Mahmood Ahmed

Belief about Nursing:

Nursing is a noble and sacred profession means to care the sick persons sympathetically and kindly.

This statement was read by me from my secondary level books and a{so heard from some scholars who

spoke for the welfare of mankind. The figure of the nursing profession is given as an angel who is full of

spirit of service to sick. Grieved and injured persons.

When I entered in this profession as a student, I was also told and reminded again this above

statement, which increased my interest to be a nurse. During student life I experienced and observed that this

is really a noble and sacred profession due to its services towards human beings. In the history of this

profession, some nurses devoted their whole life as serving human beings throughout the world. Day by day

a new inventions increased, new technology introduced in many fields of life, the nursing profession has

also increased its quality through advancing the nursing care on scientific basis. New and advanced

techniques are adopted in nursing education and nursing practice. Now a days nursing is known as a major

standardized profession along with its quality care and continuous research to improve more.

Hence, this profession is considered as a female dominant profession but males are also entering in

this profession from decades. Male nurses have been serving in nursing throughout the w and some also

worked on senior posts in nursing. Most of western countries provide quality care to their citizens. The

education standard has been developed from basic level to graduate, master and up to PhD in Nursing.

Senior nurses have been performing all over the world in many health projects.

On the other hand, like the other professions there are also many obligations / objections towards

nurses. Many nurses remain unmarried in their whole life and they go to cut off from family process. The

other negative impression of this profession is that those persons who advocate and motivate the people

towards nursing. -although they belong to nursing profession and having senior positions n nursing or they

may belong to other professions but their efforts are also courageous, those persons do not motivate their

own children towards nursing, but also prohibit their nearer relatives’ children to join the nursing because

many issues are involved to develop this situation.

It is considered as low and middle class people profession.

The difference between nurse and physician. A physician is credited as master and nurse as servant

in Hospital set up.

Image shown in different Hollywood mo as a sex object as in “Nightingales” (1989)” and television

show “Doctor’s private lives”.

Nurses during hospital environment remain with contact of such highly risk full and untreatable

diseased persons which may transfer infection to nurses, May nurses have been suffering with Aids

and other diseases transmitted from hospital patients.

We can say that any profession is never wrong but some persons who perform wrong may present in each

profession and the profession can not be blamed due to their personal activities and interests.

Education:

Education is a process of giving the knowledge to the others. This process is continuously going on

since the birth of human beings on the earth. The aim of education is to improve the life and to face the

problems in a proper way, because human life is full with the events of happiness, grief and disease from

birth to death so each religion, culture and professional institute focuses on the educational process on these

points very closely.

The education brings changes and facilitates in many ways during human life. Each educational

institute either religious or cultural or a professional focuses human beings and their surroundings during the

whole academic process. For this purpose each institute has created a curriculum for education and

developed an infrastructure for educating its participants.

The curriculum is a unique and integrated frame work of any discipline. It explains the objectives,

course contents and learning strategies. The particular experts describe the characteristics of the curriculum

when they work on it and give suggestions to modify and revise the curriculum after a period.

Nursing education is continuously developing changes. It needs an arranged and integrated frame

work of academic and clinical skills approaches. The basic nursing curriculum demands to enter the nursing

the persons who have the ability to understand and decide on the time according to situation of the event.

The graduate and master degree programs require more eligibility to have science based formal education

with nursing experience and to participate in nursing research throughout the academic session to field

practice.

In Pakistan basic nursing education curriculum is followed in all nursing institutions. The criteria of

teaching and learning depend on the teacher’s education, training, student’s personal interests, ability and

educational environment. Recently the nursing profession is facing with the shortage of teaching staff and

the present staff also needs to be tamed along with the updated nursing education.

Nursing is longer largely a matter of custom and practice closely following developments in

medicines. It is clear that the new paradigm is exciting, innovative and set to continue. Over the last few

years there appears to have been an awakening within Nurse Education of the importance of research for the

maintenance and indeed survival of the profession.

It is clear that the new paradigm is exciting, innovative and set to continue. Over the last few years

there appears to have been an awakening within nurse education of the importance of research for the

maintenance and indeed survival of the profession opportunities for undertaking research have increased and

as nurse education becomes settled within a higher education frame work, these openings will continue.

