week 2 -Evolving Practice of Nursing and Patient Care Delivery Models



Running head: Practice of Nursing

How Practicing Nursing Is Expected to Grow

Adrian Macwan

Prof. MaryLou Devlin

NRS- 440VN



The key fact about the United States’ health care system is that nurses represents the biggest number of medical practitioners, having a number of 3.4 million. This represents about 84.5% number of registered nurses. This means that lives of many American people depend on nurses in order to access affordable health care services given that it is among the biggest sector of the American workforce and this number is expected to increase every year by 200,000 from 2016 to 2026. This presentation is aimed at helping usas understand the developments expected in the nursing and I am optimistic that at the end we will all have understood the importance of nursing, and how it contributes to our Economy and the health care sector. Comment by Devlin, Mary: This is confusing. In the previous sentence you said there are 3.4 million nurses, but in this sentence you said that the 3.4 million is 84.5% RNs. I think you mean that the other 15.5% are LVNs but I’m not sure. You always want to be very clear so that your reader knows what you are saying and doesn’t have to guess at what your meaning is. Comment by Devlin, Mary: This statement is confusing. You are talking about American people depending on nurses to access the health care system, but the way this is written the next part of the sentence says the health care services are the biggest sector of the American workforce. I think you mean nurses, not the health care system.

First and foremost I am going to talk about the continuity of nursing care: we all know as from 2016, the Federal government announced the intention of employing and registering 200,000 nurses every year. This means that by 2026 the number of registered nurses will be 5.4 million, this is in addition to the 3.4 million who are already registered. What does this imply? This simply means that the continuity of nursing will need the support from the patients together with the United States health care sectors who must combine their efforts and work in partnership and collectively to achieve a quality and affordable health care services. This is because nurses play a key role in ensuring that patients get the medical services that they deserve, and we can’t therefore hid the fact that nurses are the backbone of the American health care system, and they must be enthusiastic regarding the role they play and embrace it. And the government also should ensure that nurses’ grievances are heard, looked at and solved. For this country to achieve a formidable continuity of care system, all the two key dimensions of continuity of care must be looked at and considered and these dimensions are the traditional in which the all patients should have a continuous medical care with medical practitioners who are well- known, this will not only motivate nurses to register but also improve the rate of transparency and accountability in the field of nursing. All the health care agencies should have a coordinate system through which information is shared. The multidimensional aspects should not only be developed to be improved to. Comment by Devlin, Mary: To be improved to what?

The other thing to be I want us to share about accountable care organizations: we all know that this group of medical care services providers are committed to ensuring that American citizens receive the best health care services, and they do this voluntarily without expecting payments in return. This therefore means that the government, through the State’s health care agencies and departments, need to recognize the efforts being made by these people by creating a conducive working atmosphere and regulations and even fund them even if they give the medical services voluntarily. The nurses family is very large and if the government finds a way to motivate more and more nurses will not only look for jobs so that they can be paid, but they will lead some of these organization so as to ensure that there is provision of quality health care given that if the ACOs achieve providing quality health care, millions of dollars will be saved and spent in a good way to improve the U.S health sector. Lastly lets as look at the medical facilities or homes and the nurse managed health clinic as factors that can play a role in improving and developing the nursing field. We all know that the medical homes isare a group kind of medical service system that are controlled by qualified medical practitioners to achieve a progressive and inclusive health care services to patients and their main objective is to see to it that patients receive the best primary medical care services. On the other hand, the nurse managed health clinics are managed by qualified and registered nurses who strive to provide quality and affordable primary interpersonal health care services. This there that for the nursing field to improve and grow, the government must find a way to support such medical care facilities through funding, creating a proper supportive environment and ensuring that the governing regulations don’t aren’t oppressive. Comment by Devlin, Mary: I’m confused. ACOs are a way to provide cost effective care but the providers do get paid. Comment by Devlin, Mary: This sentence is a run on sentence. Your reader loses sense of what the sentence is about before reaching the end of the sentence. Comment by Devlin, Mary: Doesn’t make sense.

Part two of the question : Nurses feedback on the role of nurses in hospital setting, clinic, medical homes and communities. Comment by Devlin, Mary: The following section is very interesting, but it does not make any reference to the feedback from your colleagues. It appears to be an essay about the role of nurses in the different settings, not what your fellow nurses thought of your presentation.

Nurses play a direct role in all factors when it comes to the hospital venture to provide high quality medical services, they carry out the daily activities, which includes managing patients’ medication, patient care, helping during surgeries, and collecting information about the patients. They also have a duty to directly monitor and asses the patients, intervene whenever necessary so as to reduce and prevent medical related complications. They also have a duty enlightening patients and families on the care after one leaves the hospital and before they leave the hospital. Nurses play all these key roles in hospitals because of factors such as: the high need for improvement in hospital standards and quality. Demand for standards and quality is rising and is attributed by the mandates of the Federal government and the local government’s requirements, regulation boards, organizations that bring together hospitals, medical communities, Non-Governmental organizations and the insurance programs and plans on health. Other factors include: the recognition magnet programs, the need for patient related quality, the challenges that are involved in the nursing duties and the need for staffing that determines the quality of patient care. Comment by Devlin, Mary: Educating patients would be a better word choice than enlightening patients.

