Student Professional Development Week 2 (The Nursing Profession) PDF

Week 2 Professional Development I Module 2: The Nursing Profession Agenda 01 02 03 Learning Nursing History & The Nursing Outcomes Education Profession 04 05 Questions? Coming Up  0 Week 2 Learning 2 Outcomes Learn...

Week 2 Professional Development I Module 2: The Nursing Profession Agenda 01 02 03 Learning Nursing History & The Nursing Outcomes Education Profession 04 05 Questions? Coming Up  0 Week 2 Learning 2 Outcomes Learning Outcomes 1 2 Describe the historical development Explore the definition, role, and of nursing practice and nursing goals of nursing education in Canada 3 4 Explore the importance of role Identify the various services that clarity among nurses nurses can deliver care and which practice settings they work in  0 Week 2 Nursing History & Education 3  Why Nursing History Matters History allows an opportunity to engage in informed decisions about present-day problems Not having historical context is dangerous – why? Nursing history provides context, explains the present, and provides a way to look forward History provides the basis for developing an informed and critical understanding of our society Provides a conceptual framework that allows us to better understand the different meanings of nursing and different experiences nurses may have (Astle & Duggleby, 2023) Why Nursing History Matters In 2008 The Canadian Nurses Association (CAN) developed a position statement on promoting nursing history, noting that learning from the lessons of history is “critical to advancing the profession in the interests of the Canadian Public” The Canadian Association of Schools of Nursing considers nursing history an essential component of nursing education – “Nursing programs must prepare students to demonstrate foundational knowledge of nursing including nursing history, nursing theories, and other knowledge relevant to practice” (Astle & Duggleby, 2023) Why Nursing History Matters Overall… An understanding of the history of nursing gives context to why nursing is the way it is today ​ The nursing profession has responded to the health care needs of society, and has been influenced over time by economical, social, and cultural factors. ​ Something to consider: During the early history of Canada, there was no cure for many diseases, so nursing care was the primary care/treatment received. (Astle & Duggleby, 2023) Early History of Nursing in Canada Nursing in Canada has a much longer history than acknowledged – preceding Florence Nightingale and her healthcare reforms Indigenous healers and midwives are often excluded from nursing history because they fall outside of the boundaries of the concept of professionally educated nurses Before European settlers colonized “Canada”, Indigenous peoples in North America had extensive healing traditions and health practices Indigenous women played essential roles within their own communities and for white settler communities Indigenous groups and white settlers had formalized functional groups for caring for others long before hospitals were built and nursing was established (Astle & Duggleby, 2023) Early History of Nursing in Canada Overview: New colony of Canada was devastated by epidemics of infectious diseases​ Good nursing care was the only effective defence​ Indigenous population​provided foundational role in developing nursing as we know it (Astle & Duggleby, 2023) Nurses & Hospitals in New France New France is now known as Quebec From the onset it was nurses rather than physicians who provided and administered healthcare in the settlement known as New France First nurses were male attendants and Jesuit priests​, who used their care of the sick to air their mission of converting Indigenous peoples to Christianity Wives of surgeons/apothecaries would visit and care for sick neighbours using knowledge acquired from husbands Marie Rollet Hebert was the first laywoman to provide nursing care in New France (Astle & Duggleby, 2023) Nurses & Hospitals in New France 1. The “Order of Nursing Sisters” (Nuns), were the first trained nurses who came in 1639 and founded Hotel-Dieu in Quebec City; 3 years later one was founded in Montreal​ Hotel-Dieu institutions were religious houses, run by religious orders​ Mission was to provide care for “bodies and souls”​ The also provided nursing services in people's homes​ Nun Orders moved further west in the 1700-1800s, establishing what would become hospitals as they went (“Grey Nuns”)​ 2. Sisters of Charity of Montreal (Grey Nuns):​ Visited the sick at home during epidemics​ Spread out from Montreal toward the West​ Established missions in Manitoba, Saskatchewan, and the Northwest Territories (Astle & Duggleby, 2023) Colonial Health Care in Canada The history of “Indian Hospitals” reveals the fact that health care services in Canada were unequal “Indian Hospitals​” Racial segregation and colonial practices negatively influenced Indigenous individuals, families, and communities​ During this period, federal government offered Indigenous peoples a health care service that was separate from the one available to the non-Indigenous population​ Indian hospitals were chronically underfunded, overcrowded, and understaffed​ (Astle & Duggleby, 2023)  Colonial Health Care in Canada Decolonizing Health Care: ​ Indigenous nurses have a long history of working for better health care for Indigenous peoples and wanted the best care for their communities Indigenous nurses were aware of the failures of the colonial health system ​ Came together in the 1970s to form the Registered Nurses of Canadian Indian Ancestry (RNCIA), now called Canadian Indigenous Nurses Association (CINA)​ This was the first group of Indigenous professionals to organize themselves as an association. The founding members were; Jean Goodwill, Jocelyn Bruyere, and Ann Callahan Primary aim of the organization was to improve the health of Indigenous communities and expand the participation of Indigenous nurses in the provision of Indigenous health services (Astle & Duggleby, 2023)  Nursing Education in Canada The first financially independent schools of nursing were founded by Florence Nightingale.​ Nursing schools spread across Europe and North America.​ This educational model was lost as hospital schools of nursing developed. ​ (Astle & Duggleby, 2023)  Nursing Education in Canada The Nightingale model shaped the development of nursing education in Canada In the late nineteenth century, hospitals were transformed into sites of modern medicine that required trained nurses Hospitals began to establish their own schools based on the principles of Florence Nightingale ○ In 1874, Theophilus Mack, MD established a Nursing school at St Catharines General ○ Many years later became part of Niagara College Mack school of Nursing These schools had no financing and required students to provide nursing (Astle & Duggleby, services to the hospital in return for their education and living expenses 2023)  Nursing Education in Canada Hospital schools:​ Students provided nursing care in exchange for education and living arrangements​ Financial benefit to the hospital​ Poor living conditions for students​ Provided education of questionable quality (Astle & Duggleby, 2023) Nursing Education in Canada Dr. George Weir recognized deficits in nursing – pivotal moment in nursing education “The Weir Report” was published in 1932 and found the following… ○ Exploitative, subservient, abusive behaviour from hospitals. Students were unhealthy and the hospital conditions were deplorable ○ Hospital nursing schools produced disciplined workforce but did not provide quality education necessary for competent nurses The report concluded that nursing education should be placed within the general education system and the minimal education requirements for the profession should be 4 years of high school followed 3 years of nursing specific training This is significant because it allowed nurses and others to talk about nursing as a profession (Astle & Duggleby, 2023) Racism in Nursing Education & Practice Racism has deep historical roots in nursing and in healthcare Nursing leaders and school administrators are guilty of using educational, linguistic, and race-related barriers to define nursing as a “respectable” profession Nursing was intended for young, unmarried, middle-class white women This was intended to “elevate” the nursing profession from untrained domestic services and caregiving work Men and racialized women were unwelcomed and barred from nursing schools Overtime, Indigenous and Black students were allowed into the schools along with small numbers of Chinese Canadian and Japanese Canadian but with the assumption they would work only in their own communities (Astle & Duggleby, 2023) Racism in Nursing Education & Practice Nursing is beginning to acknowledge its racist and colonial past and its impact on the present In 2020, the Canadian Association of Schools of Nursing (CASN), in partnership with the Canadian Indigenous Nurses Association (CINA), published a framework for responding to Canada’s Truth and Reconciliation Commission’s Calls to Action. The document included the recognition that “nursing students need to develop and understanding of the social determinants of health including systemic and interpersonal racism, learn to implement anti-racism intervention, and to provide culturally competent care” (Astle & Duggleby, 2023) Nursing Education Today With continuing expansion of healthcare knowledge and technology, beginning practitioners require a broad educational foundation New curriculum have educational institutions committing to maintaining high standards health care Standards for nursing education are monitored by provincial regulators and associations and by CASN to ensure that educational programs are of appropriate quality Anyone applying to practice as a Registered Practical Nurse in Canada must pass the Regulatory Exam – Practical Nursing (REX-PN) licensing exam and maintain good standing with the College of Nurses of Ontario on an annual basis (Astle & Duggleby, 2023) History & Evolution of Practical Nursing Practical nursing became a profession in the late 1930s but was not recognized as a distinct profession that required formal education until the 1970s.