One night as I was working as a medical-surgical nurse, an elderly nurse in his late 70s was terminally ill. He called me as I walked around at the facility, taking care of bedbound patients and monitoring the situation of critically ill patients (Gondwe, Bultemeier & Bhengu, 2011). Patrick was one of those patients who constantly reminded me of my late grandfather. His family had consented to have him withdrawn from the life support machine in order to die a natural death. Patrick felt his time to die was due, but he needed someone by his bedside. He felt that he wouldn’t last for the next two hours, so it was not necessary to call his wife at that particular time. His desire was to have someone to sit with him as he departed out of this world. I had so much that I needed to achieve before the end of my shift, but his special need took precedence overwhelmed me. I sat there next to him and held his hand, holding and patting his hand.
Honestly, I was not ready to let him go, but I could see him struggling to open his eyes. However, he was so relaxed that he had met someone so gentle and willing to do as he needed. After a while, he slowly closed his eyes, and I knew he was gone. I made him presentable and then called his wife so that she could see him for the last time. I must admit that though I had a lot of work to finish, I needed more time to grieve together with Patrick’s family. This incident really challenged me and made me realize just how much I needed to work in an environment where I would have the opportunity to spend more time with patients who need special care (Cherry & Jacob, 2016). I needed a setting where I would have enough time with patients without having to worry about unattended duties or having to feel guilty for spending more time with a patient. After exploring the opportunities within the facility, I discovered that no position could allow having sufficient time with patients and their families.
The ideal research question for the challenge in this scenario would be; what impacts have the work environment had on the quality of patient care offered by nurses? Descriptive qualitative research methods would be used for data collection. In addition, a total of 20 nurses can be recruited for purposes of sampling. Data collection methods can include audiotaped interviews with nurses. The sample would include registered nurses from different settings, such as hospital care, mental health facility, nursing home care, and home care. According to Kieft et al. (2014), the quality of care provided by nurses is influenced by many factors, including adequate staffing, managerial support, working relationship, and proper shift scheduling. However, a more conducive environment for nursing practice is associated with quality patient care and better outcomes. Improvement in the nursing practice environment, specifically by giving nurses the autonomy and freedom to spend enough time with patients, improves the quality of patient care significantly (Flynn, Liang, Dickson & Aiken, 2010). The morale of nurses increases while patients feel appreciated and well taken care of, which increases the level of satisfaction.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Flynn, L., Liang, Y., Dickson, G. L., & Aiken, L. H. (2010). Effects of nursing practice environments on quality outcomes in nursing homes. Journal of the American Geriatrics Society, 58(12), 2401-2406.
Gondwe, W. T. M., Bultemeier, K., & Bhengu, B. R. (2011). Challenges encountered by intensive care nurses in meeting patients’ families’ needs in Malawi. Africa Journal of Nursing and Midwifery, 13(2), 92-102.
Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their work environment affect patient experiences of the quality of care: a qualitative study. BMC health services research, 14(1), 249.