Health and Influence Test 2
Shaw's Textbook of Nursing
"It properly includes, as well as the execution of specific orders, the administration of food and medicine, the personal care of the patient" ADMINISTRATION
Harmer and 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" MIND OR BODY
Harmer's Textbook of the Principles and Practice of Nursing
"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" EASE
The theoretical, scientific orientation of the BSN program was in sharp contrast to the _______________ skill and service orientation that was the hallmark of hospital-based diploma education.
"hands-on"
Nursing standard of care -
"what a reasonable prudent nurse, under similar circumstances, would have done."
External Degree Programs
Excelsior College (formerly: NY Regents External Degree Nursing Program) It does not offer clinical experiences to those seeking a basic nursing education and as such they are encouraged to seek basic education that includes clinical instruction. students attend no classes.
Isabel Hampton Robb - : American Society of Superintendents of Training Schools
Investigate ways to prepare nurses for leadership TEACHER'S College - nursing professor/education
Nurse Licensure compact
Nurses licensed in a compact state can practice in their own state and in any other compact state without applying for licensure by endorsement
Recommendations of Early Studies of Nursing Education (four things)
Nursing education programs should be established within the system of higher education. Nurses should be highly educated. Students should not be used to staff hospitals. Standards should be established for nursing practice. All students should meet certain minimum qualifications on graduation.
International Council of Nurses
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 ADVOCACY, COLAB, INDEPENDENT
American Nurses Association (ANA) Nursing's Social Policy Statement: The Essence of the Profession Six essential features of contemporary nursing practice
Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals, families, groups, and communities
Formal socialization
Nursing faculty as the first mentor Orderly, building-block fashion - lectures, online activities, assignments, and clinical experiences
Royal College of Nursing: nursing definition
Nursing is the use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the BEST QUALITY OF LIFE, whatever their disease or disability, until death.
Mildred Montag's ADN program
Short duration to PREPARE NURSE TECHS Nurse technicians function under supervision of professional nurses, UNDER RN Routine care in acute and long-term settings Intended for end-point degree and not an incremental step to BSN
Growth of BSN was slow because of:
The reluctance of universities to accept nursing as an academic discipline The power of the hospital-based diploma programs
Administrative cases result
a person violates the regulations and rules established by administrative law. Example: A nurse who practices without a valid license or beyond the scope of practice.
Lia and Lim Structural conditions ? Cultural conditions ?
described two conditions that are part of professional socialization in nursing - are those in which one's professional role is shaped by rules. (STRUCTURAL) - are those in which traditions, symbols, language, and other idea systems in a society are at work in shaping how one becomes a fully socialized professional nurse. (CULTURAL)
Lower (2007)
described ways to turn incivility into a culture of civility. Recognize incivility issue Develop a framework at the institutional level Set and operationalize behavioral standards
Diploma Nursing Programs: Mid 1960s
dramatic DECLINED caused by: Growth of ADN and BSN programs, a move to the mainstream of higher education INABILITY of hospitals to continue to FINANCE nursing education Accreditation standards have made it DIFFICULT for diploma programs to ATTRACT qualified faculty Increasing complexity of health care has required nurses to have greater academic preparation.
ANA Model Practice Act
encourages consideration of the many issues inherent in a nursing practice act and the political realities of state legislature and regulatory processes.
Doctoral programs prepare nurses to become...
faculty members in universities, administrators in schools of nursing or large medical centers, researchers, theorists, and advanced practitioners. a research-focused degree—doctor of philosophy (PhD) a practice-focused degree—doctor of nursing practice (DNP)
Mary Adelaide Nutting
first nursing professor in history and became a pioneer in nursing education. School at Teachers College - Mother House of collegiate education "The Educational Status of Nursing" focused on students' living conditions, nursing education curricula, and teaching methods.
Yale University
first nursing school as a separate university with an independent budget and its own dean, Annie W. Goodrich.
Leading Change and Advancing Health: ANA urged Congress to increase___________ for Title VIII Nursing Workforce Development Programs
funding Two of the major program areas are Advanced Education Nursing, GRANTS to schools of nursing to enhance ADVANCE nursing EDUCATION, including nurse practitioners (NPs), certified nurse-midwives (CNMs), certified registered nurse anesthetists (CRNAs), nurse educators, and others; and Workforce DIVERSITY Grants that increase opportunities for persons from DISADVANTAGE backgrounds and who are underrepresented in the nursing workforce (ANA, 2015
Diploma programs
hospital based nursing education. Nursing students staffed the hospital. High-quality nursing education was not the priority.
Captain of the ship doctrine
implies that the physician is ultimately in charge of all patient care and thus should be responsible financially.
