clinical learning environment in placements outside traditional hospital settings

Nursing students’ perceptions of their clinical learning environment in placements outside traditional hospital settings
Shi & Singh advises health professionals are among the most diverse and well educated in comparison to other labor groups (2016). There are a variety of disciplines and associated professionals within health care settings. Although physicians play a leading role in the delivery of health care, nurse personnel integrate with physicians to create a system for optimal care solutions. The distribution of care to the sick is primarily managed between physicians and nurses. The roles between the two professions are fully engaged when it comes to caring for the sick yet variables in educational and training requirements, career paths and practice environments distinguish the two fields.

Requirements for becoming a physician or nurse professional varies by state and/or disciplines. All states require both physicians and nurses are licensed before entering the practice of medicine and care respectively. Physicians are responsible for evaluation, diagnosis and treatment of health problems. Physicians must graduate from an accredited medical school with a doctorate of medicine (MD) or osteopathic medicine (DO), successfully pass a national board exam and complete a supervised residency or intern program. Some residencies may last up to 6 years following medical school (Shi & Singh, 2016). Although the education and training track is duly scaled for physicians, nurse professions must also complete levels of arranged education and training.

Nurses serve as major caregivers in a variety of health care settings addressing the physical, mental and emotional well-being for the sick and injured. Like physician licensure conditions, states require that nurses are licensed and well trained before care is practiced. As a practicing nurse, one must graduate from an approved nursing program (ranging from diploma, associate or bachelor degree) and successfully pass a national exam. Most practical nurse programs include both classroom study and supervised clinical experience (Shi & Singh, 2016). Clinical placements are important in the learning processes of nursing students. Certain setting such as nursing homes settings has been found to require more work to ensure students develop the appropriate context and influence their learnings (Berntsen, Bjork, Grethe & Hestetun, 1999). Unlike physician, nurse programs vary with from program to curriculum requiring between 1 to 5 years. These programs are made available by colleges and universities nationally. The career path and opportunities available for physicians and nurses vary based upon the specialty and basis or approach to treatment.

Physicians are categorized as either generalists, specialists or hospitalists (Shi & Singh, 2016). Physicians trained in general practices are considered primary care or generalists. Specialists are physicians who focus on specific systems or diseases, requiring a certification in the specialization area. There more common specialties are – anesthesiology, cardiology, dermatology, internal medicine, neurology, obstetrics and gynecology, ophthalmology, pathology, pediatrics, psychiatry, radiology and surgery (Shi & Singh, 2016). Hospitalists seek to decrease overall cost and length of stay patients spend in the hospital. In contrast to physician categories, nurses can prepare to function as a registered nurse, licensed practical or vocational nurse, and/or advanced-practice nurse based on the degree or education level and training (Shi & Singh, 2016). The interaction between generalists and specialists is essential for patient care; however, financial and organizational changes pertaining to American medicine is causing tension affecting physician-physician relationships (Pearson, 1999). Although specialty settings are organized based upon physician certifications, advanced-practice nurses have accessibility to certification in 4 areas of specialization – clinical nurse specialist (CNS), certified registered nurse anesthetists (CRNAs), nurse practitioners (NPs) and certified nurse-midwives (CNMs) (Shi & Singh, 2016). There are a variety of settings staffed by both physicians and nurses.

Most physicians are office based in private practices with physician partners and clinical employees. Physicians can also work in hospitals, federal government agencies, public or community health clinics, schools or prisons. In comparison, nurses also work in a variety of health care settings. Nurses are often classified based on the settings in which they work. Clinical environments available to nurses include private-duty, hospital, long-term care, public health, medical office and occupational health (Shi & Singh, 2016). Active physicians in medicine continue to rise and grow in physicians to population ratio within the United States (Shi & Singh, 2016). Since World War I, the nurse profession makes up the largest group of health care professionals (Shi & Singh, 2016).

It’s amazing that we live in a society who continue to care enough to dedicate their lives to health care for missionary or professional reasons. Matthew 9:12 passage reads, ‘On hearing this, Jesus said, “It is not the healthy who need a doctor, but the sick’. These words from Jesus simply speak to the need physicians and nurses offer in this diverse world.