NURS 202 Exam 1
Mary Seacole
- (1805-1881) -Black woman who made significant contributions to the health of soldiers in the Crimean War -Jamaican nurse and businesswoman -did not refer to herself as a nurse -funded her own travel to the Crimea where her offer to be of service at the British hospital run by Nightingale was again refused -established a hotel for injured soldiers and visited the battlefield to tend to the injured and sick -experience in the management of cholera because of an outbreak in Panama while she was visiting her brother -cholera and other infectious diseases were the cause of a huge percentage of deaths of soldiers in the Crimea - Criticism of Seacole surrounds her entrepreneurship—she sold food and drinks during the war to officer and spectators -woman who "reigned on the battlefield."
Informatics Nursing
- Informatics Nurse These nurses combine science and technology into information to provide and manage the information that nurses need to effectively use a system. --Example: Systems Development --Type of Care: Improve patient safety through health systems
Florence Nightingale (1820-1910)
- entered the nurses' training program in Kaiserswerth, Germany -Crimean War (1853-1856) -Nightingale took 38 nurses to the British hospital in Scutari, Turkey -argued the case for reform of the entire British Army medical system -founded the first training school for nurses at St. Thomas' Hospital in London in 1860, which would become the model for nursing education in the United States -1859 Notes on Nursing: What It Is and What It Is Not ^^stated clearly for the first time that mastering a unique body of knowledge was required of those wishing to practice professional nursing
In response to the shortages, "team nursing" was introduced
- involved the provision of care to a group of patients by a group of care providers -the method fragmented patient care and removed the RN from the bedside - institution of the associate degree in nursing -focused on the scientific basis for nursing practice. -Clinical nursing research began in earnest, and the Journal of Nursing Research was first published.
Mary Ann ("Mother") Bickerdyke,
- widow who moved to Illinois and worked as an herbalist, creating alternative treatments with plants and herbs -active member of her Congregationalist Church learned of the squalid conditions of the battlefield hospitals through a letter sent to the church by her friend, a surgeon with the 22nd Illinois infantry -selected by her congregation to deliver supplies to troops on the Western Front and to investigate the situation in the hospital camp at Cairo, Illinois no official authority and was opposed by the camp surgeons -set up field hospitals as she accompanied Ulysses S. Grant down the Mississippi River, making cleanliness a priority -hired escaped and former slaves to work with her
Meaningful Use (MU)
--Stage 1 MU refers to basic EHR use, data sharing, and protection of patient privacy, with the goal to complete this stage between 2011 and 2012. --Stage 2 MU in 2014 refers to use of EHR to advance clinical processes; --stage 3 MU in 2016 refers to the goal of improved population health through the use of data to improve health care delivery and outcomes
first three American training schools
--the Bellevue Training School for Nurses in New York City --the Connecticut Training School for Nurses in New Haven, --the Boston Training School for Nurses at Massachusetts General Hospital in Boston ^^Modeled after Nightingale's school at St. Thomas' Hospital in London and opened in 1873
3 years after 1893 Chicago World's Fair
-1896 -Isabel Hampton Robb founded the group that eventually became the American Nurses Association (ANA) in 1911. -enhance collaboration among practicing nurses and educators
Great Depression/World War II
-1931-1945 -many families could no longer afford private duty nurses, forcing many nurses into -in 1933 President Franklin D. Roosevelt established the Civil Works Administration (CWA) in which nurses participated by providing rural and school health services -conducting health surveys on communicable disease and nutrition of children -Hospitals were forced to close their schools of nursing (economic) -^hospitals no longer had a reliable, inexpensive student workforce at the time when there was a significant increase in the number of patients needing charity care -^: unemployed graduate nurses, willing to work for minimum pay, were recruited to work in the hospitals rather than doing private duty for wealthy families
Catholic orders, particularly the Sisters of Charity, the Sisters of Mercy, and the Sisters of the Holy Cross
-American Civil War (1861-1873) -Likely the most skilled and devoted of the women who provided nursing care in the Civil War -highly disciplined, organized, and efficient`
Margaret Sanger
-American leader of the movement to legalize birth control during the early 1900's. - As a nurse in the poor sections of New York City, she had seen the suffering caused by unwanted pregnancy. - Founded the first birth control clinic in the U.S. and the American Birth Control League, which later became Planned Parenthood.