First BSN program
in University of Minnesota
Informal socialization
incidental lessons
Criminal law
involves public concerns regarding an individual's unlawful behavior that threatens society
"Prevailing"
is ascertained through expert witness testimony, documents (including national standards of practice), patient record, and other pertinent evidence (direct testimony of the patient, nurse, and others).
Nurses need a bachelor's degree to qualify nursing as a recognized profession and to provide ....
leadership in administration, teaching, and public health.
Professional socialization
process of internalization and development or modification of an occupational identity that "begins when the students are in formal nursing program and continues as they practice in the real world take these skills and make it part of their own professional identity DEVELOPMENT OF IDENTITY THRU SCHOOL PROFESSIONALLY
An accredited program voluntarily adheres to standards that _________ the quality of education, safety, and the profession itself.
protect
Loisier
the findings suggested that despite the support of the idea of collaborative learning and socialization via distance education, socialization does not occur automatically online in collaborative work and may conflict with distance students' desire for flexible and individual learning. CONFLICTS IN GROUPS HAPPEN
The board of nursing enforces
the laws and publicizes rules and regulations that expand the law.
Accreditation: Ensuring Quality Education Definition?
voluntary review process of educational programs by a professional organization authority from the US Department of Education. Two agencies: Accreditation Commission for Education in Nursing (ACEN) Commission on Collegiate Nursing Education (CCNE)
Objectives of NPA
- Defines the practice of professional nursing - Sets the minimum educational qualifications and other requirements for licensure - Determines the legal titles and abbreviations nurses may use - Provides for disciplinary action of licensees for certain causes
PhD
- research-focused doctorate and DNS or DNSc - doctor of nursing science
..
..
NPA urges the inclusion of
1) A clear differentiation between advanced and generalist nursing practice 2) Authority for boards of nursing to regulate advanced nursing practice, including authority for prescription writing 3) Authority for boards of nursing to oversee unlicensed assistive personnel (UAP) 4) Clarification of the nurse's responsibility for delegation to and supervision of other personnel 5) Support for mandatory licensure for nurses while retaining sufficient flexibility to accommodate the changing nature of nursing practice
Benner's Stages of Nursing Proficiency
1) Novice - enroll in nursing school 2) Advanced beginner - somewhat competent but experience difficulty 3) Competent practitioner - have 2 to 3 years' experience in a setting - multitask 4) Proficient practitioner practice 3 to 5 years, long term goal 5) Expert practitioner - perform intuitively, without conscious thought, automatically grasping the significance of the patient's complete experience
Four Elements of a Cause of Action for Negligence
1) The professional (nurse) has assumed the duty of care (responsibility for the patient's care). 2) The professional (nurse) breached the duty of care by failing to meet the standard of care. 3) The failure of the professional (nurse) to meet the standard of care was the proximate cause of the injury. 4) The injury is proved.
Socialization Specific to Work Setting
Establishing positive relationships with colleagues Kopp (2008) - "listen to gossip" is determining who is integral to the culture of the unit
1873: Establishment of first US training schools
1872: Famous trio: Bellevue Hospital, NY New England Hospital for Women and Children, New Haven, CT Massachusetts General Hospital, Boston 1900: 432 hospital-owned and hospital-operated nursing programs
Characteristics of Pre-licensure Baccalaureate Programs
4-year program. General education + nursing courses. Faculty qualifications - minimum of master's degree BSN graduates are eligible to take licensure exams, prepared to move into graduate programs and advanced practice certification programs. 2008 AACN. The Essentials of Baccalaureate Education for Professional Nursing Practice.
1919:_______ year BSN programs. Most BSN programs were __ years in duration
7, 5
____ and _____ have developed and suggested language for the content of state NPA
ANA and NCSBN
Professional socialization
Absorbing the culture of nursing - rites, rituals, and valued behaviors Learning vocabulary Learning new roles and anxiety, disappointments and frustrations, and disillusionment
Major areas of role preparation for masters
Administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, NP, nurse-midwifery, nurse anesthesia, and other clinical and nonclinical areas of study
Associate Degree Programs by? popularity is due to?
Begun 1952. It is based on a model developed by Mildred Montag. Popularity of ADN is due to Accessibility of community colleges Low tuition costs Part-time and evening study opportunities Shorter duration of programs Graduates' eligibility to take the RN licensure exam
The Study of Nursing and Nursing Education in the United States (Goldmark Report) focused on:
CLINICAL LEARNING experiences of students, Hospital control of the schools, Desirability of establishing UNIVERSITY SCHOOLS OF NURSING, Lack of funds specifically for nursing education LACK OF PREPARED TEACHERS (Kalisch and Kalisch, 1995)
Leading Change and Advancing Health: Aiken
Call for increased FEDERAL SUPPORT for increased federal support for the preparation of nurses at the BSN level and higher (Aiken, Cheung, and Olds, 2009). They suggested policy changes to address the growing need for nursing faculty and in the preparation of advanced practice nurses (APNs) to serve in primary care.
