Nursing Theory and Practice: A Comprehensive Study Guide PDF

Nursing Theory and Practice: A Comprehensive Study Guide ⚕️ Caring Sciences: The 6Cs and Beyond Defining Caring Sciences Caring Sciences: A distinct nursing discipline integrating the art and science of caring, emphasizing holistic patient care and the nurse's role in fostering well-being. It move...

Nursing Theory and Practice: A Comprehensive Study Guide ⚕️ Caring Sciences: The 6Cs and Beyond Defining Caring Sciences Caring Sciences: A distinct nursing discipline integrating the art and science of caring, emphasizing holistic patient care and the nurse's role in fostering well-being. It moves beyond simply treating illness to nurturing the whole person (body, mind, spirit). Key Aspects of Caring Science in Nursing: 1. Holistic Approach: Caring science views patients as whole beings, considering their body, mind, and spirit, as well as the environments in which they live. 2. Human Connection: It prioritizes authentic, empathetic relationships between nurses and patients, fostering trust and mutual respect. 3. Ethical Practice: Caring science emphasizes ethical commitment to the dignity and rights of individuals, promoting equity, respect, and justice in care delivery. 4. Healing Environment: Nurses create environments that support healing and well-being by addressing emotional and psychological comfort alongside physical health. 5. Theoretical Foundation: Many caring science frameworks are grounded in nursing theories, such as Jean Watson's Theory of Human Caring, which highlights concepts like the "caritas processes," intentional presence, and the importance of love and kindness in care. 6. Integration of Evidence-Based Practice: Caring science integrates empirical knowledge with the intuitive and aesthetic aspects of nursing, ensuring care is both scientifically grounded and personally meaningful. 7. Focus on Self-Care: It acknowledges the importance of nurse self-care, as nurses who are mindful of their own well-being are better able to provide compassionate care to others. TOUCH Touch is a fundamental aspect of the nursing profession, serving as both a practical tool and a profound means of communication. Its importance lies in its ability to convey care, build trust, and support healing beyond words. Importance of Touch in Nursing 1. Physical Care and Procedures: ○ Touch is essential for physical assessments (e.g., checking pulse, palpating for abnormalities, or measuring blood pressure). ○ It is used to perform nursing interventions like wound care, assisting with mobility, or administering treatments. 2. Emotional Support:  ○ Touch, such as holding a patient’s hand or a reassuring pat on the shoulder, conveys empathy, comfort, and presence. ○ It helps reduce anxiety and fear, especially during distressing situations. 3. Building Trust: ○ Appropriate and intentional touch fosters trust and connection, enhancing the therapeutic relationship between nurses and patients. ○ It reassures patients of the nurse’s commitment to their well-being. 4. Healing and Comfort: ○ Studies have shown that touch can activate the release of endorphins and reduce stress hormones, promoting relaxation and comfort. ○ Therapeutic touch techniques (e.g., massage or healing touch) may enhance pain management and emotional well-being. 5. Communication in Non-Verbal Situations: ○ Touch can serve as a vital communication tool when patients are unable to speak due to illness, disability, or language barriers. ○ It conveys compassion and understanding when words are insufficient. 6. Cultural Sensitivity and Boundaries: ○ While touch is universally impactful, its meaning varies across cultures. Nurses must be aware of cultural preferences and individual boundaries to ensure that touch is respectful and appropriate. 7. Self-Awareness for Nurses: ○ Nurses must be mindful of their own intentions and the context in which touch is used, ensuring it is always professional, ethical, and patient-centered. Challenges and Considerations: Misinterpretation: Misunderstanding the intent of touch can create discomfort or distrust. Infection Control: Physical contact must follow hygiene protocols to prevent cross-contamination. Consent: Nurses should seek consent before physical contact, particularly in sensitive situations. MacEwan BScN Philosophy Being Individuals, families, communities, organizations & planet Unique, knowledgeable, and self-determining Have the right to respect and dignity Embodiment (in- and with- the world) Well-being = non-binary, relational, and embodied A distinct body of knowledge Full potential  The journey of authentic Knowing Dynamic and continuous pursuit Multiple truths and perspectives Contexts may be ambiguous and in constant flux Caring Sciences utilizes ontological, anthropological, epistemological, and pedagogical knowing Complexity Science provides a framework for sense-making and decision-making Deep knowing for self-critique and critical reflection Doing Expressing authentically Discovering shared-meaning when we are in relationship Creating and sustaining brave spaces Collaborating – capacity and capability Engaging in interdisciplinary and intersectoral approaches Navigating organizational processes Mitigating structural barriers Transforming through nursing science Types of Truth 1. Objective Truth ○ Definition: Objective truth refers to facts or realities that are independent of personal feelings, perceptions, or biases. It exists regardless of individual perspectives or interpretations. ○ Characteristics: Universally applicable and verifiable. Based on observable phenomena, scientific evidence, and logical reasoning. ○ Example: "Water boils at 100°C at sea level." This is a fact that holds true regardless of who observes it or where it is observed. 2. Subjective Truth ○ Definition: Subjective truth is based on personal experiences, perspectives, emotions, or interpretations. It varies from person to person and is shaped by individual beliefs and feelings. ○ Characteristics:  Personal and influenced by individual experiences. Cannot be universally verified because it depends on the person perceiving it. ○ Example: "Chocolate ice cream is the best flavor." This statement is true for one person but not necessarily for everyone. 3. Normative Truth ○ Definition: Normative truth refers to what is considered "true" according to societal norms, values, or ethical standards. These truths often guide behaviors and are shaped by cultural, social, or moral beliefs. ○ Characteristics: Shaped by social or ethical standards. Can vary by culture, time, and place. ○ Example: "Honesty is the best policy." While generally accepted as a moral truth in many cultures, it can differ based on context or cultural values. 4. Complex Truth ○ Definition: Complex truths involve truths that are multifaceted, involve multiple perspectives, or are difficult to pin down due to their intricacies. These truths often require deeper exploration or understanding of various factors. ○ Characteristics: Multi-layered, involving various elements or viewpoints. May evolve over time as more information becomes available. ○ Example: "Climate change is a global issue." This is a complex truth, influenced by scientific, political, economic, and social factors, and its understanding may shift as new data or perspectives emerge. KNOWINGS Axiology (Study of Values) Definition: Axiology is the branch of philosophy that studies values, including ethics and aesthetics. In Nursing: ○ Guides what is considered important, valuable, or desirable in care delivery. ○ Shapes the moral compass of nursing, influencing decisions like respecting patient autonomy or providing equitable care. ○ Examples include valuing compassion, dignity, and respect in patient interactions. Epistemology (Study of Knowledge) Definition: Epistemology examines the nature, sources, and limits of knowledge. In Nursing: ○ Focuses on how knowledge is acquired, validated, and applied in practice. ○ Includes evidence-based practice, where decisions are informed by rigorous research and clinical expertise. ○ Examines both objective knowledge (scientific) and