Nursing 320: Exam 1 Study Guide
-temples became center of medical care -nurses cared for the sick in the home and community; practiced as nurse midwives -greeks believed illnesses were caused by sin of gods displeasure -the hebrews developed rules looked through the 10 commandments and mosiac Health Code for ethical human relationships, mental health, and disease control.
ancient greek civilization
The privacy rule gives that patients get the right to all except which of the following?
ask to see and get a copy of health records for her spouse
AKA situation. The internal and external surroundings that affect the client. It includes all positive or negative conditions that affect the patient, the physical environment such as family friends or significant others and the setting that they go for their healthcare.
environment
establishing a personal moral code/responsibilities. HAVE to value and obey the rules
ethical/legal
integration of best research evidence, clinical expertise, and patient values and needs to promote high quality cost effective patient care with good outcomes.
evidence based practice EBP
The privacy rule requires that every risk or accidental use of disclosure of protected information be eliminated?
false
t/f: I talk about my patients if I dont use their names or any identifiable information?
false
t/f: In order to do her job well, a nurse must make reasonable efforts to use, disclose, and request the maximum amount of protected health information needed to accomplish the intended purpose of the use, disclosure or request.
false
t/f: The covered entity must accept all changes requested
false
t/f: The covered entity must accept all requests by the patient for for restrictions for the release of the patients health information
false
t/f: Under no circumstances can the covered entity disclose protected health information without written consent from the patient?
false
t/f: Workers compensation is not entitled to the protected information unless approved by the patient?
false
___: more than one people communicating with each other Small: nurses interacting with two or more people (ie staff meeting) Organizational communication: people and the groups within an organization communicate to establish goals
group
three or more persons shared an interdependent relationship, usually based on a common purpose, experience, or patterns of contact established over time
group definition
a degree of wellness or wellbeing that the client experiences. It may have different meanings for each patient, the clinical setting, and the healthcare provider.
health
Mid __th century nursing became more of a science-nursing was more accepted and evolved (ie graduate programs)
20th
Hildegard E Peplau: Theory of ___ ____: Central theme: Nursing is a therapeutic, interpersonal, and goal-oriented process Application to clinical practice: Nursing interventions are directed toward developing the patient's personality for productive personal and community living.
Interpersonal Relations
what are the diff ways to communicate
Intrapersonal: self talking: communication within a person. Interpersonal: occurs between two or more people with a goal to exchange messages.
ISBARR: use this for nurse to nurse report, talking with nurses and physicians If you are talking with a patient to introduce yourself
Intro Situation Background Assessment Recommendation Readback
Many hospitals and health care facilities provide education and training for employees of their institution or organization, called in-service education. This is designed to increase the knowledge and skills of the nursing staff. Programs may involve learning, for example, a specific nursing skill or how to use new equipment.
in service education
promoting the dignity and respect for patient, and how to sound empathetic through care and communication
interpersonal
An ___ ____ allows energy, matter, and information to move freely between systems and boundaries, whereas a closed system does not allow input from or output to the environment (no totally closed systems are known to exist in reality).
open system
refers to a pattern of shared understanding and assumptions about reality and the world, worldview, or widely accepted values systems
paradigm
The use of communication skills to assess, implement, and evaluate individualized teaching plans to meet learning needs of patients and their families
teacher/educator
manipulating equipment in a skillful manner to learn the desired skill. Performance of skill (ie head to toe assessment).
technical
the ___ of ____: nursing information for interventions ie instructing a patient to do a breast exam
the application of knowledge
___ concepts: defined as mentally constructed independently of a specific time or place. ____concepts: are directly experiences and related to a particular time or place
abstract concrete
The protection of human or legal rights and the securing of care for all patients based on the belief that patients have the right to make informed decisions about their own health and lives
advocate
t/f: If patients refuse to allow the agency to share his patient information with family members the agency can refuse to provide services to this patient?
False
Which is not covered by the privacy rule?
