NURS 2300 Final Exam Review - Jenkins
48. Calculate basic medication problems.
(on paper)
Comparative negligence
- a type of liability in which damages may be apportioned among two or more defendants in a malpractice case. The extent of liability depends on the defendant's relative contribution to the patient's injury.
•Empacho
- is a disease that can affect children or adults and is caused by food particles becoming lodges in the intestinal tract, causing sharp pains. To manage this illness, the afflicted person lies face down on the bed with his or her back bared. The curer pinches a piece of skin at the waist, listening for a snap from the abdominal region. This is repeated several times in hope of dislodging the material.
Relationship of nursing research to nursing theory and practice
-Are circular
40. Define ethical principles of autonomy, justice, beneficence, non-maleficence, justice, fidelity, and veracity.
-Autonomy: an individual's rights to determine their own actions -Justice: Equals should be treated the same -Beneficence: To do only good. EX-choosing treatments that do more good than bad CHEMO -Nonmaleficence: The duty to do no harm EX: checking medications before administering -Fidelity: Refers to faithfulness or honoring one's commitment or promises. EX: keeping nurses skills current -Veracity: Telling the truth, or not lying.
44. Discuss the UTA Code of Ethics for Nursing Students.
-Beneficence: the doing of good -Nonmaleficence: the duty to do no harm -Justice: fair, equitable, and appropriate care -Autonomy: freedom to make own choices -Veracity: truth telling -Fidelity: faithfulness and keeping one's promises
25. Identify the role of the nurse scientist.
-Clinical studies, involvement in unit of hospital wide committees, serve on an institutional review board (all research studies are subject to an IRB review) *Nurses in practice commonly question procedures and routines, asking whether there is a better way to achieve the outcomes of patient care. One way to streamline the process of examining research literature is a process known as PICO. P-population of interest I-intervention C-comparison O-outcome (sometimes) T- time *nurse informaticians are best to understand the needs of nurses who use the systems and can customize or design them with the needs, skills, and time constraints of those nurses in mind.
Impact of nursing burnout and compassion fatigue on patient care
-Compassion fatigue: a condition in which one experiences loss of physical energy, burn out, accident process, emotional breakdowns, apathy, indifference, poor judgement, & disinterest in being introspective -Negative feelings interfere with the ability to maintain a caring attitude and drain caring out of our interactions with others
Social relationships
-Evolve spontaneously -Not time-limited -Not necessarily goal-directed -Centered on meeting both parties needs -Problem solving is rarely/occasionally a focus -May or may not include nonjudgemental acceptance -Outcome is pleasure for both parties
Professional relationships
-Evolve through recognized phases -Limited in time with termination date often predetermined -Goal-directed -Centered on meeting patients needs -Problem solving is a primary focus -Includes nonjudgemental acceptance -Outcome is improved health status of patient
Working definition of critical thinking
-The thinker improves the quality of his or her thinking by skillfully taking charge of the structures inherent in thinking and imposing intellectual standards upon them
Hardiness/Learned Resourcefulness
-ability to resist stressful life event -aquiring skills that enable effective coping
Nurse Politician
-actually running for office -seek appoinment with gov. agency -member on Board of Nursing
Sick role
-behavior that is dependent, passive, submissive -exempt form social responsibilities -cannot be expected to take care of themselves -sick person should want to get well -seek medical care "cooperate"
Nursing
-combines the preceding concepts -includes non-judgemental attitude, helps people maintain their health, receivie maximum ability, involves education, good communication, advanced skills
Virginia Henderson
-definition of nursing -nursing assists patient with 14 essential functions toward independence
Coping ability
-how well they cope with their illness/situation -positive or negative experiences
Assertiveness with the angry patient
-identify anger -give permission to be angry -give responsibility to patient to own anger -analyze the current situation that is disturbing the patient -assist patient in plan to deal with anger
Nursing interventions with angry patient
-identify why patient is angry -plan of care that involves patient -use incentives and withdrawal of privileges -interventions to decrease anxiety -provide education -set limits -promote trust by providing immediate feedback
Nurse Activist
-politically active in nursing organizations -work for a campaign -contribute money
Cultural influences on illness
-powerful effect on behaviors -personal experience -may feel sick even if no disease present -disease without loss of function
Basic test included in nursing position
-routine blood test -urine drug screen -chest radiography -skills test -pharmacology test -paper and pencil testing -psychological testing for specialty areas
47. Verbalize basic conversion and abbreviation terms.
1 Liter = 1000 Milliliters 1 Gram = 1000 Milligrams 1 Milligram = 1000 Micrograms 1 Kilogram = 2.2 pounds
Levels of perception
1. selective attention: concentrate on certain areas of an issue 2. selective exposure: type of message that we are used to "think like we do or judgement of others" 3. selective perception: individuals filter what they see and hear to suit their own needs and expectations 4. selective memory: information we retain from others interactions or experiences
Important concepts to systems to remember
1. whole system is different from and greater than some of its parts 2. set of intrarelated parts 3. a change in one part, creates change in all other parts 4. goal is balance (homeostasis)
Assertive statements: 3 parts
1. your perspective of the situation 2. your feelings about the situation 3. your needs regarding the situation
Spanish American War
1898, set stage for Army Nurse Corporation
Mary Eliza Mahoney
1st African-American professionally educated nurse
Healthy People 2000/2010/2020
2 Goals 1. increase quality in years of healthy life 2. eliminate health disparities "differences" (what everyone access to healthcare
The major provisions of the PPACA/Affordable Care for All Act take/took effect in which year? a) 2000 b) 2012 c) 2014 d) 2016
2014
Faye Abdella
21 nursing problems. client centered interventions
Which of following is NOT accepted criterion for evaluating usefulness of theory to nursing
Acceptance by members of other health care disciplines
Jessie Sleet Scales
African American public health nurse
Factors that effect ability to communicate
Age, gender, culture, experience with illness, family norms, self-awareness, emotional intelligence
Practice of Nursing
Apply knowledge from biological, physical, and social sciences, nursing procedures and skills Levels of knowledge, basic foundational thinking, highest critical thinking
Who are considered " internal customers" ?
Are employed by the organization and may include patient care staff members, staff members of other departments, administrators, social workers, dietitians, and therapists.
Evaluation of Critical Thinking
Assess the relevance, significance or applicability of the findings to the situation
Which of following is an example of a correctly formatted reference for a journal article according to the APA Manual, 6th edition?
Backer,B. A. (1993). Lillian Wald: Connecting caring with action. Nursing & Health care, 14(3), 122-129.
BSN nurse
Basic professional practice as RN, management, community and public health settings; prepares for graduate school and certification, basic programs are 4 years
Types of organizations
Broad: purpose professional organizaitons "ANA" Specialty Practice associations: "AORN" Special interest associations: "Sigma Theta Tau"
Malpractice may occur in two ways
By commission-doing something that that should not have been done- and by omission-failing to do things that should have been done
The main database used to locate journal articles in nursing- specific periodicals/journals is: a) PubMed b) CINAHL c) ProQUEST d) Google Scholar
CINAHL
Lisa Newton describes inner conflicts of nurses in wartime. What was she referring to?
Caring for wounded with result some will become well enough to cause or experience more suffering
The type of advanced practice nurse who is called to problem solve with nurses on a medical oncology unit on how to manage a particularly complex patient would likely be a: a) Nurse midwife b) Clinical nurse specialist c) Nurse practitioner d) Primary Nurse
Clinical nurse specialist
4. Interdependence
Collaborative decision making; commitment to professional role; self-concept now includes professional role identity
Associate degree programs in nursing are primarily offered by: a) hospitals b) universities c) 4-year colleges d) community and junior colleges
Community and junior colleges
Associate Degree Program
Community colleges and junior colleges and takes 2 years
C.A.R.E.
Connect: offering yourself Appreciate: clients situation, dont say "I understand" Respond: to their needs Empower: the client to problem solve with you
Applications of nursing theories include all of following EXCEPT
Directing how best to carry out specific procedures in nursing practices
Inference
Draw conclusions that are based on evidential data and are logical given the client situation
Directing( chỉ đạo)
Encourages employees to accomplish goals and objectives and involves communicating, delegating, motivating, and manage conflict -clearly communicate performance expectations - create a motivating climate and team spirit -model expected behaviors -facilitate feedback
Justice
Equals should be treated the same and that unequals should be treated differently
Nurse is assessing client's intravenous setup. Sees that the night nurse hung the antibiotics but failed to start the infusion. Nurse fills out an incident report. In doing this she has demonstrated the following?
Ethical/legal skills
Analysis
Examine the findings in relation to the situation and gather additional data as needed to validate the findings
Social, Political, Economic Factors
Feminism, Women's Movement, Consumer Movement, Graying of America, Cultural Diversity, Men in Nursing, Violence, Technological Advances
Nursing Knowledge
Focuses on knowledge needed for the care of clients, based on nursing research and research from other disciplines, evidence bases practices use evidence from research for best nursing practices
Guidelines and benefits of preceding for lectures
Guidelines -Skimming: no more than 10-15 minutes -Looking for main ideas -Vocabulary and new terms or abbreviations -Discovering patterns -Analyzing Benefits -Saves time -Helps you understand more from lecture -Speeds up reading -Gets you started unmaking study notes more quickly
Therapeutic use of self
Helpful to you in relating effectively to patients, patients families, and other health care professionals
Role of nursing assistant includes basic skills like helping with ADL's which include:
Helping with eating, bathing, dressing
Compared with international peer nations around world, the health care system in the U.S. has: a) Low total and per resident costs b) low levels of innovation c) high levels of health disparities across socioeconomic and other groups d) near-universal coverage of all residents for basic health care services
High levels of health disparities across socioeconomic and other groups
Assertiveness Ladder
L-look at own rights and needs A-arrange a time D-define the problem D-describe your feelings E-express your request simply R-reinforce the possibility of getting what you want
Why is professional socialization important
Learn professional behaviors, enhances professional commitment, improves our (nursing) image, learn the profession's expectations of its members
Clara Maas
Nurse who died after deliberarely acquiring two bites from yellow fever carrier mosquitoes
Quesitons: open and closed
Open: "How do you feel.." "Could you tell me more?" Closed: inefficient, can be answered with yes or no, "Do you feel sad?"
4 Domains of Nursing
Person, Health, Environment, Nursing
Four major concepts of nursing
Person, Health, Environment, and Nursing
Concepts in nursing metaparadigm are:
Person, environment, health, nursing
The doctoral degree in nursing that emphasizes learning to conduct research independently is: a) DNP b) PhD c) EdD d) MS
PhD
Most common reason nurses are disciplined by SBNs is?
Practicing while under the influence of alcohol or other substance, often a narcotic taken from the workplace
Assertive listening
Prepare: tune into own feelings and needs Engaged: listening-put full attention on the other person (ask for clarification) Acknowledge: let the other person know you heard his/her feelings and wants
1. Unilateral dependence
Reliant on external authority; limited questioning or critical analysis
Staffing( nhân sự)
Required to have qualified people accomplish work, such as recruiting, hiring, training, scheduling, and ongoing staff development
27. Describe therapeutic use of self.
Requires self-interest, self-understanding, an understanding of the dynamics of human behavior, ability to interpret one's own behavior as well as the behavior of others and the ability to intervene effectively in nursing situations. Empathy + respect= Therapeutic communication
Key to organizational success
Retaining professional nurses
Types of Assertive Responses
Simple: "I think" Empathetic: "I realize you are tired but.." Confrontive: "You said you would walk George, but you did not."
Client has been admitted to hospital for gastrointestinal bleed and requires transfusion of packed blood cells. Which of the following aspects demonstrates technical skill?
Starting a new, large-gauge intravenous site on the client and priming infusion tubing
Beneficence
The doing of good
23. Define evidence-based practice (EBP).
The practice of health care in which the practitioner systematically finds the most current findings as basis for clinical decisions.
