Fdn Ch.1/Ch.2

How do Nurses' educational paths differ?

(1) Formal education - Practical and Vocational Nursing Education (LPNs or LVNs) - Registered Nursing Entry Education: Diploma program, Associate degree program, Baccalaureate degree program, Master's entry programs, and Doctoral entry. - Graduate Nursing Education - Other forms of formal education: Continuing education. - In-service education (2) Informal Education - Socialization: Professional socialization begins when you enter the educational program and continues as you gain expertise throughout your career. - Benner's Model.

Why is it important to define nursing?

(1) To help the public understand the value of nursing. (2) To describe what activities and roles belong to nursing versus other health professions. (To differentiate activities from other practice) (3) To help students and practicing nurses understand what is expected of them within their role as nurses.

What are Critical-Thinking Skills?

- Objectively, not subjectively, gathering information about a problem or issue is an example of a critical-thinking skill. - Recognizing the need for more information is an example of a critical-thinking skill. - Evaluating the credibility and usefulness of sources of information is an example of a critical-thinking skill. - Recognizing gaps in one's knowledge is an example of a critical-thinking skill. - Listening, not speaking, carefully and reading thoughtfully are examples of critical-thinking skills. - Separating relevant from irrelevant data is an example of a critical-thinking skill. - Organizing or grouping information in meaningful ways. - Making inference(conclusion) about the meaning of the information. - Visualizing potential solutions to a problem. - Exploring the the advantages, disadvantages, and consequences of each potential action.

pg.24 ANA recommendations for reform in 2008

- Provide universal access to essential healthcare services for all citizens and residents. - Establish health policies that support safe, effective, patient-centered, timely, efficient, and fair care based on outcomes research. - Shift the priority from illness care to health promotion, and balance between high-tech treatment and community-based and preventive services. - Establish a single payer system for financing healthcare.

Health Restoration

- Providing hygiene and nutrition for someone unable to do so independently. - Counseling individuals or groups. - Lobbying for policy changes to improve access to care for an underserved group. - Identifying the significance of cultural and/or spiritual influences.

Caring

- Self-knowledge and ethical knowledge are components of "caring" in the full-spectrum nursing concepts. - It involves personal concern for ppl, events, projects, and things.

Illness prevention

- Teaching the importance of hand hygiene to decrease the transmission of infection. - Advocating for and administering pneumonia immunizations to those at high risk. - Promoting smoking cessation. - Promoting adequate nutrition to include a diet high in Vitamin C.

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Model of care

1. Case Method: Also called total care, is one-to-one care; one nurse provides all aspects of care for one pt during a single shift. The case method is used in intensive care, labor and delivery, and private duty care. 2. Functional Nursing: Each task assigned to a staff member with the appropriate knowledge and skills. Ex) CNA gives bath/LPN distribute medications/RN in charge and perform ordered treatments. It is difficult for the nurse to fully grasp the patient's "whole picture." 3. Team nursing: Pair up to make a team with CNA, LPN, and led by RN. Team nursing is popular during times of patients. Team nursing is popular during times of nursing shortages. 4. Primary Nursing: One nurse manages care for a group of pts. 5. Differentiated Practice: Nurses who have the necessary competencies care for pts.

Different organizations involved in nursing.