9/11
-Disaster management became a focus of nursing efforts to be better prepared for mass casualties, and disaster drills have become part of the routine in hospitals to ensure that nurses and other personnel can respond effectively and efficiently, with a focus on saving as many lives as possible during a wide-scale disaster.
When did the # of training schools increase
-During the last decades of the 19th century -By 1900 ^these schools provided hospitals w/ a steady, albeit subservient, female workforce -^ staffed primarily by students
rapid development of informational and medical technologies
-Electronic health records have become common as the U.S. health care system is moving toward becoming paperless -Digitalized health records allow for access across disciplines and across distance, with the goal to improve continuity of health care no matter where a person may require medical treatment.
2005
-Hurricane Katrina -In hospitals filled with floodwaters in their lower floors, nurses, physicians, and other providers sought to protect and comfort patients under horrendous conditions
Anita M. McGee
-In 1898, the U.S. Congress declared war on Spain -appointed head of the Hospital Corps -^^group formed to recruit nurses -initially wanted only graduates of nurse training schools in the Hospital Corps -epidemic of typhoid fever -^^the Sisters of the Holy Cross and untrained African American nurses who had had typhoid fever in the past, were accepted for service
African American nurses recognized the need for their own professional organization to manage their specific challenges.
-Martha Franklin sent 1500 letters to African American nurses and nursing schools across the country to gather support for this idea -the National Association of Colored Graduate Nurses (NACGN) was formed in 1908 in New York -objectives: --achieving higher professional standards, --breaking down discriminatory practices faced by African Americans in schools of nursing and nursing organizations, --developing leadership among African American nurses -disbanded in 1951
Clara Barton
-Massachusetts woman who worked as a copyist in the U.S. Patent Office -began an independent campaign to provide relief for the soldiers -Appealing to the nation for supplies of woolen shirts, blankets, towels, lanterns, camp kettles, and other necessities -established her own system of distribution, refusing to enlist in the military nurse corps headed by Dorothea Dix -traveled to Culpeper, Virginia -set up a makeshift field hospital and cared for the wounded and dying"Angel of the Battlefield." -founded the American Red Cross, an organization whose name is synonymous with compassionate service.
Race & Ethnicity in Nursing
-Minorities make up 37% of population-->19% of nursing
1893 Chicago World's Fair
-Several influential nursing leaders of the century, including Isabel Hampton Robb, Lavinia Lloyd Dock, and Bedford Fenwick of Great Britain, gathered to share ideas and discuss issues pertaining to nursing education -Isabel Hampton Robb presented a paper in which she protested the lack of uniformity across nursing schools, which led to inadequate curriculum development and nursing education. -A paper by Florence Nightingale on the need for scientific training of nurses was presented at this same meeting - precursor to the National League for Nursing, the American Society of Superintendents of Training Schools for Nurses, was formed to address issues in nursing education
What led to the early requirement that applicants to these programs be women
-The Victorian belief in women's innate sensitivity -high morals -was thought that these feminine qualities were useful qualities in a nurse -men were prevented from entering the profession.
Florence Nightingale worked hard to establish nursing as a worthy career for women and largely ignored the historical contributions of men
-The male role in her estimation was confined to supplying physical strength, such as lifting, moving, or controlling patients when needed. --discrimination in the profession. An exception was psychiatric nursing, which often required physical stamina and strength and was therefore considered an appropriate setting for men in nursing
Nurse managers
-These nurses act as executive figures within a nursing unit and are involved in various business aspects of the unit without compromising involvement in direct patient care. --Example: Personnel hiring and evaluation --Type of care: Direct patient care
School Nursing
-These nurses are dedicated to maintaining the overall health of students by promoting lifelong healthy habits and educating parents, teachers, and students about health concepts. --Example: Detecting child abuse/neglect --Type of Care: Counseling, First aid for minor injuries, Emergency care
Clinical Nurse Specialists
-These nurses are experts within a specific unit of nursing and thus provide advanced care in the field and act as references to their peers. --Example: Clinical mentor --Type of care: Direct patient care
1961-1982: The Great Society, Vietnam, and the Change in Women's Role
-Two 1965 amendments to the Social Security Act, designed to ensure access to health care for elderly, poor, and disabled Americans, resulted in the establishment of Medicare and Medicaid -hospitals began to rely heavily on reimbursements from Medicare and Medicaid -Because most of the care for the sick was taking place in hospitals rather than homes, the hospital setting became the preferred place of employment for nurses, giving rise to new opportunities and roles for nurses.
