Fundamentals of Nursing Practice NCM 103 PDF

Evolve. Adapt. Overcome. CEFI is now ready. FUNDAMENTALS OF NURSING PRACTICE NCM 103 PREPARED BY: Niña Mae Sumilang, RN  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Book References...

Evolve. Adapt. Overcome. CEFI is now ready. FUNDAMENTALS OF NURSING PRACTICE NCM 103 PREPARED BY: Niña Mae Sumilang, RN  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Book References: 1. Berman, Audrey (2022) Fundamental of Nursing Volume 1 and 2 11th edition Singapore Pearson Education South Asia Pte Ltd 2. Kozier, B. (2004). Fundamentals of Nursing. Prentice Hall. 3. Potter, P. A., Anne Griffin Perry, Stockert, P. A., & Hall, A. (2023). Fundamentals of nursing (11th ed.). Elsevier Health Sciences. 4. Josie Quiambao Udan. (2021). Mastering Fundamentals of Nursing Practice..  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Course Description: This course deals with concepts, principles, theories and techniques basic to nursing as a profession , science and art. It emphasizes on the concept of man as a holistic being and the professional roles of the nurse in health care setting. The learners are expected to utilize the nursing process and the basic nursing skills as primary tool in health promotion, disease prevention, restoration and maintenance, and rehabilitation.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. COURSE OUTLINE Module 1. Introductory Concepts A. Concept of Nursing I. Nursing as a Profession, Science and Art II. Roles Basic to Nursing Care B. Concept of Man, Health and Illness I. Factors and Issues Affecting Health and Illness II. Health Care Delivery System  COLLEGE OF NURSING Calayan Educational Foundation, Inc. MODULE 2: Nursing as a Profession A. Criteria B. Personal and Professional Qualities of a Nurse C. Fields of Nursing D. History of Nursing MODULE 3: Nursing as an Art A. Caring 1. Caring Practice models 2. 6C’s of Caring 3. Caring for Self and Others  COLLEGE OF NURSING Calayan Educational Foundation, Inc. MODULE 4: Nursing as an Art B. Communicating 1. Process and Modes 2. Therapeutic Communication 3. Helping Relationship 4. Communication and Nursing Process C. Teaching 1. Health Promotion 2. Disease Prevention 3. Health Restoration and Maintenance 4. Rehabilitation COLLEGE OF NURSING Calayan Educational Foundation, Inc. ACTIVITY 1. Memorize the nurses’ prayer. Recite the prayer by recording yourself blindfolded. Scan the environment before starting to ensure honesty.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. WHAT IS NURSING? In 1973, the ANA described NURSING PRACTICE as “direct, goal oriented, and adaptable to the needs of the individual, the family, and community during health and illness” In 1980, the ANA changed this definition of nursing to this: “Nursing is the diagnosis and treatment of human responses to actual or potential health problems”  COLLEGE OF NURSING Calayan Educational Foundation, Inc. In 1995, the ANA recognized the influence and contribution of the science of caring to nursing philosophy and practice. Research to explore the meaning of caring in nursing has been increasing. The current definition of nursing remains unchanged from the 2003 edition of Nursing’s Social Policy Statement: “Nursing is the protection, promotion, and optimization of health and abilities, preventions of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations”  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nursing is an art and a science. As an art, nursing involves learning to deliver care with compassion, caring, and respect for each patient’s dignity and individuality. It evolves as you gain more experience and witness how patients respond to your actions. E.g. > holding the patient’s hand > Offering hope in a time of need > Being honest. * these will ultimately comfort patients and make them feel more comfortable in their difficult situations.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. CARING is a dimension of human relating, and often referred to as the ART of nursing. Smith (2013) proposes that nursing cannot exist without caring. Caring is central to all professions, and enables people to create meaning in their lives. is sharing deep and genuine concern about the welfare of another person.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Caring is the core and basic foundation for nursing practice. (skills, techniques, specialized language are the trim) Caring is the vehicle through which nurses interact with patients and assist them to cope with suffering, to find meaning in their experiences, to promote health and wellness and to die with dignity. Caring is an action that nurtures; action that fosters growth, recovery, health and protection of those who are vulnerable. Caring is the empowering of those for whom care is given (Roach, 1997). Caring is the framework through which we as nurses implement the art and science of professional practice.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Caring is the unique characteristics of a nursing profession. Nursing’s agenda for the future (ANA, 2002) states that Nursing is the pivotal health care profession highly value for its specialized knowledge, skill and caring in improving the health status of the individual, family, and the community”. According to Florence Nightingale, 1969 “ Nursing is an art, if it is to be made an art, it requires as exclusively a devotion as hand a preparation, for what is having to do with dead canvas or cold marble compared with having to do with the living body- the temple of God’s spirit? It is one of the fine arts, I had almost said the finest of the Fine arts.”  