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58 Cards in this Set
- Front
- Back
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Florence Nightingale |
Not the first nurse but the "founder" of modern nursing. Established infectious disease control within the environment. Advocated for nurses and patients. During the Florence Nightingale time, patients were dying was due to secondary infection, not because of the primary reason for treatment. |
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Angel of Mercy |
Willing to risk their lives to help others, serene and content. Often seen as the "halo," the saving grace. |
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Battle-Ax |
Known for torturer, or treating her patients with cruelty and disdain. Often seen as the "mean/bad," nurse, they like control. |
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Nurse as a Professional |
Florence Nightingale advocated and obtained changes in the healthcare profession. |
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Naughty Nurse |
Sexy, mindless, irrelevant, or simply potential dates for bright and talented physicians. Sexualized, clueless, and unprofessional. |
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Military Nurse |
Often seen in a uniform providing support at the battlefield, characterized as warriors fighting disease. The military nurse is enhanced and respected. |
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Handmaiden Nurse |
Portrayed as the male physician in the dominant role, with the female nurse merely assisting the doctor, or perhaps supporting the patient at bedside. Servant of the physician only. |
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Full-Spectrum Nursing |
Highly trained, well educated, caring, and competent professionals. Often using clinical judgment, critical thinking, and problem solving. Nurses must: advocate, support, communicate, teach, and educate. A unique blend of thinking, doing, and caring. It is performed by nurses who fully develop and apply nursing knowledge, critical thinking, and the nursing process to patient situations for the purpose of effecting good outcomes. |
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What is Nursing? |
ANA 1980: The diagnosis and treatment of human responses to actual and potential health problems. |
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Who is the ANA? |
American Nurses Association (ANA): The official professional organization for registered nurses in the United States and its territories. |
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Formal Education |
Completion of the initial education requirements and the continuing education units required for licensure, such as the National Council Licensure Examination (NCLEX). Associates Degree/Nursing Diploma, BSN, MSN, Doctoral Degree in Nursing. |
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Informal Education |
Ultimately it is the knowledge gained by experience and observation. Meaning the direct hands on experience, observations in the real world, and informal discussions with peers and fellow colleagues. |
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Benner's Model |
Process by which a nurse acquires clinical skills and judgment. Stage 1: Novice, Stage 2: Advanced Beginner, Stage 3: Competence, Stage 4: Proficient, Stage 5: Expert. |
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Stage 1: Novice |
Starts with the onset of your education, task oriented, and strictly focus narrowly on "learning the rules." |
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Stage 2: Advanced Beginner |
Focused on the aspects of clinical situation, use more facts, sophisticated use of the rules, and recognizes similarities in situations. can distinguish abnormal finding, but cannot readily understand their significance quite yet. |
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Stage 3: Competence |
Achieved after 2-3 years of practice in one area, gaining additional expertise and are able to handle their patient load and prioritize situations. |
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Stage 4: Proficient |
The ability to quickly take in all aspects of a situation and immediately give meaning to the cluster of assessment data. Able to see the "BIG picture," much more flexible and fluent and able to adapt to nuances of various patient situations. Plan intuitively as well as consciously. |
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Stage 5: Expert |
Leader and role model, the use intuition but operate with a deep understanding of a situation and can recognize a problem in the absence of the classical signs and symptoms. |
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Continuing Education (CE's) |
A professional strategy to keep up with current clinical knowledge; the enhancement or expansion of a person's knowledge or skills. |
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Nurse Practice Acts |
State statute designed to protect patients or society, define the scope of nursing practice, and identify the minimum level of nursing care that must be provded to clients. The practice acts provide regulation of nursing by an administrative board, such as the board of nurse examiners (or the "state board of nursing"). These boards generally have the authority to regulate nursing practice and education within the states, including licensing, credentialing, and disciplinary procedures. |
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Standards of Practice |
A means of describing the focus of a profession, its activities, the recipients of service, and the responsibilities of the practitioners. Standards of care and standards of professional performance. Standards are not laws but what nurses are held to. They are a set of recommendations/guidelines to follow. |
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Healthcare Environments |
Hospitals, urgent cares, cancer centers, physician offices, research centers, extended care facilities. |
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Nursing Ethics |
Subset of bioethics, referring to ethical questions that arise out of nursing practice.
