NURS 8410 – Best Practices In Nursing Specialties Essay

The world of healthcare is one of frequent changes. Those who have dedicated themselves to the nursing profession understand that healthcare is continuously evolving, as it is our responsibility to provide only the highest standard of care to our patients. Each nurse that is certified within a nursing specialty strengthens the entire healthcare team. Those that obtain specialty certifications are seen as the leaders in the field and are strong resources for the team members lacking the specialized education. Among the multiple nursing specialty certifications obtainable, legal nursing is relatively new. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

For many years registered nurses aided legal teams by providing attorneys with needed medical knowledge without the option of obtaining specialized training, earning specialized certifications and/or having the known support of a specialized national association behind them. Only due to a clear vision and the undying determination of several registered nurses, the not for profit national organization tilted the “American Association of Legal Nurse Consultants (AALNC) was founded in July of 1989” (“American Association,” n. d, para. 1). NURS 8410 – Best Practices In Nursing Specialties Essay Paper

According to Huff, Costantini, and Mihalich, the driving force behind the birth of this national association was a group of registered nurses that had already been acting as legal consultants and were determined to educate the legal profession about the effectiveness of the nurse consultant as liaison between the legal and medical communities, and to provide a network for members to share expertise. The early pioneers recognized for initiating what now is a powerful specialty within the nursing field are Rosanna Janes, RN, Karen Wetther, RN, Joanne Behymer, RN, Paula Schenck, RN and Kathleen Loeffler, RN.

The legal nursing consultant specialty has evolved greatly since its birth and has made several major contributions during its relatively short existence. The first contribution noted within the information provided by the Legal Nurse Consulting Principles states the following: While AALNC has always offered national membership benefits to nurses licensed in any state of the U. S. , it was through the establishment of chartered chapters that AALNC fostered membership growth, networking, and education at the local level. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Within 10 years, chapter activity went from the three original local groups to chapters in more than 45 cities in 31 states. The number of chapters continues to increase each year. (Huff, Costantini, & Mihalich, n. d. , p. 27) The association demands that those with accreditation be highly educated along with maintaining current certifications to practice, the AALNC offers multiple resources to achieve these expected standards. The educational opportunities have developed and include an annual educational conference along with numerous educational materials in written, audio, and video formats that are readily available for its members.

These are designed to assist nurses at all levels of expertise in legal nurse consulting practice. (Huff, Costantini, & Mihalich, n. d. , p. 30) An additional major contribution the AALNC has provided the nursing profession is “recognizing the importance of nursing certification that incorporates experiential and educational requirements, AALNC established the American Legal Nurse Consultant Certification Board (ALNCCB) in 1997. ALNCCB developed the Legal Nurse Consultant Certified (LNCC) certification program and credential” (Huff et al. , n. d. , p. 42). NURS 8410 – Best Practices In Nursing Specialties Essay Paper

As explained above, the specialty of legal nursing has impacted multiple aspects of the healthcare system with the most important aspect being our patients. Legal nursing allows a registered nurse with specialized education to advocate for the patient from the beginning of a legal case to the end. The protection and safety of our patients is the number one responsibility of all healthcare professionals, it is essential that legal nurse consultants continue to work side by side with attorneys to ensure the best outcomes possible for all parties involved.

The legal nurse specialty has also impacted multiple other entities including insurance companies and healthcare facilities by providing the essential medical facts needed to prove false claims of malpractice. With the many strengths the legal nurse specialty has brought to the nursing profession, it is evident that this specialty is nothing short of a necessity.

Describe the legal responsibilities of nurses in the work setting. Within the nursing license, the nurse is legally bound to practice within the scope of nursing that each state defines by a Nurse Practice Act (NPA). The scope includes upholding the patient bill of rights and total patient care. According to the NLN (Springhouse, 2004), “Patients have the right to information about their diagnosis, prognosis, and treatment — including alternatives to care and risks involved — in terms they and their families can readily understand, so that they can give their informed consent. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

” For the family of Marianne, it is the nurse’s professional responsibility, within the nursing scope of practice, to provide education to Marianne’s family. Springhouse (2004) states, “For best results, patient teaching should include the family and others involved in the patient’s care. If family members understand the reason for a patient’s treatment, they’ll be more willing to provide emotional support.”