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Caring and knowledge are the core of nursing, with caring being a key component what a nurse brings to a patient experience. It is important to preserve a relationship-centered approach to patient care for all aspects of nursing. Technological advances should be coupled with compassionate care and not take nurses away from the caring practice. Caring is the heart of a nurse’s ability to work with people in a respectful and therapeutic way.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nursing Theories of Caring A. Culture Care Diversity and Universality Theory (Leininger) Based on transcultural nursing model Transcultural nursing: a learned branch of nursing that focuses on the comparative study & analysis of cultures as they apply to nursing and health- illness practices, beliefs, and values Goal of Transcultural Nursing: to provide care that is congruent with cultural values, beliefs, and practices. Cultures exhibit both diversity and universality Diversity – perceiving, knowing, and practicing care in different ways Universality – commonalities of care Fundamental Theory Aspects – culture, care, cultural care, world view, folk health or well-being systems COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Marilyn Ray’s theory on bureaucratic caring provides direction and guidance for nurses to understand the B. Theory of Bureaucratic Caring way caring is lived and expressed throughout the hospital organization. “Improved patient safety, infection control, reduction in medication errors, and overall quality of care in complex bureaucratic health care systems cannot occur without knowledge and understanding of spiritual-ethical caring, compassion and right action for all patients and professionals” (M. Ray, personal communication, April 13, 2008). Ray’s theory suggests that caring in nursing is contextual and is influenced by the organizational structure. For instance, a staff nurse who is primary involved in direct nursing care may have a different caring approach to a patient as compared to his chief nurse who is more concerned in the nursing system in the hospital.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. C. Caring, the Human Mode of Being Sister Simone Roach, (1992), states that caring is the human mode of being. Roach (1992) discusses how Roach (1992) posed an interesting question during people in healthcare professions care her work on caring. This question is: WHAT IS A for others not because they are NURSE ACTUALLY DOING WHEN HE OR SHE IS required to do so by their jobs, but CARING? because they are human beings and this trait of caring is intrinsic to all humans. The six C’s of caring have been developed by Simone Roach (2002) in response to this question. According to Roach (1992) caring is These six C’s are described as attributes of caring the underlying concept that forms the that aid in identifying the specific caring behaviors basis of what nurses do each and that a nurse engages in when providing care for a every day. patient.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Care 6 C’s OF CARING The first C of the 6 C’s is the Care. Caring characterizes both the profession and the people who work in it. It’s also vital to remember that persons receiving care will have different requirements and expectations at different phases of their lives. Hence, it’s necessary to adapt care to their specific needs and expectations. As a result, workers must constantly change their understanding of what constitutes quality care. Compassion Treating people with kindness, empathy, patience, and consideration is what Compassion is about. Individuals perceive their care as essential to how they are treated when they receive intelligent kindness.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Competence Comprehending people’s physical and mental health, utilizing the skills and expertise to understand patients’ needs is how competence is utilized in care. Communication Communication is the most critical in health and social care as this is the only way the health care provider will ever understand the needs and wants of the people they will be working for. Everyone has a different way of communicating; hence the care workers should adapt to the ways their clients or patients communicate. Listening is the first and foremost step of communication. Being a good and attentive listener can help the health care provider understand what the speaker is trying to convey.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Courage In health and social care, it is essential to have courage as the health care provider might have to face difficult situations or take challenging decisions. It needs the courage to speak up and express their concerns if they believe anything is being done unfairly or incorrectly. Also, the health care provider need the courage to innovate and attempt new approaches to their work. Commitment If the health care provider choose to work in health and social care settings, they must be exceptionally committed to their work. They must demonstrate commitment to each individual under their care to provide them with the best care and support. Additionally, continuous self-improvement is necessary to excel in this profession.