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The Importance of Nursing Research

Nursing research has a tremendous influence on current and future professional nursing practice, thus rendering it an essential component of the educational process. This article chronicles the learning experiences of two undergraduate nursing students who were provided with the opportunity to become team members in a study funded by the National Institute of Nursing Research. The application process, the various learning opportunities and responsibilities performed by the students, and the benefits and outcomes of the experience are described. The authors hope that by sharing their learning experiences, more students will be given similar opportunities using the strategies presented in this article. Nursing research is critical to the nursing profession and is necessary for continuing advancements that promote optimal nursing care.

Throughout the 21st century, the role of nurse has evolved significantly. Nurses work in a variety of settings, including the hospital, the classroom, the community health department, the business sector, home health care, and the laboratory. Although each role carries different responsibilities, the primary goal of a professional nurse remains the same: to be the client's advocate and provide optimal care on the basis of evidence obtained through research.

Baccalaureate programs in the United States prepare students for entry-level nursing positions. The focus is to care for individuals throughout the human life span. Knowledge is acquired from textbooks, classroom and Web-based instruction, simulation, and clinical experiences. The goal of all programs is for students to graduate as safe, entry-level professionals, having received a well-rounded exposure to the nursing field. Students are exposed to evidence-based nursing practice throughout their curriculum; however, the allocated time for nursing research is often limited. Many programs require only one 3-credit hour course for nursing research. This amount of time is limited, despite the broad spectrum of nursing research and its influence on current and future nursing care.

Research is typically not among the traditional responsibilities of an entry-level nurse. Many nurses are involved in either direct patient care or administrative aspects of health care. Nursing research is a growing field in which individuals within the profession can contribute a variety of skills and experiences to the science of nursing care. There are frequent misconceptions as to what nursing research is. Some individuals do not even know how to begin to define nursing research. According to Polit and Beck (2006) , nursing research is:

systematic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education, and nursing administration. (p. 4)

Nursing research is vital to the practice of professional nursing, and the importance of its inclusion during undergraduate instruction cannot be overemphasized. Only with exposure and experience can students begin to understand the concept and importance of nursing research.

The purpose of this article is to describe undergraduate students’ experiences of becoming aware of and participating in a federally funded research study from the National Institute of Nursing Research. As a part of funding for the study, which was an AREA award ( A cademic R esearch E nhancement A ward, R15 mechanism), there were designated opportunities for student involvement. The primary aim of the research study was to investigate the effects of gene-environment interactions on risk factors of preclinical cardiovascular disease in a cohort of 585 young adults who all had a positive family history of cardiovascular disease (i.e., essential hypertension or premature myocardial infarction at age 55 or younger in one or both biological parents or in one or more grandparents), verified in the medical record. Specific genes examined included cytochrome P-450, family 1, subfamily A, polypeptide 1; cytochrome P-450 2A; glutathione S-transferase mu 1; and glutathione S-transferase theta 1. Cardiovascular-dependent measures were diastolic blood pressure, endothelium-dependent arterial vasodilation, left ventricular mass indexed for body size, systolic blood pressure, and total peripheral resistance. The effects of ethnicity and gender were also explored.

Learning Opportunity

The learning process began with the principal investigator (M.S.T.) of the study visiting the junior class (class of 2007) of baccalaureate students at the Medical College of Georgia. This particular student group was chosen due to their academic standing because they would have the chance to take full advantage of learning directly from a nurse researcher for one full year before graduation. The principal investigator briefly presented and discussed the growing field of nursing research, the advancements made by nursing research, and the critical role of nursing research to nursing practice. The principal investigator also presented an overview of the funded research study and extended an invitation to students to apply for two part-time positions on the grant that were designed specifically for nursing student involvement. Students recognized the excellent opportunity and were intrigued with the future possibilities. They understood this option was unique and appeared to be a great pathway for becoming an active participant in learning the nursing research process through involvement in an official nursing research study.

The principal investigator established objective criteria for the application process. The criteria included writing a maximum 1-page essay sharing the reasons why the students wanted to join the research project as a team member and also sharing their personal and professional goals for involvement in the study. Many students were interested; thus, it was a very competitive process. The principal investigator reviewed the essays and selected approximately 10 prospective individuals for an interview. The interview was an extension of the essay. At the interview, the principal investigator further described the positions, provided a detailed overview of the grant, and had the opportunity to gain a better understanding of the student candidates. The students were encouraged to ask questions to further understand the expectations of the prospective opportunity. The interview also provided the students with increased exposure to the study's goal and more familiarization with the expectations of the funded positions.

After the interview process was completed, two individuals were selected, per the grant specifications. The selected individuals described the interview process as a positive experience that helped solidify their desire to become involved in the research study. The principal investigator emphasized that this job opportunity was designed to be a learning experience in which the students would be guided through the entire research study process and become members of a multidisciplinary team. Time responsibilities for each student included approximately 6 hours per week. The principal investigator communicated clearly that the nursing baccalaureate program was the first priority for the students, and thus provided a flexible work schedule.

Research Study Experience

The students began working in early april 2006. The first step in the work experience included 6 weeks of funded orientation. This was their first exposure to the research process; thus, it was important for the students to be provided with a strong foundation. Orientation included attending a team meeting and being introduced to the members of the multidisciplinary team (i.e., biostatistician, cardiologist, geneticists, nurse researcher, and psychologist, all of whom served as co-investigators, and the genetic laboratory personnel); reviewing the grant application; completing the Collaborative Institutional Training Initiative (CITI) (2000) ; completing the Roche educational program on genetics; and touring the worksite facilities. Reviewing the grant gave the students a better understanding of the specific aims and objectives of the study and the intended procedures of the genetic laboratory work in which the students would be involved. The complexity of the grant required the principal investigator to further explain and clarify specific details. The CITI training, which is required by the institution's Office of Human Research Protection, was completed online and took approximately 5.5 hours. The CITI program was presented in a tutorial format, and satisfactory completion of numerous quizzes was required. The task was tedious and time consuming, but valuable and essential, as it increased the awareness of the established codes of conduct for research. At the conclusion of the CITI training, the students understood the necessary policies and procedures for maintaining security and confidentiality of human subjects, the legal and ethical issues regarding the research process, and the essential procedures for research conduct.

Although the students had a basic understanding of genetics, they completed the Roche Genetics Education Program (2004) to gain a deeper understanding. The program was direct and easy to navigate and was excellent for all learning styles, as it contained both visual and auditory explanations. The explanations covered both basic and complex genetic concepts. Through the use of the genetics program, the students were able to comprehend abstract genetic details and to further understand the importance and influence of genetics on personal health. To conclude the orientation process, students were taught basic laboratory procedures, such as polymerase chain reaction and restrictive enzyme digestion, which were used to perform genotyping for the study. After these procedures had been observed several times, the students were given the opportunity to acquire hands-on experience with these laboratory techniques. Each of these components of the orientation process provided the students with the needed foundation for becoming involved in the research study.

After approximately 2 months of orientation, the students were ready to begin working in the genetics laboratory. One of the primary responsibilities of the students would be to further learn and become confident with genotyping techniques. The laboratory was shared among research personnel of several funded studies, with various research experiments being conducted concurrently. The students, under the supervision of the principal investigator and geneticist (H.Z.), also worked with experienced research assistants to perform the genotyping. The students maintained a daily log describing the laboratory genotyping procedures and experiments, and these logs were reviewed at team meetings. Although the actual procedure for polymerase chain reaction seemed straightforward, the students quickly learned that quality control must be used. Sometimes during genotyping, the DNA samples did not produce results. The students discovered that there are numerous contributing factors to successful polymerase chain reaction, such as quality of DNA templates, primer specifications, temperature settings, gel conditions, pipette measuring accuracy, and general laboratory techniques. Even the slightest error could result in permanent DNA sample loss, major experiment failure, or DNA sample contamination.

The students met with the research team members frequently to discuss and troubleshoot potential solutions and problem solve techniques that would foster improving the success rate and productivity of the genotyping. From the laboratory experience, the students learned that every detail must be considered and addressed precisely and meticulously when conducting experiments. Sometimes the process became frustrating, but the students soon discovered that patience and persistence were the most important attributes for a laboratory researcher to possess. The laboratory experience was an excellent hands-on learning opportunity. The students no longer viewed research as strictly information gathered from a journal or textbook, but rather as a physical act that required extreme concentration, dedication, and determination.

After spending numerous months in the laboratory performing the required genotyping, the students had the opportunity to be exposed to another role of a nurse researcher. They performed literature reviews regarding the study. Although the students had written papers in their nursing school program that required literature citations, they were not familiar with all of the library resources available to them. In no time, the students learned which library and online resources had the most validity and what would be the most relevant to their study. The literature search results provided the students and principal investigator with information on new studies that had been conducted on gene-environment interactions regarding tobacco smoke exposure and cardiovascular disease. From the literature review experience, the students learned the importance of being selective and time efficient. Often when a search was first begun, thousands of articles were listed, but the students learned the importance of narrowing the searches to the specific areas of focus. After the students completed their searches, they met with the principal investigator, who provided direction on the articles identified as the most relevant to the study.

The students continued working with the principal investigator during data review, analysis, and preparation of dissemination of the results (i.e., the publishing process). They helped to prepare an abstract submission of the study presented at an international meeting ( Tingen et al., 2007 ). They also helped with the preparation of manuscripts of the study results. By the conclusion of their work experience, the students will have been exposed to and participated in the entire research process.

Benefits and Outcomes

From the students’ perspectives, this opportunity was extremely beneficial. Prior to this experience, the students were not familiar with nursing research. Their original perception of research was that it was conducted by people with chemistry, biology, biochemistry, and genetic degrees in laboratories at major universities. They now realize that nursing and research can be combined and that optimal nursing care is dependent on the latest research findings. In addition, the students believe this opportunity has been beneficial in learning that nurse researchers are valuable to nurses in other settings. For example, one of the long-term goals of this research study is to develop appropriate interventions for children who are more susceptible to and at risk for the harmful effects of tobacco smoke due to their genetic heritage. The information obtained by a nurse researcher can be disseminated to nurses who work directly with the individuals to whom the research applies. Practice that has shown to be effective through research allows nurses to better advocate for patients and provide the best possible care. Although the majority of nurses who provide patient care will be consumers of nursing research, implementing evidence-based nursing practice is crucial to provide optimal nursing care. Information from nursing research has the potential to directly impact the care provided to patients in all health care settings.