This education will ensure that Marianne’s husband will make an informed decision regarding his wife’s care and help Marianne’s children to understand their father’s decision. If the husband does decide to attempt surgery for the blood clot as recommended by the physician, then the nurse must ensure that Marianne’s husband understands the procedures along with the risks involved. The nurse is responsible for objectively documenting any plans of care and any actions taken relating to the plan of care. A nurse’s legal responsibility to the patient includes reporting incidents. In the case study where the nurse is called as a witness to a malpractice suit, the nurse failed fulfilled their fundamental duty of patient protection. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Initially, upon witnessing negligent care from another nurse, an incident report was immediately filed within the healthcare institution. The nurse also took notes of the negligence the other nurse performed. According to Blais (2011), “When called into court as a witness, the nurse has a duty to assist justice as far as possible.” This duty will include answering questions regarding the incident. It is important for the nurse to remember that answering questions truthfully and objectively will ensure the appropriate justice will occur.

Springhouse (2004). Nurse’s Legal Handbook (5th Edition). Philadelphia, PA,

Nursing cannot exist without theory, and the concepts that define those principles. Every intervention a nurse organizes is based off of theory, and revolves directly around the patient. The current practice used as a Registered Nurse in the emergency room setting is similar, but less complicated than that of an Advanced Practice Nurse Practitioner. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Emergency room nurses firstly ask the patient what their chief complaint is upon arrival. The chief complaint labels the patient, and gives them a triage level based on the amount of resources needed to intervene.

The chief complaint (or illness) is the nurse’s focus of his/her practice. The nurse also takes into consideration the need to educate the patient and his or her own readiness to learn. All of these factors help reach the goal of making the patient “feel” better and regain health. Below is a model of how nurses in the emergency room revolve directly around the patient. Figure 1.1: Emergency Room Registered Nurse Conceptual Framework Making the decision to use this framework of nursing and theory helps organize the nurse and prioritize his/her actions. Without knowing the chief complaint, the nurse cannot treat. Furthermore, the nurse must ask the patient the reasoning for his visit in the emergency room today. Often, patients have many symptoms regarding their illness; nurses must prioritize which symptoms are most concerning, and ask the patient what his bothering him/her the most (i.e. headache versus shortness of breath). After learning what the patient has arrived for, the nurse must start gathering data that relates to the patient’s chief complaint. For example, if the patient presents with shortness of breath, it is important to gather data such as: oxygen saturation, respiratory rate and effort, lung auscultation, presence of cough, and observing patient color. In addition to objective data, it is important to gather subjective data. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

This type of data includes: patient symptoms, health history, and social history (such as smoking). Next, the nurse will implement her plan of care and intervene by: providing supplemental oxygen, if needed, elevate head of bed, and encourage the patient to breathe slowly if breathing appears to be labored or fast. After each intervention, the nurse must reassess the patient to see if his/her interventions worked; if not, the plan of care must be changed to improve patient status. Subsequently, the nurse must take into account the need to educate the patient and his/her ability and readiness to learn. If a patient is not ready to learn, it makes it difficult to for the nurse to teach and help reach the overall goal of restoring health. This cycle continues each time the patient gets ill; the nurse always forms her plan of care around the patient. For example, if a patient is mentally handicapped, the nurse might direct her education towards the patient’s caregiver to ensure the patient has the greatest success of reaching health. This conceptual framework is applicable to emergency room nurses’ practice because it is a constant cycle, organized, direct, and patient-focused. In the emergency room setting, it is vital that nurses are able to prioritize and organize symptoms and data. If a nurse forgets to obtain an oxygen saturation (in the data section), this can be life-threatening to the shortness of breath patient! NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Furthermore, nursing interventions are always tailored around the initial chief complaint and data gathered. It is a cycle that starts over each time a patient presents with an illness. Even though this framework is frequently utilized, there are many areas in which it could improve. What about a patient’s environment, social stability, and body’s response to the illness? In addition, there are no interrelationships noted on this model. There are many ways this framework could improve, be more in depth, and help reach goals by learning about other nursing theories and theorists. Nursing theorist Myra Estrin Levine goes into great depth on the relationships between nurse and patient, and the holistic view on healthcare. Levine had many roles as a nurse and was well educated; additionally, her views on nursing are broad and theoretical. Levine defined “three major concepts of the Conservation Model,” including: “(1) wholeness, (2) adaptation, and (3) conservation” (Alligood & Tomey, 2010, p. 227). The current model shown in Figure 1.1 does not take into account the patient as a whole; it only takes into account particular parts of the patient and current complaints/ailments. The current theory used by emergency room nurses (as explained above) could be greatly improved by understanding Levine’s major concepts, and how much environment alone can influence patients. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