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nursing as a Science: As a science, nursing practice is based on a body of knowledge and evidence-based practices that are continually changing with new discoveries and innovations. It is a basic science, just like biology. Biology is the study of life, whereas nursing science is the study of the principles and application of nursing. As a science it forms the scientific basis for professional nursing practice. The science of Nursing is the Pathophysiology, disease process, techniques learned during the nursing education and applied during patient care.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Through integration of the art and science of nursing, the quality of care you provide meets the highest standards and benefits patients and their families. Because nursing is both an art and a science, nursing practice requires a blend of current knowledge and practice standards with an insightful and compassionate approach to your patients’ health care needs.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Recipients of Nursing The recipients of nursing are sometimes called consumers, sometimes patients, and sometimes clients. A consumer is an individual, a group of people, or a community that uses a service or commodity. People who use healthcare products or services are consumers of healthcare. A patient is an individual who is waiting for or undergoing medical treatment and care. The word patient comes from a Latin word meaning “to suffer” or “to bear.”  COLLEGE OF NURSING Calayan Educational Foundation, Inc. A client is an individual who engages the advice or services of another who is qualified to provide this service. The term client presents the receivers of healthcare as collaborators in the care, that is, as people who are also responsible for their own health. Thus, the health status of a client is the responsibility of the individual in collaboration with health professionals.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nurses provide care for three types of clients: individuals, families, and communities. Nursing practice involves four areas: promoting health and wellness, preventing illness, restoring health, and caring for the dying.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Promoting Health and Wellness When health is defined broadly as actualization of human potential, it has been called wellness (Murdaugh, Parsons, & Pender, 2019, p. 12). Nurses promote wellness in clients who are both healthy and ill. This may involve individual and community activities to enhance healthy lifestyles, such as improving nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and preventing accidents and injury in the home and workplace.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Preventing Illness The goal of illness prevention programs is to maintain optimal health by preventing disease. Nursing activities that prevent illness include immunizations, prenatal and infant care, and prevention of sexually transmitted infections.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Restoring Health Restoring health focuses on the ill client, and it extends from early detection of disease through helping the client during the recovery period. Nursing activities include the following: Providing direct care to the ill individual, such as administering medications, baths, and specific procedures and treatments Performing diagnostic and assessment procedures, such as measuring blood pressure and examining feces for occult blood.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Caring for the Dying This area of nursing practice involves comforting and caring for people of all ages who are dying. Palliative care nurses are part of a medical team that focuses on providing relief from the symptoms and stress of a serious illness (e.g., cancer). The goal is to improve the quality of life for both the client and the family. A hospice nurse provides end-of life care by giving medical, psychologic, and spiritual support. The goal is to help people who are dying have peace, comfort, and dignity. Nurses carrying out these activities work in homes, hospitals, and extended care facilities.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Settings for Nursing In the past, the acute care hospital was the main practice setting open to most nurses. Today many nurses work in hospitals, but increasingly they work in clients’ homes, community agencies, ambulatory clinics, long-term care facilities, health maintenance organizations (HMOs), and nursing practice centers.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nurse Practice Acts Nurse practice acts, or legal acts for professional nursing practice, regulate the practice of nursing in the United States, with each state having its own act. Although nurse practice acts differ in various jurisdictions; they all have a common purpose: TO PROTECT THE PUBLIC. Nurses are responsible for knowing their state’s nurse practice act as it governs their practice.