Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

I.

II.

III.

Discuss Historical factors and Nursing Leaders Influencing the Development of Nursing A. Factors 1. Women s Role - nurturer 2. War (Crimean) men gone to war, women left to take care of others 3. Religion love thy neighbor 4. Societal Attitudes pleasant companion and responsible mother B. Nursing Leaders 1. Florence Nightingale hospital reformation, implementing public health policy, nursing education and changed society s view of nursing 2. Clara Barton establishing American Red Cross 3. Linda Richards First trained nurse, initiated nurses wearing uniforms, credited for pioneer work in psychiatric and industrial nursing. 4. Mary Mahoney First African American professional Nurse. 5. Lillian Wald founder of public health nursing 6. Lavinia Dock campaigned for legislation to allow nurses, not Dr s, to control their profession 7. Margaret Higgins Sanger imprisoned for opening the first birth control information clinic in US. 8. Mary Breckinridge Frontier Nursing Service provided care to rural areas. 9. Virginia Henderson first modern nurse concern with healthy and ill Discuss the evolution of Nursing education and entry into Profession Nursing Practice A. Evolution of Nursing Education 1. Controlled within the profession through State Boards and Professional Nursing Organizations 2. Originally focus on skills and knowledge 3. Evolved to include technology, cultural, political, social, physical sciences, liberal arts 4. Currently curricula emphasizes Critical Thinking and Application of knowledge 5. Two types of entry level nurses a. RN registered nurse (associate, baccalaureate, diploma) pass NCLEX b. LPN or LVN vocational nurse 6. Licenses can be a. Compact States license for multiple states b. Compact states 7. Licenses for nurses must be renewed regular and some states may require CE credits to maintain license. Describe the different types of education programs for Nurses. A. LPN 1. Programs housed in community colleges, vocational schools, hospitals. 2. Program last about 9-12 months 3. NCLEX-PN to obtain license 4. LPN s work under the supervision of RN and scope may change per state

Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

IV.

V.

B. RN programs 1. Diploma Program a. Designed to meet service needs of hospital b. 3 year program c. Hospital based rich in clinical experiences d. Decrease in programs since ANA education for those who work in nursing should be placed in institutions of learning within the general system of education 2. Associate Degree Programs a. Started around 1950 b. Made higher education more accessible for individuals, program 2 years c. Separate from hospital, no agenda d. Can work as RN while furthering education 3. Baccalaureate Degree Program a. Program 4 years b. Accelerated BSN to RN program (BSN holders can take classes to become RN) c. RN to BSN d. BSN s may be paid more and may experience more autonomy, responsibility, participation in institutional decision making, career advancement. 4. Masters Degree Programs a. Education and Administration b. Advance roles in practice i. Clinical Nurse Leader ii. Nurse Practitioner 5. Doctoral Programs a. Choose fields related to education, psychology, sociology and physiology. 6. Continuing Education a. To maintain license b. To become certified in specific area c. Education programs are more specific and shorter d. Keeps Nurses in formed of new techniques and knowledge e. Provide Nurses with essential information to practice (legal and ethical) Explain the importance of continuing Nursing Education A. Keeps Nurses in formed of new techniques and knowledge B. Provide Nurses with essential information to practice (legal and ethical) C. Help Nurses attain expertise in specialized are of practice Describe how the definition of Nursing has evolved since Florence Nightingale A. Virginia Henderson treat healthy and ill patients B. Florence Nightingale the act of utilizing the environment of the pt to assist in his recovery C. Common Themes caring, an art, a science, client centered, holistic, health promotion, maintenance and restoration.

Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

D. Professional Associations
1. ANA Nursing is the protection, promotion, and optimization of health and abilities, preventions of illness and injury, alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities and populations. Virginia Board of Nursing - "Practical nursing" or "licensed practical nursing" means the performance for compensation of selected nursing acts in the care of individuals or groups who are ill, injured, or experiencing changes in normal health processes; in the maintenance of health; in the prevention of illness or disease; or, subject to such regulations as the Board may promulgate, in the teaching of those who are or will be nurse aides. Practical nursing or licensed practical nursing requires knowledge, judgment and skill in nursing procedures gained through prescribed education. Practical nursing or licensed practical nursing is performed under the direction or supervision of a licensed medical practitioner, a professional nurse, registered nurse or registered professional nurse or other licensed health professional authorized by regulations of the Board. SRMC - Nursing is an evidenced-based practice discipline built upon a professional body of knowledge that encompasses concepts and knowledge from the biological, social, psychological and physical sciences, as well as the liberal arts. Nursing is the vigilant, continuous, and sustained care of the acute or chronically ill; the supportive care given to sustain the optimal level of health for client systems; the restorative care provided during rehabilitation and convalescence; the management of nursing care in healthcare delivery systems; and the teaching of health promotion practices. The goal of nursing is prevention of illness, alleviation of suffering, promotion, protection, and restoration of health, and support of a dignified death.