Bioethics: Refers to the application of ethical principles to healthcare. Morals: Private, personal, or group standards that consider in a broad, general manner what is good, bad, right or wrong. Moral Behavior: Consistent with customs or traditions based on the external influence. Ethics: The study of a moral principles and standards, or the process of using them to decide your conduct and actions. Ethics are a formal process for deciding right and wrong conduct in situations where issues of values and morals arise. |
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Ethical Agency or Moral Agency |
The ability to make ethical choices and to be responsible for one's ethical action. To base your practice on professional standards of ethical conduct and to participate in ethical decision making. Meaning nurses have choices and are responsible for their actions. |
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Evidence-Based Practice |
An approach that uses firm scientific data rather than anecdote, tradition, intuition, or folklore in making decisions about medical and nursing practice. EBP: The use of some form of substantiation in making clinical decisions. In nursing it includes blending clinical judgment and expertise with the best available research evidence and patient characteristics and preferences. The goal of EBP is to identify the most effective and cost-efficient treatments for a particular disease, condition, or problem. |
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QSEN Competencies |
The commission on Quality and Safety Education for Nurses (QSEN) identifies quality improvement (QI) as a competency you should achieve during your nursing education. QSEN defines QI as the ability to "use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems." The QSEN believes you one competency you should achieve in nursing school is to differentiate clinical opinion from research and evidence summaries. |
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Health |
The degree of wellness or well-being that the client experiences. Health is dynamic. Health is a highly individual perception. Health has come to mean a high level of wellness or the fulfillment of one's maximum potential for physical, psycho-social, and spiritual functioning. Health is a complex phenomenon that involves physical, mental, and spiritual aspects. Having good health is an almost universal desire. |
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Illness |
A highly personal state in which the person's physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished. Illness is highly subjective; only the individual person can say he or she is ill. |
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Health-Illness Continuum |
A graduated spectrum that cannot be divided - into parts. The continuum is personal and dynamic: Health changes over the course of time. How people perceive themselves and how others see them in terms of health and illness will also affect their placement on the continuum. The ranges in which people can be thought of as healthy or ill are considerable. |
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Acute Illness
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Typically characterized by symptoms of relatively short duration. Symptoms often appear abruptly and subside quickly and, depending on the cause, may or may not require intervention by health care professionals.
In acute illness, a person may experience the disruptions of pain, competing demands, and the unknown. However, an end is in sight. Relief is expected. |
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Chronic Illness |
Lasts for an extended period, usually 6 months or longer, and often for the person's life. Chronic illnesses usually have a slow onset and often have periods of remission when the symptoms disappear, and exacerbation, when the symptoms reappear or flare up. Chronic illness often requires complicated treatment regimens for lengthy periods that may include significant adverse reactions and be very costly. Thus, clients with chronic illnesses may be at increased risk for treatment non-adherence. |
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Stages of Illness Behavior |
Illness Behavior: A coping mechanism, involves ways individuals describe monitor, and interpret their symptoms. Stage 1: Experiencing Symptoms - A signal that illness has begun. Stage 2: Sick Role Behavior - Assumed when you have identified yourself as ill. Stage 3: Seeking Professional Care - Must determine that you are ill and that professional care is needed, and that a professional care is required to treat. Stage 4: Dependence on Others - Begins once you accept the diagnosis and treatment of the healthcare provider. Stage 5: Recovery - Dependence is given up and a gradual return to normal roles and functioning. |
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Culture |
The thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Being described as the learned and shared patterns of information that a group uses to generate meaning among its members. |
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Eight Characteristics of Culture |
1. Cultural beliefs provide identity and a sense of belonging for its members. 2. Culture consists of common beliefs and practices. 3. Culture exists at many levels. 4. Culture is learned and taught. 5. Culture is dynamic and adaptive. 6. Culture is complex. 7. Culture is diverse. 8. Culture is all-encompassing. |
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Institute of Medicine (IOM): Six Aims of Improvement |
1. Safety: Avoiding injuries to patients from the care that is intended to help them. 2. Effective: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit. 3. Patient-Centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. 4. Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care. 5. Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy. 6. Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. |
