplaced by high tech and small hospitals, health ca
re will be provided in homes and out reachfacilities and the focus will be on pr
ovider skill, out comes and user preference and satisfaction.Nurses will be the
preferred care providers and entry points for diverse services.Onthe other hand
there will be challenges related toethics, rising costs, access to care andquali
ty of care. Nurses will have an essential public health role and patients will b
ecome moredemanding. Healthier life styles, continuum of care, health environmen
ts and evidence basedpractice will beemphasized and in the forefront of nursing
agenda. Globalization will enhancefree movement, standardization, and wider oppo
rtunities and challenges. The changing workenvironment will be driven by cost ef
fectiveness and quality of care for which nursing is wellpositioned.The multifac
eted components in this unfolding will be; the revolutionary advances that wecon
tinue to witness in modern medical practice as a result of technological advance
s from thefields of physics, electronics, instrumentation, chemical and material
sciences. The advent ofmolecular medicine, with work at the frontiers of modern
biology particularly on the humangenome, and its relevance to the generic basis
of disease; the importance of recent advancesrelating to the human brain the wi
de range of opportunities becoming available through advancesin information tech
nology; the great importance of community and social medicine, of hygieneand epi
demiological studies in understanding and preventing disease.Philosophy of life,
elements of human nature, Religious factors, political ideologies,socioeconomic
factors, cultural factors and expiration of knowledge are the factors determini
ngeducational aims.Vocation, knowledge, complete living, Harmonious development,
mental and emotionaldevelopment, physical development, moral development, chara
cter development, self realization, cultural development, ideal citizenship and e
ducation for leisure are the general aimsof education. 1
2. Progress in transportation, communication andother technological areas: e.g.
automobile likeaids e. g. telephone, motion pictures, radio, television, compute
r email and internet services, useof ultrasound, CT Scan, MRI imaging machines,
electronic microscope radio active isotopes formedical research, artificial resp
irator ventilator, discovery of third generation antibiotics,findings of new dru
gs e.g.; vitamins, penicillin, insulin, chemotherapy and invention of othermedic
al supplies like cool air machine, refrigeration, air and water mattress, electr
ic beds etc.Nursing has a tremendous capacity to change people. The demands asso
ciated with nursingpractice require a broad knowledge base and critical thinking
abilities along with competentskills. The focus of nursing is shifting towards
viewing patients as collaborative beneficiariesrather than passive recipients of
care. Nursing requires psychological, social and physical skillsand certain att
itudes, which are rooted in knowledge. The demands associated with nursingpracti
ce require a broad knowledge base for decision-making. Critical thinking abiliti
es andskills in the technological aspects of care.The function of the profession
al nurse in thehospital is more comprehensive. She will beactively involved in d
irect nursing care, health teaching, planning for care in home, rehabilitationan
d service to the outpatients. She may have to teach the students also.The world
health organization (WHO) has been considering the future and predicts that by 2
000the world experiences: Major growth in the elderly population, Decline in bir
thrate, especially inwestern countries, Increases in chronic illness, Continuing
social unrest, AIDS a major problem,Many infectious diseases under control, Men
tal health a key issue and Poverty continuing toplague mach of the world.Exposur
e to human ill, sick child and baby, dying patients, cancer patients, renal fail
ure patients,still birth etc., closer nurse patient relationship, Helplessness,
Felling of incompetence inemergency situation, Lack of support system, Lack of r
esources, Often high unrealisticexpectations, High technology equipments, Commun
ication breakdown, and Heavy workload arethe causes of stress among nurses.Nurse
s are responsible for public anger because: Nurses stay 24 hours with client, Nu
rses have togive answers fault made by professionalsof other discipline, Work lo
ad very high, Less timeforcounseling and guidance to patients, Unable toexplain
their own role in clients care and Poororientation to clients and relativesProfe
ssional judgment, Defining "Care", Information system or effective communication
,Electronic network or computer link, Problem based learning, Marketing or priva
tization,Nursing standard, Nursing audit, Nursing research, Multidisciplinary he
alth team, Independentarea of practice, Community based nursing, Holistic care a
pproach, Specialized services(dialysis, Psychiatric etc.), Problem based learnin
g, Distance learning (open university system),Self directed learning, Continuing
education, Use of advanced technology, Consumerprotection act on action, Change
in uniform and dress code, Utilization of married nurses,Specialization, Leader
ship of nursing in 21st century, Human relation in nursing , Disastermanagement,
Marketing strategies for nursing, Computer application in nursing, Space nursin
g , 2
3. Nurse patient relationship and Provision for nursing consultant or specialist
are the emergingtrends in Nursing.Transitions taking place in health care are:
Curative to Preventive approaches, Specializedcare to Primary health care, Medic
al diagnosis to Patient emphasis, Discipline stovepipes toProgramme stovepipes,
Professional identity to Team identity, Trial and error to Evidence basedpractic
e, Self regulation to Questioning of professions, and Focus on quality to Focus
oncosts.In the workplace the transitions taking place are: High tech to Humanist
