- Email: [email protected]
And the beat goes on
Professional Practice And the Beat Goes On
T
HREE YEARS AGO, I was asked to write this column on a regular basis. "Of course," I said, "I have a lot to say about professional nursing practice." Over these past 3 years, I have said quite a bit. Perhaps some of it was important or helpful to other nurses struggling with the issues. Only time will tell. Curious things have happened in my practice since I began writing this column. I still provide care to residents at our teaching nursing home three mornings a week, but now patients are referred to me by physicians in our community. This has never happened before, and I was nervous about it at first. What was the "ultimate" motive in these referrals? Long-term practices of oppression can lead to feelings of paranoia. And paranoia changes very slowly. The ultimate motive is that a new respect for the unique contributions of nursing practice has developed in my community. I hear from other nurses that the same respect seems to be growing in other parts of the country as well. Professional nurses are being sought for their assistance in forging solutions to the complex problems that develop in caring for the very old. I also continue to see patients in the family practice clinic operated by the college of nursing. We now have more than 15,000 active patients, all served by faculty family nurse clinicians. The growth of this practice has been truly outstanding. Three years ago, there were about 4,000 active patients. Many of our new patients have been referred by other health care providers and by our satisfied clientele. Professional nursing practice is seen as an important part of the solution to the problem of access to primary care in an area that has no shortage of physicians or high-tech care. The early battles to justify our right to practice were bitter at times, but now are over. The faculty and I are frequently asked for our ideas on how to improve care for the elderly, the poor, and others who lack access to care. Now we
MICHAEL A. CARTER, D N S c , F A A N
Professorand Dean Collegeof Nursing University of Tennessee,Memphis Memphis,TN 38163 © 1989 by W.B. Saunders Company.
8755-722318910506-000453.00/0
believe that we must lead the way in our community and our region in addressing cost issues, continuity of care problems, and appropriate use of services. These examples and numerous others underscore this new mood that seems to be spreading over my corner of the world. Professional nursing practice is now accepted by our clients and policy makers as an answer to many of the problems that exist with health care and health care delivery. Smugly, we would like to say, "I told you so, and you would not listen!" However, we recognize that this sentiment is a bit unfair. The times were not right and we were not ready. The most wonderful aspect of the so-called nursing shortage is that professional nursing has shown that merely producing more and more nurses who are technically trained and grossly undervalued is not the way to take care of the needs of the population or to improve the health care system. Instead, we must listen to those who have been educated so well. If we are to bring abou t new ways to meet the health care needs of the decade and century ahead, we must now experiment and innovate with systems of care delivery that make full use of professional nursing's complete potential in practice. As other health care providers become more specialized, concentrating on smaller and smaller areas of the body, professional nursing continues to emerge as the epicenter of the human connection. What a challenge we present to ourselves as we rapidly push past the boundaries of our science base in our urgent drive to provide people with the quality and quantity of care they need and expect! We must focus on expanding our research base in concert with the even greater expansion of our clinical education programs at the doctoral level and the development of clinical postdoctoral educational programs. The application of vast quantities of scientific and humanistic knowledge requires that we develop expert educational programs that do not currently exist. The outstanding clinical faculty of the academic health science centers of this country have an obligation to deveIop these new programs just as nurse scientists developed predoctoral and postdoctoral programs to prepare future nurse scientists. As I close this chapter of my life as an assistant editor, I am much more optimistic about the future of professional nursing practice than I was when I began. The signs and the times are right. To paraphrase an old song from the 1960s, the beat goes on in the health care scene. Professional nursing is counting the cadence.
Journal of Professional Nursing, Vol 5, N o 6 ( N o v e m b e r - D e c e m b e r ) , 1989: p 2 9 9
299
T
HREE YEARS AGO, I was asked to write this column on a regular basis. "Of course," I said, "I have a lot to say about professional nursing practice." Over these past 3 years, I have said quite a bit. Perhaps some of it was important or helpful to other nurses struggling with the issues. Only time will tell. Curious things have happened in my practice since I began writing this column. I still provide care to residents at our teaching nursing home three mornings a week, but now patients are referred to me by physicians in our community. This has never happened before, and I was nervous about it at first. What was the "ultimate" motive in these referrals? Long-term practices of oppression can lead to feelings of paranoia. And paranoia changes very slowly. The ultimate motive is that a new respect for the unique contributions of nursing practice has developed in my community. I hear from other nurses that the same respect seems to be growing in other parts of the country as well. Professional nurses are being sought for their assistance in forging solutions to the complex problems that develop in caring for the very old. I also continue to see patients in the family practice clinic operated by the college of nursing. We now have more than 15,000 active patients, all served by faculty family nurse clinicians. The growth of this practice has been truly outstanding. Three years ago, there were about 4,000 active patients. Many of our new patients have been referred by other health care providers and by our satisfied clientele. Professional nursing practice is seen as an important part of the solution to the problem of access to primary care in an area that has no shortage of physicians or high-tech care. The early battles to justify our right to practice were bitter at times, but now are over. The faculty and I are frequently asked for our ideas on how to improve care for the elderly, the poor, and others who lack access to care. Now we
MICHAEL A. CARTER, D N S c , F A A N
Professorand Dean Collegeof Nursing University of Tennessee,Memphis Memphis,TN 38163 © 1989 by W.B. Saunders Company.
8755-722318910506-000453.00/0
believe that we must lead the way in our community and our region in addressing cost issues, continuity of care problems, and appropriate use of services. These examples and numerous others underscore this new mood that seems to be spreading over my corner of the world. Professional nursing practice is now accepted by our clients and policy makers as an answer to many of the problems that exist with health care and health care delivery. Smugly, we would like to say, "I told you so, and you would not listen!" However, we recognize that this sentiment is a bit unfair. The times were not right and we were not ready. The most wonderful aspect of the so-called nursing shortage is that professional nursing has shown that merely producing more and more nurses who are technically trained and grossly undervalued is not the way to take care of the needs of the population or to improve the health care system. Instead, we must listen to those who have been educated so well. If we are to bring abou t new ways to meet the health care needs of the decade and century ahead, we must now experiment and innovate with systems of care delivery that make full use of professional nursing's complete potential in practice. As other health care providers become more specialized, concentrating on smaller and smaller areas of the body, professional nursing continues to emerge as the epicenter of the human connection. What a challenge we present to ourselves as we rapidly push past the boundaries of our science base in our urgent drive to provide people with the quality and quantity of care they need and expect! We must focus on expanding our research base in concert with the even greater expansion of our clinical education programs at the doctoral level and the development of clinical postdoctoral educational programs. The application of vast quantities of scientific and humanistic knowledge requires that we develop expert educational programs that do not currently exist. The outstanding clinical faculty of the academic health science centers of this country have an obligation to deveIop these new programs just as nurse scientists developed predoctoral and postdoctoral programs to prepare future nurse scientists. As I close this chapter of my life as an assistant editor, I am much more optimistic about the future of professional nursing practice than I was when I began. The signs and the times are right. To paraphrase an old song from the 1960s, the beat goes on in the health care scene. Professional nursing is counting the cadence.
Journal of Professional Nursing, Vol 5, N o 6 ( N o v e m b e r - D e c e m b e r ) , 1989: p 2 9 9
299