subjective knowledge (experiential and relational). Ontology (Study of Being) Definition: Ontology explores the nature of existence, being, and reality. In Nursing: ○ Addresses questions about the essence of health, illness, and the human experience. ○ Examines the nature of patients as holistic beings with interconnected physical, emotional, and spiritual dimensions. ○ Informs the philosophy of care, emphasizing the individuality and complexity of each patient. Key Differences Between Spirituality and Religion Aspect Spirituality Religion Personal vs. Shared Primarily personal and Often shared, communal, and individualized institutionalized Structure Flexible and less formalized Structured with rituals, doctrines, and practices Beliefs More open to personal Defined by established doctrines or interpretation sacred texts Purpose Focused on personal growth Focused on worship, community, and and enlightenment adherence to religious laws Practice Meditation, self-reflection, Worship, prayers, sacred rituals, mindfulness holidays Relationship with Can be with a higher power, Typically involves belief in a personal the Divine nature, or the universe god or gods  Inclusivity Can be open to various Often adheres to specific religious philosophies and practices traditions 🔬 Nature of Nursing Knowledge: Nursing Science as Critical NURSING SCIENCE - “The science of nursing is the application of theory to practice.... Through liberal arts, nurses learn to analyze, problem-solve, think critically, and communicate. Through science, nurses bring forward knowledge of anatomy & physiology, chemistry, microbiology, psychology, and sociology.” Purpose of a Discipline The purpose of any discipline is to generate, organize, and disseminate knowledge. In nursing, this involves developing specialized knowledge to inform practice, guide research, and contribute to societal well-being. Advanced Concepts: Discuss the epistemology of nursing knowledge and the different ways of knowing in nursing (e.g., empirical, ethical, personal, aesthetic, and emancipatory). Five Criteria for a Profession A profession is characterized by: Specialized knowledge: A well-defined body of knowledge grounded in theory and research. Education and training: Formal education and rigorous training to achieve competency. Autonomy: Authority to make independent decisions within expertise. Service orientation: Focus on serving the public and enhancing societal well-being. Ethical code: Adherence to ethical guidelines and professional standards. Key Differences Between Nursing and Medicine Nursing emphasizes holistic care, considering the individual's experience and relationship with health and well-being. Medicine focuses on curing diseases and treating physical conditions based on diagnostic evidence. Embodiment in Nursing Embodiment: The integration of body, mind, and spirit in both the nurse and the patient. Care should address these interconnected aspects. Kintsugi as Embodiment in Nursing and Human Healing Kintsugi provides a lens to see physical, emotional, and spiritual wounds not as marks of failure but as opportunities for growth, transformation, and meaning. It resonates deeply with holistic and compassionate approaches to care. Practical Applications in Nursing 1. Trauma-Informed Care: ○ Viewing patients' emotional and psychological wounds through the lens of kintsugi can encourage compassionate, nonjudgmental care. ○ Helps patients integrate past trauma into their healing process. 2. Chronic Illness and Disability: ○ Kintsugi’s philosophy can inspire patients to see chronic conditions or disabilities as part of their unique narrative, not as limitations. 3. Nurse Self-Care: ○ Nurses, too, experience emotional fatigue, mistakes, and personal hardships. Kintsugi encourages self-compassion and the idea that healing creates strength and wisdom. 4. Spiritual and Holistic Healing: ○ Incorporating kintsugi's philosophy into spiritual or palliative care can help patients and families find meaning in suffering and loss. What is Nursing? Who is a Nurse? Nursing is both an art and a science, focusing on the care of individuals, families, and communities to achieve, maintain, or recover optimal health and quality of life. A nurse is a caregiver, advocate, educator, and critical thinker committed to patient-centered care, using both intuition and evidence-based practice. Advanced Concepts: Discuss the evolving definition of nursing and the expanding roles of nurses in various healthcare settings. HEALING VS CURING Curing: Eliminating disease or symptoms, typically focused on the physical aspect of health. Healing: A broader concept encompassing emotional, spiritual, and psychological recovery, emphasizing the restoration of balance and well-being. Key Differences Aspect Curing Healing Scope Disease-focused Holistic (mind, body, spirit) Goal Eliminate illness Restore balance and well-being  Approach Biomedical, technical Relational, humanistic Measurement Objective (tests, outcomes) Subjective (personal experience) Applicability Often disease-specific Applies even without disease What is Nursing Theory? Nursing theory is a structured framework of concepts, definitions, relationships, and assumptions that explain or guide nursing practice. It provides a foundation for nursing as a discipline by helping nurses understand their role, the purpose of their work, and the nature of care delivery. Purpose of Nursing Theory: 1. Guides Practice: Provides evidence-based principles for patient care. 2. Enhances Knowledge: Contributes to the body of nursing knowledge by organizing concepts and ideas. 3. Improves Communication: Establishes a common language for nurses and healthcare teams. 4. Supports Education: Frames curricula and learning objectives in nursing education. 5. Drives Research: Offers hypotheses and frameworks for scientific exploration in nursing. Patterns of Knowing in Nursing First introduced by Barbara Carper (1978), the Patterns of Knowing identify the multiple ways nurses acquire and apply knowledge. These patterns are crucial for holistic and effective care. 1. Empirical Knowing: The Science of Nursing Definition: Focuses on objective, factual, and evidence-based knowledge derived from research and science. Features: 1. Evidence-Based: Grounded in scientific research and clinical guidelines. 2. Objective: Relies on measurable and observable phenomena. 3. Systematic: Follows structured methods for acquiring and validating knowledge. 4. Predictive: Enables prediction of patient outcomes based on empirical data. 5. Generalizable: Knowledge can often be applied across different patient populations and settings. Example: Using evidence-based protocols to manage hypertension. 2. Ethical Knowing: The Moral Dimension  Definition: Centers on moral principles, values, and ethical decision-making in nursing. Features: 1. Value-Driven: Informed by ethical codes (e.g., ANA Code of Ethics). 2. Normative: Guides what should be done in morally complex situations. 3. Individualized: Considers the patient’s values, beliefs, and autonomy. 4. Reflective: Requires self-awareness and moral reasoning. 5. Justice-Oriented: Addresses fairness, equality, and advocacy for vulnerable populations. Example: Respecting a patient’s decision to refuse treatment. 3. Personal Knowing: The Interpersonal Dimension Definition: Involves self-awareness, empathy, and authentic relationships between nurse and patient. Features: 1. Relational: Builds trust and understanding in nurse-patient interactions. 2. Self-Aware: Encourages nurses to recognize their biases and emotions. 3. Empathetic: Seeks to deeply understand the patient’s experiences and feelings. 4. Dynamic: Evolves with ongoing relationships and experiences. 5. Authentic: Prioritizes genuine human connection. Example: Listening empathetically to a patient’s fears about surgery. 4. Aesthetic Knowing: The Art of Nursing Definition: Reflects the creative, intuitive, and individualized aspects of nursing care. Features: 1. Creative: Adapts care approaches to meet unique patient needs. 2. Holistic: Sees the patient as a whole person, not just their condition. 