Now that the students have had the opportunity to become more familiar with nursing research through involvement as team members, they recognize that their future professional possibilities are endless. Nursing research is an emerging and growing field in which individuals can apply their nursing education to discover new advancements that promote evidence-based care. They learned the research process and the important roles that each team member plays during the study phases of conception, design, implementation, analysis, and dissemination. Each aspect of the research process is important and contributes to the overall success of the study.

The students also discovered the benefit of trying new things. Prior to this experience, they had little exposure to the research process and nursing research. Consequently, they had to be receptive to learning and recognize that acquiring new knowledge was a gradual process. At times, the students felt anxious because all aspects were new, but they realized that without trying, they would never advance and feel comfortable with the research process. As the students reflected, they thought this was an excellent growing experience professionally, scholastically, and personally. In addition, this opportunity benefited the students’ peers through discussions and their sharing of work responsibilities, the research process, and the importance of evidence-based practice. As future nurses, the students are strong proponents of nursing research, and this experience has also broadened their horizons regarding future professional growth and opportunities. In addition, they have a better understanding of the importance of scientific evidence to support their clinical practice. As a result, the students thought that a stronger emphasis should be placed on nursing research in undergraduate baccalaureate education and that more students should have the opportunity to participate as team members in nursing research studies.

The students were almost one full year into nursing school and thought they had learned about all of the possibilities for their futures when they were first presented with this learning opportunity. They knew their future options were numerous and included working in acute care and community settings. They also realized they could further their education and pursue graduate degrees to include a master's degree and become an administrator, educator, clinical nurse specialist, nurse anesthetist, or nurse practitioner, or potentially pursue a doctorate. They did not know there was an emerging and growing field in which their nursing education could be applied and furthered—the area of research and the role of becoming a nurse researcher. Prior to this experience, students perceived their possibilities for a professional career in nursing were tremendous. Now by being involved in the entire process of conducting a federally funded research study, they realized their future professional possibilities are limitless.

The authors of this paper hope that by sharing their experience, they will encourage both nursing faculty and nursing students to not only introduce the research process into the nursing curriculum, but also to consider making nursing research a tangible and more integrated process. They think that a more beneficial approach to the introduction of research may be achieved through incorporating research-related content into each nursing course throughout the educational process. This could be conducted in addition to the current curriculum plan of many schools of nursing that require a single and concentrated 3-hour research course with a goal of research becoming a positive experience for students that is enthusiastically received as a new learning opportunity. In addition, students who are involved as team members in a funded research study may be provided with scheduled classroom opportunities for making progress reports to their peers. Also, the students could field questions regarding the research project and their experiences. These activities may foster increased learning and interest about research among the students’ classmates.

As nursing students are the future members of the nursing profession, and for the profession to continue to advance, nursing research must be the foundation of comprehensive, evidence-based clinical practice. This may only occur with increased exposure to nursing research. Therefore, it is critical that the future members of the nursing profession be exposed to, develop an appreciation for, and become more involved in nursing research, and thus incorporate its outcomes into the delivery of optimal professional nursing practice.

Acknowledgments

The lead author was awarded a grant (NR008871) from the National Institutes of Health, National Institute of Nursing Research.

  • Collaborative Institutional Training Initiative [April 14, 2006]; Office of Human Research Protection. The Medical College of Georgia. 2000 from http://www.mcg.edu/Research/ohrp/training/citi.html .
  • Polit DF, Beck CT. Essentials of nursing research: Methods, appraisal, and utilization. 6th ed. Lippincott Williams & Wilkins; Philadelphia: 2006. [ Google Scholar ]
  • Roche Genetics Education Program [May 10, 2006]; Education. 2004 from http://www.roche.com/research_and_development_r_d_overview/education.htm .
  • Tingen MS, Ludwig DA, Dong Y, Zhu H, Andrews JO, Burnett AH, et al. Tobacco smoke exposure and genetics: Youth at risk for cardiovascular disease.. Proceedings of the 13th Annual Meeting of the Society for Research on Nicotine and Tobacco.2007. p. 39. [ Google Scholar ]
  • Research article
  • Open access
  • Published: 09 November 2005

A qualitative study of nursing student experiences of clinical practice

  • Farkhondeh Sharif 1 &
  • Sara Masoumi 2  

BMC Nursing volume  4 , Article number:  6 ( 2005 ) Cite this article

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Nursing student's experiences of their clinical practice provide greater insight to develop an effective clinical teaching strategy in nursing education. The main objective of this study was to investigate student nurses' experience about their clinical practice.

Focus groups were used to obtain students' opinion and experiences about their clinical practice. 90 baccalaureate nursing students at Shiraz University of Medical Sciences (Faculty of Nursing and Midwifery) were selected randomly from two hundred students and were arranged in 9 groups of ten students. To analyze the data the method used to code and categories focus group data were adapted from approaches to qualitative data analysis.

Four themes emerged from the focus group data. From the students' point of view," initial clinical anxiety", "theory-practice gap"," clinical supervision", professional role", were considered as important factors in clinical experience.

The result of this study showed that nursing students were not satisfied with the clinical component of their education. They experienced anxiety as a result of feeling incompetent and lack of professional nursing skills and knowledge to take care of various patients in the clinical setting.

Peer Review reports

Clinical experience has been always an integral part of nursing education. It prepares student nurses to be able of "doing" as well as "knowing" the clinical principles in practice. The clinical practice stimulates students to use their critical thinking skills for problem solving [ 1 ]

Awareness of the existence of stress in nursing students by nurse educators and responding to it will help to diminish student nurses experience of stress. [ 2 ]

Clinical experience is one of the most anxiety producing components of the nursing program which has been identified by nursing students. In a descriptive correlational study by Beck and Srivastava 94 second, third and fourth year nursing students reported that clinical experience was the most stressful part of the nursing program[ 3 ]. Lack of clinical experience, unfamiliar areas, difficult patients, fear of making mistakes and being evaluated by faculty members were expressed by the students as anxiety-producing situations in their initial clinical experience. In study done by Hart and Rotem stressful events for nursing students during clinical practice have been studied. They found that the initial clinical experience was the most anxiety producing part of their clinical experience [ 4 ]. The sources of stress during clinical practice have been studied by many researchers [ 5 – 10 ] and [ 11 ].

The researcher came to realize that nursing students have a great deal of anxiety when they begin their clinical practice in the second year. It is hoped that an investigation of the student's view on their clinical experience can help to develop an effective clinical teaching strategy in nursing education.

A focus group design was used to investigate the nursing student's view about the clinical practice. Focus group involves organized discussion with a selected group of individuals to gain information about their views and experiences of a topic and is particularly suited for obtaining several perspectives about the same topic. Focus groups are widely used as a data collection technique. The purpose of using focus group is to obtain information of a qualitative nature from a predetermined and limited number of people [ 12 , 13 ].

Using focus group in qualitative research concentrates on words and observations to express reality and attempts to describe people in natural situations [ 14 ].

The group interview is essentially a qualitative data gathering technique [ 13 ]. It can be used at any point in a research program and one of the common uses of it is to obtain general background information about a topic of interest [ 14 ].

Focus groups interviews are essential in the evaluation process as part of a need assessment, during a program, at the end of the program or months after the completion of a program to gather perceptions on the outcome of that program [ 15 , 16 ]. Kruegger (1988) stated focus group data can be used before, during and after programs in order to provide valuable data for decision making [ 12 ].

The participants from which the sample was drawn consisted of 90 baccalaureate nursing students from two hundred nursing students (30 students from the second year and 30 from the third and 30 from the fourth year) at Shiraz University of Medical Sciences (Faculty of Nursing and Midwifery). The second year nursing students already started their clinical experience. They were arranged in nine groups of ten students. Initially, the topics developed included 9 open-ended questions that were related to their nursing clinical experience. The topics were used to stimulate discussion.

The following topics were used to stimulate discussion regarding clinical experience in the focus groups.

How do you feel about being a student in nursing education?

How do you feel about nursing in general?

Is there any thing about the clinical field that might cause you to feel anxious about it?

Would you like to talk about those clinical experiences which you found most anxiety producing?

Which clinical experiences did you find enjoyable?

What are the best and worst things do you think can happen during the clinical experience?

What do nursing students worry about regarding clinical experiences?

How do you think clinical experiences can be improved?

What is your expectation of clinical experiences?

The first two questions were general questions which were used as ice breakers to stimulate discussion and put participants at ease encouraging them to interact in a normal manner with the facilitator.

Data analysis

The following steps were undertaken in the focus group data analysis.

Immediate debriefing after each focus group with the observer and debriefing notes were made. Debriefing notes included comments about the focus group process and the significance of data

Listening to the tape and transcribing the content of the tape

Checking the content of the tape with the observer noting and considering any non-verbal behavior. The benefit of transcription and checking the contents with the observer was in picking up the following:

Parts of words

Non-verbal communication, gestures and behavior...

The researcher facilitated the groups. The observer was a public health graduate who attended all focus groups and helped the researcher by taking notes and observing students' on non-verbal behavior during the focus group sessions. Observer was not known to students and researcher

The methods used to code and categorise focus group data were adapted from approaches to qualitative content analysis discussed by Graneheim and Lundman [ 17 ] and focus group data analysis by Stewart and Shamdasani [ 14 ] For coding the transcript it was necessary to go through the transcripts line by line and paragraph by paragraph, looking for significant statements and codes according to the topics addressed. The researcher compared the various codes based on differences and similarities and sorted into categories and finally the categories was formulated into a 4 themes.

The researcher was guided to use and three levels of coding [ 17 , 18 ]. Three levels of coding selected as appropriate for coding the data.

Level 1 coding examined the data line by line and making codes which were taken from the language of the subjects who attended the focus groups.

Level 2 coding which is a comparing of coded data with other data and the creation of categories. Categories are simply coded data that seem to cluster together and may result from condensing of level 1 code [ 17 , 19 ].

Level 3 coding which describes the Basic Social Psychological Process which is the title given to the central themes that emerge from the categories.

Table 1 shows the three level codes for one of the theme

The documents were submitted to two assessors for validation. This action provides an opportunity to determine the reliability of the coding [ 14 , 15 ]. Following a review of the codes and categories there was agreement on the classification.

Ethical considerations

The study was conducted after approval has been obtained from Shiraz university vice-chancellor for research and in addition permission to conduct the study was obtained from Dean of the Faculty of Nursing and Midwifery. All participants were informed of the objective and design of the study and a written consent received from the participants for interviews and they were free to leave focus group if they wish.

