N138 Ch 5: Becoming a Professional Nurse

how does defining nurses focus educational curricula and research agendas?

-when schools plan their curriculum, they determine it based on the definition of nursing -as well as for research, they need it to determine the phenomena of interest, boundaries, and purpose of nursing actions

What are Benner's stages of nursing proficiency?

1. Novice 2. Advanced beginner 3. competent practitioner 4. proficient practitioner 5. expert practitioner

What are the six essential features of contemporary nursing practice?

1. Provision of a caring relationship that facilitates health and healing 2. Attention to the range of human experiences and responses to health and illness within the physical and social environments 3. Integration of objective data with knowledge gained from an appreciation of the patient or groups subjective experience 4. Application of scientific knowledge to the processes of diagnosis and treatment through the use of judgement and critical thinking 5. Advancement of professional nursing knowledge through scholarly inquiry 6. Influence on social and public policy to promote social justice

What are the six defining characteristics of the RCN's or statement?

1. Purpose 2. Mode of intervention 3. Domain 4. Focus 5. Value-based 6. Commitment to partnership

Cohen state's, "students must experience each stage in sequence to feel comfortable in the professional role." What are the stages?

1. Unilateral dependence 2. negativity/Independence 3. Dependence/mutuality 4. Interdependence

What is the most significant definition of nursing practice?

The most significant definition of nursing is contained in the nursing practice Act of the state in which a nurse practices

who was one of the most important theorists who began work during the early period of theory development?

Dorothea Orem

What is the ICN's definition of nursing practice?

"Nursing and Compasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and an 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 and shaping Health policy and inpatient and Health Systems management, and education are also key in nursing roles"

The code of ethics for nurses describes the nursing practice as?

"Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health and the care of individuals, families, groups, and communities"

What is the RCN's definition of nursing core statement?

"Nursing is the use of clinical judgment and the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death"

How does the ANA define nursing?

"The protection, promotion and optimization of health and ability, 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"

how did Nightingale define nursing?

"is put the patient in the best condition for nature to act upon him" "....to signify little more than the administration of medicines and the application of poulicies. 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."

what happened with Virginia Henderson's definition?

"the unique fxn 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 a 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" -adopted by the ICN in 1960's -widely accepted in the US and across the world

What was so liked about the RCN's definition of nursing practice?

- it describes nursing to person to do not understand - it clarified the role of nurses and multidisciplinary teams - it identified areas of research that nursing needs to strengthen its science

What is the ICN?

-International Council of nurses - a Federation of National Nurses Association that represent more than 13 million nurses worldwide in more than 130 countries

What are some strategies to remember when transitioning back to School?

-Never forget your reason for returning to school. -Be actively involved in your studies. -You may be troubled by others opinions of your return to school however set aside their ideas for your own. -Advanced education requires that you think conceptually. -Become an excellent time manager and be disciplined about how you spend your study time. -A mentor, another nurse, more advanced student, or faculty member, is an invaluable source of support. -Trust your faculty to help you, but remember that despite all experiences, they cannot read your mind.

What are some common factors that challenge socialization?

-Personal feelings and beliefs -Values, beliefs, and behaviors [ex. A personal value comes into conflict with a professional value]

What is the RCN?

-Royal College of Nursing - it's the United Kingdom's voice of Nursing - the largest professional Union of nurses in the world

Why define nursing?

-it provides a framework for nursing practice. -It establishes the parameters (boundaries) of the profession and clarifies the purposes and fxns oft he work of the nurse. -It guides the educational preparation of aspiring practitioners, nursing research, and theory development -finally, it makes the work of nursing visible and valuable to the public and to policy makers who determine when, where, and how nurses can practice

How does defining nursing clarify its purpose and fxn?

-nursing is complex, and often confusing -it assists people to grasp its nuances

how does defining nursing influence health policy at local, stat and national levels?

-policy makers require a clear understanding of the role and scope in order to institute good health care policies to maximize the uses of the nurses particular skills -nursing practice is regulated at the state level, therefore they can pass progressive laws regulating and expanding nursing practice, otherwise would be restricted and inhibit their professional growth

how can defining nursing help differentiate nursing from other health occupations?

