Nursing Fundamentals Chapter 1 PDF

Nursing Today NUR 300 Chapter 1  Objectives 1. Explain how nursing standards affect nursing care. 2. Discuss the development of professional nursing roles. 3. Describe the roles and career opportunities for nurses. 4. Discuss the influence of social, politic...

Nursing Today NUR 300 Chapter 1  Objectives 1. Explain how nursing standards affect nursing care. 2. Discuss the development of professional nursing roles. 3. Describe the roles and career opportunities for nurses. 4. Discuss the influence of social, political, and economic changes on nursing practices. 5. Discuss how advances in nursing science and evidence-based practice improve patient care. 6. Compare and contrast the educational programs available for professional registered nurse (RN) education. 7. Explain how professional nursing organizations affect both the profession and the standards of care. 8. Explain how theory is used in nursing practice. 9. Review selected nursing theories and shared theories from other disciplines.  Nursing as a Profession Patient-centered care iii Patient = individuals, families, and/or communities Patients have variety of health care needs, knowledge, experiences, vulnerabilities, & expectations Professionalism - Nursing is not just a collection of specific skills, and you are not just a person trained to perform specific tasks. Nursing is a profession Quality care in a safe, prudent, & knowledgeable manner Responsible & accountable to yourself, patients, & your peers 9y p pities g t iotvioualizeteinganaorocate im if ag Foryourpatient  Nursing as a Profession Nursing is a profession because nursing: Requires an extended education Required college/university courses to complete general education requirements Requires a body of knowledge Use a theoretical body of knowledge that guides you to develop skills & define abilities & practice according Provides a specific service to others Has autonomy in decisions Incorporates a code of ethics a Tfds pursing Ideas of rightandwrong  Professional Responsibilities Nurses are responsible for obtaining and maintaining specific knowledge and skills. In the past: professional Yelton'sb your To provide care and comfort Now: To provide care and comfort and to emphasize health promotion and illness prevention To meet these needs, nurses must demonstrate their ability to be autonomous and accountable Professional Roles isto1Scott Path Explains's Isent  Standards of Practice Nursing standards provide guidelines for implementing and evaluating nursing care. Six standards of practice: Assessment What are the Problems identification Diagnosis 6 standards of entithenursing Outcomes identification p.liE5 Planning Implementation Evaluation  ANA – 18 Standards of Professional Performance Nursing Process Ethics Advocacy (1-6)Ttilizingit Respectful & keystateholders I es Communication Collaboration Equitable Practice Alwaysbe seekingknowledge Leadership Education Scholarly Inquiry Areyouusingyourresources Professional Practice correctly Resource Quality of Practice Evaluation Stewardship Environmental Health  Code of Ethics Philosophical ideals of right & wrong that define principles used to provide care. Important to incorporate your own values & ethics into your practice. Ask yourself: How do your ethics, values, & practice compare with established standards?  Nursing Practice Nurses practice in a variety of settings. Nurses: Protect, promote, & optimize our patients’ health Prevent illness & injury Alleviate suffering through diagnosis and treatment of human responses Advocate for the care of our patients Things all nurses do regardless of your position  Nursing Practice Nurse Practice Acts - State Boards of Nursing oversees landan nnotdo y Regulate scope of nursing practice & protect public health, safety, & welfare Specify training needed for APRNs Licensure - RN candidates must pass the NCLEX-RN - standardized examination for all candidates Certification – Minimal practice requirements are set, based on the certification the nurse is seeking. Common certification is for medical-surgical nurse, diabetic nurse educator, gerontological nurse, & many more.  Nursing Practice Science and art of nursing practice A lgtYouhave caringcompassion sympathy Benner’s stages of nursing proficiency: Novice - Beginning nursing student or any nurse entering a situation in which there is no previous level of experience Advanced beginner – Nurse who has had some level of experience with the situation Competent – Nurse who has been in the same clinical position for 2 to 3 years. Proficient – Nurse with more than 2 to 3 years of experience in the same clinical position Expert – Nurse with diverse experience who has an intuitive grasp of an existing or potential clinical problem  Quality and Safety Education for Nurses (QSEN) Patient-Centered Care – Recognize pt. or designee as source of control & full partner in providing compassionate & coordinated care based on respect for patient’s preferences, values, & needs. Teamwork and Collaboration - Function effectively within nursing & interprofessional teams, fostering open communication, mutual respect, & shared decision making to achieve quality patient care. Evidence-Based Practice - Integrate best current evidence with clinical expertise&d patient/family preferences and values for delivery of optimal health care.  