Evolution of Nursing Practices

This article explores the evolution of nursing practices over time and resulting changes in scope of practice and approach to patient care. It discusses the differentiated practice competencies of ADN and BSN, application of evidence-based practice and RN-BSN education in nursing care, and communication and collaboration with interdisciplinary teams to support patient outcomes.

Evolution of nursing practices 1
EVOLUTION OF NURSING PRACTICE
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Evolution of nursing practices 1
Introduction
Nursing become secular profession in the 19th century where from earliest time cultures produced
streams of nurses who were dedicated to serve according to religious principles from both
Christendom and Muslims(White, 2014). The term nurse was derived from Latin word "nutrire",
which meant to suckle,and referred to wet nurse. In the 16th century it acquired its todays
meaning, a person who cares for the infirm(White, 2014). Before the foundation of modern
treatment in 19tn century in Europe, catholic nuns and military gave nursing like care to people.
Evolution of nursing care practice over time and resulting changes and scope of practice and
approach to patient care
Nursing today has revolutionized with nursing profession increasing the need for highly trained,
critical thinkers as well as well-educated professionals to enable them to make complex clinical
decisions which was left for doctors in the past 50 years(Rhodes, Radziewicz, Amato, Bowden,
Hazel, McClendon &McNett, 2013). This has been so as a result of changes in the need of health
care population requiring nurses and midwifes to have more education and training in order to
take new and complex roles in their practices(Rhodes et al., 2013). With the development in the
new technology, internet has given more power to patients to voice their health needs and control
their own care in a positive way. Internet has also created an avenue for peer support and nurses
can assist patients to self-manage their long term conditions(Conner &Thielemann, 2013). With
well-educated nurses taking complex roles in clinics, better services are provided to communities
and patients(Conner &Thielemann, 2013).
Comparison of differentiated practice competencies of ADN and BSN

Evolution of nursing practices 1
Traditionally, the role of a registered nurse included educating patients on diseases,supporting
the family,recording patient symptoms, simple nursing care, and medical history and using
simple medical equipment worked in consultation with the doctor(Kumm, Godfrey, Martin,
Tucci, Muenks&Spaeth, 2014). However, today nurses have advanced and can carry even more
complex roles(White, 2014). If a comparison is made between ADN level nurse and BSN nurse,
under doctors’ supervision, BSN unlike ADN will carry out procedures that are more complex
and can also supervise other nurses(Matthias & Kim-Godwin, 2016). This means, with
baccalaureate degree your career path is broader compared to AND(Kumm et al., 2014). The
main advantage of BSN over ADN is that it provides more opportunities for higher pay and
leadership responsibilities(Matthias & Kim-Godwin, 2016). BSN unlike ADN can also give you
an opportunity to move from just being a registered nurse to other ranks like public health nurse
or nurse educator, and any other area of your interest in this field requiring BSN
qualification(Kumm et al., 2014). BSN Nurses are better than ADN because of the elaborate
curriculum and clinical hours required by academic criteria making them more qualified to offer
effective, safe patient care as their training meet the nation’s patients’ nursing needs(Matthias &
Kim-Godwin, 2016). BSN have also more educational experience compared to ADNs.
Application of evidence-based practice and RN-BSN education in nursing care
By 2020, The Institute of Medicine (IOM) wants 90 percent of all healthcare practice to be
evidence-based key to this effort being registered nurses (RNs) withBSN degrees and work in
direct patient care(Ross, Fitzpatrick, Click, Krouse&Clavelle, 2014).
Some of the EBP includes hand hygiene which can be traced back in 1990s when researchers
recognized hand washing reduces the incidence of disease and infection. They cited a connection

