the current nursing culture

Running head: THE CURRENT NURSING CULTURE 1

The Current Nursing Culture

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THE CURRENT NURSING CULTURE 2

The Current Nursing Culture

Culture refers to the characteristics of a particular group and shared patterns of

interaction, behavior, cognitive constructs, and interactions. Nursing culture constitutes patterns

of actions followed by nurses and provides a standard adhered to while providing care. Nursing

practice has changed over time, forming a new culture determined by the changing needs of the

patient and the community as a whole. The shaping of the nursing culture is influenced by all

healthcare stakeholders.

The current nursing culture is characterized by a focus on the patient and delivering

patient-centered care, care coordination or interprofessional collaboration, evidence-based care,

incorporation of technology in care delivery, health promotion, and the need for participation of

patients in their care. The current nursing culture is founded on the need for patient-centered

care, which involves understanding a patient as a unique human needs and tailoring health

services towards those needs. Patient-centered represents a shift from traditional, diseased-

focused, paternalistic, and provider-driven approaches towards an approach that integrates the

needs, perceptions, and experiences of the patient at every stage of care delivery. Evidence links

patient-centered care to increased adherence to treatment, improved quality of care, and better

care ratings due to increased patient satisfaction (Fix, VanDeusen Lukas, Bolton, Hill, Mueller,

LaVela, & Bokhour, 2018). Patient-centered care has created the need for cultural competence

among the nurses to facilitate individualized care delivery.

Interprofessional collaboration, characterized by effective communication, has become a

major aspect of the current nursing practice. The need to deliver quality and safe care to patients

has necessitated effective communication and care coordination. Interprofessional collaboration


is characterized by coordination, cooperation, shared decision-making, and partnerships (Morley

& Cashell, 2017). Collaborative practice has been linked to shared knowledge and increased

experience due to the sharing of information resulting in enhanced decision-making. Effective

communication is the driving factor as it facilitates the interactions between health care

professionals. Nursing practice is now characterized by teams as nurses work with physicians to

plan care for patients. Inter-professional collaboration has been most evident in providing care to

patients with chronic diseases such as diabetes.

The current nursing is characterized by evidence-based practice. EBP refers to the use of

the best available scientific evidence to make decisions and to provide efficient and effective

care (Li, Cao, & Zhu, 2019). EBP enhances the safety of care and improves patient outcomes.

Major interventions implemented in treatment by the nurse are based on evidence that points to

better outcomes with implementing the treatment option. EBP has made research significant in

nursing practice. The nurse is, therefore, at the forefront of research projects with the aim of

acquiring evidence on the most appropriate interventions that can generate better outcomes. The

shift towards value-based compensation has facilitated the need for EBP.


The expansion of nursing roles is another aspect of the current nursing culture. The role

of nurses has expanded due to increased demand for health care services and the advancement in

technology. The number of states that support full practice authority for advanced nurses has

increased; hence the advanced nurses can act as primary care providers and are mandated to

prescribe medications autonomously and order diagnostic tests.

The adoption of information technology has expanded the role of nurses as nurses can

build a career in informatics. The use of technology has increased, especially in the sharing of

information among professionals and patients. The use of telehealth in remote monitoring of

patients also forms the culture of the current nursing practice. Nurses are currently able to

monitor the patients' vitals through technology, such as wearable devices that include wrist bands

and others. Nurses have also adopted the role of leaders at different levels, including at the

patient level. Current nursing is also characterized by health promotion. Nurses are putting effort

into disease prevention by creating awareness and educating communities on healthy behaviors

and health risks. Nurses currently focus on educating the patients, families, and the community

on the need to live healthily through proper nutrition and exercise to manage their health


conditions by delaying complications, especially for individuals with chronic illnesses such as

diabetes.

Whether the Bar for Nursing Leadership is Set at the Individual Patient-Nurse

Relationship or the Community-Nurse Relationship

Leadership entails influencing the attitudes and behaviors of others in favor of

accomplishing a shared goal. Nursing leadership involves providing support and direction,

coordinating, motivating, effective communication, collaborating, and advocating for the

patients' needs. The Institute of Medicine emphasizes exercising leadership in interprofessional

teams and the healthcare systems. According to Al-Dossary (2017), the nursing profession and

practice entails a leader's role as the roles of nurses are leadership roles. The bar for nursing

leadership, however, is set at a community-nurse relationship. The nursing practice involves

making crucial decisions on the diagnosis and medication of patients. Every nurse has the

potential to be a leader, even without have an official leadership position. Nursing leadership

focuses on clinical leadership as nurses are expected to take responsibility for their actions;

hence, they play leaders daily. In the nursing literature, leadership phenomenon has always

reflected general leadership. The fundamental role of ensuring the safety of patients has created


an interest in clinical leadership. Nurses act as leaders by advocating for the rights of patients.

