The Nursing Profession (W25) PDF

The Nursing Profession Winter 2025  Class 1 Learning Objectives  Nursing profession  Theoretical Foundations  Metaparadigms  Client, Environment, Health, Nursing  The 7 Professional Standards  Accountability in Nursing ...

The Nursing Profession Winter 2025  Class 1 Learning Objectives  Nursing profession  Theoretical Foundations  Metaparadigms  Client, Environment, Health, Nursing  The 7 Professional Standards  Accountability in Nursing  Professional organizations – CNO/RPNAO  What is Nursing?  What made you come to nursing?  What is your definition of a nurse?  What is an RPN? What is an RN? (we’ll get to that!)  What knowledge do we need to do our job?  What do you think is different and the same about RPN and RN’s?  Does your definition compare? “The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health and its recovery, or to a peaceful death that the client would perform unaided if he had the necessary strength, will or knowledge” Virginia Henderson, Nursing Theorist, Potter and Perry RN and RPN Practice: The Client, The Nurse, The Environment The Three-Factor Framework Client Factors: Complexity, predictability, risk of negative outcomes Nurse Factors: application of knowledge to provide safe ethical care Environmental Factors: Practice supports, consultation resources, stability and predictability of the environment  Theoretical Foundations of Nursing Practice The conceptual/theoretical framework refers to a structure that provides guidance for research or practice. The framework identifies the key concepts and describes their relationships to each other and to the phenomena (variables) of concern to nursing. Nursing Theorists – Models of Care 1859: Florence Nightingale 1921: 1996: Moyra Allen: The McGill Model 1955: Virginia Henderson 1952: Hildegard Peplau 1979: Jean Watson 1961: Ida Jean Orlando  Nursing Theorists 1859 – Florence Nightingale – The Founder of Modern Nursing  Nightingale is considered the first nursing theorist  Florence is most widely known for her role during the Crimean War between Great Britain and Russia. She was sent to the Barrack Hospital at Scutari, Turkey, where she cared for thousands of sick and wounded British troops.  Shift from disease process to healing environment.  Florence Nightingale's Environmental Theory defined Nursing as “the act of utilizing the patient's environment to assist him in his recovery.”  Importance of clean living areas, fresh air, presence of light, warm, comfortable, adequately fed.  Nursing Theorists 1921-1996: Moyra Allen – The McGill Model of Nursing  Focus was on promoting health  1977: Health Workshops/ Changing one’s lifestyle  Within the McGill Model of Nursing, nurses engage the person/family to actively participate in learning about health.  Nursing Theorists 1955: Virginia Henderson- The Need Theory  Henderson's widely known contributions to nursing are the Need Theory, among her other works. The Need Theory emphasizes the importance of increasing the patient's independence and focusing on the basic human needs so that progress after hospitalization would not be delayed.  The four major concepts addressed in the theory are the individual, the environment, health, and nursing. According to Henderson, individuals have basic needs that are components of health.  14 basic human needs: breathe, eat and drink, eliminate waste, move and maintain posture, rest and sleep, dress and undress, maintain body temperature, be clean, avoid danger, communicate, worship, work, play, learn ….health can be regained  Nursing Theorists 1952: Hildegard Peplau – Theory of Interpersonal Relations  the core of nursing care as the interpersonal relationships. “A nurse is an investigator, a prober, a reporter….and uses this info to assist the patient reach his/her goals.  Focus on the nurse-client relationship  Our first “mental health” nurse.  Nursing Theorists 1979: Jean Watson - The Theory of Caring  According to Watson (1997), the core of the Theory of Caring is that “humans cannot be treated as objects and that humans cannot be separated from self, other, nature, and the larger workforce.” Her theory encompasses the whole world of nursing; with the emphasis placed on the interpersonal process between the care giver and care recipient.  the individual is an embodied spirit.  the practice of caring is central to nursing… caring is a skill that has to be learnt.  offers beliefs about the unity and connectedness of all the world and the role that caring plays in that connectedness.  caring is transformative within the nurse patient relationship – actually promotes healing  rejects the disease focus to health focus  care before cure  Nursing Theorists 1961 – Ida Jean Orlando – Deliberative Nursing Process Theory In 1958, Ida Jean Orlando started the nursing process that still guides nursing care today. Defined as a systematic approach to care using the fundamental principles of critical thinking, client-centered approaches to treatment, goal-oriented tasks, evidence-based practice (EDP) recommendations, and nursing intuition. Developed the Nursing Process.  The Nursing Process The Nursing Process is an essential part of the Care Plan using a problem solving approach. The patient/client must be the central focus (client driven vs. nurse driven). ADPIE Assessment Nursing Diagnosis Planning Implementing Evaluation The Nursing Process Nursing Metaparadigms  Nursing Metaparadigms Identifies concepts central to nursing that help understand particular clinical situations.  