2.

3.

VI.

Identify the four major areas of nursing practice A. Promoting Heath and Wellness 1. Individual or community 2. Activities to enhance health lifestyles a. Nutrition b. Physical fitness c. Preventing drug and alcohol abuse B. Preventing Illness 1. Immunizations 2. Prenatal 3. Infant care 4. Prevention of STD s C. Restoring Health (to ill client) 1. Providing direct care (meds, treatments, procedures) 2. Diagnostic and assessment procedures (BP, labs) 3. Consulting with other Health care professionals 4. Educating Client 5. Rehabilitation (Physical and mental) D. Caring for Dying 1. Providing Comfort 2. Educating Client and Family 3. Support client with coping

Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

VII.

Identify the purposes of Nurse Practice Acts and Standards of Professional Nursing Practice A. Nurse Practice Act or legal acts for professional nursing regulate the practice of nursing in US by state having own legislation. Common purpose to protect the public. B. Standards of Professional Nursing Practice describe the responsibilities which the nurse is accountable for

VIII.

Describe the Roles of Nurses A. Caregiver 1. Assist client physically and psychologically while preserving dignity 2. Encompases the physical, psychosocial, developmental, cultural and spiritual lvls. 3. May be direct care or delegated B. Communicator 1. Identifies Ct. problem them communicates to other members of health team 2. With Ct, support persons, health professionals and people in community C. Teacher 1. Teach Ct about their health care need related to disease process 2. Teach colleagues

Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

IX.

X.

D. Client Advocate 1. Protect the Client 2. Help Ct exercise their rights E. Counselor 1. Help ct recognize and cope 2. Encourage Ct to look for alternative behaviors, choices and develop a sense of control F. Change Agent 1. Help Ct make modifications in their behavior 2. Medication or Technology adjustments G. Leader 1. Influences others to work together to met common goal H. Manager 1. Manages care for Ct and family 2. Manages colleagues, supervises, evaluate others performances I. Case Manager 1. Work with multidisciplinary health care team to measure the effectiveness of care and monitors outcomes based on what the clients insurance, govt assistance, or other funds . J. Research Consumer 1. Researchable problems and sensitive to rights of humans Describe the expanded Career roles of Nurses and their Functions A. Nurse Practitioner deal w/ nonemergency acute or chronic illness provide primary ambulatory care. B. Clinical Nurse Specialist expert in specialized area C. Nurse Anesthetist administers general anesthetics for surgery under supervision of physician D. Nurse Midwife prenatal and postnatal care and normal deliveries E. Nurse Researcher investigates problems to improve nursing care F. Nurse Administrator manages Ct care, including the delivery of nursing services. G. Nurse Educator teaches nurses H. Forensic Nurse consultation services to nursing, medical, law related, testimony, Discuss the criteria of a profession an the professionalization of Nursing A. Profession an occupation that requires extensive education or a calling that requires special knowledge, skill and preparation 1. Specialized training 2. Code of ethics 3. Autonomy 4. Professional Organization B. Professionalization is the process of becoming professional; acquiring characteristics considered to be professional. C. Professionalism refers to professional character, spirit or methods.

Fundamentals

Chapter 1

Historical & Contemporary Nursing Practice

XI. XII.

Discuss Benner s Levels of Nursing proficiency Describe factors that influence contemporary nursing practice A. Economics Greater support provided through public and private health insurance B. programs has increased the demand for nursing care 1. Using more Emergency Dept care, Mental Health counseling, preventive physical exams 2. Cost of Health Care Increased 3. Medicare payment to hospitals and Dr s revised to reimbursements fees according to medical diagnosis known as diagnostic related groups (DRG s) 4. Inpatient to Outpatient (Affects Nursing the most) C. Consumer Demand 1. Consumer becoming more educated now aware of need of care 2. Needs for minority and poor 3. Health is a right of all people 4. People want a feeling of wellness 5. Consumer participates more in decisions D. Family Structure 1. Single parents 2. Adolescent parents 3. Working parents E. Science and Technology 1. Cost money increasing health care 2. Nurses need more education for Technology Explain the functions of national and international nurses association A. National League for Nursing of both individual and agencies; mission is to foster the development and improvement of all nursing services and nursing education. Primary source of research data about nursing education in the US

XIII.

Fundamentals Chapter 1 Historical & Contemporary Nursing Practice B. International Nurses Association provides an organization through which member national associations can work together for the mission of representing nursing worldwide, advancing the profession and influencing health policy