TEXT B　Contemporary Professional Nursing

Dimensions of Nursing Practice

Currently in China，the practice of nursing is related to the following aspects or dimensions:

Clinical nursing.In clinical nursing，nurses generally practice in hospitals.Clients are the recipients of clinical nursing.Clinical nursing practice is implemented based on nursing science and related disciplinary theories，knowledge and skills.Evidence-based nursing，holistic nursing ideas and perspectives affect the practice of clinical nursing.Clinical nursing practice includes basic nursing，specialty nursing and diagnostic and treatment nursing skills.

Community-based health care.Community-based health care，as the term indicates，is nursing care directed toward a specific population or group within the community.In community-based health care，or more specifically，community nursing，nurses work in communities.Nurses use clinical nursing knowledge and skills to provide services aiming at health promotion，health maintenance and illness prevention.

Nursing education.Nursing education refers to formal learning and training in the science of nursing.It involves the application of educational theories in training nursing students with the necessary knowledge and skills to practice nursing.The aim of nursing education is to develop nursing students morally，psychologically，intellectually and aesthetically.

Nursing management.Nursing management is performing the leadership function of governance and decision-making within the nurse-related health care organizations.It includes processes common to all management like planning，organizing，staffing，directing and controlling.The major components of nursing management include the person （namely，nurses），fiscal and human resources，equipment and facilities，time，and information.The aim of nursing management is to ensure the services provided by nurses are appropriate，timely，safe，and effective in order to meet the clients' health care needs.

Nursing research.Nursing research is “the systematic，rigorous，logical investigation that aims to answer questions about nursing phenomena”.Nursing research requires the researcher to follow the steps of the scientific processes.There are two types of research，quantitative and qualitative.Nursing research generates a specialized scientific knowledge base that empowers the nursing profession to anticipate and meet constantly shifting challenges and to maintain social relevance.

Models of nursing care delivery

Nursing care delivery models provide a framework to organize the work of caring for patients.There are basically three methods for assigning nurses to the day-to-day care of patients in the hospital.They are functional nursing，team nursing，and primary nursing.

Functional nursing.Functional nursing divides nursing work into functional units that are then assigned to one of the team members.In this model，each care provider is responsible for specific duties or tasks.Hence，in functional nursing，the emphasis is on the task.The advantages of utilizing functional nursing include:（1）care can be delivered to a large number of patients in a short time； and （2）auxiliary health workers with certain nursing skills can be used when there is a shortage of registered nurses （RNs）.The disadvantages of this care delivery model are obvious，the care of the patient is fragmented； patients are usually not treated as individuals or given comprehensive care.

Team nursing.Team nursing is a care delivery model that assigns staff to teams that are then responsible for a group of patients.A unit is divided into two or more teams，each led by a registered nurse.The team leader supervises and coordinates all of the care provided by those on the team.Care is divided into the simplest components and then assigned to the care provider with the appropriate level of skills.The advantages of adopting team nursing include:（1）high-quality comprehensive care can be provided despite a relatively high proportion of ancillary staff on the team； （2）each member of the team is able to participate in decision making and problem solving； （3）each team member is able to contribute his/her own special skills in caring for the patient； and （4）team nursing has demonstrated improved patient satisfaction； and （5）an RN directs and evaluates the care of all patients.However，there are disadvantages:communication is complex within the team，a team may not always work effectively together； the team leader may not have the leadership skills required to effectively direct the team； and shared responsibility and accountability can cause confusion and lack of accountability.

Primary nursing.Primary nursing is a care delivery model which emphasizes continuity of care by having one nurse （called the primary nurse）organize complete care for a small group of inpatients within a nursing unit of a hospital.The primary nurse is responsible for planning and evaluating the care delivered to the assigned patients 24 hours a day.Associate nurses care for the patient when the primary nurse is not working.The advantages of this model include:（1）development of a trusting relationship between the patient，family and primary nurse； （2）encouragement of a holistic approach to care，facilitation of continuity of care； （3）definition of the accountability and responsibility of the nurse in developing a plan of care with the patient and family； and （4）authority for clinical decision making is given to the nurse at the bedside.However，the cost is high due to the requirement of a higher RN skill mix.Additionally，nurses report stress，role overload，and role ambiguity.

New Words

dimension ［daɪˈmenʃn； dɪˈmenʃn］ n.　方面；［数］维；尺寸

implement ［ˈɪmplɪm（ə）nt］ vt.　实施，执行；使生效

holistic ［həˈlɪstɪk］ adj.　整体的；全盘的

perspective ［pəˈspektɪv］ n.　观点，视角；远景

aesthetically ［iːsˈθetɪkli； esˈθetɪkli］ adv.　审美地；美学观点上地

component ［kəmˈpəʊnənt］ n.　成分；组件

fiscal ［ˈfɪskl］ adj.　会计的，财政的

empower ［ɪmˈpaʊə（r）］ vt.　授权，允许；使能够

auxiliary ［ɔːɡˈzɪliəri］ adj.　辅助的；副的；附加的

ambiguity ［ˌæmbɪˈɡjuːəti］ n.　含糊；不明确；模棱两可的话