Nursing education must be developed and modified regularly with new content and competencies that reflect the ever-changing profession. It is not always an easy process, because medical facilities are already busy, but it is crucial to maintain the same high educational standards that have already been established for the profession. With regular reviews, nursing courses stay current with what nurses need to understand about providing safe care and meeting patients’ needs as technology, new treatments, and upgraded services become the norm in hospitals.
The American Association of Colleges of Nursing published a set of new standards for nurse training at degree level and above back in 2021, entitled The Essentials: Core Competencies for Professional Nursing Education. It set out to change and improve the practice of nursing by encouraging a shift in the way healthcare workers are educated. A key aspect of this report was the idea of nursing practice in four spheres of care, and how a thorough grounding in these can become part of the curriculum.
The four spheres are disease prevention/health and wellbeing promotion, chronic disease care, restorative or regenerative care, and palliative or supportive care. These apply to all the diverse patient populations that nurses will encounter throughout their careers and to the entire lifespans of these people. By breaking down nursing practice into spheres, educators can make the content of their courses more accessible and student progress becomes more measurable.
As a result, wherever student nurses train, they experience less of a gap between theory and practice and are ready to enter the profession as influential team members. Today, thanks to online providers like Wilkes University, the same level of current, informed, quality training is available online for student nurses. Remote learning and placements in local healthcare facilities are ideal for trainees with busy lives and pre-existing commitments.
At Wilkes University, people with unrelated degrees can qualify as nurses within fifteen months through the Accelerated Bachelor of Science in Nursing (ABSN). This online ABSN comprises practical clinical experiences, online coursework, and professional support from the faculty. New nurses will be ready to apply their competencies on graduation across all four care spheres.
Nurses engaged in this sphere can work in a range of medical settings from local clinics to urban physician’s offices and hospitals. They aim to support patients when it comes to making better lifestyle choices and improving their overall health. Along with preventive care measures, activities in this sphere can reduce the instances of disease.
Aside from direct patient care, nurses share health knowledge at community education sessions, during appointments, and in counseling sessions. Informed patients are in a better position when it comes to understanding the risks of smoking or obesity, for example, and they know how to begin making changes. This intersects with chronic disease and restorative care, as nurses in these areas also educate patients on how to manage their condition effectively and avoid a worsening of their symptoms. This will often involve lifestyle changes, such as eating more healthily or taking regular exercise.
Nurses are also cognizant of secondary prevention, or how susceptible a patient is when it comes to their risk factors of getting a disease. Nurses may suggest ways of reducing high blood pressure or facilitate the prescription of statins if a person has high cholesterol. These measures can prevent the full symptoms of a disease from developing and impacting a patient’s health more significantly. Continuous health assessment is part of this sphere, and that is why nurses in this field strive to develop good relationships with their patients. This nurtures trust, ensures people come back for follow-up appointments, and helps practitioners spot changes through annual screenings, making it likely that a health problem will be detected at an early stage and giving patients a better chance of making a full recovery.
Practitioners collaborate with other professionals to run patient tests and get patient’s additional help. This could be in the form of therapy from a counselor for help with stopping smoking, advice from a dietician on healthy eating or even encouraging them to sign up for a government-funded scheme, such as the Active People, Healthy Nation initiative. In this sphere of care, managing health problems and preventing new conditions from taking hold is the key. With regular support and follow-up appointments from their nurse, as well as other professionals in the care team, patients can take control of their wellbeing and live longer, healthier lives.
According to research carried out by Frontiers in Public Health, 99.5% of Americans who are over 50 have at least one chronic disease and that number is increasing. Many patients have a poorly controlled disease, and some suffer from more than one condition. This can have a significant impact on their health and lifespan. To improve outcomes in this sphere, nurses provide sympathetic support, medical interventions, and education to encourage good self-management in patients who are living with a chronic disease. This can help them to develop skills, change unhelpful or damaging behaviors, and feel motivated. It can also prevent people from relying on their medical team to make them feel better. Instead, they feel more in control of the situation and their condition.