-to avoid losing the core identity of nursing

What is "reality shock?"

A term used to describe the feelings of powerlessness and ineffectiveness experienced by new graduates. A term that is still relevant more than 4 decades later. Psychological stress is generated by reality shock decrease the ability of individuals to cope effectively with the demands of the new role.

The student is attending a lecture on biases. Which statement indicates that further education is needed? A. "I don't need to worry about biases." B. "Unexamined biases are more likely to influence behaviors than examined ones." C. "Nurses need to be aware of their baises." D. "Nurses need to discuss biases with peers, faculty or mentors."

A. "I don't need to worry about biases." [Unexamined biases are more likely to influence behaviors than examined ones. Therefore it is important that the nurse understand personal biases, in order to prevent them from affecting nursing practice. Nurses can and should be discuss biases with peers, faculty or mentors.]

Which formal socialization activities can the student nurse take part in to build skills? (Select all that apply.) A. Attending lectures B. Nursing clinicals C. Starting an IV D. Overhearing nurses discuss patient care E. Observing an unplanned intervention for a patient

A. Attending lectures B. Nursing clinicals C. Starting an IV [Formal socialization proceeds in an orderly building-block fashion, and includes: attending lectures, nursing clinicals and starting an IV. Overhearing nurses discuss patient care, and observing an unplanned intervention for a patient are considered informal socialization. Informal socialization are events that occur incidentally.]

Which factors can the student nurse expect to influence socialization? (Select all that apply.) A. The student's personal feelings B. The patient's religious beliefs C. Short staffing on the nursing unit D. The patient's unwillingness to engage in a healthy lifestyle E. The patient's refusal to allow the nurse to provide care

A. The student's personal feelings B. The patient's religious beliefs D. The patient's unwillingness to engage in a healthy lifestyle E. The patient's refusal to allow the nurse to provide care [A variety of factors influence the student's customary way of thinking, and effect socialization. These include: the personal feelings, religious beliefs, and patient's willingness to engage in a healthy lifestyle and accept care.]

What questions arise when discussing the increase in "distance learning?"

About whether professional attitudes and values, and other words professional socialization, can be effectively achieved through distance education

What are some examples of informal socialization in nursing?

Lessons that occur incidentally, such as the unplanned observation of a nurse teaching a young mother how to care for her premature infant, practicing and a student Nurse Association, or hearing nurses discuss patient care in the nurses Lounge

A group of nursing students are listening to a lecture on nursing history and the many definitions of nursing. Which statement(s) by one of the students indicates that the teaching has been effective? (Select all that apply.) A. "Giving nursing a clear definition encourages higher wages." B. "A definition establishes boundaries." C. "A definition clarifies the purpose of nursing." D. "Having a definition clarifies the functions of nursing." E. "A definition guides educational preparation of nurses."

B. "A definition establishes boundaries." C. "A definition clarifies the purpose of nursing." D. "Having a definition clarifies the functions of nursing." E. "A definition guides educational preparation of nurses." [Having a clear definition of nursing establishes boundaries, clarifies the purpose and functions of nursing and guides educational preparation of nurses. Having a clear definition does not necessarily encourage higher wages for nurses.]

The nurse professor has just given a lecture on informal socialization. Which statement indicates that the teaching has been effective? A. "Informal socialization includes all activities that are pre-planned." B. "An example of informal socialization is assessing a patient after a fall." C. "Informal socialization is not an effective method of teaching." D. "A student can take part in informal socialization by attending nursing clinicals." E. "Informal socialization can be learned through reviewing literature."

B. "An example of informal socialization is assessing a patient after a fall." [Information socializing is an excellent educational tool that is learned incidentally from unplanned situations, such as assessing a patient after a fall.]

The nurse is listening to a lecture on the pioneers of early nursing, including the works of Hildegard Peplau. Which statement by the nurse indicates that teaching has been effective? A. "Peplau developed the self-care theory of nursing." B. "Peplau believed that the patient should be an active collaborator in care." C. "Peplau included the concept of the nursing process in her definition of nursing." D. "Peplau wrote the popular book, Notes on Nursing: What it is and What it is Not."