3. Intuitive: Draws on deep understanding and experience to anticipate needs. 4. Subjective: Based on perception and interpretation of each unique situation. 5. Expressive: Often involves non-verbal forms of care, like creating a comforting environment. Example: Using music therapy to soothe a patient with anxiety. 5. Sociopolitical Knowing: Contextual Awareness- White 1995 Definition: Focuses on understanding the social, cultural, economic, and political factors influencing health and healthcare. Features: 1. Contextual: Considers broader societal influences on health. 2. Advocacy-Oriented: Encourages nurses to advocate for systemic changes and equitable care. 3. Culturally Competent: Recognizes the impact of cultural differences on health beliefs and practices. 4. Macro-Level: Extends beyond the individual to address community and population health. 5. Policy-Aware: Involves understanding healthcare policies and their implications.  Example: Addressing health disparities in marginalized communities. 6. Unknowing: Openness to Discovery- Munhall 1993 Definition: Emphasizes humility and openness to not having all the answers, fostering genuine curiosity and learning. Features: 1. Humble: Acknowledges the limitations of the nurse’s knowledge. 2. Explorative: Invites new perspectives and patient narratives. 3. Non-Judgmental: Creates space for understanding the patient without preconceived notions. 4. Dynamic: Adapts as new information and insights emerge. 5. Patient-Centered: Prioritizes the patient’s lived experience as a source of knowledge. Example: Listening to a patient’s story about their illness without imposing assumptions. 7. Synoptic Knowing: Integration of All Patterns- Purnell 2009 Definition: Combines all patterns of knowing into a cohesive, holistic understanding of patient care. Features: 1. Integrative: Draws on empirical, ethical, personal, aesthetic, and sociopolitical knowing. 2. Holistic: Addresses the multifaceted needs of the patient. 3. Comprehensive: Considers both the micro-level (individual patient) and macro-level (societal context). 4. Contextual: Tailors care based on the specific circumstances and patient preferences. 5. Flexible: Adapts seamlessly to the dynamic nature of nursing practice. Example: Using scientific knowledge, ethical reasoning, cultural awareness, and empathy to provide compassionate, evidence-based care to a patient with complex needs. Emancipatory Knowing: The Critical and Transformative Dimension - Chinn & Kramer 2008 Definition: Emancipatory knowing focuses on the identification, understanding, and transformation of social, political, and economic conditions that create inequalities and oppressions in healthcare. It seeks to challenge and change societal structures that limit individuals' ability to access care or achieve health equity. Features of Emancipatory Knowing: 1. Critical Consciousness: ○ Definition: The awareness of and reflection on societal structures that perpetuate inequality and oppression. ○ Feature: Nurses engage in reflective thinking to identify and question social injustices, focusing on how these impact patient care and health outcomes.  ○ Example: Understanding how systemic racism or classism influences access to healthcare and addressing these issues in practice. 2. Empowerment: ○ Definition: Empowering individuals or communities to gain control over their health and well-being by challenging oppressive forces. ○ Feature: Nurses promote patient autonomy, enabling patients to make informed decisions about their care, especially in situations where they may feel marginalized or powerless. ○ Example: Supporting a patient from a low-income background to access resources that help them make better healthcare choices. 3. Social Justice: ○ Definition: Advocating for fairness and equity in healthcare systems and society at large. ○ Feature: Nurses work to eliminate social barriers and advocate for policies that create equitable opportunities for all patients, regardless of their socio-economic status, race, or other factors. ○ Example: Lobbying for health policy changes that ensure healthcare access for all populations, particularly underserved communities. 4. Reflection on Structural Inequities: ○ Definition: The practice of analyzing the societal and institutional factors that contribute to health inequities and working toward addressing them. ○ Feature: Emancipatory knowing requires nurses to understand the root causes of health disparities and take action to change the structures that perpetuate those disparities. ○ Example: A nurse working in a rural area notices limited access to healthcare services and becomes involved in advocating for improved infrastructure and services for that population. 5. Collective Action: ○ Definition: Working collaboratively to address systemic issues that affect health, with the goal of bringing about societal change. ○ Feature: Emancipatory knowing encourages nurses to engage in collective action with other healthcare professionals, community members, and policymakers to drive change. ○ Example: Nurses joining with community activists to advocate for better healthcare policies for marginalized groups, such as immigrants or Indigenous populations. Application of Emancipatory Knowing in Nursing: Empowerment of Patients: Nurses using emancipatory knowing seek to help patients understand the broader social forces affecting their health, empowering them to advocate for themselves and make informed decisions about their care. Advocating for Health Equity: Nurses address health disparities by advocating for policies that promote fair distribution of healthcare resources and the removal of barriers to access.  Social Transformation: Emancipatory knowing inspires nurses to be agents of change, using their voice and position to challenge injustices within the healthcare system and society. Example of Emancipatory Knowing in Practice: A nurse working in a community health clinic notices that many of her patients are unable to access treatment due to language barriers and lack of transportation. She uses emancipatory knowing to not only provide immediate care but also to advocate for the hiring of bilingual staff and the implementation of transportation services for patients. She also works with local community leaders and policymakers to address these systemic issues, improving healthcare access for the entire community. Paradigm vs. Metaparadigm in Nursing Paradigm: A paradigm is a worldview or framework that influences how we understand phenomena in a discipline. In Nursing: It shapes how nurses view health, patients, and care delivery. Examples: ○ Nightingale's environmental paradigm. ○ The holistic paradigm focusing on mind-body-spirit connections. Metaparadigm: The metaparadigm is a broader conceptual framework encompassing the central concepts of a discipline. In Nursing, it consists of four core concepts: 1. Person: The individual receiving care, including their needs and preferences. 2. Health: The state of well-being or wellness. 3. Environment: The physical, social, and cultural factors affecting health. 4. Nursing: The actions, skills, and processes that promote care. Difference: A metaparadigm provides the overarching framework for a discipline, while paradigms are specific worldviews or approaches within that framework. McGill Model of Nursing The McGill Model of Nursing was developed by Madeleine Leininger and Mildred Blanchard in the 1970s at the McGill University School of Nursing in Montreal, Canada. This model emphasizes a health promotion and holistic approach to nursing, with a focus on individuals and families. It views nursing not just as a response to illness, but as an ongoing process of supporting and promoting the health of individuals across their life span. Core Concepts of the McGill Model of Nursing: 1. Health as the Focus of Care: ○ The model emphasizes health promotion rather than just illness care. Health is seen as a dynamic state of well-being that can be fostered through support and education. ○ It recognizes that health is a continuous process that involves personal and environmental factors and is not merely the absence of disease. 