1. The state board of nursing is the agency responsible for regulating nursing practice. (Like protecting the health, safety, and welfare of the general public. - Approving nursing education programs. - Defining the practice of professional nursing. - Establishing criteria that allow a person to be licensed as a registered nurse (RN) or licensed practical or vocational nurse (LPN/LVN). - Defining professional practice, which determines the nurse's scope of practice or those activities that nurses are expected to perform (and by implications, those they may not). - Developing rules and regulations for guidance to nurses. - Enforcing the rules that govern nursing. - Licenses are issued by the state. 2. American Nurses Association (ANA) pg.14 - It is the official professional organization for nurses in the U.S. formed in 1911 previously known as the Nurses' Associated Alumnae of the U.S. and Canada. - Initiated code of ethics for nursing. - Advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the congress and regulatory issues affecting nurses and the public. - Mission: nurses advancing our profession to improve health for all. 3. National League for Nursing (NLN) - First nursing organization with a goal to establish and maintain a universal standard of education. - NLN sets standards for all types of nursing education programs, studies the nursing workforce, lobbies and participates with other major healthcare organizations to set policy for the nursing workforce, aids faculty development, funds research on nursing education and publishes the journal "Nursing Education Perspectives". - Supports global health policies and improve health worldwide. - Offers faculty development programs, networking opportunities, testing and assessment, nursing research grants, and public policy initiatives. - 4 Core values: Caring/ Integrity/ Diversity/ Excellence - Mission: To promote excellence in nursing education to build a strong and diverse workforce to advance the nation's health. 4. International Council of Nursing (ICN) - Quality nursing care for all, supports global health policies that advance nursing and improve worldwide health, and strives to improve working conditions for nurses throughout the world. - Works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce. - 5 Core values: Visionary leadership/Inclusiveness/Innovativeness/Partnership/Transparency - Mission: To represent nursing worldwide, advancing the profession and influencing health policy 5. National Student Nurses Association (NSNA) - Publishes Image, a journal dedicated to nursing student issues. - Mentors the professional development of future RNs and facilitates their entrance into the profession by providing education resources, leadership opportunities, and career guidance. - Mission: To mentor students preparing for initial licensure as RNs, and to convey the standards, ethics, and skills that students will need as responsible and accountable leaders and member of the profession - Nonprofit organization for students enrolled in associate, baccalaureate, diploma, and generic graduate nursing program. 6. Sigma Theta Tau International (STTI) - Vision is to create a global community of nurses who lead in using knowledge, scholarship, service and learning to improve the health of the world's people. - International honor society for nursing. - Membership is by invitation to baccalaureate and graduate nursing students who demonstrate excellence in scholarship and to nurse leaders exhibiting exceptional achievements in nursing. - Mission: to support the learning, knowledge, and professional nurses committed to making a difference in health worldwide.

Example of illness prevention activities would be?

1. performing a vision screening 2. promoting prenatal care

Advanced practice Nurses (APNs)

A nurse practitioner (NP) is a nurse with advanced education focused on providing primary care (comprehensive healthcare) to an age group or within a specialty area. NPs may work independently or in practice with physicians. They assess, diagnose, and treat diseases and illnesses and prescribe medications and treatments. A certified registered nurse anesthetist (CRNA) is a nurse with advanced education focused on providing anesthesia. Nurse anesthetists conduct preoperative screening and evaluation of patients, administer anesthesia during surgery, and evaluate the patients' response to anesthesia in the postoperative period. A clinical nurse specialist (CNS) is a nurse with advanced education and expertise in an area of clinical specialization (e.g., cardiovascular, pulmonary, orthopedics). The CNS may provide direct patient care; consult on client care; engage in client, family, community, or staff teaching; and/or conduct research. A certified nurse midwife (CNM) is a nurse with advanced education focused on women's health, pregnancy, and delivery. A CNM provides prenatal care, performs uncomplicated deliveries, and provides postpartum care.

Co-payment

A payment made by a beneficiary (especially for health services) in addition to that made by an insurer.

Being with

Being with is being emotionally present for the patient (e.g., making eye contact, actively listening).

Considering Alternatives (Another possibility)

Considering alternatives involves exploring and imagining as many alternatives as you can think of for the situation.

Secondary Care

Consists of services to diagnose and treat illness, disease, and injury.

Thinking

Critical thinking and theoretical knowledge are components of "thinking" in the full-spectrum nursing concepts.

Assisted Living Facilities

Designed to bridge the gap between independence and institutionalization for older adults who have a decline in health status and cannot live alone independently. Nurses have a limited presence at assisted living sites because residents typically travel from their homes to the physician and other service providers.

Doing for

Doing for is doing what the patient would do for himself if he could (e.g., bathing).