This portion of the metaparadigm is defined as an “organismic response;” something nurses learn in anatomy and physiology classes, but often is forgotten when they begin practicing (Alligood & Tomey, 2010, p. 228). This type of response is our autonomic nervous system telling the body to have a “fight or flight” response. This fight or flight response to stress, illnesses, and a patient’s consciousness of what is happening around him/her can induce this response. Fight or flight can increase or decrease one’s heart rate, blood pressure, anxiety, and/or stress. This response is different in all persons, and can vary greatly depending on a person’s previous experiences and if they feel a “threat actually exists” (Alligood & Tomey, 2010, p. 228). Other than the holistic approach to healthcare, Levine understood the importance of a nurse and patient relationship. Whether or not nurses and patients realize it, they are constantly utilizing Levine’s conservation models. When taking care of several patients, nurses need to conserve on energy so that they do not get tired quickly. Often, things such as IV trays or kits are used to make it easier for nurses to conserve on energy (walk less) and complete tasks efficiently. In addition, when patients are sick, they must conserve on energy and rest so that the human body can fight off an illness. Conservations like this and of many different types are needed for both the nurse and patient. The conservation of structural integrity and personal integrity are utilized within each nurse and patient interaction. When a patient has a massive head trauma, for example, the nurse must keep his/her own personal integrity to protect the patient from increasing his/her own anxiety/stress; which would utilize more energy in the patient and decrease the body’s ability to heal. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

The nurse might be overcome with feelings when seeing a large amount of blood, but realizes that he/she must be well-informed of his/her non-verbal cues towards the patient. Personal integrity also includes the nurse putting importance on patient requests such as: do not resuscitate, HIPPA compliance, patient privacy, and educating the patient on procedures and interventions that are being done. With the head trauma patient, the nurse can maintain structural integrity by holding pressure on the wound to prevent further blood loss. This type of nursing intervention can be life-saving, and prevent the patient from further deterioration. Conservation of energy, structural integrity, and personal integrity are crucial in all nursing interactions. Furthermore, it is the nurse’s responsibility to take into account and conserve social integrity as well. Society thrives on social well-being; additionally, Levine concluded that “health is socially determined” (Alligood & Tomey, 2010, p. 229). When the nurse educates the patient in a fashion that makes the patient regain independence, this makes the patient increase personal integrity and become socially accepted in that he/she is regaining health. In society, people tend to define others by their illnesses. Whether it is cancer, obesity, limb amputation, or pregnancy, society will judge a person based on those health issues; moreover, the person will then be socially accepted or rejected. Part of the profession of a nurse is to help guide a patient’s family members and friends on how to perceive and react to that patient and his/her illness (youtube.com, 2011). Furthermore, it is important that the nurse improves a patient’s social integrity while in the hospital setting by proving social media and communication tools such as: magazines, television, newspapers, or telephone (University of the Philippines Open University [UPOU], 2011). This can help improve a patient’s self-esteem, and decrease the stress illnesses can create. Understanding the nurse-patient relationship and conservation models helps the nurse and patient succeed in regaining health within a patient. Simple models such as Figure 1.1 do not include the personal feelings of a patient or nurse, and how that can affect the overall result of a patient’s health/illness. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Figure 1.2: Primary care nursing that utilizes Levine’s concepts of Conservation Model (Alligood and Tomey, 2010, p. 227)