Most of the students were females (%94) and single (% 86) with age between 18–25.

The qualitative analysis led to the emergence of the four themes from the focus group data. From the students' point of view," initial clinical anxiety", "theory-practice gap", clinical supervision"," professional role", was considered as important factors in clinical experience.

Initial clinical anxiety

This theme emerged from all focus group discussion where students described the difficulties experienced at the beginning of placement. Almost all of the students had identified feeling anxious in their initial clinical placement. Worrying about giving the wrong information to the patient was one of the issues brought up by students.

One of the students said:

On the first day I was so anxious about giving the wrong information to the patient. I remember one of the patients asked me what my diagnosis is. ' I said 'I do not know', she said 'you do not know? How can you look after me if you do not know what my diagnosis is?'

From all the focus group sessions, the students stated that the first month of their training in clinical placement was anxiety producing for them.

One of the students expressed:

The most stressful situation is when we make the next step. I mean ... clinical placement and we don't have enough clinical experience to accomplish the task, and do our nursing duties .

Almost all of the fourth year students in the focus group sessions felt that their stress reduced as their training and experience progressed.

Another cause of student's anxiety in initial clinical experience was the students' concern about the possibility of harming a patient through their lack of knowledge in the second year.

One of the students reported:

In the first day of clinical placement two patients were assigned to me. One of them had IV fluid. When I introduced myself to her, I noticed her IV was running out. I was really scared and I did not know what to do and I called my instructor .

Fear of failure and making mistakes concerning nursing procedures was expressed by another student. She said:

I was so anxious when I had to change the colostomy dressing of my 24 years old patient. It took me 45 minutes to change the dressing. I went ten times to the clinic to bring the stuff. My heart rate was increasing and my hand was shaking. I was very embarrassed in front of my patient and instructor. I will never forget that day .

Sellek researched anxiety-creating incidents for nursing students. He suggested that the ward is the best place to learn but very few of the learner's needs are met in this setting. Incidents such as evaluation by others on initial clinical experience and total patient care, as well as interpersonal relations with staff, quality of care and procedures are anxiety producing [ 11 ].

Theory-practice gap

The category theory-practice gap emerged from all focus discussion where almost every student in the focus group sessions described in some way the lack of integration of theory into clinical practice.

I have learnt so many things in the class, but there is not much more chance to do them in actual settings .

Another student mentioned:

When I just learned theory for example about a disease such as diabetic mellitus and then I go on the ward and see the real patient with diabetic mellitus, I relate it back to what I learned in class and that way it will remain in my mind. It is not happen sometimes .

The literature suggests that there is a gap between theory and practice. It has been identified by Allmark and Tolly [ 20 , 21 ]. The development of practice theory, theory which is developed from practice, for practice, is one way of reducing the theory-practice gap [ 21 ]. Rolfe suggests that by reconsidering the relationship between theory and practise the gap can be closed. He suggests facilitating reflection on the realities of clinical life by nursing theorists will reduce the theory-practice gap. The theory- practice gap is felt most acutely by student nurses. They find themselves torn between the demands of their tutor and practising nurses in real clinical situations. They were faced with different real clinical situations and are unable to generalise from what they learnt in theory [ 22 ].

Clinical supervision

Clinical supervision is recognised as a developmental opportunity to develop clinical leadership. Working with the practitioners through the milieu of clinical supervision is a powerful way of enabling them to realize desirable practice [ 23 ]. Clinical nursing supervision is an ongoing systematic process that encourages and supports improved professional practice. According to Berggren and Severinsson the clinical nurse supervisors' ethical value system is involved in her/his process of decision making. [ 24 , 25 ]

Clinical Supervision by Head Nurse (Nursing Unit Manager) and Staff Nurses was another issue discussed by the students in the focus group sessions. One of the students said:

Sometimes we are taught mostly by the Head Nurse or other Nursing staff. The ward staff are not concerned about what students learn, they are busy with their duties and they are unable to have both an educational and a service role

Another student added:

Some of the nursing staff have good interaction with nursing students and they are interested in helping students in the clinical placement but they are not aware of the skills and strategies which are necessary in clinical education and are not prepared for their role to act as an instructor in the clinical placement

The students mostly mentioned their instructor's role as an evaluative person. The majority of students had the perception that their instructors have a more evaluative role than a teaching role.

The literature suggests that the clinical nurse supervisors should expressed their existence as a role model for the supervisees [ 24 ]

Professional role

One view that was frequently expressed by student nurses in the focus group sessions was that students often thought that their work was 'not really professional nursing' they were confused by what they had learned in the faculty and what in reality was expected of them in practice.

We just do basic nursing care, very basic . ... You know ... giving bed baths, keeping patients clean and making their beds. Anyone can do it. We spend four years studying nursing but we do not feel we are doing a professional job .

The role of the professional nurse and nursing auxiliaries was another issue discussed by one of the students:

The role of auxiliaries such as registered practical nurse and Nurses Aids are the same as the role of the professional nurse. We spend four years and we have learned that nursing is a professional job and it requires training and skills and knowledge, but when we see that Nurses Aids are doing the same things, it can not be considered a professional job .

The result of student's views toward clinical experience showed that they were not satisfied with the clinical component of their education. Four themes of concern for students were 'initial clinical anxiety', 'theory-practice gap', 'clinical supervision', and 'professional role'.

The nursing students clearly identified that the initial clinical experience is very stressful for them. Students in the second year experienced more anxiety compared with third and fourth year students. This was similar to the finding of Bell and Ruth who found that nursing students have a higher level of anxiety in second year [ 26 , 27 ]. Neary identified three main categories of concern for students which are the fear of doing harm to patients, the sense of not belonging to the nursing team and of not being fully competent on registration [ 28 ] which are similar to what our students mentioned in the focus group discussions. Jinks and Patmon also found that students felt they had an insufficiency in clinical skills upon completion of pre-registration program [ 29 ].

Initial clinical experience was the most anxiety producing part of student clinical experience. In this study fear of making mistake (fear of failure) and being evaluated by faculty members were expressed by the students as anxiety-producing situations in their initial clinical experience. This finding is supported by Hart and Rotem [ 4 ] and Stephens [ 30 ]. Developing confidence is an important component of clinical nursing practice [ 31 ]. Development of confidence should be facilitated by the process of nursing education; as a result students become competent and confident. Differences between actual and expected behaviour in the clinical placement creates conflicts in nursing students. Nursing students receive instructions which are different to what they have been taught in the classroom. Students feel anxious and this anxiety has effect on their performance [ 32 ]. The existence of theory-practice gap in nursing has been an issue of concern for many years as it has been shown to delay student learning. All the students in this study clearly demonstrated that there is a gap between theory and practice. This finding is supported by other studies such as Ferguson and Jinks [ 33 ] and Hewison and Wildman [ 34 ] and Bjork [ 35 ]. Discrepancy between theory and practice has long been a source of concern to teachers, practitioners and learners. It deeply rooted in the history of nurse education. Theory-practice gap has been recognised for over 50 years in nursing. This issue is said to have caused the movement of nurse education into higher education sector [ 34 ].

Clinical supervision was one of the main themes in this study. According to participant, instructor role in assisting student nurses to reach professional excellence is very important. In this study, the majority of students had the perception that their instructors have a more evaluative role than a teaching role. About half of the students mentioned that some of the head Nurse (Nursing Unit Manager) and Staff Nurses are very good in supervising us in the clinical area. The clinical instructor or mentors can play an important role in student nurses' self-confidence, promote role socialization, and encourage independence which leads to clinical competency [ 36 ]. A supportive and socialising role was identified by the students as the mentor's function. This finding is similar to the finding of Earnshaw [ 37 ]. According to Begat and Severinsson supporting nurses by clinical nurse specialist reported that they may have a positive effect on their perceptions of well-being and less anxiety and physical symptoms [ 25 ].

The students identified factors that influence their professional socialisation. Professional role and hierarchy of occupation were factors which were frequently expressed by the students. Self-evaluation of professional knowledge, values and skills contribute to the professional's self-concept [ 38 ]. The professional role encompasses skills, knowledge and behaviour learned through professional socialisation [ 39 ]. The acquisition of career attitudes, values and motives which are held by society are important stages in the socialisation process [ 40 ]. According to Corwin autonomy, independence, decision-making and innovation are achieved through professional self-concept 41 . Lengacher (1994) discussed the importance of faculty staff in the socialisation process of students and in preparing them for reality in practice. Maintenance and/or nurturance of the student's self-esteem play an important role for facilitation of socialisation process 42 .

One view that was expressed by second and third year student nurses in the focus group sessions was that students often thought that their work was 'not really professional nursing' they were confused by what they had learned in the faculty and what in reality was expected of them in practice.

The finding of this study and the literature support the need to rethink about the clinical skills training in nursing education. It is clear that all themes mentioned by the students play an important role in student learning and nursing education in general. There were some similarities between the results of this study with other reported studies and confirmed that some of the factors are universal in nursing education. Nursing students expressed their views and mentioned their worry about the initial clinical anxiety, theory-practice gap, professional role and clinical supervision. They mentioned that integration of both theory and practice with good clinical supervision enabling them to feel that they are enough competent to take care of the patients. The result of this study would help us as educators to design strategies for more effective clinical teaching. The results of this study should be considered by nursing education and nursing practice professionals. Faculties of nursing need to be concerned about solving student problems in education and clinical practice. The findings support the need for Faculty of Nursing to plan nursing curriculum in a way that nursing students be involved actively in their education.

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Best Nursing Research Topics for Students

What is a nursing research paper.

  • What They Include
  • Choosing a Topic
  • Best Nursing Research Topics
  • Research Paper Writing Tips

Best Nursing Research Topics for Students

Writing a research paper is a massive task that involves careful organization, critical analysis, and a lot of time. Some nursing students are natural writers, while others struggle to select a nursing research topic, let alone write about it.

If you're a nursing student who dreads writing research papers, this article may help ease your anxiety. We'll cover everything you need to know about writing nursing school research papers and the top topics for nursing research.  

Continue reading to make your paper-writing jitters a thing of the past.

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A nursing research paper is a work of academic writing composed by a nurse or nursing student. The paper may present information on a specific topic or answer a question.

During LPN/LVN and RN programs, most papers you write focus on learning to use research databases, evaluate appropriate resources, and format your writing with APA style. You'll then synthesize your research information to answer a question or analyze a topic.

BSN , MSN , Ph.D., and DNP programs also write nursing research papers. Students in these programs may also participate in conducting original research studies.

