NSG6101 Nursing Research Methods

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Advanced Practice in Nephrology Nursing

         Nephrology nursing arose as a response to demands in advanced kidney care especially kidney transplantation and dialysis. Patient with chronic kidney diseases require individualized and specialty care that would ensure improved patient outcomes. The purpose of this paper to discuss the role of advanced nephrology nursing, the competencies of practicing nephrology and how this practice achieves the concepts of nursing professionalism and clinical decision-making.

Nephrology and Its Core Competencies

         Nephrology is an ANP that involves providing care to the kidneys. The South University Online programs in APN are aimed at providing academic and professional growth for adult learners through mentorship by qualified faculty staff. Hamric, Hanson, Tracy, & O'Grady (2014) described core competencies of APN that are vital in directing the practice of nephrology. One of the competencies is evidence-based practice. Nephrologists utilize research and education about kidney care to ensure that the care they provide results in better outcomes. Direct clinical practice is also a vital competency. The nephrologist is expected to provide nursing-centered through proper assessment, diagnosis, evaluation planning and implementation of treatment.

         Interprofessional collaboration is another significant competence for nephrologists; it encourages the nurse to form professional relationships that help in accomplishing their goals. Nephrology care entails interdisciplinary collaboration, which promotes comprehensive care to meet the needs of an individual patient. Leadership and management skills are crucial in this specialty of nursing since nephrologists are key in leading others to provide care. They also have a duty to mentor others to encourage development in the field of nephrology. Finally, nephrologists must maintain professional performance by ensuring ethical decision making, accountability, efficiency and safety of care. All legal requirements must be adhered to ensure that the rights and dignity of the patient are protected.

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Nephrology Practice

         Nephrology roles can be designated as clinical. These roles include the diagnosis, treatment, and management of kidney diseases such as kidney stones, cancers of the renal system, hypertension and electrolyte disorders. Some of the clinical processes that define nephrology as clinical include kidney transplantation, management of chronic kidney disease and dialysis. Diseases that affect the kidney are mostly systemic hence the need for expertise in handling them, especially through the nephrologist.

         Practice in nephrology greatly contributes to improved patient outcomes. This role promotes provision of patient-centered care which addresses the need of the patient (Sherwood &Zomorodi, 2014). Safety is guaranteed by the effectiveness of the specialized care provided that minimizes errors and harm to the patient. Administration of evidence-based patient-centered helps to provide quality treatment free from errors. Satisfaction levels among patients will increase when the desired outcomes are achieved.

         The current generation of patients is more inquisitive and conscious of their health hence the need for more knowledgeable personnel such as the nephrologist. Patients usually have predetermined mind when they come to seek medical care. In the course of informing and educating the patient about their health conditions patients will become more enlightened and with the ability to make informed health choices.

         According to Sherwood & Zomorodi (2014), teamwork and collaboration is a major component in nursing practice since care provision entails multiple providers. The interprofessional interaction encourages safety, and holistic care.  The multidisciplinary provision of care ensures the patient receives better treatment and attention that will enhance positive outcomes.

                                    Professionalism and Clinical Decision-Making

         The concept of clinical decision-making entails the efforts of the nurse utilizing ethical mechanisms to identify patient needs and coming up with implementable interventions to ensure best outcomes. Nephrologists must use all legal and nursing procedures in their decision-making process to ensure that the care they provide is of the best quality (Craven, Hirnle, & Jensen 2013).

Interview with Candace Simmons, FNP-BC, on 6/1/2018

         Candace Simmons is a Family Nurse Practitioner-Board Certified by the American Nurses Credentialing Center (ANCC). The interview entails various concepts to come up with a holistic view of nephrology nursing; different types of questions have been used including direct questions, indirect questions and interpreting questions. Some of the concepts include understanding the background of the interviewee, use of open ended questions for better answers and maintaining clarity as well as neutrality. The rationale for the questions includes giving insight for professional development in nursing, patient care and personal opinions on how the field of nephrology can be enhanced to encourage safety and provision of quality.

         The questions for this planned interview can be found in Table 1.

Conclusion

         Nephrologists are important practitioners involved in the management of chronic kidney conditions. The core competencies governing the nephrology practice include interprofessional team collaboration, critical thinking and informed decision making. Opportunities for nephrology training must be improved since statistics in the country indicate a deficit of the professionals as well as a reduced desire in joining the programs.

Table 1

Interview Questions

Number of Question	Question
1.	Kindly describe your professional journey and experience towards advancing into the field of nephrology. What prompted you to join the field of nursing and specifically nephrology against all other specialties?
2.	Tell me about the specialty of nephrology. What is the current state (Education and training, practice and human resource) of the profession in the country?
3.	Chronic diseases are a major challenge to the health system. What are some of the common ones that you come across in the line of duty?
4.	Have you ever thought of writing a journal, book or an article about your practice, life or nephrology in particular?
5.	What specific rare condition have you come across in nephrology practice? How did you manage the condition?
6.	What would you describe as your greatest accomplishment within your professional journey?
7.	I have come across patients who refuse treatment or do not want to adhere to treatment. How do you communicate to patients (especially the stubborn ones) and make them accept intense treatment procedures like dialysis?
8.	Most professions within the field of health are considered tiresome, burdensome since at times you flex beyond your muscle to cater for a patient. How do you lessen the challenges that come with care provision? What do you do to get relaxation? What is your hobby?
9.	What or who is your source of inspiration and motivation in your daily life and practice?
10.	According to you what could be the future of nephrology? What are the gray areas that need advancements through research?

 

References

1. Craven, R. F., Hirnle, C. J., and Jensen, S. (2013). Fundamentals of nursing. Wolters Kluwer Health/Lippincott Williams and Wilkins
2. Hamric, A. B., Hanson, C. M., Tracy, M. F., and O'Grady, E. T. (2014). Advanced practice nursing: An integrative approach. (5th ed.). Saunders.
3. Sherwood, G., and Zomorodi, M. (2014). A new mindset for quality and safety: the QSEN competencies redefine nurses' roles in practice. Nephrology Nursing Journal, 41(1), 15.