Nursing Programs Conceptual Mode
Philosophy of Nursing: The Nurse as Detective, Scientist, and Manager of the Healing Environment
The philosophy of nursing is anchored in the different roles of the nurse, first as the most significant patient advocate. But nurse advocacy for the patient is not an easy task to fulfil. It requires the nurse to juggle several interrelated roles that facilitate the achievement of the goal of patient advocacy. These roles are represented by three particular ones. These are the roles of the nurse as a detective, as a scientist, and as a manager of the healing environment. Several Master of Science in Nursing (MSN) model elements from the ‘Nursing Programs Conceptual Model’ by Western Governors University (WGU) support these three roles of the nurse. This paper is a discussion of how these model elements support the three roles.Nursing Programs Conceptual Mode
Nurse as Detective
The traditional work of a detective is to solve cases whose causes are not obvious. In the case of the nurse, this is their exact work. It is to be remembered – as has been discussed in the introduction above – that this role is discussed through the prism of patient advocacy. For instance, when the patient is not responding to treatment as is expected the nurse would start getting concerned. This would trigger the detective instinct in her to want to know if there is any reason to explain this. It may be that the patient is not getting culturally competent care and therefore feels that autonomy as a bioethical principle has been denied to them. It may also be due to a habit or a characteristic that they have not yet felt comfortable to reveal to anyone in the healthcare team. It would therefore take the detective work of the nurse to reveal this. One of the MSN conceptual models that may be used to demonstrate how a nurse may apply the role of detective in practice is compassionate patient-centered care. This is basically holistic culturally sensitive patient care that respects the patient and their unique preferences in an increasingly multicultural society. By using compassion and empathy, the nurse should be able to earn the confidence of the patient such that they will feel free to trust the nurse with information that would not otherwise have been known. This is how a detective works – by gaining the trust of their subject.
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The other MN model element that could be used to show how the role of the nurse as detective can be applied in nursing practice is the use of informatics and technology (McGonigle & Mastrian, 2017). Health informatics is concerned with the manipulation and storage of patient data in an easily and readily accessible way through the use of contemporary innovative technologies. The perfect embodiment of this in current practice is the electronic health record or EHR. By engaging in what is known in technological terms as data mining, the nurse can act as a detective by getting to know a patient’s social, family, medical, surgical, and treatment history. By using informatics, this is better than reading paper files from a detective standpoint in that the nurse does not need to interact with the medical records person at all (hence more confidentiality). She only needs to access the unit’s computer or another remote computer and use her unique system access credentials to access the patient’s data. System elements such as the patient data management system (PDMS) and the electronic medical record (EMR) come in handy. They will enable her to quickly and efficiently get to know the patient’s medical and other details that may explain a particular phenomenon (Alotaibi & Federico, 2017).
Nurse as Scientist
Current nursing practice is driven by evidence-based practice or EBP. This is where the nurse only uses interventions that are backed by peer-reviewed scholarly scientific evidence for efficacy (Melnyk & Fineout-Overholt, 2019). The MSN model element that can be used to demonstrate how the role of the nurse as a scientist can be applied to nursing practice is genomics and ‘genethics’. What this means is that the nurse’s knowledge about the role of genetics in disease etiology and therapeutics is crucial to offering evidence-based care. The nurse will be able to explain to a patient and their family the pathogenesis of their condition and the available therapeutic options without having to always refer them to the physician. The nurse must therefore devote their time and intellectual energy to lifelong learning as well as continuous professional development. They must also strive to increase their education to the highest levels of postgraduate study.
