Nursing Today Chapter 1

Nursing as a Profession

• To act professionally, nurses use critical thinking skills, administer quality patient-centered care, and are responsible and accountable.
• Nursing influences the lives of patients, their families, and their communities.
• Nursing requires current knowledge and practice standards, an insightful and compassionate approach, and critical thinking and clinical judgment.

Benner's Levels of Nursing Expertise

• Novice: Beginner nurse student with no nursing experience.
• Advanced Beginner: Some level of experience, possibly only observational, e.g., graduate nurse.
• Competent: A nurse with 2-3 years of experience, able to assess efficiently.
• Proficient: A nurse with more than 2-3 years of experience, with a broader range of skills in different departments/units.
• Expert: A nurse with diverse experience, having an intuitive grasp of an existing or potential clinical problem.

American Nurses Association (ANA)

• Nursing: Scope and Standards of Practice include standards of professional nursing practice, professional performance, code of ethics, and knowledge from social and behavioral sciences, biological and physiological sciences, and nursing theories.
• Incorporates ethical and social values, professional autonomy, and a sense of commitment and community.

ANA Standards of Practice (Nursing Process)

• The nursing process is a model for clinical decision-making, consisting of:
  • Assessment (subjective): collects data
  • Diagnosis: analyzes assessment data to determine actual or potential diagnoses, problems, and issues
  • Outcomes Identification
  • Planning
  • Implementation
  • Evaluation

Health Care Delivery System

• Levels of health care delivery:
  • Preventative
  • Primary
  • Secondary
  • Tertiary
  • Restorative
  • Continuing health care
• Integrated Health Care Delivery includes primary and preventive health care services, secondary and tertiary care, restorative care, and continuing care.

Integrated Health Care Delivery

• Primary and preventive health care services:
  • Focus on improved health outcomes for an entire population
  • Requires collaboration among health professionals, health care leaders, and community members
  • Includes health promotion programs to reduce disease incidence and preventive care to reduce and control risk factors
• Secondary and tertiary care:
  • Hospitals, intensive care, mental health facilities, rural hospitals, and discharge planning
• Restorative care:
  • Home care, rehabilitation, and extended care facilities
• Continuing care:
  • Longer care, nursing centers or facilities, assisted living, and respite care

Nurse Delegation

• Nurse delegation means educating, observing, and verifying that a non-nurse can complete a specific task usually performed by a nurse.
• The RN retains responsibility to supervise care received by the patient and to periodically reassess whether nurse delegation continues to be appropriate.

Health and Wellness

• Healthy People provides evidence-based, 10-year national objectives for promoting health and preventing disease.
• Healthy People 2030 promotes a society in which all people live long, healthy lives, identifies leading health indicators, and targets high-priority health issues in the United States.

Definition of Health

• A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO).

Models of Health and Illness

• Maslow's Hierarchy of Needs: prioritizes basic human needs, including self-actualization, self-esteem, love and belonging, safety, and physiological needs.

Variables Influencing Health and Health Beliefs and Practices

• Internal variables: developmental stage, intellectual background, perception of functioning, emotional factors, and spiritual factors
• External variables: family role and practices, social determinants of health, culture, and food insecurity

Three Levels of Prevention

• Primary prevention: reduces the incidence of disease, e.g., vaccinations, education
• Secondary prevention: focuses on preventing the spread of disease, illness, or infection once it occurs, e.g., treatment, screening, biopsy
• Tertiary prevention: focuses on reducing the severity of disease, e.g., rehabilitation, disability management