Running head: NURSING AS A DISCIPLINE

The Field of Nursing as a Discipline

Review of Literature
Savannah Palmer
University of Texas at El Paso

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Abstract:

A nurse is a health care professional who is engaged in the practice of nursing. Nurses are
men and women who are responsible (along with other health care professionals) for the
treatment, safety and recovery of acutely or chronically ill or injured people, health maintenance
of the healthy, and treatment of life-threatening emergencies in a wide range of health care
settings. Nurses may also be involved in medical and nursing research and perform a wide range
of non-clinical functions necessary to the delivery of health care. Nurses develop a plan of care,
sometimes working collaboratively with physicians, therapists, the patient, the patient's family
and other team members. In the U.S. (and increasingly the United Kingdom), advanced practice
nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and
prescribe medications and other therapies. Nurses may help coordinate the patient care
performed by other members of a health care team such as therapists, medical practitioners,
dietitians, etc. Nurses provide care both interdependently, for example, with physicians, and
independently as nursing professionals.

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The Field of Nursing as a Discipline

Review of Literature

The medical field is the scientific discipline that deals with finding cure for every
conceivable type of illness and disease. But when it comes to the medical profession, people
usually envision doctors with stethoscopes and surgeons with surgery knives. Even though these
two are typical representations of the medical profession, in reality, nurses are the ones that most
medical facilities cant do without. Nurses support the general practitioners, physicians, dentists
and surgeons, and provide hands-on care for the sickly and the injured. Their importance spans a
great deal of other aspects that underlie most forms of medical treatment. Nurses are also there
throughout major milestones and challenges of our life childbirth, accidents, and surgery.
They are always there to put the doctors words into action and to provide the best possible
treatment and care for us.
This review should provide a look into some of the medical field and how important
nurses really are. The health care profession of nurses contributes to society in numerous ways
from the care of an individual to the care of families and communities by attaining, maintaining
and recovering optimal health and the initial quality of life. Theyre needed in so many ways,
and research should analyze those aspects by answering the following questions:
1.
2.
3.
4.

What is a nurse and what do they do?

How does a person become a nurse?
How do the separate nursing fields differ?
How does a nurse obtain a relationship with their patient?

What is a Nurse and What Do They Do?

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Nurses are an essential part of the medical field. While a doctor is the one who decides
which treatment a patient has to take and also keeps track of the patients improvement; nurses
take care of almost everything else. Nurses mostly take the vitals of a patient (i.e. blood pressure,
heart rate, and temperature) before a doctor sees them, as well as assist the doctor with many
other things. A nurse is a healthcare professional who is focused on caring for individuals,
families, and communities, ensuring that they attain, maintain, or recover optimal health and
functioning. Nurses are capable of assessing, planning, implementing, and evaluating care
independently of physicians, and they provide support from basic triage to emergency surgery.
According to the International Council of Nurses (2015)"Nursing encompasses autonomous and
collaborative care of individuals of all ages, families, groups and communities, sick or well and
in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill,
disabled and dying people. Advocacy, promotion of a safe environment, research, participation in
shaping health policy and in patient and health systems management, and education are also key
nursing roles. "Some agencies highlight the duty of nurses to assist individuals in performing
activities that contribute to health, recovery, or peaceful death that the patients would perform if
they had the strength, will, or knowledge required. Nurses strive to achieve the best possible
quality of life for their patients, regardless of disease or disability. They use clinical judgment to
protect, promote, and optimize health, prevent illness and injury, alleviate suffering, and
advocate in health care for individuals, families, communities, and populations. The Oxford
Dictionary (2015) defines a nurse as a person trained to care for the sick of infirm, especially in
a hospital, though they do much more than just that. Using their considerable knowledge, they
protect patients from the risks and consequences of illness, disability, and infirmity, as well as
from the risks and consequences of the treatment of illness. They also protect patients from the

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risks that occur when illness and vulnerability make it difficult, impossible, or even lethal for
patients to perform the activities of daily living - ordinary acts like breathing, turning, going to
the toilet, coughing, or swallowing. If you analyze the words and images of campaigns used to
recruit nurses into the profession or listen carefully to the stories nurses tell about their work,
nurses may not use the available research to fully explain why what they do is so critical to
patient outcomes. Although many studies, conducted by nursing, medical, and public health
researchers, have documented the links between nursing care and lower rates of nosocomial
infections, falls, pressure ulcers, deep vein thrombosis, pulmonary embolism, and deaths, most
promotional campaigns and many stories nurses themselves tell about their work ignore these
data. Instead, nurses focus on their honesty and trustworthiness, their holism and humanism,
their compassion, and their caring. The problem is that when they focus on caring, they often
sentimentalize and trivialize the complex skills they must acquire through education and
experience. They often fail to explain that caring is a learned skill and not simply a result of
hormones or individual inclination. After all, knowing when to talk to a patient about a difficult
issue, when to provide sensitive information, when to move in close to hold a hand or move
away at a respectful distance all are complex decisions a nurse makes. To make these decisions,
nurses use equally complex skills and knowledge they have mastered. But all too often nurses
make these skills and knowledge invisible or describe nursing practice in terms that are far too
limited.

