Since the days of Florence Nightingale, patients in hospitals around the world depended on the care of nurses. These trained professionals assist doctors and specialists in virtually every area of medicine. In addition, nursing allows for a special type of one-on-one contact that doctors can’t provide. Nurses provide various services for patients on an hourly basis. This special, intimate contact has prompted a significant change in the field of nursing. In most modern medicinal institutions, as well as practical training programs, nurses are taught provide skillful services, as well as compassion and caring. Patients and doctors, alike, realize the value of the services nurses provide. After Florence Nightingale revolutionized the profession in the 1850’s, deaths in hospitals dropped dramatically, from 420 per 1000 to 22 per 1000 (Kurzen 59). Since that time, hospitals and rehabilitation centers have depended on the skills of nurses. Practical nursing programs began to develop in the late 1800’s to increase the opportunities of women (62). These institutions soon became vital to the growth and effectiveness of hospitals and health facilities. The demand for nursing services grew so dramatically, national organizations began to flourish to provide supervision and planning for the growing profession (62). Within a relatively short period of time, nursing had evolved from a pink-collar employment to a respected profession. Nurses must meet various qualifications for licensure to ensure that they are equipped to be efficient caregivers. The standard examination, NCLEX, requires that nurses retain curriculum taught throughout educational training programs (78). Such training allows nurses to develop an inventory of skills useful in daily routines. As technology continues to advance, training for nurses becomes more in depth. Nurses are fully qualified to "work under the Good 2 supervision of doctors, [as well as] perform basic therapeutic, rehabilitati!
ve, and preventive care for anyone who needs it" (76). For many nurses, the daily chores and duties begin long before sunrise. After receiving briefs and updates on hospital conditions, nurses must check the charts of their patients (Wolkomir 42). Charts include crucial information about the administration of "meds," and special notes from physicians (Livesay, personal interview). Mistakes in the administration of medicine can be fatal, so it is the responsibility of nurses to give precise dosages (Wolkomir 43). After completing orders from doctors, nurses perform more ordinary tasks. Many patients are unable to complete simple acts of daily hygiene, so nurses are responsible for these tasks. A nurse featured in the article, "The Quality of Mercy" said that she did not "mind her work- despite the high tech gear and the life-and-death responsibility- requires services as humble as Jesus’ washing of his disciples’ feet" (43). Patient care studies detail treatment and therapies p!
rovided by nurses for treatment of various illnesses (Livesay, Care Study). In addition, care studies outline problems and expected outcomes or goals due to a particular treatment (Livesay, Care Study). Clearly, nursing is a highly skilled profession with huge amounts of responsibility. Nurses perform these numerous duties for not one, but an entire hall of needy patients. These daily chores appear to be enough to keep any caregiver busy, yet nurses are becoming more and more responsible for another type of wellness. Good 3 In the past few years, the field of nursing has displayed a concern for not only the physical wellness of patients, but their emotional wellness. "Nurses practice medicine as an art, marshaling compassion and skill in equal measure" (Wolkomir 41). While dealing with an oncology patient, Vanessa Livesay stated "comfort is the most important gift [my patient] can be given. Support must be offered, whether accepted or not. If the spirit is in distress, there is usually little comfort for the body" (Livesay, Care Study). This new approach toward nursing is in an effort to make patients feel comfortable and at home. Since nurses are in continual contact with patients, they develop a bond of trust. A patient mentioned in "The Quality of Mercy," looks forward to the company of her nurse, and the familiarity of her voice (Wolkomir 41). Nurses are encouraged to create this situation. Practical Nursing Programs teach trainees to "create a home-like situation [and] use a gentle touch, quiet voice, and flexible approach to care-giving services ("Best Practice Interventions"). Patients should be kept in control, to combat feelings of helplessness. Modern techniques encourage patients and doctors to decide on methods of therapy together ("Principles of Therapy," par. 3). This important decision making process lends a greater sense of control to patients. A significant change in the medical field is an increased focus on family. Previously, hospitals would not allow children to visit patients (Livesay, personal interview). Today, however, children are allowed to visit patients during visiting hours. Visiting hours are also being increased in most hospitals. Nurses are taught that family awareness is crucial. "Principles of Therapy states, "If [family members] perspective on pain is sought and their participation in therapy is respected, they will be powerful allies" (par. 5). In addition, as nurses show Good 4 compassion and understanding toward family members, they are able to gain the trust of not only the family, but also the patient. A new tactic being employed in the practice of nursing is an active team approach. In the 1880’s, a single nurse was expected to care for 50 patients ("The Lot of a Nurse..."). Nurses are instructed to "discuss various modes of therapy encountered by patients" (Guidelines for Rehabilitative Nursing 3). Nurses in modern hospitals promote a team unit, striving together to overcome illness. "The patient and family as the core of this team, will require the assistance of physicians, nurses, and other professionals" ("Principles of Therapy," par. 7). Guidelines for Rehabilitative Nursing instructs that caregivers should "identify measures to facilitate cooperation between the nursing staff and the rehabilitation team" (Guidelines for Rehabilitative Nursing 3). A team approach adds to the patient’s sense of control. Team efforts are a collaboration. All members of the team work together to achieve the common goal of healing the patient. Nurses are instructed to be perceptive of the feeling of patients. "Guidelines for Rehabilitative Nursing" states that the student will "observe relationships/interactions among patient, family and staff members and discuss the effect of these relationships on the patient’s rehabilitation" ("Guidelines for Rehabilitative Nursing" 3). The nurse's interpretation of these factors may be a valuable tool in the recovery process. Such interpersonal communication helps to connect the patient and the caregiver, as well as help the caregiver to understand certain personal feelings connected to religion or other situations. Nurses are also trained extensively in communication with patients. They are instructed to use broad opening statements and acknowledge a patient’s thoughts, often through silence and not verbal sympathy Good 5 (Communication par. 1). Recognizing effective modes of patient communication can also help nurses identify blocks to communication. The overuse of cliches or advice, for example, can make patients feel like they are unable to communicate openly with their caregivers (par. 2). In addition, these communication techniques are vital when treating pediatric patients. In a pediatric care study, Livesay states that her young patient seems very attached to his mother. She even says that the child liked to be held more due to his seizure activity (Livesay, pediatric care study 3). A nurse’s a!
wareness of family situations, such as this one, enables them to comfort their patient. Nurses working with terminally ill patients take compassion to a new level. When medical technology can only be used as an effective means of prolonging life, not preserving it, the patient is in need of comfort from every possible source. "How to Handle the Five Stages of Dying" provides nurses with responses to combat patient behavior. For example, when the patient is experiencing depression, nurses are taught to try to cheer that patient up, but let them express sorrow ("How to Handle..." par. 4). An experienced nurse, armed with this knowledge, can help a patient accept their disease, and ultimately, their fate. Vanessa Livesay stated, "I want to be able to help my patients in any way possible. Not only through medicine, but also through comfort and compassion. That is, perhaps, the best skill I can offer" (Livesay, personal interview). It is very important that members of the nursing staff make the last days of terminally ill patients as comfortable as possible. An oncology care study states the importance of comfort for ill patients, mentioning positioning and turning, to keep patients in their most comfortable position (Livesay, care study). Perhaps RN Robin Glenn explained this difficult Good 6 time best when she said "I would like to think I could ease [my patient] through it as much as possible. Many times, I just listen and sometimes I help them die as comfortably as possible" (Glenn, personal interview). Clearly, medical skill, as well as caring and compassion, plays a vital role in the field of nursing. These abilities work together to create and efficient nurse, who not only treats their patients physical well being, but also facilitates a healing of emotional aspects. Medicine is a field of practice that calls for a great deal of responsibility, in addition to a desire to help others. Although nurses aren’t trained in operating procedures, they still save many lives. Patients and nurses develop intimate relationships, consisting of trust and honesty. Through employing the use of both skill and compassion, nurses impact the lives of millions every day. Vanessa Livesay stated, "I want to make a difference in someone’s life, even if its just me. I want to be the one to hold an old person’s hand when they’re alone. I want to make a child’s stomach stop hurting if I can. Nursing is truly a calling." (Livesay, personal interview). Through displaying both skill and caring, nurses truly establish themselves as "angels of mercy."
Works Cited "Best Practice Interventions." Surveyor Guidebook on Dementia. Washington: U.S. Government Printing Office. 1995. "Communication." Lord Fairfax Community College Practical Nursing Program. 1997. Glenn, Robin, RN. Personal Interview. Sept. 1998. "Guidelines for Rehabilitation Nursing." Winchester Rehabilitation Center. 1997. How to Handle the Five Stages of Dying." Lord Fairfax Community College Practical Nursing Program. 1998. Kurzen, Corrine R. Contemporary Practical/Vocational Nursing. Third Edition. Philadelphia: Lippincott, 1997. Livesay, Vanessa, LPN. "Nursing Care Study." 29 June 1998. Livesay, Vanessa, LPN. "Pediatric Nursing Care Study." 30 March 1998. Livesay, Vanessa, LPN. Personal Interview. 16 Oct. 1998. "Principles of Therapy." Lord Fairfax Community College Practical Nursing Program. 1997. "The Lot of a Nurse in 1887." Cleveland Lutheran Hospital. Wolkomir, Joyce and Richard Wolkomir. "The Quality of Mercy." Smithsonian. April. 1998: 40 - 51.
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