N138 Midterm Study Guide

What demographic trends are particularly important today?

- 2004: NSSRN reported 12.2% of RNs have minority backgrounds - 2013: Racial and ethnic minorities: 37% of Americans, 19% of RNs - 2015 The nursing workforce has grown more diverse. Non-white RNs accounted for almost half (48%) of employed nurses. - Hispanics/Latinos: Largest disparirty (underrepresented) 15.4% US population, 3.6% of RNs - Black/African American, non-hispanics: 12.2% US population, 5.4% of RNs - Asian or Native Hawaiian/Pacific islander: 4.5% US population, 5.8% of RNs - 2015: 30.1% of nursing students in entry-level BSN programs were from underrepresented backgrounds. - The pre-licensure programs for RNs produced 11,119 graduates in 2015, slightly down from a high of 11,512 in 2010. - California's RN workforce relies on foreign-educated nurses. In 2015, about one in five employed RNs were trained outside the US. - Nurses' average income was $100,000 in 2015. - In 2015, more than two-thirds (71%) of LVN graduates came from for-profit schools. - Cultural Diversity is a particularly important demographic trend important to the future of nursing!

Why is a definition of nursing is essential?

- A definition establishes the parameters (or boundaries) of the profession and clarifies the purposes and functions of the work of nursing. - A definition guides the educational preparation of aspiring practitioners and guides nursing research and theory development. - A clear definition makes the work of nursing visible and valuable to the public and to policy makers who determine when, where, and how nurses can practice.

What are the roles of nurse executives?

- Chief nurse executive (CNE) /chief nursing officer (CNO) / vice president for nursing / director of nursing - senior administrative nurse - A nurse executive is an administrative professional within the field of nursing who serves as a role model for the organization and who also helps design patient care systems for the best outcomes. - Often are members of the board of directors - Minimum requirement of master's degree in nursing, business, or health admin (or joint degrees) - CNE oversee all nursing care, could include administrative role in departments other than nursing (surgery, pharm, social services, etc.) - Oversee all RNs, LVN/LPN, UAP (unlicensed assistive personnel) - Each unit has own budget and staff, unit manager/clinical director/supervisor is relay person between staff and higher management levels

What are online programs and who they are well-suited for?

- Distance learning improves educational access for nurses in rural areas or those with significant demands on their time and prefer the flexibility of online offerings. - Master's and doctoral programs are at the forefront in the development of online programs *Those considering online programs should assess their self-discipline and ability to learn independently

What is the basic structure of Medicare (broadly)?

- Federal health insurance program established in 1965 - To qualify: older than 65 years (regardless of income) or have end-stage renal disease - Although originally designed to support elderly with lower incomes, many have found that they cannot afford to participate in Medicare - Medicare is broken up into 4 parts: 1) Part A Covers: inpatient hospital stays, skilled care nursing facilities, hospice, but not long-term care Paid for by taxes, patients using Part A must pay a deductible 2) Part B Supplementary insurance Covers: doctor visits, outpatient services, and some preventative services 3) Part C Managed medicare (private companies that approved by medicare to handle services) 4) Part D Supplementary Covers prescription drug costs

What is the basic structure of Medicaid (broadly)?

- In California, also known as Medi-Cal - Federal and state funded program Also established in 1965 - Low-income, elderly, blind, and disabled individuals qualify - Eligibility requirements are established by each state (mostly determined by income) - How much each state pays for varies as well: ranges from 50%-76.8% of total healthcare cost. - Compared to those on Medicare, those on Medicaid do not have to pay fees to participate

What are the factors leading to an inadequate supply of nursing students graduating?

- Lack of capacity of nursing schools, related to insufficient numbers of faculty, clinical sites, or other resources - Aging population of nursing faculty leads to faculty shortages--NLN estimates that as many as 75% of current nursing faculty is expected to retire by 2019 (NLN, 2005).

What is the difference between licensure and certification?

- Licensure refers to the state's regulation of who can practice nursing. It is the entry level point to be an RN. Licenses must be periodically renewed to assess basic competence to ensure that a nurse can safely serve the public. - Certification validates high level knowledge and proficiency in a particular practice area of nursing. It gives professional status (icing on the cake), but not legal status to practice.

What are the benefits of joining a professional organization?

- Network with colleagues - Pursue continuing education and certification opportunities - Stay informed on professional issues; political activism - Develop leadership skills - Influence health policy - Work collectively for job security - Access to journals, newsletters, and action alerts about particular topics that need immediate response - Eligibility for group health and life insurance - Discounts on products and services

What are Benner's five stages of nursing proficiency?

