Evidence Based Practice in Nursing Care and Treatment

Question: How important it is to equip nurses at the hospitals with a critical bent of mind? Answer: Introduction Evidence based practice in nursing helps in the providing better care and treatment to the patients. This particular approach helps in building expertise from the clinical aspect along with it, aiding in devising decisions that will provide an economic way of treatment for the patient as well as the health care management (Groves, Burns Gray, 2014). From the given case study, the question that arises is, How important it is to equip nurses at the hospitals with a critical bent of mind? The management at the hospitals should ask themselves this particular question while appointing nurses. Nursing is no longer limited to simple take care of a patient (DiCenso, Guyatt Ciliska, 2014). It as an all-round job when, at times the nurses might have to fill into the shoes of a physician in his absence. An able nurse would do it at ease; however, one who lacks that particular bent of mind might land up losing a patient due to her lack of judgement (LoBiondo et al., 2013). Hence, this idea ha s been explored in details, based on the framework of evidence based practice. According to the case study, two nurses, Jessica, Emily and Chloe, were conflicted in their opinion where Chloe wanted Emily to continue using the auscultatory based sphygmomanometer where as Jessica wanted Emily to use the oscillatory based sphygmomanometer. Having a critical bent of mind would have made Emily realize that both the instruments have their own level of advantages and a single one does not triumph the other. The two different types of blood pressure measurement are exclusive for the ambulatory blood pressure measurement (ABPM) (Levin Feldman, 2012). The auscultatory method of measuring blood pressure uses the Korotkoff sound which emanates from an acoustic transducer signal. The auscultatory based sphygmomanometer is similar in function as the normal blood pressure measurement (Polit Beck, 2013). The accuracy level is quite high of this device. It measures the systolic and diastolic pressure of the heart which is combined with the disappearance and appearance of soun ds. The disadvantage includes the poor assessment of blood pressure during weak signals of Korotkoff (Hauck, Winsett Kuric, 2014). This drawback is overcome in an oscillometry based sphygmomanometer. A similar measurement is carried out by the oscillometry based sphygmomanometer where the blood pressure can be measured even in the absence of the Korotkoff signal (Melnyk et al., 2013). It does not require a microphonic sensor. However, it has its own share of disadvantages. The accuracy of the reading is based on the algorithms that used to analyse the signals. A sound knowledge of the instruments would have made the nurses realize that these two instruments are not that different from each other. This was just one of the instances. There are several reports and case studies that can be found in the archives of the Nurses and Midwifery Board of Australia where lack of competence has made a patient lose a life and later the responsible nurse had to go through legal hassles (Straka, Brandt Brytus, 2013). One of the common problems that nurses as well as physicians face is the issue of medication safety. The government of Australia has issued the standards and Medication safety forms the fourth point. According to this standard, the nurses and the physicians have to practice safety while administering medicines to the patients (Dearholt Dang, 2012). Most of the times it has been observed that due to lack of proper communication, or a lag in the performance of the nurses, the patients well being gets compromised. There have been instances where the patient lost his life due to wrong dosage of a medication or lack of skills in administering the dosages (Grove, Burns Gray, 2012). There have been technological advances like smart IVs, computerized physician order entry, avoid adverse effect of drug, bar code verification technology, implementation of monitoring improvement, introduction of no interruption zone in critical care units, and several other modifications have been made in order to help nurses become more vigilant and attentive towards the well being of their patients (Abbott, Sherry Simmons, 2013). Along with all sorts of technicalities, it is also important for the nurses to be conceptually sound. Most of the times it has been seen, that the nurses do not pursue subjects, like biochemistry or human anatomy, in their nursing courses; the common reason being the criticality of the subjects and the poor success rate (Friesens-Storms et al., 2015). However, the lack of knowledge of these two important subjects creates a dent in the competence of the nurses. It is necessary for a nurse to know about the different human body parts and about their function and locations. It becomes handy during a diagnostic session with the patient in the absence of the physician (Stetler et al., 2014). The adverse effect of drugs can be avoided if the nurse is well versed in the chemical composition of the drug. In this way, without the aid or the prescription of the physician, the nurse herself can administer the dosages as per the requirement of the students. It helps in saving a lot of precious t ime on the part of the patient (Dogherty et al., 2013). Other than the technicalities as well as the concepts, nurses also need to develop certain personal attributes in order to serve their patients with quality treatment and care. The case study showed how upset Emily appeared with her patient who was apparently a child. She had lost her patience while dealing with the child, and had wished to be done with him soon enough (Flynn et al., 2012). Patients are unruly and demanding most of the times. Therefore, it is expected that the nurses would pay attention to all their needs and fulfil all their demands without losing a hair. It might sound like a one-way street, however, the sense of duty comes first and everything else takes a back seat in the life of the nurse (Freeman et al., 2013). Patience is a virtue and nobody has ever regretted for having developed it. Nurses should also develop leadership qualities so that they can come forward with ideas in order to improve the management and make it work in favour of the patients (Galanter e t al., 2013). The healthcare expenses are shooting through the roof these days. A smart nurse would offer a suggestion, post proper negotiation with the patient and his family, and settle down with something that is feasible and easier to meet. Compassion and good behaviour are irreplaceable characteristics in a nurse (Hakkarainen et al., 2012). They should also abide by all the medical and nursing standards that have been framed for them. It helps them from getting embroiled in legal hassles due to their carelessness in paying attention to the nitty-grittys of the standards framed by the Nurses and Midwifery Board of Australia (Ohashi et al., 2014). The management at the hospitals should devise a curriculum for the nursing students so that they inculcate these attributes in their characters before being professionally working as a nurse. The course work also needs to be revised to make sure that the nurses are equipped with all the possible concepts that will prove to be helpful for themselves while appraising the condition of a patient in the absence of a supervising physician. There should also be brainstorming sessions to realize how far they are progressing in their courses and whether they will be able to handle the pressure once they join a hospital. The needs in a hospitals scenario are very different from that of attending regular classes. Long with their course work sessions, they should be given hands on experience on several subject matters such as the human anatomy. The subject should be taught in an embedded fashion with the theory paper. It will provide a better learning of the subject and also ease out the student s who are constantly worried about not being able to clear the paper. Conclusion Every person, every patient, who visits a hospital, hopes to receive a quality treatment, recover soon and step out of the hospital as a new person. The nurses play an important role in making this desire a reality. Yes, nurses are human too. It might be definitely physically and emotionally tolling for them to carry out a tedious job. However, the well being of the patient should be the priority. They would have to work harder to match up to the expectations of the patients. Proper knowledge of the condition of the patient will help the nurse to make a better assessment of the patient and provide help for a speedy recovery. A lack of these attributes can in an unfortunate situation prove to be fatal for the patient. Hence, the hospital management should be a little wary while appointing nurses. So much depend on their hands. Evidence based practices is hugely successful in building the competence of the nurses as previous case studies make them assess the situation with a current pa tient. Although nothing can replace the level of expertise one gains from experience rather than studying case studies. However, in order to receive a background, thorough study of previous cases as noted by the doctors and available online, should be studied carefully by the nurses. Reference Abbott, P., Mc Sherry, R., Simmons, M. 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