Nursing As A Professional Midterm Part 2
Evidence-based practice
the use of research findings as a basis for practice rather than trial and error, intuition, or traditional methods, such as problem solving
What is the ultimate goal of nursing theory
to support excellence in practice
Altruism
unselfish concern for the welfare of others
When does theory-based practice of nursing occur
when nurses intentionally structure their practice around a particular nursing theory and use it to guide them in a systemic way of thinking about patient care.
Profession
work requiring advanced training and usually involving mental rather than manual effort. Usually has a code of ethics and a professional organization
According to Peplau, the most important of the 6 roles for a nurse to use in helping the patient achieve personal growth is determined by
the setting the patient-nurse interaction
Collegiality
the promotion of collaboration, cooperation, and recognition of interdependence among members of a profession
What does theory-based research test and refine
the knowledge base of nursing
Leininger's Theory of Culture Care Diversity and Universality
"goal of transcultural nursing involves planning nursing care based on specific knowledge that is culturally defined, classified and tested." This is used to provide care that is culturally congruent for patients. Transcultural nursing has become increasingly relevant with global migration creating more diverse societies
What does metaparadigm consist of
the major concepts of the discipline: person, environment, health, and nursing
Collective identity
The connection and feeling of similarity individuals in a particular group feel with one another; group identification
5 barriers to professionalism in nursing
1. varying levels of preparatory education 2. Gender issues 3. historical influence 4. External conflicts (conflicts with medicine have arises as nurses are able to provide services that were formerly part of medical practice by physicians) 5. Internal conflicts
Lucie Kelley (1981) 8 characteristics of the nursing profession
1. vital to humanity and welfare of society 2. special body of knowledge enlarges over time 3. services involve intellectual activities 4. Education in institutions of higher learning 5. Practitioners relatively independent 6. Motivated by service and importance of work 7. Code of ethics to guide practice 8. Organization supports high practice standards
Flexner Report
1910: groundbreaking work to reform standards in medical education. Criteria widely used as benchmark for status of occupations. Has had strong influence on nursing education.
Richard Hall 1968
5 point model of a profession
What did Houle identify
9 characteristics that indicate that an occupation is developing a collective identity or group identification, which is necessary for professions. These include formal training, credentialing, creation of a subculture, legal right to practice, public acceptance, ethical practice, discipline of incompetent/unethical practitioners, relationship to other practitioners, and relationship to users of services.
Imogene King's conceptual models of nursing
A Theory for Nursing Systems, Concepts, Process (1981): focuses on people, their interpersonal relationships, and their social contexts. Referred to as the personal, the interpersonal system, and the social system
Which one of nursing leader Dr. Lucie Kelly's characteristics of a profession is described as an organization that encourages and supports high standards of practice
Association
Where did Florence Nightingale birth nursing
Chicago Worlds Fair (NLN) (she wasn't there but her paper was)
Jean Watson's philosophy of nursing
Emphasized the caring aspects of nursing. Proposed 10 "carative factors" (caritas processes) to differentiate nursing from medicine. Nursing as a human-to-human relationship.
Mary Mahoney
First black nurse. Became a private duty nurse in various family homes in the Boston area. She was 33 years old when she began her nursing education at the New England Hospital for Women and Kids
Who published a list of criteria that are characteristic of all true professions and that has stood the test of time
Flexner
Nursing's social Policy Statement: The Essence of the Profession (AMerican Nurses Association [ANA], 2010)
Framework for understanding nursing's relationship with society. Contemporary definition of nursing
What did Hall recommend
He recommended that each profession needed to develop its own methods of measuring professionalism that recognize the uniqueness of that discipline
Miller's Wheel of Professionalism 1985
Hub represents the essential foundation of nursing education. 8 spokes represent other behaviors deemed necessary to maintain or increase nurses' professionalism: competence and continuing education, adherence to code of ethics, participation and communication, orientation toward community services, theory and research development and utilization, self-regulation and autonomy.
Sister Callista Roy's Adaptation model
Introduction to Nursing: An Adaptation Model (1976): focuses on individual as a biopsychosocial adaptive system. Nursing as a humanistic discipline that emphasizes the person's adaptive or coping abilities, including the need for alterations in the person's environment
Middle-range Theories of Nursing
Neither overly broad nor narrow in scope. Focus on a specific aspect of nursing. Based on empirical research. Often embedded within a larger theory. Typically merge practice and research. Well known middle-range theories include: Swanson's Caring Theory, Mishel's Uncertainty in Illness Theory, Dobratz's Psychological Adaptation in Death and Dying
Using Imogene King's Model in Practice
Nurses focus on goal attainment for and by the patient. King's model isn't linear; steps occur simultaneously as the nurse and patient work together. Care is guided by concepts at each of the system levels. Example: The personal system leads the nurse to explore a patient's personal roles and stresses. King's process provides a structure for the nurse to monitor the relationship's progress toward the goal of the patent regaining health
Using Orlando's Theory in Practice
Orlando's theory specifies how patients are involved in the nurse's decision making. In practice, the theory guides interactions toward predictable outcomes. Nurses individualize care for each patient by: attending to behavior, confirming with the patient ideas and inferences, identifying pressing needs. Nurses get to the "bottom line" more quickly when observing, listening to, and confirming along with patient. This theory saves time and energy for nurse and patient
Nursing: Scope and Standards of Practice (2004)
Outlines expectations of the professional role of practice. Delineates standards of care
Hildegard Peplau
Peplau's Theory of Interpersonal Relations in Nursing --> nurse-patient relationship.