Levine’s conservation model explains what the primary care nurse has to take into account when assessing a patient (Fig 1.2). The nurse must base her care and decisions on the patient and his/her family. Figure 1.2 also helps explain the connection of a model to nursing metaparadigm; the well-being, person as a whole, education, and nursing aspects. In addition, seeing the patient as a “whole” helps the primary care nurse remember to look at the patient’s overall health. This comprehensive assessment includes: clinical problems (body), psychological aspects (mind), and spiritual beliefs that may affect the plan of care. The interrelationships between wholeness, adaptation, and environment helps primary care nurses understand the bigger picture and how the advanced practice nurse can increase the outcome for the patient. “Adaptation” describes the patient’s variables that can affect the patient as a whole, or be affected by his/her environment. For example, a patient may increase in age, quit smoking, or increase in weight; these variables and/or variations in a patient can greatly change the patient and/or treatments and interventions. A patient’s environment must be understood “both internally and externally” by the medical team (Alligood & Tomey, 2010, p. 227). Again, this deals with the patient as a whole and is comparable to adaptation and a holistic plan of care. Knowing the environment that the patient resides in can affect his or her own health. If the patient doesn’t understand the notion that he/she is terminally ill, it may be difficult to explain the importance of a hospice program to the patient. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Figure 1.3: Levine’s “Conservation Principles” and their interrelationships within a nurse and client connection (Alligood & Tomey, 2010, p. 229).

Levine also understood the nurse-patient relationship and how that can affect many areas within the ill-or-well patient. In this relationship, it is learned that nurses and patients often want to keep their integrity during any interaction. For example, a patient’s mother named Sarah brings her three-year-old daughter Claire in to the emergency room because Claire had a seizure at home. The patient is no longer having a seizure, and has been diagnosed with seizures over 1 year ago. Claire has a prescription for anti-seizure medicine, but her mother does not feel comfortable administering the medication; instead, Sarah brings Claire directly to the emergency room with each seizure occurrence. Now, Sarah is attempting to keep her own integrity by not having to administer anti-seizure medications in her daughter’s rectum in such a high stress situation. In addition, she wants Claire’s condition to be controlled in order for her to be accepted within the community. On the other hand, the primary care nurse practitioner must keep her personal integrity by not getting upset each time this patient visits the emergency room. It is the professional’s responsibility to re-educate Sarah on the plan of care, or tailor it towards the individual and family. This would be an opportune time to discuss other options for anti-seizure medicines, education on how to administer the current medication available, and give a referral to a neurologist. When tailoring the plan of care, Levine’s four conservations come into effect (Fig 1.3). The patient’s energy is utilized with each seizure activity, and possibly structural integrity—due to depletion of oxygenation to the brain and possible neuro deficits. The nurse tries to preserve personal integrity and educate the family of Claire in a way that is skilled and direct so that they may understand the concepts and accept the plan of care. Nursing interventions and education in situations like this can be life-changing, and decrease stress for the patient’s family. It is important to remember that there are always assumptions made to any nursing model, but learning from that model is what is truly essential. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Assumptions made to Levine’s conservation theory are that nursing interventions and implementation of those interventions can affect both the ill and/or well patient. Patients do not need to be ill in order to fit within the guidelines of conservation. Most patients feel compelled to be accepted, while maintaining personal authenticity (Fawcett, Schaefer, & Moore, 1991). Moreover, the “environment” section of the model in Figure 1.2 can be falsely understood; that patients might only be able to learn in stress-free situations. Sometimes, stressful situation are where patients, families, and nurses learn best! Lastly, it appears that all human beings act in the same manner, and that patients and nurses alike utilize the same processes (UPOU, 2011). This cannot be true because all patients are diverse, and so are all nurses and primary care professionals. “Nursing intervention must be founded not only on scientific knowledge, but specifically on recognition of the individual’s behavioral responses” (Cardwell, 2013). The response to nursing interventions and the “trial and error” processes are absent in the model (explained in Figure 1.2) of advanced practice nursing based on Levine’s theories. Advanced practice nurses are constantly intervening to improve the health and wellness of a patient; however, those interventions are not always successful. Furthermore, the advanced nurse practitioner must modify her plan of care constantly. This type of framework of nursing is more of a cycle than a process. “Holistic nursing is dedicated to the humanizing experience that the nurse can bring to the bedside, certain in her knowledge and skilled in her techniques, but sensitive and responsive to the person she finds there”(Cardwell, 2013). In this phrase, Levine is summarizing the approach and goal of the advanced practice nurse practitioner. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Advancing from the role of a registered nurse, primary care nurse practitioners increase their competence, knowledge, and skills. This increase in knowledge helps nurse practitioners in decision making, treatment options, and educating the patient. The primary function of the nurse practitioner is to educate patients across the lifespan, and help patients maintain health. Prevention is the best intervention. Since nurse practitioners begin their careers as bedside registered nurses, advanced nurse practitioners agree with Levine’s “holistic approach to healthcare” and healing (Fawcett, Schaefer, & Moore, 1991). In conclusion, primary care nurse practitioners can benefit from viewing the patient as a whole, while spending a large amount of time listening and educating the patient. No two patients, medical cases, or plan of care can be exactly the same. Nurse practitioners thrive because they spend time with their patients and getting to know their needs; this helps increase patient success and healing. Nursing theory and the interrelationships between a patient’s conservation of energy, social integrity, structural integrity, and personal integrity are essential to the nurse practitioner. The increase of knowledge in the nurse practitioner helps him/her understand all aspects of the patient, and the most efficient way of approaching those patient needs. Levine once stated, “Confront reality of environment, and maintain well-being” (youtube.com, 2011) It is the purpose of a nurse practitioner to challenge the internal and external factors and environments distressing a patient, while providing resources and education to increase that patient’s health. The cycle and theories between nurses and patients will continue to transform and be challenged; it is the nurse practitioner’s role to put those theories into practice. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Good morning, my name is Annamaria Amodei. I was born in Florence Italy and lived there for 20 years. I then came to New York in 1981. In the last 30 years I went through lots of changes in my life and in my careers. I grew older and wiser by going through a marriage, 3 wonderful children, a divorce and a several jobs within several different sectors of industries, from restaurant manager and owner to medical billing therefore dealing with the public at all times.

