Definition of Nursing PDF

# DEFINITIONS IN NURSING The word nurse originated from the Latin word *nutrix*, meaning "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, and aged people. With the expanding roles and fun...

# DEFINITIONS IN NURSING The word nurse originated from the Latin word *nutrix*, meaning "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, and aged people. With the expanding roles and functions of the nurse in today's society, however, any one definition may be too limited. The International Council of Nurses (2002) captures much of what nursing means in its definition: * Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. * Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health system management, and education are also key nursing roles. The American Nurses Association (ANA) describe the values and social responsibility of nursing, provides a definition and scope of practice for nursing, discusses nursing's knowledge base, and describes the methods by which nursing is regulated within its nursing's social policy statement (2003). Within the definition, nurses focus on human experiences and responses to birth, health, illness, and death within the context of individuals, families, groups and communities. The knowledge base for nursing practice includes diagnosis, intervention, and evaluation of outcomes from an established plan of care. In addition, the nurse integrates objective data with knowledge gained from an understanding of the patient's or group's subjective experience, applies scientific knowledge in the nursing process, and provides a caring relationship that facilitates health and healing. Florence Nightingale defined nursing nearly 150years ago as "the act off utilizing the environment of the patient to assist him in his recovery" (1860/1969). Nightingale considered a clean, well-ventilated, and quiet environment essential for recovery. Often considered the first nurse theorist, Nightingale raised the status of nursing through education. Nurses were no longer untrained housekeepers but people educated in the care of the sick. Virginian Henderson (1966)was one of the first modern nurses who define nursing as "the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if had the necessary strength, will, or knowledge, and to do this in such a way as to help him gain independence as rapidly as possible”. Like Nightingale, Henderson describes nursing in relation to the client and the client's environment. Unlike Nightingale, Henderson saw the nurse as concerned with both healthy and ill individuals acknowledge that nurses interact with client even when recovery may not be feasible, and mentioned the teaching and advocacy roles of the nurse. The central focus of all definitions of nursing is the patient (the person receiving care) and includes the physical, emotional, social and spiritual dimensions of that person. Nursing is no longer considered to be concerned primarily with illness care. Nursing's concepts and definitions have expanded to include the prevention of illness and the promotion and maintenance of health for individuals, families and communities. ## Aims of nursing Four broad aims of nursing practice can be identified in the definitions of nursing: 1. To promote health 2. To prevent illness 3. To restore health 4. To facilitate coping with disability or death To meet these aims, the nurse uses knowledge, skills, and critical thinking to give care in a variety of traditional and expanding nursing roles. Nurses use four essential competencies: * Cognitive * Technical * Interpersonal * Ethical/legal ### Cognitive Cognitively skilled nurses think about the nature of things sufficiently to "make sense" of their world and to grasp conceptually what is necessary to achieve valued goals. Cognitively skilled nurses are able to accomplish the following: 1. Offer a scientific rationale for the patient's plan of care. 2. Select those nursing interventions that are most likely to yield the desired outcomes. 3. Use critical thinking to solve problems creatively. ### Technical Technically skilled nurses manipulate equipment skillfully to produce a desired outcome or result. Technical competence involves everything from manual dexterity and good eye-hand coordination to an ability to trouble shoot when equipment malfunctions, based an understanding of the technical workings of the equipment. Technically skilled nurses are able to accomplish the following: 1. Use technical equipment with sufficient competence and ease to achieve goals with minimal distress to participants involved. 2. Creatively adapt equipment and technical procedures to the needs of individual patients in diverse circumstances. ### Interpersonal Interpersonally skilled nurses establish and maintain caring relationships that facilitate the achievement of valued goals while simultaneously affirming the worth of those in the relationship. Nurses skilled in interpersonal relations are able to accomplish the following: 1. Use interactions with patients, their significant others, and colleagues to affirm their worth. 2. Elicit their strengths and abilities of patients and their significant others to achieve valued health goals. 3. Provide the health care team with knowledge about the patient's valued goals and expectations. 