​ In the late 1940s and early 1950s, demand for practical nurses increased significantly due to political and economic pressures. ​ Public demand for safe and competent practice increased at the same time as economic and personnel challenges, so Practical Nursing became more important within the health care system.​ By 1980s, most provinces had developed regulations to govern practical nursing.​ The Canadian Council for Practical Nurse Regulators (CCPNR) was formed in 2004. (Astle & Duggleby, 2023) History & Evolution of Practical Nursing 1920's – first practical nurses were called "aide" (female) or "orderly" (male). ​ 1938 – 6-month course for nursing assistants​ 1940's – laws legislating practical nursing​ 1947 – Certified Nursing Assistant.​ 1953 – training increased to 10 months​ 1957 – part time evening & high school nursing assistant programs began (Grades 11 & 12)​ 1963 – Registered Nursing Assistant​ 1990 – RNA training programs moved to community colleges.​ 1993 – Registered Practical Nurse​ 2001 – CNO says all new RPNs must have a college diploma from a 2-year nursing academic program by 2005 (Astle & Duggleby, 2023) Educational Preparations Entry-Level Competencies: Location and Length of Program: The trend toward longer and more complex education for practical nurses is driven by ​increased complexity of the patient base ○ Legislative changes​ ○ New developments in technology​ ○ Increased public expectations​ ○ Changing skill mixes​ ○ Expanded opportunities for practice (Astle & Duggleby, 2023) Educational Preparations Each province/territory in Canada has requirements for nurses to work ​ ○ Evidence of Practice ​ ○ Registration examination(s) ​ ○ Fluency in English and/or French language ​ ○ Other requirements: criminal record check; disclosure of mental or physical health problems that would have an impact on the ability to practice safely, competently, and ethically​ ○ Ontario: https://www.cno.org/en/become-a-nurse/ (Astle & Duggleby, 2023)  0 Week 2 The Nursing 4 Profession What is a Professional Nurse The Registered Practical Nurse (RPN) What Does it Mean to be a Nurse Treating clients/families/communities as unique individuals with unique needs Ensuring care is delivered with dignity and empathy Maintaining confidentiality and privacy Positive collaboration with other members of the interprofessional health care team Maintaining honesty and integrity Ensure safe client care Upholding the reputation of the profession (Astle & Duggleby, 2023) What Does it Mean to be a Nurse Clear and appropriate communication Displaying compassion to clients, families, and communities Providing leadership Strong problem-solving and critical thinking skills Utilizing emotional intelligence Following ethical standards Practicing with autonomy Endurance (Astle & Duggleby, 2023) Defining the Nursing Profession The World Health Organization: a. Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people. The Nursing Act (1991): a. The practice of nursing is the promotion of health and the assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function (CNO, 2021) The “Art” of Nursing (CNO, 2021) The “Science” of Nursing (CNO, 2021)  What Makes Nursing a Profession Does nursing meet the criteria of a “profession”? – What are your thoughts? To be a profession you must: (CNO, 2021) Nursing Practice in Ontario Nursing in a singular profession with two categories: a. Registered Nurse (RN) – This also includes the Nurse Practitioner (NP) b. Registered Practical Nurse (RPN) NPs, RNs, and RPNs are all members of the College of Nurses of Ontario (CNO) Only members of CNO are allowed to refer to themselves as nurses in Ontario. A valid certificate of registration from CNO is required of all nurses who wish to practice nursing in Ontario and perform the procedures in the Controlled Acts that are authorized to nursing.​ Nurses are largest healthcare workforce in Ontario ​ (CNO, 2021) All Nurses are accountable for their actions (or inactions) Accountability & Autonomous Practice What is meant by Accountability?​ Taking responsibility for decisions and actions ​ Collaborating, consulting, and taking action when needed​ Ensuring practice is safe and consistent with professional standards, best practices, guidelines, and regulations​ What is meant by autonomous practice?​ The ability to carry out nursing responsibilities in an independent manner​ RPNs have greatest autonomy when caring for clients with less-complex conditions in a stable environment.