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Communication |
A two-way process involving the sending and receiving of messages, to exchange information, ideas, and feelings. Communication involves verbal and nonverbal communication. |
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Space Orientation |
Refers to a person's personal space, or the boundary lines that determine how close another person can come. A person's comfort level typical goes hand in hand with their space. Space is a relative concept that includes the individual, the surrounding environment, and objects within that environment. |
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Time Orientation |
Often refers to an individuals focus on the past, the present, or the future. Far East groups tend to be past-oriented and value traditions and relationships over time and deadlines. (i.e. PT's will show up late or not at all) European Americans tend to be future-oriented. Latin Americans/Filipinos are more present-oriented and enjoy living in the moment. |
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Social Organization |
The family unit (i.e. nuclear, single-parent, or extended family) and the wider organizations (i.e. community, religious, ethnic) with which the individual or family identifies. |
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Environmental Control |
Refer's to a person's perception of his ability to plan activities that control nature or direct environmental factors. |
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Biological Variations |
The ways in which people are different genetically and physiologically, includes: body build and structure, skin color, vital signs, enzymatic and genetic variations, and drug metabolism. Biological variations create susceptibility to certain diseases and injuries and explain differences in responses to treatment. |
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Indigenous Healthcare System |
A healthcare system based on folk medicine and traditional healing methods which may include over-the-counter (OTC) and self-treatment remedies. |
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Professional Healthcare System |
A system run by a set of professional healthcare providers who have been formally educated and trained for their appropriate roles and responsibilities. |
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Cultural Competence |
Competent: Having the necessary ability, knowledge, or skill to do something successfully. Within the delivered care the nurse understands and attends to the total context of the client;s situation and uses a complex combination of knowledge, attitudes, and skills. Culturally competent care requires a nonjudgmental attitude, self-awareness, sensitivity, and respect for differences, theoretical knowledge, and the desire to be culturally competent. |
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Religion |
An organized system of worship. An ordered system of beliefs regarding the cause, nature, and purpose of the universe, especially the beliefs related to the worship of God or a Supreme Being. Religion is a sort of "map" that outlines and integrates essential beliefs, values, and codes of conduct into a manner of living. Religion offers means for accessing and expressing spirituality, and provides support for believers in responding to life's ultimate questions and challenges. |
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Spirituality |
Spirituality provides purpose and strength. Belief in or relationship with some higher power, creative force, driving being, or infinite source of energy. Spirituality is a powerful force in the lives of many patients. The vital process of discovering meaning, purpose, fulfillment, and value in life. |
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Major Religions (14) |
1. Judaism: Some observe kosher diet to varying degrees (i.e. avoid pork and shellfish, do not mix dairy and meat), Sabbath observance varies (i.e. Orthodox Jews avoid traveling in vehicles, writing, turning on electric appliances and lights, etc.) 2. Christianity: Rituals and practices vary among denominations, Christians are collectively known for their worship of Jesus Christ. Typically no dietary requirements, although some choose to abstain from eating meat on Friday's and/or during Lent. No religious objections to blood transfusion or organ transplantation. 3. Roman Catholicism: Sacrament of the Sick (previously known as Last Rites) appropriate for the ill. Be aware that some may think rite means they are dying. 4. Christian Science: Typically oppose Western medical interventions, relying instead on lay and professional Christian Science practitioners. 5. Jehovah's Witnesses: Abstain from most blood products; need to discuss alternative treatments such as blood conservation strategies, autologous techniques, hematopoietic agents, non blood volume ex-panders, and so on; contact local Jehovah's Witness hospital liaison committee. 6. Mormonism: Avoid alcohol, caffeine, smoking. Prefer to wear temple undergarments. Arrange for blessing if requested. 7. Seventh Day Adventism: Avoid unnecessary treatments on Saturday (Sabbath). Sabbath begins Friday sundown, ends Saturday sundown. Adventists prefer restful, spirit-nurturing family activities on Sabbaths. Likely to be vegetarian and abstain from caffeinated beverages. Do not smoke or drink alcohol. 8. Islam - Muslim: Respect modesty, avoid nakedness. Provide same gender nurse if possible. Support prayers five times daily (may need to assist with ritual washing and positioning beforehand.) Allow for family and imam (religious leader) to follow Islamic guidelines for burial when client dies. Eat no pork. Children, pregnant, elderly, and sick exempt from daytime fast during month of Ramadan. 9. Hinduism: Most eat no beef; many are vegetarian. Cleanliness highly valued. Many food preferences (i.e. foods fresh or cooked in oil.) 10. Buddhism: May be vegetarian. Facilitate mediation (may desire incense, visual focal point, use breathing or chanting, etc.) 11. Native American Religions: Traditional healers - medicine man/woman. Note taking by the professional is forbidden, setting should be quiet, and usually talk in low tones. Health is a state of harmony, disharmony results in disease and illness. 12. Rastafarianism: Use the old and new testament of the bible but do not consider themselves Christians. Don't eat pork or shellfish, wearing second hand clothing is forbidden, meaning they might not wear hospital gowns. 13. Atheism: 14. Hmong: Avoid eye contact, do not address women by their first names, be aware of body language. Hmong prefer hot chicken and rice, they drink hot or warm water. Surgery not acceptable. |