How Does a Person Become a Nurse?

Becoming a nurse is a long road of school, internships, exams, and work. But firstly, how
can somebody decide if they should even become a nurse, and why should they become one? If

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you want a calm, 9 a.m. to 5 p.m. desk job with little variation in the daily routine, nursing is
probably not a good career choice. But if you function well in an active, ever-changing
environment and can handle some stressful days, nursing might be for you. Nursing typically
offers good salaries and benefits, a variety of specialty fields to choose from and a career that is
in demand worldwide. You'll have the opportunity to positively affect the quality of life of the
patients in your care, with the knowledge that your decisions can make the difference between
life and death. Molly Thompson provides steps you can take in the Houston Chronicles (2012,
para. 2-4). A good first step is to ask yourself why you think you might want to become a nurse.
Make a list of what a nursing career might offer you and another of what you want from any
career. If these two lists have many similarities, nursing might be a good career choice. If, on the
other hand, the lists diverge in too many key areas, nursing might not be the way to go. For
example, if fame and fortune are important to you, nursing seldom offers those things. But if
your ideal career choice involves caring for others, feeling like you make a difference and
working with people every day, nursing can fit the bill. A good thing to do is perform a realistic
self-assessment to identify whether you have what it takes to be a nurse. Successful nurses need
to be emotionally steady and able to cope well with constant change. They need strong
communication skills and the ability to interact well with people in stressful situations. Most
importantly, they must have strong compassion and enjoy caring for others. Volunteer at a
hospital or clinic to observe nurses first-hand or perhaps get an opportunity to assist with patient
care. Visit the guidance office at your high school or career center at your college to talk to a
counselor about your career goals and whether nursing might be a good choice for you. Evaluate
your academic strengths. Are you strong in math and sciences? Successful, modern-day nurses
need to be. You also need to be willing to continue your education throughout your career, to

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keep up with continuous changes in medical treatments and technology. Think about whether
you'll be able to balance the demands of working and periodically taking courses at the same
time. Thompson (2012) says that one of the biggest factors is to assess your physical condition
and be honest about whether you're willing to commit to staying strong and healthy. Nurses face
long hours on their feet, erratic meal and sleep schedules, and even infrequent bathroom breaks
at times. They must be able to handle heavy patients and large pieces of equipment. Keeping
yourself physically healthy is essential to managing the physical, mental and emotional strain of
being a nurse. Next, if you decide on becoming a nurse, why? Nursing Links article, Nursing
101 (2015) has the answer. One of the main reasons people choose nursing is because the money,
an average registered nurse makes more than $52,000 a year and more experienced and
specialized nurses make over $72,000. . A nurse can work in different kinds of establishments,
each offering unique work environments. For example, a nurse can work in hospitals, schools,
home care facilities, government agencies, and so on. Nurses can work in flexible schedules, and
take up shifts as desired. Shifts are between 4 to 12 hours a day, and a nurse can opt for the best
shifts to accommodate other side jobs or education opportunities. As a nurse, youll make a huge
difference in peoples lives. A caring and compassionate nurse is considered as a guardian angel
by patients. This can be a very satisfying and gratifying career for the compassionate. As a nurse,
you get the opportunity to interact with patients, medical staff, doctors and administrators every
day. This gives you the opportunity to learn from other careers and add to your knowledge base,
while sharpening your interpersonal skills. Youll never know whats going to happen at any
given point in time. Theres constant excitement and challenge in a nurses life. You have the
opportunity to make swift decisions, learn each day and never get bored, as each day is different.
Nursing allows for many career advancements. You can aspire to take on bigger roles, or even