Name of nursing librarian available to ALL nursing students at O'neill:
Wanda Anderson
Professional
a person who belongs to and practices a profession. A very misused term, Ex: professional football player
certified registered nurse anesthetist
administer anesthesia, work with either physician anesthesiologist or independently, obstetric delivery rooms, dentists, podiatrists, ophthalmologist, plastic surgeons, ambulatory surgical facilities, military/govt. health services. 2-3 year specialized education with MSN.
Dorthea Dix
advocate for mentally ill
what are nurse managers in charge of?
all activities on their units, including patient care, continuous quality improvement, hiring and evaluations, resource management, and unit budgeting.
Specialized knowledge
based on biological, physical, and social sciences, pathophysiology. Use this knowledge to promote health, prevent disease, empower others
ADN nurse
basic technical care in RN positions, primarily in institutions
Self efficacy
belief in your own abilities to change
Margaret Sanger
birth control movement
change agents
care enough to work within the system to elicit change. frequently visit nurse manager or head nurse to suggest change or better way
Position power
comes from being in certain positions
Reflection of feeling
direct back what you sense a person is feeling, shows someone is trying to understand you
Focusing
emphasize a certain point, expand on a certain issue
Sympathy
feeling sorry for someone
Clara Barton
founded Red Cross
Planning
goals are identified and nursing interventions selected
Forming
group comes together and gets to initially know one another and form a group
How to become a better listener
hearing, understand, remember, interpreting, evaluating
what is nursing in the workplace described as?
hired to care for those in a workplace/occupational and environmental health nurses. (employee health nurses)
Proxemics
how people use distance and space
Portfolio
includes : • Diplomas • Transcripts • Honors and awards
Expert power
knowledge one person has
Informal Group
may have different leaders at different times, leaders are not appointed or voted in
Passive-aggressive behavior
most difficult to work with indirect aggression sarcasm sabatoging manipulation
WWII
need for nurses brought about the Cadet Nurse Corp
Lavinia Dock
nursing education reform, women's suffrage
Confusing cause and effect
occurs when one assumes that one event must cause another just because we often see the two events occur together
Resilience
pattern of successful adaptation, ability to adapt to stress
Primary prevention
preventing or slowing onset of disease "teaching nutrition"
Secondary prevention
screening on early detection of disease
Skills that provide comfort
sympathy, compassion, reflexive reassurance: AVOID "youre gonna be okay"
Professionalism
the demostration of high-level personal, ethical, and skill characteristics of a member of a profession
Informal Socialization
the learning experiences that occur incidentally, what you observe during your shadowing experience. Can be a positive or a negative experience. VERY powerful in the socialization process
Philosophy
the study that underlie professional conduct, gives reasoning to the profession, accepted by profession
Latent power
underused power (nursing)
Systems Theory
use to understand the concepts of nursing
Levels of communication
verbal, nonverbal and congruency
Visual Learners
written word, pictures, graphs, diagrams, mental visualizations, sit at the front of the room, take detailed nots. Use charts, outlines, view videos, read books, place information on a timeline
Clarification
you don't understand what the client is saying
Mentoring
• A mutual interactive method of learning in which a knowledgeable nurse inspires and encourages a novice nurse
Bureaucracy
• A system of government in which most of the important decisions are made by state officials rather than by elected representatives.
Qualitative
• A systematic, subjective approach used to describe life experiences and give them meaning
Binding arbitration
• Binding arbitration means that all parties must obey the arbitrators recommendations
Patient classification system
• Categorizes patients according to specific criteria and care needs and thus help quantify the amount and level of care needed. This may be referred to as the acuity level. • The higher the acuity level, the more intense the patient's nursing care needs
Quality and safety for nursing QSEN
• Identify competencies or abilities that all health care professionals should achieve to transform health care systems, reduce errors, and improve quality outcomes
Straw man
• Occurs when a person's position on a topic is misrepresented
Resolution Phase
- Novice nurse's ability to adjust to the new environment. If the nurse is able to positively work through the rejection phase, he or she grows more fully as a person and a professional nurse during the resolution phase. Work expectations are more easily met and the nurse will have developed the ability to elicit change
Deontology
- is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and compel them to do what is right. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if violates that moral duty.
Privacy
- refers to the right of an individual to keep information about himself or herself from being disclosed to anyone else. If a patient has had an abortion and chooses not to tell a health care provider this fact, the patient would be keeping that information private.
Effects of grass root
- registering to vote and voting in ALL elections - joining professional nursing organizations w/ policy, advocacy agendas - working in political candidates campaign - meeting with policymaker or their staffs members - attending meet the candidates town hall meeting - communicating with policymakers by email, fax, and telephone
Recovery Phase
- the return of humor is usually the first sign of the recovery phase. The novice begins to understand the new culture to a certain degree. There is less tension and anxiety, and healing begins.
Mary Seacole
-"greatest black briton" -Jamaican business woman. -did not work with nightingale, she sent a request and was declined. -a lot of experience managing cholera -mother seacole
Factors of effective and ineffective groups
-Atmosphere: comfort v tense -Goal setting: clear goals v unclear -Leader/member participation: effective leadership is shared at times v dominating autocratic -Cohesion: high level of trust -Creativity: encouraged, open to new ideas
17. Describe the benefits of defining nursing and how this is related to professional socialization.
-Defining nursing means that you have identified the essential elements of being a nurse (what a nurse is and what a nurse does). -Professional socialization guides you in developing a safe and informed nursing practice. -Part of professional socialization is absorbing the culture of nursing, that is, the valued behaviors of the profession.
32. Identify how culture affects personal beliefs about health and illness.
-Determines when one seeks health and the type of practitioner consulted. -Also prescribes customs of responding to the sick. -Culture defines whether illness is seen as a punishment for misdeeds or as the result of inadequate personal health practices. -It influences whether one goes to an acupuncturist, a herbalist, a folk healer, or a traditional health care provider such as physicians and nurse practitioners.
Keep aspects of collaboration
-ID those who have stake in the outcome -ID the problem to be solved -ID barriers to creating a solution -Clarification of the desired outcomes -Clarification of the process -ID of who will be responsible for each step in task -Evaluation
45. Create a plan to overcome negative self-talk and anxiety as a nursing student.
-Identify negative self-talk -Use a cue word/ trigger to stop the thought and clear your mind -Refocus -Counter each negative thought
46. Explain the importance of medication math skills for nurses and how this relates to patient safety.
-It's important to give the right dosage so it doesn't harm the patient nor kill them -Accuracy is key in the medical field
How the nursing profession has evolved
-Male students were not allowed in the early nursing schools that enrolled women -Chicago World Fair was a turning point: several influential nursing leaders of the century gathered to share ideas and discuss issues pertaining to nursing education
49. Evaluate personal approach to test-taking.
-Pre-read before -Take notes -Study
28. Identify key aspects of collaboration.
-Respect for other collaborators -Confidence in your own knowledge -Willingness to learn -Cooperative spirit -Belief in a common purpose -Value contributions of other disciplines -Willingness to negotiate -Excellent communication skills -Self-awareness (i.e. biases, values, goals, agendas) -Tolerance of differing opinions -Not threatened by conflict -Knowledge of one's own limits
2. Describe how the public sees nurses.
-Since 1999, nurses are number 1 in ethnic and honestly every year except for 2001 (firefighters) -95 percent of Americans trust, respect, admire nurses *( most other professions identify themselves with more professional titles, which nurses introduce themselves less formally and often by their first name)
Strategies to ease transition from student to professional nurse
-Time management: ability to organize and prioritize nursing care for a group of patients is the key to good time management -Listen to gossip: help with the culture of the unit -Must adapt to collaborating with other nursing care personnel
Characteristics of an assertive person
-confident -in control -professional image -good leader -communication skills
Disbelief/Denial
-difficulty in believing -fear of illness -believe symptoms go away
Chronic illness
-more common, gradual onset, mild to vague symptoms, permanent "HTN, Diabetes"
Six areas of potential communication breakdown
-the nurse patient relationship, lack of trust -exchange of necessary information with patient -ensure accuracy in delivering correct treatment -exchange of necessary information with health care professionals -accurate interpretation of data
Primary focus of Institute of Medicine( IOM)
-to improve human health. -provides objectives, timely, authoritative information and the advice concerning health and science policy to the government, the corporate sector, the professions, and the public
Assertive strategies
-use I messages -dont be afraid to say no (w/o saying sorry) -check your nonverbals -use paraphrasing and clarification -listen before talking -dont fear rejection -accept compliments -report unacceptable behavior
Responding to criticism
-viewed as rejection -can be painful -dealing with criticism; silence, avoidance, get evens
3 strategies to criticism
1. Acknowledgement: agreeing you need help/understand 2. Clouding: agreeing in part, something positive, be assertive still, defuses a win/lose situation 3. Probing: don't know if criticism is constructive or manipulative, confused
Stages of illness
1. Disbelief/ Denial 2. Irritability and Anger 3. Attempt to Gain control 4. Depression and despair 5. Acceptance participation
Branches of Philosophy
1. Epistemology- dealing with the theory of knowledge itself 2. Logic- study of proper and improper methods of reasoning 3. Aesthetics- study of what is beautiful (painting, music, dance, literature, and sculpture) 4. Ethics- studies standards of conduct, attempts to answer the questions, "What is the nature of good and evil?" 5. Bioethics- term describing the branch of ethics that deals with biologic issues 6. Politics- deals with regulation and control of people living in society 7. Metaphysics- consideration of the ultimate nature of existence, reality, human experience, and the universe
21. Describe the steps in the research process.
1. Identification of a researchable problem 2. Review of the literature 3. Formulation of the research question or hypothesis 5. Design of the study 6. Implementation of the study 7. Drawing conclusions based on findings 8. Discussion and/or clinical implications 9. Dissemination of findings
Bennett's model of socialization and how it applies to nursing
1. Novice -has little background and limited practical skills; relies on rules and expectations of others for direction 2. Advanced beginner -has marginally competent skills; uses theory and principles much of the time; experiences difficulty establishing priorities 3. Competent practitioner -feels competent, organized; plans and sets goals; thinks abstractly and analytically; coordinates several tasks simultaneously 4. Proficient practitioner -views patients holistically; recognizes sublet changes; sets priorities with ease; focuses on long-term goals 5. Expert practitioner -performs fluidly; grasps patient needs automatically; responses are integrated; expertise comes naturally
Picketing
A form of protest in which people (called picketers) congregate outside a place of work or location where an event is taking place. Often this is done in attempt to dissuade others from going in ("crossing the picket line"), but it can also be done to draw public attention to a cause
Health Promotion
A role of the professional nurse Finding ways to help individuals develop a state of physical, spiritual, and mental well-being. Activities encourage optimal functioning. Finding ways to help patients be healthy. "preventing illness"
Which of following is NOT correct matching of theoretical idea with example of application in nursing practice?
Adaptation theory; nurse adapts teaching regarding health problem to a patient and her children to reflect low literacy
Pharmacology Responsibilities
Administer drugs, evaluate therapeutic responses to drugs, promote client adherence, providing education, intervene for adverse effects
Crimean war
Mary Seacole's efforts to care for soldiers during the Crimean war first led to the realization of the contribution of Africa Americans to nursing
A client 68 years of age who has spent their working life in the U.S. is mosy likely covered by which of the following health insurance programs? a) Capitation b) medicaid c) medicare d) AmeriCare
Medicare
Which of following organizations has its objective to "foster development and improvement of all nursing services and nursing education"? a) CCNE- Commission on Collegiate Nursing Education b) NLN- National League for Nursing c) Sigma Theta Tau d) ANA- American Nurses Association
NLN-National League for Nursing
Central issue in malpractice is?