- Novice - Advanced beginner - Competent practitioner - Proficient practitioner - Expert practitioner

Where to find the legal definition of nursing?

- Nursing practice act of the state - constitutes the legal definition of nursing in a particular state - State nursing associations and boards of nursing actively assist legislators in drafting laws that accurately reflect the nature and scope of nursing. The current nursing practice act in each state can be obtained online or by calling or writing the state board of nursing. The website www.cybernurse.com/stateboards.html lists the contact person and contact information for all 50 states and the U.S. territories of Guam, the Virgin Islands, and the Northern Mariana Islands. (pg 91 in text)

What is nursing's social contract and who does it involve?

- Nursing's social contract reflects the professions's long-standing core values and ethics, which provide grounding for healthcare in society. Society validates the existence of the profession through licensure, public affirmation, and legal and legislative parameters. Nursing's response is to provide care to all who are in need, regardless of their cultural, social, or economic standing. - Nursing's Social Policy Statement: The Essence of the Profession: serves as a framework for understanding professional nursing's relationship with society and nursing's obligation to those who receive professional nursing care - Written by the Congress on Nursing Practice and Economics. It consisted of nurses from variety of settings & educational degrees and credentials

What are the characteristics of a profession?

- Profession- a "calling", vocation, or form of employment that provides a needed service to society. It provides the characteristics of expertise, intellectuality, autonomy, long academic preparation, commitment, and responsibility Responsibiliy Accountability Based on specialized, theoretical knowledge Institutional preparation Autonomy Clients rather than customers Direct working relationships Ethical constraints Merit-based Capitalist morality

List Nursing roles

- Provider of care - Educator - Manager - Researcher - Collaborator (requires skill & leadership) - Patient advocate

What are the strategies to overcome reality shock?

- Students must recognize that schools cannot provide enough clinical experience to make graduates feel comfortable on their first day as a new nurse - Take responsibility for obtaining as much practical experience as possible outside of school - Find a shadowing program - Talking with other new graduates about your feelings - Seek a professional mentor (an experienced nurse), which is different than having a preceptor - Maintain self care - Maintain a good balance between work and personal lives

What are the trends in nursing education?

- The number of diploma programs (hospital based) has steadily declined, educating only 4% of all new RNs in 2013 - Most nurses (53%) have initial ADN programs education - 39% reported having an ADN and 36% having a BSN as their first degree or credential. - Many ADN-prepared RNs eventually return to school to complete a BSN degree, often online Currently, about 55% of RNs have BSN or higher degrees - Globalization and the international migration of nurses has resulted in an increase of internationally educated nurses (3.7% in 2004 to 5.6% in 2008).

What is usually the focus of master's degrees?

- The purpose of master's education is to prepare people with advanced nursing knowledge and clinical practice skills in a specialized area of practice - Master's students generally select both an area of clinical specialization, such as adult health or gerontology, and an area of role preparation such as informatics, administration or teaching. - Major areas of role prep include administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, NP, nurse-midwifery, nurse anesthesia

What are the aging trends in America?

- The very old (over 85) represent the fastest-growing segment of the population, while the number of 35-44-year-old Americans is expected to decline = "Graying of America." - Older nurses are more likely to remain in the workforce because the nursing field is reasonably protected from the layoffs and downsizing experienced in other professions. - Will create stress on the economic and social systems of our nation, particularly nursing profession - Nursing profession has responded by: 1) covering care of the elderly in nursing programs 2) offering more gerontology courses, 3) gerontology-specific degrees (i.e. certification as a generalist, clinical nurse specialist, and NP)

Understand the variety of practice settings for nurses and the related practice styles, philosophies, benefits and challenges