Clinical Nurse Leader (CNL)
-a generalist providing and managing care at the point of care to patients, individuals, families, and communities, and is prepared to facilitate a culture of safety for specific groups of patients
Susie King Taylor
-a laundress but was called on to assist as a nurse -noted for teaching soldiers, African American and White, how to read and write.
Clinical Nurse Specialist (CNS)
-advanced practice nurses who work in a variety of settings, including hospitals, clinics, nursing homes, their own offices, industry, home care, and health maintenance organizations -hold master's or doctoral degrees and are qualified to handle a wide range of physical and mental health problems
Advanced Practice Nursing
-an RN who has met advanced educational and clinical practice requirements beyond the 2 to 4 years of basic nursing education required of all RNs Include: -nurse practitioner, -clinical nurse specialist, -certified nurse-midwife, -certified registered nurse anesthetist
Hospice and Palliative Care Nursing
-dedicated to improving the quality of life of seriously ill and dying patients and their families - promote and improve the patient's quality of life through the relief of suffering along the course of the illness, through the death of the patient, and into the bereavement period of the family 1. Persons are living until the moment of death. 2. Coordinated care should be offered by a variety of professionals, with attention to the physical, psychological, social, and spiritual needs of patients and their families. 3. Care should be sensitive to patient/family diversity (or cultural beliefs)
Sophia Palmer
-director of nursing at Rochester City Hospital, New York -first editor of American Journal of Nursing -goal of presenting "month by month the most useful facts, the most progressive thought and the latest news that the profession has to offer in the most attractive form that can be secured
Nursing Gender
-dominated by women -% of men increased 50%
Nursing in Medical Offices
-employed in medical office settings work in tandem with physicians, NPs, and their patients -s liaisons between patients and physicians or NPs
1960's
-era of specialty care and clinical specialization for nurses. -The successful development of the clinical specialist role in psychiatric nursing—combined with the proliferation of intensive care units and technological advances of the period—fostered the growth of clinical specialization in many areas, including cardiac-thoracic surgery and coronary care. -increase in medical specialization, along with the concurrent shortage of primary care physicians and the public demand for improved access to health care that grew out of President Lyndon B. Johnson's "Great Society" reforms, fostered the emergence of the nurse practitioner (NP) in primary care
Alexian Brothers Hospital in Chicago (1898)
-established a nursing school to train men. -They opened a second school in 1928 in St. Louis
Henry Street Settlement
-established on New York's Lower East Side in 1893. -serious health conditions related to the influx of immigrants who came seeking work in the factories of the northeastern United States -founder= Lillian Wald ^^obtained financial assistance from private sources and began the first formalized public health nursing practice -colleague= Lavinia Dock --a social activist and reformer, assisted Wald in providing services through visiting nurses and clinics that cared for well babies, treated minor illnesses, prevented disease transmission, and provided health education to the neighborhood
Telehealth Nursing
-expands access to health care for underserved populations and individuals in both urban and rural areas. -reduce the sense of professional isolation experienced by those who work in such areas and may assist in attracting and retaining health care professionals in remote areas
Nurse Entrepreneur
-identifies a need and creates a service to meet the identified need. -These are nurses who use their knowledge and skills to independently create businesses that aid in fixing or supporting health related issues. --Example: Manufacturing premature baby clothes --Type of care: Consultants, Direct care through nurse-managed centers --employed as consultants to hospitals, nursing homes, and schools of nursing
Dorothea L. Dix
-long-time advocate for the mentally ill in prewar years -appointed Superintendent of Women Nurses by the Union Army -instrumental in creating a month-long training program at two New York hospitals for women who wanted to serve
Nursing in Communities
-may work for either the government or private agencies -provide educational programs in health maintenance, disease prevention, nutrition, and child care, among others. -These nurses provide care outside of hospitals and are directly involved in maintaining the overall health of members within a community through local outlets. --Example: Locally providing immunization clinics --Type of care: Prevention care & In-home care