Writing papers during your academic program improves and develops many skills, including the ability to:

  • Select nursing topics for research
  • Conduct effective research
  • Analyze published academic literature
  • Format and cite sources
  • Synthesize data
  • Organize and articulate findings

About Nursing Research Papers

When do nursing students write research papers.

You may need to write a research paper for any of the nursing courses you take. Research papers help develop critical thinking and communication skills. They allow you to learn how to conduct research and critically review publications.

That said, not every class will require in-depth, 10-20-page papers. The more advanced your degree path, the more you can expect to write and conduct research. If you're in an associate or bachelor's program, you'll probably write a few papers each semester or term.

Do Nursing Students Conduct Original Research?

Most of the time, you won't be designing, conducting, and evaluating new research. Instead, your projects will focus on learning the research process and the scientific method. You'll achieve these objectives by evaluating existing nursing literature and sources and defending a thesis.

However, many nursing faculty members do conduct original research. So, you may get opportunities to participate in, and publish, research articles.

Example Research Project Scenario:

In your maternal child nursing class, the professor assigns the class a research paper regarding developmentally appropriate nursing interventions for the pediatric population. While that may sound specific, you have almost endless opportunities to narrow down the focus of your writing. 

You could choose pain intervention measures in toddlers. Conversely, you can research the effects of prolonged hospitalization on adolescents' social-emotional development.

What Does a Nursing Research Paper Include?

Your professor should provide a thorough guideline of the scope of the paper. In general, an undergraduate nursing research paper will consist of:

Introduction : A brief overview of the research question/thesis statement your paper will discuss. You can include why the topic is relevant.

Body : This section presents your research findings and allows you to synthesize the information and data you collected. You'll have a chance to articulate your evaluation and answer your research question. The length of this section depends on your assignment.

Conclusion : A brief review of the information and analysis you presented throughout the body of the paper. This section is a recap of your paper and another chance to reassert your thesis.

The best advice is to follow your instructor's rubric and guidelines. Remember to ask for help whenever needed, and avoid overcomplicating the assignment!

How to Choose a Nursing Research Topic

The sheer volume of prospective nursing research topics can become overwhelming for students. Additionally, you may get the misconception that all the 'good' research ideas are exhausted. However, a personal approach may help you narrow down a research topic and find a unique angle.

Writing your research paper about a topic you value or connect with makes the task easier. Additionally, you should consider the material's breadth. Topics with plenty of existing literature will make developing a research question and thesis smoother.

Finally, feel free to shift gears if necessary, especially if you're still early in the research process. If you start down one path and have trouble finding published information, ask your professor if you can choose another topic.

The Best Research Topics for Nursing Students

You have endless subject choices for nursing research papers. This non-exhaustive list just scratches the surface of some of the best nursing research topics.

1. Clinical Nursing Research Topics

  • Analyze the use of telehealth/virtual nursing to reduce inpatient nurse duties.
  • Discuss the impact of evidence-based respiratory interventions on patient outcomes in critical care settings.
  • Explore the effectiveness of pain management protocols in pediatric patients.

2. Community Health Nursing Research Topics

  • Assess the impact of nurse-led diabetes education in Type II Diabetics.
  • Analyze the relationship between socioeconomic status and access to healthcare services.

3. Nurse Education Research Topics

  • Review the effectiveness of simulation-based learning to improve nursing students' clinical skills.
  • Identify methods that best prepare pre-licensure students for clinical practice.
  • Investigate factors that influence nurses to pursue advanced degrees.
  • Evaluate education methods that enhance cultural competence among nurses.
  • Describe the role of mindfulness interventions in reducing stress and burnout among nurses.

4. Mental Health Nursing Research Topics

  • Explore patient outcomes related to nurse staffing levels in acute behavioral health settings.
  • Assess the effectiveness of mental health education among emergency room nurses .
  • Explore de-escalation techniques that result in improved patient outcomes.
  • Review the effectiveness of therapeutic communication in improving patient outcomes.

5. Pediatric Nursing Research Topics

  • Assess the impact of parental involvement in pediatric asthma treatment adherence.
  • Explore challenges related to chronic illness management in pediatric patients.
  • Review the role of play therapy and other therapeutic interventions that alleviate anxiety among hospitalized children.

6. The Nursing Profession Research Topics

  • Analyze the effects of short staffing on nurse burnout .
  • Evaluate factors that facilitate resiliency among nursing professionals.
  • Examine predictors of nurse dissatisfaction and burnout.
  • Posit how nursing theories influence modern nursing practice.

Tips for Writing a Nursing Research Paper

The best nursing research advice we can provide is to follow your professor's rubric and instructions. However, here are a few study tips for nursing students to make paper writing less painful:

Avoid procrastination: Everyone says it, but few follow this advice. You can significantly lower your stress levels if you avoid procrastinating and start working on your project immediately.

Plan Ahead: Break down the writing process into smaller sections, especially if it seems overwhelming. Give yourself time for each step in the process.

Research: Use your resources and ask for help from the librarian or instructor. The rest should come together quickly once you find high-quality studies to analyze.

Outline: Create an outline to help you organize your thoughts. Then, you can plug in information throughout the research process. 

Clear Language: Use plain language as much as possible to get your point across. Jargon is inevitable when writing academic nursing papers, but keep it to a minimum.

Cite Properly: Accurately cite all sources using the appropriate citation style. Nursing research papers will almost always implement APA style. Check out the resources below for some excellent reference management options.

Revise and Edit: Once you finish your first draft, put it away for one to two hours or, preferably, a whole day. Once you've placed some space between you and your paper, read through and edit for clarity, coherence, and grammatical errors. Reading your essay out loud is an excellent way to check for the 'flow' of the paper.

Helpful Nursing Research Writing Resources:

Purdue OWL (Online writing lab) has a robust APA guide covering everything you need about APA style and rules.

Grammarly helps you edit grammar, spelling, and punctuation. Upgrading to a paid plan will get you plagiarism detection, formatting, and engagement suggestions. This tool is excellent to help you simplify complicated sentences.

Mendeley is a free reference management software. It stores, organizes, and cites references. It has a Microsoft plug-in that inserts and correctly formats APA citations.

Don't let nursing research papers scare you away from starting nursing school or furthering your education. Their purpose is to develop skills you'll need to be an effective nurse: critical thinking, communication, and the ability to review published information critically.

Choose a great topic and follow your teacher's instructions; you'll finish that paper in no time.

Joleen Sams

Joleen Sams is a certified Family Nurse Practitioner based in the Kansas City metro area. During her 10-year RN career, Joleen worked in NICU, inpatient pediatrics, and regulatory compliance. Since graduating with her MSN-FNP in 2019, she has worked in urgent care and nursing administration. Connect with Joleen on LinkedIn or see more of her writing on her website.

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Always a Nurse

A profession for a lifetime.

Sanford, Kathleen D. DBA, RN, FACHE, FAAN

CommonSpirit Health, Chicago, Illinois.

Correspondence: Kathleen D. Sanford, DBA, RN, FACHE, FAAN, CommonSpirit Health, 444 W. Lake St, Ste 2500, Chicago, IL 60606 ( [email protected] ).

The author declares no conflict of interest.

A single career in nursing may encompass numerous and very different positions. Nurses are aware they can select from a variety of specialties, as they choose to learn additional skills or pursue new opportunities. Today's nurses use their intelligence, experience, and holistic concern for all people in more diverse arenas than ever before. This article is followed by a series of first-person accounts of jobs that may not, on first consideration, look like nursing roles. These professionals have not left nursing. They have carried their healing energy, grounding in the nursing process, as well as a desire to improve the well-being of others with them, because they are nurses.

WHAT, exactly, is a nurse? Is he or she simply a person who graduated from an accredited school of nursing? Or, are nurses persons who successfully passed, in the United States at least, one of the state boards of nursing examinations? Does pursuing a career outside of what has historically been considered mainstream health care mean that an individual should no longer identify with the profession? Or, is a nurse only a nurse when his or her professional role involves direct patient (or direct client) interactions and care?

For most of the public, the primary visual image of nurses is probably a group of (mostly) women dressed in scrubs, who perform a variety of personal care or technical procedures in a hospital or clinic setting. Some older individuals may still envision women in white uniforms. Others, who have recently interacted with them outside of acute care, might include both men and women in business clothes, military uniforms, or laboratory coats in their description. They may have encountered nurses in homes, schools, office buildings, birthing centers, rehabilitation centers, prisons, drugstores, or freestanding urgent care and emergency facilities.

All of these depictions have one thing in common: all the nurses in these environments are seen in roles that involve direct interactions with those they are serving. In other words, it is recognized that nurses work in a variety of settings, but very few people would associate an image of, say, a virtual clinician or an executive in an office with “nurse.”

Nurses themselves might recognize the emergence of the virtual role as an appropriate specialty for their profession. However, some may not accept that a person who no longer provides personal care is still performing the role of a nurse. (The exceptions to this may be nurses in public health positions or college professors who are part of educating nurses in schools of nursing.) Gail Latimer, MSN, RN, FACHE, FAAN, recipient of the 2019 American Organization for Nursing Leadership (AONL) Lifetime Achievement Award, referred to this way of thinking when she was interviewed at the AONL annual meeting. She stated that some colleagues could not understand why she would go to work for a large information technology (IT) company. They told her she was “going to the dark side.” Gail, who has helped a myriad of nurses understand how technology can help patients and their caregivers, said, “Innovation is happening in industry. Nurses need to take jobs there. Who better than Florence Nightingale's professional descendants to bring the lamp of caring to the world in every way? We are able to light the corners while carrying the badge that we once touched patients.”

Some nurses whose career journeys include jobs outside of the public's conception of the prototypical nurse may agree they are “no longer caregivers.” Many, however, continue to see themselves as nurses. They are proud of their nursing roots and realize that their successes, their belief systems, and the very core of their beings are the results of being a lifetime member of a very special profession: Nursing.

THE MANY FACES OF NURSING IN HEALTH CARE

Nurses can be found in a variety of health care organization roles that do not include individual hands-on patient care. These include positions in management, executive practice, education, quality, patient experience, safety, human resources, recruiting, infection control, advocacy, chaplaincy, finance, care management, medical records, audit, insurance, strategy, supply chain, legal affairs, communications, compliance, and any number of other “business” activities. Hospitals and others have long recognized the value of unique skills that nurses bring to “non-nursing” jobs.

