Fabia’s ePortfoio


Issues In Nursing

Fabia J Hinds-Bertrand

NUR 4130, 8549

Prof. Dato

April 7, 2013


The task of this paper is to identify and state the significance of three of the most important nursing issues today. The topics chosen were evidence based practice (EBP), importing foreign nurses and the following topic selected from the Institute of Medicine (IOM) report (2011): nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Detail information and examples will be provided on each of these issues.The aim of EBP is to successfully convert research results into clinical practice. Polit and Beck (2010) define EBP as an instrument that involves making clinical decisions on the best available evidence, with an emphasis on evidence from discipline research. According to Huston (2010), most nurse experts agree that the best practices in nursing care are also evidence-based practices. Researchers and educators have recognized the significant achievement of EBP and it’s ability to deliver quality and cost effective care. As noted by Allender, Rector, & Warner (2010), the federal Agency for Healthcare Research and Quality as well as schools of nursing, like Arizona State University and the University of Rochester, has established EBP centers. EBP works best when all involve are accommodating and supportive of the course of action. Evidence based practice is most successful when the entire organization is invested in the process and participates in and supports it (Carroll, 2006).

Some professions, such as registered nurses and professional counselors, are obliged to adapt the EBP method. As cited by Myers and Sweeney (2008), ethical practice requires the use of evidence-based techniques. Brophy and Savy (2011)acknowledged that the progress of mental health reform in many western countries remains inconsistent and in some cases obstructive to effective professional practice. Therefore, research is unremitting in order to extend and implement EBP tools for health care interventions. In an open cluster randomized trial, there was marked improvement in sicknesses in an office environment when hand washing was used. Savolainen-Kopra et al. (2012) concluded that improved personal hygiene measures combined with frequent hand washing with soap and water can reduce the occurrence of self-reported acute illnesses in common office work environment.

The next issue to be examined is the importation of foreign nurses. Nurses provide a skilled service that enable local, national and international recruiting/health care agencies to profit. Indeed, Huston (2010) noted that international recruitment and nurse migration has been viewed as a relatively inexpensive, a quick fix solution to rapidly increasing health care worker shortage. Australia, the United Kingdom and the United States are the primary destinations of most migrant nurses (Huston, 2010). Within an increasingly changing global economy and multicultural populace, these nurses have the opportunity to educate other health care providers, especially nurses, at the local and national level. Graham and Norman (2008) mentioned that globalization and multiculturalism represent a fundamental challenge to how health care practice is understood and designed.

Knowledge is key and there is an abundance of information to gain that can directly affect the way in which health care is delivered. As noted by Graham and Norman (2008), among the most influential changes is the increasing importance of knowledge as a driver in the context of the global economy, the information and communication revolution, the emergence of the worldwide labor market and global socio-political transformations. Cultural competency is one of the areas that can be improved upon as the healthcare system adjusts to the rapidly changing demographics in each state. Graham and Norman (2008) affirmed the importance of a multicultural workforce stating that it will generate a better understanding of nursing.

Critics, of importing foreign nurses, do not view the migration of nurses as an opportunity to improve the health care system via cultural exchange. Huston (2010) called the importation of foreign nurses a recruiting onslaught that affects the ability of developing countries to develop sustainable health care systems and provide appropriate care to their citizens. However, sending countries do not have the same opinion; in fact, they promote the migration of nurses. As cited in Huston (2010), the Philippines government actively endorsed and facilitated initiatives aimed at educating, recruiting, training and placing nurses around the world.

This heavy recruitment of nurses is referred to as brain drain. Research by Luca, I-Ling and Frederic (2013), suggest that the short run impact of drain brain on resident human capital is extremely crucial, as it affects not only the number of high skilled workers available to domestic production, but also the sending economy’s capacity to innovate/adopt modern technology. Some opponents against importation of nurses have query whether it is reasonable that sending countries are subjected to deteriorating economic conditions as receiving countries have the advantage of a well-prepared skilled work force. Huston (2010) asked whether global recruitment violate the principle of justice, particularly if such migration does not solve the underlying shortage and when such retention is done at the expense of the donor country.

The migration of nurses is certain to continue whether it is for remittance causes or economic autonomy/professional growth reasons. Huston (2010) noted that remittance was likely the result of financial imperative, specifically in the case of the Philippines, to encourage sums of money to be sent back to the sending countries. On the subject of autonomy, nurses must have the right to self-government without external control or influence. The individual’s right to migrate is central to self-determination (Huston, 2010).

Due to the need for highly skilled nurses, recruitment and migration will remain a reality; therefore, nurses need to continue training and improve their skills in order to deliver quality care with favorable outcomes for their patients. Nurses who have the aptitude for learning will benefit from further educational training, which can result in enriched abilities. A key message in the IOM report (2011) highlighted the need fornurses to achieve higher levels of education and training through an improved education system that promotes seamless academic progression. The IOM report (2011) recommended thecollaboration between public and private funders to expand the proportion of nurses with baccalaureate degree from fifty to eighty percent in 2020.

Unfortunately, not all nurses are able to meet this deadline due to family or financial obligations; consequently, facilities of employment should provide tuition help. As the IOM report (2011) stated, health care organizations should encourage nurses with associates and diploma degrees to enter baccalaureate-nursing programs within five years of graduation by offering tuition reimbursement, creating a culture that fosters continuing education and providing a salary differential and promotion.

Nurses can achieve their educational training through different avenues. As explained in the IOM report (2011), nursing has multiple educational pathways leading to an entry-level license to practice. After four decades of examining the established measures for nursing education, there are nosubstantial movement on the issue and no unifying agreement among those at the helm on how to proceed. In the mean time, competencies needed to practice have expanded; these new competencies have placed increase pressure on the educational system and its curricula (IOM report, 2011).

Despite these challenges, one author explained why continuing education (CE) is vital to the nursing practice and why nurses should be engaged in learning and acquiring self-knowledge through continuing education hours or attending work related seminars. According to Altmann (2011), health care is a fast paced, dynamic environment where providers of care should continually renew, update and challenge their knowledge.



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