2. The Role of the Family: ○ The family plays a central role in the model. Nursing care focuses on families as the primary unit of care, and the relationship between family members is seen as integral to an individual's health. ○ The family’s strengths and weaknesses are acknowledged, and nurses work alongside families to enhance their health and well-being. 3. Nursing as a Helping Process: ○ Nurses in the McGill Model act as partners with patients and their families to help them promote and maintain their health. ○ The model is founded on collaboration, where the nurse helps individuals identify health challenges and empower them to develop solutions. 4. Focus on Strengths: ○ A key feature of the model is its emphasis on strengths-based care, where nurses work with individuals and families to identify existing strengths and resources. The goal is to build on these strengths to enhance health and prevent illness. ○ This approach promotes resilience and positive change. 5. Holistic Care: ○ The McGill Model takes a holistic view of the individual, recognizing that physical, emotional, social, and environmental factors all play a role in health. ○ Nurses assess not only the patient’s physical needs but also their emotional, social, and spiritual needs. 6. Health Promotion and Education: ○ Nurses are seen as educators who work with families and individuals to promote healthy behaviors and lifestyle choices. ○ Health education is a primary nursing intervention, where nurses help individuals and families develop skills and knowledge to enhance their health. Key Elements of the McGill Model: 1. Assessment of Health Needs: ○ Nurses assess the health needs of individuals and families by considering the full context of their lives, including cultural, social, and environmental factors. 2. Health Promotion: ○ Health promotion is central to the model. Nurses provide interventions that encourage healthy living, illness prevention, and the enhancement of well-being. 3. Strengths and Resources: ○ Nurses identify and build on the existing strengths and resources of individuals and families to improve their health. This empowers patients and encourages active participation in their care.  4. Nurse-Patient Partnership: ○ The relationship between nurse and patient is collaborative. Nurses work with patients to set realistic health goals and provide support in achieving them. Application of the McGill Model in Practice: Family-Centered Care: Nurses focus on the health of the entire family rather than just the individual patient. For example, a nurse might work with a family whose child has a chronic illness, helping them learn how to manage the child’s condition while also promoting the well-being of the entire family unit. Health Promotion: In a community setting, nurses might organize health education programs to help people understand the importance of nutrition, exercise, and mental health, encouraging healthier lifestyles. Strengths-Based Approach: Nurses working with a patient recovering from surgery may focus on the patient’s physical resilience, positive mindset, and supportive social network to enhance recovery and prevent complications. Perspectives: 1. Objective 2. Subjectve 3. Inductive 4. Deductive Sense Making in Nursing Sense making in nursing is the process by which nurses interpret, understand, and respond to complex situations in clinical practice. It involves making informed decisions by synthesizing patient data, contextual factors, and clinical judgment to provide appropriate care. Key Features: 1. Interpretation of Complex Information: Nurses interpret clinical data and patient symptoms to form a coherent understanding of the patient’s condition. 2. Contextual Understanding: Nurses consider the broader context (e.g., social, cultural, environmental factors) in care decisions. 3. Problem-Solving and Decision-Making: Nurses make decisions based on available information, often under uncertainty or with incomplete data. 4. Reflection and Adaptation: Nurses reflect on their decisions, adapting care as new information becomes available. 5. Collaborative Process: Nurses work with the healthcare team, integrating multiple perspectives to develop a comprehensive care plan. 6. Managing Uncertainty: Nurses use intuition, experience, and evidence to make decisions in situations of ambiguity or unpredictability. Critical Thinking in Nursing Critical thinking in nursing is the process of actively analyzing, synthesizing, and evaluating information to make sound clinical decisions. It involves applying reasoning and evidence-based knowledge to solve problems, improve patient care, and ensure safety. Key Features: 1. Analysis: Examining patient data and situations to identify problems or patterns. 2. Evaluation: Assessing the credibility and relevance of information to make informed decisions. 3. Inference: Drawing conclusions based on evidence, experiences, and clinical judgment. 4. Problem-Solving: Developing and implementing solutions for patient care issues. 5. Reflection: Evaluating past decisions to improve future practice. LEVELS OF CRITICAL THINKING Basic Critical Thinking: Description: The initial level of critical thinking, where nurses rely on rules, procedures, and guidelines. Characteristics: ○ Thinking is concrete and focused on specific tasks. ○ Nurses follow established protocols and guidelines without questioning them. ○ Decisions are based primarily on facts and basic information. Example: A nurse following a prescribed medication dosage chart without considering the individual patient’s unique needs. Complex Critical Thinking: Description: At this level, nurses start to recognize that there may be multiple ways to approach a situation and consider alternatives. Characteristics: ○ Nurses analyze and evaluate information from multiple sources. ○ Decision-making involves consideration of different factors such as patient preferences, context, and evidence. ○ Nurses develop solutions based on clinical judgment and critical analysis. Example: A nurse analyzing a patient’s lab results, considering their medical history, and adjusting care plans to address specific needs rather than just following protocol. Commitment Critical Thinking: Description: At this level, nurses make independent decisions, taking full responsibility for their actions and outcomes. Characteristics: ○ Nurses make choices based on critical evaluation of the situation, experience, and evidence. ○ They stand by their decisions and are willing to take responsibility for their outcomes.  ○ Reflect on the results to improve future decision-making. Example: A nurse independently deciding to intervene in a deteriorating patient’s condition, despite it not being part of the usual protocol, based on their clinical judgment and experience. Nursing Process The nursing process is a systematic, problem-solving approach used by nurses to deliver individualized care. It involves five key steps: 1. Assessment: ○ Nurses gather comprehensive information about the patient's health status, including physical, emotional, social, and cultural factors. ○ Tools: Health history, physical examination, diagnostic tests, and patient interviews. 2. Diagnosis: ○ Nurses analyze assessment data to identify nursing diagnoses, which are clinical judgments about a patient’s responses to health conditions. ○ Example: Diagnosing a patient with "Risk for Infection" based on surgical site and immune status. 