The Evolution of Nursing: Use of Evidence-based Practice and Critical Thinking
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The Evolution of Nursing Practice
Throughout time, nursing has always been a career for those who have the passion of caring for others. However, nursing was around before it became a “career”. Back in the day, women were primarily the caretakers for families. Being caretakers meant cooking, cleaning, and mending to their family members when they became ill. Women were expected to live this lifestyle and care for others without having any training or education other than what they had learned from motherly figures.
To this day, women are still seen primarily as the caretakers of the family. However, nursing has evolved and opened many opportunities for males as well. Along with breaking the stereotype of gender norms, nursing care now relies mainly on education rather than the duty of helping others because you were meant to do so.
When it comes to nursing, there are many different routes one can go down. This can range from Nursing Assistant to a Licensed Practical Nurse, from a Registered Nurse to a Nurse Practitioner. All these career paths fall under the category of nursing. However, they are differentiated by the degrees and education one receives. In the following paragraph, I would like to focus on the differences between an associate and baccalaureate education in nursing.
When it comes to a nurse having an associate’s degree versus a baccalaureate degree, you would think the only difference is just that; the degrees. However, that is not the case. As stated in an article from nursinglicensure.org, “The level of licensing is the same, and roles do overlap, but nursing leaders are adamant: ADN and BSN roles are not the same.” By obtaining an ADN, individuals are given the opportunity to get their foot in the door of the nursing world. This can be obtained in a few short years at a local community college. With that being said, it can be completed in a shorter amount of time and at a cheaper cost.
When continuing their education to complete a BSN, nurses focus more on the research and informatics portion of nursing. Because there are always new ways of caring for and practicing with patients being explored, a BSN’s focus on critical thinking and leadership skills not only allows nurses to continuously advance in their care, but allows the opportunity to take on a wider scope of practice in the future. “For a nurse who sees herself eventually moving into a supervisory or administrative role, an extra year or two to earn a BSN degree could be a valuable investment in your future.” (Turley. 2020).
Soon most hospitals and healthcare organizations will be transitioning to only hiring nurses who have obtained their BSN. “That aggressive goal was set due to academic research that found that patients get better care in hospitals where nurses have a bachelor’s degree.” (Turley. 2020). According to the American Association of Colleges of Nursing, patients who are in the care of a nurse who has received their BSN have better outcomes due to the nurse being more proficient in using critical thinking skills. “Higher education makes a difference in the quality of clinical practice.” (nursejournal.org. 2020). Because of such high demand for BSN prepared nurses, some healthcare organizations are even offering to pay for schooling to those who want to transition from an ADN to BSN.
When it comes to handling patient care, do ADN and BSN prepared nurses differ in the way they make decisions or handle situations? A specific example comes to mind when I think about this topic. I currently work on a stroke and brain specialty unit. Along with the floor nurses, a clinical nurse coordinator is staffed every shift. What differs between the CNC and the other nurses is that in order to have that position, a nurse must obtain a BSN degree or higher. I mention this to support my example of a patient care situation in which this BSN prepared nurse assessed and reacted to a situation differently than the ADN nurse. During my shift, a coworker was responsible for a patient who was continuously requesting pain medication for pain in his feet in which he could not describe. This patient stated the Tylenol he was currently receiving was not managing his pain. This was because this patient was experiencing diabetic neuropathy. However, when told this, the patient constantly denied the fact. With this, the AND nurse was giving the patient his scheduled Tylenol whenever it was available or telling him he had to wait until it was available. During this situation, the CNC stepped inside the patient’s room to see if she could help. Rather than shutting the patient down and telling him his prescribed medication would be given soon, this BSN prepared nurse sat down next to the patient’s bedside and looked further into the situation. She provided the patient with education regarding diabetic neuropathy and suggested he talk to a diabetes education to better understand his diagnoses and why certain pain medications would not treat his symptoms. The patient responded well to the nurse’s resolution to the situation and agreed to consult with a diabetes educator. I think this is a great example of how a BSN nurse used her critical thinking skills to analyze and react to a situation. Rather than just administering a medication, the nurse used her role to find an alternative solution.
The academic preparation of the BSN nurse teaches nurses to use their knowledge of research and evidence-based practice in the workplace. “Students who participate in research while pursuing an online RN to BSN degree are better patient advocates and can support their recommendations with research.” (University of West Florida. 2020). With the use of critical thinking and evidence-based practice, nurses can see a patient’s situation as a whole, rather than just taking what they see in front of them and coming to a conclusion. The patient situation previously mentioned greatly backs this up. According to an article from patientengagementhit.com, patients who had access to health information, were able to make more improvements to their health.
Even with the use of evidence-based practice and critical thinking, positive patient outcomes would not be as prevalent without the connection between the nurse and other care teams. By collaborating with interdisciplinary teams, the nurse is able to tie in the knowledge and experience of others to support overall patient care. The nurse is the primary caregiver of the patient and shares knowledge to interdisciplinary teams to advance patient care. When everyone is on the same page, the patient is able to receive the care that is needed to safely improve their health. “Healthcare teams have a common purpose: to provide safe, optimal patient care with successful outcomes through communication and collaboration.” (Eastern Illinois University. 2020).
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