The issues related to nursing involve a thorough
examination of nursing as theory and practice. The role of the nurse practitioner especially in areas of clinical decision
making and management could be studied in the contexts of obstetrics and gynaecological department or even emergency wards.
The emphasis of most studies is on reflective practice using Gibbs (1988) model of treatment and reflection. The need to follow
clinical guidelines as given by NICE or NHS have been emphasised in several studies especially highlighting the importance
of personal cleanliness and hygiene in infection control. The role of informed consent and clinical decision making in case
of pregnancy with family history of mental health problems suggest the central role of the challenges in the decision making
process (Papers4you.com, 2006).
The need for counselling and holistic care of patients
have been emphasised in clinical practice. The role of the nurse and the importance of proper knowledge of clinical guidelines,
NHS directives and adequate medical training suggest the crucial responsibility of the nurse who plays varied roles from that
of physician to hospital manager. The studies show the varied approaches to nursing as in case of a depressed patient, the
emphasis is on counselling and psychological support whereas in case of treating a patient with high blood pressure or multiple
injuries after accident, reflective practice on immediate measures followed would be more important, suggesting a focus on
patient centered outcomes (Bowcutt, et al 2006).
Clinical management is closely related to leadership
theories and it is important for the nurse to develop adequate leadership skills to effectively perform clinical duties (Booth
and Davies, 1991). The differences between the role of the health visitor, nurse and midwife in general practice have been
studied. Social and healthcare policy and guidelines on clinical governance suggest a multidisciplinary collaborative working
approach for effective clinical management (Papers4you.com, 2006). Collaborative teamwork, holistic psychosocial treatment
and proper allocation of clinical resources are some of the issues that are very important within intensive care units and
for care of emergency patients. The ethical and legal responsibilities of a nurse practitioner and the medical team in general
are largely guided by not just clinical guidelines set by the Department of Health but also by a team of dedicated health
professionals within the clinical setting.
The issues discussed in the field of nursing include
clinical governance, collaborative teamwork, the role of the clinical nurse practitioner, the importance of reflective practice,
Gibbs (1988) Model, clinical management and decision making, ethical and legal issues in clinical care and holistic approach
Booth J, Davies C. (1991) The management of change
on a nursing development unit. Nurs Pract.;4(2):12-5.
Bowcutt M, Wall J, Goolsby MJ. (2006) The clinical
nurse leader: promoting patient-centered outcomes. Nurs Adm Q. Apr-Jun;30(2):156-61.
Gibbs, G. 1988. Learning by doing: a guide to teaching
and learning methods. London: Further Education Unit.
Papers For You (2006) "P/N/89. Medical nurse: characteristics,
requirements, guidelines", Available from http://www.coursework4you.co.uk/sprtothers15.htm [22/06/2006]
Papers For You (2006) "C/N/42. Portfolio of the
nurse. Caring for patients suffering from depression. What is the nurses responsibility?", Available from http://www.coursework4you.co.uk/sprtothers15.htm [21/06/2006]