Management and executive roles filled by nurses may either be nursing specific (such as shift supervisors, unit managers, or chief nurse executives) or general health care management (such as chief executive officers [CEOs], chief operation officers, or formal leaders of non-nursing departments). Management is a specialty, a distinction that not all nurses recognize. Those who manage (and lead) well have defined characteristics, well documented in management literature. In fact, there is a large body of management theory and researched evidence-based practices for formal leaders. 1 The failure of many nurses and nurse educators to recognize nursing management and nurse executive practice as a specialty that needs specialized education and experience has resulted in some poorly prepared nurse managers. Since managers have position power that affects culture, morale, nurse engagement (and therefore patient engagement), turnover, quality, and any number of practice environment factors, this has been detrimental to the profession, individuals, and entire organizations. It has led to the placement of great clinical specialists into a new specialty for which they are inadequately prepared. Sometimes, they are neither ready to competently perform their management jobs nor ready to advocate for their nursing colleagues and patients. In some cases, their lack of preparation or suitability to the role has reinforced perceptions of other health care leaders that nurses are not interested in, or able to manage, budgets or finances. In addition, if nursing management was widely recognized as a specialty that is just as legitimate as medical, surgical, behavioral health, or critical care, perhaps, more nurses would understand that nurses in formal leadership positions have not “left” nursing ( Table 1 ).

Nurse CEOs are even more likely to be seen as no longer belonging to the nursing profession. Some have allowed their licenses to lapse; some do not use “RN” after their names. This is in stark contrast to physician CEOs, who consistently identify themselves as “doctors” (MD or DO). Others recognize that their nurse experience has enriched their professional lives and should give them more credibility as individuals who know that they are leading a clinical enterprise, not just a business that happens to provide health care. They are proud to claim nursing and to have other know that they have touched patients and can relate to the challenges faced by caregivers ( Table 2 ).

CEO Question: How Has Being a Nurse Made You a Better CEO?
Laurie Harting, CEO, Greater Sacramento Division, CommonSpirit Health I have been a hospital or Division CEO for 15 y and I know my clinical background has provided me with the knowledge and expertise to talk directly with the physicians and nurses about practice patterns, supplies, and hospital operations. I know that once they learn that I am a nurse, they relax when they speak with me because they don't have to explain everything in the same level of detail that they do with nonclinical administrators. My clinical knowledge also allows me to challenge comments or complaints made by nurses because I have walked in their shoes—and sometimes I can offer alternative ways to think about a situation. I love being a nurse and I will always identify myself as a nurse.
Larry P. Schumacher, Senior VP Operations & CEO, Southeast Division, CommonSpirit Health Being a nurse with bedside and community experience has given me significant clinical credibility with physicians and clinical disciplines. My history gives me an expedient way to clearly comprehend their problems and help the clinical team work toward solutions. I think it has also given me the ability to listen intensely. I know and appreciate that clinicians want to be heard, and as a CEO who has been on the front lines, others can accept that I know and understand what I am hearing.
Linda Hunt, President, Arizona Division, CommonSpirit Health Being a nurse has taught me many lessons which have prepared me to be a CEO. The first lesson is that it takes a well-coordinated team to deliver outstanding patient care or run a complex health care organization. I know that clear concise communication, honesty, trust, and collaboration are all key attributes to being both a successful leader of organizations and a caregiver. The most important lesson I have learned is to listen attentively with your ears and your heart. Many times, it is more about what is not being said than what is being expressed. As a nurse, I developed a sixth sense that taught me to trust my instinct in situations and be observant and dig deeply to find out what is really going on. Your gut reaction, many times, is the best guide to form your actions.
Julie J. Sprengel, President, Southwest Division, CommonSpirit Health Being a nurse gives us the unique perspective of not only clinical expertise but also being a part of the sacred journey of vulnerability which is at the core of the patient's experience. The best CEOs are those who truly understand their business but, more importantly, their “customers” and their employees. I would argue that there is no one better to understand and lead health care than someone who knows both.

“Nurses as hospital administrators” is not a new phenomenon. In fact, historians Margarete Arndt and Barbara Bigelow have published several articles about the history of hospital management, as described in Table 3 .

Early hospital administrators were called superintendents. The majority were nurses, other than physicians, who were mostly in academic institutions. Margarete Arndt, who teaches at the Clark University Graduate School of Management in Worcester, Massachusetts, has studied extensively the evolution of “hospital administration, including how the field was “masculinized.”
In 1929, a book was published, titled . In 1934, the University of Chicago established the first graduate program in hospital administration, with the book's author, Michael Davis, as the program leader. In the 1940s, other universities began to offer this degree. Once these MHA programs were established, hospitals who wanted educated administrators could only hire men because university graduate programs admitted virtually no female students.
Arndt has also described the problems faced by female hospital superintendents that business leaders felt would be solved by moving to educated businessmen as hospital administrators:
;

A third group of nurses who are sometimes accused of having “left” nursing (and “joined” medicine) are those who have selected advanced practice specialties. Although they are educated in schools of nursing, have nursing licenses, have “nurse” in their specialty titles (nurse midwife, nurse anesthetist, nurse practitioner, etc), and are under the jurisdiction of state boards of nursing, they are sometimes not identified with the profession. By definition, physicians and advanced nurse practitioners are not the same:

Doctors, at their core, are scientists; they study diseases and how to cure them. Nurse practitioners, at their core, are healers. The vast majority began their careers as registered nurses, and focus their care on wellness of the whole body and mind. That's not to say that doctors never take a more holistic approach to health, or that Nurse Practitioners don't use scientifically tested treatments—there's plenty of overlap—but their basic approach to patient care differs at the philosophical level. 2

In addition, their biggest professional support continues to come from nursing organizations and nurse leaders who advocate for them and for laws/regulations that allow them to practice at the top of their licenses ( Table 4 ).

NURSES IN ROLES OUTSIDE OF TRADITIONAL HEALTH CARE

While most nurse leaders recognize the natural fit between nurses and health care roles that do not quite fit the stereotypes, many members of the public do not realize the variety of ways that nursing is practiced. They might be surprised to learn that there are organizations such as The American Association of Nurse Attorneys (TAANA) and the National Nurses in Business Association (NNBA).

They may know that nursing specialties include hospice, camp, cruise ship, public health, dialysis, correctional (prison), and flight nursing. These roles are still considered hands-on. Some community members may have crossed paths with nurses who are health coaches or who serve as occupational nurses, with responsibility for the health and safety of workers in industry. It is less likely that they are aware that nurses serve as informaticists, who combine the sciences of nursing and analytics; telehealth clinicians, who triage patients and help them discern next steps for care they may need; forensic nurses, with special training in protection of evidence, who care for the victims of trauma or violence in the criminal justice system; case managers, who coordinate an individual's care across the confusing landscape of a fragmented health system; or nurse writers, who compose educational/academic materials, author articles for journals or magazines, write history books, or even develop television and movie scripts that involve health care.

Nurses perform all of these roles and more. Some are also lobbyists for patients and the professionals who care for them. Some serve on boards, where they can bring the voice of these groups to decision tables. Others have determined that their knowledge and passion for healing individuals, communities, and nations can be most influential when they serve as elected officials. Table 5 describes nurse who have served (or are currently serving in) the Congress of the United States.

was a member of the United States House of Representatives from March 1998 until January 3, 2017. She represented California's 24th District. She worked for 20 y as a nurse and health advocate for public schools. She was a strong supporter of the Patient Protection and Affordable Care Act. She founded the Congressional Nursing Caucus and the School Health and Safety Caucus. She also co-founded, among others, the Congressional Caucus on Women's Issues, the Biomedical Research Caucus, the House Cancer Caucus, the Heath and Stroke Coalition, and the Caucus on Infant Health and Safety.
, from the 14th District of Illinois, was elected in January 2019. Her nursing history includes working with the Medicaid Plan in Chicago, acting as senior advisor at the US Department of Health and Human Services, and assisting communities across the country to prevent and respond to disasters, bioterrorism threats, and public health issues. She has also taught advanced practice students.
elected by the 30th District of Texas was previously the chief psychiatric nurse at the VA hospital in Dallas. She assumed office on January 3, 1993, after 16 y in that position. Before being elected to Congress, she served in the Texas State House and the Texas State Senate. She chairs the Committee on Science and Technology and sits on the Committee on Transportation and Infrastructure.

THE PAST, PRESENT, AND FUTURE FOR NURSING

There are multiple books that chronicle the history of nursing. Some record the life stories of individual nurses, such as Mary Eliza Mahoney, Edward Lynn, Clara Barton, John Hogan, Catherine McCauley, Walt Whitman, Juan Ciudad, and, of course, Florence Nightingale. Others, such as in the beautiful book by Patricia Donahue, Nursing, the Finest Art: An Illustrated History , 15 trace the history of a profession essential to the well-being of humanity.

The calendar is about to turn to the year 2020, which has been declared the Year of the Nurse and Midwife by the World Health Organization. Governments around the world have endorsed this, recognizing that the goal of universal health care will not be accomplished without these professionals. 2020 is also the 200th anniversary of the birth of Florence Nightingale and the third year of the international “Nursing Now” campaign, which has a goal of increasing worldwide health by improving the profile and status of nurses. Acknowledging the variety of roles that nurses play in their quest for universal “wellness” can help with that objective.

Today's nurses continue to use their intelligence, skill, experience, passion, and holistic concern for all people in more diverse arenas than ever before. This article is followed by a series of first-person accounts of jobs that might not, at first consideration, look like nursing roles. The nurse authors of these narratives are a very small sample of those who have pursued education and opportunities that took them away from the bedside, but who retain their identity as nurses. Every one of them speaks about how their nursing education (including training based on the Nursing Process—see Table 6 ) and experience as direct caregivers have provided the foundation for their lives and current work. They have not “left” their profession. They have carried nursing—embodied by their intellect, healing energy, love, and desire to improve the wellness of the world—with them ... because they are nurses.