1) Hospitals - Within the last 150 years: Nursing practice shifted from informal home and community settings to hospitals _ Medical centers offer comprehensive specialty services, such as cancer centers, heart centers, etc - Community-based hospitals have less severe patients; typically identify, stabilize and transport those to high level of care - Entry-level positions require RN licensure - Bachelor's degrees are required to advance on the clinical ladder or to assume management positions. - Nurse managers often require a Master's degree. 2) Communities - Lillian Wald was the founder of community nursing. - Government and private agencies - Home health and cost-effectiveness - Knowledge and skills of the home health nurse 3) Medical Offices - Nurses work in tandem with physicians, NPs, and their patients - Office-based nursing activities - Nursing knowledge and skills - Communication skills 4) Workplace - Occupational and environmental health nurses provide basic health care services, health education, screenings, and emergency treatment to employees in the workplace - "Good employee health reduces absenteeism, insurance costs, and worker errors, thereby improving company profitability" - Roles/responsibilities - Knowledge/skills 5) Armed Forces - Peacetime and wartime settings - Military nurses have broader responsibilities and scope of practice than do civilian nurses - Major benefit is the opportunity for advanced education 6) Schools - "Specialized practice of professional nursing that advances the well-being, academic success, life-long achievement, and health of students" - Counseling, health curriculum, routine illness, and emergencies - Specific issues: Abuse, school violence, and obesity 7) End-of-Life Settings - Palliative care (relief to those with serious illnesses) and hospice (end of life) 8) Telehealth - Available technology - Requires basic nursing AND technological skills - Legal/regulatory issues - New legislations 9) Faith Community - "Practice specialty that focuses on the intentional care of the spirit, promotion of an integrative model of health, and prevention and minimization of illness within the context of a faith community" - Partnerships among congregations, their pastoral staffs, and healthcare providers - Serve as members of the ministry staff or clergy of a church or other faith community - Independent practice within the legal scope of practice - Often sponsor health screenings and support groups while integrating the concepts of health/spirituality 10) Informatics - "The Science and practice [integrating] nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide 11) Entrepreneurs - Create a need/provide the services - Autonomy and scope of practice - Financial incentives & intangible rewards

What is the most effective thing that will change the image of nursing?

1) All nurses hold the professional responsibility to reinforce positive images of nursing and to speak out against negative ones 2) Changing the image of nursing occurs one nurse-patient encounter at a time, where nurses demonstrate what nurses do, and how to look and behave professionally

What are the characteristics of different types of nursing training/educational programs?

1) Diploma: - Est. late 1800s - Aligned with hospitals - Typically 3-4 years - Peaked 1920-1930, but dramatic decline since the mid-1960s due to BSN and ADN programs as hospitals are unable to finance - Accreditation standards are difficult - Increased complexity now requires more academic preparation 2) BSN - Est. mid-1930s - Aligned with a university - Usually 4 years of undergraduate work (general education + nursing courses) - Faculty requires a Master's - Graduates take licensure exams - Prepared to move into graduate programs. 3) ADN - Est. late 1950s - Aligned with community colleges - Usually 2 years - Popular due to accessibility to community colleges, low tuition costs, part-time and evening study opportunities, and shorter duration of programs. 4) External Degree Programs - Attend no classes; online only - Offers no clinical experiences. 5) Articulated Programs - Mobility between programs to facilitate opportunities to move up the educational ladder.

Stages of adjustment to an illness

1) Disbelief & Denial - difficulty believing that signs/symptoms are caused by illness - may believe symptoms will go away - fear of illness may lead to mistaken belief symptoms will subside without intervention 2) Irritability & Anger - some patients become irritable as their ability to function declines - may lead to depression - anger may be specifically directed or in general (i.e. mad at a spouse vs "mad at the world") 3) Attempting to Gain Control - some may consult their PCP or use OTC medications, folk practices or home remedies - they are aware they are ill and usually experience some concern or even fear about the outcome - fear typically stimulates treatment-seeking behavior, but may also lead to further denial/avoidance 4) Depression & Grief - the normal and expected response to any loss, including one's health - depression due to the effects on ability to work and perform ADLs; sense of well-being and freedom from pain may be lost 5) Acceptance and Participation - Acknowledging the reality of illness and may be ready to participate in decisions about treatment - Active involvement and the hope attached to pursuing treatment usually leads to increased feelings of mastery of the illness - Pts with chronic illnesses become experts of their own care and management of the condition

What are the primary work settings for RN's?

1) Hospitals 63.2% (where most nurses work!) An increase of 25% in the past decade (HRSA, 2013). 39.6% work in inpatient units in community hospitals. Others work in specialty hospitals, long-term hospitals, and psychiatric units. 1.1% of RNs work in VA hospitals 2) Ambulatory care (outpatient) 10.5% Nurse-based practices, physician-based practices, and free-standing emergency and surgical centers 3) Public and community health 7.8% 4) Home health 6.4% 5) Extended care facilities (e.g. SNFs) 5.3% 6) Others - 6.8% ... school nursing, nursing associations, local, state or federal governmental agencies, state boards of nursing, or insurance companies

What important events in the 1920's brought sweeping changes to nursing?

