Introduction Reframing Adult Nursing Practice

Healthcare delivery has been transformed over the past decades with a rapid expansion in the demand for care driven by demographic changes, technological innovation, and increasing consumer expectations. This transformation has in turn had a profound impact on the roles of health professionals in general and nurses in particular. The number of patients with multiple pathologies and complex long-term nursing care needs has also escalated, with pressure for rapid throughput in acute hospital care settings resulting in shorter lengths of stay and greater emphasis on care in the community. To meet growing demand, boundaries between the roles of health professional have blurred, with nurses now undertaking activities previously performed by doctors, and unqualified staff undertaking activities previously performed by registered nurses. These changes are all taking place in the context of economic turbulence. The shift of nursing to an all-graduate profession reflects the recognition that the future role of a registered nurse will carry greater responsibility and autonomy than ever before. The expectations of every student and qualified nurse must therefore also change in relation to the knowledge and skills that they need to deliver expert nursing interventions and clinical leadership. The next generation of nurses will increasingly lead and coordinate the care of a range of patients and clients, supervising and supporting unqualified or lay carers and referring patients to other health professionals when appropriate. As one of this new generation of qualified nurses, it is important that you are able to demonstrate expertise in the fundamentals of nursing practice. You must be equipped with the knowledge and skills needed to enable you to:…● understand the common health conditions that can affect adults; ● understand the pathophysiology of these common health conditions, and the physical and psychosocial needs and problems that result from them; ● recognize your key role in managing the problems and challenges that patients face; ● ensure that your nursing interventions are evidence-based; ● demonstrate competent assessment skills, critical thinking, and problem-solving skills to make informed clinical nursing decisions in collaboration with the patient and other team members; ● adopt an enquiring and questioning approach, and be confident in accessing and interpreting evidence to inform your choice of nursing interventions….