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53 Cards in this Set
- Front
- Back
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What is the significance of image in nursing?
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Majority of Americans get information from the televised media or from experience with a health care professional
-Influences what people think and talk about -Influences choices -Can have unintended consequences -Informs the public -Shapes public opinion -Impacts policy |
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How doe Image impact nursing?
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-Recruitment (quality, quantity, and diversity)
-Client expectations -Nurses’ self-image |
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How may image effect policy?
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Nurse researchers receive less than 0.5% of the U.S. National Institutes of Health research budget
Nursing residencies less U.S. federal funding than physician residencies receive. Few nurses sit on the board of directors of hospitals. Nursing educators receive less salary than colleagues in comparable fields. |
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What is the history of image in nursing?
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1800-Untrained servants, Soldiers, Women of religious orders, Wealthy people performing acts of Christian charity
1845-1915-Florence Nightingale (Nursing as a holy vocation) vs. Sairy Gamp (character in Charles Dickens Book, a incompetent and drunk nurse). 1915-1945-Edith Caldwell (WWI) Heroine seen during times of war. Early 1960s-Handmaid and Romantic Partner Late 60s to Present-Sex object |
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What Initiative has Johnson & Johnson taking to improve the image of nursing?
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Campaign-Nursing’s Future, a public-awareness campaign is working to address the nursing shortage in the U.S. by recruiting new nurses and nurse faculty and helping to retain nurses currently in the profession.
Profile nurses in the profession and give recognition for their accomplishments |
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What initiative is the Robert Wood Johnson Foundation and the Institute of Medicine taking to improve the image of nursing?
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Future of Nursing
1. Nurses should practice to the full extent of their education and training. 2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. 3. Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States. 4. Effective workforce planning and policy making require better data collection and an improved information infrastructure. |
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What is the metaparadigm of nursing?
(a metaparadigm is a set of concepts and propositions that sets forth the phenomena with which a discipline is concerned) |
Person
Health Environment/setting Nursing |
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What is Philosophy in Nursing?
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Set of beliefs
World view that reflects values Contains some or all concepts of the metaparadigm Examples: Nightingale, Watson, Henderson |
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What is Theory in Nursing?
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A group of related concepts….that describe a certain view of nursing phenomena from which to describe, explain, or predict outcomes”
Less abstract then models and usually propose specific outcomes. Examples: Orlando, Leininger, Peplau |
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Florence Nightingale
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philosophy
Nurse-every women would be one at sometime in her life Patient-passive acted upon by the nurse Health- Being well and using every power we have to the fullest extent *Environment- includes everything from the patient’s food and flowers to the nurses verbal and nonverbal interactions with the patient |
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Virgina Henderson
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-philosophy
Nursing- assist the patient in needs that he would do if he could and help he to reach independence asap Health- 14 basic needs to maintain Environment- external conditions and influences affecting the life and development *Person- individual who requires assistance to achieve health and independence or peaceful death, family and patient a unit, physiological and emotional balance |
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Conceptual Models or Frameworks of Nursing
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-Attempt to make concrete the concepts they represent
-May consist of words, mathematical notations, or physical material -Theories may be graphically represented by models Examples: Levine, Rogers, Roy, King, Orem |
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Dorothea Orem
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Conceptual Model - 3 interrelated theories - Theory of Self-Care, Theory of Self-Care Deficit, Theory of the Nursing System
focuses on the patient's self-care capacities and the process of designing nursing actions to meet the patient's self-care needs. Developed through: diagnostic (relationship with client to see need), prescriptive (planning with the client), regulatory (system of care) |
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Clallista Roy
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Conceptual Model -Adaptation Model
Individual as a biopsychosocial adaptive system and describes nursing as a humanistic discipline that emphasizes the person's adaptive or coping abilities. Nurse focuses on the adaptation of the patient and the environment (internal and external).Any environmental change demands increasing energy to adapt to the situation 4 models(effectors)-physiological needs, self-concept, role function, interdependence |
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Hildegard Peplau
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Theory of Nursing - Interpersonal Relationship
Focus on the nurse as well as the patient. Survival and for the patient to understand their health problem and develop new behaviors. |
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Influence of Nursing Theory on a Nurse's approach to practice
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Strengthens the profession by contributing to knowledge building; Helps with reasoning, critical thinking, and decision-making
Organize data, Analyze data, Recognize pertinent, evidence, Understand data, Make decisions, Plan care Predict outcomes of care Evaluate patient outcomes |
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Ethics
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is a term used to reflect what actions an individual should take; are concerned with what should be done.