Negligence- the failure to act as a reasonably prudent person would have acted in the same circumstances
What is the title of the book that summarizes Nightingale's ideas regarding the essential components of nursing practice? a) Nightingale's Writings b) Notes by the Lady with the Lamp c) Notes on nursing, What It Is and What It Is Not d) Notes on Hospitals
Notes on Nursing, What it is and What it is Not
Examples of job titles typically held by nurses with advanced practice preparation include: a) nurse practitioner or clinical nurse specialist b) nurse researcher or nurse educator c) staff nurse of nurse manager d) licensed practical nurse or registered nurse
Nurse practitioner or clinical nurse specialist
Nurse malpractice
Nurses are accountable for their own practice and can be named in a malpractice suit just as any practitioner can be named
How the public sees nurses
Nurses are well respected by the public and enjoy a generally positive image
Which of following is true statement
Nursing theories aim to assist, explain, predict and control outcome of interest to nursing
Characteristics between professions and occupations
Occupation -Training may occur on the job -Length of training varies -Work is largely manual -Decision making is guided largely by experience or by trial and error -Values, beliefs, and ethics are not prominent features of preparation -Commitment and personal identification vary -Workers are supervised -People often change jobs -Material reward is main motivation -Accountability rests primarily with employer Profession -Education takes place in a college or university -Education is prolonged -Work involves mental creativity -Decision making is based largely on science or theoretical constructs (evidence-based practice) -Values, beliefs, and ethics are an integral part of preparation -Commitment and personal identification are strong -Workers are autonomous -People are likely to change professions -Commitment transcends material reward -Accountability rests with individual
8. Distinguish between the characteristics of professions and occupations
Occupation: -training occurs at job -workers supervised - ex. police, truck driver, waiter, cashier Profession: -Education done in college/university -Code of ethics, values, beliefs -ex. lawyer, doctor, nurse, teacher Profession: a calling, vocation, or form of employment that provides a needed service for society. shows expertise, autonomy, academic prep, commitment, and responsibility. professions are more evolved version of occupations as they require specialized education. Occupation: a persons regular work, job, or principal activity
16. Identify commonalities in various definitions of nursing.
PAMA Prevention of disease Assistance Maintaining/Promoting health Administration of medicine
42. Describe ethical dilemmas resulting from conflicts between patients, health care professionals, family members, and institutions.
Personal Value Systems -When personal values are in conflict with professional values. Peers' and other professionals' behaviors -Conflicts can evolve because of differing value systems, cultures, education levels, or a variety of other factors. Patients' rights -Consumers of healthcare are increasingly demanding to have a voice in their health care decisions. Institutional and societal issues -Nurses may experience moral dilemmas when they disagree with the policies of their institutions (i.e. constraints) Patient data access issues -Inappropriate access of patient's Electronics Health Records
Content of Nursing Knowledge
Physiology and patho, pharmacology, nutrition, nursing procedures, mathematics, information technology, legal issues, ethical issues, effective communication
Watson
Promote health, restore patient to health, and prevent illness.
Which of the following interpersonal skills is essential to the practice of nursing? a) promoting dignity and respect of patients as people b) maintaining emotional distance from clients and families c) keeping personal information among shared clients confidential d) performing technical skills knowledgeably and safely
Promoting dignity and respect of patients as people
Legal Issues
Protect the public, provide safe care, maintain currency of practice, adhere to practice acts, understand legal requirements of informed consent, advance health care directives, Health Insurance Portability and Accountability Act. HIPPA
Leininger
Provide care consistent with nursing's emerging science with caring as a central force
9. Discuss traditional and alternative ways of becoming a registered nurse as well the difference between licensure and certifications.
RN usually begins in one of three ways -In a hospital based diploma program -BSN program -An associates degree in nursing (ADN) program. -Licensure and certifications overlap -Licensure: required for practice -Certification: not required for practice
Call numbers for nursing literature in O'Neill begin with:
RT
3. Dependence/mutuality
Reasoned appraisal; begins integration of facts and opinions following objective testing
Which of the following is the best example of patient-centered care provided by a Registered Nurse (RN)? a) implementing a standardized plan of care for a newly-admitted patient b) reassuring a client who is anxious about a procedure c) inserting a nasogastric tube )NGT_ for gastric decompression d) administering pain medication every 4 hours to a postoperative client
Reassuring client who is anxious about the procedure
Interpretation
Recognize, understand, and explain the meaning of a situation
Theory
Refers to a group of related concepts, definitions, and statements that describe a certain view of nursing phenomena (observable occurrences) from which to describe, explain, or predict outcomes.
What is evidence based practice (EBP)?
Refers to nursing care that is based on the best available research evidence, clinical expertise, and patient preference.
Maintain Consistency
Regular work and steady application and self pacing equals success, avoid procrastination by breaking large tasks into smaller ones
What is the job of the State Boards of Nursing?
Regulate nursing to protect the public from harm by unprepared or incompetent practitioners
2 main categories of nursing journals
Research and clinical
S.O.L.E.R. position
S-sitting squarely in front of the patient O- open posture L-leaning forward shows interest E-eye contact R- relaxed appearance
Important personal critical thinking characteristics for nurse with person-centered practice?
Self-aware, honest, persistent, authentic
Which of following is current trend in the U.S. health care system? a) Ongoing commitment to fee-for-service models of payment b) Shift from hospitals to community-based care c) Narrowed areas for nursing practice d) Increased length of hospital stays
Shift from hospitals to community based care
Nursing theorist most associated with idea of adaptations is
Sister Callista Roy
Team of nurses discussing theoretical framework not supported by research data. Representation of how nursing should be practiced rather than how it is today. Theory described as
Speculative and normative
Philosophies of Nursing
Statements of beliefs about nursing and expressions of values in nursing that are used as bases for thinking and acting
24. Identify strategies to promote EBP and barriers to implementation.
Strategies to promote EBP- Learn where and how to search -Insufficient time to explore questions on the job. -Rejection of need for change -The experienced Do not think they need it. -Inability to critically read and understand.
Cohen's Model of Socialiazation
Students must experience each stage in sequence to feel comfortable in the professional role
Nurse Scientist
Study the various aspects of health, illness, and health care
Key Components of Service Learning
Sufficient thought and preparation, action, reflection and analysis about the experience
what is the formula for Success?
System + Schedule
Which of following is true regarding critical thinking in nursing? a) it documents trends and patters in client status b) it makes judgement based on conjecture c) it supplies validation for reimbursement d) it is a systemic way of thinking
Systemic way of thinking
Meaningful Reading
Take time to complete reading will reduce time required to review for exams Mistakes include, reading too fast, reading immediately, reading passively, underlining too much/little
Veracity
Telling the truth, or not lying
41. Discuss the relevance of a code of ethics for the profession of nursing.
The code of ethics is continually revised and edited by the ANA to ensure that it reflects the contemporary issues of this profession and is consistent with the ethical standards of the society.
Non-Maleficence
The duty to do no harm
Fidelity
The faithfulness or honoring one's commitments or promises
Therapeutic Use of Self
The use of one's personality and communication skills to help patients
Nursing is a profession in a rapidly changing health care environment. What is most important reason for a nurse to develop critical thinking and clinical reasoning? a) to provide quality care with nursing ability and knowledge b) because clients deserve experts who know how to care for them c) the licensing examination requires nurses to be adept at critical thinking d) to be able to employ the nursing process in client care
To provide quality care with nursing ability and knowledge
Purpose of HIPAA
To reinforce the protection of patient information as it is transmitted electronically. The regulations protect medical records and other individually identifiable health information, whether on paper, electronically, or communicated orally.
The definition of nursing adopted by the American Nurses Association emphasizes: a) treating human responses to health and health problems b) curing human disease c) caring for persons who are ill d) developing sick nursing and health nursing
Treating human responses to health and health problems
Barriers to Professionalism
Variability in education preparation Differentiation of Practice: to utilize nursing skills efficiently Gender issues- men "power" Historical events- nurses had to serve/obey doctor External conflicts- hospital politics Internal conflicts- between the nurses ourselves Level of Autonomy and independence of practice
Today's scope of practice for bachelor's-educated Registered Nurses not licensed for advanced practice: a) consists almost exclusively of activities that no other group of paid or unpaid workers is legally permitted to engage in b) is limited to service for hospitalized or institutionalized clients c) involves diagnosis of medical illness and prescription of medications d) varies somewhat from setting to setting but generally focuses on the protection, promotion and restoration of health
Varies somewhat from setting to setting but generally focuses on protection, promotion, restoration of health
Henderson
Work independently with other health care workers, help patient gain lacking strength.
Health
World Health Organization: WHO state of complete physical, mental, and social well-being but not the absence of disease
Nursing theory
a conceptualization of some aspect of nursing reality communication for the purpose of describing phenomena ,explain the relationships between phenomena ,predicting consequences, or prescribe nursing care.
Pareto chart
a graphic tool that helps break down a big problem into its parts and then identifies which parts are the most important. The bars are arranged in descending order so that the most commonly occurring problem are readily visible.
Occupation
a group or jobs that are similar in type of work and that are usually found throughout an industry or work environment "low level of commitment"
what is a clinical ladder?
a multiple step program that begins with entry level staff nurse positions, and climbs as a nurse gains experience, participates in CE (continuing education), and become certified for higher positions.
All hazard approach
a process approach for all sectors to prepare for any emergency or disaster that may occur
System
a set of intrarelated parts that come together to form a whole (patients, family)
Profession
a type of occupation that meets certain criteria that raise it to a level above that occupation. Requires high level of commitment and responsibility
Motivation
ability to be enthusiastic in uninteresting work
Self Regulation
ability to control emotion, cope with change
Emotional awareness
ability to identify mood changes, knowing the effect you have on people
Social Skills
ability to listen, handle conflict
Power Approach
ability to make things happen Independence- how much independence does a profession have? Control- how much power does the profession control? Ex: money, political power
Empathy
ability to tune into someone elses needs
Philosophies based on Beliefs
acceptance of something that is correct or true based on experiences or religion
Acceptance participation
acknowledged the reality of illness and ready to participate in decisions
All of the following were key factors in the emergence of community health nursing in the early 20th century EXCEPT: a) limited availability of health services in many poorer urban and most rural areas b) commitment to social justice issues by key leaders in the profession c) active support by the medical profession for the idea of nurses delivering community-based service d) difficulties encountered by nursing school graduates in finding work
active support by medical profession for idea of nurses delivering community based service
Native
adopts ways of least resistance and mimics other nurses
Child with chronic illness in pain is unable to participate in any activities. Child wants to take medication; father doesn't want her to become dependent on that. Nurse worries about social withdrawal and discusses potential options. Role demonstrated is:
advocate
Empathy
an attempt to experience another person's point of view without losing one's own identity
Irritability and Anger
anger directed toward body or person
General leads
anything that encourages the client to verbalize, head nod, "I wanna hear more"
dorothea dix
appointed Superintendent of Women Nurses by the Union Army
Formal group
appointed or voted into the position, BUT doesn't mean other leaders emerge
Successful communication
appropriate: timing, place, situation efficient: clear and simple flexible: learn to change your approach with each patient Includes feedback Clarify persons perceptions of your message ALWAYS
How to determine whether potential employees a good fit for you
assess the work climate by walking through the facility
Empathetic listening
attempting to understand and respond nonjudgementally, shows support, caring, warmth
Burn out
bottles up conflict; fatigued, depressed, angry
At 11am a nurse goes into the patient's room and changes the dressing on a Stage II decubitus ulcer and gets a blood sugar reading using a glucometer. The nurse is functioning in which of the following roles? a) leader b) coordinator of care c) care provider d) educator
care provider
Storming
chaotic vying for leadership, members focused on control issues
Client complains of weakness following his administration of insulin. Nurse decides to assess blood sugar and prepare a snack. Which of the following has nurse demonstrated?
clinical reasoning
what is special about community nurses?
community nurses provide educational programs in health maintenance, disease prevention, nutrition, and child care. they also conduct immunization clinics and health screenings, and work with those in the community.
