Research Proposal on "Nursing Education in He USA"

Research Proposal 10 pages (2543 words) Sources: 5 Style: APA

[EXCERPT] . . . .

Nursing Education in the United States of America

The objective of this work is to answer the question of whether the national professional organizations, such as the American Association of Colleges of Nurses, the American Nurses Association, the American Organization of Nurse Executives and the National League for Nursing, advanced or hindered attempted to unify the educational system? This work will further relate the policies and activities of these four organizations to the role and expectations of a professional organization and will define the nature of the membership and policymaking bodies of the four organizations and the effect on entry-level higher education. Other factors relevant will be indicated. The second part of this work will be in relation to clinical professions such as medicine, dentistry, pharmacy and audiology, which require pre-professional education in a four-year liberal arts and science undergraduate program. In these disciplines and others, the first degree for professional education begins at the master's or doctoral levels. For example, preparation for pharmacy now requires a six-year doctoral program. This work will answer the question of whether a belief is held by the writer that the above approach to be a viable solution to initiating a unified system of entry-level education. If the answer is yes this will be explained and if the answer is no a proposal will be given.

II. Introduction

The American Association of Colleges Nursing (AACN) states that is "recognizes the shortage of faculty in schools of nursing with baccalaureate and graduate programs is a continuing and expanding problem. Over the past several years, the deficit of faculty has reached critical proportions as the current faculty workforce rapidly advances toward retirement and the pool of younger replacement faculty decreases." (American Association of Colleges Nursing, 2005) the U.S. is presently experiencing "an unprecedented shortage of registered nurses." (American Association of Colleges Nursing, 2005) it is expected that this shortage will "persist because of the increasing demand for health care as baby boomers approach retirement: the aging nursing workforce.

III. Primary Challenges

The primary challenges that the American Association of Colleges Nursing cites for the future are those as follows:

1) Increasing Demand: (a) Demand for nurses has exceeded supply in certain types of patient care specialties, such as critical care, cardiac, neonatal, and perioperative nursing; (b) Demand is particularly great in some geographical regions due in part to a maldistribution of nurses throughout the United States, e.g., Massachusetts has twice the number of nurses per capita as California; - Demand has intensified for more baccalaureate-prepared nurses with skills in critical thinking, case management, and health promotion skills across a variety of inpatient and outpatient settings; and (d) Demand has increased for more culturally competent nurses with knowledge of gerontology and long-term care because of rapidly changing population demographics. (American Association of Colleges Nursing, 2005)

2) Slow Growth in Supply:(a) Supply of new nurses has decreased with declining numbers of new students and declining applications to schools of nursing; (b) Supply of nurses is adversely impacted by faculty shortages in schools of nursing making it difficult to increase the number of students across the country;- Supply of nurses is affected by a highly competitive labor market that attracts the best candidates away from health professions careers; and (d) Supply of nurses is negatively influenced by the inaccurate media images of nursing, decreasing the selection of nursing career options by young people. (American Association of Colleges Nursing, 2005)

3) Aging of the Nursing Workforce: (a) the current nursing workforce is estimated to be nearly 2.7 million, with the average age of nurses at 45.2 years. Of these, only 82% or 2.2 million are employed either full- or part-time in nursing with an average age of 43.3 years; (b) the largest cohort of currently practicing nurses will be in their 50s or 60s in the next decade, with many of these nurses retiring or decreasing their work time; and - the average age of nurses is increasing at more than twice the rate of all other occupations in the U.S. workforce, with the number of nurses under age 30 decreasing by 41% from 1983 to 1998. (American Association of Colleges Nursing, 2005)

It is related additionally by the American Association of Colleges Nursing that the Magnet Hospital study published in 1983 gave leaders in nursing greater comprehension of the characteristics that attract and retain "professional nurses in the national health care system." (2005) the investigation made by the American Academy of Nursing of the American Nurses Association was one in which a "nationwide investigations of hospitals known for successful nurse recruitment and retention" were examined. The foundation for the Magnet nursing Services program is stated to be the 'Scopes and Standards for Nurse Administrators' (ANA, 1995)

