In recent decades, there has been a change in the field of nursing education. Practical orientation in teaching is giving way to education that involves a broad awareness of other disciplines related to medicine, often involving professional education and the use of research findings in clinical and managerial decision making. This change is in full accord with the results of a year-long debate among nurse educators themselves, the broader health professions community, and society at large about the goals of health professions education in the United States. It is essential to analyze the Evidence-based practice: an integrative approach to research, administration, and practice to understand the complexity of the sphere.
As a general rule, nursing education consists of theoretical and practical training. This education is provided by medical students who are taught by experienced nurses and other health care professionals who have earned a certificate of proficiency. According to Hall and Roussel (2020), nursing training is based on a fundamental principle that operates in the United States. This means a comprehensive approach to the patient’s condition and seeing the whole picture. Fragmentary knowledge in this method is not enough; it requires a solid knowledge base, which allows for creative thinking from a professional point of view, taking into account the characteristic features of each patient (Hall & Roussel, 2020). As the authors note, the logical consequence of this principled approach is, first, a small number of patients per unit – the nurse’s attendant; second, a high-quality education and high level of clinical thinking demanded of the nurse, including knowledge of advances in evidence-based medicine (Hall & Roussel, 2020). The nurse is the central person responsible for patient care in the U.S. model of medical care. This systemic function of nursing in the U.S. health care dictates accordingly the overarching principles of education and training for this segment of the health care workforce.
The nurse is required to have a wide range of knowledge for hospital work: from the procedures and operations that can occur in the hospital, to the proper interpretation of clinical laboratory tests; to the diagnosis of bedsores and the ability to prevent and treat them. In addition, the nurse must have knowledge of dietology, probe and parenteral feeding, a good knowledge of pharmacology, regarding the compatibility of medications, depending on the specialty, make and interpret ECG and understand the transcripts of functional diagnosis, and be able to explain the purpose of the procedure to the patient in simple words to sign consent for the procedure with the patient (Kiyimba & Lester & O’Relly, 2018). Characteristic features of the nurse’s work organization in the United States include the following:
- First, the nurse is present on the ward at all times, unlike the physician, who is not on the ward all day. Given that patients in U.S. inpatient care facilities are serious and intensive, and that patients’ doctors come to the ward once a day, the nurse is in charge the rest of the time and must call the doctor in case of an emergency. Of course, there are hospital duty doctors who come to the ward as needed.
- Second, in a typical medical department, there are 4 to 8 patients per nurse during a shift; 6 patients is the most common number of patients per nurse.
- Third, shifts are usually 12 hours long. The work of night nurses is no different than that of day nurses (Hall & Roussel, 2020).
- Fourth, each ward employs nurses whose duties include sanitary care, feeding, taking blood pressure and temperature of all patients once a shift, changing beds for each bedridden/dependent patient, and assisting those who get up on their own.
It is necessary to compare the official definition of nursing functions with the authors’ conclusions. The American Nurses Association, ANA defines nursing as protecting, promoting and optimizing a person’s health and abilities (Kumar, 2019). It consists in the prevention of disease and injury, the relief of suffering through diagnosis and treatment, and the protection and assistance provided to individuals, families, communities, and populations (Kumar, 2019). The authors interpret the function of nursing as coordination and responsibility for timely and appropriate treatment. Thus, Hall and Roussel have a different view of nursing, emphasizing more coordination functions than applied and therapeutic functions.
Hall, H. R., & Roussel, L. A. (2020). Evidence-based practice: An integrative approach to research, administration, and practice. Jones & Barlett Learning, LLC.
Kiyimba, N., Lester, J. N., & O’Relly, M. (2018). Using naturally occurring data in qualitative health research. A practical guide. Springer International Publishing.
Kumar, R. (2019). Nursing research & statistics. Jaypee Brothers Medical Publishers Pvt. Limited.