Week 1 Fa2024 Student PDF

Please pick up a notecard or note page. Welcome to your first nursing class!!! Please make a name tent to be placed on the table in front of you. This will help us get to know each other and allow faculty to use your name. ☺...

Please pick up a notecard or note page. Welcome to your first nursing class!!! Please make a name tent to be placed on the table in front of you. This will help us get to know each other and allow faculty to use your name. ☺ https://mylifeinscrubs.com/2016/06/06/hello-from-the-other- side-an-open-letter-to-the-new-nursing-student-from-a-recent- nursing-grad/ Introduction to Nursing NURS 3351 Learning Objectives 1.Define nursing. 2.Discuss nursing’s professional values. 3.Distinguish the characteristics of a profession. 4.Identify the roles of the nurse. 5.Discuss history of nursing and its relationship with modern nursing practice.  “Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts” (Nightingale, as cited in Wittmann-Price & Godshall, 2009, p. 1) Over the course of time, the “student moves from acting like a nurse to being a nurse.” Thus, nursing education, as professional education, is a matter of educating for formation of disciplinary knowledge and skill, as well as professional values and identity” (Fowler, 2015, p. 87). Your Thoughts What is a nurse? What does a nurse do? What qualities must a nurse have? Nurse Nurse, nourish, nurture Merriam-Webster defines Nurse as “a person who cares for the sick or infirm” “one that looks after, fosters, or advises”  American Nurses Association (ANA) (1980): “The diagnosis and treatment Nursing Is of human responses to actual and potential health problems.” Nursing practice is individualized. Nurses care by establishing partnerships. ANA (2015): “Nursing is the protection, Caring is central to the practice of the RN. promotion, and optimization of health and RNs use the nursing process to plan and abilities, prevention of illness and injury, provide individualized care to their facilitation of healing, alleviation of suffering healthcare consumers. through the diagnosis and treatment of human A strong link exists between the response, and advocacy in the care of individuals, professional work environment and the families, groups, communities, and populations.” RN’s ability to provide quality healthcare and achieve optimal outcomes. (ANA, 2010) Nursing definition 2021 (Scope & Standards, p. 1) Why Define Nursing? Helps the public understand the value of nursing Helps differentiate activities of nursing from those of medicine Helps students understand what is expected of them Copyright © 2018. F.A. Davis Company What are Important Qualities for Nurses? Critical-thinking skills Problem solving Reflective thinking Listening skills Caring and compassionate Patience Detail oriented Competence Organizational skills Emotional stability Speaking skills Physical stamina What are actions or behaviors for each of these areas (different than those in the book)? Others??  Key Responsibilities of Registered Nurses Perform physical exams and health histories before making critical decisions Provide health promotion, counseling and education Administer medications and other personalized interventions Coordinate care, in collaboration with a wide array of health care professionals ANA. (n.d.). What is Nursing? Retrieved from https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/  Professional Nursing Roles 1. Caregivers Diagnostic and Teaching– 2. Client advocate Helping patient coaching monitoring 3. Teacher Administration Effective Monitoring of and 4. Change agent management monitoring of and ensuring of rapidly the quality of 5. Coordinator therapeutic changing health care interventions situations practices 6. Counselor and regimens Organizational 7. Colleague and work-role competencies 8. Lifelong learner  Profession, Occupation, or Discipline? Profession Occupation Technical and scientific knowledge; be Nursing is often described as an evaluated by a community of peers; have occupation, or job. a service orientation and a code of ethics Most nurses are hourly wage earners. (Starr, 1982). The employer, not the nurse, decides the conditions of practice and the nature of the work. Discipline Nurse practice acts do not prevent nurses To be considered a discipline, a profession must have a domain from functioning more autonomously. of knowledge that has both theoretical and practical boundaries. The theoretical boundaries of a profession are the questions that arise from clinical practice and are then investigated through research. The practical boundaries are the current state of knowledge and research in the field—the facts that dictate safe practice (Meleis, 1991). What is a Profession? An occupation that meets specified criteria: Prolonged education in a college or university that results in acquisition of a body of knowledge based on theory and research Educational preparation includes values, beliefs, and ethics relating to the profession Autonomy in decision making Accountable for one’s own actions Strong commitment and personal identification to the profession  Six Essential Features of Professional Nursing Provide caring relationship that promotes health, healing Assess, attend to full range of human responses, experiences Integrate subjective, objective data Use professional judgment, critical thinking Use scholarly inquiry Strive for social justice by influencing social, public policy Characteristics Authority to control its Credentialing own work systems to certify of a Profession competence Exclusively unique body of knowledge Legal reinforcement Extensive period of of professional formal education and standards training