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128 Cards in this Set
- Front
- Back
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Profession of nursing
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- Client center of practice
- respect for human dignity - uses biological principles and technologies - uses social science principles - caring and compassion mixed with technology, advancements , teamwork and leadership |
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Discipline
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Branch of knowledge or teaching
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Occupation
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Source of livelihood
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Profession
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- Requires training in liberal arts and sciences
- technical and scientific knowledge - evaluated by a community of peers - service orientation - code of ethics |
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Practice
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The carrying out or exercise of a profession
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Calling
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A strong urge toward a particular way of life or career
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Professional Roles
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Caregiver
Advocate Educator Communicator Manager Researcher |
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Career Paths
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Clinician, Advanced Generalist, Advanced Practice
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Clinician
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Acute, chronic, specialty, critical care, community health, hospice
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Advanced Generalist
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Clinical Nurse Leader
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Advanced Practice
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CNS, NP, Midwife, NA, Educator
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ANA definition of nursing
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The protection promotion and organization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families and communities and populations
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ANA Standards of practice
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Assessment
Diagnosis Outcomes Identifications Planning Implementation Evaluation |
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ANA Standards of Professional Performance
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Quality of Practice
Education Professional Practice Evaluation Collegiality Collaboration Ethics Research Resource Utilization Leadership |
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Nursing Education
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Diploma Nursing
LVN Associate Degree in Nursing Baccalaureate degree in Nursing International degrees in Nursing |
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Nursing Education
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Masters Degree in Nursing
Post Master Certificates Doctorates: EdD, PhP, DNP, DNS |
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LVN
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Technical Role, task oriented
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RN
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Professional role
Leader Decision maker Evidence and standards based Educator |
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American Association of Colleges of Nursing
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Accredits Nursing School
Qualify for NCLEX exam after graduation |
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Licensure
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Accreditation
Practice Readiness Conformity to minimum education standards Passing State boards (275 questions – 6 hours) CEUs |
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Common themes in history of nursing
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Focus on the most vulnerable
Active in social policy and political arenas Lobby for health care policy Expanding knowledge for better care |
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Florence Nightingale/Crimean War
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Reduction of infection &Improvement of sanitation
Lead to decrease in mortality |
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Nightingale Accomplishments
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Formulated the Environmental Theory of Nursing
- First Nurse epidemiologist - Connected sanitation to dysentery -Considered nurse’s responsibility as being “in charge of somebody’s health” - Reduced war time mortality from 42% to 2.2% in 6 months |
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Role of religion in nursing history
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- Convents and monasteries served as hospitals for the poor
- All religious frameworks teach compassion, which is often expressed as care for the sick, injured and vulnerable - Traditional healing methods often offered within a spiritual framework |
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Role of Military in Nursing History
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Civil War stimulated growth in nursing
- Clara Barton founded the American Red Cross - Nurses oversaw and organized hospitals, appointed nurses to war stations and regulated supplies to the troops - Nurses walked battlefields looking for wounded soldiers |
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Legal oversight of the Nursing profession
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National Council of State Boards f Nursing
State boards of Nursing |
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California Board of Registered Nursing
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Maintain licensure
CEU Mandate State Reciprocity |
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Educational Accreditation Agencies
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National League of Nursing
American Association of Colleges of Nursing (CCNE) BRN |
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Public Health
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1890’s – Lillian Wald, Mary Brewster
- Found that the poor immigrants living in squalor. - Settlement House, lower East Side of NYC - Provided care to all, regardless of whether or not they could pay. |
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“Wild Western” Nursing
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1800-s to 1900s
-Public Health nurses traveled by horseback -often acted as midwives -carried supplies with them. |
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Influence of the Women’s Movement
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- 1970 – 1980’s through today
- Role of gender in nursing -Traditional gender roles challenged -Nursing reclaimed autonomy as profession matured -Now more women enter medicine, and more men enter nursing |
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Nursing Education
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1870-1970 – Training centered at hospital (Diploma RN)
-1930-s first college programs -After WWII – community colleges open programs -1970- Hospital care became more complex, nurses needed more education. School of nursing moved to colleges and universities (AND and BSN) - As science of nursing developed advanced degrees did to (MSN, PhD, DNP) |
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Nursing Licensure
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1867 – licensure for nurses first considered in England
1901 – New Zealand is the first country to require liensure -1903 Standardize |
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Theory
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Governs what we do, what we research
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Paradigm
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Links science, philosophy, and theories accepted and applied by discipline
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Nursing paradigm
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Direct the activities of the nursing profession, including knowledge development, philosophy, theory and educational experience research and practice.
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Definition of nursing
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Diagnosis and treatment of the human responses to actual or potential health problems
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Nursing theory
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Conceptualization of some aspect of nursing communicated for the purpose of describing, explaining, predicting and/or prescribing nursing care.