The other MSN model element that can be used in this case as proof of how the role of the nurse as a scientist is applicable in practice is evidence-based practice or EBP. This has been mentioned above with regard to the provision of optimum nursing care. EBP is practice that is the gold standard or best practice. It is the practice of using interventions that carry the best chance of efficacy as dictated by the latest empirical scientific evidence. The opposite of EBP is common practice where treatments and therapies are used just because they have always been used that way. Common practice is devoid of clinical inquiry and is the worst form of practice the nurse could engage in due to its resultant poor patient outcomes. By questioning common clinical practices and enriching EBP through clinical inquiry, the nurse will be correctly exercising their role of scientist.Nursing Programs Conceptual Mode
Nurse as Manager of the Healing Environment
This role of the nurse inspired by the fact that the nurse is the patient’s advocate is anchored in Florence Nightingale’s Environmental Theory. This theory holds that the health of the patient can be guaranteed by having clean air, clean (drinking) water, proper hygiene, visibility (light), and proper drainage and sanitation (Gonzalo, 2019). An environment that has all these five factors at optimum levels is therefore an environment that can be classified as a healing environment. It is the environment in which the patient has the best chance of recovery and return to wellbeing. But in order to optimize the environment in which the patient is being treated to have all these factors present, the nurse must manage it. That is where the role of the nurse as manager of the healing environment comes in. She will ensure that there is no environmental air pollution in terms of fumes, irritants, and smoke that may cause respiratory problems to the patient. She will also make sure that there are enough and proper sanitary provisions for the patient to therapeutically relieve themselves. This will include proper drainage of any effluent that may be a health hazard. The nurse will guarantee the availability of clean drinking water in the patient’s environment. This will help prevent water-borne diseases that may cause further infection of the patient and prolong their hospital stay. A longer hospital stay accompanied by increased hospitalization costs due to that prolonged stay are both negative indicators of quality calling for quality improvement or QI. Lastly but not least, the nurse will see to it that the patient is always clean and there is enough light to illuminate the surroundings. In the context of nursing, ensuring cleanliness of the patient may even mean giving a bed bath to the patient, if they cannot perform this activity of daily living (ADL) themselves.
One MSN model element that can be used to express how the role of the nurse as manager of the healing environment can be used in practice is leadership and education. To effectively lead, the nurse must attain education up to the highest level possible. This is either the MSN or a doctorate (DNP or PhD) and it allows the nurse to have a firmer grasp of the socio-political, cultural, economic, and environmental factors that affect patient management and recovery. Then the nurse must practice the best leadership style that is guaranteed to produce desirable results with regard to quality nursing care and excellent patient outcomes. In this case, transformational leadership has proven to be the most effective (evidence-based) leadership style that best suits healthcare settings (Choi et al., 2016). By practicing transformational leadership, the nurse manager will provide a conducive environment for work and motivate her nursing workforce to deliver the best possible patient care. This will be possible through the empowerment of her nurses.
The other MSN model element in this case is effective communication. Leadership alone will not achieve the results required for maintaining a healing environment. To facilitate it, the nurse must be skilled at effective communication. That includes therapeutic communication between her and the patients, and professional communication between her and her nurses.
Conclusion
There are three most important roles of the nurse that facilitate the objective of being a patient advocate. These are the roles of scientist, advocate, and manager of the healing environment. All these roles are supported by the Western Governors University (WGU) Nursing Programs Conceptual Model. The conceptual model contains specific MSN model elements that can be used to demonstrate how these three roles are useful in nursing practice.Nursing Programs Conceptual Mode
References
Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631
Choi, S.L., Goh, C.F., Adam, M.B.H., & Tan, O.K. (2016). Transformational leadership, empowerment, and job satisfaction: The mediating role of employee empowerment. Human Resources for Health, 14(1), 73. https://doi.org/10.1186/s12960-016-0171-2
Gonzalo, A. (August 22, 2019). Florence Nightingale: Environmental theory. https://nurseslabs.com/florence-nightingales-environmental-theory/#:~:text=The%20Environmental%20Theory%20by%20Florence,health%2C%20and%20that%20external%20factors
McGonigle, D., & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge, 4th ed. Jones & Bartlett Learning.
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4th ed. Wolters Kluwer. Nursing Programs Conceptual Mode