Nursing: Art, Science, and Profession

• Quality of care provided through nursing integrates the art and science of nursing, adheres to the highest standards, and benefits patients and their families.
• Nursing, as an art, means delivering care with compassion, caring, and respect for each patient’s dignity and individuality.
• Nursing as a science, is the practice based on continuously evolving knowledge and evidence-based practices due to discoveries and innovation.

Nursing as a Profession

• The patient is the central focus; based on your setting, they may include individuals, families, and communities.
• Patients have different healthcare needs, knowledge, experiences, vulnerabilities, and expectations, making nursing challenging and rewarding.
• Nursing requires more than skills; nurses are not simply trained to perform specific tasks.

Science and Art of Nursing Practice

• Nursing practice blends current knowledge and practice standards with a compassionate approach to patient care.
• Clinical expertise requires time dedication and commitment.
• Well-thought-out care with compassion and caring ensures patients receive the best nursing practices.

Scope and Standards of Practice

• Providing specified services follows a code of ethics and standards of practice.
• Practices include knowledge of social, behavioral, biological, and physiological sciences, in addition to nursing theories.
• According to the American Nurses Association(ANA) in 2021, nursing includes the protection, promotion, and optimization of health, prevention of illness and injury, healing, and compassionate presence.
• The diagnosis and treatment of human responses, advocacy plus care for individuals, families, groups, communities, and populations while acknowledging the relationship of humanity are all included.
• According to the International Council of Nurses (ICN) in 2021, nursing encompasses autonomous and collaborative care for people of all ages, families, groups, and communities whether ill or well, across settings.
• It includes promoting health, preventing illness, caring for the ill, disabled, and dying, advocating for safe environments, performing research, and shaping health policy via patient and healthcare systems.

American Nurses Association (ANA) Standards of Nursing Practice

• Assessment involves the registered nurse collecting data and information related to the healthcare consumer's health or situation.
• Diagnosis involves the registered nurse analyzing the data to determine actual or potential diagnoses, problems, and issues.
• Outcomes identification involves the registered nurse indentifying expected outcomes for a consumer individualized plan.
• Planning involves the registered nurse making strategies to achieve expected outcomes.
• Implementation involves the registered nurse putting the identified plan into action.
• Implementation includes care coordination, and the registered nurse's coordinating care delivery.
• Implementation includes health teaching/promotion, and the the registered nurse's strategies for teaching and promoting health and wellness.
• Evaluations involves the registered nurse evaluating progress toward attaining goals and outcomes.

American Nurses Association (ANA) Standards of Professional Performance

• Ethics involve registered nurses incorporating them into practice.
• Advocacy involves the registered nurse showing advocacy in all roles and settings.
• Respectful and equitable practice involves registered nurses practicing with cultural humility and inclusiveness.
• Communication involves registered nurses effectively communicating in all areas of professional practice.
• Collaboration involves registered nurses seeking others out, as well as healthcare consumers,
• Leadership involves the registered nurse leading within the practice setting and the profession.
• Education involves the registered nurse seeking knowledge and competence that reflects current nursing practice, as well as futuristic thinking.
• Scholarly inquiry involves registered nurses integrating scholarship, and research.
• Quality of practice involves registered nurses contributing to quality nursing practice.
• Professional practice evaluation involves registered nurses evaluating others' and their own nursing practice.
• Resource stewardship involves registered nurses employing resources that sustain evidence-based nursing services or fiscally responsible action.
• Environmental health involves the registered nurse taking care in a way that advances environmental safety.
• The nursing code of ethics is a philosophical statement of right and wrong and defines the principles nurses use to care for patients.

Professional Responsibilities and Roles

• Nurses provide care and comfort in all healthcare settings.
• Meeting patients' needs remains a priority regardless of health promotion/illness prevention, disease/symptom management, family support, or end-of-life care.
• Autonomy and accountability are essential elements of professional nursing and include independent nursing interventions without medical orders.
• As caregivers, nurses help patients maintain and regain health, manage disease/symptoms, and attain maximal function/independence.
• As patient educators, it is paramount to their health and recovery.
• Effective and improved teaching enhances patients' knowledge, skills, self-care activities, and informed decisions.
• Effective communication is essential for nurse patient relationships, to know including their preferences, strengths, weaknesses, and needs.
• Nurse managers direct groups of

Career Development

• Clinicians provide direct (hands-on) patient care in acute care settings.
• Advanced Practice Registered Nurses (APRN) are the most independently functioning nurses.
• APRNs require a master's degree/Doctor of Nursing Practice (DNP) degree; advanced knowledge in pathophysiology, pharmacology, and assessment; and certification and specialized expertise.
• APRNs include clinical nurse specialists, nurse practitioners, certified nurse midwives, and certified registered nurse anesthetists.
• Nurse educators provide staff development in healthcare agencies and patient education in nursing schools.
• Nurse educators require clinical experience coupled with practical skills and theoretical knowledge.
• Nurse administrators manage nursing staff in healthcare agencies.
• Nurse researchers conduct research-based performance improvement to advance nursing.

