Chapter 1: Introduction to Nursing

Identify current trends in nursing.

Changing demographics and increasing diversity; technologic explosion; globalization of the world's economy and society; the era of the educated consumer, alternative therapies, and genomic/palliative care; and the shift to population-based care and the increasing complexity of patient care.

Discuss the importance of self-care in relation to the demands of the nursing profession.

Compassion fatigue: loss of satisfaction from providing good patient care. Burnout: cumulative state of frustration with the work environment that develops over a long time. Secondary traumatic stress: feeling of despair caused by the transfer of emotional distress from a victim to caregiver, which often develops suddenly.

Describe the historical background of nursing, definitions of nursing, and the status of nursing as a profession and as a discipline.

Many of the Western societies began to shift from religious orientations to an emphasis on warfare, exploration, and expansion of knowledge; Florence Nightingale established the first training school for nurses and wrote books on health care and nursing education. WWII had a large effect on nursing, increased emphasis on nursing knowledge as the foundation for evidence-based practice (EBP) led to the growth of nursing as a professional discipline. The word nurse originated from the Latin word nutrix which means 'to nourish', whereas most definitions describe the nurse as a person who fosters, nourishes, and protects; and who is prepared to take care of the injured, sick, aged, and dying people. It is recognized as a profession that is based on: the code of ethics, autonomy, and self-regulation, ongoing research, professional organization that sets standards, strong service orientation, well-defined body of specific and unique knowledge, and recognized authority by a professional group.

Discuss the effects in nursing practice of nursing organizations, standards of nursing practice, nurse practice arts, and the nursing process.

Organizations are concerned with the current issues in nursing and health care, and influence health care policy and legislation. The standards allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution. Nurse practice arts are laws established in each state in the U.S. to regulate the practice of nursing. The nursing process is another of the major guidelines for nursing practice.

Describe the various levels of educational preparation in nursing.

Practical and vocational nursing education, licensed practical nurse (LPN), registered nurse (RN). Registered nursing education, diploma, associates degree in nursing (ADN), and baccalaureate programs (bachelor of science in nursing, BSN). Graduate education in nursing, advanced practice nursing (APRN), clinical nurse leader (CNL), family nurse practitioner (FNP), American Association of college in nursing (AACN), and the doctor of nursing practice (DNP).

Explain the aims of nursing as they interrelate to facilitate maximal health and quality of life for patients.

The aims of nursing practice can be identified to promote health, prevent illness, facilitate coping with disability or death, and to restore health.

Explain how nursing qualifies as a profession.

Uses existing and new knowledge to be able to solve problems creatively and meet human needs; the code of ethics, autonomy, and self-regulation, ongoing research, professional organization that sets standards, strong service orientation, well-defined body of specific and unique knowledge, and recognized authority by a professional group.

6. A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which examples of nursing interventions reflect this goal? Select all that apply. a. A nurse councils adolescence in a drug rehabilitation program. b. A nurse performs range of motion exercises for a patient on bed rest. c. A nurse shows a diabetic patient how to inject insulin. d. A nurse recommends a yoga class for a busy executive. e. A nurse provides hospice care for a patient with end-stage cancer. f. A nurse teaches a nutrition class at a local high school.

a, b, c. Activities to restore health focus on the person with an illness and range from early detection of a disease to rehabilitation and teaching during recovery.

4. Nurses today work in a wide variety of healthcare settings. What trend occurred during World War II that had a tremendous effect on this development in the nursing profession? a. There was a shortage of nurses and an increased emphasis on education. b. Emphasis on the war slowed development of knowledge in medicine and technology. c. The role of the nurse focused on acute technical skills used in hospital settings. d. Nursing was dependent on the medical profession to define its priorities.

a. During World War II, large numbers of women worked outside the home.

9. Nursing in the United States is regulated by the state nurse practice act. What is a common element of each states nurse practice act? a. Defining a legal scope of nursing practice. b. Providing continuing education programs. c. Determining the content covered in the NCLEX examination. d. Creating institutional policies for healthcare practices.

a. Nurse practice act are established in each state to regulate the practice of nursing by defining the legal scope of nursing practice, creating a state board of nursing to make and enforce rules and regulations, define important terms and activities in nursing, and establish criteria for the education and licensure of nurses.

10. According to the National Advisory Council on Nurse Education and Practice, what is a current healthcare trend contributing to 21st-century challenges to nursing practice? a. Decreased numbers of hospitalized patients. b. Older and more acutely ill patients. c. Decreasing healthcare costs owing to managed-care. d. Slowed advances in medical knowledge and technology.

b. The National Advisory Council on Nurse Education and Practice identifies the following critical challenges to nursing practice in the 21st-century: a growing population of hospitalized patients who are older and more acutely ill, increasing healthcare costs, and the need to stay current with rapid advances in medical knowledge and technology.

1. A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency department. The nurse anticipates preparing the patient for ordered diagnostic tests. What aspect of nursing does the nurse's knowledge of the diagnostic procedures reflect? a. the art of nursing b. the science of nursing c. the caring aspect of nursing d. the holistic approach to nursing

b. the science of nursing is the knowledge base for care that is provided.

5. A nurse practicing in a primary care center uses the ANA's Nursing Social Policy Statement as a guideline for practice. Which purposes of nursing are outlined in this document? Select all that apply. a. A description of the nurse as a dependent caregiver. b. The provision of standards for nursing educational programs. c. A definition of the scope of nursing practice. d. The establishment of a knowledge base for nursing practice. e. A description of nursing's social responsibility. f. The regulation of nursing research.

c, d, e. The ANA Social Policy statement describes the social context of nursing, a definition of nursing, the knowledge base for nursing practice, the scope of nursing practice, standards of professional nursing practice, and the regulation of professional nursing.

7. A nurse instructor outlines the criteria establishing nursing as a profession. What teaching point correctly describes the criteria? Select all that apply. a. Nursing is composed of a well defined body of general knowledge. b. Nursing interventions are dependent upon medical practice. c. Nursing is a recognized authority by a professional group. d. Nursing is regulated by the medical industry. e. Nursing has code of ethics. f. Nursing influenced by ongoing research.

c, e, f. Nursing is recognized increasingly as a profession based on the following defining criteria: well-defined body of specific and unique knowledge, strong service orientation, recognized authority by a professional group, code of ethics, professional organization that sets standards, ongoing research, and autonomy and self-regulation.

8. A nurse is practicing as a nurse midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level? a. LPN b. ADN c. BSN d. MSN

d. A masters degree (MSN) prepares advanced practice nurses.

2. Nurses today complete a nursing education program, and practice nursing that identifies the personal needs of the patient and the role of the nurse in meeting those needs. Which nurse pioneer is MOST instrumental in this birth of modern nursing? a. Clara Barton b. Lilian Wald c. Lavinia Dock d. Florence Nightingale

d. Florence Nightingale elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education.

3. The role of nurses in today's society was influenced by the nurses role in early civilization. Which statement best portrays this earlier role? a. Women who committed crimes were recruited into nursing the sick in lieu of serving jail sentences. b. Nurses identified the personal needs of the patient and their role in meeting those needs. c. Woman called deaconesses made the first visits to the sick, and male religious orders cared for the sick and buried the dead. d. The nurse was the mother who cared for her family during sickness by using herbal remedies.

d. In early civilizations, the nurse usually was the mother who cared for her family during sickness by providing physical care in herbal remedies.