Nursing education is the foundational pillar that enables future nurses to become competent and knowledgeable in their respective practices. This education was normally provided to nursing students through various didactic theoretical lectures and practical clinical training but recently, the use of advanced simulation technology as an adjunct educational tool has slowly become a significant addition to student centric learning.
History of Simulation
The concept of simulation practice can be traced back to the fields of military, aviation, and nuclear power (with military having used simulation the longest), dating back to the 18th century. Simulation was initially created as a cost-effective strategy for training professionals because it was considered exorbitant to train in these areas in the real world. As the years progressed however, the healthcare profession realized the practicality and usefulness of incorporating advanced simulation technology into educational practice and as a result, spurred the growing movement of simulation in healthcare training settings and educational establishments around the world.
The Impact of Simulation on Nursing Students
The emergence of computer technology has led to the development of innovative tools for healthcare professionals such as simulation technology and patient simulators Simulation technologies have had a profound effect on the nursing profession because it allows nursing students to apply their recently learned skills and knowledge to solve real life scenarios in a safe and structured setting.
In a typical simulation session, two students are often asked to participate and mimic the roles of a registered nurse or a certified nurse assistant (CNA). The rest of the remaining students are then asked to go to a separate room and observe the scenario through a one-way mirror and a live video stream. At the start of the session, the facilitator usually gives report on the patient, which allows the students to familiarize themselves with the patient’s situation, history, charts, and medications in order to successfully manage and implement high quality nursing care for the patient. As the simulation progresses, the facilitator controls the patient’s prognosis and provides cues to the team to enhance the realism of the situation. Once the simulation is completed, the students are then asked to head back to the debriefing room to discuss their experiences.
During the debriefing session, the students learn through self-reflection, group interaction, and questions asked by the facilitator. The use of group discussion engages students in reflective learning and enables the group members to consider a situation from multiple perspectives and consider other alternatives in order to broaden their scope of practice and clinical understanding. By performing simulation scenarios on a regular basis, students are able to develop better critical thinking skills, decision-making abilities, and application of theoretical knowledge in real-life situations.
Facilitating Simulation into Nursing Practice
According to the Institute of Medicine (IOM), approximately 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors. This means that adverse events affect nearly 1 of 10 patients in the hospital setting. Based on this staggering number, the IOM called for a systematic change in healthcare practices and identified simulation practice as a resource to address the needed reform. By fostering experiential learning, simulation ingrains good nursing habits early, while discouraging bad nursing habits from forming before it becomes second nature.
In addition to allowing individuals to hone their nursing skills, simulation has also proven to increase student confidence and self-efficacy once they transition into the clinical setting. Nursing efficacy is an important aspect in nursing practice because it gives the students the confidence required to provide excellent nursing care to their patients. By incorporating what they have learned in simulation, more students are self-reliant in their capabilities, which are invaluable in ensuring that patient safety is implemented in the hospital setting.
Implications for Future Nursing Practice and Further Study
The shortage of availability of clinical sites is quickly becoming the norm for many nursing schools due to changing healthcare reform and the struggling economic crisis. One solution to combat the shortage of clinical sites however is to utilize simulation practice to replicate essential aspects of clinical situations for beginning nursing students. The National Council of State Boards of Nursing is currently conducting a landmark, longitudinal study to examine the knowledge and clinical competency outcomes of students when simulation technology is used in the place of actual clinical experiences. Although calls for additional research in these areas need to be performed, simulation is still quickly gaining momentum as the gold standard for effective learning practice in nursing education.
The concept of effectual leadership is an important aspect in the field of nursing and health care. Leaders have a significant role in creating a culture and mindset that not only inspire but also unite individuals within a group or society. Since the perception of leadership is different to certain individuals however, various leaders around the world function and interpret leadership in unique and distinct ways. As a result of this realization, the following principles and philosophies are necessary to becoming an effective and successful leader in the health care arena.
1. Master and Perfect your Unique Craft.
Since all leaders have distinct leadership styles and abilities, every leader must learn to recognize and master their unique leadership craft. Understanding this concept is crucial because all leaders are responsible for the effectiveness of organizations and provide a guiding purpose to those who need them. In order for this to occur, an individual must be willing to listen to his or her inner voice and remain true to who they are. Only after the individual fully accepts themselves and their idiosyncrasies can they move on to the second step in the leadership hierarchy.
