Nursing today is both a science and an art. As a professional nurse, you will learn to provide care with compassion, care, and respect for the dignity and personality of each patient. Nursing practice, as a science, is founded on a body of knowledge that is always evolving as new discoveries and improvements are made. When you incorporate the art and science of nursing into your practice, the care you provide to your patients is of the highest quality, which helps both the patients and their families.
Nursing as a Profession
Nursing offers a wide range of career options, including clinical practice, education, research, management, administration, and even entrepreneurship. As a student, it is critical that you understand the scope of professional nursing practice and how nursing affects the lives of your patients, their families, and the communities in which they live. Your practice focuses on the patient. Individuals, families, and/or communities are all part of your patient. Patients have a wide range of healthcare needs, knowledge, experiences, vulnerabilities, and expectations, but it is precisely this diversity that makes nursing both challenging and rewarding. Making a difference in your patients’ lives is rewarding (for example, assisting a dying patient in finding pain relief, assisting a young mother in learning parenting skills, and assisting older adults in remaining independent in their homes). Every day, nursing provides personal and professional rewards. This chapter provides a current perspective on the evolution of nursing and nursing practice, as well as the historical, practical, social, and political influences on the nursing discipline.
Nursing is more than just a set of skills, and you are more than just a person who has been trained to perform specific tasks. Nursing is a career. There is no single factor that distinguishes a job from a profession, but the distinction is significant in terms of how you practice. Professionalism entails providing high-quality patient-centered care in a safe, prudent, and knowledgeable manner. You are accountable to yourself, your patients, and your colleagues.
Science and Art of Nursing Practice
Because nursing is both an art and a science, nursing practice necessitates a combination of up-to-date knowledge and practice standards, as well as a thoughtful and compassionate approach to patient care.
Your patients’ healthcare needs are multifaceted and ever-changing. Thus, your care will reflect societal needs and values as well as professional care and performance standards, meet the needs of each patient, and integrate evidence-based findings to provide the highest level of care.
Nursing has a specific body of knowledge; however, in order to fully understand and apply this knowledge and develop professional expertise, you must socialize within the profession and practice. Clinical expertise necessitates time and dedication. According to Benner (1984), when acquiring and developing generalist or specialized nursing skills, an expert nurse progresses through five levels of proficiency.
According to Benner
Novice: A beginning nursing student or any nurse entering a situation where there is no prior level of experience (for example, an experienced operating room nurse who chooses to practice in home health). The learner is guided through a set of rules or procedures that are typically stepwise and linear.
Advanced Beginner: A nurse with some experience with the situation. Although this is only an observational experience, the nurse is able to identify meaningful aspects or principles of nursing care.
Proficient: A nurse who has worked in the same clinical position for at least two to three years. This particular nurse understands the organization as well as the specific care required by the type of patient (e.g., surgical, oncology, or orthopedic patients). He or she is a skilled practitioner who can anticipate nursing care and set long-term goals. During this stage, the nurse has typically had experience with all types of psychomotor skills required by this particular group of patients.
Expert: A nurse with a wide range of experience who has an intuitive understanding of a current or potential clinical problem. This nurse is able to focus on multiple aspects of the situation and zero in on the problem. He or she is adept at identifying both patient-centered and health-care system-related issues, as well as the needs of the new nurse.
Expert clinical nursing practice entails applying knowledge, ethics, aesthetics, and clinical experience. Your ability to interpret clinical situations and make complex decisions is the foundation for your nursing care as well as the advancement of nursing practice and nursing science (Benner, 1984; Benner et al., 1997, 2010).
Practice Scope and Standards
It is critical to provide a certain service in accordance with practice standards and to adhere to a code of ethics when providing care (ANA, 2015). Professional practice includes knowledge from social and behavioral sciences, biological and physiological sciences, and nursing ideas. In addition, ethical and social ideals, professional autonomy, and a sense of commitment and community are all included in nursing practice (ANA, 2010b).The following definition from the American Nurses Association (ANA) exemplifies nurses’ unwavering commitment to providing care that benefits their patients and communities (ANA, 2010a). Nursing is the protection, promotion, and optimization of health and abilities; avoidance of sickness and damage; alleviation of suffering via the \sdiagnosis and treatment of human response; and advocacy in the care of people, families, communities, and populations (ANA, 2010b) (ANA, 2010b). Nursing, according to the International Council of Nurses (ICN), “includes autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or healthy, and in all contexts.” Nursing encompasses the promotion of health, sickness prevention, and the care of the sick, disabled, and dying. Nursing also plays important roles in advocacy, promoting a safe environment, research, shaping health policy, patient and health system management, and education. Both definitions affirm nursing’s popularity and significance in providing safe, patient-centered health care to the worldwide community.
Nursing Practice Standards of the American Nurses Association
- Assessment: The registered nurse gathers detailed information about the patient’s health and/or situation.
- Diagnosis: Based on the evaluation data, the registered nurse determines the diagnosis or difficulties.
- Identifying Expected Outcomes: The registered nurse determines expected outcomes for a strategy that is unique to the patient or environment.
- Planning: The registered nurse creates a strategy and alternate plan to achieve the desired results.
- Implementation: The identified plan is carried out by the registered nurse.
- 5a. Care Coordination: The registered nurse oversees the delivery of care.
- 5b. Health Education and Promotion: The registered nurse employs a variety of tactics to promote health and a secure environment.
- 5c. Consultation: A graduate-level specialty nurse or advanced practice registered nurse provides consultation in order to impact the specified plan, increase others’ abilities, and effect change.
- 5d. Prescription Authority and Treatment: In line with state and federal rules and regulations, the advanced practice registered nurse employs prescriptive authority, procedures, referrals, treatment, and treatments.
6. Evaluation: The registered nurse assesses how well the patient is progressing toward the desired outcomes.
ANA Standards of Professional Performance
- Ethics: The licensed nurse conducts herself in a professional manner.
- Education: As a registered nurse, you will gain knowledge and skills that are relevant to modern nursing practice.
- Evidence-Based Practice and Research: The registered nurse applies evidence and research findings to her or his work.
- Quality of Practice: The registered nurse contributes to high-quality nursing.
- Communication: In all areas of practice, the registered nurse communicates well.
- Leadership: In both the professional practice setting and the profession, the registered nurse exhibits leadership.
- Collaboration: In the course of nursing practice, the registered nurse collaborates with the health care consumer, family, and others.
- Nursing Practice Evaluation: The registered nurse assesses her or his own nursing practice in light of professional practice standards and guidelines, as well as any statutes, rules, and regulations.
- Resources: The registered nurse employs suitable resources in order to plan and deliver nursing services that are both safe and cost-effective.
- Environmental Health: The registered nurse practices in a safe and healthy manner for the environment.
Code of Ethics
The code of ethics defines the philosophical ideas of right and wrong that dictate the principles you will use to provide care to your patients. It’s crucial that you apply your personal ethics and ideals to your work. As you incorporate these values, you’ll learn what kind of nurse you’ll be and how you’ll function within the discipline (ANA, 2015). Examine how your ethics, values, and procedures compare to industry standards. A number of publications on nursing ethics and human rights are available from the American Nurses Association (ANA).