Advances in Neonatal Care:
Letter From the Editor
Section Editor(s): Witt, Catherine L. MS, NNP-BC
What do you think of when someone mentions standards of practice? Often, one thinks of things that directly affect patient care: things like assessment, nursing diagnosis, identifying outcomes, and making a plan of care.1 It is easy to forget that the American Nurses Association has identified a number of other standards, including ethics, education, evidence-based practice and research, quality of practice, communication, leadership, collaboration, professional practice evaluation, resource utilization, and environmental health.1 All of these standards help to define what professional nursing is, and these are the standards to which the nurse is held accountable.
Catherine L. Witt, M...Image Tools
For professional nurses, continuing education is essential to safe and effective nursing care. The amount of knowledge required to take care of critically ill patients cannot be obtained simply through experience on the unit or at the bedside. Despite the fact that neonatal care has changed rapidly over the past 20 years, the time for new information to be incorporated into bedside care has been estimated to be 15 years or more.2,3 The current emphasis on competency in health care means that this is no longer acceptable, if it ever was. There will be continued increasing emphasis on the need to demonstrate ongoing education and competency. Nurses have a professional and legal responsibility to update their knowledge and apply that knowledge to the bedside.4,5
The debate about the effectiveness of continuing education on clinical outcomes is often used as a reason for not requiring continuing education for licensure or as a reason not to attend an educational offering. The Institute of Medicine in a report on continuing education and health care professionals reviewed the literature available, looking at the effect of continuing education and quality of health care.4 While admittedly there are difficulties in measuring outcomes, the report states that there is evidence that continuing education can improve knowledge base and skill level, can change behaviors and attitudes, and improve clinical outcomes.4 Continuing education has been shown to increase nurses' professional behavior and improve the knowledge of patient management and nursing practice.5
Despite the abundance of continuing education offerings, many nurses do not participate in them. A number of barriers have been cited in the literature, including financial considerations and lack of institutional support, time constraints, and family commitments.2,4,6 These barriers are real and must be addressed by individuals and institutions. Institutions must make a bigger commitment to lifelong education of nurses and other health care providers. Support for education is too susceptible to random budget cuts in the times of economic stress, and many institutions do not provide time or money for nurses or other professionals to attend conferences and other continuing education events. Nurses must also make a personal commitment to the value of continuing education as part of their professional responsibility. Too often, hospital-based or local educational opportunities are poorly attended, making it less likely that such events will be offered in the future.
Nursing organizations such as the National Association for Neonatal Nurses (NANN) are striving to provide a variety of educational opportunities. Many nursing journals, including this one, offer continuing education for a nominal fee. Increasing the use of technology allows for the Web-based education and seminars, online educational opportunities, and interactive educational forums. These provide opportunities for education that are in addition to attending a national conference or meeting. However, the benefits of attending a national or regional meeting cannot be overstated. Opportunities for networking and career growth are important reasons for attending an organization's national meeting. The NANN national meeting offers a number of educational opportunities such as poster presentations of best practices and new research, preconference seminars on particular topics of interest, and networking opportunities with special interest groups. The ability to open doors to new opportunities makes attending a conference a worthwhile part of career development.2
Florence Nightingale, throughout her “Notes on Nursing,” speaks to the fact that nurses must learn constantly, not only through observation and experience but also by seeking new knowledge and new evidence.7 She was quick to recognize that the accepted way of doing things was not always the best and strived to discover new ways to care for patients and create healthy environments. This is no less true today. A commitment to continued learning is a professional responsibility that nurses owe to themselves and to their patients if excellence in practice is to be achieved.
1. American Nurses Association. Scope and Standards of Practice. 2nd ed. Silver Spring, MD: American Nurses Association; 2010. Nursebooks. org.
2. Skees J. Continuing education, a bridge to excellence in critical care nursing. Crit Care Nurs Q. 2010;33:104–116.
4. Dickerson PS. Continuing nursing education: enhancing professional development. J Contin educ Nurs. 2010;41:100–101.
5. Gallagher L. Continuing education in nursing: a concept analysis. Nurse Educ Today. 2006;27:466–473.
6. Schweitzer DJ, Krassa TJ. Deterrents to nurses' participation in continuing professional development: an integrative review. J Contin Educ Nurs, 2010;41:441–447.