From fictional M*A*S*H star Major Margaret Hoolihan to Catherine Barkley, love interest in Hemingway’s A Farewell To Arms, nurses are portrayed as iconic figures in western culture. Even real-life figures like Mother Teresa and Florence Nightingale remain household names well after their deaths due to their dedication to the nursing profession. It’s no coincidence that the idiom “to nurse back to health” can apply to everything from actually helping a sick person to repairing a computer system on the brink of collapse.
We tend to view nurses as the link between patient and medical doctor. However, the role of the modern nurse is highly diversified. Nurses perform many functions within the medical health community, providing specialized care to patients at all levels of medical practice. The job of a nurse is anything but routine, and it varies according to the level of training a nurse has attained. For instance, a Certified Nurses Aide (CNA) can become certified through technical colleges, while a Licensed Practical Nurse (LPN) passes a national licensing exam. Registered Nurses (RN) also become state-certified, and Advance Practice RNs (APRN) complete graduate study. Top-level nurses earn their Doctor of Nursing Practice (D.N.P.).
Hot issues in the nursing community right now include the continual development and practice of nursing theory, evidence-based nursing, and the debate over whether nurses should be allowed to function as primary care providers.
The body of knowledge devoted to diversified and appropriate nursing practice is known as nursing theory. Nursing theory encompasses many approaches to specific aspects of patient care. To start research into nursing theory, check out Faye Glenn Abdellah’s Typology of 21 Nursing Problems, which sets the standard for nurses as caring, educated professionals whose job is to provide competent, technical medical care to patients. Next, see the website assembled by Cardinal Stritch University for an overview of nursing theorists from Callista Roy to Betty Neuman. Another excellent resource is the University of San Diego’s Nursing Theory Page. Detailed Nursing theories and sub-theories are available from Top Nursing Colleges, and the Nursing Theory Network provides an exceptionally comprehensive list of more nursing theories, which encompasses virtually all topics from “Moral Reckoning in Nursing” to “Acute Pain Management”. You can also find background on nursing theory and those who practice it in the book Understanding the work of nurse theorists: A creative beginning. 2nd Edition.
Evidence Based Nursing
Evidence based nursing, simply put, is the application of current medical research by a nurse to manage a patient’s health care. A nurse sees a patient, forms a question about his or her medical condition, and performs relevant research to figure out the answer to that question. For a nurse starting out in the field, the University of Minnesota provides a basic introduction to evidence-based practice. After the tutorial, you can practice your investigative skills via interactive case-studies.
For a list of excellent resources including a glossary of key terms, see the website maintained by Virginia Commonwealth University entitled Nursing Resources for Evidence Based Practice. In a similar vein, the University of North Carolina Health Services offers dozens of quality Evidence Based Nursing Resources including books, websites, and articles on the subject. Finally, to keep up with current issues in the field and write-ups of specialized cases, see the Evidence-Based Nursing Journal published quarterly by The RCN Publishing Company Limited and the BMJ Publishing Group.
Primary Care Nursing
One of the sharpest debates in health care right now regards the expanding role of primary care nurses. Primary care is defined as the first contact a patient has with a member of the medical staff. A primary nurse, then, is wholly responsible for the implementation of health care for a patient or group of patients for the duration of their medical problem. The debate, which is summarized well in “The Battle over Letting Nurse Practitioners Provide Primary Care”, centers around the legislative proposition that nurse practitioners be allowed to act as independent primary care providers without the direct supervision of a medical doctor. Some physicians strongly object to the idea, claiming that nurse practitioners lack the training and expertise to appropriately treat patients.
Other doctors present less opposition, for today, fewer medical students are choosing to go into primary care. Proponents of the proposition say the shortage of primary care physicians must be met somehow. Additionally, some medical professionals argue that clinical doctors are overqualified to be primary care physicians. For a full discourse, see the paper written by the American College of Physicians entitled “Nurse Practitioners in Primary Care”.
In order to fully understand the current issues in nursing like primary care, evidence based nursing practice, and nursing theory, it helps to have a background in general nursing and health care. To that end, professional organizations like the Royal College of Nursing and the American Association of Colleges of Nursing are outstanding nursing resources.
For nurses and other health care professionals, see Resource Nurse for editorial columns, links to continuing education, and a bookstore. Additionally, the Virginia Henderson International Nursing Library provides free online access to reliable research, conference abstracts, and journals. An extensive list of Essential Nursing Resources, published by the Interagency Council on Information Resources in Nursing, can lead you to more information about virtually any branch of nursing.