Nursing: Today and Beyond. Obstacles and Competencies

In any medical facility, nurses are the doctor’s right hand and his most essential assistants. The skills acquired during the training give them the right to provide first aid, perform simple manipulations such as injections, measure temperature and pressure, perform simple procedures and make a description of the examination dictated by a doctor. The nurse cannot fully assume the responsibilities of a doctor and make a diagnosis, establish a treatment sequence, or cancel or prescribe recommended drugs since it is the doctor responsible for the final result of the therapy or the outcome of the operation. The grateful patients who managed to be cured are the most pleasant in the work of a nurse. However, there are many more difficulties for nurses, such as night shifts, constant physical and emotional stress, and responsibility for someone else’s life. Although there are some obstacles to being a nurse, this profession is undergoing continuous improvement because of its social significance.

Obstacles for Modern Nursing

The Ethical Issue

Since ancient times, medicine has developed uniform ethical principles that aim to protect the interests of the patient, and their humanity, it would seem, is undeniable. But in real life, there are situations in which it is impossible to fulfill one postulate without violating another. And then the doctor, making a decision, is forced to take a rather slippery path. There are many examples of such situations. An essential point in field surgery and emergency medicine is the sorting of the wounded, divided into three groups: minor injuries, severe injuries, and hopelessness. Nurses bandage the wounded and try to send them to the rear as soon as possible, render the most significant reasonable assistance on the spot, and evacuate. For hopeless patients, doctors ease the suffering, but they do not transfer them to the rear.

Some of the hopeless ones can be saved if a team of highly qualified doctors provided with the most modern equipment takes care of such patients, or they are urgently sent to a high-class hospital with all the precautions and accompanied by doctors. However, in this case, the seriously injured will remain without the necessary help, and there will be a threat to their life as well as slightly injured may develop complications. Leaving a person virtually without hope of salvation is contrary to ethics. Saving one and forgetting about all others is also impossible. There is no ethically perfect way out; therefore, the practical task is posed (Cherry & Jacob, 2016). Nursing personnel ought to preserve the life and health of as many people as possible.

The Financial Issue

Moreover, nurses are regularly facing financial difficulties while assisting in the health sector. For example, the work of nurses is not rated as highly as the work of professional doctors. Thus the staff is faced with insufficient motivation due to inadequate financial support. For employees with external motivation, this circumstance can be essential as a factor that supports and regulates the motivational state. To solve the presented problem and develop motivation, one can advise an increase in nurses’ salaries and the improvement of the financing of the health sector.

The Social Issue

Furthermore, nurses often face various social and psychological problems during work. Since many patients and doctors do not take into account the significance of the role of the nurse in providing medical care, this attitude can cause emotional burnout and an imaginary decrease in the social status of the employee. For example, if a person does not receive proper social approval, they get nervous exhaustion and lose the desire to continue working even for a decent payment. Moreover, the employee may feel that their place in the social hierarchy is lower, which also adversely affects the provision of work. Thus, employers and senior doctors need to change attitudes towards nurses to solve these problems and improve the quality of primary care.

Improving Nursing Education

In 2010, the Institute of Medicine published the Future of Nursing report that provided five key messages. One of them stated that “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (The Institute of Medicine, 2010). Recent advances in clinical medicine and the ability to manage the treatment of many somatic diseases, for well-known health difficulties, make it possible to improve the organization of training not only for doctors but also for nurses. Modern medical institutions operating in conditions of financial deficit need two categories of workers.

First, these are professionals of high level who can accurately perform any manipulations, are well-versed in pre-medical equipment, and are ready for an unusual clinical situation. Second, with the changing importance of the inpatient phase of treatment, a need arose for specialists who had not only medical knowledge but also were familiar with the basics of economics, psychology, and labor organization (Barton, Bruce, & Schreiber, 2018). The introduction of new disciplines is unrealistic in connection with the excellent saturation of the programs of medical universities in any specialty. Nevertheless, the health sector can increase the number of highly qualified specialists while providing on-the-job training. Thus, employees will be able to undergo continuing education programs without interrupting the work process or stopping it for a short time.

Five Core Competencies

There are five core competencies in providing medical care, each of them is essential for ensuring quality work. The first competence is patient-centered health care, which means a complete focus on the patient’s safety and health, not on personal benefits (Bormann, 2016). This approach involves the active participation of the patient in the treatment process. However, an obstacle may be a person’s refusal to cooperate with nurses and doctors, so staff is required to obtain medical data on their own. The other competence is teamwork and cooperation, which means that nurses’ role is to connect patients, doctors, and external employees. Ensuring partnership in healthcare facilities helps to prevent severe medical errors and incidents. However, not all hospital personnel may be open to communication, which can reduce the speed of treatment.

The third competence is evidence-based practice, which means that before applying a particular diagnostic or treatment method, one must have evidence of the effectiveness of the method used. The intervention offered to the patient should present the highest efficacy and least risk. This method of practice is the most effective but not always possible in the modern world. Nowadays, more and more innovative ways of providing medical care appear, but many of them are only useful in theory. Thus, when using new techniques, treatment may not always be practical. The fourth competence is in improving the quality of medical care. This competence states that the development of patient assistance’s systematic provision should be advanced continuously (Izumi, 2012). However, improvements often require significant financial resources, which may not be possible with low funding.

The last competence is a medical information system, which is a combination of knowledge, databases, software, and hardware designed to automate various processes that occur both in individual medical institutions and in the health care system. The main goal of medical informatics is to optimize information processes in medicine by using computer technologies and improving the quality of public health protection. A positive effect is achieved for all participants in the healthcare system by introducing medical information systems. For example, treatment productivity is increased, the doctor has enough time to work with patients by reducing paperwork, and quickly receiving diagnostic data increases the speed of appointment and the effectiveness of the corresponding treatment. However, data stored in electronic form may be lost, and not all facilities have sufficient technical equipment to ensure this feature.

Therefore, despite the importance of the nursing profession, these employees still face discrimination in the workplace and various professional obstacles. Subsequent improvements may be proposed to address these issues in the future. Changes in the approaches to training at medical colleges and schools will provide not only practical experience but also more profound knowledge and communication skills. More practical skills will allow future specialists to feel confident and possess the necessary abilities. Nurses will be able to improve their professions, expand their authority, and, accordingly, apply for higher salaries. Changes in nursing work should be performed, and only new approaches to education, remuneration, and prestige will allow retaining qualified specialists and attracting new ones to the future business. The nursing sector of healthcare should be seen as significant and be taken into account when governmental improvements are considered.

References

Barton, G., Bruce, A., & Schreiber, R. (2018). Teaching nurses’ teamwork: Integrative review of competency-based team training in nursing education. Nurse Education in Practice, 32, 129–137.

Bormann, L. (2016). Institute of medicine core competencies for health professionals: Foundation for care coordination in practice. 

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing. St. Louis, MO: Elsevier Health Sciences.

Izumi, S. (2012). Quality improvement in nursing: Administrative mandate or professional responsibility? Nursing Forum, 47(4), 260–267.

The Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health.