4. Work collaboratively with other members of the health care team as a respected and credible colleague to reach valued goals. ### Ethical/legal Ethically and legally skilled nurses conduct themselves in a manner consistent with their personal moral code and professional role responsibilities. Nurses skilled in ethical/legal competence are able to accomplish the following: 1. Be trusted to act in ways that advance the interests of patients. 2. Be accountable for their practice to themselves, the patients they serve, the care giving team, and society. 3. Act as effective patient advocates. 4. Mediate ethical conflicts among the patients, significant others, the health care team, and other interested parties. 5. Practice nursing faithful to the tenets of professional codes of ethics and appropriate standards of practice. 6. Use legal safeguards that reduce the risk of litigation. The primary role of the nurse as caregiver is given shape and substance by the interrelated roles of communicator, teacher, counselor, leader, researcher, advocate, and collaborator. ## Promoting health Health is a state of optimal functioning or well-being. As defined by the WHO, one's health includes physical, social, and mental components and is not merely the absence of disease or infirmity. Health is often a subjective state – a person may be medically diagnosed with an illness but still consider himself or herself healthy. Wellness, a term that is often associated with health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health. Health is an essential part of each of the other aims of nursing. Nurses promote health by identifying, analyzing, and maximizing each patient's own individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death. Health promotion is motivated by the desire to increase a person's wellbeing and health potential. A person's level of health is affected by many different interrelated factors that either promote health or increase the risk for illness. These factors include genetic inheritance, cognitive abilities, educational level, race and ethnicity, culture, age and gender, developmental level, lifestyle, environment and socioeconomic status. A level of health or wellness is also strongly influenced by what is termed "health literacy." Health literacy, (defined by the US department of health and human services in the document healthy people 2010,)is the ability of patients to obtain, process, and understand the basic information needed to make appropriate decisions about health. Healthy people 2010, also establishes health promotion guidelines for the nation as a whole. The guidelines are focused on meeting two overarching goals: 1. To increase quality and years of healthy life. 2. To eliminate health disparity. ## Preventing illness The objectives of illness prevention activities are to reduce the risk for illness, to promote good health habits, and to maintain optimal functioning. The motivation for illness prevention is to avoid or achieve early detection of illness, or maintain function within the constraint of an illness. Nurses prevent illness primarily by teaching and by personal example. Such activities include the following: 1. Educational programs in areas such as prenatal care for pregnant women, smoking-cessation programs, and stress reduction seminars. 2. Community programs and resources that encourage healthy lifestyles, such as aerobic exercise classes, “swimnastics,” and physical fitness programs. 3. Literature, television, radio, or internet information on a healthy diet, regular exercise, and the importance of a good health habits. 4. Health assessments in institutions, clinics, and community settings that identify areas of strength and risk for illness. ## Restoring health Activities to restore health encompass those traditionally considered to be the nurse responsibility. These focus on the individual with an illness and range from early detection of a disease to rehabilitation and teaching during recovery. Such activities include the following: 1. Performing assessments that detect an illness (e.g. taking blood pressure, measuring blood sugars). 2. Referring questions and abnormal findings to other health care providers as appropriate. 3. Providing direct care of the person who is ill by such measures as giving physical care, administering medications, and caring out procedures and treatments. 4. Collaborating with other health care providers in providing care. 5. Planning, teaching, and carrying out rehabilitation for illnesses such as heart attacks, arthritis, and strokes. 6. Working in mental health and chemical-dependency programs. ## Facilitating coping with disability and death Although the major goals of health care are promoting, maintaining, and restoring health, these goals cannot always be met. Nurses also facilitate patient and family coping with altered function, life crisis and death. Altered function decreases an individual's ability to carry out activities of daily living and expected roles. Nurses facilitate an optimal level of function through maximizing the person's strength and potentials, though teaching and through referral to community support systems. Nurses provide care to both patients and families during end- of -life- care, and they do so in hospitals, long term care facilities, and homes. Nurses are active in hospice programs, which assist patients and their families in preparing for death and in living as comfortably as possible until death occurs. ## ROLES