FACTORS THAT INFLUENCE NURSING PRACTICE

Professional Associations

Professional associations play a significant role in influencing nursing practice so that it keeps pace with society's health care needs. They identify and address practice issues and lead the nursing community with respect to improved, expanded, and advanced practice and education. Professional associations also inform the general public about the scientific discipline of nursing and influence external bodies (e.g., governmental agencies, private foundations) in garnering support for nursing education and research.

Many professional associations are involved in additional activities, such as (1) creating standards of care to delineate the scope of practice and professional accountability, frameworks for measuring patient outcomes, and parameters for practice evaluation; (2) developing codes of ethics to guide ethical decision making and the delivery of ethically centered care; (3) supporting education and research activities (e.g., journals, continuing education programs, certification, and grants) to improve and foster nursing knowledge and contribute to professional development; and (4) supporting a governmental affairs program to influence regulatory and policy initiatives.

Professional societies can provide relevant educational opportunities and help identify mechanisms for increasing the level of integration of environmental health concepts into practice. Several national and international organizations including the ANA, the International Council of Nurses (ICN), the American Association of Occupational Health Nurses, and the International Commission on Occupational Health (ICOH) play key roles in practice, education, and research relevant to environmental and occupational health and can serve as models for other associations. The American Public Health Association, an interdisciplinary professional society, provides a forum for building consensus on emerging public health needs and disseminating innovative strategies to address these needs, including environmental health issues. Professional associations can have a major influence on the integration of environmental health concepts into general and specialty nursing practice, and they must be considered in strategies for altering nursing practice to include environmental health issues.

Ethical Dilemmas

Environmental and occupational health issues are fraught with potential ethical conflicts. Nurses may find themselves in situations where



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