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continue education to perform in different capacities. You can change specialties and move on to
a health care specialty that suits your better. For example, if you like children, you can work in
the pediatrics department. If you like being on hand to assist in trauma cases, you can work in the
emergency room. You can decide what you want to do based on your aptitude and your tolerance
level. Unlike a lot of jobs, you work anywhere you want. Your skills are a nurse are entirely
portable and with the right qualifications, experience and recommendations, youre able to shift
to any state in the country and practice your nursing skills there. You dont need any equipment
or facilities to do your job. Your skills as a nurse are universal, and youll be able to help others
without needing four walls in which to work. Just like doctors, your skills come in useful when
theres an accident, or crisis. Youll be valued anywhere you go, as you represent a person who
can help heal illnesses and distress in people. You can easily qualify to become a practical nurse
and even a registered nurse. The best thing is, you can work as a regular or practical nurse while
studying to be a registered nurse. The friendly shift timings help you to achieve your educational
aspirations. Your background as a nurse helps you advise people in general about how to live life
in a clean environment. You can educate people in poor localities and also work with the
homeless, bringing sanitation and wellness into peoples lives. You can always get paid better by
completing higher nursing or medical care degrees. As a nurse, you have many career
opportunities that can be achieved via further education. You help care for the health of your
family and friends. Your nursing education and experience prepares you to handle family
emergencies; this is a definite advantage if you have children of your own. Youre able to work
in the medical field alongside doctors but you dont have to study for 12 to 14 the way doctors
have to. With 2 or 4 years of professional education, you can work alongside top medical
professionals and contribute to healthcare. If something goes wrong with a patient, the doctor is

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liable for malpractice, not the nurse. However, that doesnt mean you can afford make costly
mistakes. You get to spend a lot of time with patients and build lasting relationships. You get the
chance to meet some unique people and this will enrich your life experience. Doctors seldom get
the time to spend with patients. When a doctor picks a specialty, he or she has to stick to it, as
changing the specialty means continuing education. However, as a nurse, youre able to change
specialties and shift from pediatrics to trauma to cancer ward by attending an orientation training
session and hands on. You can start your career with a minimum amount of debt, unlike doctors,
who have to spend a lot of money to graduate and specialize before they start making returns on
their investments. The schooling to become a nurse can be the most difficult. Most nursing
degree programs take a minimum of two to three years to complete. The American Nurses
Association says that every state and the District of Columbia has a board of nursing with a
mission of protecting the public from harm. The ANA also says governance of the practice of
nursing includes establishing requirements for initial licensure and retaining basic education,
continuing education and/or competency, interpreting scope of practice parameters, defined by
state statute (nurse practice act), investigating complaints of licensees and disciplinary actions.
While the basic requirements for becoming a nurse are getting an associate degree in nursing,
applying for a nursing license and taking the National Council Licensure Exam, it really depends
on which program you want to join and what level of nurse you want to be. The National Council
Licensure Exam is a nationwide examination for the licensing of nurses in the United States and
Canada since 1994 and 2015, respectively. There are two types, the NCLEX-RN and the
NCLEX-PN. After graduation from a school of nursing, one takes the NCLEX exam to receive
his or her nursing license. A nursing license gives an individual the permission to practice
nursing, granted by the state where he or she met the requirements. NCLEX examinations are

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developed and owned by the National Council of State Boards of Nursing, Inc. (NCSBN). The
NCSBN administers these examinations on behalf of its member boards which consist of the
boards of nursing in the 50 states, the District of Columbia, and four U.S. territories, American
Samoa, Guam, Northern Mariana Islands and the Virgin Islands. To ensure public protection,
each board of nursing requires a candidate for licensure to pass the appropriate NCLEX
examination, NCLEX-RN for registered nurses and the NCLEX-PN for vocational or practical
nurses. NCLEX examinations are designed to test the knowledge, skills and abilities essential for
the safe and effective practice of nursing at the entry-level.

How Do the Separate Nursing Fields Differ?

There are quite a few sub-fields of nursing such as paramedics, emergency care, and
pediatrics, but theres way too many so theres only a couple described here. The American
Academy of Pediatrics (AAP) (2015) describes pediatrics as the branch of medicine that deals
with the medical care of infants, children, and adolescents, and the age limit usually ranges from
birth up to 18 years of age, in some places until completion of secondary education, and until age
21 in the United States. The AAP also explains the difference between adult and pediatric
medicine. The body size differences are paralleled by maturational changes. The smaller body of
an infant or neonate is substantially different physiologically from that of an adult. Congenital
defects, genetic variance, and developmental issues are of greater concern to pediatricians than
they often are to adult physicians. A common adage is that children are not simply "little adults".
The clinician must take into account the immature physiology of the infant or child when
considering symptoms, prescribing medications, and diagnosing illnesses. Pediatric nurses are
very different from other kinds of nurses. A major difference between the practice of pediatric