Clinical Judgement
decision made regarding a course of action based on a critical analysis of date when nursing knowledge is applied to a clinical situation -help ensures safe care, high quality care, client centered care
Benefits of Service Learning
developing civic capacity, leadership skills, self-awareness, sensitivity about vulnerable populations, communication skills
The nurse asks the patient which medication he takes to manage his blood pressure and when he should take it, once or twice a day. Based on her assessment, she realizes that he does not understand these details and proceeds to make sure he knows these details. What role is nurse carrying out? a) leader b) coordinator of care c) educator d) role model
educator
Miller's Wheel of professionalism
essential core is that all nursing education be in a 4 year school
Norming
eventual agreement of goals and how group should operate
External Factors Influencing socialization
experiences with the health care system, family, friends' values, and beliefs
Mary E. Mahoney
first African American nurse to study and work as a professionally trained nurse
Isabel Hampton Robb
founded the NLN and ANA
Mary Breckinridge
founder of Frontier Nursing Service
florence nightingale
founder of modern nursing, cared for wounded men of crimean war; took 38 nurses to organize, clean, and aid hospital/soldiers. founded first training school for nurses @ St. Thomas' hospital in London. her most famous publication was titled "Notes on Nursing: what it is, and what it is not"
Clara Barton
founder of the American red cross
Run chart
graph of data in time order that help identify changes that occur over time; also called time plot. A run chart that has a centerline and statistical control limits added is known as a control chart. Control limits help detect specific types of change in a process
Performing
group becomes effective in meeting objectives
Theories
group of related concepts, definitions, and statements Guides nursing practice by describing, explaining, predictin, and controlling phenomena, or patient behavior and outcomes
Group process
how an organizations members work together to get things done
Perception
how we interpret it, process of being aware of and understanding the world
Watson- 10 Curative Factors
human caring, instill hope, use science to problem solve
nursing in palliative and end of life care include what responsibilities?
improving the quality of life and tending to those in hospice or close to death
describe nursing in a hospital setting
in general, nurses working in hospitals care for patients with medical or surgical conditions (ex: diabetes, cancer, post operative care, severe trauma or burns, L&D/Newborn care,) there are specialty units in hospitals that nurses may work in as well, such as ER, ICU, cardiology, neurology, etc.
Assessment
information about the client is collected, may be physical, psychological, social, spiritual ex: physical health assessment data
Hildegard E Peplau theory
interpersonal relations model explores the interpersonal relationship of the nurse and the client and identify the client feeling as a predictor of positive outcomes related to health and wellness
Florence Nightingale theory
investigate the effect of the environment on healing
cupping
involves placing a heated cup on the skin, as it cool, it contracts, drawing what is believed to be toxicity into the cup.
Durable power of attorney
is a legal document that authorizes the patient to name the person who will make day-to-day and final end-of-life decisions once he or she is decisionally incompetent.
Living will
is a legal document, a type of advance directive, in which a competent adult makes known his or her wishes regarding care that will be provided in the final stages of terminal illness
Variance analysis
is the process by which deviations from budgeted amounts are examined by comparing actual performance results against expected, or budgeted, performance.
Auditory Learners
learn best by hearing, verbal repetition, tapes, lectures, like to talk things through, listen to others, dislikes working quietly for a long time, easily distracted by noise and silence Read text aloud, use tape recorder in class, record summary of notes, create songs, study in groups
Tactile Learners
learn best by touching and doing, projects, concept maps, simulations, role-playing, easily distracted from learning, enjoy using computer Simulation, create models or displays, practice kits with equipment, be active during scheduled breaks
Formal Socialization
lessons planned during school, shadowing and clinical experiences
Active listening
listening problems attending to what your patient is saying
Which of the following elements is a key component of definitions of a professional today? a) High pay/salary level b) Personal characteristics one is born with dictate who is admitted and success c) Mastery of a body of theoretical as well as practical knowledge d) Commitment to a set of ethical standards arrived at by personal discernment
master of body of theoretical as well as practical knowledge
describe a nurse practitioner
masters/post masters degree. qualified to handle a wide range of basic health problems. independent practitioners and can be directly reimbursed by medicare/medicaid.military & private insurance for their work
War on Terrorism
need for nurses identified especially mental health practitioners
Trial and Error
not a good method to problem solve, come up with several solutions and try them all until one works
Silence
not absence of communication, allow patient to gather thoughts, say nothing when we don't know what to say
what are ambulatory care settings?
nurse based practices, physician based practices, free standing emergency rooms, free standing surgery centers
Evaluation
nurse looks at goals met-in progress-not met -may result in continuing the care plan, revising it or discontinuing the plan of care
what is telehealth?
nursing from a distance, which includes interactive radio and voice linkages, real time teleconferencing and lab data, computer usage, and clinical technologies to help the patient
what are some of the settings and roles in which today's registered nurses practice, including advanced practice roles?
nursing in hospitals, communities, medical offices, workplace, armed forces, schools, palliative care and end of life settings, from a distance (telehealth), faith community, managing information in nursing (informatics), nursing in business (entrepreneurs)
Implementation
nursing orders/care plan is carried out
Internal Factors Influencing socialization
own beliefs, values, religious beliefs
nursing in a faith community focuses on...
parish nursing, which is the intentional care of the spirit
Which of the following is NOT one of Nightingale's accomplishments? a) development of systems for selecting and educating nurses b) pioneering the use of statistical data in health policy c) pioneering the use of isolation precautions for infectious diseases in hospitals d) influential writings on attention to environmental influences in healing
pioneering use of isolation precautions for infectious diseases in hospitals
Values
principles, ideals, standards that give meaning and guidance
Communication theory
process that is dynamic and ongoing, exchange of thoughts, ideas, information, collaborative if you need someone else, requires involvement, involves messages: different meanings for different people
Runaway
real world too difficult; leaves profession or returns to graduate school with a goal to teach nursing
Security
refers to the means to control access and protect information from accidental or intentional disclosure to unauthorized persons and from alteration, destruction, or loss.
Self-evaluation is a method nurses use to promote their own development and to grow in confidence in their nursing roles. This process is referred to as: a) learning from mistakes b) reflective practice c) assessment of oneself d) promoting the nurse's self-esteem
reflective practice
Group- 3 or more individuals
relationships make them in some way to interdependent and interact for a goal or purpose
Restatement
repeat back to clients exact words, patient knows you heard, encourages client to continue
Nursing Process
results in an individualized plan of care for a patient, series of steps to developing appropriate nursing care, requires critical thinking, need format/blueprint
what are a few scheduling techniques that can aid in time management?
schedule a time for everything such as sleeping/eating/exercising, and try to multi task
A nursing student at Boston College can apply to become a member of which international nursing honor society during their junior and senior year? a) ANA (American Nurses Association) b) CCNE (Commission on Collegiate Nursing Education) c) State Board of Nursing d) Sigma Theta Tau
sigma theta tau
Credible threat
situation in which the Federal Bureau of Investigation determines that a terrorist threat is credible and confirms the involvement of a weapon of mass destruction in the developing terrorist incident
Henderson's Basic Needs
sleep, water, communicate emotions, worship, play
Numbers power
specific to organizations, # of people in a group
Paraphrase
state in "own words" what client said, checking perception
Philosophy of Nursing
statement of beliefs about nursing the demonstrate our values, used to make decisions, ethic issues, critical thinking
Tertiary prevention
stopping the disease from progressing "rehab therapy"
Kinesics
study of body movement, how someone carries themselves, hand gestures: movements that you make with hands and arms
Health Belief Models/ Health Promotion Models
study or predict why people change their behavior and why others don't, based on beliefs, perceptions 1. Am I vulnerable or susceptible to this disease? 2 How effective is the change? (health behavior) 3. Triggering events that change health behavior
Veracity
that telling the truth in personal communication is a moral and ethical requirement. If there is the belief in health care that truth telling is always right, then the principles of veracity can itself pose some interesting challenge
Knowledge
the acqusition of facts and principles based on evidence and is considered to be the foundation of reason action. -acquired in classroom, online, clinical settings, other activities. Reinforced when applied in laboratory and clinical situations
Triangulation
the use of a variety of methods to collect data on the same concept
nursing in communities can include working in....
these nurses may work for government or private agencies, ambulatory clinics, health departments, hospices, homes, and a variety of other community based settings.
describe nursing in the armed forces
these nurses serve either in active duty or in military reserve units, which means they will be called to duty in case of emergency
Nurse citizen
voting, being informed, speaking out
what are certified nurse midwives
well-woman care, attend/assist childbirth in hospitals, birthing centers, private practice, home birthing services. MSN required. must be accredited. licensed independent health care providers who can prescribe meds
nursing in medical offices consists of
working in unison with physicians, NPs, and their patients while conducting health assessments, reviewing medications, drawing blood, giving immunizations, administering medications, and providing health teaching
The idea of "self-regulating" in context of nursing profession refers to: a) the ability of nurses to endure great physical and emotional stress through power of will b) the social contract that places members of the nursing profession heavily in charge of selection, education and quality control in exchange for providing essential services c) The use of professional "peer-pressure" rather than legal constraints on how nursing is practiced d) the absence of social, economic or political influences on nursing practice
Social contract that places members of nursing profession heavily in charge of selection, education and quality control in exchange for providing essential services
Knowledge worker
• Conceptually, nursing is first and foremost "knowledge work", regardless of age, gender, ethnic background, ethical perspective, or level of job satisfaction of the nurse. • Knowledge workers are people who require specialized education to do work that requires judgment. The knowledge work of nurses counts in terms of human lives and financial costs
Type of offense you recieve if you fail to report abuse
• It could result in criminal charges and claims of negligence
Confidentiality
• Refers to the act of limiting disclosure of private matters. Once a patient has disclosed private information to a health care provider, that provider has a responsibility to maintain the confidentiality of that information and not reveal the information to others who do not have a legitimate need to know.
Ethics
• Science or study of moral values
Movement influenced unionization
• The Industrial Revolution
Compassion fatigue
• The gradual decline of compassion over time as a result of caregivers being exposed to events that have traumatized their patients.
Needle stick safety and prevention act 2000
• To require the use of safer needle devices to protect from sharps injuries. The law requires employers to solicit the input of nonmanagerial employees responsible for direct patient care who are potentially exposed to sharp injuries in the identification, evaluation, and selection of effective engineering and work practice controls. • This law also requires employers to maintain a sharps injury log to contain, at a minimum, the brand of device involved in the incident, the department or work area where the exposure incident occurred, and an explanation of how the incident occurred.
Honeymoon-
• everything is just as the new graduate imagined. The new nurse is in orientation with former school friends or other graduates who often share similarities.
Bilis
• is a disease brought on by anger. It primarily affects adults and commonly occurs a day or two after a fit of rage. If untreated, bilis can cause acute nervous tension and chronic fatigue, although herbal remedies usually are effective
Licensed practice nurse -LPN
• usually are 9 to 12 months in length and may be offered by high school adult education programs, community colleges, vocational and proprietary schools, and hospitals. •The LPN graduate is required to work under the supervision of the RN
Mal ojo
•- is thought to be caused by persons giving admiration. For example, Hispanic clients may believe in mal ojo in which a child becomes ill as a result of excessive attention from a stranger (tie red yarn around wrist) Symptoms include sleeps restlessly, has fever and diarrhea and could ultimately die. Treatment includes rubbing the body with an egg for three consecutive nights.
Ethic group likely to be lactose intolerant
•African Americans, Asians, Hispanics, American Indians
Sunset legislation
•Are intended to insure that legislation is current and reflects the needs of the public. When sunset provisions are included in a nurse practice act, the act must be reviewed by a specific date. If the act is not reviewed, it is automatically rescinded. This review process allows for revisions to update practice acts to be consistent with current nursing practice.
Baccalaureate Degree
•The 28-month program required scientific studies and clinical work and had the prestige and authority of other departments, with its own dean and budget
Who created NCLEX?
•The National Council of State Board of Nursing
Relief Response Phase
Response activities - first emergency response to victims - stabilize the situation -require the interaction of emergency responders - fire and police -emergency medical services Hazmat teams - health care agencies and department
Disclosure
- A process in which the patient's primary provider gives the patient, and when applicable, family members, complete information about unanticipated adverse outcomes of treatment and care
Shock (Rejection) Phase
- The nurse comes into contact with conflicting viewpoints and different ways of performing skills, but lacks the security of having an expert available to explain uncertain or gray areas. During this phase the novice nurse may be frightened or react by forming a hard, cold shell around himself or herself. After going home from a shift, the new nurse may experience feelings of rejection and a sense of lack of accomplishment.