Ethical practice Specialized competence Creation of collegial Control over work subculture performance Intrinsic rewards Service to society Public acceptance Self-regulation Characteristics of a Profession - Knowledge Service to Society Intellectual Characteristics Five conceptualizations of Body of knowledge on which caring: professional practice is based Caring as human trait Specialized education to transmit Caring as moral imperative body of knowledge to others Caring as affect Ability to use knowledge in Caring as interpersonal interaction critical, creative thinking Caring as therapeutic intervention  Profession Characteristics – Autonomy and Self-Regulation Autonomy Independence, willingness to take State boards of nursing provides risks, accountability for one’s actions, copies of nurse practice act upon self-determination, self-regulation. initial licensure National Council of State Boards of Provide legal reinforcement against Nursing (NCSBN) incompetence Developed licensure examinations for Specifies legal definition of nursing professional, practical nursing practice, minimal education preparation for licensure Imposes penalties for illegal, unethical, negligent practice Profession Characteristics – Ethical Practice: Guiding Principles Respect for human dignity, uniqueness Protection of confidential information Acts to safeguard persons Responsibility, accountability for nursing actions Maintenance of nursing competence Use of informed judgment Participation in research, other activities Participation in activities to improve, implement nursing standards Integrity to profession Collaboration with other health care professionals, consumers Entry Into Practice Registered Nurse Advanced Practice Diploma programs Master’s 3-year program, hospital-based Doctorate Associate degree (AD) programs PhD 2-year program, community DNP college Baccalaureate degree programs College and universities RN-BSN  Phases of Nursing (Benner, 1984) https://nursology.net/nurse-theories/from-novice-to- expert/#:~:text=Benner's%20Novice%20to%20Expert%20Theory,practice%20situation%2Fevent%20over%20time.  Regulation of Practice & Education State Nurse Practice Texas Board of Nursing Acts State Boards of (TBON) Nursing Mission: “protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of ANA Standards of Texas is competent to practice safely” (TBON, 2013). Practice Regulation of the practice of nursing Approval of nursing education programs Mission, derived from Nurse Practice Act, supersedes the interest of any individual, the nursing profession, or any special interest group  Mission: “protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the State of Texas is competent to practice safely” (TBON, 2013). Texas Regulation of the practice of nursing Board of Nursing Approval of nursing education programs (TBON) Mission, derived from Nurse Practice Act, supersedes the interest of any individual, the nursing profession, or any special interest group Professional Organizations American Nurses Association (ANA) National Student Nurses’ National professional organizations Association (NSNA) National League for Nursing (NLN) Represents nursing students Establishes and maintains a universal Sigma Theta Tau International standard of education (STTI) International Council of Nurses National Honor Society for Nursing (ICN) Specialty Federation of national nursing Clinical, group identity, or value- organizations specific Copyright © 2018. F.A. Davis Company  Individuals Referred to a patients, Groups Recipients clients, persons of Nursing Care Families Communities  Case method Functional nursing Models of Nursing Team nursing Care Primary nursing Differentiated practice Healthcare Delivery System Where is healthcare provided? Hospitals Extended care facilities Assisted living facilities Rehabilitation centers Ambulatory care centers Home healthcare agencies Community or public health centers Interprofessional Healthcare Team Advanced practice Registered nurses Physicians (MDs or nurses Physician (RNs)/licensed DOs) (APNs)/nurse assistants (PAs) practical nurses practitioners (NPs) (LPNs) Unlicensed Assistive Personnel Pharmacists Therapists Technologists (UAPs)  Financing Healthcare Individual Health maintenance organizations Individual private insurance (HMOs) Employment-based private insurance Preferred provider organizations Government (PPOs) Medicare Medicaid Charitable organizations Question What is the purpose for nurses to participate in professional organizations? A. Links to other nurses in specific area of practice B. Creates sense of moral belonging, imperative C. To have regulation of professional nursing practice D. Boost ability to make ethical practice decision Question The nurse questions a doctor's order of Morphine sulfate 50 mg, IM for a client with pancreatitis. Which role of the nurse best fits this situation? 1. Change agent 2. Client advocate 3. Case manager 4. Collaborator https://www.proprofs.com/quiz-school/story.php?title=fundamentals-of-nursing- test-i_1 Question Which of the following best defines “nursing”? 