Foundations: Module 1 - Evolution of Nursing

Foundations: Module 1 - Evolution of Nursing

• Nursing is a professional field that has been successfully professionalized
• It includes ethical standards, special knowledge and skills, widely recognized as a body of learning derived from research, education, and training at a high level
• Professionals are prepared to apply this knowledge and exercise these skills in the interest of others.
• American Nurses Association (ANA) (1980) defines nursing as the diagnosis and treatment of human responses to actual and potential health problems.
• ANA (2010) describes nursing practice as individualized, emphasizing partnerships and caring as central to the practice of registered nurses (RNs).
• RNs utilize the nursing process to provide individualized care to patients.
• Strong links exist between professional work environments and RNs' ability to provide quality healthcare and achieve optimal outcomes.
• ANA (2015) defines nursing as the protection, promotion, and optimization of health and abilities; preventing illness and injury, facilitating healing; alleviating suffering; diagnosing and treating human responses, and advocating for the care of individuals, families, groups, communities, and populations.
• Defining nursing helps the public understand its value, differentiate nursing activities from medicine, and helps students understand expectations.

Influential Persons in the Evolution of Nursing

• Florence Nightingale, Dorothea Dix, Clara Barton, Lillian Wald, Mary Brewster, Edward Lyon, Lavinia Dock, and Mary Mahoney were influential figures in the evolution of nursing.

Safe, Effective Nursing Care

• Several individuals contributed to the advancement of nursing.
• Discussions focus on how "caring" continues to be crucial in a nurse's role.
• Demonstrations of "caring" should be discussed.
• Florence Nightingale's contributions significantly improved patient outcomes.
• Relating specific competencies associated with providing goal-directed client-centered care to Nightingale's actions is important.

Nursing Organizations

• American Nurses Association (ANA) is the official organization of nurses in the US.
• National League for Nursing (NLN) sets universal standards for nursing education
• Each state board is responsible for defining nursing practice, scope of practice for nurses, and approving nursing education programs
• State boards develop rules and regulations for nurses' practice.

Nursing Today

• Nurses are competent and caring professionals.
• The complexity of healthcare delivery requires nurses to use critical thinking, communication, organization, leadership, advocacy, and technical skills.
• These abilities help ensure safe and effective care for clients.

Thinking Skills

• Clinical judgment is a process that involves recognizing and analyzing cues, prioritizing hypotheses, generating solutions, taking actions, and evaluating outcomes.
• Critical thinking involves collecting and analyzing information and carefully considering options for action.
• Problem-solving entails considering an issue and seeking a satisfactory solution.

Important Qualities for Nurses

• Critical thinking, caring and compassionate, listening skills, patience, emotional stability, physical stamina, detail-oriented, organizational, and speaking skills are important for nurses.

Entry Into Practice

• Entry into nursing practice has five levels of education namely Diploma, BSN, RN to BSN, Master's, and Doctorate.
• Continuing Education is a professional strategy used to maintain knowledge.

Nursing Education

• Patricia Benner's theory outlines five stages of nursing development (Novice, Advance Beginner, Competence, Proficient, and Expert)
• Nursing education includes diploma programs (3-year hospital-based and 2-year community college associate degree programs), and baccalaureate degree programs (8 semesters at colleges and universities).
• RN to BSN programs allow nurses with associate degrees to achieve BSN degrees.

Roles of the Nurse

• Nurses act as direct care providers and communicators, educators and counselors, advocates, use critical and detailed thinking, are caring and compassionate, change agents, leaders and managers, case managers, research consumers, team players, knowledgeable, and listeners.
• Nurse's roles cover various locations of healthcare, including hospitals, skilled and custodial care facilities, ambulatory care centers, home healthcare agencies, community/public health centers, and independent living facilities.

Ethical Principles and Responsibilities of a Nurse

• Basic ethical principles include advocacy, responsibility, accountability, confidentiality, autonomy, beneficence, fidelity, justice, non-maleficence, and veracity.
• Ethical dilemmas involve the complex interplay of morality and science, examining the boundaries of right and wrong.

The 6 Functions of Clinical Judgment

• Recognize cues, analyze cues, prioritize hypotheses, generate solutions, take actions, evaluate outcomes.

The Nursing Process: ADPIE

• Assessment data (subjective and objective), diagnosis (primary problem), planning (goals), intervention (teaching/goals), evaluation (goal achievement).
• Nursing process steps are not always performed in strict order, and can evolve dynamically during patient care, with plans both written and internal.

Types of Nursing Diagnoses

• Problem-focused diagnoses relate to (related factors) as evidenced by (defining characteristics).
• Risk diagnoses describe potential issues (risk factors)
• Health promotion diagnoses relate to factors influencing health promotion and/or maintenance.
• Syndrome diagnoses relate to complex patterns of health data.

Nursing Delegation Notes

• 5 rights of delegation include task, circumstance, person, direction, and supervision.
• Unlicensed Assistive Personnel (UAPs) and Licensed Practical Nurses (LPNs) often perform basic routine tasks under the oversight and accountability of registered nurses (RNs)

Interprofessional Teams

• Interprofessional teams include physicians, nurse practitioners, physician assistants, registered nurses, licensed practical nurses, unlicensed assistive personnel, pharmacists, therapists, technologists, dieticians, social workers, spiritual care providers, and alternative care providers.

Therapeutic Communication

• Verbal communication (between nurses, patients, and interprofessional teams).
• Nonverbal communication (facial expressions, body language).
• Factors impacting communication (age, environment, gender, communication style).

Communicate Using ISBAR

• Situation (patient's details and concerns), Background (patient's history), Assessment (clinical impression, concerns, vital signs, early warnings), Recommendations.

Safety in Healthcare

• Factors affecting safety include communication, patient identification, medication use, infection prevention, suicide risk mitigation, and surgical error mitigation.
• Never events (serious reportable events) are largely preventable.
• Ensuring staff communication and safe alarm usage are crucial aspects of patient safety.

Maslow's Hierarchy of Needs

• Maslow's Hierarchy prioritizes physiological (basic needs), safety, love/belonging, esteem, and self-actualization needs.
• Holistic View considers physiological balance, safety, love and belonging, self-esteem, self-actualization, together with holistic perspective of the whole person to plan care for a patient's needs.

1-Minute Paper

• Reflection on learning through a quick, focused writing activity.
• Reflecting on and summarizing key takeaways from a course or learning session.