In the mid 90s I decided to return to school and because my interest was in health I enrolled in a 2 year nutrition program receiving an associated degree in dietetics in 2000. Instead of applying my degree to a job in nutrition, I become a co-owner of a surgical supply store which has kept me occupied for the past 10 years. I’ve been again involved with the public, this time a very different one. The people I see are mostly physically sick, handicapped or in some kind of physical pain They were coming into my store because they knew that I could help them with my knowledge, experience and a deep will to help others. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

I found myself helping one person after another and I realized that helping others gave me a lot of joy, because I knew that I was able to make a difference in someone’s life. So about a year ago I decided to go further with my studies. I searched for a program to fulfill my needs and a school that would offer excellent training. That is why I applied to D’Youville College where I’m going to start my nursing education in January 2011. I have so much love in me and so much compassion to give that I cannot think of a better way to share that with other people than to care for them as a nurse.

I want to impact people’s lives whether it’s just for a second, a moment or a lifetime. I want to be that nurse that cannot only be just a nurse, but can also be a friend to her patients. A nurse can touch lives in so many different ways and aspects. The purpose of a nurse is to fulfill his/her job in different areas of people’s lives and situations, and because we all ail in different ways. A nurse is trained to make sure that each patient is comfortable no matter what is the nature of their illness. I ruely believe that if you are a good nurse you will find satisfaction in your patient’s recovery and it is a nurse’s obligation to treat all patients with the utmost respect as well as to maintain their dignity at all times. A nurse has to be knowledgeable enough to understand each patient’s situation as an individual and attend to their needs accordingly because every case is so different and unique. That is why I strongly believe that education and experience are very important keys for a nurse to master her/his profession. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

There are many other ways that a nurse with a bachelor or a master degree in USA can find employment outside the hospitals settings. Community Health Nurses – Usually this type of nurses work for the government, towns, cities and also non-profit agencies. Their job is to inform the public about how to avoid health risks, how to achieve a healthier lifestyle including principals of good nutrition and the basics of physical fitness. They often address a certain segment of population, such as children or elderly, and they usually will be doing public speaking at schools, churches, community groups, etc.

Prison-Jail Nursing – This is another way a nurse can give her services to a population that unfortunately is growing and they also have a lot of health problems and they require the proper attention. It takes a special kind of nurse to work in a correction facility and they probably have had many prior opportunities to experience nursing before beginning a prison nursing career. Managed Care Nursing – Is another way that a nurse can find employment. More and more people are having health insurance and a lot of health problems, so the cost of healthcare is skyrocketing. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

HMO’s, Medicare Medicaid and other private insurance companies are hiring nurses directly to work for them. Managed care nurses serve both patients and their employers providing quality health care for more people by educating their clients in prevention and healthy lifestyles, and looking for different health care delivery in order to keep the cost of insurances down. Nursing Educator –. Because of the increasing nurseing shortage, the demand for nurse educators is becoming very popular.