Quality and Safety Education for Nurses (QSEN) Quality Improvement - Use data to monitor outcomes of care processes & use improvement methods to design & test changes to continuously improve quality & safety of health care systems. HowdoweImprove Howdowegetbetter Safety - Minimize risk of harm to patients & providers through both system effectiveness & individual performance Informatics - Use information & technology to communicate, manage knowledge, mitigate error, & support decision making  Historical Perspective Highlights Nurses: Respond to needs of patients Responds to health care needs of society - influenced by economic, social, & cultural variables of a specific era. Actively participate in policy Respond & adapt to challenges - As health care system changes, the art, science, & practice of nursing evolves Make clinical judgments and decisions about patients’ health care needs based on knowledge, experience, & standards of care Nursing: Care is provided according to standards of practice & a code of ethics.  Where did we come from? Nursing Pioneers Florence Nightingale believed that the role of nurses was to help the body recover & remain free from disease. The first practicing epidemiologist. Improved sanitation in battlefield hospitals, showed how effective fresh air, hygiene, & nutrition were in the treatment of wounded soldiers. Organized the first school of nursing Practices she advocated remain a basic part of nursing care in the twenty- first century. Health & illness are two components of nursing Nursing is separate & distinct from medicine Nutrition is important to health Occupational & recreational therapy is important in illness Continuing education in nursing is important Maintenance of accurate records – recognized as the beginnings of nursing research Nursing Pioneers Served during Civil War, tended to soldiers on battlefield Clara Barton Founder of the American Red Cross Served during Civil War, supervised female nurses in Dorothea Dix Union Army Advocate for reform of treatment of mentally ill Founder of public nursing Lillian Wald Established Henry Street Settlement to care for the poor Established ambulance nursing services for wounded Mary Breckenridge soldiers on battlefield Established one of the first nurse midwifery schools in US Served in Crimean War Mary Jane Seacole Known for herbal remedies and folk medicine Nurse and abolitionist, joined Union Army during Civil War Harriet Tubman Active in the underground railroad movement  The Twentieth Century Movement toward developing a scientific, research-based defined body of knowledge and practice Military nursing Study of nursing education and first professors of nursing Professional nursing associations Specialty nursing organizations (AACN, ENA, etc.)  Twenty-First Century Nursing code of ethics Code of ethics revised periodically to reflect current ethical issues that affect nursing practice Changes in curriculum - Nursing curriculum continues to change to meet changing societal needs. Nursing in multiple care settings outpatientsettings Advances in technology and informatics erecoros End-of-life care - end-of-life care & practices brought into nursing curricula and professional continuing education programs  Contemporary Influences Importance of nurses’ self-care and resilience preventingerrors Rising health care costs Demographic changes culturaldiversity Medically underserved of gettin Eeyhed Health Care Reform Affects how health care is paid for & delivered- greater emphasis on health promotion, disease prevention, & illness management More services will be in community-based care settings, schools, homes, and senior centers Nurses need be skilled at assessing for resources, service gaps, and how patients adapt to return to their communities  Nursing Education - Undergraduate Professional registered nurse education 2-year associate’s degree - Basic sciences & theoretical/clinical courses related to practice of nursing 4-year baccalaureate degree - Focuses on basic sciences & theoretical/clinical courses, as well as social sciences, arts, & humanities, to support nursing theory Graduates of both programs eligible to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) to become RNs in the state in which they will practice. Continuing and in-service education - You will continue to develop or learn additional knowledge, skills, & competencies necessary for the practicing registered nurse.  Nursing Education – Master’s Degree Master’s Degrees in Nursing Advanced practice registered nurse (APRN) Clinical nurse specialist (CNS) - Expert clinician in specialized area of practice: population (e.g., geriatrics), setting (e.g., critical care), disease specialty (e.g., diabetes), type of care (e.g., rehabilitation), or type of problem (e.g., pain). Nurse practitioner (NP) – Provide primary, acute, and specialty health care to patients of all ages and in all types of health care settings.Directpatientcare Certified nurse-midwife (CNM) - Educated in midwifery & certified by American College of Nurse-Midwives. Provide full range of primary health services for women from adolescence beyond menopause. Certified registered nurse anesthetist (CRNA) - Advanced education from nurse anesthesia–accredited program. Provide surgical anesthesia and pain services under the guidance & supervision of an anesthesiologist who is a physician with advanced knowledge of surgical anesthesia. Other Master’s Degree Options in Nursing Nurse Educator, Nurse