Person or Client (human beings)  Environment (each client is part of a complex environment in hospital and out)  Health (each person has his/her own state of well being/health goals)  Nursing (many definitions/theories of nursing)  Nursing Metaparadigms Client/Person Environment  Recipient of health care (individuals, families, group & communities)  All that influences people and  More than just person their health  System of interacting parts,  Internal & external surroundings competing human needs affecting client, which includes  Any action must be people in physical environment, individualized with regards to all facets of the individual families, friends or significant others  Range of health statuses  E.g. family, society, community,  Interactive relationship b/w nurse and client health care system, geopolitical issues that affect health  Nursing Metaparadigms Health Nursing   Remember the Nursing Ideal state of optimal health, absence of disease, wellness, Theorist and their models of generally addresses the care? person’s state of well-being.  How each nurse uses theory to  Different meanings guide their practice  Some people will say that they  But they don’t necessarily are healthy while living with a agree on one theory chronic illness while others may interpret differently  Nursing Metaparadigms  Think about 3 patients with the same diagnosis (post appendectomy).  Would care of all of them be the same?  1. 21 year old smoker, eats on the go, nursing student  2. 87 year old CHF controlled, lives alone, eats well, takes meds  3. 61 year old Diabetes Mellitus in Long Term Care Questions? Nursing is a Knowledge Profession  The Nursing Profession  An occupation that requires extensive education or a calling that requires special knowledge, skill, and preparation  Distinguished from other occupations by: a) Requirement of prolonged specialized education, specialized training to acquire body of knowledge pertinent to the role b) Orientation toward a service either community or organization c) Standards are determined by the members d) Self regulated - Self-regulation is a privilege granted to professions that have shown they can put the interests of the public ahead of their own professional interests.  HOW is Nursing Regulated at a PRACTICE LEVEL?  CNO (http://www.CNO.org)  Our mission is to protect the public’s right to quality nursing services by providing leadership to the nursing profession in self-regulation.  Our vision is excellence in nursing practice everywhere in Ontario.  RPNs are regulated by the CNO through the Regulated Health Professions Act, 1993, and the Nursing Act, 1991 as amended.  Mandatory Membership  RPNAO (http://www.rpnao.org/)  Vision: Respected, knowledgeable professionals playing a vital role in Ontario's health care community  Mission: Optimizing RPNs' professional practice for a healthier Ontario  Voluntary membership (political, advocates for RPNs) RN and RPN Practice: The Client, the Nurse and the Environment Practice guidelines are documents that help nurses understand their responsibilities and legal obligations to enable them to make safe and ethical decisions when practicing. They provide an outline of professional accountabilities and relevant legislation. – CNO The Three-Factor Framework Client Factors Nurse Factors Environment Factors  Standards of Professional Nursing Practice  Nursing standards are expectations that contribute to public protection. They inform nurses of their accountabilities and the public of what to expect of nurses. Standards apply to all nurses regardless of their roles, job description or areas of practice. — College of Nurses of Ontario  7 Standards of Professional Nursing Practice 1. Accountability 2. Continuing Competence 3. Ethics 4. Knowledge 5. Knowledge Application 6. Leadership 7. Relationships 1. Therapeutic nurse-client relationships 2. Professional relationships CNO's 7 Professional Standards  Practice Standard: Accountability Each nurse is accountable to the public and responsible for ensuring that her/his practice and conduct meets legislative requirements and the standards of the profession. A nurse demonstrates the standard by: identifying her/himself and explaining her/his role to clients; providing, facilitating, advocating and promoting the best possible care for clients; advocating on behalf of clients; seeking assistance appropriately and in a timely manner; sharing nursing knowledge and expertise with others to meet client needs; ensuring practice is consistent with CNO’s standards of practice and guidelines as well as legislation; taking action in situations in which client safety and well-being are compromised; maintaining competence and refraining from performing activities that she/he is not competent in; taking responsibility for errors when they occur and taking appropriate action to maintain client safety; reporting to the appropriate authority any health care team member or colleague whose actions or behaviours toward clients are unsafe or unprofessional, or indicate abuse, in accordance with applicable legislation, including (but not limited to): Fixing Long-Term Care Act, 2021; ◗the Child, Youth and Family Services Act, 2017; ◗the Public Hospitals Act, and reporting sexual abuse of a client by a regulated health professional to the appropriate regulatory college Questions