Family members
Courses seminars expand knowledge often needed for an RN to keep a license.
continuing education
A system communicates with and reacts to its ____ through factors that enter the system (input) or are transferred to the environment (output).
environment
Nursing shifted from a religious orientation to an emphasis on welfare exploration and expansion of knowledhe Nursing had a poor reputation; Nurses received low pay and worked long hours in unfavorable conditions INC in nursing staff women convicted of crimes and prostitution were recruited to nursing (dark ages) Hospitals were built to to health care demand Early middle ages ended in chaos. Many monastaries and covens were closed leading to lack of people to care for the sick. Led to DARK ages of nursing, no longer respectful profession (lower class were nurses)
16th century
theory of animism
16th century: good spirits brought health. Evil spirits brought sickness and death. Attempt to explain a mysterious change in our body function. Thought everything in nature was alive. Treated disease by chanting, inspiring fear, opened skull.
Nursing broadened in all areas -practice in a wide variety of health care settings (ie rehab, short term, long term care, doctors office, med surge ect..) -the development of a specific body of knowledge -the conduct and publication of nursing research -recognition of the role of nursing in promoting health -increased emphasis on nursing knowledge as a foundation of EBP lead to the growth of nursing as a professional discipline
1950s to present
Social reforms changed the roles of nurses and of women in general Nursing as we know it now began, nased on many of the beliefs of Florence nightingale Nightingale changed prejudices against women and elevated the status of nurses SHe established the first training school for nurses and wrote books about health care and nursing education
19th-20th century
Hospital schools organized to provide more easily controlled and less expensive staff for the hospital -in England had a school for nursing, hospital preception apprenticeship, worked to get their degree Hospitals saw an economic advantage in having their own schools, and most hospital schools were organized to provide more easily controlled and less expensive staff for the hospital. This resulted in a lack of clear guidelines separating nursing service and nursing education. Females were under the control of male hospital administrators and physicians (whatever the male said they had to do, slow progress to professionalism in nursing).
19th-21st century
Specialized organizations work in critical care= AACN certificate.
AACN (american Association of Critical-Care Nurses)
Scope and standards of practice code of ethics and nursing social context.
ANA (American Nursing Assocation)
____ ____ called nursing distinct from the medical practice "Health nursing vs illness nursing"
Florence Nightingale
Four blended competenties
Cognitive Interpersonal Technical Ethical/legal
called the building blocks of theories. They are primarily the vehicles of thought that involve image
Concept
SIster Callista Roy: ____ Model Central theme: Humans are biopsychosocial beings existing within an environment. Needs are created within interrelated adaptive modes: physiologic self-concept, role function, and interdependence. Application to clinical practice: Nursing interventions are required when people demonstrate ineffective adaptive responses.
Adaptation
-defines adaptation as the adjustment of living matter to other living things and to environmental conditions. -Adaptation is a continuously occurring process that effects change and involves interaction and response. -Human adaptation occurs on three levels: the internal (self), the social (others), and the physical (biochemical reactions).
Adaptation theory
Ineffective Communication Techniques
Aggressive behavior -involves asserting ones rights in a negative manner -can be verbal or physical -communication is marked by tension or anger, inhibiting the formation of good relationships and collaboration -characteristics include using an angry tone of voice, making accusations, and demonstrating belligerence and intolerance. -focus is usually "winning at all costs" DIsruptive interpersonal behavior -incivility -bullying -horizontal violence (nurse to preceptor) -Nursing bullying -negative communication between nurse and physician Blocks to effective communication Failure to perceive patient as a human being Failure to listen Nontherapeutic comments and questions Using cliches (ie the doctor knows what hes doing) Using closed questions Using questions containing the words "why" or "how" (prying into their business) Using questions that probe for information Using leading questions Using comments that give advice Changing the subject Giving gossip and rumors Using disruptive interpersonal behavior
Madeline M Leininger: ___ ___ theory of diversity and universality Central idea: Caring is the central theme of nursing care, knowledge, and practice. Application to clinical practice: This provides the foundation of transcultural nursing care. Caring improves human conditions and life processes.
Culture care
Helping relationship characteristics
Dynamic Purposeful and time limited Person providing assistance is professionally accountable for outcomes and the mean to obtain them.
The covered entity must have all the following except ?
Employee personnel policies
Which of the following is not individually identifiable information?
