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Wednesday, 3 March 2011






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Government Gazette

Nurses and 'culture of care'

Nurses have become indispensable in creating a 'culture of care.' With spiralling costs, heavy reliance on technology adding to overheads and the shortage of doctors, nurses are a vital link in physician-led healthcare.

Nurses are going beyond their usual two-year associate and four-year baccalaureate programs beginning to serve as anesthesiologists under supervision by doctors. Many are given incentives to do post-graduate clinical training here in the US.

The term nurse practioner is now becoming commonly used. These specialized nurses are able to diagnose and do the initial work when admitting patients.

Aftercare in homes are now regularly done quite well by nursing staff with the help of volunteers in many Western countries to look after patients released from intensive care.

Due to the currently bulging senior patient population and their attendant complex medical problems in most parts of the world, health care systems have to rely on division of labour to a great degree.

The need to maximize the contribution of every member of the health care system is critically felt today. Due to the sheer volume of patients in the system, the diverse responsibilities have to be shared between the doctors, nursing staff, technicians and auxiliary service employees.

Keeping objectives in mind

Today health care administers are more aligned to keep the overall goals of quality care in mind at all times instead of being immersed checking insurance claims, billing and the like. Nurses have become a major source of support.

According to the Transitional Care Model program at Pennsylvania University, for example, getting everyone to fit in to the overall caring is becoming routine.

Nurses currently form the largest sector of health care providers in the US. It is so almost everywhere. The role of nurses had become a topic of study during the past two years following the shortfall anticipated in many areas - especially the lack of doctors.

A holistic approach is becoming established according to a report by a national panel of experts titled 'The Future of Nursing: Leading Change, Advancing Health.' It offers several recommendations, including what amounts to a rebuke of the current piecemeal education of nurses. The American Academy of Nursing has welcomed the approach.

Innovative nursing led-services

Part of that blueprint includes innovative nursing-led services like the Transitional Care Model program at Pennsylvania in Philadelphia, where nurses are assigned to elderly hospitalized patients deemed to be at high risk for relapse.

For up to three months after discharge, the nurses make home visits, accompany the patients to doctors' offices and collaborate with the primary care physician and family caregivers. In early trials, the program has significantly decreased hospital readmissions and costs by as much as $ 5,000 per patient.

The trend now is for nurses to revamp the way they are educated, citing the decades-long struggle within the profession to define what exactly a nurse is. It is no longer an adjunct to something remotely connected to health-care but an ongoing participation to serve the patients.

The goal of having a reasonable nurse-to-patient ratio is sought through out the world. California is implementing legislation passed in 1999 that mandated a ratio of one nurse to every five patients on general medical floors. That is a goal worth striving for.


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