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Spiritual Interventions |
Interventions to treat and prevent spiritual problems related to the patient's illness. To ultimately promote spirituality in patients. When performing interventions, remember that you absolutely must follow the patients lead and be caring and respectful without inserting your own beliefs into the conversation. |
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The Joint Commision |
A group that oversees and establishes standards of quality and performance measurement in the healthcare system and annually publishes The Accreditation Manual for Hospitals. These outcomes and measures are used to evaluate the quality of care in healthcare institutions. |
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Never Events |
A list of "never events" that are serious and are costly errors that can cause serious injury or death, and that are mostly preventable. (i.e. falls, burns, restraints, or bed-rail injuries, foreign objects left in patients, air embolism, administering wrong blood, trauma, pressure ulcers, infections associated with catheters urinary/intravenous that lead to UTI, surgical site infections, DVT, and PE) |
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Root Cause Analysis |
Process for identifying factors that bring about deviations in practices that lead to an event. Must not simply punish individuals but, must learn to improve the situation. Not to single anyone out but ultimately improve overall situation. |
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Falls |
Falls are by far the most common incident reported in hospitals and long-term care facilities. Knowing the procedures and safety features to prevent falls is essential. |
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Equipment-Related Accidents |
This occurs when equipment malfunctions or is used improperly (i.e. bed alarm failure, suction devices, infusion pumps not working properly, wheelchairs and/or beds not locked) Interventions to ensure safe use of equipment: 1. Seek advice if you are unsure how to operate the equipment. 2. Make sure medical equipment has been properly inspected. 3. Be alert to signs that the equipment is not functioning properly. 4. Make sure that rooms are not cluttered with equipment. 5. Follow agency policies regarding all equipment use. All equipment needs to be inspected for proper grounding and safe cords. |
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Restraints |
Protective devises used to limit physical activity of the client or a part of the body. A restraint is a device or method used for the purpose of restricting a patient's freedom of movement or access to his body, with or without his permission. A restraint may also be (1) a mechanical device, material, or equipment, such as a cloth vest or side-rails or (2) a chemical restraint given to control disruptive behavior, for example sedatives and psychotropic agents. Restraints are themselves a safety hazard, and actually increase the likelihood of injury. Avoid restraints when possible but, sometimes they are necessary depending on the use (i.e. used for direct support for medical healing, or behavioral reason). |
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SPEAK - UP |
The Joint Commission encourages patients to become active, involved, and informed participants on the healthcare team, and for parents to do the same to help protect their children from medical errors. The following simple steps are based on research that shows that patients who take part in decisions about their healthcare are more likely to have better outcomes. Speak Up Pay Attention Educate Yourself Ask for an Advocate Know your Medications Use a Medical Facility that upholds the highest Standards of Care and QSEN Participate in your Treatment |
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To Err is Human |
The IOM released a report in 1999 concluding that tens of thousands of Americans die each year as a result of preventable mistakes in their care, the report lays out a comprehensive strategy by which government, health care providers, industry, and consumers can reduce medical errors. This is where the Six Aims for Improvement came into play. |
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The overall goal of the QSEN |
The overall goal of the QSEN is to meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSA's) necessary to continuously improve the quality and safety of the healthcare systems within which they work. Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values and needs. Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication mutual respect, and shared decision-making to achieve quality patient care. Evidence-Based Practice: Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal healthcare. Quality Improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance. Informatics: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making. |
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Melnyk & Fineout-Overholt EBP Model |
The overall goal is to emphasize evidence and clinical decision making. |