These consequences of returning to a status where educational research was not integral to it would be the

return of a profession with a fragmented, discordant voice, losing right: of its aims and losing its influences

on health care settings and client care.

Nurses need continuing education:

One of nursing, s early founders, Florence Nightingale identified the need for nurses of her day to

continue learning after their training. Today’s need is even more acute because nurses are challenged with

keeping current in a field that is exploding with new information. Technical and scientific advance in

medicine, and increasing consumer demand for high quality health care increasing the need for continued

learning by nurses These advances are changing medical and nursing science so rapidly that nurses who

graduated from Pulsing school five years ago are finding that some of their nursing education is already

absolute. New graduates can no longer feel confident because their nursing science and nursing theory

courses are fresh in their memories. After graduation, they quickly discover they have tremendous amount to

learn in their first years out of school.

Today’s nurse, like today’s physicians, must contend with the information explosion. One way they are

doing this is by coming specialists in narrower fields of practice. Nursing specialization helps provide the

overwhelming amount of information nurses need to know, but it does not extinguish the need for continued

earning. The rapidity of advancement in medical science, even in specialized a must also be dealt with. This

rapidity can be dealt with by the nurse taking an active responsible role in their own continued growth and

learning. Many nurses find this challenge exciting and seek out continuing education courses in their

specialty area. These nurses are fulfilling the idea of continued education as many of nursing founders

envisioned it.

Nursing education programs must accommodate to the curriculum revolution of the institution of higher

education and the mandate for change in nursing curricula. Regardless of debates about professional versus

technical education and preparation for entry into practice, schools of nursing are raising questions about

what is learning, what should be taught, how should it be taught, and how can performance and outcomes be

assessed. As nurse educators question historical models of curriculum development and urge reform of both

undergraduate and graduate education, new patterns in nursing curricula are emerging to integrate theory

and practice, to redefine learning, and to use teaching-learning strategies that facilitate learning as in nurse’s

move from novices and beginning practitioners to expert clinicians.

Student Beliefs and Responsibilities:

The process of education ‘lever ends. A person always remains like a student during whole life. A student in

any discipline who is assigned for achieving a specific goal within a given time period is responsible to

understand the objectives and then to success in that task.

As a student there some responsibilities are on the students to respect the teachers to understand the theme of

the education process and much comprehension of the course contents and to do best as he or she can do the

best performance to achieve the task. In education process students, teachers and learning resources are

inter-acted with each other. To gain knowledge depends on students’ personal interest, ability and also some

what on learning resources used in learning process.

In nursing education at basic level students are expected to be expert in academic course contents along with

clinical skills in a given time period. It is important to use critical thinking and problem solving approach to

face the problems. They are emphasized to understand the other related factors and issues which may be

faced time by time during the clinical practices.

In degree classes the students are expected to develop own bib1io identify the area of strength and weakness

in term of meeting the objectives, seek assistance when appropriate. A strident assumes responsibility for

learning and takes independent study course.

The student use suggestions of teacher to increase learning. Students use ‘teacher provided guidelines, ask

questions and share ideas.

They use their critical thinking skills and to participate actively in research process in their study area.

Criticism towards any ethnicity and values is strictly-prohibited and students are expected to respect all the

people with their status.

The Nurse as Nurse Educator/Teacher:

In education the teachers have always a central role. The teacher was full authoritarian on education process

in past and respected due to his knowledge. The students of previous era followed the teacher as a mentor.

The role of teacher was to mentoring the students and the students were not allowed to discuss the matter,

questions with the teacher, because the teacher’s comments were understood the final and authentic. But this

trend changed day by day and now the teacher is considered as a facilitator to his students and the students

are responsible to learn and search about their course contents according to teacher’s guidelines.

The teacher provides guidelines for developing bibliography. He validates area of strength and weakness,

sets parameters for required learning experiences, provides criteria for meeting objectives.

The teacher counsels students in relation to their needs as learners, guides each learning activity and

stimulates the students to think and question.

Teachers perceive their role as updating theoretical knowledge and basic clinical liaison to support clinical

staff.