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Values
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beliefs, ideals, and attitudes that one uses to guide behavior.
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Morals
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established rules of conduct to be used in situations where a decision about right and wrong must be made; provide standards of behavior that guides the actions of an individual or social grp.
Learned over time from experiences and culture. reflect what is done in a situation |
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General content and purpose of a code of ethics
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Having a code of ethics has long been a hallmark of disciplines considered to be professions.
A code of ethics is an implied contract through which the profession informs society of the principles and rules by which it functions |
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Autonomy
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based on the assertion that individuals have the right to determine their own actions and the freedom to make their own decisions. Respect for the individual is the cornerstone of this principle.
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Beneficenece
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commonly defined as “the doing of good” and is often thought to be the most critical ethical principle in health care. In essence, one should always consider one's actions in the context of promoting good for others (i.e., the patient).
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Nonmaleficence
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is defined as the duty to do no harm. The principle of double effect considers the intended foreseen effects of actions by the professional nurse. The doctrine states that as moral agents we may not intentionally produce harm. It is ethically permissible, however, to do what may produce an evil or undesirable result if the intent is to produce an overall good effect
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Justice
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patients with the same diagnosis and health care needs should receive the same care.
Those with greater or lesser needs should not receive different care. |
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Veracity
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defined as “telling the truth.” Telling the truth is expected. Inherent in nurse-patient relationships is the understanding that nurses will be honest with their patients.
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Fidelity
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refers to faithfulness or honoring one's commitments or promises to patients.
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Steps in ethical analysis or decision-making
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“the best decision” will be made. In an ethical dilemma, there is not a right or wrong answer. Instead, we search for the best answer.
Ethical decision-making models are helpful in determining the best action to take when faced with an ethical dilemma. |
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Role of legislation in Nursing
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Statutory law— U.S Congress or state legislatures
-Criminal- public concerns that threaten society Felony and Misdemeanor -Civil-issues between individuals |
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Role of Administration in Nursing
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Regulatory/Administrative law-delegated to agencies to implement - Board of Nursing
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Role of judicial levels of government in Nursing
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Common law—Judicial decisions
Informed consent, right to refuse treatment |
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Components of a model nurse practice act
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ANA
A clear differentiation between advanced and generalist nursing practice Authority for Board of Nursing (BON) to regulate advanced practice nurses (APNs), including authority for prescription writing Authority for boards of nursing to oversee unlicensed assistive personnel (UAP Clarification of the nurse’s responsibility for delegation and supervision Support for mandatory licensure with flexibility to accommodate changing nursing practice |
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Authority of state boards of nursing
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-Established by the state legislature
-Responsible for enforcing the nursing practice act of the state (quasi-executive) -Disseminates rules and regulations that flesh out -the law (quasi-legislative) -Has authority to deny, suspend, revoke licensure and to discipline a licensee (quasi-judicial) |
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State statutory issues of importance to nurses
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Public health laws, Uniform Determination of Death Act, Physician-assisted suicide, Good Samaritan laws, Licensure
WI CHAPTER 441 -Defines the practice of professional nursing -Sets the educational qualifications and other -requirements for licensure -Determines the legal titles and abbreviations nurses may use -Provides for disciplinary action of licensees |
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Nursing concerns related to delegation
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-can it be delegated
-does individual have knowledge needed to perform task |
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Nursing concerns related to assault and battery
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Assault
Threat or attempt to make bodily contact with another person without the person’s consent precedes battery example: Threatening to tie a patient down. Battery The assault carried out example: Giving treatment patient has refused will make nurse liable for battery |
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Nursing concerns related to informed consent
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-Provided by the physician and the responsibility of the physician
-Explanation of the procedure/treatment -Names/qualifications of persons performing procedure -Description of potential harms -Alternatives, including risk of no intervention -Right to refuse doesn’t mean w/d of other tx -Right to refuse even after procedure has started |
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Srategies nurses can use to protect their patients , thereby protecting themselves from legal action
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-Practice in a safe setting
-Communicate with other health professionals -Meet the standard of care -Attend to and document every step of the nursing process -Delegate appropriately -Understand liability and carry liability insurance -Treat patients and families with respect |
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Elements of Malpractice
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1. Nurse assumed the “duty of care”
2. Nurse fails to meet the standards of care 3. Failure to meet standard caused the injury 4. The injury is proven |
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Malpractice vs. Negligence
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Malpractice: negligence applied to the acts of a professional Commission, Omission
Torts --civil wrongs against a person, intentional or unintentional that results in harm. Negligence--failure to act reasonably or prudently |
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Current public policy agenda and prospective legislative changes that are of significant consequence to nurses
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see hand out
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What are the benefits of belonging to professional nursing associations/organizations?