The 1980s and 1990s were also marked by an enormous increase in the use of
-medical technologies, including the wide use of life support -Many ethical questions were raised during these years regarding the use of life support technologies and when they are appropriate
women of the South
-outpouring of support for Confederate soldiers -late 1861 and early 1862-> female volunteers or wounded soldiers staffed Confederate hospitals -several women were appointed as superintendents of hospitals -only a few were appointed as matrons of hospitals
Affordable Care Act (ACA)
-passed in 2010 by the 111th Congress 1.—the Patient Protection and Affordable Care Act (PL 111-148) 2.Health Care and Education Affordability Reconciliation Act (PL 111-152). -Signed into law by President Barack Obama -health care reform
Nursing in the Armed Forces
-practice in both peacetime and wartime settings -broader responsibilities and scope of practice than do civilian nurses because of the demands of nursing in the field, on aircraft, or onboard ship -travel and change are emphasized
Faith Community Nursing
-practice specialty that focuses on the intentional care of the spirit, promotion of an integrative model of health, and prevention and minimization of illness within the context of a faith community -a holistic approach to healing that involves partnerships among congregations, their pastoral staffs, and health care providers. -practice independently within the legal scope of the individual state's nurse practice act -These nurses work alongside faith communities to provide care that combines health and spirituality. --Example: Advocates for health services --Type of Care: Prevention care, Advising care, Spiritual care
Dr. Edward T. Devine
-president of the Charity Organization Society -noted the high incidence of tuberculosis among New York City's African American population -determined that a Black district nurse should be hired to work in the African American community to persuade people to accept treatment ^^^Jessie Sleet Scales hired
occupational and environmental health nurses
-provide basic health care services, health education, screenings, and emergency treatment to employees in the workplace
Home health care
-provide quality care in the most cost-effective and, for patients, most comfortable setting possible -
Certified Nurse-Midwife (CNM)
-provide well-woman care and attend or assist in childbirth in various settings, including hospitals, birthing centers, private practice, and home birthing services -require an average of 1.5 years of specialized education beyond basic nursing education and must be accredited by the Accreditation Commission for Midwifery Education
1946 Hill-Burton Act
-providing funds to construct hospitals, which led to a surge in the growth of new facilities -This rapid expansion in the number of hospital beds resulted in an acute shortage of nurses and increasingly difficult working conditions long hours, inadequate salaries, and increasing patient loads made many nurses unhappy with their jobs, and threats of strikes and collective bargaining ensued
2 Noteworthy events of the 1920's
-publication of the 1923 Goldmark Report ^^study of nursing education that advocated for the establishment of schools of nursing associated with colleges and universities, rather than hospital-based diploma programs, and encouraged the establishment of rural programs in midwifery
The first edition of the American Journal of Nursing
-published in October 1900 -Nurse leaders Isabel Hampton Robb, Mary Adelaide Nutting, Lavinia L. Dock, Sophia Palmer, and Mary E. Davis were heavily involved in the development of the journal
The passage of the Affordable Care Act (ACA)
-signed into law by President Barack Obama in March 2010 -health care reform -The ANA supported the passage of this Act and in 2011 affirmed its continuing support for the Act in the face of efforts by subsequent sessions of Congress to repeal it. -Early provisions banned lifetime limits on insurance coverage by insurers so that patients with extreme medical costs can be assured of continuing benefits over the course of their illness and lifetime -prevents insurance companies from denying coverage to children and teens younger than age 19 because of a preexisting condition -coverage of recommended preventive services with no out-of-pocket expenses for insurance holders, the right to appeal coverage decisions, and having a choice of primary care providers -persons with a preexisting health condition could not be denied health insurance coverage
Social Security Act (SSA) of 1935
