Question

How will you address these 3 issues?

Three very traditional barriers to new or expanding roles for nurses in clinical practice or health system management are:

(1) physician resistance to what they perceive to be incursions into the “medical” domain;

(2) patient reluctance to shift their confidence to what they may see as a new category of health worker; and

(3) legal limitations to the type of businesses or practices that may be run by nurses.

Answer 1

How will you address these 3 issues?

Three very traditional barriers to new or expanding roles for nurses in clinical practice or health system management are:

(1) physician resistance to what they perceive to be incursions into the “medical” domain;

(2) patient reluctance to shift their confidence to what they may see as a new category of health worker; and

(3) legal limitations to the type of businesses or practices that may be run by nurses.

answer:

The three very traditional barriers to new or expanding roles for nurses in clinical practice or health system management can be adressed as explained below.

(1) physician resistance to what they perceive to be incursions into the “medical” domain;

The barrier of the physician resistance can be addressed to by collaboration between the medical and the nursing professional organisations.The steps to resolve this barrier are to emphasize the need for advanced clinical nursing practice for the benefit of the community, define the boundaries of the practice and discuss and resolve the conflict of interest between the medical and nursing domains that may arise,arriving to a consensus of symbiotic survival for better public healthcare delivery.

The  collaborative inter-organizational efforts must be coupled with legal governaces and policy initiatives by the professional nursing organisations.

Policy initiatives have to be taken by the members of the nursing association to bring about the relevant change in the perception of the medical community towards advanced nursing practice

The changing times drive need of collaborative team effort at health care. It must be emphasized to the members of the physician organisations that the traditional physician led health care needs to be changed to a collaborative team care to provide healthcare within the community and provide individualized health care plans for the people.

Acceptance for the new role of the nursing must be sought for by discussions, debates,policy changes and legal governances within the medical fraternity

The issue of traditional barrier to the advanced practices of a nurse with respect to the patient reluctance and patient perception can be addressed with the following interventional steps.

1. at individual level or personal level

At an individual level while providing advanced clinical care to the patient, the patient must be made aware of the increasing nursing competence in expanding clinical practice on account of their rigorous and complex training.One must provide quality care and expertise while dealing with patients at a personal level and clear their misconceptions and educate them about the advanced training that is being received by the nurses of today as compared to the old days which has led to the creation of a new health care worker.

The patient reluctance to shift their confidence to what they may see as a new category of health worker must not discourage the nurse who is in advanced clinical practice and he/ she must must be seen in a positive manner and as an opportunity to provide patient education about the same for his good and society at large.

2. at community level

Community education about the advanced training and study of nurses to handle various aspects of clinical practice and health management and the need of a new health care worker category must be planned at community level.

There is a perception in the society at large that the traditional nursing care is the only fundamental role that has to be played by a nurse. This perception has propagated through generations and has to be changed to to resolve this traditional barrier. The education of the society through mass media,social media and propaganda about the the high level training received by the nurses and their competence in the field of clinical practice and healthcare mangement systems to make them aware of the the changing trends is imperative to resolve the patient perception barrier to advanced clinical nursing practice.

The long waiting period for the appointments, the inaccessibility of healthcare in some areas ,the poor provider to patient ratio make it imperative that the understanding and acceptance of the new category of the healthcare worker percolates in the community as also the its aim of providing quality healthcare and indiviualised care. The  community awareness regarding same must be raised by organising talks or events and the advantages explained.

3 at the professional organisational level

The professional nursing organisations must organise awareness events for the education and information of the general public regarding the nursing training and expanding domain into the clinical practice,its need and positive effects  in order to to instill confidence,respect ,acceptance and faith in the people for the nurses who are practicing expanding roles in the clinical and the healthcare management.

Faith heals and faith of people in the new nursing role must be restored to resolve the traditional barrier of patient perception and reluctance to accept the roles of nurse as a new health care category.

legal limitations to the type of businesses or practices that may be run by nurses.

The barrier caused by the  legal limitations to the type of businesses or practices that may be run by nurses can be addressed as under:

1.at an individual level:

Effort must be made by the the nurse practitioner in an advanced clinical practice to become a part of the Legal procedure that makes the laws regarding the businesses and the practices of the nurse and seek a say in the governance pertaining to nursing legal system.The nursing practice must be within the legal limitations of the the place of practice and hence efforts done to change the laws to overcome this barrier. It is important that the businesses or the practice that is run by the nurse follows the state and Federal laws of the place till the time legal changes are made.

2.At community level

The community has to be made aware through education,propoganda and sensitization that if certain legal barriers are removed from the nursing practices,it will benefit them by providing them individualized healthcare and benefit the community at large. Legal help for changing existing laws can be sought from the various not for profit service oriented organisations

3.At professional organisational level

In order to overcome the barriers placed by the legal limitations ,efforts have to be made at the level of the professional organisations. The nurses must have a representation in the governance and system of legislations and nursing practice legal rules committee. This can be done by representation of the nursing association in the legal bodies of the place and bringing about the implemention of  new laws and legal directives to encompass the expanding role of the nurse.