Becoming Certified: Validating Knowledge & Proficiency Licensure Certification
Certification Benefits of being a certified nurse ANCC and standardized certification Requirements Licensure refers to state regulation of the practice of nursing. Required of individuals at the entry point to practice and must be renewed periodically Legal designation that ensures public safety by assessing basic and continuing competence.
Leading Change and Advancing Health: Tri-Council for Nursing and Policy Statement
Current healthcare reform initiatives call for a nursing workforce that integrates EVIDENCE BASE clinical knowledge and research WITH effective COMMUNICATION and leadership skills. These competencies require increased education at all levels.
Baccalaureate Programs for Registered Nurses RN-to-BSN Education
Diploma and ADN nurses are given credits to meet certain BSN requirements. Transfer of general education courses Options for advanced placement Programs for Second-degree Students Accelerated or fast-track sequence to award a second bachelor's degree or in some cases MSN Online and Distance Learning Programs
Diploma Nursing Programs 1800-early 1900s
Diploma programs PROVIDED formal education and jobs to women. Modified apprenticeship model Demanding schedule Duration: 3 years (current programs: 24 months) Most colleges and universities DID NOT recognize diploma programs. Current practice: Diploma programs establish agreements with colleges and universities
Leading Change and Advancing Health: Patricia Benner
Educating Nurses: A Call for Radical Transformation Bachelor of science in nursing (BSN) as the entry level for registered nurse (RN) practice All RNs be required to earn a master of science in nursing (MSN) within 10 years of licensure
1965: ANA Position Paper
Educational preparation for Nurse Practitioners and Assistants to Nurses. It did not refer to Medicare and Medicaid. It concluded that BACCERLARATE EDUCATION should become the FOUNDATION for professional practice.
challenges (higher education)
Faculty and other resources shortages Quality and safety education for nurses (QSEN) IOM (2003) identified five problems in professional health education. 1. Students are not being educated to care for the increasingly diverse, elderly, and chronically ill patient populations. 2. Students are not being prepared to work in teams, but once in practice, they are usually expected to work in interdisciplinary teams. 3. Students are not consistently educated in how to find, evaluate, and use the rapidly expanding scientific evidence on which practice should be based. 4. There is little opportunity to learn how to identify, analyze, and eliminate the root causes of errors and other quality problems in health care delivery systems. 5. Students often are not provided basic informatics training to enable them to access information and use computerized order entry systems.
Two requirements of malpractice action: The defendant (nurse):
Has the specialized knowledge and skills Causes the plaintiff's (patient's) injury through the practice of that specialized knowledge and skills
1970: National Commission for the Study of Nursing and Nursing Education published An Abstract for Action (Lysaught Report)
It made recommendations concerning supply and demand for nurses, nursing roles and functions, and nursing education. Priorities identified by the study: -The need for increased research into both practice and education of nurses -Enhanced educational systems and curriculam INCREASE RESEARCH & IMPROVE EDUCATION
Factors Influencing Socialization
Key Point: Identify those "hot button" issues that seem to affect you negatively so that you can understand your own responses and how to set them aside while still providing excellent care of your patients.
Types of Licensure Laws:
Mandatory law - requires any person who practices the occupation or profession to be licensed. Permissive law - protects and limits the use of the title granted in the law but does not prohibit persons from practicing the occupation/profession if they do not use the title.
Articulated Programs Definition Purpose
Mobility between programs Facilitate opportunities to MOVE UP the educational ladder Articulation agreements facilitate student movement between programs and accept transfer credit between institutions. These result in acceleration or advanced placement.
Cohen's Model of Basic Student Socialization
Model consist of 4 Stages, Studies of beginning students attitudes toward nursing, She stated students must experience each stage in sequence to feel comfortable in the professional role Stage I: Unilateral dependence (Students are unlikely to question or analyze critically the concepts teachers present) Stage II: Negativity/independence (They begin to question authority figures) (cognitive rebellion) Stage III: Dependence and mutuality (Students may begin to demand to care for additional or more complex patients) Stage IV: Interdependence Students develop the capacity to make decisions in collaboration with others.
the purpose of master's education
Prepare people with advanced nursing knowledge and clinical practice skills in a specialized area of practice.
2008: NLN Position Statement
Preparing the Next Generation of Nurses to Practice in a Technology-rich Environment: An Informatics Agenda - call on nursing programs to prepare graduates to use of electronic health records
The state boards of nursing has the power to sanction a nurse for performing professional functions that are dangerous to the patient or general public.