They also act as leaders through effective communication in their interaction with patients,

families, and other health care providers. They also act as leaders in evidence-based practice.

Leadership at an individual patient-nurse relationship is, however, not recognized despite the

impact it has on patient outcomes, including patient satisfaction.

An example of how the bar for nurse leadership is set at the community-nurse

relationship and not the individual patient-nurse relationship is the recognized efforts of nurse

theorists whose efforts impacted community levels. Measures of improvement in health care are

not based on the outcomes in an individual patient but on the community as a whole. Another

example is how health outcomes are measured across populations.

Definition of Nursing Leadership in Relation to Health Policy and the Community from the

Review of DNP Essentials and the 2011 Institute of Medicine Future of Nursing Report

Essential II of the DNP programs focuses on organizational and system leadership for

improving quality and system thinking. The graduates are equipped with expertise in assessing

organizational issues, identifying any issues in the systems, and facilitating practice delivery


changes. They are also prepared to assume leadership roles at various levels, including informal

leadership in clinical settings and formal leadership at executive levels. The DNP essentials

recognize leadership as the ability to conceptualize new care delivery models based on

contemporary nursing science (American Association of Colleges of Nursing, 2006). The models

should be feasible within the existing cultural, political, economic, and organizational

perspectives. Nursing leadership entails possessing knowledge and skills that are consistent with

health care and nursing goals aiming at eliminating health disparities, promoting the safety of

patients, and excelling in practice. The essential outline of leadership is the ability to assess the

impact of health procedures and policies in meeting the intended populations' needs. The role of

leaders in nursing is, therefore, aligning policies and strategies with health goals. The focus

should not only be on individual patients at clinical facilities but the whole population.

Leadership in relation to community focuses on health disparities and improving outcomes while

meeting the needs of the community members.

The Future of Nursing report by the Institute of Medicine states that nurses should play

key roles of team members and leaders for a better-integrated and reformed health system that is

patient-centered. The report highlights that nurses provide a steadfast commitment to improved


safety and quality, patient care, and better outcomes. The report recognized the need for

education to enable the nurses to deliver effective care, engage with other health care

professionals, and assume leadership roles in redesigning the health care system. Such statements

show that the nurse has a role as a leader to redesign health care systems through policies and

other changes that they find appropriate. Their commitment to patient-centered care, equitable,

high-quality, and safe care covers the community as a target group in improving health care. The

report recognizes the capacity of nurses to transform health care through policies when granted

favorable working conditions and opportunities. The recommendation of the report includes

granting nurses full practice authority, high levels of education, the chance to be full partners

with physicians, and the provision of necessary resources. Nurses are recognized and partners

and assets in reforming the health care industry through partnerships (American Hospital

Association, 2020).

The recommendations of the report focus on the intersection of the health needs of

diverse communities and the actions of the nurses. The recommendations reflect the nurse's

potential to bridge the gap between access and coverage of health care by partnering with

different health care professionals. The report views the nurse as change agents in the health care


industry. Their potential is not limited to any strategies or the clinical level. The report addresses

some of the areas that act as barriers. They are presented as innovators in areas including policy

change and in addressing the health needs of communities. According to Udod and Wagner

(2018), the nurse is change agents, although the process is faced with various challenges and

complexities due to the evolving health care environment. The IOM report addresses a major

challenge by recommending education to equip nurses with the necessary skills and knowledge

to address the challenges and expand their scope to widen the impact of their roles as leaders.


References

Al-Dossary, R. N. (2017). Leadership in nursing. Contemporary Leadership Challenges, 251.

American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for

Advanced Nursing Practice.

American Hospital Association. (2020). Future of Nursing IOM Report.

Fix, G. M., Vandeusen Lukas, C., Bolton, R. E., Hill, J. N., Mueller, N., Lavela, S. L., &

Bokhour, B. G. (2018). Patient-centered care is a Way of Doing Things: How Healthcare

Employees Conceptualize Patient‐ Centred Care. Health Expectations, 21(1), 300-307.

Li, S., Cao, M., & Zhu, X. (2019). Evidence-Based Practice: Knowledge, Attitudes,

Implementation, Facilitators, and Barriers Among Community Nurses—Systematic

Review. Medicine, 98(39).

Morley, L., & Cashell, A. (2017). Collaboration in Health Care. Journal of Medical Imaging and

Radiation Sciences, 48(2), 207-216.

Udod, S., & Wagner, J. (2018). Common Change Theories and Application to Different Nursing

Situations. Leadership and Influencing Change in Nursing.

the current nursing culture

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