Nurse educators seek a curriculum revolution. Fundamental assumptions about learning, teaching and

curriculum are being challenged. Such as nursing programs responding to the need for change, nursing

education research revealing about effective and efficient teaching-learning strategies, student and program

outcomes evaluation and current accreditation models services to the needs of students, educators, and

clients.

Help the learners of graduate level to identify the starting point for a learning project and discern

relevant modes of examination and reporting.

Encourage students to view knowledge and truth as contextual, to see value frameworks as cultural

constructs, and to appreciate that they can act on their world individually or collectively to transform

it.

Create a partnership with the students by negotiating a learning contract for goals, strategies and

evaluation criteria.

Be a manager of the learning experience rather than an information provider.

Help students acquire the needs assessment techniques necessary to discover what objectives they

should set.

Encourage the setting of objectives that can be met in several ways and offer a variety of options for

evidence of successful performance.

Provide examples of previously acceptable work.

Make sure that students are aware of the objectives, learning strategies, resources, and evaluation

criteria once they are decided upon.

Teach inquiry skills, decision making, personal development, and self-evaluation of work.

Act as advocates for educationally underserved populations to facilitate their access to resources.

Help match resources to the needs of students.

Help students locate resources.

Help students to develop positive attitudes and feelings of independence relative to learning.

Recognize learner personality types and learning styles.

Use techniques such as field experience and problem solving that take advantage of graduates rich

experience base.

Develop high-quality learning guides, including programmed learning kits.

Encourage critical thinking skills by incorporating such activities as seminars.

Create an atmosphere of openness and trust to promote better performance.

Help protect students against manipulation by promoting a code of ethics.

Behave ethically, which includes not recommending a learning approach if it is not congruent with

the learners, needs.

Conduct research on trends and students’ interests.

Obtain the necessary tools to assess students’ current performance and to evaluate their expected

performance.

Provide opportunities for students to reflect on what they are learning.

Recognize and reward earners when they have met their learning objectives.

For its implementation, Promote learning networks, study circles, and learning exchanges.

Provide staff training on self-directed learning, critical thinking and broaden the opportunities.

The graduate characteristics of a Charge Nurse:

The nurses who join a health care setting after completion of their general training and registration with

concerned authority are assigned as Charge Nurse, Staff Nurse or RN. In Pakistan nurses am assigned as

Charge Nurse and Staff Nurse and in U K and USA as RN and Staff Nurse.

These nurses continue to practice in a variety of direct and indirect care roles, In spite of the rapidly

changing health care environment, the role of the staff nurse continues to be central to safe, quality patient

care and to the nursing profession. Expert, caring, conscientious caregivers continue to significantly affect

the lives of patients for whom they care. The staff nurse role, now more than ever, requires practitioner

precision. Among the requisite skills for today staff nurse arc sharp assessment skills, accurate problem-

solving and clinical decision-making abilities, therapeutic communication skills, ability to safely delegate to

others, teambuilding skills, and commitment to patient advocacy. Adequate numbers of staff nurses are

critical to the provision of safe .quality patient care in hospitals and other practice settings. Registered nurses

are associated with reducing hospital mortality, length of stay, cost, and morbidity. A similar trend occurs in

on settings. In nursing homes, a strong, positive relationship exists between the general level of nurse

staffing and resident outcome. The importance of the staff nurse must never be underestimated or

undervalued. The public has begun to recognize the importance of the staff nurse. Washington Post staff

writer Judy Mann wrote in an article in Sigma Theta Tau’s Reflections, “Anyone who gets a major illness

that requires ongoing care quickly discovers one of’ the health system’s most important groups of

caregivers: the nurse” (Mann 1998).Whereas many registered nurses practice at the bedside throughout their

careers, others pursue other professional experiences. There arc more such opportunities today than ever

before first nurses. In an attempt to organize and categorize the growing opportunities for nurses, ANA, s

Task Force on Standards and Regulations of Managed Care identified seven categories of new opportunities

for registered nurses who continuous go through educational up gradation , such as graduation and they will

develope skills in the following categories:

Consumer Advocacy

Change agent

individual Growth,

Community-Based Care,

information Systems,

Entrepreneur or entrepreneur and

Public Health Policy and Regulatory Agencies.