Employments records that the covered entity maintains in its capacity as an employers
The first baccalaureate nursing programs were established in the United States in the early 1900s. The number of programs and the number of enrolling students, however, did not increase markedly until the 1960s. Most graduates receive a BSN. Recommendations by national nursing organizations that the entry level for professional practice be at the baccalaureate level have resulted in increased numbers of these programs. Although BSN nurses practice in a wide variety of settings, the 4-year degree is required for many administrative, managerial, and community health positions. In BSN programs, the major in nursing is built on a general education base, with concentration on nursing at the upper level. Students acquire knowledge of theory and practice related to nursing and other disciplines, provide nursing care to individuals and groups, work with members of the health care team, use research to improve practice, and have a foundation for graduate study. Nurses who graduate from a diploma or associate degree program and wish to complete requirements for a BSN may choose to enroll in an on-campus, online, or external degree RN-to-BSN program. In addition, there are accelerated BSN programs for people who already have a degree in another area.
Baccalaureate degree in nursing
Dorothy E Johnson: ____ System Model Central idea:Nursing problems arise when there are disturbances in the system or subsystem, or the level of behavioral functioning is below an optimal level. Application to clinical practice: Nursing interventions are designed to support/maintain health, educate, counsel, and modify behavior.
Behavioral
history of florence
Born in 1820 in England to a wealthy family. Well educated and pursued a career as a nurse at 31. Despite her families wishes. -crimean war broke out: she organized care for military hospital in turkey and saw nurses working in unsanitary conditions (based her theory off of this)
Florence Nightengale's ___ Theory: Central theme: Meeting the personal needs of the patient within the environment Application to clinical practice: Concern for the environment of the patient, including cleanliness, ventilation, temperature, light, diet, and noise.
Environmental Theory
Maximizing a person's strengths and potentials -patient teaching (do they understand their diagnosis and how can their strengths help them?) -referral to community support systems Providing end of life care: hospice programs
Facilitating coping with disability and death
-outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death -Although the pattern has definite stages, the progress and behaviors of a person within each stage are unique. -Heredity, temperament, emotional and physical environment, life experiences, and health status influence the growth and development of a person.
Developmental Theory
Effective communication techniques:
Dispositional traits- characteristic or customary way of behaving. Nurses who consistently demonstrate warmth and friendliness; openness and rapport; empathy, honesty, authenticity, and trust; caring; and competence are well disposed to communicate effectively. Rapport builders: a feeling of mutual trust experienced by people in a satisfactory relationship , facilitates open communication. Good rapport can be achieved by paying attention to the following variables. -specific objectives -comfortable environment -confidentiality -patients vs task focus: HAVE to be more focused on the patient and make them feel like they're important -utilization of nursing observation -optimal pacing Assertive Nurse's self presentation -confident open body posture -Use of clear concise "I" statements -Ability to effectively share one's thoughts feelings, and emotions -working to capacity with or without supervision -asking for help when necessary -giving and accepting compliments -admitting to mistakes and taking responsibility for them
____ ____ Theory: Ludwig Von Burtenfly describes how to break whole things into parts and then to learn how the parts work together in "systems." It emphasizes relationships between the whole and the parts and describes how parts function and behave. These concepts may be applied to different kinds of systems, for example, molecules in chemistry, cultures in sociology, organs in anatomy, and health in nursing.
General Systems Theory
classification of nursing theory that is abstract broad in scope and complex requiring further research for clarification. Do not guide specific nursing interventions but rather provide a general framework and nursing ideas. Theorists develop their works based on their own experiences and their time, explaining why there is so much variation among theories. ** address the nursing paradigm components of person nursing health and environment
Grand nursing theories:
3 classifications of nursing theories
Grand nursing theories: abstract broad in scope and complex requiring further research for clarification. Do not guide specific nursing interventions but rather provide a general framework and nursing ideas. Theorists develop their works based on their own experiences and their time, explaining why there is so much variation among theories. ** address the nursing paradigm components of person nursing health and environment Middle range nursing theories: more limited in scope and present concepts and propositions at a lower level of abstraction. They address a specific phenomenon in nursing. Nursing scholars propose this level bc of the difficulty of grand theories. Most of these theories are based on a grand theorists' work but can be conceived from research, nursing practice or theories of other disciplines. Practice level nursing theories: situation specific that are narrow in scope and focuses on a specific patient population at a specific time. Provide framework for nursing interventions and suggest outcomes or the effect of nursing practice. Have a more direct effect on nursing practice.
