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Many reforms have been made in many countries to improve provision of clinical care. Learning institutes provide programs and curriculum in medical department for students who want to pursue their career in medicine. Government ensures that upon offering a job to any person, has sworn to work according to the ethical standards. Advanced Practice Nursing has brought confusion due to roles played by nurses in hospital and the level of education required for a person to become a nurse. On the other hand, issues have risen in Clinical Nurse Specialist because of the change in technology and improvement in education system. Researches have criticized the practice; hence no perfect descriptions have been implemented, because each person brings up new opinion. Hamric came up with some characterizes explaining the provision of direct clinic care by APN.
Analysis of Hamric’s six characteristic
Use of holistic perspective
Hamric got concern about the patient and focused on inner issues of the patient which can assist in enhancing the provision of direct care. He focused on the wholeness of the patient and concentrated on things like spirit, soul and the body. He suggests patients issues should be incorporated to assist in recovery. Things like cultural, Christian beliefs, education, functional abilities and social stressors need consideration. He focused on those issues because people should get complete treatment, and this can be evidenced by serving the patient. When individuals fail to get respect of personal issues they feel betrayed, and they can change their perception (Hamric Sprouse and Hanson, 2009).
Hamric explains that all issues should be considered and before serving the patient the background information should be gathered and prepared to understand the need that person has and the way to handle him or her. The medical nurse should respect the personal dignity and put the religion, culture, education, ability, and disease in practice of care. They should provide treatment of clients in respect of those aspects. Hamric describes this characteristic has helpful and should be incorporated in provision of direct care to patient (Hamric Sprouse and Hanson, 2009).
The application and incorporation of those aspects in clinical care can not assist and when applied the care will not be appropriate. There some people who have different perception of life, and when asked about their inner life they can not give out details fully. Some patients spent only few hours in health care and in this case no enough time to interact with patient. In other occasions, there some Christian believes which can not assist in practicing clinical care. There some people who respect the Sabbath day, and they do not work but go to church. When this characteristic by Hamric applied it means that the patient will not receive medical attention even if required. The patient should comply with the roles of the person providing care and description because only professionals have the mandate to provide medical care (Scott, 1999).
Use of evidence as a guide to practice
Hamric suggest in employment of research in performance. Currently, the care provided need to change in order for the patients to receive the favorable care. The patients should get the attention required and not according to what stated in books or previous findings. The staffs should be flexible willing to research on improvement of the service. Hamric describes that the change in problems should have different ways option to handle. Change in technology has caused a great change in provision of care, and the APN should provide research on application of emerging technology in provision of care. APN should collaborate with other people in the filed and get materials from internet and other sources to improve their performance (Redekopp, 1997).
Expertise clinical reasoning and skillful performance
Hamric stress out the aspect of consultation, and clarifies the prominent consultation to include four aspect of which should be applied to the patient and they should have positive outcome. The aspects include assessment, intervention, evaluation and finally reassessment. If all this aspect fails the APN should consult a physician to get assistance and help of what should be done. The staffs provide additional care and explain the problem and the means to solve the patient’s problem. Hamric describes this aspect as an additional knowledge gathered by APN to handle such situation in future without consulting the Physician (Harrell, 2003).
APN should incorporate this characteristic described by Hamric since it assist a lot in making the APN to work according to professional ethic. Skillful performance will make the APN to handle the patient with care and make sure the treatment administered to patient assist. When the problem is out of control the APN should consults a physician and this improves the performance and makes the staff to know what she/he did not know. Application of clinical reasoning and skillful performance leaves the patient certified and both the patient and the APN cerebrates, because when the patient gets better the nurse becomes confident because of working successfully (Benner Tanner and Chelsea, 2009).
Use of reflective practice
The author beliefs in reflecting on past issues can help in solving the current issues. He has a strong belief in the word of God and the belief brought out by the caring parents who told him the word of God. The author beliefs that the reflection he has on past things has helped him to have a favorable life, though he could not write them note book to remember. He suggests that by reflection of what has occurred in the past can make people to avoid mistakes done and improve their performance. The APN should reflect the practice done and decide on how to work better basing the performance from past experience. They should have an attitude of learning things from practices they make in patients (Harrell, 2003).
Reflection of practice can sometimes not be relied, because all the staffs go to professional colleges to practice and learn practicing procedure. Some practices made make the staff have negative attitude towards the work. For example, when the patient’s responds arrogantly to the staff this creates misunderstanding, and the staff dislikes serving such patients. The reflection of such practice can make the service provider to develop negative attitude in provision of care and finally abandon the profession or work against the code of ethic (Benner Tanner and Chelsea, 2009).
Formation of therapeutic relationship with patients
According to Hamric idea the patient and the nurse should have theoretical relationship. One should know the patient and understand each other before service. The patient should be aware of the person serving him. For example, Orthodox Jew shakes hand of individuals as a sign of greeting. The nurse in provision of service should not only shake the hand but ask the patient first if is permissible for him to shake the hand. The nurse should not get annoyed of this custom but should understand and learn how to deal with other and receive the patient with welcoming mood. Hamric also states things like cultural differences makes the people involved in provision of care and the patient to have misunderstanding. He believes that application of open communication makes the patient and APN staff to understand each other and they solve their cultural differences (Scott, 1999).
This characteristic can not be applied since some people have negative attitude toward other. Some communities feel superior, and they belief they can not get services from minority ethnic groups. Hamric description can not help people in practicing, since when a person with negative attitude towards some communities notes that the person in his service belongs to that ethnic group he will not accept the care. The relationship which can assist in care is only the treatment relationship but knowing each other can make some patients loose confidence to the APN staff (Redekopp, 1997).
Diverse approaches to health and illness management
Hamric put across this characteristic as the most important in APN practice. He suggests that APN should collaborate with other people in clinical department in order to receive new skills. They should incorporate team work in practice and this will assist in mixing of ideas in which each person brings up suggestions of what to apply for provision of care to different patients with different cases. The application of team work can not be applied in emergency room, because the Tennessee states law states that a physician should perform in an emergency room, and the emergency room setting does not require many people. He stress on the provision of care and financial management by patient. APN should utilized resources in order to provide care to the patient with minimum cost which will help all people of different class to receive the care without straining (Scott, 1999)
All states should take in to consideration the activities performed in direct clinic care, and provide regulations to govern the provision of services. This will improve the performance in the provision of direct clinic care. Education improvement for professionals will assist in the provision of high quality direct clinic care, because professionals work ethically.