When it comes to the clinics just like in the hospitals, a clinic nurse has several roles and duties that they play to ensure the provision of quality health services and such duties include: conducting patients intake where they work relatively and closely with the patients during the process so as to assist doctors in developing plans and methods of treatment, they do this by asking patients question regarding the symptoms, their medical records, and the medications they may have used before so as to give doctors a better understanding on the patient’s medical requirements, and they also do first or preliminary testing which include respiratory and blood pressure checks. They also support the doctors by preparing the needed equipment, this therefore forces nurses to quickly change tasks together with duties to suite the doctors’ requirements. The clinical nurses also provide medication and care directly to the patients such as treatments where they do wound dressing, topical application of treatments and even provide medication through intravenous ways and injecting that they administer directly. They also make a follow up on patients to evaluate if the objectives of the treatments process and yielding positive results since they examine the patients when they do a follow-ups.

Besides the direct medical care services that clinical nurses provide, they also have other duties such as keeping the relevant detailed medical records of their duties and work. They have to record what they find out when they administer tests and keep the outstanding log on the patient’s progress and hey also have to record lab findings. These nurses also play a role of educating the patients in an outpatient environment, and they are the basic contact for patients and those that care for the patients at home. They enlighten the patients on how they can administer to themselves medication and observe physical therapy need. Nurses also provide information on the importance of nutrition and pain control and on how to recognize sickness symptoms and together with complications. The outpatient service nurses hold different community forums and seminars to address precise health care aspects and family health care givers on how to take care of those they love.

In home health care nursing, nurses give several care to patients from the young to the old. They view this as a low cost but effective method through which they can give quality care in a convenient way to the patients and clients. They strive to achieve objectives as per their patient’s diagnosis and their plans involves preventative measures, rehabilitation measures and the therapeutic treatments. The nurses under the home care supervise the qualified assistants in the nursing field. These nurses also act as case or situation mangers as they coordinate several services that are from different patient disciplines such as pharmacy and community resources. According to the set regulations by the government and other nurses’ bodies, all those practicing nursing from the hospitals to the clinic and home health care services must have at least a diploma certificate or bachelor degree of science in nursing. They must also be licensed to practice nursing. After they can sit for an examination they are administered by the American Nurses Credentialing Center which then certifies them to become home nursing services providers.

Also, according to the three nurses the general scope and quality of the home health care nursing practice relates directly with the process of nursing which includes assessing, diagnosing, creating plans, putting the plans into implementation and the evaluation of the outcomes. The qualities of home nursing involves proper researching, the correct use of resources, educating, the standards of the care that is being provided, the teamwork and the societal principles. However, there are a few challenges that affect home nursing care such as impossibility of them relying on others given that when they are visiting the clients they are sometime alone this means that they must adapt to being autonomous. Other challenges come from some of the homes that the home health nurses may go to since the car for patients highly relies on the level of safety and cleanliness and sometime not all homes have the capacity and capability of providing these two requirements.

In conclusion, the role nurses play must be honored and appreciated by everyone staring from the government all the way to the people. As the number of nurses increases, the number of medical facilities and equipment that will facilitate quality provision of health care services should be increased and the standards of the existing ones should also be improved.

References Comment by Devlin, Mary: Please review APA format for your references. You need a hanging indent.

De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Moons, Philip (December 2015). "Exploring the activity profile of health care assistants and nurses in home nursing". British Journal of Community Nursing20 (12): 608–614. doi:10.12968/bjcn.2015.20.12.60

 Ellen Becker, Carol Hall; Samia, Linda; Cushman, Margaret J.; Alster, Kristine (2008).  "Patient Safety and Quality in Home Health Care" . National Center for Biotechnology Information. Agency for Healthcare Research and Quality (US). Retrieved 24 September 2017

Stanhope, Marcia; Lancaster, Jeanette (2014). Foundations of nursing in the community: community-oriented practice (4th ed.). St. Louis, Missouri: Elsevier/Mosby. pp. 549–563. ISBN 978-0-323-10094-6

Homer CJ, Klatka K, Romm D, et al. (October 2008). "A review of the evidence for the medical home for children with special health care needs". Pediatrics. 122 (4): e922–37. doi:10.1542/peds.2007-3762PMID 18829788.

National Commission on Correctional Health Care 2019 https://www.ncchc.org/


I can tell you worked hard on this paper, but, as you can see from my comments, there are some issues with it. In many places, it is difficult for me to understand the point you are making. I marked a few of those places but I don’t like to return a paper that is completely marked up. Your description of ACOs is inaccurate, which makes your discussion of them inaccurate. There are some APA mistakes in the paper, specifically in the reference list and your margins. If you need help with APA, you can check out the GCU writing center under the student resources tab in the classroom. Another great APA resource is the Purdue University Online Writing Lab. They are free and user friendly. I just google Purdue OWL when I need APA help. Finally, another strategy that you might try is to ask someone to read your paper before you submit it. I always did that and my friend always found mistakes I missed, or places where my friend didn’t understand what I was saying and I thought I was very clear. You have really good ideas, they just need to be clear so your reader can benefit from those ideas.

Please let me know if you have questions.

Mary Lou