Forming- inclusion, orientation, acceptance, anxiety, superficial, development of trust/confidentiality, Leaders develop interaction, purpose, conduct, and expectations. Storming: counterdependency, integrating individuals with group goals. Power and controls issues, behaviors emerge, uncomfortable, leads to group norms, leaders should model group effective behaviors and confront ineffective behaviors. Norming: cohesion, standards set, feedback spontaneous, accepted behavioral standards formed, apathy is scrutinized. Performing: interdependence, sharing and working towards goals, accomplishing work, cohesiveness, esprit de corps (feeling of pride), affirmation Adjourning: independence, plans for future growth, summation.
Group dynamics/process by Bruce Tuckman (5 stages)
Characteristics of effective and ineffective groups
Group identity: effective- Members value and "own" the aims of the group; aims are clearly articulated. Ineffective: Group's aims are not of major importance to members. Cohesiveness: effective: Members generally trust and like one another and are loyal to the group; high commitment; high degree of cooperation. Ineffective: Members often feel alienated from the group and from one another; low commitment; members tend to work better alone than with the group. Patterns of interaction: effective- Honest, direct communication flows freely; members support, praise, and critique one another ineffective- communication is sparing; little self-disclosure; self-serving roles (i.e., dominator, blocker, or aggressor) may be unchecked. Decision making: effective- Problems are identified, appropriate method of decision making is used (i.e., individual, minority, majority, consensus, or unanimous); decision is implemented and followed through; group commitment to decision is high. Ineffective- Problems are allowed to build without resolution; little responsibility is shown for problem solving; group commitment to decision is low. Responsibility: strong sense of responsibility to group outcomes vs not Leadership: Have an effective leader or not? Power: effective- Sources of power are recognized and used appropriately; needs or interests of those with little power are considered Ineffective- Power is used and abused to "fix" immediate problems; little attention to needs of powerless.
Attain high quality longer lives free of preventable disease disability injury and premature death Achieve high equity, eliminate disparities and improve the health of all groups Create social and physical environments that promote health for all groups Promote quality of life, healthy development, and healthy behaviors across all life stages.
Healthy people 2020 health promotion guidelines
representations of the interaction among and between the concepts showing patterns. They present an overview of the theories' thinking and may demonstrate how theory can be introduced into practice.
Model
Set NCLEX questions for each state.
NCSBN (national council of state boards of nursing)
open to all people interested in nursing, including nurses, nonnurses, and facilities. Established in 1952, its objective is to foster the development and improvement of all nursing services and nursing education. The NLN conducts one of the largest professional testing services in the United States, including pre-entrance testing for potential students and achievement testing to measure student progress. It also serves as the primary source of research data about nursing education, conducting annual surveys of schools and new RNs. The organization also provides voluntary accreditation for educational programs in nursing.
NLN (national league of nurses)
___ is unique because of how we are disciplined in our health care, service based on what you know and how you do your skills
Nursing
Define the legal scope of nursing practice Create a state board of nursing to make and enforce rules and regulations (ie NCLEX) Define important terms and activities in nursing including legal requirements and titles of RNs and LPNs Establish criteria for the education and licensure of nurses.
Nursing Practice Acts
____ ____: organized bodies of knowledge Defines what nursing is and why they do it Provides a way to define nursing as a discipline that is separate from other disciplines (ie medicine) Framework of concepts and purposes intended to guide nurses at a more concrete and specific level
Nursing Theories
Phases of helping realtionship
Orientation phase: The patient will call the nurse by name. -The patient will accurately describe the roles of the participants in the relationship. -The patient and nurse will establish an agreement about: -Goals of the relationship -Location, frequency, and length of the contacts -Duration of the relationship Working phase:The patient will actively participate in the relationship. -The patient will cooperate in activities that work toward achieving mutually acceptable goals. -The patient will express feelings and concerns to the nurse. Termination phase (goal): The patient will participate in identifying the goals accomplished or the progress made toward goals. -The patient will verbalize feelings about the termination of the relationship.
PICO question
P: Population I: Intervention C: Comparison O: Outcomes T: TIme (not always part) S: setting (not always part)
___ ___'s: Caring, Clinical Wisdom and Ethics in Nursing Practice Central theme:Nursing practice occurs within a context of caring and skill development. Caring is a common bond of people situated in a state of being that is essential to nursing. Application to clinical practice: They presented a systematic description of stages of nursing practice: novice, advanced beginner, competent, proficient, and expert.
