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First Year University – Nursing

First Year University – Nursing


Service users can trust a newly registered nurse to: "make a holistic and systematic assessment of their needs and develop a comprehensive plan of nursing care which promotes their health and well-being and minimizes the risk of harm". Based on this idea, the nursing profession is expected to gain effectiveness in patient healthcare. The promotion of the healthcare services is based on the inspiration to serve the clients/patients to the best of the nursing abilities. However, it is expected that this reform in the nursing profession is realize different challenges. Hence, it is only important to assess the features of the services.



The vision of the nursing practice contributes in the initiative to the assessment of physical, emotional, psychological, social, cultural and spiritual needs, including risk factors by identifying, recording, sharing and responding to clear indicators and signs that can be found among the patients. The practice is facilitated with the relevant and appropriate application of knowledge of age and condition-related anatomy, physiology and development when interacting with patients/clients. Therefore, the newly registered nurse or NRN are introduced to have a broader understanding on the patients’ situation because of the open communication. Therefore, the nurses can analyze the benefits of a healthy lifestyle and the potential risks involved with various lifestyles or behaviors (NMC, 2007).


Because of the continuous effort in supporting the patient-nurse relationship, the hospitals and other clinical institutions are experiencing the weakness the low nursing staff. The weakness in the workforce may affect the ability of the nursing providers to implement the new approach in health care and may contribute for its failure. Moreover, the practice without the appropriate training and orientation might affect the relationship that the healthcare settings are trying to emphasize. The idea that there is a mismatch on the patient and nurse and their behaviors or personalities didn’t complement in each other might deliver the unstable relationship. 

Nurses are the one whom the patients trust their health outcomes and build the nurse-patient relationship which aims to assist their patients even in decision making. The workload that the nurses endure is such as great burden in fulfilling their functions in the medical society, most importantly when they are unrelated in their job. It is true that the shortage in nursing staff in the medical can be the main reason but the work overload will only create an undesirable result in achieving the patient satisfaction. The rapid change in the society and the increasing demand of the patient appears to be the primary reason behind the changes in the hospital settings. But because of these changes, the quality of care among the hospitals is encouraged to maintain their competency.   

The Concerns and Expectations

Aside from introducing the changes, the model used should promote its objectives and managed to satisfy the organizational objectives. Moreover, the changes that the model in healthcare promoted can be only effective are all the elements in the health care settings such as the nurses and leaders understand the implication of the models. In this way, the model can be applied accordingly. Despite of the changes in the hospital, it seems that the mission remains the same. In this case, the nurses can have the freedom to assess the effectiveness of each model through gauging the changes in terms of their role in delivering the services. In an effort of addressing the quality, efficiency, and safety outcomes, the health care organizations spent many investments in developing the structure of the settings, acquisition of technologies, and workload designs.

However, because of the engagement of the patients as partners in care, it is expected that the patients can meet their own needs then the nurse will ensure that these are addressed in accordance with the known wishes of the patient/client or in their best interests.


Within the nursing education, the nursing practices and programs play an essential role towards achieving the respective outcomes and proficiencies under the Standards of proficiency for pre-registration nursing education (NMC 2004). With the elements of care, compassion, and communication, the patients/clients can trust the newly RN in terms of the providing the appropriate care based practices which are in highest standards, knowledge and competence. The treatment provided by the nurses is expected to implement with dignity and respect towards the patients. This is possible through the listening and communicating strategies that are filled with warm and sensitivity. Therefore, even if the patient is foreign or the nurse is serving in culturally diversified clinical settings, there is an assurance that the nurses will provide the quality measurements in patient care. Accordingly, the standard in the nursing and proficiency emphasizes the activities which manage the confidentiality and privacy of the patients (NMC, 2007). The information of the patient is recorded or registered so thus the nurses can update and analyze the status of the client’s situation. But because of the sensitivity of most of the patient’s cases, the nurses are bound to treat the information with appropriate protection and must assure that the relative information which is subject for discussion should firstly sought the consent of the patients.    

The issue of delivering the quality health care is thoroughly based on the assessment of the nurses. Based on the nursing plan and the information that the nurses recorded, they can recognize the indicators of patient’s lifestyles. This is part of the organizational aspects of health care. Within the assessment of the information, the nurses can understand the relative impact of the lifestyles towards the illness of the patients and create an appropriate relationship with the patients in order to minimize the bad health lifestyles of the patients. The response of the nurses promotes the application of evidence-based practice or EBP in order to have an adequate delivery in the nursing care delivery.

Nursing Care Delivery in EBP

The nursing policies are also evidential in terms of the introduction of the evidence based practice (EBP) that is promoted in the emergency nursing practitioner (ENP). The EBP is applied in clinical settings to effectively manage and ensures the capability of delivering quality healthcare services to the patients to achieve the patient’s satisfaction. The Evidence Based Practice (EBP) is guidelines that promoted and systematically formed to develop a comprehensive statement wherein the experts can deliberately explain or provide the quality care. The specific clinical condition of a patient is the most available scientific evidence and from the past experience and knowledge of the health care provider, the judgment can be created. The adequate prescription can be the last statement that a health care provider can give which is also suitable in the patient’s needs.  The experiences of the nurses is important because it forces of changes that include competitive pressures, alternate health care delivery mechanisms, changing cost structures, monitoring by public and private groups, increased information availability, and a markedly better-informed clientele. Therefore, the use of protocol is part of the strategies in most of the hospitals to recognize the different improvement in the situation of the patient (Pearson, et al., 2007). Through the use of appropriate procedures such as the observations and recording, the critical assessment on the evidences can be strong and valid. In association to the EBP, the nurses are also expected to communicate with other nurses and share their experiences in nursing to explore and assess the patient’s needs and demands.