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-network with colleagues
-continuing education and certification -stay informed on professional issues -develop leadership skills -influence health policy -work collectively for job security |
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Factors that influence the professional nursing scope of practice
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-law governing practice
-what is allowed under license -what education is required |
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How can nurses get involved with policy and politics and how does policy influence the practice of nursing?
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Understand the connections between individual practice and public policy
-citizen (voting, advocate to health and human services, community activities) -activist (contacting public offices, joining nursing organizations, lobbying) -politician: |
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What is the difference between therapeutic and social relationships?
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PROFESSIONAL
Limited in time, Goal directed, Patient centered, Obligation to problem solve, Nonjudgmental acceptance, Aim is to improve health of the client, Planned and purposeful SOCIAL Not time limited, Not usually goal directed, Centered on both parties, No obligation to problem solve, May or may not be nonjudgmental, Aim is pleasure, Spontaneous BOUNDARIES ARE DIFFERENT |
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What does "Self-awareness and therapeutic use-of-self" mean?
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The use of communication for the purpose of creating a beneficial outcome for the client
Facilitates the establishment of the nurse-client relationship and fulfills the purposes of nursing Forms a connection between client and nurse |
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Therapeutic and non-therapeutic communication techniques and application
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See hand outs
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Steps of Nursing Process and application
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Assessment
Diagnosis Outcomes Planning Interventions Evaluation |
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Nursing diagnoses - purpose, parts, and application
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Label:Concise term or phrase that names the diagnosis
Definition: Term or phrase that clearly delineated meaning and helps differentiate from similar diagnosis Defining characteristics: Clusters of observable cues or inferences Risk Factors: Factors that increase vulnerability to an unhealthful event Related Factors: Factors that precede, are associated with, or relate to the diagnosis Problem (NANDA Dx) r/t etiology (causes) aeb signs and symptoms |
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What are the Types of Nursing Diagnoses
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Actual Diagnosis; Human responses
Health Promotion/Wellness Diagnosis: to increase well being Risk Diagnosis: a clinical judgement about human experience/response to health condition Syndrome Nursing Diagnois: Cluster of nursing diagnoses that occur together and are being treated with similar interventions. |
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What is mutuality between the nurse and the client in the nursing process?
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Mutuality: Collaboration between nurse and client in problem solving
Nurse and client agree on health problems and means for resolving them Nurse and client are both committed to enhancing the client’s well-being Mutuality increases the probability of success Mutuality contributes to shared accomplishment and satisfaction |
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What are primary and secondary sources of data?
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Primary Research involves the collection of data for original research. The research has not already been analyzed by other parties.
Secondary research analyzes, interprets or summarizes primary research. |
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Abstract to More Concrete
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Metaparadigm
Conceptual Models or Frameworks Theory Middle Range |
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How do you achieved Mutuality?
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Use of questions
To identify the problem To discover relationships between the problem and influencing factors To move through the nursing process collaboratively with the client To integrate problem solving and therapeutic communication |