IV. Scopes and Standards for Nurse Administrators

The American Nursing Association states that this program provides a framework to acknowledge excellence in the following areas:

1) nursing services management, philosophy, and practices;

2) adherence to standards for improving the quality of patient care;

3) leadership of the chief nurse executive and competence of nursing staff; and 4) attention to the cultural and ethnic diversity of patients, their significant others, and the care providers in the health care system. (American Association of Colleges Nursing, 2005)

The American Association of Colleges Nursing (2005) states that as the health environment has increased so have the need for clinical experiences to enable graduates and students in their transition. Secondly noted is differentiated nursing practice models which are models of clinical nursing practice that are defined or differentiated by level of education, expected clinical skills or competencies, job descriptions, pay scales and participation in decision making." (American Association of Colleges Nursing, 2005)

VI. Hallmarks of the Professional Nursing Practice Environment

The Hallmarks of the Professional Nursing Practice Environment are those stated as follows:

1) Manifest a philosophy of clinical care emphasizing qualify, safety, interdisciplinary collaboration, continuity of care, and professional accountability;

2) Recognize contributions of nurses' knowledge and expertise to clinical care quality and patient outcomes;

3) Promote executive level nursing leadership;

4) Empower nurses' participation in clinical decision-making and organization of clinical care systems;

5) Maintain clinical advancement programs based on education, certification, and advanced preparation;

6) Demonstrate professional development support for nurses, for example;

7) Create collaborative relationships among members of the health care provider team;

8) Utilize technological advances in clinical care and information systems. (American Association of Colleges Nursing, 2005)

VII. The ANA, NLS and AONE - Joint Petition Statement

The American Nurses Association states in its 'Joint Statement on Delegation' that there is "...more nursing to do than there are nurses to do it. Many nurses are stretched to the limit in the current chaotic healthcare environment. Increasing numbers of people needing healthcare combined with increasing complexity of therapies create a tremendous demand for nursing care. More than ever, nurses need to work effectively with assistive personnel. The abilities to delegate, assign, and supervise are critical competencies for the 21st century nurse. In 2005, both the American Nurses Association and the National Council of State Boards of Nursing adopted papers on delegation. Both papers presented the same message: delegation is an essential nursing skill. This joint statement was developed to support the practicing nurse in using delegation safely and effectively." (American Nurses Association, 2005) Delegation is defined "as the process for a nurse to direct another person to perform nursing tasks and activities" and as "transferring authority" as well as "transfer of responsibility" all of which means that "...a registered nurse (RN) can direct another individual to do something that that person would not normally be allowed to do." (American Nurses Association, 2005)

VIII. Policy Considerations

Policy considerations stated by the American Nurses Association include those listed as follows:

1) State nurse practice acts define the legal parameters for nursing practice. Most states authorize RNs to delegate;

2) There is a need and a place for competent, appropriately supervised nursing assistive personnel in the delivery of affordable, quality health care;

3) the RN assigns or delegates tasks based on the needs and condition of the patient, potential for harm, stability of the patient's condition, complexity of the task, predictability of the outcomes, abilities of the staff to whom the task is delegated, and the context of other patient needs; and 4) All decisions related to delegation and assignment are based on the fundamental principles of protection of the health, safety and welfare of the public. (American Nurses Association, 2005)

IX. Principles of Delegation

Principles of Delegation are stated to be inclusive of the following:

1) the RN takes responsibility and accountability for the provision of nursing practice;

2) the RN directs care and determines the appropriate utilization of any assistant involved in providing direct patient care;

3) the RN may delegate components of care but does not delegate the nursing process itself. The practice pervasive functions of assessment, planning, evaluation and nursing judgment cannot be delegated;

4) the decision of whether or not to delegate or assign is based upon the RN's judgment… READ MORE

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