Problem
Our facility has a philosophy of nursing, a document with many words that most nurses are not familiar with and that does not appear to guide practice.
Purpose
The purpose was to define what it means to be a professional nurse at our institution. The development of a framework enables the nurse to articulate the facets of nursing to peers and other health care providers as well as the community. Research has shown that a well-developed professional self-concept can positively affect the delivery of care
Description of the Project
A committee of CNSs and managers convened to determine a framework to serve as a model for nurses to clearly articulate their role. It was thought that a graphic representation of the facets of the professional nurse would have more of an impact than words on paper. Review of literature, hospital standards, and brainstorming assisted the committee to delineate the facets of nursing to include in the model.
Methods
The concepts were presented to the Professional Nurse Council, other managers, and CNSs to validate the model and seek broad support. It was decided that a survey should be conducted to ask nurses in the organization what they thought it meant to be a nurse. Through the survey process, nurses assisted the committee in ensuring that all elements of professionalism were covered in the model. Pictures of staff nurses were taken and life-size displays were used to collect the entries. Another method of implementation included the development of a 30 x 30 game board of the model with a spinner in the middle. This was utilized at staff meetings as well as during nurse's week to elicit discussion with nurses about the facets of nursing on their units. Crossword puzzles and word searches were also distributed and prizes awarded from a drawing of the returned puzzles. The model has also been integrated into orientation by the CNSs. By including a presentation in orientation, new nursing staff are exposed to the tone of professionalism.
Outcomes and Evaluation of Practice Change
A questionnaire with a Likert scale was developed by the committee to evaluate the nurses' perception of the model in their work environment. The initial survey will be repeated in 18 months to fully evaluate the impact of the model. Initial results reveal findings consistent with previous surveys. Opportunities for improvement include professional relationships with physicians and teamwork. Initial implementation efforts have been successful, and positive comments from many staff, CNS, and managers have been noted.
Implications
The findings from the research, as well as the model itself, will guide the growth of clinical excellence in nursing staff. These facets can serve as a basis for future evaluations on a managerial level, and also as a foundation for CNS to utilize for continued professional development with staff during rounds and in-services.
Section Description
This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.