Patricia Benner
beliefs and values that define a way of thinking and are generally known and understood by a group or discipline
Philosophy
classification of nursing theory where the situation specific that are narrow in scope and focuses on a specific patient population at a specific time. Provide framework for nursing interventions and suggest outcomes or the effect of nursing practice. Have a more direct effect on nursing practice
Practice level nursing theories
Nursing aims to:
Promote health (by education, communcation) Prevent illness Restore health (may not be able to get back to where they once were but maintain what they have Facilitate coping with injury or death
Patient centered care- recognizes the center for care based on the patients needs Team work and collaboration- function w other nurses and professionals joint team decision care Quality improvement- use data and method to improve system Safety- minimize harm to patient/ staff Evidence based practice- integrates the best research with clinical experience and knowledge, and family preference for the best care. Informatics- use technology to communicate and manage knowledge.
QSEN competencies
Dorothea E Orem: ___ ___ Theory Central theme: Self-care is a human need; self-care deficits require nursing actions. Application to clinical practice: Nursing is a human service, and nurses design interventions to provide or to manage self-care actions for sustaining health or recovering from illness or injury.
Self Care
The maximum disclosure accounting period is
Six years immediately proceeding the accounting request
-Systematic reviews: a narrowly focused synthesis of research findings from quantitative studies, has the same standards of clarity, rigor and replication as primary research studies. -Meta-analysis: statistically pools results from previous studies into a single quantitative analysis. Allows for application of scientific criteria ie sample size level of significance variables. -Experimental studies
Sources of evidence based practice
-standard 1 assessment: The registered nurse collects pertinent data and information relative to the health care consumer's health or the situation. -standard 2 diagnosis: The registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues. -standard 3 outcome identification:The registered nurse identifies expected outcomes for a plan individualized to the health care consumer or the situation. -Standard 4 planning: The registered nurse develops a plan that prescribes strategies and alternatives to attain expected, measurable outcomes. -Standard 5 Implementation: The registered nurse implements the identified plan - Standard 5a Coordination of care: The registered nurse coordinates care delivery -Standard 5b Health teaching and health promotion: The registered nurse employs strategies to promote health and a safe environment. -Standard 5c consultation: Have to consult another provider -standard 5d Prescriptive authority and treatment: following what the practitioners treatments are. -Standard 6 evaluation: the registered nurse evaluates progress toward attainment of goals and outcomes.
Standards of Practice
steps of EBP
Step 0: cultivate a spirit of inquiry Step 1: Ask a clinical question in PICOT formation Step 2: Search for the BEST evidence Step 3: Critically appraise the evidence Step 4***: integrate the evidence with clinical expertise and patient preference and values Step 5: Evaluate the outcomes of practice decision based on the evidence Step 6: disseminate the EBP results
5 Parts of the Communication Process
Stimulus or reference: patient that needs to be addressed Sender or source of the message (encoder): a person or group who initiates the communication process Message itself: the actual communication product from the source. It might be a speech, interview, conversation, chart, gesture, memorandum, or nursing note. Medium or channel of communication: how the message is being given (ie auditory touch visual) Receiver: decoder, must translate and interpret the message being received -feedback: the receiver has understood the intended message -Noise: distorts what you are saying ex ty on
-____ is a set of interacting elements, all contributing to the overall goal of the system. The whole is always greater than the sum of its parts. - ___are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole.
System systems
defines activities that are specific and unique to nursing. Standards allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is provided. Each nurse is accountable for his or her own quality of practice and is responsible for the use of these standards to ensure knowledgeable, safe, and comprehensive nursing care
The ANA's 2015 Nursing: Scope and Standards of Practice
What is HIPPA?
The federal standards for the protection of health information
The "Covered entity" may use or disclose protected health information when?
The individual who is subject of the information
What does the privacy rule do?
The privacy rule addresses the use and disclosure of an individuals (patients) health information
The helping relationship does not occur spontaneously, as do most social relationships. It occurs for a specific purpose with a specific person. The helping relationship is characterized by an unequal sharing of information. The patient shares information related to personal health problems, whereas the nurse shares information in terms of a professional role. In a friendship, information sharing is more likely to be similar in quantity and type. The helping relationship is built on the patient's needs, not on those of the helping person. In a friendship, needs of both participants are generally considered. A friendship might grow out of a helping relationship, but this is separate from the purposeful, time-limited interaction described as a helping relationship. Communication is to establish rapport and help trusting relationships.
