Unit 1: Fundamentals of Nursing Concepts

The profession of nursing is

an art and a science

Knowledge

an awareness of the reality one acquires through learning or investigation

Prevention

anticipatory action taken to prevent the occurrence of an event or to minimize its effects after it has occured

Deontological:

-an action is right or wrong based on a rule, independent of its concequences

Wellness

-associated with health -an active state of being healthy by living a lifestyle that promotes good physical, mental, emotional and spiritual health

Stereotyping:

-assuming groups are alike

Florence Nightingale's contributions to nursing

-needs of patient -standards of hospital management -respectful occupation for women -health and illness -nursing separate and distinct from medicine

Integrity:

-the quality of being honest and having strong moral principles;

Utilitarian:

-the rightness or wrongness of an action depends on the consequences of the action

Factors affecting health and illness:

-Basic Human needs -physical -emotional -intellectual -environmental -sociocultural -spiritual

Nurses' Role in Healthcare Reform

-Cost containment -Improved access -Increased quality of services -Political action (nurses day on the hill)

Nursing Code of Ethics

-Framework (to make decisions) - professional expectations -Goals and values of profession -Protects patients

Influences on growth and development:

-Genetic heredity -Prenatal -Individual and caregiver factors -Environment -Nutrition -Health and illness -Culture

Political Action for Healthcare Reform

-Healthcare crisis is a societal problem -Nurse advocacy for our patient's well- being is an ethical obligation -Nurses need to use their political muscle & credibility

Improve care of patients:

-Improve quality -Improve cost effectiveness -Increased safety

Caring

-Nursing actions that demonstrate an attitude of positive regard, respect, empathy and integrity when providing relationship centered care.

Nurse Practice Act

-Protects the public -Lists violations -Excludes untrained or unlicensed people

Trends In Health Care Delivery

-Self-care focus -Knowledgeable consumers -Cost containment -Fragmentation of care -Aging & diversity of America -Nursing shortage

Professionalism

-The nursing student embraces personal and professional responsibility for maintaining current knowledge, skills and attitudes based on evidence, integrity clinical competence and excellence to provide quality care in a changing health care environment.

Collaboration

-The partnership with the individual, family and health care team that utilizes health information/informatics to achieve safe, quality outcomes in a changing healthcare environment.

Critical thinking

-The student utilizes the nursing process as a clinical decision making tool to promote health for individuals within a family and community context.

Nursing as a profession

-uses an organized body of knowledge -generated from research and theory (provides rational for our nursing intervention actions)

Psychoanalytical theory of Growth and Development (Freud)

-Theory emphasizes the effect of instinctual human drives on behavior -4 major components: -5 stages: -If no resolution in one stage, fixation follows with arrested development -Ego is defense mechanism

Adaptation Theory

-adaptation: adjustment of living matter to other living things and to environmental conditions -continual process that effects change and involves interaction and response -Human adaptation has 3 levels: internal, social, and physical

Values:

- belief about the worth of something -formed over a lifetime -environment -family -culture

Cognitive Theory of Growth and Development (Piaget)

-4 stages of cognitive development from birth to adolescent -Framework for how children learn rules -Each stage transforms and supersedes the one before -Stages are universal (affects all cultures, all people)

Psychosocial Theory (Erikson)

-8 stages : infancy to late adulthood -Each stage has major crisis -Lack of resolution prevents aliening to develop fully -Never to late for resolution of any stage crisis

Human dignity:

-An individual or group's sense of self-respect and self-worth, physical and psychological integrity and empowerment

Healthy People 2020 goals:

-attain high-quality, longer lives free of preventable disease, disability, injury, and premature death -achieve health equity, eliminate disparities, and improve the health of all groups -create social and physical environments that promote good health for all -promote quality of life, healthy development, and healthy behaviors across all live stages

Normal physiological changes in older adults:

-balance declines -decreased ability to maintain homeostasis -integument (skin declines) -senses decline

Race:

-based on specific physical charectoristics

Types of Ethics

-bioethics -clinical -nursing

Physiological

-body function

Patricia Benner

-caring is a common of persons situated in a state of being that is essential to nursing -a systematic description of stages of nursing practice, novice, advanced, beginner, and expert

Madeline Leininger

-caring is the central theme of nursing care knowledge and practice -provides the foundation of transcultural nursing care. caring improves human conditions and life processes

Authoritative knowledge:

-comes from experts and is accepted as truth based on the persons' perceived expertice

Nursing Theory

-composed of a group of concepts that describe a pattern of reality -statement that explains or characterizes a process, occurrence, or an event that is based on observed facts -arrange a group of related statements or concepts that give meaning to a series of events

Nursing Theories are developed to:

-describe -explain -predict -control *the desired outcomes of nursing care

Maslow

-developed the theory of basic human needs -physical and psychological needs considered essential to human life

Secondary:

-early detection -health maintenance -early intervention KEY: screenings

Broader study of people and nursing to enhance:

-education -policy developments -ethics -history

Psychosocial

-emotional, reactions with environment, other humans

Martha Rogers

-emphasis on science and art of nursing, with unitary human being central to the discipline of nursing -nursing interventions are directed towards repatterining human environment fields or assisting in mobilizing inner resources

Principles of growth and development

-growth and development are orderly and sequential as well as continuous and complex -growth and development follow regular and predictable trends -growth and development are both differentiated and integrated -different aspects of growth and development occur at different stages -happens on an individual basis

