Nursing : Theory of the Healing Environment

Running head: NURSING
Task 1
Name of the Student
Name of the University
Author Note

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A. My nursing practice has been most influenced by the theory of the healing
environment that had been established by Florence Nightingale. This theory
elucidates that the organisational culture and physical setting plays an important role
in supporting patients and their family members during hospitalisation and recovery
from illnesses. The theory highlighted that while caring for patients, nursing
professionals must promote a healing environment by creating provision for
appropriate light, nutrition, socialisation, noise, hope, and comfort.
1. Our nursing profession requires us to hold responsibility for the environment
in which our patients are treated. As the frontline managers of care delivery,
we have the accountability of modifying the care environment as per the
demands and preferences of the patient, in order to promote their optimal
wellbeing and recuperation.
2. As an ICU nurse, my duties encompass assessing the patient’s circumstances,
administering medication, and offering continuous support during their
recovery from the health ailment. In order to be a successful ICU nurse, I am
expected to have the tenacity of addressing difficult situations, while working
with a team in order to prevent deterioration of the patient. This theory fits my
practice since I try to prevent noise in the ICU ward, in order to decrease stress
of the patients. I often ask my patients if they would like me or their family
members bring along some artwork, photographs, plants or sacred objects. I
also try to make the patient feel comfortable by playing relaxation music and
engaging in compassionate discussions.
B. Two historical figures who made significant contributions in the field of nursing are
Florence Nightingale and Hazel W. Johnson-Brown. While the former is regarded as

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the founder of contemporary nursing, the latter was an educator and nurse who served
in the US Army.
1. Nightingale's long-lasting contribution to the profession can be accredited to
her role in establishment the current nursing profession. She formulated an
illustration of compassion, empathy, commitment to caring for the patient, and
hardworking and considerate hospital administration (Alligood, 2017). Earlier,
nurses considered their occupations to be insignificant and of low-status, since
they were untaught and generally learned through practice. Her efforts
transformed nursing into a reputable profession, increasing its standards by
integrating education and accountabilities into the occupation. Nurses were
gradually respected and valued, and the hospital environment also improved
significantly. Hazel Johnson-Brown made history for being the first ever
African American female general in the year 1979. She commanded around
7,000 men and women nurses in the Army Reserves and Army National
Guard, besides establishing policies and overseeing the operations in different
medical centers, community hospitals, and freestanding clinics (Jacob, 2018).
2. While delivering care, I try to emphasise on the significance of patient
observation, with the aim of identifying their needs and symptoms, based on
which I deliver tailored care. I stress on the value of sanitary conditions and
always ensure that my patients are provided much needed warmth, air,
nutritious diet and light in the ICU. I have also acquired leadership traits that
help me oversee the incorporation of patient care, along with treatment plan
development, collection and analysis of results, and patient management.
C.

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1. The primary difference between the American Nurses Association (ANA) and
the State Board of Nursing (BON) is that the latter is a public institute, in
comparison to ANA that is privately owned (American Nurses Association,
2015). The BON acts as a not-for-profit organization looking after matters
affecting health, welfare and safety of the public, compared to the ANA that
requires membership for enhancement of career (Florida Board of Nursing,
2019).
2. The state board of nursing in Florida helps me to set my professional standards
and potentials for the treatment that I offer to my patients, and also offers me
the licensure to work as a nurse. The ANA affects my practice by promoting
my career progression and professional expansion.
3. I hold the nursing licence in Florida. Registered Nurses (RNs) working in
Florida have to renew their license based on three categories namely, (i) group
1 with current licence expiring at midnight, April 30, 2020, (ii) group 2 with
current licence expiring at midnight, July 31, 2020 and (iii) group 3 with
current licence expiring at midnight, April 30, 2021 (all Eastern Standard
Time). The license gets renewed by the department on submitting the
completed CE requirements, duly filled-in renewal application, and the fees
(Florida Board of Nursing, 2019).
a. Failure to maintain the requirements for license need to reapply to gain
their licensure, besides complying with the rules and legislation.
4. Compact states allow nurses to practice their profession in remaining NLC
state lines, without the complication of obtaining extra licensure from the
individual states, compared to non-compact states where every time a nurse
practices in a different state, additional eligibility requirements have to be met.