Probation Suspension Revocation - you're removed from working
State Boards of Nursing
Reason for existance is public protection; regulation of nursing care **
1948: Lucille Brown. Nursing for the Future. (The Brown Report). Sponsor: Carnegie Foundation
Recommendation: Basic schools of nursing must be placed in universities and colleges with an effort to recruit MEN and MINORITIES.
1982 National League for Nursing Position Statement on Nursing Roles
Scope and Preparation - affirmed BSN as minimum educational level for professional nursing practice and ADN or diploma as the preparation for technical nursing practice. BSN IS PROFESSIONAL - DIPLOMA IS TECHNICAL
Leading Change and Advancing Health: Institute of Medicine
The Future of Nursing: Leading Change. Advancing Health. 4 Key Messages. Fully practice, if you want masters the school has to be harder/improved, should have ties with partners, and improved data and info 1) Nurses must practice to the fullest extent of their education and training. 2. Nurses should attain higher education levels through a system of improved education with seamless progression across degrees. 3. As health care in the United States is being transformed, nurses should be full partners with other health care professionals in this effort. 4. Improved data collection and information infrastructure can result in more effective workforce planning and policy development.
1996: AACN Position Statement
The baccalaureate Degree in Nursing as the Minimal Preparation for Professional Practice. It supports articulated programs which enable ADN nurse to attain BSN.
Florence Nightingale and formal nursing preparation
The nurse should be trained in an EDUCATIONAL INSTITUTION supported by public funds and associated with a medical school, maybe affiliated with one, include theory and practical experience,
Executive Authority of State Boards of Nursing
The state boards of nursing authority is limited. They can adopt rules that clarify general provisions of NPA. They do not have the authority to enlarge the law. Functions of state boards of nursing: Executive - authority to administer the nursing practice act Legislative - authority to adopt rules necessary to implement the act Judicial - authority to deny, suspend, or revoke a license or to discipline a licensee or to deny an application for licensure
2005: NLN Position Statement
Transforming Nursing Education - emphasis on evidence-based education
Florence Nightingale definition of nursing
What It Is and What It Is Not:I use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet— all at the least expense of vital power to the patient FOCUSES ON PERSONAL CONNECTION
Accreditation Commission for Education in Nursing (ACEN)
accredits LPN/LVN, diploma, and ADN programs.
Respondent superior
attributes the acts of employees to their employer.
Post-World War II Definitions: World War II helped advance..
available technologies.
Standard of care
basic minimum level of prudent care based on the ethical principle of non-maleficence ("do no harm")
The legislature delegates authority to enforce the law to an executive agency - the
board of nursing
Professional negligence (malpractice) may occur by (Two things)
commission - doing something that should not have been done omission - failing to do things that should have been done
State nursing practice act
constitutes the legal DEFINITION of nursing in a particular state
1910: Columbia University's Teachers College -
creation of the Department of Nursing and Health
Nursing Practice Act
defines and controls nursing
Bandura
described a type of socialization, modeling, which is useful when learning any new behavior
Sauer (2012)
described incivility (communication that is rude, impolite, discourteous, and lacking in good manners)
Reality shock - kramer
the feelings of powerlessness and ineffectiveness experienced by new graduates
Endorsement - the RN (may/may not) practice in different states without having to take another licensing exam
may
Commission on Collegiate Nursing Education (CCNE)
national agency for accreditation of bachelor's and graduate nursing education programs.
1980: National Commission on Nursing The major block to the advancement of nursing was the
ongoing conflict about educational PREPARATION for nurses.
Civil law
recognized and enforces the rights of individuals in disputes over legal rights or duties of individuals in relation to one another
Factors Influencing Socialization The Code of Ethics for Nurses
requires that nurses work with all patients regardless of their beliefs.
Croke - NEGLIGENECE 6
review of 350 trial, appellate, and supreme court cases summaries A nurse was engaged in the practice of nursing as defined by his or her state's nurse practice act. A nurse was a defendant in a civil lawsuit as the result of an unintentional action (no criminal cases were considered). A trial was held between 1995 and 2001. Six major categories of negligence resulted in malpractice lawsuits against nurses FAILURE OF CARE, EQUIPMENT, COMMUNICATION, DOCUMENT, ASSESS & MONITOR, ACT AS PATIENT ADVOCATE - 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
Civil conduct
shows respect for others, makes them feel valued, and contributes to effective communication (Lower, 2007, p. 49)
The ________ ___________ ___ __________ have the authority to set and enforce minimum criteria for nursing education criteria.
state boards of nursing
Puterbaugh, Shannon, and Gorton
suggested that distance learning may be used successfully and with adequate socialization