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and adult medicine is that children, in most jurisdictions and with certain exceptions, cannot
make decisions for themselves. The issues of guardianship, privacy, legal responsibility and
informed consent must always be considered in every pediatric procedure. Pediatricians often
have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in
their own legal class, having rights to their own health care decisions in certain circumstances.
The concept of legal consent combined with the non-legal consent (assent) of the child when
considering treatment options, especially in the face of conditions with poor prognosis or
complicated and painful procedures/surgeries, means the pediatrician must take in to account the
desires of many people, not just the patient. Paramedics are the EMS in the ambulances. They
work predominantly in the pre-hospital and out-of-hospital environment. Paramedics have it the
worst, though. (Disclaimer: Im about to say a very true, and very gross story.) -- One of my
friends was a paramedic because he thought that they were the most important part of emergency
care, and he didnt want a boring hospital job. On one of his calls, he had to tend to a car crash
where the patients were two parents and an infant. This accident was so bad that a piece of
shrapnel went through the car window and cut off the babys head. My friend was the one who
had to search the side of the road for the babys skull. -- So paramedics have to be the strongest
kind of nurses not just physically, but mentally. Seeing some of the stuff they do is really quite
traumatizing and not for the weak-stomached. Anyways, theres different levels of nursing.
Registered Nurses (RNs), Advanced Practice Registered Nurses (APRNs) and Licensed Practical
Nurses (LPNs) also called Licensed Vocational Nurses (LVNs). According to the ANA (2015)
there are approximately 3.1 million active registered nurses in the United States. The Oxford
Dictionary (2015) describes a registered nurse as a clinician who has completed at least an
associate degree in nursing or a hospital-based diploma program. The RN has successfully

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completed the NCLEX-RN examination for initial licensure. Associate degrees in nursing
frequently take three years to complete because of the increased volume of undergraduate
coursework related to the profession of nursing. Bachelor of Science in Nursing degrees include
more thorough coursework in leadership and community health. Specialty certification is
available through organizations such as the American Nurses Credentialing Center, a subsidiary
of the American Nurses Association. After meeting the eligibility requirements and passing the
appropriate specialty certification exam, the designation of Registered Nurse Board Certified
(RN-BC) credential is granted. The Oxford Dictionary (2015) says an APRN is a nurse with
post-graduate education in nursing with advanced didactic and clinical education, knowledge,
skills, and scope of practice in nursing. APRNs demonstrate effective integration of theory,
practice and experiences along with increasing degrees of autonomy in judgments and
interventions. Intensive post-graduate education is designed to teach an APRN to use multiple
approaches to decision-making, manage the care of individuals and groups, engage in
collaborative practices with the patient or client to achieve best outcomes; provide a supportive
environment for colleagues; manage the utilization of staff and physical resources; engage in
ethically justifiable nursing practice; protect the rights of individuals and groups; engage in
activities to improve nursing practice; develop therapeutic and caring relationships; fulfill the
conduct requirements of the profession; act to enhance the professional development of self; and
function in accordance with legislation and common law affecting nursing practice .APRN
education forms the basis of four recognized general areas of specialization: Nurse anesthetists
(in the United States, certified registered nurse anesthetists or CRNAs) Nurse midwives (in the
United States, certified nurse midwives or CNMs) Clinical nurse specialists (CNSs) Nurse
practitioners (NPs). Each nurse specialty, especially NPs, can have sub-specialties or

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concentrations in a specific field or patient population in healthcare. Each has a unique history
and context, but shares the commonality of being an APRN. While education, accreditation, and
certification are necessary components of an overall approach to preparing an APRN for practice,
these roles are regulated by legislation and specific professional regulation. This allows for
prescribing and referral, insurance reimbursement, and admitting privileges to health care
facilities. In the US, the licensing boards are governed by state regulations and statutes and are
the final arbiters of who is recognized to practice within a given state. While APRNs are
educated differently depending on their specific specialty, all APRNs are now trained at the
graduate level and are required to attain at least a master's degree, generally a Master of Science
in Nursing in their field of concentration. In 2004, The American Association of Colleges of
Nursing (AACN) in conjunction with the National Council of State Boards of Nursing (NCSBN)
recommended that advanced practice registered nurses move the entry level degree to the
doctorate level by this year. Accordingly, all APRN training programs are recommended (but not
required as of yet) to convert their master's degree to a Doctor of Nursing Practice degree by this
year. Although the American Association of Nurse Anesthetists approved this recommendation, it
is not requiring program compliance until the year 2025. The majority of programs will grant a
DNP. Because 45% of the nurse anesthesia programs are located in schools of allied health, these
programs will award a Doctor of Nurse Anesthesia Practice (DNAP). The DNP will be the directentry, minimum academic requirement for advanced practice registered nurses; it is a
clinical/practice-based doctorate but because it is not the entry degree for the profession of
nursing (which includes advanced practice registered nursing), it is a terminal degree.
How Can a Nurse Obtain a Relationship with Their Patients?