ic, Competition toCooperation, Need to supervise to Coaching, mentoring, and Hie
rarchies to Decentralizedapproach.Transitions taking place in nursing are: Conti
nued competencies to Competencies a condition,Hospital environment to Community
environment, Quality as excellence to Quality as safe, andClear role to blurring
rolesThe Major issues in nursing education are: Selection of students: Lack of
valid tool to selectproper students, Gap between theory and practice: There is v
ast gap between actual theory taughtin classroom and the actual practice in clin
ical setting, Student status: In most of institutionsstudents are vitalized for
patient services, Nursing Competencies: To develop nursingcompetencies knowledge
, under standingskill and attitudes are essential factors, Underutilization of c
linical facilities in government colleges / schools, In adequate library facilit
ies,Poor transport facilities, Less stipend for nursing students, Poor supply of
AV aids, LessPromotional opportunities for teachers of both schools and college
s, Very few M. Sc. courses isavailable, Few Ph. D. Courses in Nursingcolleges, a
nd In private Institutions: there is Lack ofqualified teachers, Hired building,
Most institutes has not own hospital for clinical practice, Veryexpensive, In ad
equate hostel facilities for students and Poor provision of library.The Issues i
n nursing service are: Poor working condition, Staffing level not based on stand
ardnorms, Inadequate quality In-service education programme, Less wages, Lacking
in formalpractice guidelines, Work activities roles not well defined, Deficienc
ies in Team work, Lackingadvanced extended nursing practice, Professional relati
onship with doctors decreasingday byday, Inadequate use of modern technologies,
Inadequate availability of equipment and supplies,Poor team spirit among colleag
ue, Very few professional representationsin higher authorities,Poor exposure of
nurses in National conferences workshop and forums, Inadequate availabilityof sc
ientific research findings, As the education raises the gap between nurses and p
atients alsoraises, Nurses are more busy in administrative and paper worksin com
pression to bed side care,Nurses are not research oriented, Use of non professio
nal manpower to deliver nursing service,Monitoring, supervision, recording, depo
rting and evaluation system are poor in nursing service,Expert senior nurses are
usually not involved in planning nursing manpower in an institution,There is no
t a system for scheduling planned annual leave for nurses, Lack of autonomy ande
mpowerment for nursing leaders, Lack of understanding of nursingprofessional rol
es andresponsibilities in general, and Gap in the latest managerial knowledge an
d skills among seniornursing leadersCommon problems of nursing administration ar
e: Poor involvement of nursingadministrators in planningand decision making in t
he government hospital administration, No 3
4. specific power has been assigned to nursing Incharges but she has been made I
ncharges of allinventories and linen of hospital, In many institutions nursing s
uperintendent will have noauthority to sanction leave to their subordinates, Lac
k of knowledge of managementof nursingadministration among nursing administrator
s, Administrators most of the time depends on theadvice of clerical staff in all
matters including technical aspects, Prevalence of role ambiguityamong administ
ration administrators, Unnecessary interferences of nonnursing personnel innursi
ng administration, No clear cut written nursing policies and manuals, Poor job d
escriptionfor various nursing cadres, Poor organized staff development programme
, which includesorientation, in-service education, continuing education etc,. Po
or provision of incentives like:awards, visits, praise, conferences etc. Ineffic
iency of nursing councils to maintain standards,and inadequate efforts at higher
level for implementation of separate directorate of nursing.Less educational pr
eparation, Refuse to accept new role, Adhere to tradition, Failure to unityamong
nurses, Failure to work with consumers or public, and Failure to delivery nursi
ng care tomeet (satisfy) public needs are thecommon professional limitations in
Nursing Profession.Conclusion: Transition generally occurs or takes place in eac
h and every individualof thisworld. Nurses as an individual, involved in caring
profession, also faces this transition arenothing but the passages or changes fr
om one situation or state to another that occurs over time.There are often wide
ranges of emotions experienced during the transition process that can affectthe
emotional and physical well being.Some ways to Prepare for transition process ar
e: Positing thinking, flexible to adjust invarious situations, organized persona
l life, practice healthy life style, find an ideal mentor, havesome fun and able
to know what is expected to learn to rules of road early.References 1. Celebrat
ing nursing past claiming the future. International nurses day 1999.Internationa
l council of nurses, Geneva Switzerland. 2. International nursing review 1999; 4
6 (1): 16 26 3. Jolley M, Allan P. Current issues in nursing. 1st edi. Chapman a
nd hall; London; 1989 4. Regu M Tabish SA. Nursing education in the new millenni
um Journal of medical science 2002; 4 (2): 183 189. 5. Deloughery Issues and tre
nds in nursing Mosby year book, London; 1991 6. Oulton J. International trends i
n nursing profession development. International nursing review 1997;44 (2): 47 5
1 7. Shyamalamanivannan. Transition in nursing. Journal of Nepal nursing council
; 2000; 9:201 - 202 8. Hemanalini BE. Emerging trends in nursing education in th
e third millennium Nursing journal of India Dec. 2000; 12: 267 268 9. Hamer J, W
lder B. A. new curriculum for a new millennium. Nursing outlook. 2001; 49: 127 1
31. 4 Search
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