I feel very unhappy by reading this article. (NST-9February2010). The writer did not understand the meaning of nursing. Nurses are the back bone of the health care delivery system. No one can specify the most valuable side of the coin. I think all the health team members are vital to health care delivery. Doctors alone cannot deliver the health care. They are the part of the medical team. Each and every one contribution is very important to the success of the health care sector.
The writer says the doctor assess and admits the patient. Who is going to take care of the patient afterwards? Compare to all the other professional’s nurses are the one who is taking care of the client for 24 hrs. Nursing is not only providing the hygienic care. Hygienic care is the one part of her role. She is meant for delivering the health care as whole. Nurses are educated to take care of the person as whole. They are not focused towards only the client physical illness; they are with the client to take care of them psychologically, socially and spiritually (Holistic nursing care). Nurses are educated to bring the connectivity between the body, Mind and spirit. We can have a clear idea of nursing from the following definition by international council of nursing, “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.”
The function of the nurse is very clear based on Virginia Henderson’s definition of Nursing (1966),The unique function of the nurse is to assist the individual, sick or well, in performance of those activities contributing to health or its recovery (or peaceful death) that he/she would perform unaided if he/she had the necessary strength, will or knowledge. And to do this in such a way as to help him/her gain independence as rapidly as possible. She has given the following 14 components as the basic component of basic Nursing care.
1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body waste.
4. Move and maintain desirable postures.
5. Sleep and rest.
6. Select suitable clothes dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and
modifying the environment.
8. Keep the body clean and well groomed and protects the integument.
9. Avoid changes in the environment and avoid injuring others.
10. Communicate with others expressing emotions, needs, fears, or opinions.
11. Worship according to one s faith.
12. Work in such a way that there is a sense of accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads to normal development
and health and use of the available health facilities.
Is it agreeable that bathing, cleaning and making bed are the lower ranking jobs? How we can perceive a mother doing these things for her baby? Nursing is not starting from somewhere else. It starts from your own mother. Hygienic care is not the low grading job. There are lot of observations can be made during the hygienic care. I feel so sad my friend: You do not know what are all the observations can be made during hygienic care? (Bed sore, wound healing , fluid retention and problems in elimination)
Nurses are scientifically plans the nursing care based on the nursing process. Nursing process is a systematic method of providing nursing care. It provides framework for planning and implementing the nursing care. Nursing process consists of five steps, Assessment, diagnosis, planning, implementation and evaluation. This is the example of best independent approach for the nurse by using three skills , cognitive, technical and soft skills. The center of attention of the medical diagnosis is on the client illness. Contrary to a nursing diagnosis which focuses on the person and their physiological and/or psychological response to the illness. Medical problems are considered to be the important one in the medical diagnosis. The medical diagnosis is formulated based on the medical illness. But the nursing diagnosis varies from it. It focuses on the client present and potential problems. A Nursing Diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable in delivering the patient care.
Doctors formulate the medical diagnoses to treat medical problems; as nurses, we then care for the person behind that illness. The center of attention of the nursing diagnosis is varies from the medical diagnosis, example the medical diagnosis – Asthma, the nursing diagnosis is ineffective airway clearance to ineffective coping, Impaired nutritional status, Sleep disturbance and fear and anxiety. The medical practitioner can diagnose and plan the treatment of the medical diagnosis. Nursing care is focused on positioning, oxygen administration suctioning. This is the independent care which she can perform autonomously.
Nursing diagnosis identifies the situations the nurses are licensed and qualified to treat. Medical diagnosis identifies the situations the doctors are licensed and qualified to treat. Nursing has its own professional boundaries. This helps them avoid getting into the others job. These margins are drawn by the nursing council /Nursing Board or the nursing authorities. This limits the working role of the nurse. So the nurses are functioning according the rules and regulations of the nursing Board /council.
The people with in the small circle, does not understand what is happening in the rest of the world. Same way my friend does not know the world level changes and development on the nursing profession. Many advanced roles are taken by the Nurses in western countries. This has been well perceived by the public and doctors.Nurse Practitioner, Nurse Clinician, Nurse Anaesthetist and Nurse Advocate are the some of the challenging roles are taken by the nurses. The nurses in these advanced roles are assessing and diagnosing the patient. Many of the nurses in western countries are prescribing the medications also. Malaysia is also moving towards the better change on the nursing profession. The time is not so longer. I hope with in a shorter period of time we also can expect greater changes in Malaysia also.
Every profession possess its own responsibility and roles. Nursing profession also has unique responsibilities, roles and Skill. It would be very long list to categorise it. It has countless specialities, opportunities and the career pathways.
There are tremendous changes in the view of the public also. The numbers of admission to the nursing colleges are greatly increasing. Without the good opinion and attitude of the public how is it possible?
Due to this broad scope, the job opportunities are increasing day by day. They have vast opportunities. Malaysian nurses are in highly demand by the gulf countries. They give a great contribution to boosting up of the economy of the country.
Many nursing theorists and researchers have been developed all over the world. They have contributed greatly to the client care improvement. The nurses can voice out and bring out the scientific changes through the nursing journals. Nursing journals are playing a vital role in communicating the nursing research papers. Some of the research has shown that the nurses are significantly better in performing hand hygiene and infection control than doctors.
There are many evidences available that nursing research has been started long back. Florence Nightingale is founder of modern nursing. She has used the scientific principles in taking care of the sick. There are many nursing leaders given much contribution to the development of the profession.
Approximately 60 percent of the hospital work force is by the nurses. It is very important to understand the necessity of the hospital workforce. In Malaysia, there are number of institution have started with Master and Doctorate programmes for the nurses. It shows new pathway and specialisation for the nurses.
In some occasions the junior doctors are learning from the senior nurses. It is not wise to argue who is the frontline in delivering the health care. We have to in one line towards the betterment of the health care sector and the client welfare. The trend of the world is changing to the greater extent. The new emerging concept is collaborative working. No one is superior or inferior. All the department are necessary for providing successful care.
Nurses are with the human at the time of birth as well as at the end of life. So I feel this is more blessed profession. I am more proud to be the part of this profession. Healthcare is a complex area that requires collaborative learning and shared experiences and ideas, and the medical profession need to ensure they value nurses’ knowledge and expertise.
Doctor’s produces doctors and the nurses produce nurses,
Competitions between the professions are unhealthy,
We should welcome the collaborative working.