Administrator, Nurse Leader, Nurse Informaticist Nursing Education – Doctoral Degree Doctoral Degrees in Nursing PhD in Nursing – research-focused doctorate Doctor of Nursing Practice (DNP) – practice-focused doctorate Doctoral degrees are currently optional for APRNs but may be required in the future  Nursing Theory wedothethingswe need why todo a Theory is the foundation for the art and science of nursing. Theory, research, and practice are bound together in a continuous interactive relationship. Theory generates nursing knowledge for use in practice, thus supporting evidence-based practice (EBP). Theory-based nursing practice helps you to design and implement nursing interventions that address individual and family responses to health problems. Goal of nursing knowledge: to explain the practice of nursing as different and distinct from the practice of medicine, psychology, and other health disciplines 1 98 91 sureganPANP In medicine, providers diagnose and treat disease In nursing, nurses diagnoses and treat human responses to actual or potential health problems 0 holisticperspective sin Who this thepatientholisticly  y Theory Helps explain an event by Defining ideas or concepts Explaining relationships among the concepts Predicting outcomes Nursing theory Is a conceptualization of some aspect of nursing Describes, explains, predicts, and/or prescribes nursing care Offer a framework for assessing patient situations Helps you recognize and analyze cues that emerge from data Helps to identify the focus, means, and goals of practice Enhance communication and accountability for patient care Shared theories (from other disciplines, used in nursing) Basic human needs (Maslow) Developmental (Piaget, Erickson)- help determine whether patients are adapting during their specific developmental stage in life Psychosocial (Harlow)- help predict patient responses to physiological, psychological, sociocultural, developmental, spiritual needs Systems- focuses on the arrangement of and relations between the parts which connect them into a whole themas in awhole 0  align Nursing Paradigm Nursing paradigm allows nurses to understand and explain what nursing is, what nursing does, and why nurses do what they do. Person – Recipient of nursing care, including individual patients, groups, families, & communities Important to provide individualized patient-centered care Health – Different meanings for each patient, the clinical setting, and the health care profession. Dynamic & continuously changing Your challenge as a nurse is to provide the best possible care based on the patient’s level of health and health care needs at the time of care delivery. Environment/situation - All possible conditions affecting patients & the settings in which their health care needs occur Continuous interaction between patient and environment that has positive and negative effects on a person’s level of health and healthcare needs Nursing – Care of people of all ages, sick or well, in all settings. Includes promotion of health, prevention of illness, and care of ill or disabled or dying people The nursing process is a method of applying theory and knowledge Assess patient’s responses to disease or treatment Use critical thinking skills to integrate knowledge, experience, attitudes, & standards into the individualized plan of care for each patient. Nottested THEORIST FOCUS of the THEORY FRAMEWORK FOR PRACTICE Nightingale’s Health status is linked to environmental Nurses should improve patient’s Environmental factors (ventilation, light, noise, environment to increase health and Theory hygiene, nutrition) comfort (Grand) Peplau’s Interpersonal relations between Nurses develop therapeutic Interpersonal nurse, patient/family and relationships with patients that are Theory developing the nurse-patient respectful, empathetic, and (Middle-Range) relationship nonjudgmental Nurses assess patient’s ability to Orem’s Self-Care People who participate in self-care perform self-care and intervene as Deficit Theory activities are more likely to improve needed to ensure the patient’s needs (Grand) their health outcomes (biological, psychological, developmental, social) are met Culture influences everything that Nurses should provide patients with Leninger’s Culture involves a patient (health beliefs, role of culturally specific care (integrate Care Theory family and community, dietary traditions, values, beliefs into plan of (Middle-Range) practices) care) NCSBN Clinical Judgment Model (NCSBN-CJM) Nurses must use clinical judgment to make sound decisions when providing patient care NCSBN-CJM builds upon other nursing theories related to critical thinking, clinical judgment, and decision making Use this model to learn how to think like a nurse and make safe clinical decisions to positively influence patient care and patient outcomes NCLEX based on this model 0 0 Review Question The components of the nursing paradigm include: 1.Person, health, environment, and theory. 2.Health, theory, concepts, and environment. 3.Nurses, physicians, health, and patient needs. 4.Person, health, environment, and nursing 0 Review Question Theory is essential to nursing practice because it does all of the following except: 1.Contributes to nursing knowledge. 2.Predicts patient behaviors in situations. 3.Provides a means of assessing patient vital signs. 4.Guides nursing practice. 5.Explains relationships between concepts. 0