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D. The Center for Medicare and Medicaid Services and the Food and Drug
Administration are affiliated to the Human Services and the Department of Health.
The FDA governs the usage and marketing of medicinal products, in contrast to CMS
that controls the compensation for healthcare services and products, associated with
the major healthcare agendas of the nation namely, Medicaid and Medicare (Food and
Drug Administration, 2019; Center for Medicare and Medicaid Services, 2019). The
primary objective of the latter is to guarantee operative, up-to-date healthcare
insurance and quality care to all recipients.
1. My professional practice is influenced by the aforementioned organisations
since the CMS oversees whether the care I deliver to the patients is tailored
according to their needs and based on best available evidences. The FDA
monitors whether the care I deliver, including the medications and other non-
pharmacological interventions are safe for the patients.
a. When patients seek alternative therapy, my role requires me to guarantee
that the alternative treatment is safe, and that there will be no
contraindications or adverse effects on the patient. I also try to increase
awareness of the patients on the potential advantages and drawbacks of
the therapy (if any), following which I involve them in shared decision
making and seek their opinion about the plan of care.
E. The exclusive legislative purpose of the NPA in Florida is to guarantee that all nurses
working in this state are able to meet the minimum necessities for safe practice. It
highlights that nurses failing below the minimum proficiency or those posing threat to
the public need to be outlawed from working in this state ( The 2019 Florida Statutes,
2019). The NPA influences my practice by governing the steps that I need to follow in
order to obtain the licensure, for renewing my licence. It also influences my code of

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conduct and the disciplinary actions that might be taken if I ever engage in unlawful
actions. It also helps me make conscious efforts to avoid involvement in situations or
actions that necessitate penalties and violations.
1. The scope of practice for Registered Nurses in Florida are defined in Section
464.003(3)(a) and suggests that the practice is not restricted to observation,
nursing diagnosis, assessment, intervention, planning, and care evaluation.
RNs are expected to teach and counsel the injured or infirm, while promoting
their wellness and preventing disease of others. They also have to administer
medications as prescribed, apart from teaching and supervising other
personnel (Thehealthlawfirm.com, 2008).
2. Delegation refers to the transferral to a knowledgeable person the right to
perform a designated job or activity in a particular condition by a nurse skilled
by licensure and knowledge to accomplish the task or action. According to the
Florida Department of State (1996), it is not necessary for the RN to delegate
particular activities that are not within the scope of practice, or those that
comprise of usage of nursing procedures, and necessitate particular
knowledge, skills and judgment. These typically include nursing assessment,
nurse care goal establishment, nursing diagnosis determination, and progress
evaluation.
F.
1. As a scientist, I try to study numerous characteristics of health, disease and
health care. By formulating and executing scientific studies, I strive for ways
to advance the care delivered and health care outcomes of my patients. I spend
considerable time in evidence based practice with the aim of identifying the
research questions, following which I explore scientific studies and scholarly

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evidences, collect and examine their data and document the findings to
enhance patient outcomes. I try to remain updated with advancements and
progress in the field of medicine and also question the interventions that do
not appear appropriate for patient. One such instance occurred while caring for
a patient in ICU who had acquired nosocomial infection. I searched for
evidences about alternative infection control strategies, apart from soap and
water and found Chlorhexidine to be effective. On presenting the findings to
the physician, he approved my input and prescribed the use of Chlorhexidine
washcloths.
2. I adorn the role of a detective by using my clinical imagination, together with
evidences from nursing to analyse patient situations and determine the effects
of deviation from traditional care plan. I utilise my experiences and knowledge
gained over the years to prevent injury or unintentional harm to the patients. I
also focus on the usage of health information technology for maintaining
patient records, and referring to previous cases on noticing similar symptoms.
For example, while caring for a stroke patient, I investigated the probable
benefits of wearable devices to prevent patient fall after discharge from the
hospital and suggested the same to the senior physician-in-charge.
3. Environments play an important role in inducing negative feelings or
promoting positive attitudes amid patients. As a nursing professional, I try to
remain accountable for the impact that the care environment creates on the
stress and anxiety faced by patients and their family members. I also try to
deliver compassionate and patient-centred care to all clients, by playing the
role of active listener, giving them blankets, offering assistance while getting

