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