Week 1 Fundamentals Sherpa CH 1-Theoretical Base of Nursing & Nursing Practice
What is nursing? According to International Council of Nurses (ICN)
"Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles."
What is nursing? According to American Nurses Assoc. (ANA)
"Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations."
What is nursing? According to Medical Definition of Nursing (Shiel, 2020)
"Profession concerned with the provision of services essential to the maintenance and restoration of health by attending the needs of sick persons."
What is nursing? According to Florence Nightingale (1860)?
"The act of utilizing the environment of the patient to assist him in his recovery."
What is nursing? According to Virginia Henderson (1966)?
"The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible."
The Clinical Judgment Measurement Model (CJMM)
(1) forms hypotheses, (2) refines hypotheses, and (3) evaluates
Maslow's Hierarchy of Needs
(level 1) Physiological Needs (level 2) Safety and Security (level 3) Relationships, Love and Affection (level 4) Self Esteem (level 5) Self Actualization (acceptance of facts)
Evolution of Nursing: 20th Century
-Establishment of professional nursing organizations such as the American Nurses Association (ANA) and the National League of Nursing (NLN). -In 1900, the American Journal of Nursing, the first journal to be published in nursing, was established.
Evolution of Nursing: Renaissance & Reformation
-Health care was based on charity and the sanctity of human life; women cared for the sick in their homes; herbs and new methods of healing were used. -The Roman Catholic church became a central figure in health care. -The cross used during this period became a badge and forerunner for the design of nursing pins.
Evolution of Nursing: Early Civilizations
-Hippocrates, considered the "father of medicine," was the first to attribute disease to natural causes rather than supernatural causes and curses of the gods. -Developed laws on cleanliness, food use and preservation, drinking, exercise, and sexual relations, and created a pharmacopeia with more than 700 drugs. -Developed the Mosaic Code, one of the first organized methods of disease control and prevention. -First military hospital in Europe in Rome; men cared for the injured and began to practice advanced hygiene and sanitation. -Developed procedures to perform major/minor surgical operations with wound sutures; public hospitals; stressed prenatal care
Evolution of Nursing: Prehistoric
-Practices were guided by beliefs of magic, religion, and superstition. -Illness was believed to be caused by evil gods, demons, and spirits that entered the body and had to be cast out. Rituals, dance, sacrifice, special herbs, roots, and vegetables were used to cast out the "curse" of illness. -Medicine men typically fulfilled the leadership role of healer for their communities
The modern sense of the nurse appeared late in what century?
16th
Sister Callisa Roy Theory
Adaptaion Model-help patients adapt to changes.
Betty Newman's System Model
Betty Newman's Systems Model views patients' health holistically but does not focus on promoting healing through caring
In which roles do nurses serve? Select all that apply. Care provider Educator Therapist Researcher Analyst
Care provider Educator Researcher
Which nursing roles are inherent roles? Change agent Nurse administrator Faith community nurse Patient advocate Case manager
Change agent Patient advocate
Which role describes how nurses function to ensure that members of the health care team work together to accomplish a common goal? Change agent Manager Collaborator Advocate
Collaborator
Florence Nightingale theory
Concept of balance between environment and patient: emphasized prevention; clean air, water, and housing
Which characteristics are associated with grand theories? Select all that apply. Define a broad perspective for nursing practice Focus on a specific condition or population Are the most abstract Narrow focus and may be generalized Difficult to test in practice
Define a broad perspective for nursing practice Are the most abstract Difficult to test in practice
The nurse is teaching a patient recently diagnosed with diabetes how to administer insulin injections. Whose theory is the nurse demonstrating? Betty Newman Sister Callista Roy Dorothea Orem Florence Nightingale
Dorothea Orem
Which concept is included in Martha Rogers' Science of Unitary Human Beings? Views the patient's holistic response to stress Each being is unique and needs to be looked at as a whole Based on setting goals to meet patients' needs A method for nurses to assist patients to adapt to changes
Each being is unique and needs to be looked at as a whole
A 16-year-old patient who is physically stable and healing is acting withdrawn. At various times during interactions with the patient, the nurse observes the patient sucking his thumb. Which contributor's theory would be beneficial if applied to this patient's care? Rosenstock Maslow Imogene King Erikson
Erikson
Which non-nursing theory do nurses use to plan care for their patients at different stages in life? Maslow's Hierarchy of Needs Lewin's Change Theory Erikson's Psychosocial Theory of Development and Socialization Rosenstock's Health Belief Model
Erikson's Psychosocial Theory of Development and Socialization
Which elements are included in the ANA standards of professional performance? Ethics Collaboration Nursing process Quality of practice Resource utilization
Ethics Collaboration Quality of practice Resource utilization
Which terms are components of critical thinking as listed in Paul's Critical Thinking Theory? Select all that apply. Experience Reasoning Proficiency Observation Caring
Experience Reasoning Observation
The nurse implemented strict infection control procedures for an immunocompromised patient. Whose theory did the nurse apply when caring for this patient? Jean Watson Florence Nightingale Hildegard Peplau Virginia Henderson
Florence Nightingale
Which contemporary nursing role is one of the fastest-growing specialties in the 21st century? Case manager Flight nurse Faith community nurse Forensic nurse
Forensic nurse
Imogene King's Theory
General Systems Framework, the nurse and patient work together to achieve desired patient goals. However, this theory does not focus on self-healing.
