Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing”. The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: time, fiscal restraint, and failure of the system to support a full staff of nurses, so those employed are working at full capacity. It is important to recognize that different practice settings have varying needs. One size does not fit all. Yet the requirements for nursing assessments, developing a plan of care, coordinating care with other health care providers, implementing interventions, and evaluating care outcomes are a requirement of all.

The author, Martin Alpert, presents a method by which individual nurses can be independent, improve patient care, have fun, and earn more money. He proposes that the nursing profession become the leader in a shift to sustainable, least invasive therapies and evaluations (LITE). LITE represents a major profit opportunity for nurses. Many of these new therapies require medical professionals, but not necessarily doctors. They can be administered by dedicated and trained nurses. The impact of LITE on the global society of nursing leading this area of medicine could be transformational for nursing, medicine, and society. Nursing could lead in diagnosis and treatment under the LITE paradigm. Acupuncture is becoming part of conventional therapy. It can be a part of nursing practice. Recently, the World Health Organization estimated that 80” of people worldwide rely on herbal medicines for some part of their primary health care.

This chapter proposes some strategies for systematic inquiry into already existing facets of the health care institutions (HCI), while also suggesting strategies for developing new initiatives. It explores educational opportunities for promoting cultural competency. The chapter describes action-focused strategies for educational innovation. Major emphasis is placed on self-appraisal and determining educational priorities and goals. Systematic self-assessment evaluates the various dimensions that can impact upon the educational process and on the achievement of educational outcomes. New employee orientation has the potential to initially introduce and reinforce the HCI’s philosophy and purposes, specifically those concerning cultural competence development. The American Nurses Credentialing Center (ANCC) Magnet model provides a framework for excellence in nursing practice within the context of global issues in nursing and health care and includes five interrelated model components: Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, and New Knowledge, Innovations.

This chapter examines the concept of triage nurse expertise that holds a particularly important role in the domain of nursing practice. It defines the attributes for triage nurse expertise such as triage skill and triage knowledge. The antecedents to triage nurse expertise are education, training, and experience. In order for triage nurse expertise to be present, an individual nurse must have the education, training, and experience to adequately assess and prioritize patients for care. Triage education programs must provide nurses with adequate practical experience in order to develop advanced decision-making skills. Appropriate action and decision making are the consequences of triage nurse expertise. Appropriate triage is reflected in the emergency severity index (ESI) level assigned to the patient. The attributes, triage skills and triage knowledge, can also be measured using patient simulation scenarios. The chapter provides case studies demonstrating the presence and absence of the attributes.

Science-fiction (SF), a genre of literature in which stories frequently focus on the future, could offer opportunities to envision the future of nursing. SF has focused on technical and social implications of scientific advancement. The literature review examined three aspects of the image of nursing: the public view, the occupational view, and the view depicted in specific aspects of popular culture. The image of nursing in SF literature was described in a qualitative study using content analysis methodology. To develop a thorough understanding of the image of nursing, several approaches were used to organize the data. Nursing activities included providing basic care, communicating with colleagues, interacting with patients/significant others, providing technical care, assessing/evaluating patients, assisting the physician, and participating in educational activities. Technical care involved performing various nursing skills, providing emergency care, and dealing with equipment.

Organizations are goal-directed entities that can be created in society, business, health care, and family units. Organizational commitment (OC) consists of three behaviors: identification, loyalty, and involvement. The defining attributes of OC in nursing practice are multidimensional, continuous, collective goal seeking, and involvement. The three broad categories of antecedents for OC are personal characteristic, work experience, and organizational environment. Work experience antecedents include opportunities and job security. Organizational environment antecedents to OC are trust of the organization and leadership style. One of the important consequences of OC is that once it exists, it empowers individuals and stabilizes behavior as circumstances change. Two widely known quantitative instruments have been utilized to measure OC. These instruments are the Organizational Commitment Questionnaire (OCQ) and the Affective, Continuance, and Normative Commitment Scale. The hospital should then provide work opportunities that foster the OC behaviors.

Queen behavior in the workplace is not unique to nursing. This chapter describes one of the most toxic workplace behaviors and its serious impact on patient care, staff relationships, and quality of work life. Queens are tough to manage. Many nurse managers can become victims of a queen when engaged in a power struggle. Workplace queens are the embodiment of unprofessional behavior that is nothing short of bullying. The impact of the queen’s toxicity is not limited to the practice setting and can leech into other areas of the organization, community, and beyond. Managing queen behavior is never optional. How it is managed depends on the type of behavior, circumstances, experience of the manager, and resources available to support the process. To tackle queen behavior in the workplace, the nurse managers use both short-term and long-term strategies.

This chapter aims to create clarity around the understanding of the concept of clinical autonomy and considers a number of theoretical perspectives on autonomy. For individuals to be autonomous, they must have some control over their actions and the capacity for rational and critical thinking. The defining attributes of clinical autonomy in nursing practice includes practicing within a professional context, capacity to exercise clinical judgment, authority to make patient care decisions, and context of interdisciplinary collaboration. Specific practice contexts require nurses to possess particular competencies and skills in order to engage in clinical practice; an example is nurses working in critical care areas such as the emergency department (ED). There are a number of consequences of clinical autonomy among nurses. These include: job satisfaction, nurse retention, accountability for care decisions, and improved patient care and safety.