3. Planning: ○ Nurses set measurable and realistic goals and outcomes, developing a care plan that outlines interventions and timelines. ○ Example: Goal: "Patient will show signs of healing in the surgical wound within 7 days." 4. Implementation: ○ Nurses carry out the interventions specified in the care plan. This may include administering medications, providing education, and collaborating with the healthcare team. ○ Example: Administering prescribed antibiotics and educating the patient on wound care. 5. Evaluation: ○ Nurses assess the effectiveness of the care plan by evaluating patient outcomes and adjusting the plan as needed. ○ Example: If the patient’s wound does not heal as expected, the nurse may revise the care plan to address new issues. NCSBN's Clinical Judgment Measurement Model (CJMM) Recognize Cues: Description: Nurses gather and identify relevant patient data, including observations, physical assessments, and clinical information. Example: A nurse notices that a patient is unusually lethargic and has a low-grade fever. Analyze Cues:  Description: After recognizing cues, nurses analyze the gathered information to understand its significance. This involves identifying patterns, comparing data, and synthesizing the information to assess the patient’s condition. Example: The nurse correlates the fever with the patient’s recent surgery, considering it as a possible sign of infection. Prioritize Hypotheses: Description: Nurses develop potential hypotheses (diagnoses or concerns) based on the analyzed cues. They then prioritize which issues require immediate attention and intervention. Example: The nurse prioritizes the potential for infection over other less urgent concerns because untreated infections could lead to more serious complications. Generate Solutions: Description: Nurses consider different possible interventions or actions based on the prioritized hypotheses. They generate solutions that are appropriate for the patient’s needs. Example: The nurse decides to administer antibiotics, take blood cultures, and monitor the patient’s temperature closely. Take Action: Description: Nurses implement the selected interventions to address the identified problems, ensuring that actions are evidence-based and in line with best practices. Example: The nurse administers the prescribed antibiotics and informs the physician about the patient’s deteriorating condition. Evaluate Outcomes: Description: Nurses assess the effectiveness of the interventions and reflect on the results to determine whether patient outcomes align with the desired goals. Example: The nurse monitors the patient’s response to treatment, checks for improvement, and adjusts the care plan accordingly if the patient’s condition does not improve. Two-Eyed Seeing Two-Eyed Seeing is a concept developed by Mi’kmaq elder Albert Marshall, which calls for the integration of both Indigenous knowledge and Western scientific knowledge. It is a way of seeing the world with two "eyes," one that views the world through Indigenous ways of knowing and one that views it through Western scientific perspectives. The goal is to use both ways of knowing to enrich understanding and solve problems, creating a more holistic approach to issues like health, education, and environmental sustainability. Indigenous Eye: Focuses on community, relationship, and connection to the land, with a holistic and spiritual understanding of the world. Western Eye: Focuses on objective, empirical, and evidence-based reasoning, often emphasizing linear thinking and individualism. The concept of Two-Eyed Seeing emphasizes collaboration, mutual respect, and the complementary strengths of both knowledge systems. Indian Act The Indian Act is a Canadian law that was first passed in 1876 and governs many aspects of the lives of Indigenous peoples, including land management, education, and governance. The act was designed to control and assimilate Indigenous peoples into European-style systems. It imposed policies that disrupted traditional Indigenous governance structures, prohibited cultural practices (such as the potlatch and sun dance), and controlled Indigenous land and resources. Over time, the Indian Act has been a source of tension and oppression, and calls for its repeal or reform continue. Despite amendments over the years, it remains a controversial piece of legislation that many see as a tool of colonialism. TRC Call to Action The Truth and Reconciliation Commission (TRC) of Canada was established in 2008 to address the legacy of the residential school system, which sought to assimilate Indigenous children by forcibly removing them from their families and communities. The TRC issued 94 Calls to Action in 2015, which outline steps for Canadian society to take in order to redress the impacts of colonization and support reconciliation with Indigenous peoples. These calls cover areas such as education, justice, child welfare, language revitalization, and public awareness. Some key Calls to Action include: Education: Ensuring that the history and impacts of residential schools are taught in schools and universities. Health: Improving access to health care services for Indigenous communities, particularly in areas of mental health and wellness.  Justice: Addressing the over-representation of Indigenous people in the criminal justice system. Commemoration: Preserving the stories and memories of residential school survivors and ensuring these histories are known and recognized by all Canadians. Five Principles to Engender Cultural Safety & Humility Protocols Personal knowledge Partnerships Process Positive purpose ✊ Understanding Social Location and Anti-Racism/Discrimination Activism Defining Key Terms Discrimination: Unfair or prejudicial treatment of people based on their race, age, gender, sexual orientation, or other characteristics. Anti-racism: Active opposition to racism and systemic inequalities. It involves challenging racist ideologies and structures and promoting equity and justice. Racism: Prejudice, discrimination, or antagonism directed against a person or people on the basis of their membership in a particular racial or ethnic group, typically one that is a minority or marginalized. Advanced Concepts: Explore the historical and systemic roots of racism. Systemic Discrimination: Discrimination embedded in social structures and institutions. It's not just individual prejudice but patterns of inequality built into systems. Cultural Safety, Humility, and Competence Cultural Safety: is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care. Cultural Humility: is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience. Cultural Competence: The ability to understand and appreciate cultural differences and provide culturally appropriate care. Advanced Concepts: Discuss the limitations of a solely competence-based approach and the importance of humility and safety. Social Location as a Fluid Concept Social Location: The complex interplay of factors (race, class, gender, sexual orientation, etc.) that shape an individual's experiences and perspectives. It's not static but changes over time. Advanced Concepts: Explore the concept of intersectionality and how multiple social locations intersect to create unique experiences of oppression and privilege. Strategies for Anti-Racism/Discrimination Activism Individuals can engage in anti-racism/discrimination activism through: Education: Learning about systemic inequalities and challenging one's own biases. Advocacy: Speaking out against discrimination and supporting marginalized groups. Allyship: Standing in solidarity with marginalized groups and working to dismantle systems of oppression. Community engagement: Participating in community initiatives that promote social justice. Political action: Advocating for policies and legislation that promote equity and justice. Sister Marie Simone Roach Sister Marie Simone Roach is a prominent figure in the development of caring theory in nursing. Her work has been influential in defining caring as the essence of nursing practice. Roach articulated six C's of caring, which outline the essential components of caring in nursing: Compassion: The ability to recognize, understand, and respond to the suffering of others. Competence: The ability to provide quality care that is grounded in knowledge, skills, and the willingness to learn. Confidence: The assurance in one's ability to provide compassionate and competent care. Conscience: Being guided by a sense of moral integrity and responsibility in nursing practice. Commitment: A dedication to providing continuous care that prioritizes the patient’s well-being. Comportment: The behavior, demeanor, and professional conduct exhibited by the nurse that communicates caring and respect for others. The 7th C: Communion Communion: A deeper connection with the patient, fostering a sense of shared humanity and mutual respect. It involves entering into the patient's world and understanding their unique experiences. Advanced Concepts: Explore the spiritual dimension of care and the role of the nurse in supporting patients' spiritual needs. Relational Incompetence Relational Incompetence: The intentional failure to intervene in problematic healthcare situations involving incompetent colleagues, failing to educate, support, or report them to management. This highlights the ethical responsibility of nurses to advocate for safe patient care. Advanced Concepts: Analyze the systemic factors that contribute to relational incompetence and strategies for addressing them. Patient and Nurse Outcomes of a Caring Science Approach Adopting a caring science approach leads to positive outcomes for both patients and nurses: Outcome Category Patient Outcomes Nurse Outcomes Physical Improved physical health, reduced pain, faster recovery Reduced physical strain, improved physical well-being Emotional Increased emotional well-being, reduced anxiety Reduced emotional exhaustion, increased job satisfaction Spiritual Enhanced sense of purpose, improved spiritual well-being Increased sense of purpose, improved spiritual well-being Relational Stronger nurse-patient relationships Improved teamwork, stronger professional relationships 🌈 Embracing a Humanistic Approach for Inclusivity Understanding Sexual Identity and Expression Sexual Identity: An individual's self-perception of their sexual orientation (e.g., heterosexual, homosexual, bisexual, asexual). Advanced Concepts: Explore the fluidity of sexual identity and the impact of societal norms on self-perception. Sexual Expression: How an individual expresses their sexuality. This can encompass a wide range of behaviors and preferences. Advanced Concepts: Discuss the diversity of sexual expression and the importance of respecting individual choices. Heteronormativity in Healthcare Heteronormativity: The assumption that heterosexuality is the default or preferred sexual orientation. This can lead to several negative consequences in healthcare: Exclusion and marginalization of LGBTQ2+ individuals: LGBTQ2+ patients may feel unsafe or unwelcome in healthcare settings. Lack of culturally competent care: Healthcare providers may lack the knowledge and skills to provide appropriate care for LGBTQ2+ patients. Reinforcement of harmful stereotypes and biases: Heteronormative assumptions can perpetuate negative stereotypes and biases about LGBTQ2+ individuals. Strategies to Foster Inclusivity Nurses can adopt several strategies to foster inclusivity in their practice: Use inclusive language: Avoid gendered language and use person-first language.  Respect pronouns and names: Always ask for and use a person's preferred pronouns and name. Create a safe and welcoming environment: Ensure that all patients feel safe and welcome, regardless of their sexual orientation or gender identity. Educate yourself: Learn about LGBTQ2+ health issues and cultural considerations. Advocate for change: Advocate for policies and practices that promote inclusivity in healthcare. 🏥 Quality Practice Environments Components of the Health Professions Act (2000) The Health Professions Act (2000) outlines the framework for regulating health professionals. Key components include: Registration: The process of becoming a licensed professional. Discipline: The process of addressing professional misconduct. Continuing competence: The requirement for ongoing professional development. Restricted activities: Activities that only licensed professionals can perform. Differences Between Nursing Organizations Different nursing organizations play distinct roles in promoting quality practice environments: CRNA (College of Registered Nurses of Alberta): Focuses on regulation and public protection. ANA (Alberta Nurses Association): Advocates for nurses' interests and promotes professional development. UNA (United Nurses of Alberta): Represents nurses' collective bargaining rights and working conditions. Self-Regulation in Nursing Self-regulation: The process by which nurses govern their own profession, ensuring quality of care and public safety. This involves setting standards of practice, enforcing ethical codes, and addressing professional misconduct. Advanced Concepts: Discuss the benefits and challenges of self-regulation and its impact on professional autonomy. Scope of Practice: Influencing Factors An RN's scope of practice is influenced by several factors: Legislation: Laws and regulations governing nursing practice. Public policy: Government policies related to healthcare. Employer policy: Policies of the healthcare organization where the nurse works. Practice setting: The specific context of nursing practice. Evidence: Research and evidence-based practice guidelines.  Education/Knowledge: The nurse's level of education and knowledge. Personal level of competency: The nurse's individual skills and abilities. 👩‍⚕️ Professional Identity Defining Professional Identity Professional Identity: A nurse's self-perception as a professional, encompassing their values, beliefs, and sense of purpose. It's shaped by education, experience, and interactions with colleagues and patients. Advanced Concepts: Explore the concept of professional socialization and its impact on the development of professional identity. Components of Professional Identity Key components of professional identity include: Values: The principles that guide a nurse's actions and decisions. Beliefs: The nurse's convictions about the nature of nursing and its role in society. Sense of purpose: The nurse's understanding of their role and contribution to patient care. Competencies: The skills and abilities required for effective nursing practice. Professional behaviors: The nurse's conduct and interactions with colleagues and patients. Commitment to lifelong learning: The nurse's dedication to ongoing professional development. Developing Professional Identity Nursing students can actively develop their professional identity through: Reflection: Regularly reflecting on their experiences and learning. Mentorship: Seeking guidance and support from experienced nurses. Networking: Connecting with other nurses and building professional relationships. Professional development: Engaging in ongoing learning and professional development activities. Clinical practice: Gaining practical experience and applying theoretical knowledge. ⚖️ Ethical Knowing as Political Action Ethics vs. Morals Ethics: Rules provided by a social system. Morals: Personal principles regarding right and wrong. Advanced Concepts: Explore the relationship between ethics and morals in nursing practice and the influence of societal values and personal beliefs on ethical decision-making. Key Ethical Concepts Agency: The capacity of individuals to act independently and make their own choices. Courage: The willingness to act in the face of adversity or opposition. Dilemma: A situation where there are two or more conflicting ethical principles. Distress: The emotional suffering experienced by nurses when they are unable to provide the care they believe is ethically right. Disengagement: The process of withdrawing from ethical conflicts due to feelings of powerlessness or frustration. Agent: An individual who acts on behalf of others. Overall Goal: Ethical (or moral) well-being; congruence between thought and action. Advanced Concepts: Explore the concept of moral distress and its impact on nurses' well-being. Discuss strategies for addressing moral distress and promoting ethical practice. Values Clarification Values Clarification: A process of identifying and prioritizing personal values. This is crucial for ethical decision-making. Advanced Concepts: Discuss the role of values clarification in resolving ethical dilemmas and promoting ethical practice. Four Principles of Bioethics Autonomy: Respect for patient's right to make informed decisions. Beneficence: Duty to act in the best interest of the patient. Nonmaleficence: Duty to avoid harm. Justice: Fairness and equity in the distribution of resources. Advanced Concepts: Analyze complex ethical dilemmas involving these principles and the application of ethical frameworks. Professional Relationships: Ethical Considerations Veracity: Truthfulness. Fidelity: Commitment and loyalty. Privacy: Respect for patient's physical body and information. Confidentiality: Protecting patient information. Advanced Concepts: Discuss the legal and ethical implications of breaching confidentiality and strategies for maintaining patient privacy. Ethical Decision-Making Models The Oberle and Raffin model is a useful framework for ethical decision-making: 1. Assess the situation, relationships, goals, beliefs, and values. 