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up from bed or during toileting, and providing water and diet, as per their
needs.
G. Provision 1 states that all nurses must practice with sympathy and admiration for the
characteristic dignity, value, and exclusive attributes of every individual. Provision 3
states that nursing professionals must advocate for, promote, and defend the health,
rights, and security of their patients (American Nurses Association, 2015).
1. The provision 1 creates an impact on my nursing practice by guaranteeing that
I provide equal care to all patients, notwithstanding any cultural, racial, or
ethnic differences (American Nurses Association, 2015). This provision also
oversees that while implementing treatment plans, I display a willingness of
attending to the needs of my client and tailor the care plan in alignment with
their beliefs and values. It also confirms that I do not force the patients during
decision making about their treatment. The provision 3 influences me to
search for the best interests of my patients, while providing them possible
solutions regarding their treatment, and other resources once they are
discharged from the hospital (American Nurses Association, 2015). It also
requires me to ensure that there are no adverse events or errors during the
course of treatment, thereby averting avoidable incidents.
2. One nursing error that may occur in clinical practice is that the patients and
their family members might be provided with unclear instructions related to
self-care, owing to cultural differences, which in turn might make the patient
susceptible to adverse incidents. The provisions identified above can be
applied to advocate for the patient’s right to treatment, while showing respect
and maintaining dignity.

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H. Four leadership traits that represent brilliance in nursing are namely, uprightness,
responsibility, communication skills and critical thinking.
1. While working as a leader at the bedside, it is necessary for nurses to develop
the ability of making decisions based on the patient’s current situation, while
utilising both verbal and nonverbal communication skills, and maintaining
honesty about the illness and care plan. At the bedside, I maintain uprightness
by being truthful to the patients about the plan of care and their health status. I
also hold responsibility for the care delivered and engage in critical thinking
while delivering novel interventions to the patients. Likewise, as a member of
an interdisciplinary team, it is expected of nurses to consider different factors
while making decisions, in addition to communicating about the possible
interventions, and being accountable for the health outcomes of the patient.
While working in a team, I encourage the members to share their opinion and
also engage in problem-solving while making critical decisions. Moreover, I
display a willingness to help my co-workers, which helps them place their
trust on me at difficult situations.
2. Work environment creates an impact on nursing leadership since my job role
requires me to advocate for my patients, while ensuring that they are being
offered care in a safe and secure environment, with no imminent threats to
their health and wellbeing. As a nurse leader, I have to foster collaboration,
communication and also display problem solving skills. I have also been
called a ‘major support system’ of the hospital, which in turn encouraged me
to work more towards my personal development and enhancement of patient
outcomes.

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3. On a regular basis, we have to make crucial decisions about the diagnosis and
treatment of patients. I use my clinical expertise and knowledge gained over
the years to inform my practice. I also try to collaborate with my seniors and
interdisciplinary team members in order to facilitate patient recovery.
4. My work environment encourages me to enrol for additional certificate and
diploma courses related to this field in order to promote my professional
growth. I also has the provision for tuition compensation.
References
Alligood, M. R. (2017). Nursing theorists and their work-e-book. Elsevier Health Sciences.
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements.
Retrieved from
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsfor
Nurses/Code-of-Ethics-For-Nurses.html
Center for Medicare and Medicaid Services. (2019). We’re putting patients first. Retrieved
from https://www.cms.gov/
Florida Board of Nursing. (2019). Registered Nurse (RN). Retrieved from
https://floridasnursing.gov/renewals/registered-nurse-rn/
Florida Department of State. (1996). Delegation to Unlicensed Assistive Personnel. Retrieved
from https://www.flrules.org/gateway/ChapterHome.asp?Chapter=64B9-14
Food and Drug Administration. (2019). About FDA. Retrieved from
https://www.fda.gov/about-fda

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Jacob, S. R. (2018). The Evolution of Professional. Contemporary Nursing E-Book: Issues,
Trends, & Management, 1.
The 2019 Florida Statutes. (2019). CHAPTER 464 NURSING- PART I NURSE PRACTICE
ACT (ss. 464.001-464.027). Retrieved from
http://www.leg.state.fl.us/statutes/index.cfm?
App_mode=Display_Statute&URL=0400-0499/0464/0464.html
Thehealthlawfirm.com. (2008). CHAPTER 6 THE FLORIDA NURSE PRACTICE ACT AND
THE SCOPE OF NURSING. Retrieved from
https://www.thehealthlawfirm.com/uploads/Ch-6%20Florida%20Nurse%20Practice
%20Act%20and%20Scope%20of%20Nursing-revised.pdf