Though the EBP is applied in the nursing practice and tends to promote the effectiveness in the delivering the nursing, there still continuous improvement and development in the policies of health care. In the pursuance of the investment in the health care community, the changes practically affected the nursing practice. The changes in terms f economic, equation, and services practically nudge another shift in the nursing care model to bring back the nursing productivity. Accordingly, the nursing productivity can be achieved through the idea of value-added care. The paradigm of value-added care goes beyond direct care activities and includes team collaboration, physician rounding, increased registered nurse (RN) to aide in communication, and patient centeredness. Of course, all of which are crucial to the nurse’s role and the patient’s well-being. Accordingly, the utilization of appropriate staff can be achieved depending on the assessment and implementation of the adopted changes. Beyond the transformations, it is essential that the medical settings recognize the areas that should be changed. For example, the nurses stationed in frontline of the hospitals should adopt strategies or techniques that enable them to increase time spent in value-added care and to decrease waste activities with an improvement in efficiency, quality, and service (Upenieks, Akhavan, & Kotlerman, 2008).

The evidence-based practice (EBP) has become popular for human services. The EBP relied on the experimental research in human services practice. Still, the question of its usefulness remains. Furthermore, the study of efficacy requires standardized interventions like experimental or control. The use of EBP is to mean greater use of research in practice and policymaking (Tanenbaum, 2005). The concept of evidence-based practice (EBP) has assumed a central position in health and behavioral health care disciplines. EBP is frequently defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. It is also described as the movement of scientists, public or private officials, and advocacy groups that seek to establish a new knowledge in terms of health care and health services (Chronister, et al., 2008).

Improving Population Health

There are many ways on how evidence-based medicine can help improve the quality of patient outcomes. According to the Rand Corporation report, the use and critical follow of evidence-based guidelines can improve the 55% of patient diagnoses. The utilization of knowledge from the EBP can help individuals who suffer in various diseases to improve their health. Like for example, the disease that has a high possibility of life-threatening can lessen when the application of EBP is adopted. For most research, there are drugs that can lower the mortality rates that those prescribed drugs (Sonduck, 2007).

On the other hand, the EBP can help control the costs and reduce inefficiencies. Because of the critical study about the health aspects of an individual, the unnecessary factors can be eliminated. The inefficiency of health care can be lowered because the health providers have more knowledge and can definitely understand the things involve in health care services. With this, the service can achieve all the preventing and treating aspects even it is a rare or dangerous disease. 

Using the evidence-based medicine can align the benefits. With linking benefit design to medical practices with demonstrated effectiveness enhances health and quality of life of human population. It is because; evidence-based medicine will reduce the use of unproven or ineffective treatments, thus protecting the health care. Part of it is the benefits the employers and employees will enjoy through the reliable health care investments.

Most especially, the evidence-based medicine and practice can help in providing solutions and care managements for deadly health conditions: asthma, congestive heart failure, depression, and diabetes (Sonduck, 2007). Each and every year these four health problems contributed more hundred thousand deaths. And this is alarming since the human body cannot handle all the medications given. But if the use of evidence-based health practice is applied, the possibility to give the human race in prolonging their life can be achieved.


The EBP today, has permeated a wide array of health and allied health care disciplines. One driving force behind EBP is the financial pressure associated with the U.S. health care system. In response to the health care costs, efforts have been underway to carefully review how resource are used and spent to consolidated services. The face of EBP in health care is deeply connected to both financial viability and efficiency of staff and resource. Health care administrators need to know what works, which person the work would be, and in what situation would the action be applicable. The use of clinical practice guidelines and clinical pathways can have the guiding forces in service delivery and managed care business practices.


Chronister, Julie, A., Fong Chan, Elizabeth da Silva Cardoso, Ruth Torkelson Lynch, & David A. Rosnthal. “The Evidence-Based Practice Movement in Healthcare: Implications for Rehabilitation”. The Journal of Rehabilitation, 74.2 (2008)

NMC “Essential Skills Clusters (ESCs) for Pre-registration Nursing Programmes”, Circular September 2007. 10 December 2010 <,127365,en.pdf>

Pearson, Alan; Rick Wiechula, Anthea Court, & Craig Lockwood. “A Re-Consideration of What Constitutes “Evidence” in the Healthcare Professions”. Nursing Science Quarterly, 20.1 (2007).  

 Sonduck, Matthew. “Why the Business Group Believes in Using Evidence-Based Medicine in Benefits Design and Care Decisions”, Creative Health Benefits Solutions for Today, Strong Policy for Tomorrow, 2007. 10 December 2010 <>

Tanenbaum, Sandra J. “Evidence-Based Practice: What Does it Mean for Aging?” American Society on Aging, 2005. 10 December 2010 <>

Upenieks, Valda V., Jaleh Akhavan, & Jenny Kotlerman. “Value-Added Care: A Paradigm Shift in Patient Care Delivery” Nursing Economics, 26.5 (2008)


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