2. Reflect on potential actions and their values. 3. Select an ethical action maximizing the good. 4. Engage in the ethical action. 5. Reflect on and review the ethical action. 🗣️ Relational Inquiry & Critical Reflection Emotional Intelligence Emotional Intelligence: The ability to understand and manage one's own emotions and the emotions of others. This is crucial for effective communication and building relationships. Advanced Concepts: Explore the different components of emotional intelligence and their application in nursing practice. Relational Practice Relational Practice: A nursing approach emphasizing the importance of relationships in providing care. Key elements include: authenticity, connection, humanism, intentionality, mutuality, reflexivity, shared discovery of meaning, and the importance of the other. Advanced Concepts: Discuss the philosophical underpinnings of relational practice and its implications for nursing education and research. Continuum of Awareness: Reflection, Reflexivity, and Critical Reflection Reflection: Thinking about an experience after it has occurred. Reflexivity: Examining one's own beliefs, feelings, and actions in relation to the experience. Critical Reflection: Identifying, questioning, and assessing power dynamics and social structures that shape the experience. Advanced Concepts: Discuss the different levels of reflection and their application in developing critical consciousness and promoting social justice. Relational Inquiry Relational Inquiry: An approach to research and practice that emphasizes the importance of relationships and the interconnectedness of individuals and their environments. Advanced Concepts: Explore the different methodologies used in relational inquiry and its application in various research settings. Cultural Humility Cultural Humility: A process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Advanced Concepts: Discuss the importance of cultural humility in addressing health inequities and promoting culturally safe care. ✊🏽 Emancipatory Justice; Nursing Activism Social vs. Moral Justice Social Justice: Fair distribution of resources and addressing root causes of inequities. Moral Justice: Ethical commitment to humanity and sacred activism. Emancipatory Knowing Emancipatory Knowing: Acknowledging social and political injustice, realizing things could be different, and using experience and context to improve people's lives. It integrates all five patterns of knowing (empirical, ethical, personal, aesthetic, and emancipatory). Praxis for Building Solidarity Praxis: The integration of theory and practice to effect change. It involves critical reflection, action, and ongoing evaluation. PEACE (Praxis, Empowerment, Awareness, Cooperation, Evolvement) is a framework for building solidarity. Bearing Witness in Nursing Bearing Witness refers to the act of being present, attentive, and empathetic in the care of others, especially in situations of suffering, pain, or injustice. Nurses who bear witness are deeply engaged in the lives of their patients, offering compassionate care and emotional support, even in difficult circumstances. It is an acknowledgment of the suffering of others, without judgment or intervention, while providing care that respects the dignity of the individual. The Role of Nurses: Nurses bear witness to patients’ experiences of illness, trauma, and suffering. This allows them to understand the emotional and psychological dimensions of care, not only focusing on the physical aspects but also on the human experience. Nurse-Patient Relationship: Bearing witness fosters a deeper connection between the nurse and patient, as it emphasizes empathy and validation of the patient's experience. It also encourages nurses to reflect on their own emotions and responses to the suffering they witness. Nurse Activism and Strategies Nurse Activism: Nurses engaging in advocacy and action to promote social justice and health equity. Strategies include:  Advocating for policy changes: Working to influence healthcare policies that promote equity and justice. Community organizing: Building coalitions and working with community partners to address health inequities. Research and knowledge translation: Conducting research to inform policy and practice and translating research findings into action. Education and awareness-raising: Educating the public and healthcare professionals about social justice issues. Direct action: Engaging in direct action to challenge injustice and promote change. 🕰️ Historical Nurses: The Good & The Ugly Early Healers Early nursing practices involved healers, wise women/men, and religious orders. These individuals provided care based on traditional knowledge and practices. Advanced Concepts: Explore the historical context of early nursing practices and the evolution of nursing as a profession. Key Historical Figures and Their Contributions Several nurses have made significant contributions to the profession: Rufaida bint Saad Al-Aslameya: A 7th-century nurse known for her public health work and ethical practice. Became a distinguished healer. First Ethicist. First nurse in Islamic history who set up a tent outside the Prophet’s mosque. Mary Seacole: A Jamaican nurse who provided care during the Crimean War. Despite facing racial prejudice and challenges in gaining acceptance from the British Army, she independently traveled to Crimea to establish a hospital and provide care. Her courage, determination, and expertise have made her an iconic figure in nursing history, particularly in promoting the importance of holistic care and resilience in nursing. Florence Nightingale: Often called the founder of modern nursing, Florence Nightingale revolutionized healthcare by introducing sanitary practices in hospitals, significantly reducing mortality rates. She is credited with formalizing nursing education and using statistics to advocate for healthcare reforms. Her work established nursing as a recognized profession and influenced healthcare policies worldwide. Sojourner Truth: An abolitionist and women's rights activist, Sojourner Truth contributed to nursing by advocating for the care of African American soldiers during the Civil War. She was a pioneering voice for racial equality and women's empowerment, which intersected with healthcare and nursing, encouraging the inclusion of African American women in the healthcare workforce. Charlotte Edith Anderson Monture: The first Indigenous woman to vote, also a nurse and midwife. Her role in breaking barriers and representing Indigenous nurses paved the way for others, helping to bridge the gap in healthcare delivery to Indigenous communities.  