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Contemporary Issues Faced In Nursing

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Contemporary Issues Faced In Nursing

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Contemporary Issues Faced In Nursing

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Question:

What Is the Contemporary Issues Faced In Nursing?

 
Answer:

Introduction
India’s healthcare system encounters several interconnected challenges and issues while providing high quality, cost-effective and innovative care to the patients. Several contemporary issues are identified by the nurses on a daily basis while providing care due to issues such as poor working conditions, number of staffs available, fewer wages. Moreover, depending upon the requirement of the patients the nurses have to drain their brains accordingly to provide appropriate support. While doing so, the educational background of the nurses hinders their practice and also not recognised completely. Therefore, the role of clinical leadership in context of nursing in context of India’s healthcare systems is a significant issue. In order to provide high-quality nursing care, clinical leadership plays a significant role as this ensures delivery of care in a timely manner, system and discipline within the hospital and the overall performance of the hospital. One of the biggest issues of nursing in India is the poor working condition for the nurses that indirectly affect the health of the patients.
This project includes the description of the project along with the aim and objectives, critically evaluating the contemporary issues and the role of effective clinical leadership followed by the implementation and evaluation of the plan.
Project Description
Aim of the Project
The aim of the project is to develop a systematic and thorough planning of a clinical project in terms of contemporary issues in nursing in India. This will help in understanding the related issues encountered in the professional practice. 
Objectives and Evidence of Achievement
The objectives of the project are:

To identify the issues encountered in the nursing practice

SMART

Objective

S- Specific

The objective is specific as this provides an opportunity to identify the key issues faced in nursing practice

M- Measurable

The objective is measurable as improvement in the healthcare services can be determined

A-Attainable

The objective is attainable by involving skilled personals and looking for suitable opportunities

R- Realistic

The objective is realistic as identifying the issues will improve the service provided in nursing care

T- Time Specific

The objective is time specific as the issues can be identified within every 3 months

 
To understand the impact of the contemporary issues on the healthcare industry

SMART

Objective

S- Specific

The objective is specific because this will understand the impact of the issues on healthcare industry

M- Measurable

The objective is measurable because the impacts can be evaluated

A-Attainable

The objective is attainable by evaluating the past issues and their impacts on nursing

R- Realistic

The objective is realistic because understanding the impacts will help in improving service

T- Time Specific

The objective is time specific as it needs to be done every 3 months

  To critically evaluate the leadership issues in clinical practice

SMART

Objective

S- Specific

The objective is specific as evaluating the leadership issues will maximise the efficiency in clinical practice

M- Measurable

The objective is measurable because effective leadership will improve the service in clinical practice

A-Attainable

The objective is attainable by implementing strategies to identify the leadership issues

R- Realistic

The objective is realistic as identifying the issues will improve leadership issues

T- Time Specific

The objective is time specific as the issues needs to be evaluated verey 6 months

