Incorporating the nephrology nursing scope and standards of practice into clinical practice

The recently released American Nephrology Nurses' Association (ANNA) Nephrology Nursing Scope and Standards of Practice, 7th edition, provides a broad foundation for defining and evaluating nephrology nursing practice. ANNA's standards present a similar approach as the American Nurses Association (ANA) 2010 standards. The ANNA Nephrology Nursing Scope and Standards of Practice, 7th edition, is expanded to incorporate a section on how to use the standards in practice. This article provides an overview of the scope of practice, standards, and situations that require intervention by nephrology nurses. Samples of tools that can be used to incorporate the standards into the various situations are discussed.     

'Spirituality as integrative energy': a philosophical analysis as requisite precursor to holistic nursing practice

Spirituality is a universal human phenomenon, yet conceptual confusion, ambiguity and scientific scepticism have prevented adequate investigation into its potential healing effects A recent resurgence of interest in non-medical sources of healing and holistic medical practices is causing increased speculation regarding the nature of spirituality The lack of conceptual clarity, and absence of a precise theoretical definition, prevent recognition of spiritual distress and, hence, appropriate nursing intervention In this paper, current usage and definitions of spirituality are discussed and a philosophical definition of 'spirituality as integrative energy' is proposed The metaphysical nature of this phenomenon makes it the proper concern of philosophy, consequently, a philosophical analysis of the aforestated proposition was completed using the five predicables of logic theory species, genus, differentia, logical property and logical accident Implications of this definition for providing holistic nursing care are also presented     

Understanding nursing scope of practice: a qualitative study

Background

The past decade has seen increased patient acuity and shortened lengths of stays in acute care hospitals resulting in an intensification of the work undertaken by nursing staff in hospitals. This has ultimately led to a reconsideration of how nursing staff manage their work.

Aim

The aim of this study was to understand how medical and surgical nurses from two Australian hospitals conceive their scope of practice in response to the available grade and skill mix of nurses and availability of unlicensed health care workers and other health care professionals. By exploring these meanings, this study aimed to build an understanding of how nursing work patterns were shifting in the face of changing patient acuity, patient profiles and nursing skill mix.

Method

A constructivist methodology, using critical incident technique (CIT) was used to explore nurses’ role and scope of practice. Twenty nurses, 16 registered nurses (RNs) and four enrolled nurses (ENs), discussed significant events during which they perceived they were undertaking either patient care activities they should be undertaking, or activities that should have either been delegated or undertaken by a higher level of care provider.

Findings

Five themes emerged from the data: (1) good nurses work in proximity to patients providing total patient care; (2) safeguarding patients; (3) picking up the slack to ensure patient safety; (4) developing teamwork strategies; and (5) privileging patients without mental illness or cognitive impairment. A pattern woven throughout these themes was the idea of negotiation. RNs were struggling with the notions that direct patient care was sometimes not the best use of their time, and delegation did not equate with laziness.

Conclusion

Negotiation has become a fundamental aspect of nursing practice given the variety of nursing care providers currently employed in acute care settings. Negotiation has allowed nurses to redefine appropriate nurse–patient proximity, promote patient safety and find innovative ways of working in nursing teams.     

Standards of holistic nursing practice as guidelines for quality undergraduate nursing curricula

The accreditation criteria of the Commission for Collegiate Nursing Education (CCNE) direct faculty to select nationally developed standards for professional practice to guide curricula and to articulate curriculum outcomes. Recently, the CCNE proposed that all undergraduate programs should adopt the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education as one set of national standards for undergraduate and prelicensure programs. Standards of Holistic Nursing Practice, developed by the American Holistic Nurses' Association, is an additional set of standards that assists in defining quality for undergraduate nursing education. Standards of Holistic Nursing shares major concepts with Essentials; however, it accentuates the concepts of nurse self-care, articulated nursing theory as a foundation for practice, managing the care environment to promote healing, and care of the environment as essential to professional practice. These standards do not change the care being provided by professional nurses adhering to nursing theory and current evidence, but they do raise awareness and change emphasis of practice to reflect a holistic perspective. Used together, Standards and Essentials provide complementary guidelines for curricula-preparing professional nurses to care for client and self.     

Nutrition support nursing: a specialty practice: historical development

Nutrition Support Nursing as an area of specialization within nursing emerged from the development of new technology that enabled patients to be fed totally by vein and from the realization that this complex, new therapy could not be administered safely and effectively without the involvement of nurses who had special expertise. This paper will examine how a specialty organization has developed and evolved over two decades, characterized by dramatic changes in the health care system. The involvement of nurses in nutrition support facilitated the early research in this area and was instrumental in developing a strong nursing role in the care of these patients.     

Advanced practice community health nursing in community nursing centers: a holistic approach to the community as client

Community nursing centers are unique arenas for advanced practice community health nursing. These innovative nurse-managed delivery models are grounded in a holistic approach to the community-as-client. They provide the public with direct access to a range of advanced practice professional nursing services that are not otherwise available. Community Nursing Centers are collaborative with other health professions and organizations. They aim to meet the assessed needs of underserved populations using extant resources to achieve optimal health for all members of the community. This article discusses the underlying conceptual basis for development of community nursing centers and provides a case study example.     

The perioperative dialogue: holistic nursing in practice

This article is a synthesis of 2 qualitative studies focusing on patients', anesthetists', and operating-room nurses' experiences of the perioperative dialogue and employing grounded theory as the method of analysis. The aim of the synthesis was to achieve a new holistic understanding of health in the perioperative dialogue. The synthesis highlights the importance of being in communion in a continuous whole due to continuity of care for the creation of health in both patients and nurses.