1) Nurses' roles in WWI and flu pandemic led to expansion of profession. 2) National Committee on Nursing was formed Chaired by Mary Adelaide Nutting (professor of Nursing and Health at Columbia Univ.) and Jane Delano (director of nursing in American Red Cross). - Initiated publicity campaign to recruit young women to nursing trainer. - Established Army School of Nursing (Annie Goodrich as dean) - Vassar Training Camp for Nurses 3) Red Cross pushed public education in home care and hygiene after flu pandemic 4) 1920: Congress passed bill providing nurses with military rank 5) 1923 Goldmark Report: study of nursing education; advocated for establishment of nursing schools associated with colleges/universities rather than hospital-based diploma programs; encouraged establishment of rural programs in midwifery 6) 1925: Mary Breckinridge established Frontier Nursing Service (FNS) - Originally Kentucky Committee for Mothers and Babies (first US midwifery program) - FNS worked in isolated areas in Appalachian Mountains; traveled by horseback - Delivered babies, provided pre/postnatal care, educated mothers/families about nutrition and hygiene, and cared for sick

What are the barriers to professionalism in nursing?

1) Nursing in the only profession that allows less than a bachelor's degree to practice - BSN, ADN, and diploma in nursing 2) Gender issues - is it perceived that nursing is a "women's profession". It is slowly becoming more balanced 3) Historical influences - nursing has positive and negative connections with religious orders and the military. 4) External conflicts - as nurses assume more responsibilities in managing patient care, there has been a bit of tension between nurses and medicine. We must continue to strive for collaboration, rather than competition with physicians and other health care providers. 5) Internal conflicts - within nursing, we must be sure to equally respect RNs with varying education levels.

What are the foundation documents of nursing and what do they address?

1) Nursing's Social Policy Statement: The Essence of the Profession - A Contract with Society - Purpose: It expresses nursing's own understanding of its commitment to society. - Serves as a framework for understanding professional nursing's relationship with society and nursing's obligation to those who receive professional nursing care 2) Nursing: Scope and Standards of Practice - Purpose: It is a statement of ethical values, obligations, duties, and professional ideals of nurses individually and collectively. - Delineates the standards of care and associated competencies for professional nursing (i.e. Nursing Process) - Establishes responsibilities for which nurses are accountable - Each standard is accompanied by a list of competencies by which practice care can be assessed 3) Code of Ethics for Nurses: Purpose: It is nursing's non-negotiable ethical standard. - Includes: respect for human dignity, relationship with patients/colleagues, patient interests, collaboration, professional boundaries, confidentiality, performance standards/responsibilities, protection of patient health and safety, authority, accountability, moral virtue, ethical obligations, etc. 4) Pain Management Nursing - Scope and Standards of Practice - Includes: Roles/practice, ethics, trends and standards in pain management nursing.

What are the basic provisions of the Affordable Care Act?

1) PRE-EXISTING CONDITIONS KEY PROVISION: No child will be denied insurance based on pre-existing health conditions. 2) COVERAGE FOR YOUNG ADULTS KEY PROVISION: Young adults can now remain insured through their parents' health insurance plan until the age of 26. 3) PREVENTIVE CARE SERVICES KEY PROVISION: Insurers must cover preventative care for children--well-child visits, vision and hearing tests, development screenings--without requiring co-payments, deductibles or co-insurance. 4) SPENDING LIMITS KEY PROVISION: Insurance companies cannot limit their expenditures for a child on their health plan over a lifetime. Annual limits will no longer be allowed after the year 2014. 5) MENU LABELING REQUIREMENT IN RESTAURANTS/FAST FOOD KEY PROVISION: Chain restaurants, including fast-food chains and vending machines, will be required to post calorie counts of their menu items directly on the menu. 6) PREVENTION AND PUBLIC HEALTH FUND KEY PROVISION: The Public Health Services Act will be funded to invest in prevention and public health programs. 7) COMMUNITY TRANSFORMATION GRANTS (CTG) KEY PROVISION: Local communities will address health disparities and reduce chronic disease by promoting healthy living and addressing the root causes of poor health.

What are the 4 types of nursing care delivery systems?