2. Appreciate the Fundamentals of Leadership.
Fundamental leadership is composed of various ingredients that an individual must grasp before he or she can successfully lead. The first ingredient is defined as the guiding vision, which is the individual’s overall goal for himself or herself. All leaders must have a clear idea of what he or she wants to do—professionally and personally—and the strength to persist in the face of setbacks or failures. This ingredient is vital because it exemplifies the importance of possessing a strong sense of conviction in both aspects of the individual’s life as well as the importance of knowing what you desire and how you plan to achieve it. The second and third ingredient in fundamental leadership is passion and integrity. Passion is when you put more energy into something than is required to do it. It is more than just enthusiasm or excitement, but ambition that is materialized into action to put as much heart, mind, body, and soul into something as humanly possible. In addition to this, integrity is also a much-needed component in becoming an effectual leader because it is based on honesty and a steadfast devotion to principle and ethics. Without these three ingredients, leaders will have a difficult time not only motivating others but also gaining the trust and support necessary to accomplish a shared goal or objective.
3. Embrace your Inner Self.
The third and most important step in becoming an effectual leader is learning how to embrace your inner self. The premise of authenticity is a central theme in effectual leadership because the most charismatic and effective leaders are those who are genuine representations of their innermost nature. One of the best ways individuals can gain this is by experiential learning, which provides the individual with a rich and solid foundation for the future. Through experiential learning, individuals are exposed to the repercussions of their choices and as such, decide for themselves whether or not to make the same choices in the future. This exposure ultimately shapes and forms the leader to become emotionally mature and develop the mental acumen required to be authentic and transparent leaders across the health care spectrum.
Enrolling in a Doctor of Nursing Practice (DNP) program can be a daunting task for many students due to the rigorous academic requirements often associated with it. Although DNP school can be intimidating, students who choose to enroll not only embrace the significance of pursuing higher education but also the possibility of advancing their roles as prominent health care leaders in the nursing profession. As a DNP candidate myself, I’ve grown to appreciate the triumph and struggles associated with pursuing a terminal degree. Therefore, I believe students who are considering pursuing their DNP degree must harness these seven attributes to ensure that they are not only readily prepared but also successful in their scholastic endeavors.
1. Clear Vision
Setting a vision and goal for the future is vital for success in the DNP program. Possessing a clear vision is necessary because it helps you organize your individual objectives and helps you maintain accountability throughout the program. If choosing to enroll in DNP school perfectly aligns with your personal and professional goals, having a vision that is well defined will not only help you focus on your objectives but also create a sense of purpose that ultimately becomes your own measurement for success.
2. Ability to Prioritize
Students who know what and how to prioritize tend to be more successful in DNP school because they know how to differentiate tasks as either critical or noncritical. One of the best ways to prioritize in DNP school is by looking over the program and course objectives of each class and determine which tasks need to be completed first. By knowing how to prioritize your tasks wisely you will not only be able to minimize stress but also maximize results more effortlessly and efficiently.
3. Effective Time Management Skills
Possessing excellent time management skills is an important trait prior to beginning DNP school because of the high academic workload associated with pursuing a doctoral degree. Managing your time effectively will allow you to accomplish more tasks in a shorter period of time and help lower your stress and increase your concentration and attention. To ensure that your time is properly managed, it helps to keep a written or electronic record, diary, or calendar to ensure that you know what tasks are required and when they must be completed.
4. Strong Work Ethic
Maintaining a strong work ethic is essential in determining your overall success in DNP school. Students who possess a strong work ethic understand that success can only be achieved by practicing the ideals of discipline and hard work on a regular basis. To maintain a strong work ethic, it is vital to practice positive habits consistently every day so that hard work is almost automatic. Forming respectable habits such as exercising daily, staying punctual, maintaining your obligations, and finishing tasks immediately help establish your credibility and image as a doctorally prepared nurse.
5. Healthy Work-Life Balance
While it is important to study and work hard in DNP school, it is equally important to create a healthy work-life balance and set aside much needed time for yourself and your loved ones. Learning how to care for yourself is extremely important in DNP school as working too much can ultimately cause you to become overwhelmed, overworked, and overstressed. To avoid this, it is best that you take consistent breaks throughout the day to maintain your overall well-being. Learning how to take ample rest breaks is vital to ensure your physical, mental, and emotional health is adequately cared for in DNP school.
6. An Understanding that Excellence is a Lifelong Process
One of the key principles that DNP students must understand is that excellence is a lifelong process. Understanding this concept is vital because sustainable success in DNP school and in life is not something that is built overnight but rather an extended period of time. As leaders in the nursing realm, DNP students must understand that sustainable excellence requires constant monitoring, learning, and improvement with the realization that the journey is just as important as the destination.
7. Perpetual Curiosity
DNP students who remain perpetually curious are more susceptible to success because curiosity not only propels innovation but also self-reflection. Fostering your curiosity in DNP school is essential because it allows you to be fully present in the moment. Curious people are not only happier but also more successful because they are non-blaming, non-shaming, supportive, and focused on exploring options to find the best solution that supports collaboration and innovation.