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Theory
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A set of concepts, definitions assumptions or propositions to explain a phenomenon
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Phenomenon
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An aspect of reality that people consciously sense or experience
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Grand theories
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Broad in scope, complex and require further research
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Mid-range theories
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Address specific phenomenon and reflect practice
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Descriptive theories
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First level of theory development, which describes phenomenon and speculates why they occur
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Prescriptive theories
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Address nursing interventions and predict the consequences of specific nursing interventions
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EBP
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Evidence based practice
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Evidence Based Practice
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Problem solving approach to clinical practice that integrates the conscientious use of the best evidence in combination with the clinician experience
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Developing PICO Questions
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P – Patient Population of interest
I – Intervention of interest C – Comparison of Interest O – Outcome |
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Transcultural perspective
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- Madeline Lenininger
- Essence and central unifying domain that distinguishes caring from other health disciplines |
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Transpersonal Caring
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- Watson
- Holistic model for nursing that suggests that a conscious intention to care promotes healing and wellness |
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Swanson’s Theory of Caring
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- Kristen Swanson
- Nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment and responsibility 1- knowing : striving to understand 2- being with: emotionally present 3- Doing for: as she/he would if possible 4- Enabling: facilitiating 5- Maintaing Listening Touch Providing presense …… |
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Presence
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Person to person encounter conveying closeness and a sense of caring
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Caring theory
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- Assists with the ways we communicate
- absolutely central to nursing practice - action to promote healing |
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Threats to caring
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- Acuity
- Time constraints - Chaotic environment - Technology - Cold and indifferent |
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Pain theory
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Assists with was to choose an appropriate pain assessment tools
- physical - emotional |
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Fluid and electrolyte theory
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Assists with understanding patient’s response to surgery
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Dorthea Orem’s theory
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Assists with ways to assess level of efficacy with self care.
- (make up for unmet needs due to illness) |
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Nightingale
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Hygiene, clean air, nutrition and rest.
-put the patient in a healing environment. Each human being has the capacity to heal themseles |
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Four domains of nursing care
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Person
- receipient of care Health - dynamic and continually changing Environment/situation - all possible conditions affecting health and care Nursing - diagnosis and treatment of the human response to actual or potential health problems |
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Nursing theory components
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- Phenomenon
- Concepts - Definitions - Assumptions |
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Why have Nursing Theories
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-Guide Nursing care
-Help us to plan care -Improve nursing administration -Guide Research studies -Formulate legislation governing nursing -Develop curriculum -Guide development of care delivery systems -Provide rationale for nursing activities. |
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Nightengale (1860)
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“facilitation of the body’s reparative processes"
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Neumans Systems Theory of Nursing
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- Systems theory as a transdisciplinary
- Humans are open systems - Person interacts with environment, environment is both internal and external, stressors from the environment may effect the well being of the patient |
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Goals for Healthy People 2010
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- Increase quality and years of healthy life
- Eliminate health disparities |
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Four areas of concentration for Healthy People 2010
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1) Promote healthy behaviors
2) Promote healthy and safe communities 3) Improve Systems for personal and public health 4) Prevent and reduces disease and disorders |
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Health
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State of complete physical, mental and social well being, not merely the absence of disease
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Health Beliefs
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A person’s ideas, convictions, and attitudes about health and illness
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Health Belief Model
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- Rosenstoch, Becker & Mainman
- addresses the relationship between a person’s belief and behaviors |
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3 Components of the Health Belief Model
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) perception of susseptabilty to an illness
2) perception of the seriousness of the illness 3) liklihood of the person to take preventative action |
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Health Promotion Model
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- Pender
- defines health as a positive dynamic state - directed at increasing the level of well being |
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3 Areas of focus in Health promotion Model
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) Individual Characteristics and experiences
2) behavior specific knowledge and effect 3) behavioral outcomes |
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Basic Human Needs Model
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- based on Maslow’s Hierarchy of need
-physical -safety and security -love and belonging - self esteem - self actualization |
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Internal Variables effecting health and health beliefs
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- Developmental phase
- Intellectual background - Perception of functioning - Emotional and spiritual factors |
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External variables effecting health and health beliefs
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- Family Practice
- Socioeconomic factors - Cultural background |
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Holistic Health Model
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- create conditions that promote optimal health
- clients considered ultimate expert regarding their health - clients involved in healing process and are responsible -recognizes the bodies natural healing abilities - complement to traditional medical care |
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Health promotion activites
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Help clients maintain and enhance their present level of health
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Wellness education
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Teaches people how to care for themselves in a healthy way
ie physical awareness, stress management |
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Illness Prevention Activites
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Protect from actual or potential threats to health
ie immunizations |
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Passive Strategies of Health Promotion
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Individuals gain from the activities without acting themselves
Fluoridation of water, fortification of milk |
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Active Strategies of Health Promotion
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Individuals are motivated to adopt specific health programs
Weight loss, smoking cessation |
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Primary Prevention
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Prevention of disease before the onset of symptoms
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Secondary Prevention
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Focuses on individuals who are experiencing health problems and who are at risk of developing complications of worsening conditions
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Tertiary Prevention
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When a condition is permanent and irreversible.