Primary:

-health promotion -illness prevention KEY: teaching

Role of Nurse for elderly

-health restoration -health maintenance -health promotion

Leading health problems

-heart and lung conditions -arthritis -diabetes -HIV

Health Promotion Model

-how people interact with their environment as they pursue health

Sister Callista Roy

-humans are biopsychosocial being existing within an environment. needs are created within interrelated adaptive modes: physiological self-concept, role function, and interdependence -nursing inventions are required when individuals demonstrate ineffective adaptive responses

Growth

-increase in body size or changes in body cell structure, function, and complexity

Health

-individually defined -integrates all the human dimensions -holistic care is important

Human needs

-influenced and responsive to both internal and external enviornments -holistic nursing care provides individualized and health-orientated care

Cognitive

-intelligence, thinking

Health promotion:

-is the behavior of a person who is motivated by a personal desire to increase well-being and health potential

Social justice:

-justice in terms of the distribution of wealth, opportunities, and privileges within a society

Scientific knowledge:

-knowledge obtained through the scientific method (research)

Nurses:

-largest employee group in healthcare -part of health care team -practice guided by the nursing process

Evidence based research

-nursing care provided that is supported by reliable research based evidence -its use mandates critical analysis and extensive systematic reviews of research articles and findings to improve nursing interventions and actions

Watson

-nursing is concerned with promoting and restoring health, preventing illness and caring for the sick -holistic care: promote humanism, health, and quality of living -caring is universal and is practiced through interpersonal relationships

Hildegard Peplau

-nursing is therapeutic, interpersonal and goal orientated -nursing interventions are directed towards the developing the patient's personality for a productive personal and community living

Inductive reasoning

-one builds from specific ideas or actions to come to a conclusion about general ideas -SMALL ideas come together to form a BIG picture

Deductive reasoning

-one examines a general idea then considers specific actions or ideas -BIG idea broken down into small ones

Health is subjective

-one may be diagnosed with a clinical disease but still consider themselves to be a healthy individual

Cultural Assimilation:

-ones values are replaced by the values of the dominant culture

Development

-orderly pattern of change in structure, thoughts, feelings or behaviors resulting from maturation, experiences and learning

Developmental Thoery

-outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death -defined stages; the process and behaviors of an individual within each stage are unique

Traditional knowledge:

-part of nursing practice that has been passed down from generation to generation -"we've always done it this way"

Health Belief Model

-perceived susceptibility to disease -perceived seriousness of a disease -perceived benefits of action

Restoring health

-performing assessments that detect an illness -referring questions and abnormal findings to other health care providers -providing direct care to the person who is ill -collaborating with other health care providers -assisting with the rehab process -working with mental health and chemical dependency

Chronic illness

-permanent change -slow onset -requires education and support for rehab

Levels of Prevention

-primary -secondary -tertiary

Value clarification:

-process of understanding your own values and value system

5 Core Integrating Concepts

-professionalism -critical thinking -caring -collaboration -therapeutic nursing interventions

Goals of Nursing

-promote health -prevent illness -restore healthy living -facilitate coping with disability or death

Acute illness

-rapid onset of symptoms and lasts only a relatively short time

Preventing Ilness

-reduce risk for illness -promote good health habits -maintain optimal functioning

Spiritual

-religious, sense of correctness with inner self

Illness

-response of the person to a pathological problem where level of functioning is changed -individually defined

Tertiary

-restoration -care of dying

Evidence based practice:

-review and critique research reports -identify level and strength of the evidence -make specific recommendation for the practice (validate/change)

Dorothea Orem

-self-care is a human need, self-care deficits require nursing action -nursing is a human service, and nurses design interventions to provide or manage self-care actions for sustaining health or recovering from illness or injury

Autonomy:

-self-determination; being independent and self governing

Ethnicity:

-sense of identification, sharing of unique cultural and social beliefs

Moral

-sense of right and wrong

Culture:

-shared system of beliefs and behavioral expectations -social structure for daily living -defines how we treat others/our family systems

Ethics

-systematic inquiry into principles of right and wrong conduct of virtue and vice and of good and evil as they relate to conduct

Healthy people 2020

-the ability of patients to obtain, process, and understand the basic information needed to make appropriate decisions about their health -establishes health promotion guidelines for the nation

Altruism:

-the belief in or practice of disinterested and selfless concern for the well-being of others.

Culture Shock:

-the feelings a person expierences when placed in a different culture

General Systems Theory

-whole is greater than the sum of its parts -systems are interrelated and changing one thing in a subsystem can change the entirety of a system -boundaries separate systems from each other and their environments -systems communicate through means of inputs and outputs -closed and open systems -to survive open systems maintain balance through feedback

3 types of knowledge

1. Traditional 2. Authoritative 3. Scientific

Stages of Illness

1. experiencing symptoms 2. assuming sick role 3. assuming a dependent role 4. achieving recovery and rehabilitation

ANA Definition of Nursing

Nursing is the diagnosis and treatment of human responses to actual or potential health problems

Ethnocentrism:

belief that one's ideas, beliefs, and practices are best or superior

Risk factor:

increased chances for illness or injury

Disease

pathologic change in the structure or function of the body or mind

Health

state of optimal functioning or well being