-significant part of President Roosevelt's plans to bring the nation out of the Depression, -enhanced the practice of public health nursing -strengthen public health services and to provide medical care for children with disabilities and blind persons -public health nursing became the major avenue for the provision of care to dependent mothers and children, the blind, and children with disabilities
Gender
-social construction of behaviors, roles, beliefs, and values that are specific to women or men -Assignment of gender roles starts early (even before birth in some cases) and is part of socialization, -^^the process through which values and expectations are transmitted from generation to generation -Gender-role stereotyping can be subtle but begins early with cues as commonplace as pink clothing for baby girls and blue for boysthe most common roles assumed by women were within their families and involved caring for others, maintaining a household, and taking care of their husbands and children -This type of stereotyping shaped the type of training that nurses received, which was fundamentally task oriented, and this form of instruction persisted for many years
Nurse Educators
-teach in licensed practical nurse/licensed vocational nurse programs, diploma programs, associate-degree programs, bachelor's-and higher-degree programs, and programs preparing nursing assistants -Nurse educators in accredited schools of nursing offering a bachelor's or higher degree must hold a minimum of a master's degree in nursing
The first program established exclusively for training of African American women in nursing was established at
-the Atlanta Baptist Female Seminary (later Spelman Seminary, now Spelman College) in Atlanta, Georgia, in 1886 -2 years long and led to a diploma in nursing -global leader in the education of women of African descent today.
Nurse Practioner
-work in clinics, nursing homes, their own offices, or physicians' offices. Others work for hospitals, health maintenance organizations, or private industry
Early 20th century
1900-1945 -institution of state licensure for nurses was a huge milestone -early efforts at licensure were not well received -state legislatures in New Jersey, New York, North Carolina, and Virginia passed what were known as permissive licensure laws for nursing in 1903
World War I/ Early Depression Era
1917-1930 -The U.S. involvement in World War prompted the opening of an Army School of Nursing to recruit nurses. These nurses eventually became proficient in caring for wounded soldiers, which earned them military rank. -The influenza pandemic prompted the need for "public education in home care and hygiene through Red Cross nursing
World War II
1939-1945 -Inadequate supply of nurses -Congress enacted legislation to provide substantial financial support for nursing education -The military -Students received tuition, books, a stipend, and a uniform in return for a commitment to serve as nurses for the duration of the war in either civilian or military hospitals, the Indian Health Service, or public health facilities and collegiate programs of nursing formed the Cadet Nurse Corps, an alliance to train student nurses.
National Committee on Nursing
Chaired by Mary Adelaide Nutting, professor of Nursing and Health at Columbia University, -included Jane A. Delano, director of Nursing in the American Red Cross. -Charged with supplying an adequate number of trained nurses to U.S. Army hospitals abroad. - initiated a national publicity campaign to recruit young women to enter nursing training -established the Army School of Nursing with Annie Goodrich as dean -introduced college women to nursing in the Vassar Training Camp for Nurses.
1983-2000
Challenges for Nursing—HIV/AIDS and Life Support Technologies
first trained nurse in the US
Linda Richards
first African American professionally educated nurse
Mary Eliza Mahoney -received training at New England Hospital for Women and Children in Boston
First state to have mandatory licensure
New York -1930's -not fully mandated until 1947
influence on the way that health care is delivered in the United States
Recent legislation, demands of patients as consumers of health care, and the need to control costs while optimizing outcomes
The earliest school established exclusively for the training of men in nursing was
School for Male Nurses at the New York City Training School, established in 1886
second male school for nurse training
The Mills College of Nursing at Bellevue Hospital -founded in 1888
2001-2015
The Post-9/11 Era, Natural Disasters, and Health Care Reform
1945-1960: The Rise of Hospitals—Bureaucracy, Science, and Shortages
The professionalization of nursing continued after the end of World War II
In 1920 Congress passed
a bill that provided nurses with military rank
In 1950 the NLN assumed responsibility for
administering the first nationwide State Board Test Pool Examination.