The Task Force identified the skills needed for success in each category. In the Consumer advocacy

category, the graduate nurses will develope skills as the use of decision trees/tools, projection of statistical

probabilities, negotiation, group interaction and facilitation, patient teaching using new media, and

understanding of ethical principles.

For the Change Agent category, the graduate nurses will develop skills in understanding chaos and change

theory leadership skills versus management skills, and self-managed team abilities, as well as organizational

behavior and development theory.

In the Individual Growth category’ the following skills are expected: se1f-empowerment, professional

image, accountability for lifelong learning and relevancy in a changing environment, computer literacy and

networking skills. In addition, business-related skills were listed as an important part of this category.

Business-related skills include; but are not limited to, effective verbal and written presentations, knowledge

about communications technology, Publication and media production, economics, finance, forecasting,

sensitivity to cost and quality issues including the total quality management process, benchmarking,

utilization management, cost analysis, and data integrity, tracking and evaluation.

Skills in the Community-Based Care category are cultural competence, keen assessment skills, ability to

provide population-focused care, ability to find innovative approaches to enhancing health of a community,

epidemiology and environmental health knowledge, and understand of risk concepts.

Graduate nurses who seize opportunities in the Information Systems category deed computer- related

technical skills, an understanding of informatics concepts and principles, proficiency in the use of decision

support systems, and an ability to access data and process it in a user-friendly manner.

Graduate nurses, in the Entrepreneur or Intrapreneur category will develope an understanding of contracts,

innovative program development abilities, effective marketing/ sales programs, and program budgeting and

business plan development abilities, and they must effectively identify problems and cost out solutions.

In the category of Public Health Policy and Regulatory Agencies, legislative skills, legislative and regulatory

process knowledge, and an understanding of administrative, legislative, and judicial roles of government is

imperative, as are knowledge of principal state and federal nursing and health care-related regulatory

agencies, and legal interpretation and statutory d skills.

These seven categories are not mutually exclusive and may not encompass every role in which registered

nurses find themselves practicing after graduation. Many emerging roles require expertise in a number of the

identified categories. If registered nurses are going to continue to fill expanded roles, it is imperative that

they should continue their education and have the skills necessary to successfully serve in these totes.

In a survey, findings were skills that employers desired in nursing graduate personals. These skills were

divided into hospital and community categories. In the hospital category, employers identified the Following

as the top 10 skills they desired from graduate nurses:

Critical thinking problem solving,

Resource management skills,

Flexibility.

Leadership ability,

Delegation skills,

team-building and teamwork skills,

Knowledge of health care systems,

Good written and verbal communication skills,

professional orientation, and

Case management skills.

In the community category, employers desired graduate nurses with the following skills and experience:

Clinical experience,

Good assessment skills,

Good technical skills,

Resource management skills,

Interpersonal communication skills,

General clinical skills.

Highly technical skills such as tracheotomy and central ine care.

Long-term care experience,

Good written and verbal communication skills, and

Supervision skills.

The graduate from a baccalaureate program in nursing is prepared to perform the following:

Provide professional nursing care, including health promotion and maintenance, illness care,

restoration, rehabilitation, health counseling, and education based on knowledge derived from theory

and research.

Synthesize theoretical and empirical knowledge from nursing, scientific, and humanistic disciplines

with nursing practice.

Use the nursing process to provide nursing care for individuals, families, groups, and communities.

Accept responsibility and accountability for the evaluation of the effectiveness of their own nursing

practice.

Enhance the quality of nursing and health practices within practice setting through the use of

leadership skills and knowledge of the political system.

Evaluate research for the applicability of its findings to nursing practice.

Participate with other health care providers and members of the public in promoting general health

and well being.

Incorporate professional values and ethical, moral, and legal aspects of nursing into nursing practice.

Participate in the implementation of nursing roles designed to meet emerging health needs of the

general public in a changing society.

References:

Grace .L . Deloughery (1991). Issues and Trends in Nursing .Missouri USA Mosby. Year Book

ANF & ANA(1998).Role of RN in Managed Care journal of American Nurses

Association.3(7)Retried(2007) from .http://www.nursigworld.org/readroom/nti/980.htm.

Janet. A Secrest.(2000).I was actually a Nurse. Nursing Education 42(2), 77-81.