I. Assessment The nurse gathers information about the patient's psychological, physiological, sociological, and spiritual status. This is done through patient interviews, physical examinations, patient and family history, and general observation.
II. Diagnosis The nurse makes an educated judgment about potential or actual patient health problems. Multiple diagnoses are sometimes made for a single patient. These include present problems and risks of future problems.
III. Planning Nurse and patient agree on diagnoses. A plan of action is then developed. Each problem is assigned a clear, measurable goal. Nurses refer to standardized terms and measurements for tracking patient wellness.
IV. Implementing Nurse follows through on plans of action, which are specific to each patient. Actions include monitoring, direct care, performance of technical procedures, educating and instructing patients and family, and referring or contacting patient for follow-up.
V. Evaluating Nurse evaluates whether goals for wellness have been met. Possible outcomes are improvement in patient condition, stabilized patient condition, or the patient's condition deteriorated. If the patient has shown no improvement or wellness goals have not been met, the process begins again from the first step.
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Nursing Research Paper

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This sample nursing research paper provides a comprehensive exploration of the multifaceted nursing profession, examining its historical development, theoretical foundations, and the current state of nursing education and practice. The paper delves into the evolution of nursing roles, the impact of significant figures in the field, and the progression towards advanced nursing practices. It also scrutinizes the ethical and legal frameworks that govern nursing, highlighting the importance of these considerations in daily practice. Furthermore, it discusses the challenges and opportunities that the future holds for nursing, including technological advancements, changes in healthcare delivery, and the ongoing development of nursing as a profession. Through a synthesis of scholarly literature, this paper aims to offer a nuanced understanding of the critical role nurses play in healthcare and the dynamic nature of nursing as it adapts to meet the changing needs of society.

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This sample nursing research paper seeks to clarify the domain of nursing within the broader context of healthcare, charting its historical progression and delineating the contemporary role of nurses within healthcare systems. Nursing, traditionally rooted in care and compassion, has evolved into a complex, evidence-based discipline integral to healthcare delivery (Alligood, 2017). Its domain extends beyond bedside care into realms of research, policy, and education, reflecting a breadth of influence on patient outcomes and healthcare efficacy.

The historical trajectory of nursing is rich and varied, with its modern form shaped significantly by the pioneering work of figures such as Florence Nightingale, whose emphasis on sanitary conditions during the Crimean War set a precedent for the integration of environmental factors in patient care (Dossey, 2010). As the profession has developed, so too have the educational and regulatory frameworks that support it, transitioning from informal apprenticeships to advanced degree programs and licensure requirements (Judd & Sitzman, 2014).

In contemporary healthcare systems, nurses function as the linchpin of patient services, providing not only direct patient care but also engaging in health promotion, disease prevention, and advocacy across a variety of settings. Their roles have expanded to include leadership positions where they influence healthcare policies and contribute to interdisciplinary teams aimed at improving healthcare quality and accessibility (Institute of Medicine, 2010). The role of nurses continues to adapt, driven by changes in healthcare needs, advances in medical knowledge, and shifts in societal expectations.

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Historical Context of Nursing

Nursing Research Paper

Influential figures have been instrumental in shaping the trajectory of nursing. Florence Nightingale, often revered as the pioneer of modern nursing, introduced principles of hygiene and sanitation during the Crimean War, dramatically reducing mortality rates (McDonald, 2001). Her subsequent establishment of the first secular nursing school at St. Thomas’ Hospital in London set the foundation for formal nursing education. Another seminal figure, Clara Barton, known for her role in founding the American Red Cross, emphasized the importance of nursing in public health and disaster response (Pryor, 1988). These pioneers not only advanced nursing practice but also elevated the status of nursing to a respected profession.

The emergence and development of nursing education and professional standards have further defined nursing as a critical component of the healthcare system. The late 19th and early 20th centuries saw the establishment of nursing schools that not only imparted technical skills but also instilled a professional ethos. The American Nurses Association, formed in 1911, and the International Council of Nurses, established in 1899, began setting professional standards and advocating for the rights of nurses and the nursing profession worldwide (Dock & Stewart, 1938). As the 20th century progressed, nursing education expanded to universities, embracing scientific research and evidence-based practice, which has continued to elevate the profession’s standards and scope of practice.

Theoretical Foundations of Nursing

The theoretical underpinnings of nursing serve as the scaffolding for the profession, offering guidance and a framework for nursing practice, research, and education. Florence Nightingale’s Environmental Theory, which emphasizes the importance of the patient’s environment in healing, laid the groundwork for modern nursing theory (Nightingale, 1860). Subsequent nursing theories have expanded on this foundation, integrating concepts from health, personhood, environment, and nursing itself. For instance, Virginia Henderson’s Need Theory focuses on the nurse’s role in assisting patients to achieve independence and wholeness through the fulfillment of basic human needs (Henderson, 1966).

The utilization of these theories in clinical practice is not merely academic; it directly influences patient care. Jean Watson’s Theory of Human Caring, for instance, centers on the relationship between patient and nurse and proposes that caring can promote health better than a simple medical cure (Watson, 1979). This theory has been employed in various healthcare settings, shaping patient-nurse interactions by fostering a holistic approach to care that encompasses physical, emotional, and spiritual well-being.

The progression from basic nursing practice to advanced practice is also deeply intertwined with theoretical knowledge. Advanced practice nurses, including nurse practitioners, clinical nurse specialists, and nurse anesthetists, draw upon a rich theoretical foundation to inform their decision-making and practice. For example, Patricia Benner’s Novice to Expert Theory outlines the stages of clinical competence, providing a framework for the continual growth and development that characterize the journey from novice nurse to expert practitioner (Benner, 1984). This theoretical model not only guides nurses in their personal professional development but also underscores the value of experience and education in delivering high-quality, nuanced patient care.

In essence, nursing theories are not static constructs but are dynamic and integral to the ongoing development of nursing as a science and an art. They provide a lens through which nurses can understand their practice, contribute to patient outcomes, and advance the field of nursing.

Nursing Education and Professional Development

Educational pathways and licensing for nurses.

The educational journey for nurses is a cornerstone of the healthcare profession, ensuring that the individuals caring for patients possess the necessary knowledge and skills. This journey typically begins with foundational programs that lead to initial licensure. Prospective nurses may choose between several educational pathways, such as diploma programs, which historically were the most common route, associate degree programs (ADN), which offer a balance of time-efficiency and thorough preparation, and bachelor’s degree programs in nursing (BSN), which have become increasingly favored in recent years (Institute of Medicine, 2010). The BSN programs, in particular, are gaining prominence due to research indicating that a higher level of education among nursing staff is correlated with better patient outcomes, including lower mortality rates and improved quality of care (Aiken et al., 2014). Following the completion of these academic programs, graduates must successfully pass the National Council Licensure Examination (NCLEX-RN for registered nurses) to practice as licensed professionals. This examination serves as a critical gatekeeper, ensuring that all practicing nurses meet a standardized competency level to provide safe and effective patient care.

Ongoing Education and Areas of Specialization within Nursing

The field of nursing is one characterized by lifelong learning, with ongoing education seen as both a professional responsibility and a personal commitment to excellence in patient care. Advanced practice nurses (APNs), including nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives, often require a master’s degree (MSN) or doctoral degrees (DNP or PhD) to specialize and practice independently or in advanced roles (Institute of Medicine, 2010). Specialized areas such as pediatrics, gerontology, oncology, and cardiac care not only require advanced knowledge but also specific clinical skills that are often acquired through additional certification programs and clinical practice hours. These specialized roles are integral to the healthcare system, providing targeted care that addresses the specific needs of diverse patient populations. The demand for specialization is anticipated to grow, particularly as healthcare becomes more complex and the population ages, necessitating a workforce adept in specialized care (Buerhaus et al., 2017).

Influence of Professional Nursing Organizations on Career Advancement

The role of professional nursing organizations is pivotal in fostering a nurse’s career development. These organizations, such as the American Nurses Association (ANA), Sigma Theta Tau International (STTI), and the International Council of Nurses (ICN), provide members with access to a wealth of resources that are essential for professional growth and development. They offer opportunities for continuing education, professional networking, and leadership development, all of which are critical for career advancement (Matthews, 2012). In addition to educational benefits, these organizations advocate for the profession’s interests, influencing policy and legislation that affect nursing practice and healthcare delivery. Active participation in these organizations can elevate a nurse’s professional profile, open doors to leadership positions, and contribute to the advancement of the nursing profession as a whole.

In conclusion, nursing education and professional development are essential components of a robust healthcare system. As the demands of healthcare evolve, so too must the educational and professional development opportunities available to nurses. Ensuring that nurses have access to quality education and ongoing professional development is critical not only for their personal career advancement but also for the provision of high-quality patient care.

Ethical and Legal Considerations in Nursing

The practice of nursing is deeply entrenched in ethical and legal principles that guide the profession in providing safe, compassionate, and competent care to patients. Nursing ethics, a subset of bioethics, involves dilemmas and decisions nurses must navigate in their daily practice, often relating to issues such as patient autonomy, informed consent, confidentiality, and the allocation of healthcare resources (Fry & Johnstone, 2002). Nurses are commonly faced with ethical issues like end-of-life care decisions, handling cases of potential abuse, and respecting patients’ wishes even when they conflict with the family’s desires or the healthcare team’s opinions (ANA, 2015).

Legal responsibilities in nursing practice are equally important, as nurses must operate within the boundaries of the law to protect their patients, themselves, and their employers. In the United States, for instance, nurses must adhere to the Health Insurance Portability and Accountability Act (HIPAA), which governs the confidentiality and security of patient health information (Annas, 2003). Furthermore, nurses are legally obligated to report any suspected abuse or neglect and must maintain a high standard of care to avoid negligence claims.

The critical nature of ethical decision-making and adherence to legal standards in nursing cannot be overstated. Ethical decision-making models can assist nurses in systematically approaching difficult decisions, allowing them to consider all aspects of a situation before taking action (Butts & Rich, 2013). The American Nurses Association’s Code of Ethics provides a foundational framework for nurses to carry out their responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession (ANA, 2015).

In essence, the convergence of ethics and law in nursing practice serves as the bedrock upon which the integrity of the profession stands. It is imperative for nurses to continually educate themselves on ethical principles and legal requirements, which are ever-changing as societal norms evolve and new health care laws and regulations emerge.

Nursing Practice and Patient Care

Nursing practice encompasses a broad range of responsibilities that vary significantly across different healthcare environments. In hospitals, nurses are involved in direct patient care, administering medications, monitoring vital signs, and collaborating with physicians to provide comprehensive care plans (Blegen, Goode, & Spetz, 2013). In community settings, nurses may focus more on health promotion and disease prevention, conducting screenings, and educational programs. In long-term care facilities, nurses often manage chronic conditions, support rehabilitation, and provide end-of-life care. The scope of practice is also influenced by state laws and licensure requirements, which delineate the level of autonomy a nurse has in performing procedures and making clinical decisions (Huston, 2013).