Evolution of nursing practices 1
between patient mortality and providers who handled dead bodies(Ross et al., 2014). Dr.
IgnazSemmelweisused chlorine in hand washing and leading to the rate of patient deaths
decreased. From then hand washing became an essential public health tool(Ehigiator, Azodo,
Ehizele, Ezeja, Ehigiator&Madukwe, 2013). The other one is dress code and started when a
Richmond, VA-based hospital gave nurses different dress code based on research that had found
some positive correlation between appearance of professionalism and identification of staff and
the standardized attire(White, 2014). The researchers recommended the nurses to wear specific
attire(Kalb, O'Conner-Von, Brockway, Rierson&Sendelbach, 2015). The nurses were also issued
with gold and black tags identifying their professional tittles.Nurse education was the other EBP
where IOM published it health profession education in 2003 stating healthcare providers be
equipped with adequate training and education(Ehigiator et al., 2013). The institute included
training as EBP as one of vital requirement for healthcare providers.
EBP has obstructed all territories of healthcare practice, creating a need for providers to get
prepared to implement new standards based on facts and evidence(Kalb et al., 2015). Approaches
without evidentiary value that have been used for decades are on their way out.
Communication and collaboration with interdisciplinary teams to support patient outcomes
An environment for medical error to occur is created by the lack of communication. Failure to
communicate in clinical situations is the leading root cause of deaths of between 44,000 to
98,000 people in U.S hospitals every year due to errors of commission as reported to Joint
Commission up to 60% of sentinel in 2013(Ross et al., 2014). Lack of communication many
times leads to wrong-site surgeries, delays in treatment,medicationerrors, fatal falls and operative
and postoperative events. From traditional times emphasizes has been put to the importance of

Evolution of nursing practices 1
error free practice in clinical situations to achieve perfection by utilizing intense peer pressure
during treatment or even diagnosis(White, 2014). Nurses today are advised to create a safe space
to share information, handle conflict with care, have a common goal with their teams, and avoid
grudges amongst themselves so as to collaborate and communicate well for effective service
delivery for better patient outcomes(Ross et al., 2014). Communication and collaboration
between nurses provides an avenue for job satisfaction, increased sense of teamwork, enhanced
communication abilities with team members,improved job satisfaction, improvements in staff
efficiency, increased ability to address patient fears and worries, and improvements in patient
safety.
Conclusion
The history and evolution of nursing profession is a complex matter that may not have the exact
detailed information. The evolution can be better compared or discussed in a span of 50 years
period. Over the past 50 years, great changes have been brought about in nursing profession due
to issues such like technology, internet, education, and improved infrastructure. What a
registered nurse could not be allowed to do 50 years down the line he or she can do due to the
level of education and specialized training.

Evolution of nursing practices 1
References
Conner, N. E., &Thielemann, P. A. (2013). RN-BSN completion programs: Equipping nurses for
the future. Nursing Outlook, 61(6), 458-465.
Ehigiator, O., Azodo, C. C., Ehizele, A. O., Ezeja, E. B., Ehigiator, L., &Madukwe, I. U. (2013).
Self-medication practices among dental, midwifery and nursing students. European
Journal of General Dentistry, 2(1), 54.
Kalb, K. A., O'Conner-Von, S. K., Brockway, C., Rierson, C. L., &Sendelbach, S. (2015).
Evidence-based teaching practice in nursing education: Faculty perspectives and
practices. Nursing Education Perspectives, 36(4), 212-219.
Kumm, S., Godfrey, N., Martin, D., Tucci, M., Muenks, M., &Spaeth, T. (2014). Baccalaureate
outcomes met by associate degree nursing programs. Nurse Educator, 39(5), 216-220.
Matthias, A. D., & Kim-Godwin, Y. S. (2016).RN-BSN students’ perceptions of the differences
in practice of the ADN-and BSN-prepared RN. Nurse educator, 41(4), 208-211.
Rhodes, C., Radziewicz, R., Amato, S., Bowden, V., Hazel, C., McClendon, S., ...&McNett, M.
(2013). Registered nurse perceptions after implementation of a nurse residency
program. Journal of Nursing Administration, 43(10), 524-529.
Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., &Clavelle, J. T. (2014).
Transformational leadership practices of nurse leaders in professional nursing
associations. Journal of Nursing Administration, 44(4), 201-206.
White, L. (2014). Mindfulness in nursing: An evolutionary concept analysis. Journal of
Advanced Nursing, 70(2), 282-294.