AND FUNCTIONS OF THE NURSE Nurses assume a number of roles when they provide care to clients. Nurses often carry out these roles concurrently, not exclusively of one another. For example, the nurse may act as a counselor while providing physical care and teaching aspect of that care. The roles required at a specific time depend on the needs of the client and aspects of the particular environment. ### Caregiver The caregiver role as 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 client in attaining their highest possible level of health and wellness. Care giving encompasses the physical, psychosocial, developmental, cultural and spiritual levels. The nursing process provides nurses with a framework for proving care. A nurse may provide care directly or delegate it to other care givers. ### Communicator Communication is integral to all nursing roles. Nurses communicate with the client, support persons, other health professionals, and people in the community. In the role of communicator, nurses identify client problems and then communicate it verbally or in writing to other members of the health 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 health care needs to be met. ### Teacher As a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health. The nurse assesses the client's learning needs and readiness to learn, set specific learning goals in conjunction with the client, enact teaching strategies, and measures learning. Nurses also teach unlicensed assistive personnel (UAP) to whom they delegate care, and they share their expertise with other nurses and health professionals. ### Client advocate A client advocate act to protect the client. In this role the nurse may represent the client's need and wishes to other health professionals, such as relaying the client's request for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves. ### Counselor Counseling is the process of helping a client to recognize and cope with stressful psychological or social problems, to help improve interpersonal relationships, and to promote personal growth. It involves providing emotional, intellectual, and psychological support. The nurse counsels primarily healthy individuals with normal adjustment difficulties and focuses on helping the person develop new attitudes, feeling, and behaviors by encouraging the client to look at alternative behaviors, recognize the choices, and develop a sense of control. ### Change agent 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 health care system. Technological change, change in the age of the client population, and changes in medications are just a few of the changes nurses deal with daily. ### Leader 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 client, colleagues or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people, the knowledge to apply the leadership skills, and the interpersonal skills to influence others. ### Manager The nurse manages the nursing care of individuals, families, and communities. The nurse manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance. Managing requires knowledge about organizational structure and dynamics, authority and accountability, leadership, change theory, advocacy, delegation, and supervision and evaluation. ### Case manager Nurse case managerswork with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes. Each agency or unit specifies the role of the nurse case manager. In some institutions, the case manager works with primary or staff nurses to oversee the care of a specific case load. In other agencies, the case manager is the primary nurse or provides some level of direct care to the client and family. Insurance companies have also developed a number of roles for nurse case managers, and responsibilities may vary from managing acute hospitalizations to managing high cost clients or case types. Regardless of the setting, case manager help ensure that care is oriented to the client, while controlling cost. ### Research consumer Nurses often use research to improve client care. In a clinical area, nurses need to: 1. Have some awareness of the process and language of research. 2. Be sensitive to issues related to protecting the rights of human subjects. 3. Participate in the identification of significant researchable problems and 4. Be a discriminating consumer of research findings. ### Expanded career roles Nurses are fulfilling expanded career roles, such as those of nurse practitioner, clinical nurse specialist, nurse midwife, nurse educator, nurse researcher, and nurse anesthetist, all of which allow greater independence and autonomy. ## THE VIRTUES OF NURSES Virtues are human excellencies, cultivated dispositions of character and conduct that motivate and enable us to be good human beings. Clinical virtues enable nurses to provide good care to patients. While there is no official list of essential virtues of nurses, the following virtues are frequently named: * Competence * Compassionate caring * Subordination of self interest to patient care * Self effacement * Trustworthiness * Conscientiousness * Intelligence * Practical wisdom * Humility * Courage * Integrity Since these human qualities cannot be “put on” the way one puts on uniform or identity badge, it is important that they are part of the nurse's character, part of who the nurse is. They form an important basis of what allows patients to trust us!