Nightingale's philosophy in practice
She believed that health was related to patients' environments (clean water and environments...) She recognized nursing's role in protecting patients (shielding from harm, not discussing upsetting news, not tiring a patient). She promoted sensitivity to the effect of the environment, which was the foundational work for the theory that changing patients' environments could positively affect their health
Using Hildegard Peplau's Theory in Practice
She describes a 4 pronged process for the nurse to assist the patient in achieving personal growth. The process involves 6 roles of the nurse. The setting determines which roles are emphasized: counselor, resources, teacher, technical expert, surrogate, leader. Focuses the importance on what happens between the nurse and patient in the therapeutic relationship
Florence Nightingale's philosophy of nursing
She was born to a wealthy family... BUT her book: Notes On Nursing: What It Is an What It Is Not (1859) made a distinction between the work of nursing and the work of physicians by identifying health rather than illness as the major concern of nursing. Focused the profession on person, health (as opposed to illness), and nursing (as opposed to medicine)
Bixler & Bixler
Studied nursing's status as a profession
Orlando's Nursing Process Theory
The Dynamic Nurse-Patient Relationship: Function, Process and Principles (1990): the goal of the nurse is to determine and meet patients' immediate needs and to improve their situation by relieving distress or discomfort. This theory emphasizes deliberate action.
Who did Florence Nightingale get most of her ideas from
Theodore Fleedner
Code of Ethics for Nurses With Interpretive Statements (ANA, 2010)
There are 9 provisions accompanied by interpretations. 3 describe nurses' values and commitments. 3 address boundaries of duty and loyalty. 3 address aspects of duties beyond individual patient encounters
Theoretical Challenges for Nursing Education, Practice, and Research
To continue forward movement in nursing and to improve quality of nursing care, nurses must engage in: theory-based practice, theory-testing research, theory-generating research. Theory based education: curricula are built on one or more conceptual models. It is important for students to understand that their coursework is based on a philosophy or a conceptual model that shapes the way nursing is taught. Theory based practice occurs when nurses intentionally structure their practice around a particular nursing theory and use it to guide them as they: assess, plan, diagnose, intervene, evaluate nursing care. Theory provides a systematic way of thinking. Theory provides the tools to challenge the conventional views of patients, illness, interventions, and health care delivery systems.
What is a more specific organization of nursing phenomena than a philosophy
a conceptual model or framework
Professional
a person who engages in one of the professions, such as law, medicine, or nursing
Occupation
a person's principal work or business
Professionalization
a process through which an occupation evolves to professional status
What is nursings distinct theoretical orientation to practice based on
a specific body of knowledge that is built on theory
Code of ethics definition
a statement of professional standards used to guide behavior and as a framework for decision making
Caring
a theoretical framework central to nursing that results in a professional form of relating to, attending to, and providing for the needs of others
Definition of grand theory
a very broad conceptualization of nursing phenomena
Association
an organization of members with common interests
Using Dorothea Orem's Model in Practice
appropriate care for the patients is developed through a series of 3 operations 1. diagnostic: to determine the patient's ability to provide effective self-care. begins with the establishment of the nurse-patient relationship 2. Prescriptive: occurs when therapeutic self-care requisites are determined and nurse reviews various methods, actions, and priorities with the patient. Planning stage for formulating a plan of care 3. Regulatory: nurse designs, plans, and produces a system for care. Range from wholly compensatory to supportive-educative
How is nursing's body of knowledge shaped
by how nurses view the world
Using Jean Watson's philosophy in practice
caring
What is an important standard for professional nurses
collegiality
ANA's 2004 Nursing: Scope and Standard of Practice includes
collegiality as one of 9 standards of professional performance
Dorothea Orem's philosophy of nursing
critical thinking. Less abstract and more formalized that philosophies. 3 interrelated theories: 1. theory of self-care 2. theory of self-care deficit 3. theory of nursing system
Houle 1980
delineated characteristics that indicate an occupation is moving toward professional status
What are the outcomes of research findings
enable nurses to improve quality of care and understand how evidence-based practice influences improved patient outcomes.
Define middle range theory
narrower in focus than grand theory and makes connections between grand theories and nursing practice.
Using Sister Callista Roy's model in practice
nurses assess the environmental stimuli of both internal and external environments. Then, nurses assess a patients adaptive behavior that results from the stimuli. Nurses next develop nursing diagnoses as a result. These guide goal-setting and interventions aimed at promoting adaptation. Nurses modify the environment to facilitate patient adaptation
Professionalism
professional behavior, appearance, and conduct
What distinguishes an occupation from a profession
professional preparation and commitment. Profession is a needed service
Code of ethics
public document reminding nurses and the public of nurses' obligations and responsibilities to patients and others
Philosophy
refers to a set of beliefs about the nature of how things work and how the world should be viewed. It provides a broad, general view of nursing that clarifies values and answers broad disciplinary questions such as What is the profession of nursing? What is the nature of human caring?
Metaparadigm
refers to the most abstract aspect of the structure of nursing knowledge
Using Leininger's Theory in Practice
respecting the culture of the patient
Accountability
responsibility for one's behavior
Autonomy
self determination. control over one's own professional practice
What does the essence of collegiality include
supportive and healthy work environments, cooperation, recognition of interdependence among members of the nursing profession
Nurse researchers are increasingly meeting the challenge of using nursing theory to structure nursing research that:
tests theory, develops theory through qualitative research
What does nursing philosophy tie together
the concepts of nursing's metaparadigm