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Standards of Nursing Practice Establishing and implementing standards of practice are major functions of a professional organization. The Philippine Professional Nursing Practice Standards (Professional Regulatory Board of Nursing Resolution Nos. 22,series 2017) outlines the duties and competencies expected of all registered nurses regardless of role, population, or specialty. The standards aim to promote, guide, and direct professional nursing practice. They are used by nurses, employers, educators, the public, and regulatory bodies. The standards are based on nursing laws and have four domains: value-based nursing practice, knowledge-driven practice, outcome-oriented professional relationships, and leadership and governance. The standards took effect in 2018-2019.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. A. Value Based Nursing Practice Is a clinical decision- making process guided by empirical body of knowledge , ethico-moral values and practices, rules and regulations combined with appropriate competencies in client care reflecting personal and professional values when engaging with others of diverse culture. Standard A1. Care of Clients is the provision of professional nursing services to varied clients: individual across the lifespan with varying health-illness status and gender; to healthy or at- risk families, population group and communities.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Standard A2. Ethical, Moral and Legal Practice. Adherence to ethical, moral and legal standards in the provision of care. Ethical refers to the principle that encourage universal values such as trust, respect, fairness and benevolence. Moral refers to beliefs of what is right or wrong. Legal refers to conformity to the provision or relevant laws and jurisprudence.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Standard A3. Personal and Professional Values. Personal values are a set of individual’s principles, standards, concepts, beliefs and ideas that are internalized from the society or culture in which one lives. Professional values are beliefs and principles that guide nursing practice and which influence one’s work behavior. These are acquired through experience, education, training and practice considering but not limited by regulatory standards, Code of Ethics, and the core values of the nursing profession.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. B. Knowledge Driven Nursing Practice Standards Knowledge driven nursing practice refers to the consistent application of a scientific body of knowledge and skills through the integration of the different patterns of knowing (Carper, 1978) such as esthetic, ethics and personal relationships as bases for safe and sound judgment to appropriate care of clients. B1. Research is a scientific process that validate existing theories/ models and generates new knowledge to improve nursing practice, client outcomes, and health care delivery system. COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. B2. Evidenced Based Nursing Evidence-based practice is a problem-solving approach that integrates current best evidences, clinical expertise and client's preference and values in making decision towards promoting safe and quality nursing practice. B3. Continual Quality Improvement Continual Quality Improvement is the analysis of performance, monitoring of the outcome processes and application of strategies for the improvement of safe and quality nursing practice. COLLEGE OF NURSING Calayan Educational Foundation, Inc. B3 B2  COLLEGE OF NURSING Calayan Educational Foundation, Inc. C. Outcome- Oriented Professional Relationship Outcome-oriented professional relationship refers to intra- and inter- professional relationship that leads to an enhancement of one’s role through communication, collaboration and understanding of cultural context to achieve mutually-agreed upon outcomes for client care. C1. Communication is a relational process whereby messages are transmitted and understood by both the sender and the recipients using varied mode, skills and approaches including media and information technology with the goal to facilitate effective health care delivery.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. C2. Collaboration and Teamwork. Collaboration refers to the process where there is partnership among the health care professionals which is reciprocal and founded on respect and trust, considering each other’s expertise in achieving mutual goals. Teamwork is to “function effectively within nursing and interprofessional teams, fostering open communication, mutual respect and shared decision-making to achieve quality patient care.” ( American Association of Colleges of Nursing, 2013)  COLLEGE OF NURSING Calayan Educational Foundation, Inc. C3. Transcultural Nursing Care Transcultural Nursing Care is the provision of safe, efficacious, responsible and meaningful nursing service to people according to their culture values and health-illness context.