Planning( lập kế hoạch)
- defines goals and objectives to be achieved - identify resources needed -determine actions steps, -establish a timeline for the actions and goals achievement - developing policies and procedures -determining resources allocation( xat dinh phân bổ nguồn lực) -developing evaluation methods * without the planning , the management will fail
Susto
- fright or sickness is an emotion-based illness that is common among Mexicans. An unexpected fall, a barking dog, or a car accident could cause susto. Symptoms include colic, diarrhea, high temperature, and vomiting. Treatment includes brushing the body with "ruda" for nine consecutive nights.
Organizing( cấu tạo)
- identifying the management structure to accomplish work - determining communication processes, and coordinating people, time, and work - establish a formal structure that defines the line of authority, communication, and decision making within an organization - develop policies and procedures to help outline how work will be done - involve using resources wisely, assigning duties, coordinating activities with other subordinates
Apeal to emotion
- is an attempt to manipulate other people's emotions in order to avoid the real issue.
Controlling( kiểm xoát)
- performing employee performance reviews, analyzing financial activities, and monitoring quality of care Ensure that employees accomplish goals while maintaining a high quality of performance - establish performance or outcome standards -determine actions plan to improve performance - evaluate employee performance
30. Define cultural competence.
-Ability of providers and organizations to effectively deliver healthcare services that meet the social, cultural, and linguistic needs of patients -Can help improve health outcomes -Guides the nurse in understanding behavior and planning appropriate approaches to patient needs
26. Identify factors related to the sender and receiver that can influence how a message is interpreted.
-Alertness (i.e. sleep, nutrition, and exercise) -Positive attitude -External Distractions (i.e. Type of music, study area setting) -Internal Distractions (i.e. Daydreaming, Worrying) -Working at a Fast Pace (this helps you stay focused) -Ability to Study for Extended Periods -Cues to Start Studying (i.e. setting up your work space)
Informed Consent
-All patients or their guardians must be given an opportunity to grant informed consent before treatment unless there is a life-threatening emergency -Three major conditions of informed consent: 1. Consent must be given voluntarily 2. Consent must be given by an individual with the capacity and competence to understand 3. The patient must be given enough information so that the locus of the decisions lies within the patient and not the provider
Effect of incivility and disruptive behavior in both classroom and workplace
-Bullying between people -Starts with common behaviors that are distracting, annoying, or irritating to others -Poor communication -Unprofessional behaviors negatively affect patient outcomes and behaviors -Occurs when people are stressed and feel powerless -Can briefly give one a sense of control or power
Importance of self-care
-Caring for yourself is foundational to being able to care for others -Achieving balance through a variety of practices and activities is important to your health, which will allow you to be more effective in all the roles you fulfill in your life
Benefits of defining nursing and how this is related to professional socialization
-Defining nursing means that you have determined the essential elements of being a nurse: what a nurse is and what a nurse does -The goal of socialization is the development of professionalism -Professional socialization: process os internalization and development or modification of an occupational identity (for the RN retiring to school for a BSN degree, modification of an already-formed professional identity occurs) -The goal of socialization as a professional nurse is the development of a professional identity such that the attributes of nursing become "part of a nurse's personal and professional self-image and behavior"
36. Identify nursing responsibilities related to delegation, informed consent, and confidentiality.
-Delegation: giving someone the authority to act for another. of nursing "The nurse must make responsible efforts to assess individual competence when assigning selected components of nursing care to other health care workers. This assessment involves evaluating knowledge, skills, and experience of the individual to whom the care is assigned the complexity of the assigned task and the health status of the patient. -Informed consent: consent must be given voluntarily, consent must be given by an individual with the capacity and competence to understand, The provider cannot influence the patient unduly by giving incomplete information or obscuring data that the patient should have to make a truly informed decision -Confidentiality: The nurse has a duty to maintain confidentiality of all patient information, both personal and clinical in the work setting and off duty in all venues, including social media and any other means of communication. Nurses are responsible for providing accurate, relevant data to members of the health care team others who have a need to know.
39. Discuss the ethical theories of deontology, utilitarianism, virtue ethics, and principlism.
-Deontology: an act was moral if its motives or intentions were good, regardless of the outcome -Utilitarianism: Moral rightness of an action is determined solely by its consequence -Virtue ethics: an approach to Ethics that emphasizes an individual's character as the key element of ethical thinking, rather than rules about the acts themselves -(Deontology) or their consequences (Consequentialism) -Principlism: Uses key ethical principles of beneficence (do good), nonmaleficence (do no harm), autonomy (respect for the person's ability to act in his or her own best interests), and justice in the resolution of ethical conflicts or dilemmas.
29. Practice effective techniques for therapeutic communication. Differentiate between social and professional relationships.
-Empathy, open-ended questions (tell me how you feel? What exactly hurts?), giving information (not giving opinions), reflection and silence. Social: -Evolve Spontaneously -Not time-limited -Not necessarily goal-directed; broad purpose is pleasure, companionship, sharing -Centered on meeting both parties needs -Problem solving is rare/occasional -May or may not include non judgemental acceptance -Outcome is pleasure for both parties Professional: -Evolve through recognized phases: interactions are planned and purposeful -Limited in time with termination date often predetermined -Goal-directed, systematic exploration of identified problem areas -Centered on meeting patients needs; do not address nurses needs -Problem solving is a primarily focus -Includes non judgemental acceptance -Outcome is improved health status of patient
5. Describe how nursing has reacted to nursing shortages and how those affect patient outcomes
-External shortages: can include changes in demand for nursing services, and increasing age of American population, greater acuity (degree of illness) of the hospitalized individual, public perceptions of nursing as a profession and ever-widening career options for women. -Internal shortages: salary issues, long hours, increased responsibility for unlicensed workers and significant responsibility with little authority. -Two solutions attempted: 1) increase the supply of nurses 2) create less-trained worker supplement the number of nurses. *increasing the numbers of faculty in nursing programs will decrease the nursing shortage by allowing for more nursing students.
4. Describe the influence and contributions of key figures in the history of nursing, including Florence Nightingale.
-Florence Nightingale: * Founded the first training school for nurses at St Thomas hospital in London in 1806. Focused on sanitation influences by policy as well. Famous nurse, affluent. Focused on prisons and military. Reduced mortality rate by 2% by feeding the people and keeping them clean/sanitation/ventilation. Supervised 38 nurses. Founded first nursing school in St. Thomas Hospital in London. -Mary Seacole: (Jamaican) Called Mother Seacole. Expert in Cholera. Manage/Funded for soldiers in Crimea. Was voted the Greatest Black Britain 2003. Did not consider herself a nurse. * -Clara Barton: Angel of Battlefield. Founded the American Red Cross is 1881.* -Dorothea Dix: Civil War superintendent of union army * -Mary E. Mahoney: first educated african american professional Nurse. Graduated in 1879 * -Lillian Wald: Founded Henry Street Settlement in New York which offered health care and social services to the member of the community -Mary Ann Breckenridge: demonstrated that nurses could provide midwifery services in rural setting *
Factors that influence perception, evaluation, and transmission
-Gender -Age -Culture of sender and receiver -interest and mood of both parties -Value -Clarity -Length of message Presence or absence of feedback -Context
Factors that influence group functioning
-Goals: provide rationale and motivation for people to form a group -Norms: the rules or expectations of behavior -Cohesiveness- sense of wellness, the cement that holds the group together -Leader behavior: democratic v autocratic -Member behavior: motivated v not involved
How nursing has reacted to nursing shortages and how those affect patient outcomes
-Increase the supply of nurses and create a less-trained worked to supplement the number of nurses -Qualified applicants aften denied admission to US schools of nursing because of insufficient numbers of faculty
43. Discuss provisions of the ANA Code for Nurses.
-Integrate the Code for Ethics for Nurses with Interpretive Statements (ANA, 2015) to guide nursing practice and articulate the moral foundations of nursing. -Maintain competence through continued personal and professional development. -Practice with compassion and respect for the inherent dignity, worth, and unique attributes of all people. -Advocate for the rights, health, and safety of the health care consumer and others.
Characteristics of a profession
-Intellectual and is accompanied by a high degree of individual responsibility -Based on a body of knowledge that can be learned and is developed and refined through research -Practical, in addition to being theoretical -Can be taught through a process of highly specialized professional education Strong internal organization of members and a well-developed group consciousness -Has practitioners who are motivated by altruism (desire to help others) and who are responsive to public interests
34. Explain the elements of malpractice and discuss common reasons nurses are sued for malpractice.
-Malpractice is negligence applied to the acts of a professional. In other words, malpractice occurs when a professional- for example a nurse or a physician- fails to act as a reasonably prudent professional would have acted under the same circumstances. Malpractice does not have to be intentional malpractice that is professional negligence may occur in two ways, by commision - doing something that shouldn't have been done- and by omission- failing to do things that should have been done Six major categories of negligence that result in malpractice lawsuit 1. Failure to follow standards of care, including failure to Follow a physician's verbal or written orders 2. Failure to use equipment in a responsible manner, including failure to Place equipment properly during treatment 3. Failure to communicate, including failure to Seek higher medical authorization 4. Failure to document, including failure to recognize the patient's record A patient's progress and response to treatment 5. Failure to assess and monitor, including failure to Implement a plan of care. 6. Failure to act as a patient advocate, including failure to Provide a safe environment Common reasons nurses are sued for malpractice: -Failure to follow standards of care -Failure to use equipment in a responsible manner -Failure to communicate -Failure to document -Failure to assess and monitor -Failure to act as a patient advocate
Commonalities in various definitions of nursing
-Nightingale: put the patient in the best condition for nature to act upon him -Shaw: nursing as an art: "It properly includes, as well as the execution of specific orders, administration of food and medicine, the personal care of the patient" -Harmer's textbook: the object of nursing is not only to cure the sick... but to bring health and ease, rest and comfort to mind and body. Its object is to prevent disease and to preserve health -Virginia Henderson: nursing may be defined as that service to an individual that helps him to attain or maintain a healthy state of mind or body -Hildegard Peplau: nursing is a significant, therapeutic, interpersonal process... nursing is an educative instrument... that aims to promote forward movement of personality in the direction of creative, constructive, productive, personal, and community living
Several note taking strategies
-Note cards: repeated review -Category charts: compare and contrast -Flow charts: movement or change over time -Diagrams: used when expected to know the name, location, or arrangement of parts of an abject -Mapping: pictorial tool used to arrange complex topics
19. Describe Benner's model of socialization and how it applies to nursing.
-Novice: Has little background and limited practical skills; relies on rules and expectations of others for direction. -Advanced beginner: Has marginally competent skills; uses theory and principles much of the time; experiences difficulty establishing priorities. -Competent Practitioner: Feels competent, organized; plans and sets goals; thinks abstractly and analytically; coordinates several tasks simultaneously. -Proficient Practitioner: Views patients holistically; recognizes subtle changes; sets priorities with ease; focuses on long term goals. -Expert Practitioner: Performs fluidly; grasps patient needs automatically; responses are integrated; expertise comes naturally.
How a nurse uses critical thinking and clinical judgment in practice
-Nurses who think critically are engaged in a process of constant evaluation, redirection, improvement, and increased efficiency -Critically thinking skills provide you with a powerful means of determining patient needs, interpreting physician orders, and intervening appropriately -Know the limitations of your expertise
3. Identify ways in which students and nurses can promote the profession of nursing.
-One-patient-at- a-time -Speak out against negative portrayals -ANA can enhance image by offering services as consultants to media and setting professional standards -Confront those responsible for negative portrayals of nursing in the media *educate people about what nurses really do
Therapeutic Nurse-Patient Relationship
-Orientation Phase: "getting to know you" -Working Phase: the nurse and patient address tasks outlined in the previous phase, "two steps forward and one backward" -Termination Phase: Includes activities that enable the patient and the nurse to end the relationship in a therapeutic manner
20. Describe strategies to ease transition from student to professional nurse.
-Orientation programs in the work setting. -Biculturalism: Joining of school values with workplace values. Allows new nurse to introduce ideas or values from nursing school and integrate them into the work environment. -Role models and Mentors: Experienced professional nurses who provide guidance to the novice nurse regarding goal setting. Attributes: enjoys nursing, compatible professional goals or values,sincere desire to assist the new nurse, trustworthy. -Preceptorships: During the final semester of school, the student is assigned to an experienced nurse, who serves as a preceptor with whom the student experiences everyday practice. One-to-one relationship between preceptor and novice nurse provides security and environment in which to grow. -Self-Monitoring: Learn appropriate references. Develop problem-solving skills. Willing to ask questions.