Therapeutic relationship vs. social relationship
verbal and nonverbal communication
Verbals Spoken language Non verbal communication Facial expression, touch, eye contact Posture gait gestures General physical appearance Mode of dress and grooming Sounds, silence Electronic communication (do not violate HIPPA) *** your nonverbals are the truth of what you are trying to say
___ _ and ___ _changed the roles of women- sought higher education more independent, wanted lecture nursing, research, and were assertive
WWI and WWII
Large numbers of women worked outside the home and became more independent and assertive (men were off fighting in the war) Explosion in medicine and technology broadened the role of the nurse Growth of nursing as a professional discipline efforts were directed at upgrading nursing education Schools of nursing were based on educational objectives and were increasingly developed in university and college settings, leading to degrees in nursing for men, women, and minorities.
WWII
Most associate degree in nursing (ADN) programs are offered by community or junior colleges. These 2-year educational programs attract more men, more minorities, and more nontraditional students than do the other types of programs. Associate degree education prepares nurses to give care to patients in various settings, including hospitals, long-term care facilities, and home health care and other community settings. Graduates are technically skilled and well prepared to carry out nursing roles and functions. As defined by the National League for Nursing (NLN), competencies of the ADN on entry into practice encompass the roles of provider of care, manager of care, and member of the discipline of nursing.
associate degree in nursing
Accepted as truth and are based on values and beliefs. Explain the nature of concepts, definitions, purpose, relationships, and structures of a theory.
assumptions
comes from an expert and is accepted as truth based on the person's perceived expertise—for example, when a senior staff nurse teaches a new graduate nurse a more efficient method of doing a technical procedure, such as inserting an intravenous catheter. Authoritative knowledge generally remains unchallenged as long as presumed authorities maintain their perceived expertise.
authoritative knowledge
To survive, open systems maintain ____ through feedback.
balance
____ of ____: from your discipline and others ie chemistry biology psychology
body of knowledge
____separate systems both from each other and from their environments
boundaries
The provision of care to patients that combines both the art and the science of nursing in meeting physical, emotional, intellectual, sociocultural, and spiritual needs. As a caregiver, the nurse integrates the roles of communicator, teacher, counselor, leader, researcher, advocate, and collaborator to promote wellness through activities that prevent illness, restore health, and facilitate coping with disability or death. The role of caregiver is the primary role of the nurse.
caregiver
what are all the roles of what nurses do
caregiver communicator teacher/educator counselor leader researcher advocate collaborator
A nurse prepared at the graduate level who oversees the lateral integration of care for a distinct group of patients and who may actively provide direct patient care in complex situations. The CNL role is not one of administration or management.
clinical nurse leader
nurse with an advanced degree, education, or experience who is considered to be an expert in a specialized area of nursing; carries out direct patient care; consultation; teaching of patients, families, and staff; and research
clinical nursing specialist
using critical thinking systematically to form/shape ones thinking
cognitive
The effective use of skills in organization, communication, and advocacy to facilitate the functions of all members of the health care team as they provide patient care
collaborator
The use of effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with patients of all ages in a wide variety of health care settings
communicator
are used to describe or label a phenomenon. They are words or phrases that identify, define, and establish structure and boundaries for ideas generated about a particular phenomenon.
concepts
a group of related ideas, statements or concepts
conceptual framework
Identified personal needs of patient and role of nurse to meet them. Established standards for hospital management Established nursing education and nursing as a respected occupation for women Belived nursing is a separate from distinct medicine Recognized that nutrition is important to health Instituted occupational and recreational therapy for sick people Stressed the need to continuing education for nurses Maintained accurate records, recognized as the beginning of nursing research
contributions of florance nightingale
The use of therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision-making skills
counselor
Originated from the latin word Nutrix (to nourish) Most definitions of nursing describe the nurse as a person who nourishes, fosters, and protects and who is prepared to take care of sick, injured, aged, and dying people. With the expanding roles and functions of the nurse in today's society, however, any one definition may be too limited.
definition of nursing
used to convey the meaning of the concept of the theory. Can be theoretical or operational
definitions
____ theory: first level of theory development. Describe the phenomenon and identify its properties in which it occurs. Are not action oriented and do not attempt to change the situation. _____theory: Addresses the nursing interventions for a phenomenon guide practice change and predict consequences. Call for change, used to anticipate the outcomes of nursing interventions.