Literature Review
Contemporary issues faced in nursing
Nursing is one of the significant branches in healthcare system that allows trained professionals to provide care to the patients for health improvement. As mentioned by Parahoo (2014), poor working conditions, less pay, lack of equipments and workplace stress. Due to the contemporary issues, the nursing cares provided to the patients are hindered. In certain countries such as India, the working conditions for the nurses are inappropriate. As mentioned by Boese et al., (2013), the number of patients has increased extensively compared to the healthcare space and facilities available. As a result, the cares provided to the patients are inappropriate and lack of improvement is also noticed. The nurses are unable to provide suitable care to the patients. Moreover, having appropriate number of nursing staffs is also an issue in nursing. This is noticed due to increased job responsibilities and stress for the nurses while providing care. Due to lack of adequate nursing staffs, stress on the existing nurses’ increases that also eventually hampers the service provided by them.
As asserted by Aiken et al., (2013), nurses have opted for other professions due to lack of opportunities, slow growth rate and less pay in this profession. The rate of pay is inadequate compared to the amount of hard work and dedication required by the nurses while providing care to the patients and maintaining discipline. As a result, the nurses feel work stress extensively that eventually hampers their personal and professional life. Therefore, the nurses opt for different career due to higher pay and better career opportunities. Moreover, the brain storming and dedication expected from the nursing staffs are huge thereby, affecting the personal life. Stress related to workplace affects the physical and psychological well-being of the nurses thereby, causing issues in retaining the valuable staffs.
Concept of clinical leadership issues in nursing
Clinical leadership in nursing a one of the significant aspects as this emphasises both on the healthcare system and patients. As asserted by Huber (2013), clinical leadership in nursing focuses on healthcare teams and patients in terms of communication and advocacy. This provides an opportunity for the leaders associated to communicate with the patients and their families, teams of healthcare professionals and working in partnership with the nurses as they are the ones having deeper understanding of the patients. According to Mannix, Wilkes & Daly (2013), nurses are considered as the initial level of making any decision thereby, taking responsibility of their actions. This enables them to build their foundation in the leadership role. Nurses act as the medium of communication between the healthcare team and the patients thereby, assuring care. Clinical leadership is said to emphasise more on the healthcare teams and patients rather than formal leadership positions.
As mentioned by Hutchinson & Jackson (2013), clinical leadership is also defined as the behaviours of the nursing staffs thereby, providing guidance and direction to the healthcare teams and patients in delivering appropriate care to the patients. A highly qualified nurse is considered as a clinical leader in a healthcare setting that influences the healthcare teams, patients and their familiar thereby, ensuring continuity and care. This eventually helps in achieving positive results for the health of the patients. As asserted by Adeniran, Bhattacharya & Adeniran (2012) each registered and qualified bedside nurses are considered as clinical leaders. Therefore, the concept clinical leadership in nursing is related to the activities of the nurse professionals that ensure care at bedside that is distinct from traditional leadership.
 