Nurses with a master degree and several years of experience who love their profession combined with a love for teaching and the passion for sharing their knowledge are perfect for this kind of job. Missionary Nurses –There are many organization and agencies providing support and relief to third world countries. If you want to help people less fortunate than yourself and you don’t mind spending time overseas, there is no better way to do that than putting all your knowledge and skills to work for these agencies and organizations.

School Nursing – Private or public schools are employing more nurses than ever before because today there are more kids enrolled in school than ever and with more special needs. A school nurse needs to love working with kids and adolescents. Pain Management Nursing – For this kind of nursing a master degree is required. Many nurses in this field work with cancer patients, in homes, hospitals or with Hospice. In the past few years there have been tremendous advances in understanding pain, measuring its intensity and responding with appropriate doses of medication. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Administrative Nursing – This kind of nurses work in large medical clinics, legal firms and big companies. If you have talent for managing people and enjoy working in an administrative position and you‘ve got good office and people skills, this is also a very good nursing career. This position requires a master degree and some experience. Substance Abuse Nursing – Alcohol and drugs are unfortunately a growing number in today’s society. These nurse work with people who are struggling with addition. Many of them work in detox and rehab clinics.

They help people to safely end their addition and try to work with them on the cause of the problem and help them overcome and build a drug and alcohol resistance. This nursing career can be very frustrating at times due to the power that these additions have over people, leading to many relapses. But for a nurse who really wants to improve people’s lives this is an admirable career. Temp Nursing – Many nurses choose not to work for a single facility and they associate with one of the many temporary nurses stuffing agency across the country.

This is a very flexible kind of work, they can choose to work or not in a particular place. Some agency specializes in travel nursing which means that a nurse could work several weeks from Los Angeles to New York and even in Hawaii. The housing is paid for and this is an excellent opportunity for single people. If you are a nurse that wants lots of flexibility then a temp nurse is an excellent career choice. Nurses are also needed in all branches of the military. Some of them become hospice nurses dedicated to care for those that are terminally ill and during their last days of life. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

The world of nursing career is wide open and new job descriptions are being created all the time as nurses responds to a rapidly changing world. A career in nursing has endless opportunities and that is why I’m much exited to start this program. I would like to thank Dr. Mariano (and Dr. Lewis) for giving me the opportunity to speak to you about why and how I decided at my stage in life to change careers and become a nurse I also want to thank all of you for listening this morning. I wish you the best in your journey through medical school Ciao

Alcohol and drug addiction are foremost, habitual, advanced, and often a catastrophic problem. United States society does not acknowledge addiction as a disease, but as a moral failure or lack of will power. (Trossman 27) Several nurses are reserved when faced with a colleague who may have a substance-abuse addiction because of dedication, concerns of being a hypocrite, or concerns of threatening a colleague’s license to practice. Substance abuse addiction must be accepted as an illness so that nurses can help one another recognize and seek treatment for the problem. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

The prevalence of substance abuse in the nursing population has not been fully documented, but it is thought to be equal to the general population. An estimated 10 percent of the nursing population has an alcohol and/or drug abuse problem, and of that 6 percent of nurses have problems that are serious enough to interfere with their ability to practice. (Ponech) The American Nurses Association shows that 6 percent to 8 percent of nurses abuses alcohol or drugs to an extent adequate enough to impair their professional judgment. (Daprix) Nurses tend to use prescription-type medication more than marijuana and cocaine. (Trinkoff) Statistics show that nurses are more likely to practice sobriety when compared to other occupations. (9)

A significant underlying reason for nurses to participate in substance abuse is associated to family histories that include emotional impairment, alcoholism, drug use, and/or emotional abuse that result in low self-esteem, overachievement, and overwork. (Monahan) Nurses are often highly caring individuals who often take on the role of caregivers, which could be healthy or unhealthy; this characteristic attracts them to the nursing field. Many nurses find this occupation allows them to continue with the role of a caregiver, the same role they play as the children of alcoholic parents. (Monahan) Nurses have a higher occurrence rate of alcoholism then their family history. (Fisk) One statistic shows that family alcoholism contributed to alcohol abuse in approximately 80 percent of nurses who had an alcoholic family member. (Stammer) NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Stress in the workplace presents another reason for why some nurses abuse substances. Increased workloads, decreased staffing, double shifts, mandatory overtime, rotating shifts, and floating to unfamiliar units all contribute to feelings of alienation, fatigue, and, ultimately, stress. (Bennett, Mustard) Many nurses are workaholics and are addicted to their careers so they choose to deal with these issues. (Trossman)