1. To nourish and to care 2. To care and provide medical treatment 3. To nourish and to cure 4. To care and prescribe medicine  Nursing History AACN Domain #1: Knowledge for Nursing Practice Quotes "No occupation can be intelligently followed or correctly understood unless it is, at least to some extent, illumined by the light of history interpreted from the human standpoint" (Dock & Stewart, 1938 in AAHN, 2001). A Nurse’s Duty “To the doctor, the first duty [of the nurse] is that of obedience—absolute fidelity of his orders, even if the necessity of the prescribed measures is not apparent to you. You have no responsibility beyond that of faithfully carrying out the directions received.” – Quote from a 1902 textbook of nursing Copyright © 2018. F.A. Davis Company The Early Days Early Christian Era Church Deaconesses First hospitals Middle Ages Monks, Nuns jointly cared for sick Hildegarde: books with accurate physiology of reproductive, circulatory, nervous systems Order of St. John: men devoted to charitable work, formed convalescent homes & separate hospitals for lepers Religious orders of nursing for women: structured approach to care of ill; vows of chastity, poverty, obedience  Protestant reformation → monasteries/convents closed Hospitals removed from church possession 1500-1819: Care of sick fell to “common” women (lower class, too old or ill for other work) Europe, Attendants lacked nursing care knowledge Nurses often sanctioned for fighting, foul England, & language, petty theft, & money extortion from patients Americas 1700s brought hospital reform Nursing Becomes Respectable Elizabeth Fry Appearance of first nursing manuals Established program for women Specific instructions on how to do prisoners to make, sell goods to improve procedures, use of equipment living conditions of children born in Stressed importance of attending to prison patient psychological needs, maintaining Referred Florence Nightingale to health of caregiver Kaiserworth (German training program Nursing Society of Philadelphia was founded for nurses) Home maternity services Catherine McAuley Home, school on cooking, obstetrics Led formation of Religious Sisters of Clinical instruction in client homes Mercy Spiritual focused perspective Florence Nightingale Reformed patient care, established nursing as profession Superintendent of Nursing Staff during Crimean War Transformed hospitals, reduced mortality rate Establishment of “Nightingale fund” Elevated profession Nursing as an art Important Historical Nurses Mary Seacole (1805-1881) Black nurse who also cared for wounded in Crimean War on front lines Walt Whitman poet who worked as nurse during Civil War Sojourner Truth (1797-1883) fought for abolition & equity, informally trained nurse; 1844 speech “Ain’t I a Woman” demanding equality Anna Maxwell (1851-1929) organized first Army Nurse Corps Hazel Johnson-Brown (1927-2011) first A-A woman General & Dean of Walter Reed Army Institute School of Nursing Other Important Nurses in History Dorothea Dix (1802 – 1887) appointed as Superintendent of Women Nurses; advocated for mental health Mary Breckinridge: (1881-1965) founded Frontier Nursing Service in Appalachia Mary Eliza Mahoney (1845-1926) – first AA nurse to complete official nurse training, co- founded Nat’l Assoc Co Clara Barton (1821-1912): Civil war “untrained” nurse served @ the front, founded American Red Cross Margaret Sanger (1879-1966) – founded American Birth Control League -> Planned Parenthood Lillian Wald (1867-1940) started Visiting Nurses Association & Henry Street Settlement House  Male Nurses Selective Services Act: Male nurses were denied professional status and served as enlisted personnel in health-related positions 1955: Korean Conflict: Legislation allowed appointment of male nurses as reserve officers in the Army, Navy, and Air Force “one form of “discrimination” in their student years as having to serve as models during clinical demonstrations more often than not. After all, you can’t demonstrate a bed bath as well on a female in front of a male as the other way around. “I always had to be the model for anatomical positions, movements, and bandaging techniques,” explained Henry. “At times I was so trussed up that the whole next teaching period was wasted in unraveling me!” (from https://nurseslabs.com/men-nursing-like-1900s/) Nurse Licensure Nurse registration and licensure was designed to protect the public by differentiating nurses with education, who have met the standards of the profession, from those who with little or no education and therefore have not met the standards of the profession. Opponents held that nursing is a matter of personality rather than training and examinations cannot demonstrate personal qualities. What do you think? Copyright © 2018. F.A. Davis Company  Licensure ”The trained nurse of to-day has no legal standing.... She does not belong to a profession, she is not classed even with the graduates of a technical school, and the woman who has taken up nursing without any training, or who has been discharged from a training-school for serious cause, has the same right to call herself a trained nurse before the law as she who has given three years of hard work and hard study”. (AJN, November 1902) 1901: NY first state nurses association Initial state regulations included the following: Applicants must have a diploma from an approved (accredited) school; Must pass a standard examination "State Boards" 1978: National Council of State Boards of Nursing (NCSBN) https://www.americannursinghistory.org/nursinglicensure-and-registration Question Which of the following were appointed as the Superintendent of Women nurses and lobbied for better living conditions for the mentally ill? 1. Margaret Sanger 2. Florence Nightingale 3. Dorothea Dix 4. Lilian Wald Question In the early 1900s., what was the first duty of the nurse? 1. Obedience 2. Respect 3. Critical thinking 4. Organization Question Nurses made many contributions to the care of Civil War soldiers. A nurse who understood this, would state which of the following? 1. “Nurses established a safe haven for soldiers from the battlefield.” 2. “Nurses provided a clean environment with food and water.” 3. “Nurses began medication administration on the battlefield.” 4. “Nurses organized the men to care for other injured soldiers.”