Impact of Clinical Leadership in Nursing
Effective clinical leadership is the most significant feature in nursing as this ensures high quality health care system. As mentioned by Martin et al., (2012), providing high- quality care helps in maintaining consistency in the care provided to the patients by the nurses. A clinical nurse leader ensures cost-effectiveness, efficiency and production in the healthcare system. This provides an opportunity for the nurses to provide direct care and support to the patients thereby, improving the care provided to the patients. Due to this feature of clinical leadership of the nurses’ positive outcome within the patients are noticed extensively. As commented by Ingebrigtsen et al., (2014), clinical leadership in nursing also ensures quality and safety provided to the patients. The nurses consider the safety of the patients as their top priority thereby, ensures high care while wound care, controlling of infection, managing the medicines and the education of the patients. This eventually helps in accomplishing positive and desired outcome in the health of the patients.
As mentioned by Reem, Kitsantas & Maddox (2014), a positive relationship is found between the effectiveness of clinical leadership and the outcomes of the patients. The effectiveness is noticed in lowered rate of hospital stay, reduced rate of medication error, reduced infections in the urinary tract and readmission of patients in the hospital. Clinical leadership in nursing also reduces that rate of mortality among the patients admitted in the hospital. Nurses having clinical leadership skills thereby enhance the care setting and the outcomes of the patients. Therefore, clinical leadership in nursing has been beneficial for the patients and the healthcare settings. 
Characteristics of Effective Nurse Clinical Leaders
Some of the significant characteristics of a successful clinical nursing leader possess the characteristics of critical thinking, needs to be open to new ideas facilitating innovation and flexibility and also needs to possess the quality of continuous learning. As mentioned by Grossman (2016), the clinical nursing leader needs to be knowledgeable, enthusiastic about continuous career growth and remain updated. This ensures development in the healthcare setting and positive outcome within patients are also noticed. Another crucial characteristic of clinical nursing leader is the ability to motivate others in order to achieve the desired goal of the healthcare organisation. According to Martin et al., (2012), the clinical nursing leaders need to have the ability to establish an effective communication thereby, ensuring high-quality care. The characteristic of being an effective listener is essential as the patients, families and fellow staffs may ask for guidance. Therefore, the clinical nursing leader can use their problem-solving characteristic to improve the situation.
As asserted by Twigg & McCullough (2014), an efficient clinical nursing leader also possesses the quality of self-awareness. This provides them the opportunity of reading the feelings of different individuals along with the idea about how that will affect other individuals. For example, if the family member of the patient is unhappy with the treatment provided to them by the nurse, the nurse might develop mixed feelings. In such cases, the clinical nursing leader needs to keep calm and handle the situation as out bursting can affect the emotion of the patients and the family. According to Stanley (2014), managing time efficiently is also an important characteristic of clinical nursing leaders. This provides an opportunity for the clinical nursing leaders to plan, organise and prioritise responsibilities and tasks at a regular basis that is essential for the healthcare settings and the patients.
Moreover, the clinical nursing leaders also possess the quality of being empathic, caring, dynamic and passionate in terms of the values and needs of the patients. This provides an opportunity for the clinical nursing leaders to be inspirational towards others, achieve the minimum standards at the healthcare settings. Therefore, this influences the healthcare outcomes in a positive manner by improving the quality of care provided to the patients. However, a dedicated clinical nursing leader is always motivated and committed towards the vision of the organisation. As mentioned by Nelsey & Brownie (2012), the characteristics of respectful, trustworthiness and honest are noticed within a successful clinical nursing leader.
Project Implementation Plan
Project Plan
The contemporary issues in nursing in India are a biggest issue as the nurses form the backbone of medical facility along with the doctors. As mentioned by Sarojini & Khanna (2012), the nurses in India have poor and unsatisfactory working conditions that eventually affect the healthcare system. The respect and dignity of the burses in India are highly exploited due to which they have gone for strike several times. However, due to lack of appropriate union for the nurses, their demands and requirement has remained unfulfilled (“Condition of Nurses in India”, 2017). The fact that several nurses have a poor family background needs to pay high fees to complete their education that leaves them with high debts. In spite of shortage of nurses in the hospitals, the nurses are not recruited based on their qualification but on the basis of contract. The nurses are recruited with extremely low salaries based on the minimum wages policy that is also very low. Lack of job opportunities and unsatisfactory basic pay are poor working conditions for nurses in India (“Indian nurses face injustice, exploitation”, 2017). Nurses in India has to work long hours due to inadequate qualified and skilled nurses without any allowances and incentives (Reddy, 2013). Moreover, the nurses are not even given any health coverage though they are most vulnerable in getting infected.
The project implementation plan emphasises on resolving the main contemporary issue faced in Indian nurses.
Name of the Project: Satisfactory and healthy working conditions for the nurses in India
Name of the Sponsor: Management of the Hospital
External or Internal: Internal
Approval Date: June 10, 2017

Change Request

Originator

Change requested by

Date requested

1

Hospital management

Nurses

June 6, 2017

Description of the required change

Change in the poor working conditions for the nurses in hospitals in India

Reason for Change

Poor working condition for the nurses are hampering in retaining the qualified nurses thereby, compromising with patients and care settings

Proposed approach to Resolve

Poor working condition for nurses in India

Approvals to proceed

Originator/date

Project leader/date

Sponsor/date

Customer/date

 

Purpose
The primary purpose of the project implementation plan is to develop satisfactory and well-built working conditions for the nurses. As mentioned before, the various reasons that has lead to poor working conditions for nurses, the plan emphasises on maintaining 8 hours working schedule for the nurses by recruiting adequate number of skilled nurses and maintaining ethical conduct within the hospital to prevent exploitation of the nurses.
In order to achieve the objective, the hospital needs to recruit skilled and qualified nurses by accepting online application as this will help in sorting the interviews based on the criteria before personal interview. A group of people in the management needs to imply strict code of conduct for maintaining discipline within the hospital that will prevent exploitation.
 