State Nurse Practice Acts
Governs nursing practice as they provide the scope of practice defined by each state and set forth legal limits of nursing practice
Which characteristic describes the classification of a practice theory? May be generalized to other settings Is difficult to test in nursing practice Guides nursing care of specific populations Is the most abstract and theoretical theory
Guides nursing care of specific populations
Rosemary Rizzo Parse
Human Becoming Theory views patients as constantly changing persons, but does not focus on caring. 1981
Jean Watson's theory
Human Caring Theory focuses on caring as central to nursing practice, which promotes growth, health, and healing. 1979
Which organization's definition of nursing includes the autonomous role of nurses? International Council of Nurses (ICN) American Nurses Association (ANA) State Board of Nursing (SBN) National League for Nursing (NLN)
International Council of Nurses (ICN)
The nurse is discussing with a student the importance of caring for patients to promote health and healing. Principles of which contributor's theory would be part of this discussion? Jean Watson Imogene King Betty Newman Rosemary Rizzo Parse
Jean Watson
A dean in a college of nursing is trying to inspire a faculty member to obtain a terminal degree. Which nursing role does this action represent? Leader Manager Collaborator Educator
Leader
Match the theory or model with its description. Three-step process in which individuals encounter the unknown Skills like conceptualizing and reasoning help guide nursing actions Resolution of a developmental stage results in age-appropriate behavior Predicts an individual's response to treatment and health behaviors
Lewin's Change Theory Paul's Critical Thinking Theory Erickson's Psychosocial Theory Rosenstocks Health Belief Model
Match the theory or conceptual framework with the theorist who developed it. Madeline Leininger Martha Rogers Rosemarie Rizzo Parse Hildegard Peplau
Madeline Leininger-cultural care theory Martha Rogers-science of unitary human beings model Rosemarie Rizzo Parse-human becoming theory Hildegard Peplau=theory of interpersonal relations
A charge nurse is authorized to make changes in the number of staff members who work a shift. Within which nursing role is the charge nurse functioning? Leader Manager Collaborator Delegator
Manager
Which 19th-century nurse used her extensive knowledge in tropical medicine to treat patients during the cholera epidemic in the 1850s? Florence Nightingale Florence Nightingale made many contributions to the nursing profession, including establishing the first nursing school in England in 1860. Clara Barton Clara Barton is best known for establishing the American Red Cross. Dorothea Dix Dorothea Dix headed the US Sanitary Commission, a forerunner of the Army Nurses Corp. Mary Seacole Mary Seacole contributed to the control of cholera and yellow fever epidemics through her extensive knowledge in tropical medicine.
Mary Seacole
Evolution of Nursing: Colonial Period
Mexico First hospital in North America built in Mexico City; first medical school built at the University of Mexico. Individuals with infectious diseases were isolated in almshouses or "pest houses." Colonial America Deficient health care and low life expectancy; plagues such as yellow fever and smallpox were a constant threat. In 1752, through the efforts of Benjamin Franklin, Pennsylvania Hospital was the first hospital to open in the United States.
Evolution of Nursing: 21st Century
New challenges have emerged in a new century: -Advances in technology and informatics -Increased acuity (levels of illness) in hospitalized patients with early discharge -Current lack of resources to train new nurses Robert Wood Johnson Foundation (RWJF) and Institute of Medicine: Future of Nursing emphasized the following: -Nurses should practice to full extent of education and training -Higher levels of education for nurses encouraged -Interprofessional collaboration promoted to redesign health care
Paul's Critical Thinking Theory (1993)
Nurses analyze data, develop a patient care plan, implement a plan of action for the patient, and evaluate the plan of care.