Once a patient contracts a chronic disease, they will often require a sustained course of treatment over a long period. By following up on a patient’s progress regularly and closely, nurses can see and tackle problems at an early stage. These could be in terms of the patient not sticking with their treatment plan, a worsening of symptoms, or failing to respond to medication. To monitor a patient, the nurse may choose to conduct face-to-face appointments, schedule regular blood screenings, or have telephone appointments with the patient. Some may also use apps or medical devices to monitor their patients remotely. These strategies are not just about nipping problems in the bud, they also allow the nurse and wider team to show they are ready to help and care about the patient’s progress.
Taking part in interprofessional team care is one way that nurses ensure their efforts with chronic disease patients are successful. Although people with a chronic condition will always have a primary care physician, a range of clinical and self-management services will be provided by nurses and other practitioners. The patient care plan will be designed to draw on the diverse skills of the team. This includes designing treatment plans that include multidisciplinary care, using evidence-based courses of therapy, and promoting more effective self-management. No one professional has the time or experience to deliver each of these services, so there are many advantages to the patient when several practitioners collaborate.
After a patient has received an injury, been ill, or experienced a substantial medical intervention, nurses in the regenerative and restorative sphere will provide care. The goal is to get a person back to the stage they were at before the event and to allow them to function as well as possible. Specifically, nurses will work on patients having a full range of motion, or as near to that as they are capable of. They will also strive to help patients carry out daily living tasks, such as washing, dressing, and other aspects of personal hygiene.
A plan will be created to help the nurse set measurable goals and ensure the program of treatment encompasses all the challenges faced by a patient. The plan considers what the patient can do, and what they would like to do independently. It looks at the barriers the patient is facing when it comes to achieving these aims and what action can be taken to help the patient overcome their obstacles. During a course of treatment, the focus will always be on nurturing the patient’s strengths and abilities, rather than the tasks they struggle with. For instance, people who can drink independently, but struggle to eat, will always be encouraged to drink alone, and work can be done to improve their ability to eat.
In this sphere of care, assisting the patient with becoming more autonomous and independent is a basic goal. That is because when people can do things by themselves without asking for help, they often experience a better quality of life and have higher self-esteem. To support this aim, nurses will work collaboratively with social workers and home care providers to schedule visits and assistance which allows their patients to have more autonomy. The nurse may also work with orthotics experts and prosthetists to ensure people have a better quality of life.
Although restorative and rehabilitative care is often provided in specialist centers, or within hospitals during an extended stay, it will usually continue after the patient is discharged. The techniques learned will be practiced at home by the patient, with help from a home health assistant, or the patient’s family. Therefore, the nurse can also work with the patient and their family to help develop a support network outside of the medical world.
Serious diseases and medical conditions come with a range of side effects, and these can be difficult to manage. As well as tackling the social issues that come with an illness, patients must manage the emotional and physical side of their condition. Nurses who provide help with these challenges work within the sphere of palliative and supportive care. Their assistance is provided to patients alongside the treatments they are receiving to cure, slow, or halt their disease.
All ages of patients can receive this form of care and it can be offered at every stage of a more general treatment plan — the idea is to improve people’s quality of life. Nurses work to help patients manage their pain, reduce their symptoms, and deal with feelings of stress and anxiety over their condition. At the beginning of a course, the nurse will examine a patient’s current care plan to gain a deeper understanding of their condition. They will then devise a plan that considers the patient’s concerns, the secondary effects of their medication or illness, and the health goals they have.
Together with the patient, the nurse will write down the symptoms that are causing a problem. They will ask how the patient feels during an episode, how often these experiences happen, when during the day they happen, and how painful, or uncomfortable they are. In practical terms, the prescribed care could include a course of analgesics — medications that prevent pain — and advice on managing a medication plan. The nurse may also provide suggestions for care equipment, such as dosage boxes that make dosing medications easier, shower chairs for sitting down while washing, and wheelchairs, so patients can remain mobile when they are feeling weak.
Palliative care and supportive care are highly collaborative practices that complements the efforts of oncologists, pharmacists, and physiotherapists. The entire team around a patient can also include social workers, psychologists, and occupational therapists, but the professionals will vary depending on the needs of each patient.
As these four spheres of care become more established in nurse education, the workforce will be boosted by practitioners who meet the needs of diverse patients and deliver safe, effective care in several settings. As well as using science to support patient outcomes, they will be able to work in leadership roles and move into specialty practices, depending on their ambitions. The US healthcare system is always evolving and remains complex, but with a dedication to lifelong learning, both new and experienced nurses will be able to meet their goals in each sphere.