System Overview
In order conduct online recruitment, the hospital needs to have technologically qualified and skilled staffs that can sort the applicant based on the desired criteria. This will help in sorting the applicants easily and will save time. Therefore, the number of applicants appearing for the personal interview will be restricted thereby, easy to recruit. The code of conduct developed and implemented needs to be applicable for all nurses and breach of code of conduct will impose severe punishments.
Management overview
In order to conduct online recruitment, the hospital management needs to make suitable arrangements in terms of arranging proper work stations and assisting staffs who are technology friendly. The management also needs to advertise the job roles they are hiring for using the latest technologies such as digital advertisement. Moreover, the management can also publish the advert in newspaper or work in partnership with consultancies. Moreover, the management also look into the financial standard of their hospital as recruiting new nurses requires paying them. Therefore, if the financial turnover is stable, then recruiting new nurses is a fruitful option.
Points of Contact

Role

Name

Contact number

Project sponsor

 

 

Project Manager

 

 

Project Officer from the Government

 

 

System Developer or Maintainer

 

 

Quality Assurance Manager

 

 

Configuration Management Manager

 

 

Security Official

 

 

Database Administrator

 

 

Site Implementation Representative

 

 

IV & V Representative

 

 

The table provides the list of people that are associated with the implementation and completion of the project. The list makes it easier to contact the responsible person if a sudden issue is encountered while implementing the plan. Also, the responsible persons can keep a track of the latest developments in the project implementation plan.
Major Tasks
The major tasks of the project implementation plan include:
Providing the overall coordination and planning for the implementation
Providing suitable training to the responsible persons
Upon requirement, ensuring that all the manuals is readily available
Proving the required technical assistance
Scheduling special computer processing required for the implementation
Performing survey before implementation of the project
Ensuring that all the requirements are fulfilled before the date of implementing the project
Acquiring special hardware and software systems based on requirement
Preparing site facilities for appropriate implementation
Following the above-mentioned credentials will help in completion of the major tasks that plays a crucial role in making the project implementation plan successful. This will ensure all the criterions are fulfilled thereby; preventing hindrances while completion of the project. However, based on the current requirement while implementing the project, the tasks can be modified accordingly.
Implementation Schedule                     

Tasks

Week 1

Week 4

Week 8

Week 12

Week 16

Week 20

Preliminary Investigation

 

 

 

 

 

 

Interviews

 

 

 

 

 

 

Management Decision

 

 

 

 

 

 

Draft Report

 

 

 

 

 

 

Evaluation of Project Plan

 

 

 

 

 

 

Conclusion

 

 

 

 

 

 

Privacy and Security
Based on the project implementation plan, the suitable policies needs to be maintained. For example, the hospital needs to pay the nurses according to the minimum pay to avoid exploitation. Moreover, the hospital needs to emphasise on protection of data by implementing suitable legislations.
Implementation Support
Implementation support is essential in project implementation plan as this includes the hardware, software and other supportive materials for implementation along with maintaining documentation, required materials and individuals for completion of the implementation plan successfully.
Software, Hardware, Facilities and Materials
In order to facilitate online recruitment, the hospital needs to make suitable arrangements in terms of building workstation, installing hardware and software. The hardware systems used for documentation of the patients and maintaining hospital and patient records needs to be kept free. Therefore, hardware systems need to be installed solely for the purpose of recruitment and maintaining records of the applicants. The hardware systems include computers, servers, peripheral equipments, simulators and emulators.
The computer hardware needs to have suitable software that will help in taking the applicant’s resume and sorting them according to requirement. The hospital also needs to have technologically skilled and qualified staffs handling the matter. The software includes databases, compilers, operating systems and utilities.
The facilities in the hospital include physical workspace, desk space, floor space for the equipments, space for providing training to the new recruits. The maintenance of the facilities will thereby, help in resolving the poor working conditions of the nurses in India by recruiting skilled and qualified nurses. This will provide an opportunity for the existing nurses to exchange their duties and perform duties efficiently. The materials of the support implementation include technology and supplies.
Documentation
The documentation of the project implementation plan includes the keeping record and track of the progress of the implementation plan. Therefore, in the case of any sudden situation, the documentation can help in deducing the reason of the occurrence. Documentation of project implementation plan also includes security or privacy protection of the considerations associated with the systems used for the implementation plan of the project. At certain instances, specific software is also built in order to maintain the documentation of the project implementation plan.
Personnel
This includes the committed and proposed staffing requirements that are required for successful execution of the project implementation plan. In the case of mitigating the poor working conditions of the nurses in India, expert, skilled and qualified staffs are essential to accomplish the aim of the project.
The implementation support of the project implementation plan enables in providing required support to each aspect while implementing the project. This also helps in addressing sudden issues that is encountered while implementing the plan due to the present situations. This also provides an opportunity of emphasising on the security and privacy related issues associated while implementing the project plan. Effective implementation of the project plan will ensure resolving the poor working condition for the nurses in India. 
 