B. "Peplau believed that the patient should be an active collaborator in care." [Hildegard Peplau was an early pioneer and psychiatric nurse, who believed that the patient should be an active collaborator in care. Dorothy Orem was another pioneer who developed the self-care theory, and believed that the nurse should only perform activities for the patient that the patient could not complete, due to illness or injury. Martha Rodgers included the concept of the nursing process in her definition of nursing. Florence Nightingale wrote the popular book, Notes on Nursing: What it is and What it is Not.]

The nursing instructor is planning assignments for a group of nursing students. Which characteristics should the nurse expect from students in Benner's novice stage? A. Marginally competent performance B. Student who relies rigidly on rules C. Base their actions on theory and principles, but have difficulty establishing priorities D. Are able to think abstractly and analytically

B. Student who relies rigidly on rules [Students in Benner's novice stage or stage I have little background to base their clinical behavior, and rely rigidly on rules. Students in the advanced beginner stage, or stage II are marginally competent, and base their actions on theory and principles, but have difficulty establishing priorities. Students in the competent practitioner's stage, or stage III are able to think abstractly and analytically.]

The student nurse has self-identified with stage one of Cohen's Model of Basic Student Socialization. Which actions are expected for this nurse? A. The student's critical thinking abilities expand. B. The student will rely on external limits established by the clinical instructor. C. The student learns to test concepts. D. The student develops a more realistic appraisal process.

B. The student will rely on external limits established by the clinical instructor. [Cohen's Model of Basic Student Socialization consists of four stages that student's progress through. A student in stage one of Cohen's model wound rely on external limits established by the clinical instructor. Students in stage two would have expanded critical thinking. Students in stage three would develop a more realistic appraisal process and learn to test concepts.]

What are cultural conditions and professional socialization in nursing?

Cultural conditions are those in which Traditions, symbols, language, and other idea systems in a society are at work and shaping how one becomes fully socialize professional nurse

The nursing professor is giving a lecture on Lai and Lim's conditions that are part of professional socialization in nursing. Which statement by one of the students indicates that the teaching has been effective? A. "Structural conditions include traditions in society that shape how one becomes a professional nurse." B. "Structural conditions that influence how one becomes a professional nurse include languages and symbols." C. "Cultural conditions that influence how one becomes a professional nurse include job descriptions." D. "Structural conditions that influence how one becomes a professional nurse include workplace policies."

D. "Structural conditions that influence how one becomes a professional nurse include workplace policies." [Structural conditions that influence how one becomes a professional include rules, including: job conditions, workplace policies and carrying out prescriptions for care for physicians and other healthcare providers. Cultural conditions that influence how one becomes a professional includes traditions, symbols and languages and other idea systems in a society.]

The nurse is caring for a terminally ill patient in the hospital. Which action shows that the nurse is in Benner's expert practitioner's stage, or stage IV? A. "Does not allow extra visitors in the patient's room." B. "Has difficulty establishing priorities." C. "Relies rigidly on the rules." D. "Suggests that the patient's wife bring the family dog for a visit."

D. "Suggests that the patient's wife bring the family dog for a visit." [The nurse in Benner's expert practitioner stage, or stage IV, understands that family experiences and traditions are important to honor as death approaches. The nurse recognizes these as important, and will break the rules for the benefit of the patient. Nurses in Benner's novice stage, or stage I, rely rigidly on rules and therefore may not allow extra visitors. Nurses in the advanced beginner stage, or stage II, base their practice on theory and principles, and tend to have difficulty establishing priorities.]

Describe stage 3 of Cohen's model

Dependence / mutuality. Students are more reasoned evaluation of other's ideas. They develop an increasingly realistic appraisal process. They are more impartial, accepts some ideas and reject others. This is when students begin to appreciate the usefulness of the nursing process and organizing care and using more sophisticated critical thinking skills.

how was nursing defined in the early 20th century?