1) Team Nursing - A democratic work group with different skill levels represented by different team members. RN usually serves as the team leader. The most skilled and experienced members care for the more seriously ill/complex, while the less experienced members care for patients with less complex care. Advantages: - potential for building team identity - provide comprehensive care - each workers ability is used to the fullest - promotes job satisfaction - decreases non professional duties of RN's Disadvantages: - ongoing need for communication amongst team members requires commitment of time - all team members must promote team work or team nursing is unsuccessful - team composition varies from day to day which can be disruptive and confusing, and decrease continuity of care - it may result in blurred role boundaries resulting in confusion and resentment. 2) Primary nursing - Deliver consistent, comprehensive care by identifying one nurse who is responsible, has authority, and is accountable for patient outcomes. Role of the primary nurse: 24-hour accountability for care outcomes. Advantages: - high patient and family satisfaction - promotes RN responsibility, authority, autonomy, and accountability - the nurse can care for entire patient physically, emotionally, and spiritually - patient knows the patient well and vice versa - promotes patient centered decision making - increases coordination and continuity of care - promotes professionalism - promotes job satisfaction and sense of accomplishment for nurses Disadvantages: - difficult to hire all RN staff - expensive to pay all RN staff - nurses are not familiar with other patients making it difficult to cover for one another - may create conflict between and primary and associate nurses - stresses of around the clock responsibility - heavy responsibility especially for new nurses 3) Case management nursing - Work to reduce the cost of providing services through coordination of providers across the continuum of care. Advantages: - promotes interdisciplinary collaboration - increases quality of care - cost effective - eases patients transition from hospital to community services - nurse has increased responsibility Disadvantages: - requires additional training - requires nurses to be off the unit for periods of time - is time consuming - is most useful only when high risk patients and high cost high volume conditions 4) Patient centered care - More of an attitude than a particular model of care. Patient's needs have priority over institution's needs; brings traditional and non-traditional components to optimize the healing environment. Advantages: - expedites care - promotes patient convenience - capitalizes on professional competence of team members - emphasizes continuum of care and reduces fragmentation of care - uses resources efficiently - fosters teamwork, collaboration, and communication Disadvantages - requires right staff at right time to meet patient needs - difficult to explain, uses several models of care delivery - expensive, requires high percentage of RN's with both clinical and management skills

What are the categories of services?

1. Health promotion and maintenance, including early detection - Assists patients to remain healthy; prevent diseases & injuries; early disease detection; promote healthier lifestyles 2. Illness prevention - Address health problems after risk factors are identified (e.g. promote cessation of EtOH with known liver dz) 3. Diagnosis and treatment - Modern technology helps refine methods of diagnosing and managing illnesses (e.g. imaging and detection of cancers; minimally invasive surgery) 4. Rehabilitation and long-term care - Help restore the pt to the fullest possible level of function & independence after injury or illness; help patients understand/manage chronic conditions

What are the ongoing issues in nursing education reflected in a number of position papers?

5 major problems: 1) Students are not being trained to care the growing populations that are diverse, elderly, and chronically ill 2) Students aren't trained to work in disciplinary teams, while they will constantly do so while in the workforce 3) Students are not consistently educated on how to find, evaluate, and use rapidly expanding scientific evidence on which practice should be based 4) There is little opportunity to identify, analyze, and eliminate the root causes of errors and quality issues in hospitals 5) Students are not being trained on basic informatics to help them access information and used computerized order entry systems

What are the benefits of a vocabulary search term database or key word search term database?

A subject search is more specific than a keyword search: it looks in only one field of each record - the subject field. Many databases use subject headings that are unique to that particular database. This controlled vocabulary allows for consistency of terms across the database.

What are the features of the SMU databases described in the lecture?

CINAHL Controlled Vocabulary Search - Content geared towards nursing PubMed MeSH Databasesearch - large medical database - The easiest way to determine if an article is peer reviewed is to do a web search on the journal title and look in the "About This Journal" section. - If you find something great; click Related Citations which will locate similar articles. - Watch out for articles that have brackets around the title. These articles are in a language other than English. RefWorks - Reference list creator

Acute illness

Characterized by severe symptoms that are relatively short-lived (e.g. common cold, acute appendicitis, MI)

Internal Influences on Illness Behavior

Dependence/independence needs Coping ability Resourcefulness Resilience Spirituality and religion

Chronic illness

Develops gradually, requires ongoing medical attention, and may continue for the duration of the individual's life (e.g. diabetes)

What are the different Doctorate programs in nursing and how do they differ?

Doctoral programs in nursing prepare nurses to become: - Faculty members in universities - Administrators in schools of nursing or large medical centers - Researchers - Theorists - Advanced practitioners Doctoral programs are divided into two categories: - Research-focused: doctor of philosophy (PhD and DNSc) - Practice-focused: doctor of nursing practice (DNP)

What are the differences between a for-profit and not-for-profit organizations?