Project Evaluation Plan
The project evaluation plan emphasises on the solutions of the issues identified while developing the project. In accordance to the two major contemporary issues indentified for the nurses in India, the solutions furnished below will be beneficial.

In context of the poor nursing conditions for the nurses in India, it is essential for the government and the management of the hospitals to understand the requirements of improving the working conditions of the hospitals. According to the government, the minimum wages of the experienced and skilled nurses are comparatively low thereby, making it stressful for them. Therefore, the government needs to emphasise of increasing the minimum wage of the nurses in order to retain them for uplifting the healthcare system (“Study on Nursing and Midwifery in India: A Critical Review”, 2017). The hospital needs to pay the nurses they are recruiting suitable salary for retaining them. In order to do so, the management needs to evaluate their financial capacity for paying their new and existing nurses.
In order to cope up with the increasing demand of nurses for providing service to the patients, the nurses has to work beyond the normal working hours. The nurses have to work for 10-11 hours in order to take care of the patients for health improvement. Report suggests, the nurses are not even paid incentives for their extra working hours and dedication. This provides a bad impression about the profession in the mind of the nurses thereby, making them rethink of opting for other career opportunities (“A Profession on the Margins: Status Issues in Indian Nursing”, 2017). In order to decrease the extra working hours for the existing nurses, the hospital needs to focus on new qualified and skilled nurses so that duties can be exchanged accordingly.
Another issue identified is lack of health coverage for the nurses. The nurses are most vulnerable in being infected as they are the once that stays in close enough with the patients for providing care. Due to lack of vaccination or low immunity power, the nurses are infected with infectious diseases. Therefore, nurses needs to provide with health coverage in case of any sudden outbreak. Though necessary, most the nurses are devoid of health coverage that leaves with health uncertainties (La Forgia & Nagpal, 2012). Therefore, the hospital along with the support of the management needs to provide health coverage to nurses for security.
Lack of space and infrastructure is also an issue identified while implementing the project plan. In order to recruit new nurses, the hospital needs to build suitable workstations and install hardware systems for performing the actions. Adequate number of hardware system with appropriate software needs to be installed within the hospital in order to recruit without any issues (Paul, Chatterjee & Ghosh, 2012).

According to the evaluation of the project plan, the solutions listed will help in mitigating the contemporary issues noticed among the nurses in India. In order to resolve issues related to the contemporary issues for nurses in India, the government plays a significant role. However, it is under the authority of the government to increase the minimum wage of the nurses and limiting the daily working hours of the nurses. Moreover, the government needs to impose strict punishments for the individuals exploiting and violating the nurses at workplace. The nurses need to be treated with respect and dignity at workplace.
Project Conclusion
In this assignment, it can be concluded that clinical leadership plays a significant role in resolving the contemporary issues encountered in nursing. Due to rapid changes in the environment, the patients are facing distinct health issues and complications that are difficult in treating by traditional methods. Clinical leadership helps in providing bedside care to the patients thereby providing opportunities for the nurses to take intensive care. Moreover, due to clinical leadership in nursing, issues such as errors in medication, lack of care are also rectified efficiently. The clinical nursing leaders are found to be trustworthy, honest, enthusiastic and knowledgeable that has influenced the nursing practice. The primary contemporary issues identified for nurses in India are poor working conditions in terms of low wage, excess working hours, lack of career opportunity and lack of health coverage.
The project implementation plan has been developed in order to mitigate the main issue by nurses in India, that is, poor working conditions. The project implementation plan has been developed to improve the working conditions of the nurses. The hospital and the management aim towards hiring new skilled and qualified nurses in order to ease the workload of the existing staffs. In order to do so, the hospital needs to build and install suitable workstation and hardware respectively along with maintaining other requirements.

