Nursing essay questions are typically focused on key areas of clinical practice, either in relation to the needs of a client, or to an area of practice. Most nursing questions ask students how to respond to particular scenarios. As such, the student needs to identify the key words in the essay question, and ensure that their answer contains reference to the key words.
Some questions require the student to use a reflective model to review their own practice, or the practice involved in a particular case. Ideally, the student should identify the model, and structure the essay around the sub-headings or concepts contained within that model. Most essay questions will also require the student to make good use of the evidence surrounding a topic or area of practice. Therefore, the student is expected to use a range of sources of primary literature to answer the question. Primary literature would include primary research articles, review articles, debate and discussion articles, and articles which provide case studies or reflections on practice. Some attempt should be made to comment on the quality of the literature relating to the topic. Evidence can include not only evidence about clinical issues, such as drugs or treatments, but also evidence surrounding key elements of nursing care, governance, nursing philosophies and models, and even nurse education.
To discuss an area of practice is not simply to present the evidence for and against the theories and practice points shown in the literature, it is to explore it from all angles. Nursing practice is based on concepts of health and illness, interprofessional working, medical versus social models of health and health care, governance and care planning, and management. Therefore, interpreting the question involves identifying what elements of practice are required to be examined. Usually, a nursing question asks the student to explore the concept, or treatment, its application, its implications, and, crucially, elements of the role of the nurse. Identifying these, and making recommendations for practice, drawing conclusions about practice, and recommending areas for future research, are key to answering a nursing essay question.
In addition to these framework concepts, nursing essays are very much related to the concept of professionalism, and to the ethics of nursing care and practice. Professionalism is enshrined in the publications of the nurse’s governing body, which depends on which country the nurse is practising in. It is also enshrined in the ethics and philosophies of nursing. Current trends in nursing can be seen in the choices made about research methodologies, and in reactions to government documents, policies and strategies. Therefore, a good nursing essay will include reference to relevant policies and strategies, but will (usually) link these to the patient-centred models that dominate nursing care.
Nursing questions must be interpreted in the light of the assessment, which is usually based on the module or unit of learning, the area of practice, such as community nursing, paediatric nursing, surgical nursing, elderly care, or the like, and usually relates to some of the concepts and ideas described above. But more than anything, interpreting the question means answering the question as set.