Clinical Nursing Skills for Nurses: from Evolution to Revolution

Up until the late 19th century, nurses were commonly viewed as free or inexpensive labor with very limited tasks. Clearly at the time, nurses were the victims of the prevailing medical working ethos which dictated that only doctors should be meeting the patient in a diagnostic encounter mode. By the beginning of the 20th century, nurses were allowed to practice some limited clinical skills with temperature recording being the most advanced technique they could perform. Yet, within 100 years, and in the new millennium now, clinical nursing roles have advanced to sophisticated interventions and evidence based clinical skills such as catheterization or complex monitoring.


Editorial
Up until the late 19th century, nurses were commonly viewed as free or inexpensive labor with very limited tasks. Clearly at the time, nurses were the victims of the prevailing medical working ethos which dictated that only doctors should be meeting the patient in a diagnostic encounter mode. By the beginning of the 20th century, nurses were allowed to practice some limited clinical skills with temperature recording being the most advanced technique they could perform. Yet, within 100 years, and in the new millennium now, clinical nursing roles have advanced to sophisticated interventions and evidence based clinical skills such as catheterization or complex monitoring.
The landmark evolution of clinical nursing in the USA was introduced in the late '70s when nurses were gaining a greater professional autonomy and distancing themselves from the established traditional dominance of medical authority. Yet, the paradox was that the more nursing was advancing to innovation, the more it was encompassing 'traditional' medical skills and roles [1].
Thus, nursing has evolved from a practice-based trade to a professional discipline that has reached a high scientific paradigm particularly within the last few decades. Yet, getting hard evidence and relevant sources across to a wider global nursing audience also needs constant attention and effort. One notable example is that pockets of sophisticated nursing excellence (especially from advanced western world centers) still remain inaccessible at large to nurse training in poorer countries. It is now time to find new ways of communicating nursing excellence in a easily recognized format and subsequently be freely conveyed to a wider nursing world.
With the rapid advancement of technology, significant changes need to be made to the way healthcare sectors operate. In addition, clinical nurses need to learn and adapt to using new materials, techniques and resources to optimize patient care delivery. Therefore, efficient and effective use of technology is also a key component of nursing education and training.
Another major challenge for contemporary nursing, especially in most countries of the western world, is the acute shortage of skilled registered nurses. This phenomenon is likely to be exacerbated by nurses migrating to specific countries seeking a better life and the looming shortage of medical staff in the countries they leave [2].
For many years nursing experience and expertise in terms of clinical skill development has been long identified as one of the most common stressful elements causing student anxiety in most nursing programs [3]. Nurses have identified lack of practical clinical experience, unfamiliar areas of care delivery, encountering challenging patients, fear of making mistakes or performance anxiety and the stress of being evaluated by other health care team members with lack of empathy as the main anxiety-producing situations in their routine clinical practice [4].
Yet, currently, the international literature today, thrives with resources which aim to improve and update clinical nursing skills. Almost all of these are on-line, but still most are not free of charge. These learning resources focus on almost all areas of clinical nursing skills as practiced daily in a wide range of clinical areas, including technical skills, basic and advanced patient care, nursing communication skills, cultural competency, critical thinking skills and decision-making skills. Thus, multiple resources to improve nursing skills and learning in order to meet both patient's holistic care needs and professional standards include: Multi-user virtual environments and Web-2 technology are now widely considered to be the 'next wave' of educational tools for nurses. These have been effectively used across a wide range of learners and subjects. Therefore, learning in virtual reality presents with many benefits and advantages over traditional teaching methods, including enhanced positive learning outcomes and positive processes.
Consequently, technology especially in the early 2000s has the ability to advance nursing skills by reaching a wide audience, demonstrating good clinical practice through new clinical roles, competences and innovation. Modern nursing identity is therefore becoming more intellectually demanding and advanced nurses are considered to be the cutting edge of nursing innovation, challenging the deep-seated traditions of medically orientated health professions and organisations. Nurses today are drivers of change and are more revolutionary in their approaches to improve patient care [5].
Therefore, the constant evolution of nursing from an art to include science especially in the last century led to extended professional autonomy and scientific body of knowledge unique for this discipline. The addition of more science into the art of nursing triggered an evolution of nursing skills leading to a revolution of the core sphere of nursing education and practice.
Hence, contemporary nurses must strive to keep updating and extending their clinical skills in order to meet the great potential of their mission in society.