​ As client complexity increases or the environment becomes unstable, there is a corresponding increase in the need for RPNs to consult with RNs (CNO, 2021) Registered Practical Nurse Role Role clarity between RPNs and RNs is important but is not always clear. ​ Similarities: ​ Both roles required to continually enhance knowledge and skills (quality assurance) ​ Both roles work as collaborators within a health care team​ Accountability and Autonomous practice ​ Both roles must recognize limits of own practice​ (Astle & Duggleby, 2024) Registered Practical Nurse Role Differences:​ Registered Nurses and Registered Practical Nurses differ in the depth and breadth of their knowledge base.​ Competencies, rather than tasks, are useful in differentiating Registered Nursing and Registered Practical Nursing practice (Astle & Duggleby, 2024) RNs and RPNs at a Glance RN’s study for a longer period allowing for greater:​ breadth and depth of knowledge, decision-making, critical thinking, leadership, research utilization, and resource management​ RPN’s have greatest autonomy when the patient’s needs are less complex, more predictable, and are in a more supportive environment​ Key to RPN practice: work to your full scope but know when you are in a situation that is outside of your skill set; know who you need to call and collaborate with! (Astle & Duggleby, 2024) The Future of Practical Nursing in Canada The healthcare system in Canada is continually changing. These changes affect Practical Nursing and must be viewed as an opportunity as opposed to a threat Practical nursing will continue to adapt and change to meet socioeconomic and health demands. ​ Practical nursing will position its significance for health care of the future by developing more diverse and specialized competencies in our changing society. Practical nurses have the competencies to contribute significantly within primary care and on interprofessional and intraprofessional teams (Astle & Duggleby, 2023) The College of Nurses of Ontario The College of Nurses of Ontario (CNO) is the regulatory body for all nurses in Ontario (NPs, RNs, and RPNs) It serves to protect the public by outlining the Standard of Practice for Nurses to uphold and ensure nurses are accountable for their actions You will learn more about the CNO in the coming weeks of this course (CNO, 2021) Nursing Registration Registration means the listing of an individual's name on an official roster​ Canadian law requires that all practicing nurses in the country be registered and hold a current valid registration (license)​ Registration must be renewed annually​ CNO initial registration: https://www.cno.org/en/become-a-nurse/new-applicants1/ontario/initial-registration/​ CNO annual membership renewal: https://www.cno.org/en/maintain-your-membership1/annual-membership-renewal/ (RNAO, 2014) Nursing Class & Title Protection What are the various “classes” that nurses can be registered in Ontario? ​ General – nurses working in Ontario with no limitations or restrictions​ Non-practicing – could have been previous General or Extended class member, but are not currently practicing nursing in Ontario and want to remain registered with CNO​ Extended – have additional education and certification beyond requirements of General Class (NPs) ​ Temporary – recent graduates who have met all requirements to register in the General Class but have not yet completed education and registration exam requirements. Subject to specific terms, conditions, and limitations. ​ (RNAO, 2014) Nursing Class & Title Protection What are the various “classes” that nurses can be registered in Ontario Cont’d Special assignment – time limited registration for nurses who have an assignment with an approved Ontario facility. Subject to terms, conditions, and limitations. ​ Emergency assignment – qualified nurses permitted registration in Ontario when the government issues an emergency need (RNAO, 2014) Nursing Class & Title Protection What does “title protection” mean? ​ In Ontario, only members of the CNO can use the title “nurse” “Registered Nurse” “Registered Practical Nurse” “Nurse Practitioner” or any variation/abbreviation etc. (RNAO, 2014) Roles and Functions of a Nurse (RNAO, n.d.) References Annual Report. (2021). College of Nurses of Ontario. https://www.cno.org/en/what-is- cno/annual-report/ Astle, Duggleby, Potter, Perry, Stockert & Hall. (2023). Potter and Perry's Canadian Fundamentals of Nursing (7th edition). Toronto: Elsevier Canada Registered Nurses Association of Ontario. (n.d.). Types of Nursing – Which will you choose? Retrieved from https://careersinnursing.ca/new-nursing-and-students/career- options/types- nursing Registered Practical Nurses Association of Ontario (2014). Understanding the role of the registered practical nurse in Ontario’s health care system. https://www.werpn.com/wp- content/uploads/2019/11/RoleClarityReport_.pdf  0 Week 2 5 Coming Up… Coming up… Ensure you have completed 1 hour of asynchronous work for Module 2 Prepare for Module 3 (Week 3) - The Interprofessional Team ○ Review module objectives ○ Begin required readings and activities and come prepared to engage in lecture  0 Week 2 6 Questions