What is Nursing? Where does Nursing Fit in the Healthcare System and What is my Role?

What is Nursing?

Nursing is a profession of highly educated and specialized individuals that participates in many fields of healthcare. It contributes to nursing practice, education and administration, research, and the political field to promote positive changes in health policies (Munhall, 2012).

Nursing works in collaboration with other healthcare professionals but often works alone. (CNA, 2019b). It is an autonomous, self-governing profession that regulates its entry level registration and licensing and ensures that its members maintain and strive to improve their competencies (CNA, 2019b). It has a framework and a code of ethics that guide and regulate its practice. This ensures that the practice is both competent and ethical and it this way it is held accountable to the government and the pubic it serves (CNA, 2019b).

Nursing is guided by a metaparadigm that consists of four concepts, human beings, environment, health and nursing. These concepts are intertwined and direct nursing practice (Fawcett, 1984). The College of New Jersey (n. d.) describes nursing as both a science and an art. It is a science based on knowledge acquired through evidence-based research, critical analysis and evaluation and is developed through nursing theory for practice (The College of New Jersey, n. d.). This scientific knowledge is then integrated into nursing practice using a compassionate and holistic approach to care (Marchuk, 2014).

Where does Nursing Fit in the Healthcare System?

Healthcare costs in Canada have increased 100% in the past ten years from $100 billion to over $200 billion (Canadian Institute for Health Information. (CIHI), 2012). Yet the CNA (2013b) writes that Canadians are still waiting for their care and services. They note that there is a critical need for change in our healthcare system and that nurses can be instrumental in this change (CNA, 2013a). With the enactment of the Canada Health Act (CHA) in 1985 (Government of Canada, 1985), Canadian nurse leaders were instrumental in having a portion of the Act modified to include healthcare practitioners as part of the description of covered healthcare service providers (CNA, 2013b). This enabled nurse practitioner services to be covered by Medicare in the future (Wagner, 2018).

Nurses are the largest body of healthcare workers nationally at 48 %, with 425,757 regulated nurses cited as having an active license to practice in 2017 (Canadian Institute for Health Information (CIHI), 2017 as cited in Canadian Nurses Association (CNA), 2019a). Their experience, education and knowledge make them essential in improving healthcare accessibility and efficiency while helping to cut costs. Nurses are taking leadership roles in helping to change health policies by advocating a shift from the focus on acute care to community care. They also endorse a cost efficient model of care that puts the emphases on “primary care, health promotion and the prevention and management of chronic diseases” (CNA, 2013a. para. 2).

Mamishi (2017) writes that nurses, through their close interpersonal relationships with patients, are in a position that is amenable to an educative role. They are involved in educating in acute and long term health settings, in the community and in schools. Nurses are active in educating about risk factors in primary prevention, they assist in screening programs and they contribute to management and treatment of illnesses (Mamishi, 2017). Further, they are also nurse educators, and encourage, teach and mentor present and future nurses (Mamishi, 2017). Nurses are well suited for educational leaderships roles as they have strong communication skills, are experienced in clinical settings, possess exceptional critical thinking and analysis skills, and can implement theoretical evidence into practice (Mamishi, 2017).

Finally, nurses work as researchers. This research provides scientific evidence that guides clinical practice and helps in understanding how best to deliver positive healthcare outcomes, improved patient satisfaction and more cost effective healthcare delivery (Salmond, & Echevarria, 2017).

What is My Role?

As a nurse, I think my primary responsibility is to my patients. I live by my professional code of ethics, “providing safe, compassionate, competent and ethical care, promoting health and well-being, promoting and respecting informed decision-making, honouring dignity, maintaining privacy and confidentiality, promoting justice, and being accountable” (CNA, 2017, p.3). These core nursing values address a nurse’s honesty and integrity and facilitate in providing compassionate, individual and ethical care to human beings.

As a member of the profession of nursing I think I must be accountable to my regulatory body and the public we serve, to abide by my code of ethics, to maintain my competencies, to continue my education and to be involved in trying to make positive changes in our healthcare system. In this capacity I can promote the discipline of nursing and the healthcare system, continue to encourage and mentor new nurses and to better serve the public.

Elizabeth

References

Canadian Institute for Health Information. (CIHI). (2012). National health expenditure trends, 1975 to 2012. Retrieved from https://secure.cihi.ca/free_products/NHEXTrendsReport2012EN.pdf

Canadian Nurses Association (CNA). (2013a). Registered nurses: Stepping up to transform health care. Retrieved from https://www.cna-aiic.ca/~/media/cna/files/en/registered_nurses_stepping_up_to_transform_health_care_e.pdf

Canadian Nurses Association (CNA). (2013b). One hundred years of service. Ottawa, ON: CNA. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/cna_history_book_e.pdf?la=en

Canadian Nurses Association (CNA). (2017). Code of Ethics. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive

Canadian Nurses Association (CNA). (2019a). Nursing Statistics. Retrieved from https://www.cna-aiic.ca/en/nursing-practice/the-practice-of-nursing/health-human-resources/nursing-statistics

Canadian Nurses Association (CNA). (2019b). The practice of nursing. Retrieved from https://www.cna-aiic.ca/en/nursing-practice/the-practice-of-nursing

Fawcett, J. (1984). The metaparadigm of nursing: Present status and future refinements. Image: Journal of Nursing Scholarship, 16(3), 84–87., doi:10.1111/j.1547-5069.tb01393.x.

Mamishi, N. (2017, November 3). The role of nurses in primary care reform: “The wheel and hub of health care system. The McGill Journal of Medicine (MJM). Retrieved from https://www.mjmmed.com/article?articleID=5

Marchuk, A. (2014). A personal nursing philosophy in practice. Journal of Neonatal Nursing, 20, 266-273 Retrieved from https://www.sciencedirect.com/science/article/pii/S1355184114000891

Munhall, P. (1982). Nursing philosophy and nursing research: In apposition or opposition. Nursing Research, 31(3). Retrieved from https://journals.lww.com/nursingresearchonline/Abstract/1982/05000/Nursing_Philosophy_and_Nursing_Research__in.12.aspx

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12–25. doi:10.1097/NOR.0000000000000308 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266427/

The College of New Jersey, (n.d.). Metaparadigm concepts, School of Nursing. Retrieved from https://nursing.tcnj.edu/about/mission-and-philosophy__trashed/meta-concepts/