descriptive perspective
In the 1950s nursing wasn't lecturing from nurses, it was ____who lectured and practical experience of caring for patient in clinical
doctors
the perspective or territory of a profession or discipline
domain
Nursing has formal and more clearly defined roles. Led by the idea that love and caring for others were important, women called "deaconesses" made the first organized visits to sick people, and members of male religious orders gave nursing care and buried the dead. Both male and female nursing roles were founded during the crusades Nursing developed purpose and direction and leadership. MORE A RELGIOUS PART FOR NURSES
early christian period
The assertive, self-confident practice of nursing when providing care, effecting change, and functioning
leader
the most general statement of discipline and functions as a framework in which the more restricted structures of conceptual models develop. Four major concepts: person, environment, health and nursing
metaparadigm
classification of nursing theory that is more limited in scope and present concepts and propositions at a lower level of abstraction. They address a specific phenomenon in nursing. Nursing scholars propose this level bc of the difficulty of grand theories. Most of these theories are based on a grand theorists' work but can be conceived from research, nursing practice or theories of other disciplines.
middle range nursing theory
A nurse who functions at various levels of management in health care settings; is responsible for the management and administration of resources and personnel involved in giving patient care
nurse administrator
A nurse who completes a course of study in an anesthesia school; carries out preoperative visits and assessments; administers and monitors anesthesia during surgery; and evaluates postoperative status of patients
nurse anesthetist
A nurse, usually with an advanced degree, who teaches in educational or clinical settings; teaches theoretical knowledge and clinical skills; conducts research
nurse educator
A nurse, usually with an advanced degree, who may manage a clinic or health-related business, conduct research, provide education, or serve as an adviser or consultant to institutions, political facilities, or businesses.
nurse entrepreneur
A nurse who completes a program in midwifery; provides prenatal and postnatal care; and delivers babies for women with uncomplicated pregnancies
nurse midwife
A nurse with an advanced degree, certified for a special area or age of patient care; works in a variety of health care settings or in independent practice to make health assessments and deliver primary care
nurse practitioner
A nurse with an advanced degree who conducts research relevant to the definition and improvement of nursing practice and education
nurse researcher
attributes, characteristics, and action providing care on behalf or in conjunction with the client. GOAL to improve patient care
nursing
1950s care under doctor (no ___ ____) this was tradition and nurses couldn't question orders
nursing diagnosis
ICN definition of nursing
nursing encompasses autonomous and collaborative care for individuals of all ages, families groups and communities sick or well and in all settings.
AKA client or human being. The recipient of nursing care, and may include individuals, patients, groups, families, or communities.
person
4 major concepts of the Nursing Metaparadigm
person environment health nursing
an idea or response about an event, a situation, a process, a group of events or a group of situations. May be temporary or permanent. Nursing theories focus on the phenomenon of nursing.
phenomenon
were established to teach graduates to give bedside nursing care to patients. Schools for practical nursing programs are located in varied settings, such as high schools, technical or vocational schools, community colleges, and independent facilities. Most programs are 1 year in length, divided into one third classroom hours and two thirds clinical laboratory hours. On completion of the program, graduates can take the National Council Licensure Examination-Practical Nurse (NCLEX-PN) for licensure as an LPN. LPNs work under the direction of a health care provider or RN to give direct care to patients, focusing on meeting health care needs in hospitals, long-term care facilities, and home health facilities.
practical (vocational) nursing programs
Educational programs in areas such as prenatal care for pregnant women, smoking cessation programs, and stress reduction seminars. Community programs and resources encouraging healthy lifestyles (IE 12 step AA meeting, family group for Alzheimer's). Literature, TV, radio or internet information on healthy diet, exercise and good health habits (make sure information is legit ie .gov .edu) Health assessments in institutions clinics and community settings that identify areas of strengths and risks for illnesses.
preventing illness
___ group: spontaneous, informal, automatic or by choice ____ group: planned time limited leader is specific, purpose is identified and structured. Disbands after the goal is met. Ex work group, interdisciplinary health team and education groups.