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The nurse-patient relationship can be sacred, in the way that patients lives are in the
hands of their nurse. Nurses are expected to always act in the best interests of the patient to
maintain a relationship that is strictly with all intent to only benefit the client. The nurse must
ensure that their clients needs are met while being professional. Extensive research and clinical
observation has shown that the body, mind and emotions are in unity. Therefore, in order to help
another person, one must consider all these aspects; this means not neglecting the person and
strictly just treating the illness. Caring for patients is beyond the treatment of disease and
disability. The necessary knowledge aspects that are needed to maintain a therapeutic nurseclient relationship are: background knowledge, knowledge of interpersonal and development
theory, knowledge of diversity influences and determinants, knowledge of person, knowledge of
health/illness, knowledge of the broad influences on health care and health care policy, and
knowledge of systems. Background knowledge is the nurses education, and her life experience.
Knowledge of interpersonal and development theory is the knowledge of theories of the sense of
self and self-influence on others. The specific theories are: The Interpersonal Theory, Object
relation theory, Developmental theory, and Gender/developmental theory. Knowledge of person
explains that nurses must take the time to understand the client, and their world; what is
meaningful to them, and their history. Knowledge of Health and Illness is the knowledge that the
nurse must attain about their clients health issue. Knowledge of the broad influences on health
care and health care policy explains that nurses need to be aware of the influences of the clients
care; social/political forces, expectations of health-care system, and changes in accessibility, and
resources. Knowledge of Systems explains that the nurse needs to know about the health-care
system so they can help their patients access services. Effective communication in nursing entails
being empathic, non-judgmental, understanding, approachable, sympathetic, caring, and having

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safe and ethical qualities. The first statement of the CNO Standard is Therapeutic
Communication, which explains that a nurse should apply communication and interpersonal
skills to create, maintain, and terminate a nurse-client relationship. All of the aspects to a
therapeutic relationship are interrelated. You cannot efficiently use one aspect without the other;
they are all connected and work together to create a successful relationship. Nurses assist clients
to achieve their health related goals including improving their relationship with others. "The help
that nurses offer to their clients is much more than technical expertise. The relationship between
nurse and client is a powerful healing force by itself.
Conclusion
In conclusion, the literature reviewed different areas of nursing and the field as a career.
Nursing is a vast and rewarding career to be in. A nurse is more than a caregiver, nurses are the
people who help you gain strength and well-being. The following four questions focused the
research towards topics that the reader may encounter in the future or have an opinion on now:
1.
2.
3.
4.

What is a nurse and what do they do?

How does a person become a nurse?
How do the separate nursing fields differ?
How does a nurse obtain a relationship with their patient?

Nurses are crucial to the healthcare system and medical fields because of their compassion and
education in their fields. To put it as simply and clearly as possible, nursing is as important as
any other component of the projects they undertake in helping colleagues around the world
improve the capacity, quality, efficiency and safety of health care. Helping their colleagues
develop top-notch nurses is as big a priority to us as ensuring there are top-notch physicians and
administrators. One reason is fairly obvious: nurses tend to spend more time in direct contact
with patients than physicians do, and so the patient experience is highly influenced by what goes

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on with nursing. As nurses continue to move full speed into the era of patient-centered medicine,
the ability of nurses to affect the perceived quality of care is becoming more significant.

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References

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2. Alyson, J. (2012, October 8). Different jobs in the nursing field. The Houston Chronicles.
Retrieved October 17, 2015, from http://work.chron.com/list-different-jobs-nursing-field14283.html
3. Gordon, S., & Nelson, S. (2005). An end to angels. American Journal of Nursing, 105(5),
62-69. Retrieved October 18, 2015, from
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4. Hornby, A. (n.d.). Oxford Advanced Learner's Dictionary of Current English (9th ed.).
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6. Olshansky, E. (2011). Nursing as the most trusted profession: Why this is important.
Journal of Professional Nursing,27(4), 193-194.
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7. What is nursing? (2015, October 1). Retrieved October 19, 2015, from
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8. What nurses do. (n.d.). Retrieved October 19, 2015, from
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9. What we do. (n.d.). Retrieved October 19, 2015, from http://www.icn.ch/what-wedo/what-we-do/

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