For-profit: - Uses profits to pay shareholders. - A controversial issue related to For-Profit Agencies is the possibility that they might not treat nonpaying patients. - Example: Home health care, nursing homes, certain hospitals, ambulatory surgery. Not-for-profit: - Uses profits to pay personnel, improve services, provide educational programs or otherwise contribute to the mission of the agency. - Example: Joint Commission

Ethonocentrism

Inclination to view one's own cultural group as the standard by which to judge the value of other cultural groups

What is Kelly's Criteria and the hallmark of nursing practice?

Kelly's Criteria: Eight Characteristics of a Profession 1. The services provided are vital to humanity and the welfare of society. - Why do students want to become a nurse? "To help people" - Services versus caring: --> Caring is the core of professional nursing through which nurses intervene for their patients --> Services - nursing interventions are the "services" 2. There is a special body of knowledge that is continually enlarged through research. - Research nursing degrees (PhD) - Nursing is no longer based on simple problem solving but increasingly relies on theory and research as a basis for practice. Example: Evidence-based practice 3. The services involve intellectual activities; individual responsibility (accountability) is a strong feature. - Critical and creative thinking serves as basis for providing nursing care. Example: Nursing process - ANA defines accountability as being answerable for something one has done. - Accountability is firmly rooted in the ethical principles of "fidelity (faithfulness), loyalty, veracity, beneficence, and respect for the dignity, worth, and self-determination of patients." 4. Practitioners are educated in institutions of higher learning. - 1909: University of Minnesota - first university-based nursing - 1965: ANA Position Paper - All nursing education should take place in institutions of higher education. - Debate: Entry level into Practice (ADN) 5. Practitioners are relatively independent and control their own policies and activities (autonomy). - Autonomy = control over one's practice. - Licensure by state boards means that nurses are autonomous - "Doctor's orders" connotation obedience from nurses - Groups that control nursing practice: --> Organized nursing --> Organized medicine --> Health service administration - Magnet Recognition program - recognizes hospitals that attract and retain nurses (autonomy and control over practice were key in these hospitals) - Survey of nurses - these nurses did not have influence on decisions related to patient care 6. Practitioners are motivated by service (altruism) and consider their work an important component of their lives. - Altruism = the belief in or practice of disinterested and selfless concern for the well-being of others - Nurses' altruism is sometimes questioned when they demand higher compensation and better working conditions. - Collective bargaining - some say it goes against the altruistic component of nursing - Some still see nursing as "simply a job" 7. There is a code of ethics to guide the decisions and conduct of practitioners. - ICN and ANA established a Code of Ethics through which profession-wide standards of practice are established, promoted, and refined - 1893: Nightingale Pledge - functioned as nursing's first code of ethics 8. There is an organization (association) that encourages and supports high standards of practice. - American Nurses Association (ANA) = official voice of nursing - Purposes - work for the improvement of health standards and the availability of healthcare standards, foster high standards of nursing, and to stimulate and promote the economic and general welfare. - Relatively low percentage of nurses who belong to ANA and the constituent state nurses association (>10%) - A significant political influence is unrealized for the profession.

Who is considered the founder of public health nursing?

Lilian Wald

What is the significance of the Brown Report?

Lucille Brown published the "nursing for the future" aka the Brown report. Recommended that basic schools of nursing be placed in universities and colleges with effort made to recruit men and minorities.

List the nursing definitions with the nurses who espoused them

Nightingale's (1859) - "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" Shaw's (1907) - "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 (1922) - "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" Harmer & Henderson (1939) - "Nursing may be defined as that service to an individual that helps him to attain or maintain a healthy state of mind or body" Peplau's (1952) - "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" Orem's (1959) - "Nursing is perhaps best described as the giving of direct assistance to a person, as required, because of the person's specific inabilities in self-care resulting from a situation of personal health"

How do BSN nurses affect outcomes to patients in hospitals?

Patients on surgical units with more BSN-prepared nurses had fewer complications than patients on units with fewer BSN nurses. Hospitals with a higher percentage of nurses with a BS in Nursing had both a higher standard of patient care and a lower incidence of patient post-surgical mortality

What are the CEU (continuing education units) requirements for registered nurses in California?

RNs are required to earn 30 CEUs every two years to renew

What is the significance/recommendations of the 2010 IOM report?

The Institute of Medicine published a report, The Future of Nursing Leading Change, Advancing Health, with 4 key messages at the center of it: 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 workplace planning and policy development.