HIPAA regulations require several major patient protections
-Patients are able to see and obtain copies of their medical records, generally within 30 days of their request, and to request corrections if they detect errors. -Providers must give patients written notice describing the provider's information practices and explaining patient's rights. Patients must be asked to agree to these practices by signing or initialing the notice. -Limitations are placed on the length of time records can be retrieved, what information can be shared, where it can shared, and who can be present when it is shared.
Identify factors related to the sender and receiver that can influence how a message is interpreted
-Perception: is the selection, organization, and interpretation of incoming signals into meaningful messages -Evaluation: the analysis of received information -Transmission: the expression of information, verbal or nonverbal
18. Identify factors that influence an individual's professional socialization.
-Personal feelings -Beliefs (i.e. religious beliefs) -Morals -Personal Values -Distance Learning (i.e. online courses) -Generation (i.e. "millennials")
Factors that influence an individuals professional socialization
-Personal feelings and beliefs, some of which may conflict with professional values -Being bias -Structural conditions: one's professional role is shaped by rules -Cultural conditioning: traditions, symbols, language, and other idea systems in a society are at work in shaping how one becomes a fully socialized professional nurse
Protecting yourself from legal problems
-Practice in a safe setting -Communicate with other health professionals, patients, and families -Meet the standard of care -Carry and understand professional liability insurance -Promote positive interpersonal relationships -Delegate wisely
Cover letter
-Provides an opportunity to sell oneself and make the recruiter look forward to meeting an attractive candidate -Reflects the nurse's own style of writing, not copied from a book -Should be a clean, direct, and perfect letter on a single page of heavyweight bond paper -Addressed to a specific person -Single-spaced and three to four paragraphs, skipping a line between paragraphs >Follow up by telephone 1 week later to make sure the letter was received. Be very courteous
Characteristics of a critical thinker
-Raises questions and problems and formulates them clearly and precisely -Gathers and assesses relevant info, using abstract ideas for interpretation -Arrives at conclusions and solutions that are well reasoned and tests them against relevant standards -Open-minded and recognizes alternative ways of seeing problems and has the ability to assess the assumptions, implications, and consequences of alternative views of problems Communicates effectively with others as solutions to complex problems are formulated
50. Formulate a personal plan for effective test-taking.
-Read each question carefully -Take my time -Think
10. Differentiate between licensed practical nurses, registered nurses, associate degrees, and bachelor's degrees.
-Registered nurses (RN) have, at the minimum, a two-year degree or three-year diploma. ... -Licensed practical nurses (LPN) have about a year of nursing education, often culminating in a certificate. -Associate's degree programs are 2-year programs that may prepare students for a career or to transfer into a bachelor's degree program. -Bachelor's degree programs are usually 4-year courses of study available at colleges and universities that provide more advanced study in a particular major. *the BSN and ADN programs will allow the graduate to be a bedside RN in a hospital. (The LVN program has a separate licensure exam, and does not provide a RN license. Both the BSN program and ADN programs graduates can take the NCLEX-RN exam) * CRNAs require an advanced practice degree known as masters
22. Describe the relationship of nursing research to nursing theory and practice.
-Research ideas are generated through: clinical practice, literature, and theory. Through these ideas is how nursing knowledge continues to grow. -Nursing research findings not only improve patient care but affect the health care system itself.
33. Describe the authority of state boards of nursing to award licenses to practice nursing and discipline nurses.
-SBNs have three functions that mirror those of the federal and state governments: -Executive, with the authority to administer the nursing practice act. -Legislative, with authority to adopt rules necessary to implement the act (note that rules are different from laws, which are made by the state's legislative body) -Judicial, with authority to deny, suspend, or revoke a license or to otherwise discipline a licensee or to deny an application for licensure. -Each of these functions is as broad or limited as the state legislature specifies in the nursing practice act and related laws. -In most states SBNs have the authority to set and enforce minimum criteria for nursing education programs. -The most common reason nurses are disciplined by the SBNs is for practicing while under the influence of alcohol or other substance.
31. Describe nursing behaviors and attitudes that demonstrate cultural competence.
-Takes cultural differences into consideration, are aware of potential "trouble spots" that can occur, usually interpret patient behavior accurately, and recognize problems that need to be managed. -They realize that cultural norms must be included in plan of care to prevent conflicts between nursing goals and patient/family goals.
Cultural Competence
-The ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients. -Guides the nurse in understanding behaviors and planning appropriate approaches to patient needs -Guides the patient's response to health care providers and their interventions
14. Distinguish between novice thinking and expert thinking.
-The ability to think critically separates novice from expert nurses. -Novice nurses may rely heavily on step by step procedures. -Expert nurses know when it is okay and beneficial to bend rules and can quickly re-modify a procedure or treatment if a patient requires an alternative; expert nurses more confident
35. Identify the purposes of HIPAA and implications for practice.
-The ethical principle of confidentiality and HIPAA regulations place significant limitations on the content of nurse's social social media activities and comments. -Violating HIPAA regulations means that the nurse has broken state laws in the process.
37. Describe strategies nurses can use to protect their patients, thereby protecting themselves from legal actions.
-The nurse must make reasonable efforts to assess individual competence when assigning selected -Practice in a safe setting -Communicate with other health professionals, patients, and families -Meet the Standard of Care -Carry and Understand Professional Liability Insurance -Promote Positive Interpersonal Relationships
Confidentiality
-The protection of private information gathered about a patient during the provision of health care services -Code of Ethics states, "the nurse has a duty to maintain confidentiality for all patient information, both personal and clinical in the work setting and off duty in all venues, inclosing social media... Nurses are responsible for providing accurate, relevant data to members of the health care team and others who have a need to know." -The Code acknowledges exceptions to the obligation of confidentiality. these include discussing the care of patients with others involved in their direct care, quality assurance activities, legally mandated disclosure to public health authorities, and information required by third-party payers
Purpose of Professional Organizations
-allow members to work together towards a common goal -ensure competence and learning among members -influence policy members -provide educational opportunities
Florence Nightingale
-born in 1820, aristocratic family -went with mother to homes of sick to provide care -age 30, began nurse's training in Germany -tended wounded British soldiers at Scutaru Hospitals in Turkey during Crimean War -reformed British Army Hospitals -established 1st training school for nurses in London -wrote "Nurse on Nursing" - identified unique body of nursing knowledge
Environment
-circumstances and influences that affect the individual -Family: supportive, functional, learn to assess family -Cultural systems: attitude, behaviors, ethnic groups, what could influence health -Social Systems: neighborhood health, level of poverty, access to healthcare -Community Systems: larger environment that influences health ex: epidemic, job market, weather
Barriers to Communication
-confusing messages -giving advice -too much self disclosure -excessive questioning -WHY questions, AVOID -changing subject -false reassurance
Cultural competence
-consider cultural differences when planning care for their patients -interpret behaviors accurately -respect
Rutter
-considers nursing just a job
Attempt to gain control
-consult health care provider, use OTC -aware they are ill -treatment seeking
External influences
-culture -past experiences
Analysis and Diagnosis
-data is validated, compared to normal and a problem is identified -clinical judgement about an actual/potential health problem that the nurse can treat
Method
-decide what data to be collected to answer the question. -decide on and identify the step by step procedure that will be used to collect these data.
Internal influences
-dependence/independence -coping ability -hardiness/learned resourcefullness -resilience -spirituality
Main components of assertiveness
-directing people to do things -straight forward/fair -sensitive and responsive to other people
Martha E Rogers
-energy fields -openness -pattern -organization
Evaluation
-examine the results to determine the relevance of outcome data in answering the hypothesis. -determine the significance and identify the potential for future research.
Assertiveness and the challenging patient
-express empathy -describe feelings -state expectations -list consequences
preparedness phase
-focused on planning, preparedness, prevention, and warning. every disaster begins as local event - heaviest burden falls on the local community - state and federal assistance is appropriate when the local system is overwhelmed - community preparedness: assess the community for risks - plan for a coordinated response effort by local agencies/ service ( law enforcement, fire, health care, emergency medical service. EMS - build capability to respond to consequences( shelters, supplies, handling mass causalities) - local agencies must have an emergency operating plan( EOP) Identified chain of command - plan interaction with other agencies
Lillian Wald
-founded Henry Street Settlement -1st public health nursing -visiting nurse
Clara Barton
-founded american red cross
Dependence/Independence
-helpless attitude -everything for them self, being in charge of their health
Assertive behavior
-increases patient safety -improves patient -promotes a positive working environment
Spirituality
-inner strength related to belief and sense of connectedness with a higher power
7. Identify the characteristics of a profession
-intellectual, accompanied by a high degree of individual responsibility. -body of knowledge that can be learned and is refined and developed through research -practical & theoretical -taught through specialized education -internal organization of members and developed group consciousness -has practitioners motivated by altruism (helping others) *no other profession allows entry into practice at less than the baccalaureate level. In fact, many professions require post-graduate preparation for beginning professional practice.
WWI
-national campaign to recruit nurses, Army School of Nursing -initiated public health education and home nursing through Red Cross
Nonverbal skills/attending skill
-not what you say, but how you say it -more than just your facial expressions
Vietnam War
-nurses worked without direct MD supervision -performed emergency procedures on their own
Culture
-pattern of learned behavior and values that are reinforced through social interactions 1. communication (verbal v. nonverbal) 2. personal space 3. values 4. role expectations -ETHNOCENTRISM (your culture is superior to everyone else's
How to develop self-awareness
-pay attention to the effect you have on people -listen to feedback -be open to new experiences -be non-judgemental
Assertiveness facts
-promotes mutual understanding -respect of all parties is fostered -communication is fair -facilitates effective problem solving and conflict management -standing up for your rights without violating rights of others
Functions of organization
-regulate nursing practice -identify standards of practice -develop knowledges -communicate with public -support through networking -provides mentoring
Dorothea Orem
-self care model -care for and help patient attain total self care.
Elements of communication process
-senders and receivers: speaking and listening -message: verbal and nonverbal -feedback: response to message, create meaning -context: situation and setting
Acute Illness
-short lived, resolved on own, no permanent damage "common cold"
Control group
-subjects in an experiment who do not receive the experimental treatment and whose performance provides a baseline against which the effects of the treatment can be measured. When a true experiment design is not used, this group is called a comparison group
Power
-the ability to make something happen -without power ther is "no influence"
Person/Individual
-the person we are caring for, freedom of choice, need to think each is unique, values affect decisionmaking -Human Needs Theory: Maslow's Theory- review basic needs, must be met -Adaptation: persons ability to grow and change, very individualized, resilience is ability to adapt -Homeostasis: balance, intrastability
Ida Jean Orlando theory
-theory of nursing process. Calibrate nursing approach using nursing process, which stress the action of the individual client in determining the action of the nurse -focus is on the present or short term outcome
Asian culture
-time is viewed as being more flexible than in Western culture, and being on time or late for appointments is not priority -in case of Southeast Asians, dermal practices, such as cupping, pinching, rubbing, and burning are common practice.
the practice of burning in Asian culture
-touching a burning cigarette or piece of cotton to the skin, usually on abdomen, to compensate for "heat" lost through diarrhea.
