The issues related to nursing involve a thorough examination of nursing as theory and practice. The role of the nurse practitioner especially in areas of clinical decision making and management could be studied in the contexts of obstetrics and gynaecological department or even emergency wards. The emphasis of most studies is on reflective practice using Gibbs (1988) model of treatment and reflection. The need to follow clinical guidelines as given by NICE or NHS have been emphasised in several studies especially highlighting the importance of personal cleanliness and hygiene in infection control. The role of informed consent and clinical decision making in case of pregnancy with family history of mental health problems suggest the central role of the challenges in the decision making process (Papers4you.com, 2006). The need for counselling and holistic care of patients have been emphasised in clinical practice. The role of the nurse and the importance of proper knowledge of clinical guidelines, NHS directives and adequate medical training suggest the crucial responsibility of the nurse who plays varied roles from that of physician to hospital manager. The studies show the varied approaches to nursing as in case of a depressed patient, the emphasis is on counseling and psychological support whereas in case of treating a patient with high blood pressure or multiple injuries after accident, reflective practice on immediate measures followed would be more important, suggesting a focus on patient centered outcomes (Bowcutt, et al 2006). Clinical management is closely related to leadership theories and it is important for the nurse to develop adequate leadership skills to effectively perform clinical duties (Booth and Davies, 1991). The differences between the role of the health visitor, nurse and midwife in general practice have been studied. Social and healthcare policy and guidelines on clinical governance suggest a multidisciplinary collaborative working approach for effective clinical management (Papers4you.com, 2006). Collaborative teamwork, holistic psychosocial treatment and proper allocation of clinical resources are some of the issues that are very important within intensive care units and for care of emergency patients. The ethical and legal responsibilities of a nurse practitioner and the medical team in general are largely guided by not just clinical guidelines set by the Department of Health but also by a team of dedicated health professionals within the clinical setting.

The issues discussed in the field of nursing include clinical governance, collaborative teamwork, the role of the clinical nurse practitioner, the importance of reflective practice, Gibbs (1988) Model, clinical management and decision making, ethical and legal issues in clinical care and holistic approach to treatment.

Bibliography

Booth J, Davies C. (1991) The management of change on a nursing development unit. Nurs Pract.;4(2):12-5.

Bowcutt M, Wall J, Goolsby MJ. (2006) The clinical nurse leader: promoting patient-centered outcomes. Nurs Adm Q. Apr-Jun;30(2):156-61.

Gibbs, G. 1988. Learning by doing: a guide to teaching and learning methods. London: Further Education Unit.

Papers For You (2006) "P/N/89. Medical nurse: characteristics, requirements, guidelines", Available from http://www.coursework4you.co.uk/sprtothers15.htm [22/06/2006]

Papers For You (2006) "C/N/42. Portfolio of the nurse. Caring for patients suffering from depression. What is the nurses responsibility?", Available from Papers4you.com [21/06/2006]