Public health is an important aspect in the nursing profession because it involves addressing medical illnesses on a global scale. Due to the aging population and the advancement of medical technologies, public health nurses are vital in developing and providing skilled nursing care aimed at promoting preventative measures to increase the global health of the population. It is this understanding that fuels public health nurses to continue their efforts to not only educate society about certain illnesses, but also promote healthy lifestyles across the patient gamut.
What is Public Health?
According to the Public Health Institute, public health is defined as “the science and practice of protecting and improving the health of a community, as by preventative medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards.” The focus of increasing public health awareness is significant especially in today’s society because of the growing paradigm shift towards preventative care versus diagnostic care. In addition to this, public health awareness also requires a collaborative and multidisciplinary effort consisting of physicians, epidemiologists, statisticians, and dietary professionals. This interprofessional collaboration is vital because it involves gathering a sizeable amount of clinical data to effectively screen and prevent a disease from adversely affecting the general public.
The Impact of Nursing in Public Health
The impact of nurses in supporting public health efforts is invaluable because of their strong emphasis on health promotion and disease prevention. Nurses not only possess the proficiencies but also competencies to tackle the burden of health determinants and the various environmental and behavioral factors associated with it. Subsequently, nurses must have the skillset to proactively confront these challenges within an individual and societal context. In order to evaluate these activities, nurses must be diligent in both planning and implementing to ensure public health concerns are addressed directly. Finally, nurses who are actively involved in lobbying for societal and structural reform are then able to promote effectual health care strategies aimed at reducing negative health outcomes associated with poor health decisions and a lack of knowledge.
Why is Public Health Important?
Due to the health care industry shifting towards more preventive care strategies, nurses continue to play a major role in leveraging public health awareness. By identifying and monitoring health concerns that may affect entire communities, public health nurses are uniquely qualified to not only advocate, but also promote societal change to safeguard the health and well-being of all individuals around the world. Therefore, a nurse’s role in health promotion includes various responsibilities related to advocating, enabling, and mediating activities to ensure salubrious decisions equate to healthier outcomes.
According to the American Medical Association (AMA), physician-assisted suicide (PAS) is defined when “a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” A variety of terms have historically been used to describe an event when a physician uses lethal medications on a terminally ill patient for the purpose of easing their suffering. The term “physician-assisted suicide” was conceptualized to accurately reflect the relationship between the doctor and patient while denoting the etymological roots of suicide as “auto-killing” or “self-killing.” After years of courtroom and political battles, California, Colorado, the District of Columbia, Montana, Oregon, Vermont, and Washington are the only U.S. states that currently allow PAS as a result of the Death With Dignity Act enacted in 1997. As of January 1, 2019, Hawai’i will be added to that list.
The perception of PAS is a highly controversial topic within the nursing profession because it centers on the decision of terminating a human life to ease physical and emotional agony. For centuries, issues related to PAS have been zealously debated, with neither advocates nor opponents gaining much ground. Currently, those who favor PAS view the process as a peaceful and painless death while those who oppose it believe that the consequence of any form of suicide will ultimately result in irreparable legal and ethical ramifications. With recent societal and technological advancements in science and medicine, choices involving both life and death have become much more complicated in recent years. As a result of this worldwide controversy in health care, many nurses nationwide are now forced to deal with this ethical dilemma head on.
Risks and Benefits
Like many controversial topics in contemporary society, there are numerous risks and benefits nurses must be familiar with when it comes to justifying PAS. Those who support PAS argue that people should have the right to choose the timing and manner of their death in the event of an adverse clinical aftermath. Proponents of PAS strongly believe that allowing a patient to needlessly suffer can cause additional pain and distress, which can ultimately eliminate whatever shred of dignity the patient may possess. As a result of this realization, many proponents believe that PAS can provide patients with a unique treatment alternative to their incessant agony.
Despite the urgings of proponents however, many opponents argue that the sanctity of human life should be continually honored and respected in spite of physical or emotional discomfort. The argument contends that only God Himself has the authority to give and take life, and that individuals should not be allowed to take any life, including their own.
Lastly, the potential for PAS is tremendously high in vulnerable populations because of their lack of access to quality health care. Since PAS may become a cost-containment strategy that can lead to serious litigation if not performed properly, opponents strongly forbid PAS to stop these abuses from occurring.
The Impact of Nursing in Physician-Assisted Suicide
PAS is an exceptionally controversial issue because it encompasses both legal and medical ramifications centered on the individual’s unique moral and ethical principles. With the ever-expanding ability to both prolong and end life, nurses must not only remain cognizant but also prepared for any and all repercussions associated with life and death situations.