__________ prayed to various gods and goddesses to remove illness and maintain health. Women assumed the role of nursing, providing comfort and supportive care to the sick.

Early Egyptians

Enabling

Enabling is supporting the patient through coping with life changes and unfamiliar events, such as hospitalization.

Ethical knowledge

Ethical knowledge is knowledge of obligation, or right and wrong, and consists of information about moral principles and processes for making moral decisions.

Independent Living Facilities

For Seniors 55years or older who are (a)independent in all aspects and (b)want to live in a community with other senior citizens.

Maintaining belief

Having faith in the pt's ability to get through the change or event and to find fulfillment and meaning. (Swanson, 1990)

Define nursing in your own words.

In 1980, ANA (American Nurses Association) defined nursing as "the diagnosis and treatment of human responses to actual and potential health problems". In 1973, ICN (International Council of Nurses) defined nursing according to the beliefs of respected theorist Virginia Henderson: The unique function of the nurse is to assist the individual, sick or well, in the performance of those avcitivities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. (Henderson 1966) Then revised it's definition in 2010. (Pg. 7)

Inquiry

Inquiry involves applying standards of good reasoning to your thinking when analyzing a situation and evaluating your actions.

What is QSEN competencies?

It is 6 areas of expertise that nursing students are expected to acquire before graduation. 1. Patient-centered care: Recognize the pt or designee as the source of control and (a) full partner (when) providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. 2. Teamwork and collaboration: Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care. 3. Evidence-based practice: Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal healthcare. 4. Quality improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safe of HC systems. 5. Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance. 6. Informatics: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.

Primary Care

Keeping PT well by preventing illness and by treating acute episodic problems. Most of these services are offered in the community at physicians' offices, clinics, and diagnostic centers.

Knowing

Knowing is striving to understand what an event (e.g., an illness) means in the life of the patient.

Tertiary care

Long-term Rehabilitation services and care for the dying.

How is nursing practice regulated?

Nursing practice in the U.S. is regulated by laws and professional organizations' standards of practice. Each states enacts its own nurse practice act(laws that regulate nursing practice) The state board of nursing is the agency responsible for regulating nursing practice. (Like protecting the health, safety, and welfare of the general public. - Approving nursing education programs. - Defining the practice of professional nursing. - Establishing criteria that allow a person to be licensed as a registered nurse (RN) or licensed practical or vocational nurse (LPN/LVN). - Defining professional practice, which determines the nurse's scope of practice or those activities that nurses are expected to perform (and by implications, those they may not). - Developing rules and regulations for guidance to nurses. - Enforcing the rules that govern nursing. - Licenses are issued by the state.

Patient Situation

Patient data and patient preferences and context are components of "patient situation" in the full-spectrum nursing concepts.

Doing

Practical knowledge and the nursing process are components of "doing" in the full-spectrum nursing concepts.

Practical Knowledge

Practical knowledge—knowing what to do and how to do it—consists of processes (e.g., the decision process and the nursing process) and procedures (e.g., how to give an injection), and is an aspect of nursing expertise.

During what period believed illness was thought to be caused by evils spirits that had invaded the body. Care was aimed at removing the evil spirits through ceremonial rituals?

Prehistoric period

End-of-Life Care

Promote comfort, maintain quality of life, provide culturally relevant spiritual care, maintain dignity, and ease the emotional burden of death.

Community/Public Health Centers

Provide care for the community to at risk populations and devise strategies to improve the health status of the surrounding community.

Home Healthcare Agencies pg.17

Provide continuing care to pt after hospitalization.

Rehabilitation Center

Provide extended care and treatment for patients with physical and mental illness.

Nursing Home

Provides custodial care(consists of help with ADL) for people who cannot live on their own but are not sick enough to require hospitalization.

Ambulatory Care Center

Provides services for clients who are able to come and go from the facility. Clients live at home or in nonhospital settings and come to the site for care. Provided to patients who do not need to be admitted to a hospital for treatment. The types of procedures and treatments are sometimes referred to as "outpatient care." As the "ambulatory" in the term would seem to suggest, classically the patient can get into a medical facility for treatment under his or her own power.