primary secondary
Organized steps, changes,or function intended to bring about a desired result
process
Identifying, analyzing and maximizing each patient's individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death
promoting health
Statements that describe the relationship between the concepts
proposition
systematic subjective approach. Involves non numerical data. Philosophy is based on a holistic interpretive stance which states that: truth is dynamic, multiple realities exist, deductive reasoning is used. Purpose is to: investigate human experiences and interactions. -Phenomenological: describe an experience -Grounded theory: formulate and test a theory -Ethnographic: in depth study of a culture -Historical research: an analysis of events to provide understanding.
qualitative
formal objective process. Involves measurement and numerical data. Philosophy is based on logical positivism where: truth is absolute, a single reality exists, deductive reasoning is used. Purposes include: test hypotheses, determine cause and effect and/or identify relationships among variables -descriptive research: measures what it is -correlational research how concepts relate to each other -quasi experimental and experimental: manipulate or control one aspect of the situation to examine the effects.
quantitative research
-Diploma in nursing: Many nurses practicing in the United States today received their basic nursing education in a 3-year, hospital-based diploma school of nursing. The first schools of nursing established to educate nurses were diploma programs; until the 1960s, they were the major source of graduates. In recent years, the number of diploma programs has decreased greatly. Graduates of diploma programs have a sound foundation in the biologic and social sciences, with a strong emphasis on clinical experience in direct patient care. Graduates work in acute, long-term, and ambulatory health care facilities.
registered nursing education (3 types)
define the relationship (link) between two or more concepts.
relational statements
In the 21st century, the Institute of Medicine (IOM) issued its seminal report, The Future of Nursing (IOM, 2011), which identifies __ ____ for transforming nursing practice, nursing education, and nursing leadership. "Taken together, the recommendations are meant to provide a strong foundation for the development of a nursing workforce whose members are well educated and well prepared to practice to the full extent of their education, to meet the current and future health needs of patients, and to act as full partners in leading change and advancing health"
research priorities
The participation in or conduct of research to increase knowledge in nursing and improve patient care
researcher
Promoting assessments that detect an illness Referring questions and abnormal findings to other health care providers as appropriate. Providing care to the person who is ill Collaborating with other healthcare providers in providing care Planning, teaching, and carrying out rehabilitation for illnesses such as heart attacks, arthritis, and strokes Working in mental health and chemical dependency programs
restoring health
-physician as medicine man -nurse as a caring mother: mothers and sisters helping with healing used physical care and herbal remedies. This nurturing and caring role of the nurse has continued to the present.
role of nurses and physicians separated and distinct
knowledge obtained through the scientific method (implying thorough research). New ideas are tested and measured systematically using objective criteria.
scientific knowledge
One of the criteria of a profession is having a professional organization that sets standards for practice and education. Nursing's professional organizations are concerned with current issues in nursing and health care, and influence health care policy and legislation. The benefits of belonging to a professional nursing organization include networking with colleagues, having a voice in legislation affecting nursing, and keeping current with trends and issues in nursing.
the nursing organizations
One of the major guidelines for nursing practice Helps nurses implements their roles Integrates the art and science of nursing Allows nurses to use critical thinking and clinical reasoning Defines the area of care that are within the domain of nursing 5 essential activities of the nursing process: assessing, diagnosing, planning, implementing, and evaluating
the nursing process
ANA definition of nursing
the protection, promotion, and optimization of all health and abilities, prevention of illness and injury facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals families groups communities and populations -patient is the CENTRAL FOCUS OF ALL DEFINITIONS (patient centered care) - includes physical, emotional, social and spiritual dimensions of the patient
___ definitions: define a particular concept based on the theorists perspective - ___definition: states how concepts are measured (ie height is defined by the number of feet/inches a person is)
theoretical operational
A belief policy or general procedure proposed or followed as the basis of action. It refers to a logical group of general propositions used as principles of explanation
theory
____ has to contain: concepts, definitions, rational statements and assumptions that explain a phenomenon
theory
3 SOURCES of Nursing Knowledge
traditional authoritative scientific-knowledge
part of nursing practice passed down from generation to generation. When questioned about the origin of such nursing practices, nurses might reply, "We've always done it this way." Changing bedclothes is an example of how traditional knowledge has affected nursing practice.
traditional knowledge
t/f: A legally authorized personal representative is authorized to make health care decisions on the patients behalf?
true
t/f: Individuals have the right to request use or disclosure of protected health information?
true
t/f: The covered entity must post the privacy rules in a prominent place easily seen by the patients.
true
t/f: The individual may request that the "protected" information on file be changed
true