Bernice Redmon: A public health nurse in Nova Scotia. Black nurse who significantly contributed to the advancement of nursing education and the improvement of healthcare services for marginalized communities. She was instrumental in advocating for civil rights within nursing and healthcare, and her legacy continues to inspire nurses who fight for equity and justice in healthcare settings. Rosemarie Riddell: A gay activist and nurse who changed policy regarding HIV/AIDS. The "Ugly" Side of Nursing: White Privilege and Systemic Racism The history of nursing is intertwined with systemic racism and white privilege. This has resulted in significant inequities in healthcare access and quality for marginalized communities. Advanced Concepts: Explore the historical and ongoing impact of colonialism and racism on Indigenous communities and people of color. Discuss the role of nursing in perpetuating and challenging systemic inequalities. Strategies for a Just and Equitable Future To address racism and promote equity in nursing, we need: Decolonizing nursing history: Challenging Eurocentric narratives and recognizing the contributions of nurses from diverse backgrounds. Addressing systemic racism: Working to dismantle systems of oppression and promote equitable access to healthcare. Promoting cultural safety and humility: Creating healthcare environments where all individuals feel safe and respected. Anti-racist education and training: Integrating anti-racism education into nursing curricula and professional development programs. Advocacy and activism: Engaging in advocacy and activism to promote social justice and health equity. Quality Practice Environments The Health Professions Act (2000) This act provides a regulatory framework for health professionals, ensuring the safe and competent delivery of care. Its key components are: Registration: Sets the criteria for becoming a health professional. This ensures only those who meet specific education and skill standards are allowed to practice. Discipline: Establishes procedures to address professional misconduct or violations, safeguarding the public and maintaining the profession's integrity. Continuing Competence: Mandates ongoing education and skill development to ensure professionals stay updated with advancements in their fields. Restricted Activities: Identifies high-risk tasks that only trained professionals can perform, such as administering controlled substances or invasive procedures. Differences Among CRNA, ANA, and UNA CRNA (College of Registered Nurses of Alberta): ○ Primary focus: Public safety and regulatory standards. ○ Role: Develops entry-level competencies, practice guidelines, and ethical standards to ensure safe nursing care. ANA (American Nurses Association): ○ Primary focus: Advocacy for nurses and professional development. ○ Role: Promotes nursing through policy development, education, and advancing standards. UNA (United Nurses of Alberta): ○ Primary focus: Labor rights and working conditions. ○ Role: Acts as a union for Alberta nurses, negotiating salaries, benefits, and workplace conditions. Key Difference: CRNA emphasizes regulation for public safety, ANA focuses on professional advocacy, and UNA centers on labor rights and member welfare. Self-Regulation in Nursing Self-regulation allows nurses to: Autonomy: Make decisions independently based on professional judgment. Public Trust: Maintain credibility by adhering to ethical and professional standards. Quality Care: Ensure consistent improvement in skills and knowledge, directly impacting patient outcomes. Self-regulation reinforces nurses' responsibility for their actions and encourages lifelong learning to meet evolving healthcare needs. Scope of Practice The scope of practice defines what nurses can and cannot do, influenced by: 1. Legislation: Legal frameworks like the Health Professions Act that outline permissible activities. 2. Public Policy: Broader healthcare policies that impact nursing responsibilities. 3. Employer Policies: Organizational rules that may restrict or expand nursing roles. 4. Evidence: Research and data that inform best practices. 5. Education/Knowledge: The nurse's formal training and certifications. 6. Personal Competency: Individual skills and experience levels that vary by nurse. Professional Identity The concept of professional identity is multifaceted: Pro Argument: A strong identity fosters pride, a sense of belonging, and advocacy for the profession. It motivates nurses to uphold standards and contribute to the profession’s growth. Con Argument: A rigid identity can exclude diverse perspectives and stifle innovation. It may deter nurses from integrating new approaches or collaborating across disciplines. Conclusion: A balanced approach that values both a strong nursing identity and inclusivity can enhance collaboration and patient care. Practical Case Studies The document includes scenarios to help students analyze their scope of practice: Case Study #1: Involves assisting a post-surgery patient. Nursing students must understand their limitations, such as the inability to administer medication independently. Case Study #2: Focuses on a sensitive situation with a patient receiving Medical Assistance in Dying (MAiD). It challenges students to navigate ethical considerations and their professional boundaries, such as avoiding tasks beyond their competency (e.g., starting an IV). These cases highlight the importance of understanding one’s scope of practice, ethical principles, and cultural sensitivity. Quality Practice Environments Factors contributing to a supportive nursing environment include: Leadership: Strong leaders guide and support nursing teams. Collaboration: Effective teamwork enhances care quality. Mentorship and Support: Experienced nurses mentoring others fosters skill development. Ongoing Education: Opportunities to learn and grow are vital for maintaining competence. Work-Life Balance: A balance reduces burnout and enhances job satisfaction. Monetary Incentives: Competitive pay, benefits, and funding for education attract and retain talent. These elements collectively create an environment where nurses can thrive and deliver optimal patient care. Professional Organizations and Resources The document lists several organizations essential for nursing professionals: CRNA: Provides guidelines, position statements, and practice advice specific to Alberta nurses. CNSA: Offers leadership opportunities and support for nursing students at the national level. UNA: Advocates for nurses' rights in Alberta, focusing on workplace conditions and legal representation. CNA (Canadian Nurses Association): Provides national-level advocacy and educational resources. These organizations support nurses through education, advocacy, and professional development. Facts to Memorize 1. Caring Sciences: Integrates art and science of caring, focusing on holistic patient well-being. Key theories include Watson's and Roach's. 2. 6Cs of Caring: Compassion, Competence, Conscience, Commitment, Comportment, Confidence. 3. 7th C: Communion: Deeper connection with patient, shared humanity, mutual respect. 4. Relational Incompetence: Intentional failure to address incompetent colleagues, jeopardizing patient safety. 5. Heteronormativity: Assumption of heterosexuality as default, marginalizing LGBTQ2+ individuals in healthcare. 6. Strategies for Inclusivity: Inclusive language, respecting pronouns/names, creating safe environments, education, advocacy. 7. Health Professions Act (2000): Registration, discipline, continuing competence, restricted activities. 8. Nursing Organizations: CRNA (regulation), ANA (advocacy), UNA (collective bargaining). 9. Self-Regulation: Nurses govern their profession, ensuring quality and public safety. 10. Scope of Practice Factors: Legislation, public/employer policy, practice setting, evidence, education, competency. 11. Professional Identity: Self-perception as a professional, encompassing values, beliefs, purpose, competencies, behaviors, and lifelong learning. 12. Social Justice: Fair resource distribution, addressing inequity root causes. 13. Moral Justice: Ethical commitment to humanity, sacred activism. 14. Emancipatory Knowing: Acknowledging injustice, envisioning change, using experience to improve lives. 15. Praxis: Integrating theory and practice for change (PEACE framework). 16. Nurse Activism: Advocacy and action for social justice and health equity (policy changes, community organizing, research, education, direct action). 17. Cultural Safety: Creating safe, respectful environments regardless of cultural background. 18. Cultural Humility: Lifelong commitment to self-reflection and learning about other cultures. 19. Cultural Competence: Understanding and appreciating cultural differences to provide appropriate care. 20. Social Location: Interplay of factors shaping individual experiences (race, class, gender, etc.). It's fluid and changes over time.