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. D. Leadership and Governance Standard Leadership and Governance is influencing other people through the exercise of authority, direction, control and regulation in the practice of the nursing profession to achieve desired goals. D1. Personal and Professional Development this refers to the acquisition of knowledge and skills for ensuring that one’s performance in the chosen area of expertise is always at the highest possible level, in both career and life goals. COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. D2. Responsibility and Accountability Responsibility refers to the nurse’s obligations, accountability and liability in carrying out the authority accorded by the state through the Nursing Law and other regulatory laws, policies and rules. Accountability is the nurse’s willingness to be judged against performance expectation and live with the consequences of one’s action. COLLEGE OF NURSING Calayan Educational Foundation, Inc.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. D3. Positive Practice Environment Positive practice environment is one where the nurse performs in a supportive, safe, caring encouraging, and positively charged workplace where the individual’s potential are maximally developed. It includes the physical, psychological, socio-political, cultural, and spiritual dimensions of the work-setting.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. D4. Social Responsibility Social responsibility is an obligation to act in fulfilling one’s civic duty for the benefit of the society. The nurse is sensitive and responsive to the social, cultural, economic, political, spiritual and environmental issues. COLLEGE OF NURSING Calayan Educational Foundation, Inc. D5. Resource Management Resource management refers to the efficient and effective allocation of resources where and when they are needed and which include human , organizational, information, financial, technical, equipment, materials and physical resources.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Roles and Function of the Nurses Nurses assume a number of roles when they provide care to clients. Nurses often carry out these roles concurrently, not exclusively of one another. The roles required at a specific time depend on the needs of the client and aspects of the particular environment. The CAREGIVER ROLE has traditionally included those activities that assist the client physically and psychologically while preserving the client’s dignity. The required nursing actions may involve full care for the completely dependent client, partial care for the partially dependent client, and supportive-educative care to assist clients in attaining their highest possible level of health and wellness. Caregiving encompasses the physical, psychosocial, developmental, cultural, and spiritual levels.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. In the role of COMMUNICATOR, nurses identify client problems and then communicate these verbally or in writing to other members of the healthcare team. The quality of a nurse’s communication is an important factor in nursing care. The nurse must be able to communicate clearly and accurately in order for a client’s healthcare needs to be met. As a TEACHER, the nurse helps clients learn about their health and the healthcare procedures they need to perform to restore or maintain their health. The nurse assesses the client’s learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies, and measures learning.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. A CLIENT ADVOCATE acts to protect the client. In this role the nurse may represent the client’s needs and wishes to other health professionals, such as relaying the client’s request for information to the healthcare provider. They also assist clients in exercising their rights and help them speak up for themselves. The NURSE COUNSELOR counsels primarily healthy individuals with normal adjustment difficulties and focuses on helping the individual develop new attitudes, feelings, and behaviors by encouraging the client to look at alternative behaviors, recognize the choices, and develop a sense of control  COLLEGE OF NURSING Calayan Educational Foundation, Inc. The nurse acts as a CHANGE AGENT when assisting clients to make modifications in their behavior. Nurses also often act to make changes in a system, such as clinical care, if it is not helping a client return to health. Nurses are continually dealing with change in the healthcare system. A LEADER influences others to work together to accomplish a specific goal. The leader role can be employed at different levels: individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. The nurse manages the nursing care of individuals, families, and communities. The NURSE MANAGER also assigns and delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance. Nurse case managers work with the multidisciplinary healthcare team to measure the effectiveness of the case management plan and to monitor outcomes. Regardless of the setting, CASE MANAGER help ensure that care is oriented to the client, while controlling costs.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. Nurses RESEARCH CONSUMER often use research to improve client care. In a clinical area, nurses need to: (a) have some awareness of the process and language of research, (b) be sensitive to issues related to protecting the rights of human subjects, (c) participate in the identification of significant researchable problems, and (d) be a discriminating consumer of research findings.