When did the move toward formal education and training for nurses grow
after the Civil War
Nursing in Hospitals
care for patients who have medical or surgical conditions (e.g., those with cancer or diabetes, those in need of postoperative care), children and their families on pediatric units, women and their newborns, and patients who have had severe trauma or burns
The changing nature of health care in one arena (e.g., rapid responses in the field) has implications for
care in another arena (e.g., long-term rehabilitation of veterans with missing limbs).
The Frontier Nursing Service (FNS)
established in 1925 -by Mary Breckinridge, a nurse and midwife -Originally established as the Kentucky Committee for Mothers and Babies - provided the first organized midwifery program in the United States -worked in isolated rural areas in the Appalachian Mountains, traveling by horseback to serve the health needs of the poverty stricken mountain people -demonstrated that nurses could play a significant role in providing primary rural health care
By 1923 all states required
examinations for permissive licensure, but the examinations were not standardized.
In 1947 military nurses were awarded
full commissioned officer status in both the Army and the Navy Nurse Corps and segregation of African American nurses was ended.
National Sample Survey of Registered Nurses (NSSRN)
gave policy makers, educators, and other nurse leaders data about the workforce, allowing them to make informed decisions about allocation of resources, development of programs, and recruitment of nurses -DISCONTINUED
in 1983 the first incidence of the spread of HIV was noted in
hemophiliacs as a result of HIV-contaminated blood products. -all persons were susceptible to HIV
Primary/Most common work site for nurses
hospitals
During the 11th, 12th, and 13th centuries in Europe
men provided much of the nursing care, often under the authority of military or religious orders
What was clear from both the World Trade Center attacks and the aftermath of Hurricane Katrina is that
nurses were called on to act in conditions that had been previously unimaginable and unaddressed -Nursing as a profession has responded by increasing preparedness for human catastrophes and natural disasters that are certain to occur in the future.
The 1920s also saw increased use
of hospitals and an acceptance of the scientific basis of medicine
The training school at the New England Hospital for Women and Children in Boston agreed to admit
one African American and one Jewish student in each of their classes if they met all entrance qualifications.
Julie O. Flikke was the first nurse to be
promoted to the rank of colonel in the U.S. Army
In 1971 Idaho became the first state to
recognize diagnosis and treatment as part of the legal scope of practice for NPs
Jessie Sleet Scales
recommended to Lillian Wald that Elizabeth Tyler, a graduate of Freedmen's Hospital Training School for Nurses in Washington, D.C., work with African American patients at the Henry Street Settlement -established the Stillman House, a branch of the Henry Street Settlement serving Black persons in a small store on West 61st Street
In 2006, in response to the arrest of two nurses for administering lethal doses of morphine and midazolam to four terminally ill patients in the aftermath of Hurricane Katrina
the American Nurses Association (ANA) published comments on nursing care during disasters, citing the "unfamiliar and unusual conditions with the health care environment that may necessitate adaptations to recognized standards of nursing practice
The early 1980s was marked by
the recognition of the rapid spread of a retrovirus that later became known as the human immunodeficiency virus (HIV) -virus was isolated from a person with acquired immunodeficiency syndrome (AIDS), and ultimately resulted in the change in health care globally -affecting everything from materials such as needles, intravenous catheters, and gloves to global AIDS initiatives in resource-poor nations, particularly in Africa.
In 1954 men were allowed
to enter the military nursing corps
Vietnam War
—provided nurses with opportunities to stretch the boundaries of the discipline. -occurred in jungles not easily accessed by rescue workers or medics and without clearly drawn lines of combat -Mobile hospital units were set up in the jungles, where nurses often worked without the direct supervision of physicians as they fought to save the lives of the wounded. -performed advanced emergency procedures such as tracheotomies and chest tube insertions, never before executed by nurses -many nurses suffered posttraumatic stress disorder, as did the returning soldiers