From Shaw's textbook, nursing was defined as an art, "It properly includes, as well as the execution of specific orders, the administration of food and medicine, the personal care of the patient" Harmer's textbook built off Shaw's, "the object of nursing is not only to cure the sick...but to bring health and east, rest and comfort to mind and body. Its object is to prevent disease and preserve health" Virginia Henderson redefined Harmer's definition, "...that service to an individual that helps him to attain or maintain a healthy state of mind or body"

how was nursing defined in the post-WWII?

Hildegard Peplau: "...is a significant, therapeutic, interpersonal process...an educative instrument...that aims to promote forward movement of personality in the direction of creative, constructive, productive, personal, and community living." Dorothea Orem: "...as the giving of direct assistance to a person, as required, because of the person's specific inabilities in self-care, resulting form a situation of personal health" Henderson's adapted version - (stated in a few cards later) Martha Rogers: "...aims to assist people in achieving their maximum health potential. Maintenance and promotion of health, prevention of disease, nursing diagnosis, intervention, and rehabilitation encompass the scope of nursing's goals"

Most nurses agree that which kind of socialization experiences were more powerful and memorable and their development? Informal or formal?

Informal

Describe stage 4 of Cohen's model

Interdependence. Students need for both Independence and mutuality come together. Students develop the capacity to make decisions in collaboration with others. They successfully socialize with self-concept that includes professional role identity that is personally and professionally acceptable. They are often highly self-directed, seeking out learning experiences to maximize their knowledge before the completion of their formal education.

What is the goal of socialization as a professional nurse?

Is the development of a professional identity such that the attributes of nursing become "part of the nurses personal and professional self-image and behavior"

Becoming a professional nurse requires what?

Learning how to deal with conflicts in values such as these while respecting patients differing viewpoints

What are some examples of formal socialization in nursing?

Lectures, online activities, assignments, clinical experiences such as planning nursing care, writing a paper on professional ethics, learning steps of physical examination of a healthy child, starting an IV line, practicing communication skills with a psychiatric patient or spending time with a mentor

Describe stage 2 of Cohen's model

Negativity / Independence. Students critical thinking abilities and knowledge bases expand. They begin to question authority figures. Students begin to free themselves from external controls and rely more on their own judgments. They think critically about what they are being taught. At this stage, students might not consult with their clinical faculty before attempting a new procedure because they do not appreciate the safety net the clinical faculty brings to the situation. Students may begin to demand to care for additional or more complex patients.

Describe Benner's second stage

Performance is marginally competent. They can base their actions on both Theory and principles but tend to experience difficulty and establishing priorities

Describe Benner's fifth stage

Reached after extensive practice experience. These nurses perform intuitively, without conscious thought, automatically grasping the significance of the patients complete experience. They move fluidly through nursing interventions, acting on the basis of their feeling of rightness of action. Typically just comes naturally, and have difficulty expressing verbally how or why they selected certain actions.

What are structural conditions in professional socialization in nursing?

Structural conditions are those in which one's professional role is shaped by rules

Describe Benner's first stage

Students first enroll in nursing school. Generally have a little background, they must depend rather rigidly on rules and expectations. Practical skills are limited.

Describe Benner's fourth stage

Typically have been in practice three to five years. They are able to see patient situations holistically rather than and parts, to recognize and interpret subtleties of meaning, and too easily recognized priorities for care. They can focus on long-term goals and desired outcomes. They are likely to be leaders of the units having wealth of experience and commitment to nursing. This nurses likely to allow the rules to be broken and deference to the needs of the family.

Describe stage 1 of Cohen's model

Unilateral dependence. Students rely on external limits and controls established by Authority. Students are unlikely to question or analyze critically the concepts teachers present because they lack the necessary background to do so. The student absorbs the faculties direction and discussion about patient without yet making linkages of his or her own and thinking about patient's condition. Student ultimately do as they are told because they lack the experience and knowledge to question.

Describe Benner's third stage

Usually has two to three years experience and the setting. They feel competent, organized, and efficient. These feelings of Mastery are results of planning and goal-setting skills and the ability to think abstractly and and analytically. They can coordinate several complex demands simultaneously

What are common questions asked of the nursing profession?

What is nursing? What is the role of the nurse? What is unique about nursing? What are the boundaries of nursing practice?