Depression and Despair
-work/daily activities altered -depression based on severity of illness
Purposes and phases of the nursing process
1. Assessment -info about patient, family, or community is gathered -two types: Subjective data: obtained from patients as they describe their needs, feelings, strengths, & perceptions of problem. Objective data: collect through observation, examination, or consultation. data is measured 2. Analysis -group and cluster data so problems can be identified 3. Planning -identify patient goals and determine ways to reach those goals 4. Implementation -occurs when nursing orders are actually carried out 5. Evaluation -nurse examines patients progress in relation to the goals and outcome criteria to determine whether a problem is resolved, process of being resolved, or unresolved
Traditional and alternative ways of becoming a registered nurse as well the difference between licensure and certifications
1. Diploma programs -hospital-based diploma program was the earliest form of nursing education -about 24 months in duration 2. Baccalaureate programs -was the start of the movement to bring nursing education into the recognized system of higher education 3. Associate degree programs -newest form of basic preparation for RN practice -began as a result of a post-World War II nursing shortage -now the most common type of basic nursing education program and graduate the most RN candidates of all basic programs -community colleges 4. External degree programs -students attend no classes -learning is independent and is assessed through highly standardized and validated competency-based outcome assessments 5. Articulated programs -purpose of articulation is to facilitate opportunities for nurses to move up the educational ladder -LPN,LVN,ADN,BSN,MSN -Licensure: refers to state regulation of the practice of nursing. Required of individuals at the entry point to practice and must be renewed periodically -Certification: goes beyond licensure by validating a high level of knowledge and proficiency in a particular practice area. Has professional but not legal status
Stages of Group development
1. Forming 2. Storming 3. Norming 4. Performing
Steps in the research process
1. Identification of a research problem - come from clinical situations, literature, or theories 2. Review of the literature - create a conceptual framework 3. Formulation of the research question or hypothesis 4. Design of the study - Experimental design: determine the effect of an intervention or to compare the responses of participants to 2+ more differing treatments. Also provide evidence of a cause-and-effect relationship between actions -Non experimental design: "descriptive" or "exploratory" research because the investigator is seeking to increase knowledge base about a nursing phenomenon be doing careful, disciplined research. Types include surveys, descriptive comparisons, evaluation studies, and historical- documentary research 5. Implementation of study - Actual study is conducted. Two main tasks during this phase are data collection and data analysis 6. Drawing conclusions based on findings - Accurate presentation of the facts is the only requirement 7. Discussion and/or clinical implications 8. Dissemination of findings - Nurses doing research: addressing the problem of hypothermia in premature infants
Code of Ethics
A hallmark of mature professions and a social contract through which the profession informs society of the principles and rules by which it functions
13. Discuss how a nurse uses critical thinking and clinical judgment in practice.
A nurse who is giving an injection might ask themselves, "have I made the correct assumption about this patient? how do i know i am making the correct assumptions? can i look at this situation differently?"; The nursing process represents a universal intellectual standard by which problems are addressed and solved. Solving patient problems in a professional practice. *adapting the patient position to the situation at hand
Striking
A work stoppage caused by the refusal of a large portion if employees to perform work; usually takes place to enforce demands relating to employment conditions on their employer or to protest unfair labor practices. Sympathy strike occurs when one union stops work to support the strike of another union
15. Explain the purposes and the phases of the nursing process.
ADPIE (Assessment, diagnosis, planning, implementation, evaluation ASSESSMENT: gather information/data about individual, family and community -Subjective Data: (symptoms) pain, nausea, anxious -Objective Data: (signs) can measure and does not change from person to person Ex: pulse rates, blood pressure, etc. DIAGNOSES: identifies the problems the patient is experiencing as a result of the disease process, human response to illness, etc. Nursing care PLANNING/ outcomes identification: Goals agreed on both patient and nurse. Comes from diagnosis and goal has a specific intervention; goals can be set long term or short term IMPLEMENTATION of care plan: occurs when nurse orders are actually carried out; documentation; previous three steps must be accomplished carefully to gain positive outcome. nurse should continually assess patient through this step EVALUATION: examining the patients progress as compared to the goals set in the planning step. can determine whether a different plan of care should be implemented. make sure to evaluate frequently and make changes when necessary
Delegation
ANA's Code of Ethics for Nurses states, "The nurse must make reasonable efforts to assess individual competence when assigning selected components of nursing care to other healthcare workers. This assessment involves evaluating the knowledge, skills, and experience of the individual to whom the care is assigned, the complexity of the assigned tasks, and the health status of the patient... Nurses may not delegate responsibilities such as assessment and evaluation; they may delegate tasks... Employer policies or directives do not relieve the nurse of responsibility for making judgments about the delegation and assignment of nursing care tasks."
The most influential provisions of the Patient Protection and Affordable Care for All Act relate to: a) Electronic health records b) Hospital reimbursement c) Access to health insurance d) Advanced practice nursing
Access to health insurance
Who is at the top of most clinical ladders, and what do they do?
Clinical nurse specialists (CNS), includes the responsibility for serving as a clinical mentor and role model for other nurses, as well as setting standards for nursing care on the unit(s). CNS also establish protocols, and ensure that the nursing practice on the unit is evidence based practice.
Patient's cardiac monitor alarms and nurse recognized rhythm as atrial flutter. What two skills did the nurse use to interpret?
Cognitive and technical
2. Negativity/independence
Cognitive rebellion; diminished reliance on external authority
Professional Socialization
Every professional has a socialization process, it is the ability to think and act like a professional nurse, absorb the culture of the profession the process where students internalize new knowledge, skills, attitudes, behaviors, and values and make these a part of their professional identity
38. Explain the responsibilities of nurses to enforce professional boundaries, including the use of social media.wZ
In regards to social media nurses must not... -Post anything about the patients that may violate their rights to privacy and confidentiality. -Post images of patients. -Contact patients online (this could mean turning down a patient's friend request) -You must report any breach in confidentiality or privacy that you encounter online.
11. Identify a working definition of critical thinking.
Includes effective communication with others while formulating solutions to problems. In addition, critical thinking considers patient's values, beliefs, and follows ethical standards *effective communication with others while formulating solutions to problems. * investigating the research that supports a viewpoint the nurse disagrees with
Pender's Health Promotion Model
Individual characteristics: prior related behaviors, personal factors (age, women, education, income) Behavior specific thoughts: perceived benefits, barriers, self efficacy (time, income, inconvenience access)
Autonomy
Individuals have the right to determine their own actions and the freedom to make their own decisions
Explanation
Justify the reasoning and conclusions drawn in relation to the evidence and contextual considerations
Novice thinking and expert thinking
Novice -Organize knowledge as separate facts. Rely heavily on resources. Lack knowledge gained from actually doing -Focus so much on actions that they may not fully assess before acting -Need and follow clear-cut rules -Often hampered by unawareness of resources -Hindered by anxiety and lack of self-confidence -Rely on step-by-step procedures and follow standards and policies rigidly -Focus more on performing procedures correctly than on patients response to procedure -Limited knowledge of suspected problems -Learn more readily when matched with a supporter Expert -Store knowledge in a highly organized and structured manner, recall info easier -Assess and consider diff. options for intervening before acting -Know which rules are flexible and when its appropriate to bend rules -Aware of resources -Self-confident -Know when its safe to skip steps or do steps together - Comfortable with rethinking a procedure
Strategies to promote EBP and barriers to implementation
PICOT -Population of interest -Intervention -Comparison -Outcome -Time
In video Sentimental Women need Not Apply, all of following themes in the history of American nursing is explored EXCEPT: a) role of historically underrepresented groups such as African-Americans and men in the profession over time b) the path towards a research-based discipline c) the relationship of feminism and women's rights in the profession d) the community as well as the hospital as a workplace for nurses
Path towards researched based discipline
Which of following most accurately reflects state of US health care? a) high-cost repetitive primary care interventions are rewarded over higher-value intensive medical interventions capable of saving more lives b) Patients and families often navigate unassisted across different providers and care settings, fostering frustrating and dangerous patient experiences c) Communication and accountability for a patient among multiple providers reduces errors and avoids duplication of effort d) Well-developed peer accountability, quality improvement infrastructure, and clinical information systems currently foster excellent quality of care
Patients and families often navigate unassisted across different providers and care settings, fostering frustrating and dangerous patient experiences
Operations of communication
Perception: interpretation of message Evaluation: Do I think what your saying is important? Transmission: how you express your ideas
Which of the following statements best reflects the nature of secondary care? a) Secondary care mostly involves primary care physicians and nurse practitioners caring for clients with common health problems b) Secondary care typically involves general hospital care and services like same day surgery c) Secondary care emphasizes the use of technology and patients tend to be referred to secondary care providers from long distances d) In secondary care settings, advanced practice nurses and specialist physicians tend to treat rare and complex disease states
Secondary care typically involves general hospital care and services like same day surgery
Common Characteristics of all definitions of professionalism
Service- responsibility to society-altruism Specialized body of knowledge skills Autonomy Ethical behavior Professional commitment
Which of the following is true? a) black nurses were always welcomed in the nursing profession in the U.S. b) Racial integration of nursing in the US Armed forces in World War II is widely considered a pivotal moment in the history of the American profession c) Until the late 20th century, African-American nurses' contributions to health in Black communities was limited d) Unlimited numbers of Black students were permitted to enroll in early 20th century U.S. nursing schools
Racial integration of nursing in US armed forces during ww2 is widely considered a pivotal moment in the profession
12. Identify the characteristics of a critical thinker.
Raises questions and problems and formulates then clearly and precisely, gathers and assess relevant information using abstract ideas for interpretation, arrives at conclusions and solutions that are well reasoned and tests them against relevant standards, open-minded and recognizing alternate ways of seeing problems, ability to assess assumptions, implications, and consequences of alternate views of problems, communicates well with others in giving solutions
The nurse determines that the current pain medication prescribed for the patient is not adequate to manage the patient's pain level. After discussing this with the patient, she calls the physician and asks for the dosage to be increased. The nurse is functioning in the following role: a) role model b) coach c) advocate d) care provider
Advocate
6. Identify social and demographic factors that influence the development of nursing in the United States.
Aging population and increasing diversity. Since people are living longer the population of older people is increasing (baby boomers) this population or group is more likely to have chronic conditions /illnesses; Gender, technology, population trends, image, and the nursing shortage
Evidence- bases practice
Approach to the delivery of health care that "integrates the best evidence from research studies and patient care data with clinician expertise and patient preferences and values"
Values
Attitudes, ideals, or beliefs that an individual or a group holds and uses to guide behavior
Recovery phase
Begins 72 hours after the disaster - may continue to 2 or 3 years - activities to enhance recovery, rehabilitation, and reconstruction - evaluation or the disaster preparedness and response plan.
Utilitarian ethics
Believe that what makes an action right or wrong is its utility, with useful actions brining about the greatest good for the greatest number of people
Nursing conceptual models
Broad conceptual structures that provide comprehensive, holistic perspectives of nursing by describing the relationships of specific concepts
Process of Valuing
Choosing: from alternatives, considering consequences Prizing: feeling about a choice Acting: behavior "acting on values" Your nursing care: demonstration of what you value
Which of following organizations verifies the quality of education provided by schools of nursing offering baccalaureate, master's and doctoral programs in nursing and provides accreditation to those that are successful? a) American Nurses Association b) Commission on Collegiate Nursing Education c) State Board of Nursing d) National League for Nursing
Commission on Collegiate Nursing Education
Transactional leader
Concerned with the day-to-day operations of the facility -reward staff for desired work - monitor work performance,and correct as needed - wait until the problem occur, deal with the problem
Trait Approach
Flexner, Bixler, Pavalko- sociologists who determined the following characteristics to be most important professional traits 1. high intellectual activity 2. high level of individual accountability/responsibility 3. specialized body of knowledge 4. education in a 4 yr. college/university 5. focus on service and altruism 6. valued over financial gain 7. atonomy in independence 8. strong organization represents their group 9. code of ethics
The goals of health care reform include which of the following? a) Decreasing health care services to provide all citizens with some access to care, but control escalating costs b) Focus on cost containment with improved access and quality of services for everyone c) Controlling health care costs through limited services for more consumers of health care d) improving quality of care, while limiting access for the uninsured, to control rising costs
Focus on cost containment with improved access quality of services for everyone
1. Discuss how the nursing profession has evolved.
From the work of Florence in the Crimea in the mid-1800s to the present, the profession of nursing has been influenced by the social, political and economic climate of the times as well as by the technological advances and the theoretical shifts in medicine and science. *1893 Chicago worlds fair was a significant turning point in nursing history because nursing learners net and founded the group that became the national league for nursing
Which of following pairs of elements establish nursing as both a profession and a discipline? a) development of distinct RN roles, creation of advanced practice degrees in nursing b) creating nursing practice guidelines, having a distinct body of knowledge c) having a distinct body of knowledge, conducting and publishing nursing research d) establishing a legal definition of nursing practice, conducting and publishing research specific to the field
Having distinct body of knowledge, conducting and publishing nursing research
Civil war
Health care conditions in the US were similar to those encountered by Nightingale and Seacole. Numerous epidemics plagued the country, including syphilis, gonorrhea, malaria, smallpox, and typhoid • Dorothea Cox was appointed to organize military hospitals and provide medical supplies to the Union Army soldiers • Clara Barton served on the front line during the civil war and operated a war relief to provide supplies to the battlefields and hospitals called the American Red Cross
Roy
Identify types of demands placed on patients, assess adaptation to demands and help patient adapt.