 
References

A Profession on the Margins: Status Issues in Indian Nursing. (2017). Retrieved 9 May 2017, from https://www.cwds.ac.in/wp-content/uploads/2016/09/A-Profession-on-the-margins.pdf
Adeniran, R. K., Bhattacharya, A., & Adeniran, A. A. (2012). Professional excellence and career advancement in nursing: a conceptual framework for clinical leadership development. Nursing administration quarterly, 36(1), 41-51.
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Sermeus, W., & RN4CAST Consortium. (2013). Nurses’ reports of working conditions and hospital quality of care in 12 countries in Europe. International journal of nursing studies, 50(2), 143-153.
Boese, M., Campbell, I., Roberts, W., & Tham, J. C. (2013). Temporary migrant nurses in Australia: Sites and sources of precariousness. The Economic and Labour Relations Review, 24(3), 316-339.
Condition of Nurses in India. (2017). Retrieved 9 May 2017, from https://www.socialism.in/index.php/condition-of-nurses-in-india/
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. FA Davis.
Huber, D. (2013). Leadership and nursing care management. Elsevier Health Sciences.
Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing inquiry, 20(1), 11-22.
Indian nurses face injustice, exploitation. (2017). OWSA. Retrieved 9 May 2017, from https://southasia.oneworld.net/news/indian-nurses-face-injustice-exploitation#.WRFWSfmGPIV
Ingebrigtsen, T., Georgiou, A., Clay-Williams, R., Magrabi, F., Hordern, A., Prgomet, M., … & Braithwaite, J. (2014). The impact of clinical leadership on health information technology adoption: systematic review. International journal of medical informatics, 83(6), 393-405.
La Forgia, G., & Nagpal, S. (2012). Government-sponsored health insurance in India: Are you covered?. World Bank Publications.
Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary nursing: an integrative review. Contemporary nurse, 45(1), 10-21.
Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical leadership programme for nurse leaders. Journal of nursing management, 20(1), 72-80.
Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical leadership programme for nurse leaders. Journal of nursing management, 20(1), 72-80.
Nelsey, L., & Brownie, S. (2012). Effective leadership, teamwork and mentoring–Essential elements in promoting generational cohesion in the nursing workforce and retaining nurses. Collegian, 19(4), 197-202.
Parahoo, K. (2014). Nursing research: principles, process and issues. Palgrave Macmillan.
Paul, P. K., Chatterjee, D., & Ghosh, M. (2012). Medical information science: Emerging domain of information science and technology (IST) for sophisticated health & medical infrastructure building-an overview. International Scientific Journal of Sport Sciences, 1(2), 97.
Reddy, R. N. (2013). Revitalising economies of disassembly. Economic & Political Weekly, 48(13), 63.
Reem, A. D., Kitsantas, P., & Maddox, P. J. (2014). The impact of residency programs on new nurse graduates’ clinical decision-making and leadership skills: A systematic review. Nurse education today, 34(6), 1024-1028.
Sarojini, N., & Khanna, R. (2012). An investigation of maternal deaths following public protests in a tribal district of Madhya Pradesh, central India. Reproductive Health Matters, 20(39), 11-20.
Stanley, D. (2014). Clinical leadership characteristics confirmed. Journal of Research in Nursing, 19(2), 118-128.
Study on Nursing and Midwifery in India: A Critical Review. (2017). Retrieved 9 May 2017, from https://planningcommission.nic.in/data/ngo/csw/csw_nurse.pdf
Twigg, D., & McCullough, K. (2014). Nurse retention: a review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies, 51(1), 85-92

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