Reflecting skeptically and deciding what to do

Reflecting skeptically and deciding what to do involves questioning, analyzing, and reflecting on the rationale for your decisions.

Self-Knowledge

Self-knowledge—that is, self-understanding—is awareness of your beliefs, values, and cultural and religious biases. This kind of knowledge helps you to find errors in your thinking and enables you to tune in to your patients.

Benner's Model

Stage 1. Novice - Little nursing experience and is at the first stage of acquiring clinical focus narrowly on "learning the rules". Ex) During sterile dressing change, you may be so concerned with following the steps in the skills checklist that you forget to assess the pt's reaction to the procedure. Stage 2. Advanced beginner - Usually new graduates. Begins to focus on more aspects of a clinical situation, use more facts, make more sophisticated use of the rules, and recognize similarities in situations. The nurse can distinguish abnormal findings, but cannot readily understand their significance. Ex) A new graduate assess that her postoperative abdominal surgical patient's blood pressure has decreased and his pulse rate has increased, and he has become more restless during the last 2 hours. Advanced beginner will report these as changes but doesn't recognize that these signs/symptoms may indicate early blood loss. After considerable exposure to clinical situations, nurses improve in performance and, through repeated experiences or mentoring, begin to recognize the elements of a situation. Stage 3. Competence - After 2 to 3 years of nursing practice in the same area. They are able to handle their pt load and prioritize situations. Also more involved in their caregiving role and may be emotionally involved in the clinical choices made. - Has more sophisticated use of rules; recognition of abnormal findings but not of significance. Ex) Competent nurse would immediately connect the changes in the vital signs with the surgical procedure, recognize possible early signs of shock, and conduct a more in-depth assessment. Stage 4. Proficient - Is able to quickly take in all aspects of a situation and immediately give meaning to the cluster of assessment data, and serves as a resource for less experienced nurses. Also able to see the "big picture" and can coordinate services and forecast needs. Ex) Immediately recognize a pt's symptoms as a possible heart attack, pulmonary embolus, or brain attack (stroke) and immediately gather the resources to initiate treatment. Stage 5. Expert - Is able to see what needs to be achieved and how to do it. They trust in and use their intuition while operating with a deep understanding of a situation, often recognizing a problem in the absence of the classic signs and symptoms.

Professional organization for nurses in U.S. part 2

The American Nurses Association (ANA) is the official professional organization for nurses in the United States. It establishes and updates standards of nursing to promote high-quality care and work toward licensure as a means of ensuring adherence to the standards. Representatives track healthcare legislation, serve as liaisons with national government representatives, and develop and sponsor legislation that will have a positive effect on nursing and on patient care. The National League for Nursing (NLN) was the first nursing organization with a goal to establish and maintain a universal standard of education. The NLN sets standards for all types of nursing education programs, studies the nursing workforce, lobbies and participates with other major healthcare organizations to set policy for the nursing workforce, aids faculty development, funds research on nursing education, and publishes the journal Nursing Education Perspectives. The International Council of Nursing (ICN) represents over 13 million nurses on a global level. It is composed of a federation of national nursing organizations from more than 130 nations. The ICN aims to ensure quality nursing care for all, supports global health policies that advance nursing and improve worldwide health, and strives to improve working conditions for nurses throughout the world. Sigma Theta Tau International (STTI) is the international honor society for nursing. Membership includes the clinical, education, and nursing research communities and senior-level baccalaureate and graduate programs. The goal of this organization is to foster nursing scholarship, leadership, service, and research to improve health worldwide.

Theoretical Knowledge

Theoretical knowledge consists of information, facts, principles, and evidence-based theories in nursing and related disciplines (e.g., physiology and psychology).

Contextual awareness

pg35,36 Contextual awareness involves an awareness of what's happening in the total situation, including values, cultural issues, interpersonal relationships, and environmental influences.