Historical Influences

• Knowledge of nursing history informs understanding of the social and origins.
• Florence Nightingale established the first nursing philosophy centered on health maintenance and restoration and was the first practicing nurse epidemiologist.
• Nightingale's statistical analysis connected poor sanitation to the incident of cholera and dysentery.
• Nightingale volunteered during the Crimean War (1853) and traveled with a lamp to treat patients at night on the battlefield.
• The Civil War led to the founding of Dorothea Lyndon Dix, Mary Ann Ball(Mother Bickerdyke), and Harriet Tubman were key people.
• Clara Barton founded the American Red Cross.
• Dix and Bickerdyke organized hospitals and ambulances and cared for wounded soldiers.
• Harriet Tubman was active in the Underground Railroad.
• Mary Mahoney, the first African-American nurse, advocated cultural diversity and respect in nursing.
• Lillian Wald and Mary Brewster founded Henry Street Settlement in 1893, emphasizing the health needs of the poor in NYC.

Early 20th-Century Advancements

• Movement toward scientific and research-based nursing knowledge.
• Mary Adelaide Nutting became the first nursing professor at Columbia Teachers College in 1906.
• Magnet Recognition Program- Creation of specialty organizations for nurses - AORN, INS, and Ena.
• The ANA established the Center for Ethics and Human Rights in 1990.
• The 21st-century challenge is adapting nursing.

Contemporary Influence on Nursing

• Nurses must prioritize self-care.
• Nursing is physically and emotionally demanding, meaning self-care maintains compassionate care for others.
• Exposure to grief and loss can cause compassion fatigue(burnout).
• Burnout arises when resources do not meet emotional involvement.
• Healthcare reform emphasizes health promotion and disease prevention at the community level.
• Nurses will adapt to improvements in resource management and patient discharges.

Health Care Costs

• Rising costs require nurses to deliver quality care effectively and economically.
• The population is aging/becoming more diverse, increasing the demand for health care resources.
• By 2030, all baby boomers will be over 65, and by 2044, many U.S. minority groups will be part of a U.S. minority group.
• There is a shift from rural to urban residences.
• Medically underserved groups (unemployment, underemployment, mental illness, homelessness, and health care costs) face challenges in accessing social, economic, and health literacy.
• Patients will need palliative care services if there are low health literacy rates.

Trends in Nursing

• Nursing evolves with, health care priorities, technologies, and the profession.
• Nurses must make judgments based on education and experience, not just evidence.
• EBP- The public is more informed about medical errors which requires and emphasized the need for EBP.
• Evidence-based practice must be used in healthcare agencies to control

Quality and Safety Education for Nurses (QSEN)

• QSEN prepares nurses with knowledge, skills, and attitudes (KSAs) to improve healthcare quality and safety.
• QSEN defines patient-centered care competencies, safety, and informatics.
• Technologies like EHR, CPOE, and Telehealth care improve data, data managing, and improve.
• The technologies guide/enhance patient care given by nurses.
• Genomics involves studying gene interactions, impacting qualities, and health.
• Genomics involves the role of nurses, risk factors, and tests, and confidentiality.

Public Perception

• Consumers get health information (Hospital Compare and HAHPS) for choice of care.
• Nursing is an essential health deliverer for people with professionals that make up the largest group.
• Nurses are advocating health with standards and care.
• ANA advances equitable, standards, and development.

Nursing Education

• Prelicensure Education: A Bachelor's Degree (BSN/BScN/BN): is needed
• A 4-year program in science, nursing theory, social sciences, arts, and the humanities is necessary.
• Graduate Education: Nursing must be prepared in Doctoral/Master's studies.
• A nursing philosophy of research(PhD) must be a doctorate of science (DNSC/DSN) in applying practice.
• With DNP, the practice will have advanced evidence.
• Nurses practice through continuing in-service programs.
• Practice is maintained through practice and advanced education.
• Practice will provide the regulations in the scope of safety and public (Practice Act).
• Practice is administered under the Board of Nursing/state.
• To acquire a license, nurses practice with NCLEX.

Nursing Organizations

• Organizational provide the practice through specialty support and regulations.
• The focus should be with nurses that organize/develop students.

Explore the art and science of nursing, focusing on the definitions by ANA and ICN. Understand the blend of skills needed for professional practice, patient safety, and autonomy in nursing. Learn about patient care and education.