- minimizing effects |
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Risk factor
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Any situation, habit, social or environmental concern that increases the vulnerability of an individual or group to an illness or accident
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Types of Risk Factors
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- Genetic and physiological factors
- Age - Environment - Lifestyle |
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Illness
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A state in which a person’s physical, emotional, intellectual, social, developmental or spiritual functioning is diminished when compared with previous experience
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Evidence Based Practice
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- The age of accountability, the old adage of health care provided based on tradition is no longer accepted
- Use problem solving steps to find the best practice -guide for clinical decisions - Ask the question “Where is the evidence for this?” |
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Five Steps
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1. Ask the clinical question
2. Collect the most relevant data 3. Critically appraise the evidence you gather 4. Integrate all evidence into practice 5. Evaluate the practice decision or change |
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PICO Questions:
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P- Population
I – Intervention C- Comparison (What is the usual standard of care) O - Outcome (What is the result you wish to achieve) |
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Traditional definition of health
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Wholeness of body, parts functioning properly, mental balance…harmony with nature…yin and yang
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WHO definition of health
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A state of complete physical, mental social well-being, not merely the absence of disease
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Biological definition of health
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Absence of diagnosable disease; “normal” physical findings
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Modern definition of health
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Health and illness must be defined in terms of the individual
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Illness
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A state in which a person’s physical, emotional, intellectual, social, developmental or spiritual function is diminished compared with a previous experience
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Maslow’s Hierarchy of Needs
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Physiological
Safety Love/belonging Esteem Self-actualization |
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Health – Illness continuum
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Health is a moving state as a person adapts to changes to maintain a state of complete well-being. The continuum is personal and dynamic
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Becker and Maiman Health Belief Model
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Health beliefs area a person’s ideas, convictins and attitudes about health ans illness
Three components 1. individuals perception of suseptibiltiy to illness 2. perception of the seriousness 3. likelihood that a person will take preventive action |
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Pender’s Health Promotion Model
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Health is positive dynamic state and not just the absense of disease
- prior related behavior -perceived self efficacy |
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Internal variable influence health
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Developmental stage
Intellectual background Perception of functioning Emotional factor Spiritual factor |
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External variables influencing health
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Family practice
Socioeconomic factors Cultural background |
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Risk Factors
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Genetic and physiological factors
Age Environment Lifestyle |
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Levels of preventative care
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Primary-precedes disease
Secondary – experiencing symptoms Tertiary – chronic illness |
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Primary level of preventative care
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Health promotion (approach)
Illness prevention (avoidance) |
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Secondary level of preventative care
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- Currently experiencing symptoms
- Activities aimed at diagnosis and intervention - Screening test - Treatment of acute stages of illness |
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Tertiary Level of Preventative care
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- Chronic illness
- minimize effects - Rehab |
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who may leaglly use the title nurse
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lvn + rn
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Collaborative Problem
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- Problems requiring several disciplines
- complications that nurses monitor to detect the onset of changes |
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Medical diagnosis
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Identification of a disease
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Nursing Diagnosis
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Classification of health problems within the domain of nursing
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Clinical Criteria
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Objective or selective signs and symptoms, or risk factors
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Goal
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Broad statement that describes a desired change in status
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Expected outcome
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Specific measureable change in status
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Client centered goal
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Reflects a clients highest possible level of wellness
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7 guidelines for writing goals and outcomes
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1. Client centered
2. Singular 3. Observable 4. Measureable 5. Time limited 6. Mutual 7. Realistic |
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Nursing Intervention
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Any treatment based on clinical judgement & knowledge that a nurse performs to enhance clinical outcomes
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Direct Care
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Treatments performed via interactions with client
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Indirect Care
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Treatment performed away from but on behalf of the client (charting, collaboration
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Nursing Process
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Assessment
Diagnosis Planning Implementation Evaluation |
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NANDA
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North American Nursing Diagnosis Association
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Nursing paradigm
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person health environment and nursing
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Four components of nursing theory
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Concepts , definitions, phenomenon and assumptions
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PICO
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P - patient
I - intervention C –comparison to standard O- outcome |
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Presence in the nursing contact
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involves a person to person encounter that convey closeness and a sense of caring
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Listening is not only taking in what the client says
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but also includes interpreting and understanding.
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There is a contemporary move towards nursing as EBP
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– nursing researchers will test theories to describe or predict patient outcomes
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In the US, Nurse practice acts are overseen by
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BRN
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What is the primary characteristic of professional nurse
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a theoretical body of knowledge body of knowledge
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The NCLEX for RN licensure ensures
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I minimum body knowledge
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Most California nurse are practicing at the
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associate level.
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