Rosenstock's Health Belief Model is based on four core beliefs about the patient's perceptions:
Patients' perceived threat of an illness Perceived severity and potential consequences of the potential illness The positive benefits of taking preventive actions Any barriers to the preventive actions
Rosenstock's Health Belief Model
People's decisions about health-related behaviors are guided by four main factors: 1. Perceiving a *personal threat* of developing a specific health problem Ex: Do you believe that you will get lung cancer from smoking? 2. Perceiving the *seriousness* of the illness and its consequences Ex: How serious do you think lung cancer is and what are the consequences? 3. *Believing* that changing a behavior will reduce the threat Ex: Will giving up smoking prevent you from getting lung cancer? 4. *Comparing perceived costs and benefits* of a health-related behavior change Ex: Will the reduced chance of getting cancer in the future be worth the loss of pleasure associated with not smoking now?
The Standards of Professional Nursing Practice published by the ANA work to ensure quality care and provide legal criteria for care. The standards consist of two parts.
Professional Nursing Practice: These include ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice, research, quality of practice, professional practice evaluation, resource utilization, and environmental health. Nursing process: the multistep scientific approach nurses use to care for their patients. As a care provider, the nurse follows this process to assess patient data, prioritize nursing diagnoses, plan care for patients, implement appropriate interventions, and evaluate care in an ongoing cycle.
The 6 phases of the CJMM are?
Recognize cues Analyze cues Prioritize hypotheses Generate solutions Take action Evaluate outcomes
Which roles is the nurse demonstrating when recognizing a problem and collecting data to sufficiently support the need for policy updates? Select all that apply. Patient advocate Manager Researcher Delegator Change agent
Researcher Change agent
Which theory predicts general health behaviors of an individual? Maslow's Hierarchy of Needs Lewin's Change Theory Rosenstock's Health Belief Model Erikson's Theory of Development
Rosenstock's Health Belief Model
The nursing student understands that which concepts are tiers in Maslow's Hierarchy of Needs? Select all that apply. Motivation Safety Individuality Physiologic Esteem
Safety Physiologic Esteem
Martha Rogers Theory
Science of Unitary Human Beings
According to the International Council of Nurses (2012) uses:
Technical and psychomotor skills interpersonal skills are used to communicate Ethical and legal skills
Hildegard Peplau theory
Theory of interpersonal relations model: -explores interpersonal relationship of nurse and client -identifies clients feelings as a predictor of positive outcomes related to health and wellness
Practice Theories
Theory to bedside practice; guides nursing care of specific populations and situations; built on other theories practice theories are specific to populations and situations and bring theory to the bedside.
Which concepts are included in Hildegard Peplau's Theory of Interpersonal Relations? Select all that apply. Patient adaptation Therapeutic interactions Person as a whole Interpersonal roles Environment
Therapeutic interactions Interpersonal roles
Evolution of Nursing: 19th Century
Times of war led to growth in the role of the nurse in the 19th century. -Florence Nightingale Mary Seacole-Jamaican Dorthea Dix Clara Barton
Erickson's stages of psychosocial development
Trust/Mistrust, Autonomy/Shame, Initiative/Guilt, Industry/Inferiority, Identity/Role Confusion
The nurse recognizes that the staff seems apprehensive when discussing a new electronic medical record that will be placed on each unit and will require staff training. Based on Lewin's Change Theory, which stage does the staff apprehension represent? Movement Unfreeze Refreeze Contemplate
Unfreeze
The nurse is implementing concepts from which theorist when facilitating a patient's independence? Betty Newman Hildegard Peplau Madeline Leininger Virginia Henderson
Virginia Henderson
During which time frame in nursing history did Dorothea Dix organize military hospitals and head the US Sanitary Commission? a. Colonial American period b. 19th century c. 20th century d. Crimean War
b. 19th century
Erickson's Theory of Psychosocial Development
based on psychology and social functioning
Which major contribution did Hippocrates make toward the evolution of medicine and health care? a. Was the first to develop procedures to perform surgical operations b. Developed the Mosaic code to organize methods of disease control and prevention c. Was the first to attribute disease to natural causes rather than supernatural causes and curses of the gods d. Established the first military hospital in Europe
c. Was the first to attribute disease to natural causes rather than supernatural causes and curses of the gods
nursing theory
conceptualizes an aspect of nursing to describe, explain, predict, or prescribe nursing care
Virgina Henderson Theory
defined nursing as assisting a patient to increase his/her independance Nurses role as subsitute, supplemantary, or complementary
3 levels of nursing theories from most abstract to least:
grand-broad and abstract Middle-Range-narrowly focused and concrete practice -practice theories are specific to populations and situations and bring theory to the bedside.
Lewin's Change Theory
unfreezing: initiation of change moving: motivation/moving toward the change refreezing: implementation of a change