Nursing care methodologies are guided by the principles of evidence-based practice, which involves integrating clinical expertise with the best available evidence and patient preferences (Melnyk & Fineout-Overholt, 2011). This approach ensures that nursing interventions are not only scientifically sound but also tailored to individual patient needs. For instance, patient-centered care models emphasize the importance of understanding the patient’s experience and values, leading to personalized care plans that can result in higher patient satisfaction and better adherence to treatment recommendations.

The impact of nursing on patient care outcomes is well-documented. Research has consistently shown that higher staffing levels of nurses with baccalaureate education are associated with lower rates of hospital-acquired conditions, such as infections, falls, and pressure ulcers, and lower patient mortality rates (Aiken et al., 2014). Furthermore, the presence of advanced practice nurses, such as nurse practitioners, has been associated with improved management of chronic diseases, such as diabetes and hypertension, leading to better patient outcomes (Kleinpell et al., 2014).

In conclusion, the scope of nursing practice is diverse, adapting to the unique demands of various healthcare settings. Nursing care methodologies grounded in evidence-based practice are fundamental to delivering high-quality care. The positive effects of nursing on patient care outcomes underline the importance of investing in a well-educated nursing workforce and supporting nurses in their practice to ensure optimal patient care.

Advanced Nursing Practice

Responsibilities of advanced practice nurses (apns).

Advanced Practice Nurses (APNs) are registered nurses who have achieved advanced levels of education and training. Their responsibilities extend well beyond those of a registered nurse (RN) and are characterized by a higher degree of clinical autonomy and expertise. Nurse Practitioners (NPs), one of the four primary APN roles, provide a full spectrum of healthcare services, including the diagnosis and management of acute and chronic illnesses. Clinical Nurse Specialists (CNSs) offer expertise in specialized areas such as oncology, pediatrics, or geriatrics, and focus on improving health care systems and outcomes. Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia and related care before, during, and after surgical procedures, while Certified Nurse-Midwives (CNMs) offer primary care for women, including gynecological and obstetric services (American Association of Colleges of Nursing [AACN], 2006).

APNs are expected to lead initiatives to improve health care quality and patient safety. They are involved in developing and implementing evidence-based practices, conducting research, and contributing to health policy. In primary care settings, NPs often serve as patients’ primary healthcare provider, coordinating care, counseling on preventive health measures, and managing overall patient wellness. This level of responsibility has proven particularly vital in rural and underserved urban areas, where APNs frequently serve as the most accessible health care providers (Stanley, 2005).

The Role of APNs in Healthcare Delivery and Patient Outcomes

The contribution of APNs to healthcare delivery is substantial, with research consistently demonstrating positive patient outcomes under their care. Studies have shown that patients under the care of NPs often experience lower hospital readmission rates, shorter hospital stays, and higher satisfaction with care. Similarly, CNSs have been shown to significantly improve patient outcomes through their expert interventions and system changes in specialty and acute care settings (Begley et al., 2010).

The role of APNs extends into the management of chronic diseases, where their patient-centered approach and emphasis on education and self-care have resulted in improved management of conditions such as diabetes, hypertension, and respiratory diseases. Their unique blend of clinical expertise and holistic care aligns well with contemporary healthcare delivery models that emphasize patient engagement and chronic disease management (Kaplan & Brown, 2017).

Regulatory Considerations for APNs

The regulatory framework for APNs is complex and varies by jurisdiction. In the United States, for example, the scope of practice for APNs is determined at the state level, leading to a patchwork of regulations that can vary widely. Some states grant “full practice” status, allowing APNs to evaluate patients; diagnose, initiate, and manage treatments; and prescribe medications independently. Other states have “reduced” or “restricted” practice, requiring collaboration, supervision, or team management by another health provider, such as a physician (Pearson, 2015).

Ongoing debates regarding the scope of practice for APNs often center on patient safety, access to care, and the utilization of the full capabilities of APNs. Proponents of expanding APN practice authority argue that such measures are essential to address the shortage of primary care providers, especially in underserved areas. Conversely, opponents express concerns about ensuring consistent quality of care across diverse healthcare settings (Auerbach et al., 2012).

As the healthcare landscape continues to evolve, it is likely that the roles and regulations governing APNs will also change. The future may see a greater harmonization of scope-of-practice laws to reflect the growing body of evidence supporting the safety and effectiveness of APN care. Professional organizations like the AACN and the American Nurses Association (ANA) continue to advocate for the removal of practice barriers for APNs, emphasizing the need for healthcare policy to adapt to the modern realities of healthcare delivery and to optimize the contributions of these skilled professionals.

In summary, Advanced Practice Nurses hold crucial roles in the healthcare delivery system, with their advanced clinical skills and education significantly impacting patient care outcomes. As the demand for high-quality healthcare increases, the responsibilities and autonomy of APNs are likely to expand, necessitating a regulatory environment that supports their full contribution to patient care.

Challenges and Opportunities in Nursing

The nursing profession, while deeply rewarding, is not without its challenges. Contemporary issues in nursing span a variety of complex and interrelated themes, from addressing the nursing shortage to managing the stress and burnout associated with increasingly high patient loads and administrative duties (Kovner, Brewer, & Djukic, 2009). The ongoing COVID-19 pandemic has further highlighted these challenges, placing unprecedented demands on nurses and the healthcare system at large.

Despite these challenges, the future of nursing is ripe with potential for innovation and growth. Technological advancements are rapidly transforming healthcare, and with it, the nursing profession. Telehealth, electronic health records, and advanced medical devices are creating new realms of practice and opportunities for improving patient care. Nurses are poised to play a crucial role in the integration and optimization of these technologies within healthcare delivery (Risling, 2017).

The prospects for professional growth and leadership within nursing are also expanding. There is a growing recognition of the need for nurses to occupy decision-making roles in healthcare policy and administration. Leadership programs and doctoral education, including the Doctor of Nursing Practice (DNP) degree, are preparing nurses to lead change in healthcare, ensuring that nurses have a voice in shaping the policies and practices that affect their profession and the care of their patients (Institute of Medicine, 2010).

Furthermore, the push towards interprofessional education and collaborative practice models is creating new avenues for nurses to lead in the coordination of patient care. As patient advocates and care coordinators, nurses are uniquely positioned to bridge the gap among various healthcare disciplines, contributing to more holistic, patient-centered care (Institute of Medicine, 2010).

Nurses are also expanding their roles in public health, community outreach, and global health initiatives, addressing broader social determinants of health and working to reduce health disparities. The expertise of nurses in health promotion, disease prevention, and emergency preparedness is increasingly vital in the face of global health challenges such as pandemics, climate change, and population aging (Kovner et al., 2009).

In conclusion, while nursing faces a set of substantial challenges, the profession is also presented with numerous opportunities for innovation, growth, and leadership. The future will likely see nurses stepping into more diverse roles, leveraging technology to improve patient care, and taking on greater leadership in health policy and system design. As the healthcare landscape continues to evolve, the nursing profession will remain an indispensable pillar, adapting to meet the changing needs of patients and communities worldwide.

Global Nursing and Healthcare

Nursing’s role in global health is both vast and essential, encompassing a wide range of activities from direct patient care to participation in policy development and implementation. Nurses are often at the forefront of international health initiatives, working with communities to address health concerns, improve access to care, and reduce health disparities. Their involvement is crucial in areas such as infectious disease control, maternal and child health, and non-communicable disease management. Global health nursing not only refers to the work done by nurses within their own countries but also includes their contributions on an international scale, such as through humanitarian relief efforts or health education programs in low-resource settings (Benton, Ferguson, & Pérez, 2016).

International nursing standards and practices are developed to ensure a consistent and high-quality level of nursing care across different countries and healthcare systems. These standards, often set by professional nursing organizations like the International Council of Nurses (ICN), guide the education, licensure, and practice of nurses globally. They serve as a framework for the delivery of culturally sensitive and evidence-based care and are integral to the advancement of the nursing profession worldwide. The World Health Organization (WHO) also contributes to setting global standards for nursing and midwifery, recognizing the critical role these professionals play in achieving international health goals (World Health Organization, 2020).

Cultural competence in nursing is increasingly recognized as a critical component of healthcare delivery in a globalized world. As populations become more diverse, nurses must be equipped with the skills and knowledge to provide care that respects cultural differences and values. This includes understanding how cultural backgrounds can influence health beliefs, practices, and patient interactions. Developing cultural competence involves a combination of education, self-awareness, and experiential learning, and is an ongoing process. Culturally competent nurses are better able to establish trust with patients, leading to improved health outcomes and patient satisfaction (Campinha-Bacote, 2011).

In summary, the impact of nursing on global health is profound and multifaceted. Nurses contribute significantly to healthcare delivery in diverse cultural contexts, and their role in the international healthcare landscape continues to expand. As they advocate for and implement global health initiatives, nurses are also instrumental in setting international standards and practices. Moreover, cultural competence remains a critical skill for nurses as they navigate the complexities of a global patient population. The future of global nursing is one of increased interconnectivity, cultural understanding, and collaboration across borders to meet the health challenges of the 21st century.

Nursing Leadership and Administration

Leadership theories applicable to nursing.

Leadership within nursing is not just a positional role but a pivotal function that influences healthcare delivery at all levels. Various leadership theories have been adapted to the nursing context to promote effective management and guide professional practice. Transformational leadership, which fosters an inspiring vision and encourages team members to exceed their own interests for the sake of the group or organization, is particularly resonant in nursing (Doody & Doody, 2012). This leadership style aligns well with the collaborative nature of healthcare, encouraging nurses to take initiative and contribute innovatively to patient care. Similarly, servant leadership, which emphasizes the leader’s role as a caretaker who prioritizes the needs of others, including team members and patients, is another model that has proven effective in nursing settings. It promotes a people-first approach, crucial in the patient-centered environment of healthcare.

Management of Healthcare Teams and Resources by Nurses

Nurse leaders are responsible for the management of healthcare teams, often navigating complex dynamics to ensure cohesive and efficient functioning. Effective team management involves conflict resolution, delegation, communication, and advocacy. Nurse administrators also play a critical role in resource management, which includes staffing, budgeting, and ensuring that the clinical setting is equipped to provide high-quality care (Marquis & Huston, 2015). They must be adept at balancing fiscal responsibility with the ethical imperative to provide the best possible patient care, which can involve making tough decisions about resource allocation in a healthcare landscape often characterized by scarcity and competing needs.