Nurses are also at risk for substance abuse due to the high availability of medications in their workplace, and with their knowledge of pharmacological agents, this provides a climate that makes it seem safe to correct internal feelings or illnesses. (Serghis) Nurses have always been taught that medications solve problems such as pain, infections, and anxiety. Not only are medications highly accessible, but nurses wrongly believe that they are able to control and monitor their personal self treatment without becoming addicted. (Creighton, Ellis) Nurses become familiar with controlled substances and easy access to them increases the changes that they will use them for personal use. Due to the fact that nurses administer these medications and watch how they affect their patents, they tend to falsely believe that they can control and monitor their own personal use. (Trinkoff) Some nurses “believe that they are immune to the negative consequences of drug use because they are so familiar with drugs.” (Trinkoff 581). NURS 8410 – Best Practices In Nursing Specialties Essay Paper

The effectiveness of a nurse’s job performance can be aggravated by sleep deprivation, a poor social life, financial problems and being overworked. Several nurses blame psychological or physical pain, emotional problems that are too complex to handle, added with a demanding, high -pressure, and stressful work environment reasons that led them to chemical substance abuse. (Stammer) Even though these nurses who abuse substances have a hard time admitting that they have problems, they are well-liked and respected, highly skilled, and ambitious.(Stammer) Statistics shows that nurses who abuse alcohol “tend to be achievement oriented people who strive to be ‘super nurses’ at work and ‘superwomen’ elsewhere.” (Stammer 79)

Studies have proven that nurses don’t abuse substances more than the rest of the society, (Trinkoff) there are nursing subgroups that are more prone. Exposure to death and dying, lack of education on alcohol and medication hazards, and burnout in general increase the risk of substance abuse. (Trinkoff) Every nursing specialty has different personnel factors, demands and availability of controlled substances. NURS 8410 – Best Practices In Nursing Specialties Essay Paper

Critical care nurses, in the emergency rooms, intensive care units, and operating rooms, show more prescription-type substance abuse along with easier access. (Trinkoff) The frequency of patients dying, work pace, work demands, access to controlled substances results in an increase in substance abuse for these subgroups. (Trinkoff) Critical care unit nurses show to be emotionally and technically demanding. Nurses can have feelings of failure, if patients die unexpectedly. These work demands can test a nurse’s training which can have its downfalls, leaving the nurse with high levels of stress.

Oncology nurses have increased substance abuse rates, specifically with alcohol, and binge drinking. (Trinkoff) It is thought that these nurses are trying to distance themselves from the emotional pain they are experiencing while working with patients who have cancer, so they use alcohol to cope. (Monahan)

Psychiatric nurses experience increase levels of substance use, this practice is heavily oriented around pharmacologic agents. (Trinkoff) These nurses tend to self-medicate more because they are exposed to a culture that accepts using psychotropic medications to cope with life. Psychiatric nurses tend to be more willing to report their substance abuse than other specialties because they tend to believe this is an acceptable form of treatment. (Trinkoff). NURS 8410 – Best Practices In Nursing Specialties Essay Paper

The lowest nurses to report use of addictive substances are pediatric and women’s health nurses. (Trinkoff) This is most likely due to the lack of availability of these substances, or these types of nurses are emotionally expressive. Most people that express their feelings may have less need for substance use. (Trinkoff)

Some nurses may be successful at disguising or hiding a drinking or drug problem, other peers that are familiar with substance abuse are more likely to detect it. (Bennett) Many of the symptoms are general, but when the nurse’s behavior is scrutinized over a period of time, the outcome becomes conclusive. Symptoms such as poor job performance, such as excessive time off, isolation, fatigue, mood swings, and impaired cognition. (Bennett)

Nurses who abuse drugs may support their addiction with prescription medications. They may forge prescriptions, or divert medications directly from patients or the unit’s supply. (Ponech) Nurses may use saline to substitute for a patient’s dose, and save the medication for their personal use. Another way to distract medications would be to sign them out for patients who are discharged, or needed medication for patients that have not requested it. (Ponech). NURS 8410 – Best Practices In Nursing Specialties Essay Paper