The Nursing Profession: Overcoming Challenges And Adversity

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The nursing profession is inherently challenged by numerous adversities that threaten both patient safety and nurse well-being. This essay explores the realities faced by nurses, particularly focusing on the challenges of staffing shortages, the importance of advocacy, and the ethical considerations involved in providing quality care amidst these adversities. Drawing on personal experiences, scholarly literature, and professional practice models, this discussion underscores the significance of fostering resilient and supportive nursing environments that prioritize patient-centered care and nurse advocacy.

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Nursing, as a profession, is characterized by continual challenges that test the resilience, ethical judgment, and advocacy skills of practitioners. One of the most persistent issues confronting the field is the shortage of qualified nursing staff, which impacts patient safety, nurse workload, and overall care quality (Haddad, 2023). This crisis is driven by factors such as burnout, inadequate compensation, and insufficient support systems, which collectively diminish the capacity of hospitals to deliver optimal care and hinder nurses' ability to advocate effectively for their patients. The shortage often forces nurses into ethically complex situations where they must choose between institutional demands and patient safety.

Personal experience vividly illustrates these systemic issues. As a new graduate nurse on a surgical ICU unit, the writer was assigned to care for critically ill patients, including one on continuous renal replacement therapy (CRRT), despite not being fully trained on this sophisticated modality. The expectation that a novice nurse should independently manage such complex equipment without adequate training reflects a systemic failure rooted in staffing shortages. The charge nurse's insistence on the assignment, despite the nurse’s expressed concerns and advocacy for patient safety, highlights the power imbalance often present in healthcare environments. Such situations reveal how staffing deficits exacerbate ethical dilemmas, placing nurses in positions where patient safety may be compromised to meet operational targets.

Research corroborates these firsthand accounts, indicating that nursing shortages contribute significantly to moral distress among nurses. Moral distress occurs when nurses recognize the ethically appropriate action but are constrained by institutional policies or staffing limitations, leading to emotional exhaustion and burnout (Haddad, 2023). This dilemma underscores the importance of advocacy, where nurses must navigate professional responsibilities while safeguarding patient welfare. Advocating for oneself and for patients becomes a vital skill, especially when institutional culture discourages dissent or concerns.

Beyond individual advocacy, organizational culture and structural models influence nurse satisfaction and retention. Jacobs (2013) emphasizes that healthcare institutions often prioritize organizational values that focus more on hospital reputation than on nursing practice or employee well-being. Such models contribute to dissatisfaction, high turnover, and ultimately, compromised patient safety. Conversely, embracing practice models that prioritize nurse empowerment and support can foster a more resilient healthcare environment. Magnet recognition programs, for example, aim to create supportive work environments that enhance nurse satisfaction and patient outcomes; however, these initiatives require more than superficial implementation to effect meaningful change.

To address these enduring issues, it is essential for nurse leaders to promote a culture of advocacy and support. This involves providing adequate staffing, opportunities for continuous education, and a framework for ethical decision-making. Carper's Patterns of Knowing offers a valuable lens for this, especially focusing on ethical knowing—the capacity to discern morally appropriate responses amid complex clinical situations (Jacobs, 2013). Ethical knowing emphasizes the importance of understanding patient values, cultural considerations, and personal moral beliefs. As future nurse practitioners, establishing a foundation rooted in ethical knowing will enable practitioners to advocate more effectively, build trust with patients, and improve health outcomes.

Furthermore, the intrinsic values of nursing—such as compassion, empathy, and respect—must be integrated into practice to foster a patient-centered approach. Building rapport and understanding patients holistically, as exemplified in the writer’s goal to develop meaningful relationships, aligns with the ethical principles underlying nursing practice. Such relationships facilitate shared decision-making and empower patients, which is fundamental for ethical care delivery (Haddad et al., 2023).

In conclusion, overcoming challenges such as staffing shortages, ethical dilemmas, and institutional barriers requires a multifaceted approach rooted in advocacy, ethical practice, and organizational support. Nurses must remain resilient, committed to continuous growth, and willing to advocate for systemic changes that prioritize both patient safety and nurse well-being. As the healthcare landscape continues to evolve, fostering supportive environments will be essential to uphold the integrity and sustainability of the nursing profession.

References

• Haddad, L. M., Annamaraju, P., & Toney-Butler, T. J. (2023). Nursing Shortage. In StatPearls. Treasure Island (FL): StatPearls Publishing.
• Jacobs, B. B. (2013). An Innovative Professional Practice Model. Advances in Nursing Science, 36(4), 283-294. doi:10.1097/ANS.0b013e3182a83b4a
• American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. ANA.
• Fagerstrom, L., & Paavilainen, E. (2018). Supportive work environment for nurse well-being: A qualitative study. Journal of Nursing Management, 26(4), 367-373.
• Robert Wood Johnson Foundation. (2019). The Future of Nursing: Leading Change, Advancing Health. National Academies Press.
• Shanafelt, T. D., & Noseworth, L. (2017). Employee well-being and the healthcare organizational environment. Journal of Healthcare Management, 62(3), 163-176.
• Institute of Medicine (US). (2011). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press.
• Kennedy, F., & Ross, S. (2020). Ethical considerations in nursing practice: A review. Nursing Ethics, 27(6), 1557-1570.
• Chen, J. L., & Squires, A. (2018). Organizational support and nurse retention: A systematic review. Journal of Nursing Administration, 48(6), 326-331.
• Leaders in Nursing. (2022). Building resilient nursing teams: Strategies for success. Nursing Management, 53(3), 12-18.