Strategic Planning for Nursing Quality Improvement

Strategic planning in nursing is essential to foster quality improvement and advance healthcare goals. Nurse leaders are integral to this process, as they help to set objectives, outline strategies, and implement plans that aim to improve patient outcomes and care delivery processes. Quality improvement in nursing can encompass a wide array of initiatives, from reducing hospital-acquired infections to improving patient satisfaction scores or streamlining discharge processes. Through the use of quality improvement models such as Plan-Do-Study-Act (PDSA) cycles or Six Sigma, nurse leaders can systematically analyze current practices, identify areas for improvement, and measure the impact of implemented changes (Sherwood & Barnsteiner, 2012).

In summary, nursing leadership and administration are critical to the functioning and advancement of healthcare services. Nurse leaders and administrators must be well-versed in leadership theories that can be applied effectively within healthcare environments. They are tasked with the important responsibilities of managing diverse healthcare teams, efficiently utilizing resources, and leading strategic initiatives for quality improvement. As the healthcare industry continues to evolve, the roles of nurse leaders and administrators become increasingly vital in shaping the future of patient care and nursing practice.

Technology and Innovation in Nursing

The integration of information technology into healthcare has had a transformative effect on the nursing profession. Electronic Health Records (EHRs) have become a standard in modern healthcare facilities, significantly impacting the way nurses manage and record patient care. EHRs enhance communication between healthcare providers, improve access to patient information, and facilitate more accurate and efficient documentation (Hebda & Czar, 2013). Moreover, information technology has streamlined many processes, such as medication ordering and lab results retrieval, reducing the potential for errors and allowing nurses more time for direct patient care.

Telehealth has emerged as a rapidly expanding sector within nursing, propelled by advances in technology and the need for accessible healthcare. Telehealth nursing allows patients to receive care remotely, increasing access for those in rural or underserved areas. It also enables continuous patient monitoring and management of chronic conditions, improving patient outcomes while reducing hospital visits and readmissions (Rutledge et al., 2017). For nurses, telehealth has opened new roles and responsibilities, including serving as telehealth coordinators or specialists, requiring them to develop new skill sets for the effective delivery of remote care.

Innovation in nursing care is continually advancing, with new technologies being applied to improve patient outcomes and nursing workflows. Wearable health devices and sensors can now provide real-time data on patient vitals, allowing for immediate interventions when necessary. Robotics in nursing, although still in its early stages, is beginning to assist in tasks ranging from patient transport to surgery, potentially revolutionizing the future of nursing practice. Furthermore, artificial intelligence (AI) applications in nursing are being explored for their ability to analyze vast amounts of health data to assist in clinical decision-making (Topol, 2019).

In conclusion, technology and innovation are driving significant changes in nursing practice, offering opportunities to enhance patient care and improve the efficiency of healthcare delivery. As the adoption of these technologies continues to grow, nursing education and professional development programs will need to evolve to equip nurses with the necessary competencies to thrive in a technologically advanced healthcare environment.

Public Health and Community Nursing

Community health nursing is a vital branch of nursing that focuses on the health needs of entire populations. It operates on the principles of social justice, equity, and the social determinants of health, aiming to provide and improve access to care, particularly for the most vulnerable populations. This practice is characterized by a holistic approach that considers the multifaceted aspects of health, including physical, psychological, social, and environmental factors. Community health nurses work in various settings, from schools and community centers to homes and neighborhood clinics, delivering care that is culturally sensitive and tailored to the specific needs of the community (Maurer & Smith, 2013). They engage in comprehensive care that includes health education, advocacy, and policy development to facilitate environments that promote good health.

Nurses play an integral role in public health initiatives, often serving as the primary link between healthcare systems and communities. They are involved in designing and implementing programs that target major public health concerns such as infectious diseases, obesity, substance abuse, and mental health. Their involvement is not limited to the provision of direct care but also includes policy advocacy and collaboration with governmental and non-governmental organizations to address health disparities and influence health policy (Stanhope & Lancaster, 2015). Public health nurses may also participate in emergency preparedness and response, playing critical roles in managing and mitigating the effects of natural disasters, epidemics, and bioterrorism threats.

The strategies employed by nurses in disease prevention and health promotion are grounded in evidence-based practice and public health science. Nurses conduct screenings and immunization clinics, provide counseling and education on healthy lifestyle choices, and support chronic disease management programs. They also utilize community assessment techniques to identify health risks and develop targeted interventions that can prevent disease and promote health across populations (Allender, Rector, & Warner, 2014). By focusing on prevention, nurses contribute to the reduction of healthcare costs and the burden of disease, ultimately improving the overall health and well-being of the communities they serve.

In conclusion, public health and community nursing are essential components of the healthcare system, emphasizing prevention, health promotion, and the well-being of populations. Nurses in this field are advocates, educators, and leaders in health initiatives, committed to improving community health and shaping health policies. As society continues to face complex health challenges, the role of public health and community nurses will remain critical in fostering healthy and resilient communities.

Nursing Research and Evidence-Based Practice

The role of research in nursing practice development.

Research in nursing is pivotal for the development and enhancement of nursing practice. It forms the backbone of clinical decision-making, ensuring that nursing care is based on the latest and most reliable evidence. Engaging in research activities empowers nurses to validate and refine existing knowledge and to discover new insights into patient care, disease management, health promotion, and prevention (Polit & Beck, 2017). Moreover, nursing research drives the profession forward by fostering a culture of inquiry and lifelong learning among nurses. It enables practitioners to stay abreast of advancements in healthcare, thereby continually improving practices and patient care outcomes. This dedication to research also helps elevate the nursing profession by demonstrating the complexity and scientific rigor involved in nursing practice, which is critical for gaining recognition and respect from interdisciplinary team members and stakeholders.

Research Methods in Nursing

Nursing research encompasses a variety of methods tailored to the specific questions being addressed. Quantitative research methods, such as experimental and quasi-experimental designs, provide a means to test hypotheses and establish causal relationships. Surveys and epidemiological studies are also common quantitative methods that allow for the examination of trends, attitudes, and the prevalence of health-related issues within populations. On the other hand, qualitative research methods, including phenomenology, grounded theory, and ethnography, enable researchers to gain a deeper understanding of the human experience related to health, illness, and nursing care (Creswell & Creswell, 2017). These methodologies can reveal the complexities of patient behaviors, the meanings individuals ascribe to health experiences, and the social context of health and illness.

Mixed-methods research, which combines both quantitative and qualitative approaches, has gained popularity in nursing research. This methodological approach provides a comprehensive perspective, allowing for the exploration of multifaceted health phenomena. It enables nurse researchers to address research questions with a broader scope, enhancing the depth and breadth of understanding required to inform practice. By employing a mixed-methods approach, researchers can corroborate findings across different methods, increasing the validity and reliability of the results (Creswell & Creswell, 2017).

Application of Evidence-Based Practice in Nursing

The application of evidence-based practice (EBP) is a hallmark of modern nursing care. EBP involves a systematic process of appraising and incorporating the best available research evidence with clinical expertise and patient preferences. It is an ongoing, dynamic process that requires the ability to ask relevant clinical questions, search for and critically appraise the literature, implement appropriate interventions, and evaluate outcomes (Melnyk & Fineout-Overholt, 2011). The use of EBP allows nurses to provide care that is not only scientifically justified but also aligned with the values and needs of patients, resulting in higher quality and more personalized care.

Nursing education programs now emphasize the importance of EBP, equipping future nurses with the skills needed to integrate research findings into their clinical practice. Furthermore, many healthcare organizations have developed EBP guidelines and protocols to standardize care and ensure that all patients receive the most effective treatments. Nurse leaders and managers play a critical role in fostering an organizational culture that values EBP, by providing resources, facilitating training, and encouraging the dissemination and implementation of research findings.

Healthcare organizations that prioritize EBP often establish dedicated roles or departments focused on research and quality improvement. These departments work to translate research findings into practice, develop policies, and evaluate the impact of care interventions on patient outcomes. They also collaborate with academic institutions and research organizations to conduct clinical trials and other research studies within the clinical setting.

Challenges and Future Directions in Nursing Research and EBP

Despite the recognized value of EBP, there are several challenges to its full integration into nursing practice. These include a lack of time, limited access to research resources, and insufficient training in research methods and critical appraisal skills. Addressing these barriers is crucial for the advancement of nursing practice and requires a concerted effort from educational institutions, healthcare organizations, and the nursing profession itself.

The future of nursing research and EBP is promising, with advancements in technology providing new avenues for research dissemination and education. Online databases, digital libraries, and mobile applications are making research findings more accessible than ever before. Virtual reality and simulation technologies offer innovative ways to educate nurses on EBP and to evaluate the impact of care without risking patient safety.

As nursing continues to advance as a research-based profession, it is likely that more nurses will engage in research activities and contribute to the body of knowledge that underpins nursing practice. The integration of EBP into all levels of nursing care will continue to be a priority, ensuring that patients receive care that is not only compassionate and patient-centered but also empirically sound.

In summarizing the central themes of this comprehensive examination of nursing, it is clear that the nursing profession serves as a linchpin within the health sector. From the historical context to the modern evolution of nursing practices, this paper has underscored the dynamic and essential role that nurses play in patient care and the broader healthcare system. Nurses not only provide hands-on care but also engage in critical thinking, leadership, and advocacy that shape healthcare delivery and policy (Institute of Medicine, 2010).

The scope of nursing practice, as discussed, has expanded far beyond its traditional boundaries, now encompassing advanced practice roles, a commitment to public health, and a central role in global healthcare initiatives. Nurses are at the forefront of integrating evidence-based practice into clinical settings, ensuring that patient care is guided by the best available evidence and patient values. The profession has risen to the challenge of embracing technological advancements and innovations, from telehealth to sophisticated health informatics systems, which have revolutionized the way nursing care is delivered and documented (Huston, 2013).

Looking to the future, nursing is poised to continue its trajectory of growth and influence. As the demands of healthcare evolve with an aging population, emerging global health threats, and complex chronic health conditions, the need for skilled, compassionate, and innovative nurses is more pronounced than ever. The profession must continue to advocate for advanced education, research opportunities, and practice environments that enable nurses to practice to the full extent of their education and training.

Nursing’s future will also be characterized by a continued emphasis on interprofessional collaboration, as patient care becomes more integrated and team-based. Nurses will undoubtedly take on leadership roles in these teams, utilizing their expertise in patient care coordination and holistic care to improve health outcomes and patient experiences (American Nurses Association, 2015).

In conclusion, the field of nursing is not static but continually advancing, driven by research, technological innovations, and an unwavering commitment to patient care. As this paper has demonstrated, nursing is central to the health sector, and its future trajectory is one of greater impact, with the potential to shape the face of healthcare in the years to come.

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