Media Impact on Nursing
Image of Nursing TV< movies, newspapers Promote positive image by: nursing uniforms, communication, and tell others what nurses do
Nurse observes patient problem consistently occurring and asks researcher if they can test her hypothesis by conducting research. He is using:
Inductive reasoning
Components
Input: energy that helps achieve the purpose of a system Throughput: system makes sense of something Evaluation: how effective it is Feedback: continuous communication within systems
A client has a private insurance policy that pays for most health care costs and services. In what sense is this plan a third-party player? a) Medicare and Medicaid will pay most of the remaining costs. b) The family of the client is required to pay costs c) The insurance company pays most or all of service costs d) the client gets the bill and pays the service provider
Insurance comp. pays most or all of service costs
Information Technology
Internet, electronic records, telehealth. Clients are better informed, transmit client information electronically, connect rural clients to specialists
Context and types of communication
Interpersonal: between 2 people Small Group Interprofessional Collaborative Communication: between other health care professionals Public: audience Mass communication: electronic, through the internet
Transformational leader
Is the one committed to organizational goals, has a vision, and able to empower others with that vision - able to guide employees to feel pride in the work of the organization and to inspire them to be actively engaged to achieve the mission and goals of the organization - spend time teaching and coaching, seek different perspectives when faced with problem to solve, and seek new ways to improve the work environment
Intuition
Knowing something w/o hard evidence, must not depend solely on this to make nursing judgement. Use intuition to send up a "red flag"- pay attention to this feeling but gather more data and look for evidence to support you inuition
Which of the following is likely the best explanation for relatively low representation of men in nursing? a) the strong linkage in the public imagination of the profession after Nightingale with women and women's virtues b) high failure rates of male students in nursing education programs c) refusal of members of the medical profession to work with male nursing graduates d) limited historical precedent for men's involvement in caregiving
Strong linkage in public imagination of the profession after Nightingale with women and women's virtues
Relationship between nursing theory, research, and practice
They are circular- literature, theory, clinical practice
Locus of Control
Who is responsible? Internal- believe what they do makes a difference External- believe what they do won't make a difference
what is a clinical nurse specialist?
in hospitals, clinics, nursing homes, own offices, industry, home care, health maintenance orgs. MSN or Doctorates. Qualified to handle a wide range of basic physical/mental health problems and are experts in a specific field. perform health assessments, make diagnoses, deliver treatment, develop quality control methods. consult, research, education, administration
ABC system
• A= is assigned to the high-value items • B= to the medium-value items • C= the low-value items • The A items should stand out from the other items because of their worth to the person making the list. Also the A items are likely to require more energy and time, but they should be completed before and of the B or C items.
Computerized adaptive testing
• Adapts to the level of the candidate's knowledge, skills, and ability. After a candidate answers a question at a particular level of difficulty, the computer then selects the next item that the candidate should have a 50% chance of answering correctly. • Candidates have ample opportunity to demonstrate their competence because the exam does not end until stability of the pass or fail result is certain or time runs out.
Metripolitan medical response system
• Builds a cadre of specially trained responders and equipment. • The system is coordinated with area and state-wide planning systems and integrates the efforts of all of the emergency response teams • The MMRS includes plans for expanding hospital based care, enhancing emergency medical transport and emergency department capabilities, locating specialized pharmaceuticals to respond to an MCE, managing mass fatalities, and providing mental health care for the community, victims, and health care providers
Appropriate response to identifying your weakness at an interview
• Delegating to peers
Partcipatory management
• Encourages staff participation in decision making • Involves staff in planning and developing new ideas and programs • Believes in the best in people • Communicates effectively, and provides regular feedback • Builds responsibility in people • Works well with competent, highly motivated people
Determine when to choose a delegate
• Identify exactly what is to be delegated and why • Select the best person for the tasks; this may be the person most qualified or it may be the person whose development the delegator chooses to contribute to • Communicate the assignment in detail, perhaps even including written instructions • Involve the delegatee in establishing the objectives and deadlines for the task • Have the delegatee repeat the details of the task • Give the delegatee the authority for accomplishing the task • Provide adequate resources and support needed • Schedule regular meetings for progress reports • Establish controls and monitor the results • Evaluate the process and progress of the delegatee • Let the delegatee do the job • Enjoy the results of having the delegated task completed and being able to accomplish other task simultaneously
Political ACtion committee
• Is an arm of a corporation, association, or union formed to provide support and resources either to work toward the election or reelection of policymakers who support the organization's overall goals or to persuade a policymaker to support a certain policy
Time plot
• Measuring data over time to evaluate patterns in process variation typically is suited for tools such as run charts and control charts. Run charts, also known as time plots, are graphs of data points as they occur over time.
Prehistoric period
• Nursing in the prehistoric period was delineated by health practices that were strongly guided by beliefs of magic, religion, and superstition • Individuals who were ill were considered to be cursed by evil spirits and evil gods that entered the human body and caused suffering and death if not cast out • These beliefs dictated the behavior of primitive people, who sought to scare away the evil gods and spirits. • Members of tribes participate in rituals, wore masks, and engaged in demonstrative dances to rid the sick of demonic possession of the body. • Sacrifices and offerings, sometimes including human sacrifices, were made to rid the body of evil gods, demons, and spirits • Many tribes used special herbs, roots, and vegetables to cast out the "curse" of illness
Grassroots
• Personal advocacy by individual constituents- everyday citizens - in support of a problem/position/option related to a policy issue
Social security act of 1935
• Provided avenues for nursing care, and nursing jobs were created. • With funds from the Social Security Act, public health nursing became the major source of health care for dependent mothers and children, the blind, and crippled children. • Nurses found employment as public health nurses for county or state health departments • Hospital job opportunities also were created for nurses, and the hospital became the usual employment setting for graduate nurses
Budget assumption
• Statements that reflect issues affecting the future performance of the organization; used as the framework for developing the budget; budget assumptions address questions such as the following: Are supply prices likely to increase or decrease? What salary range will ensure that the organization is able to recruit and retain quality employees? What are the competitors offering in terms of new services? Is the patient census likely to increase or decrease over the next year?
Right to work law
• Statutes enforced in 22 US states, mostly in the southern and western United States, allowed under provisions of the Taft Hartley Act, which prohibit agreements between unions and employers that make membership or payment of union dues or "fees" a condition of employment either before or after hiring.
Plaintiff
• The complaining person in a lawsuit; the person who claims he or she was injured by the acts of another
Know the difference between planned performance and planned variance:
• The difference between the planned budget and the actual results is called a variance. A variance is favorable when the results are better than expected, or it is unfavorable when the results are worse than expected.
Most common reason for nurse to leave their job
• The downturn in the US economy in 2009 led to an easing of the nursing shortage in some parts of the country. This was largely due to many retired nurses re-entering the workforce due to economic pressures, nurses who had planned to retire who are holding on to their positions, some nurses working part-time who have taken full-time positions, and hospitals treating fewer patients because many people are delaying procedures or not seeking care due to loss of insurance.
States require CEs( continuing education) credits
• The first state to require it was California
Cultural self assessment
• The first step to becoming a culturally sensitive and competent health care provider is to conduct a cultural self-assessment. • The nurse should engage in a cultural self-assessment to identify individual culturally based attitudes about clients who are from a different culture • Cultural self-assessment requires self-honesty and sincerity and reflection on attitudes of parents, grandparents, and close friends in terms of their attitudes toward different cultures. • Through identification of health related attitudes, values, beliefs, and practices, the nurse can better understand the cultural aspects of health care from the client's perspective
Function of the budget process
• The primary use of a budget is to evaluate the progress of unit or department.
Telehealth
• The use of telecommunications technology to assess, diagnose, and, in some cases, treat persons who are at a distance from the health care provider. • Nurses, physicians, radiologists, psychiatrists, and others use this technology via telephone. Computers, interactive videos, and teleconferencing. In many instances, telehealth makes possible the delivery of health care services to populations, such as rural communities, older adults, or prisoners that may have difficulty accessing necessary services
Whisle blower
• There are countless situations in which the official policing body will never be involved, and the obligation to denounce a harmful action or potentially threatening situation falls to a fellow member of the profession. Sometimes known as the whistle-blowing, the obligation to denounce is based on the fact to remain silent is to consent to the action or threatening situation.
Nursing shortage
• There was a projected short fall of 20% or 400,000 RN'S expected by 2020. • However colleagues report that the registered nurse supply is growing faster than projected due to the surge in new nurses 23 to 26 years of age who are entering the workforce. • The RN shortfall trends have reversed over the past decade as nursing has become a more attractive career. • Legislative effort to stem a nursing shortage began in 2002 with the Nurse Reinvestment Act, which provided nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. • In 2010, the Patient Protection and Affordable Care Act increased the nursing student loan amounts, provided $50 million per year to fund nurse-managed health centers, funded gerontology nursing fellowship programs, provided up to $40,000 in educational loan repayment for nurse faculty and $80,000 for doctorally prepared nurse faculty, and significantly strengthened Title VIII advanced nursing education grants. • Funding was made available for graduate nursing demonstration grants to hospitals providing advanced nursing education clinical training to advanced practice nurses.
Social media
• Thirty three state boards of nursing reported receiving complaints about the nurses' use of social media, and 26 of these state board nurses reported having disciplined the licenses of nurses • Nursing students have been expelled from nursing programs because of both positive and negative postings about patients. • The courts have upheld those decisions because of the significant breach of professional boundaries. • Nurses have "friended" patients and their familes, leading to significant professional concerns about maintaining professional boundaries. • Nurses have been terminated from positions and had their license disciplined or removed because they have posted pictures of patients on a social media site. • It is important for the nurse to understand that whatever is posted can be seen by others as well as intended person and is available to be seen forever
Partnership model
• This model was designed to make more efficient use of the RN, who delegates nonprofessional tasks to the partner, thus providing more time for the RN to address professional demands, such as assessment and patient education
Filtration
• Unconscious exclusion of extraneous stimuli
Time out
• Universal protocol for preventing wrong site, wrong procedure, wrong person. (1) Conduct a preprocedure verification (2) Mark the procedure site (3) perform a time-out before the procedure
Top down process of leadership
• Upper management sets budget goals and imposes those goals on the rest of the organization
Nurse Reinvestment act of 2002
• Which provided nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants.
First university offered a baccalaureate in the UNiTed states
• Yale University
Ethic group that are considered minorities
•African Americans, Hispanics, American Indians, and Asians or Pacific Islanders
Martha rogers
•Science of unitary human beings: energy fields, openness, pattern, and organization; nurse promotes synchronicity between human beings and their universe or environment .
SBAR
•Situation- patient information and brief sentence of what is happening now •Background- diagnosis, relevant lab and assessment data, chief complaints •Assessment- analysis of the problem, what is of concern •Recommendation- form as a question of what may be a solution or request for help
Generalizability
•The inference that findings can be generalized from the sample to the entire population
Madeline Leininger
•Theory of cultural care diversity and universality. Trans-cultural nursing and caring nursing; concepts are aimed toward caring and the components of a culture care theory; diversity, universality, worldview, and ethnohistory are essential to the four concepts (care, caring, health, and nursing)
When NCLEX shuts off at 75 questions
•you will completely pass or completely fail, - there will be the chance that you still can fail the test
