Professional Nursing Concepts Ch 1-6 Questions and Answers

Professional Nursing Concepts Ch 1-6 Questions and Answers ANA definition of nursing "The protection, promotion, and optimization 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, communities, and populations". Altruism the nurse shows concern for the welfare of patients, other nurses, and other health care providers. Autonomy i. Planning care in partnership with patients ii. Honoring the right of patients and families to make decisions about health care iii. Providing information so patients can make informed choices and decisions. Human dignity i. Providing culturally competent and sensitive care ii. Protecting the patient's privacy iii. Preserving confidentiality of patients and health care providers; and iv. Designing care with sensitivity to individual patient needs. Integrity Acting in accordance with an appropriate code of ethics and accepted standards of practice Social Justice i. Supports fairness and non-discrimination in the delivery of care; ii. Promotes universal access to health care; and iii. Encourages legislation and policy consistent with the advancement of nursing care and health care. how professional nursing values are acquired. a. Acquired during socialization into nursing from code of ethics, nursing experiences, teachers, and peers. b. Traditions and cultural, ethnic, and religious groups Values something of worth; an enduring belief or attitude held dearly by a person about people, objects, ideas, or action Beliefs Interpretations or conclusions that one accepts as true Attitudes Mental positions or feelings toward a person, object, or idea the 7-step Patient Value Clarification Process. 1. List alternatives 2. Examine possible consequences of choices 3. Choose freely 4. Feel good about the choice 5. Affirm the choice 6. Act on the choice 7. Act with a pattern What is the 7-step Patient Value Clarification Process. A process for a nurse to use when patients' value system is detrimental to their health CARING promoting health, healing, and hope in response to the human condition INTEGRITY respecting the dignity and moral wholeness of every person without conditions or limitation DIVERSITY affirming the uniqueness of and differences among persons, ideas, values, and ethnicities EXCELLENCE creating and implementing transformative strategies with daring ingenuity Truth i. Faithfulness to fact or reality ii. Attitudes 1. Accountability 2. Authenticity 3. Honesty 4. Inquisitiveness 5. Rationality 6. Reflectiveness Florence Nightingale o Well educated o Holistic view of health: body, mind o Saved many lives in Crimean war o Focus on cleanliness & Nutrition o Founded first nursing school 1860 o Focused on data and outcomes o Layed foundation for evidence based practice: Notes on Nursing Dix and Barton recruited nurses in the civil war Mahoney initiated integration of Nursing Wald established Public Health Nursing Jewish doctors developed a hygeine code o Beliefs: Disease is a curse r/t sin Romans used slaves for nursing care Greeks Hippocrates (father of western medicine) wrote first medical text Christianity in Middle Ages o Wealthy women helped peasants o Deaconesses gave care in homes o Catholic convents founded religious orders o Reformation - convents closed Renaissance o Dark period for nursing o Prostitutes and prisoners served as nurses o Fighting, foul language, petty theft o Expansion of scientific knowledge o Divinci - anatomy o Small pox vaccine o Stethoscope developed o Began to think of disease prevention Colonial America o Little infrastructure to support nursing o Catholic nursing orders and slaves provided care Goldmark Report called for nursing education to be a separate from and precede employment- also advocated nursing licensure and proper training for faculty at nursing institutions Brown Report - recommended that nursing education programs be housed in universities- formed basis for evaluating nursing programs Hill Burton Act established federal funds to build more hospitals, at one point too many hospital beds- believe to cause shortage of nurses Accreditation of Schools of Nursing o National League for Nursing (NLN) o American Association of Colleges of Nursing (AACN)* o National Organization of Associate Degree Nursing (N-OADN) NLN promotes excellence in nursing education to build a strong and diverse nursing workforce o Represents all nursing programs AACN represents university and baccalaureate programs in nursing o Activities include educational research, government advocacy, data collection, publishing, and initiatives to establish standards for BSN and graduate degree o Concerned with development of standards and resources and promotes innovation, research, and practice to advance nursing education o Involved in accreditation of university nursing programs through its commission on collegiate nursing education o Only represents university-level nursing education programs STTI Not for profit international organization o Mission- to provide leadership and scholarship in practice, education, and research to improve the health of all people ANA organization that represents all RNs in the U.S. o Labor union- option for members to participate o Strategic imperatives- professional practice and excellence, healthcare and public policy, knowledge and research, unification, advocacy for workforce, and organizational effectiveness LPN o administration of treatments and medication o Assist with ADL o under the direct supervision of a RN, a licensed physician or dentist o May supervise CNAs in nursing homes and assisted living facilities RN o Assess & monitor health status o Plan, implement, evaluate nursing care interventions o Coordinate and oversee pt care o Anticipate risks and intervene to prevent complications o Focus on health promotion and patient education ARNP advanced registered nurse practitioner CNM certified nurse midwife- masters degree focuses on midwifery-pregnancy and delivery CRNA masters degree that prepares nurses to deliver anesthesia Clinical specialist masters degree offered in any clinical area-usually work in hospital settings Associate degree offered as culmination of a 2 year program that includes some liberal arts and sciences curriculum but focuses more on nursing Bachelors Health assessment, leadership/mgmt, research, public/community health/ teaching an advocacy Masters 2 year program after receiving BSN PhD doctoral degree (doctor of philosophy) - usually involved in research- may be called doctor Doctorate (DNP) not a PhD program- practice focused doctoral degree program Advocate The nurse protects the client by preventing physical and/or chemical injury. o In the role, the nurse assists clients in expressing their rights whenever necessary. o The nurse also works to preserve clients' legal and human rights in times of health and illness, and during the process of dying. Caregiver The nurse addresses the client's holistic health care needs to promote health and the healing process. o In the role, the nurse administers treatment for specific disease processes and applies measures to restore the emotional and social well-being of the client. Critical Thinker Nurses use decision-making and critical thinking skills in conjunction with the nursing process. o Before actually delivering nursing care, the nurse determines the best method of care delivery for each client. o The nurse's plan of care is based on consideration of all aspects of the situation and thinking through alternative strategies to achieve a number of possible outcomes. Communicator Open and consistent communication is vital for effective nursing practice. o The nurse must possess excellent communication skills to provide care, rehabilitation, teaching, comfort, and protection to clients. Manager Nurses are responsible for the management and coordination of client care. o Delegate, collaborate, consult o All nurses need good management skills, whether they supervise others in the provision of nursing care or whether they provide direct care themselves. Rehabilitator The nurse administers rehabilitative activities along with members of other disciplines such as physical therapists to ensure that a client returns to a maximal state of functioning . o When clients experience alterations in health, the nurse's role is to promote client adaptation and coping. Researcher Nursing research provides the evolving body of knowledge and theory for our profession. o Nurse researchers may be employed in an academic setting, a community service, or an independent professional agency. o The nurse researcher usually conducts studies and investigates problems to improve client health and nursing care. Teacher the nurse provides clients and family members with information about health, treatment or therapy, and lifestyle changes. o the nurse determines if the client understands the information presented and reinforces the learning as necessary. o The nurse then evaluates the client's progress towards health-related goals. o The nurse uses teaching methods that are compatible with the client's knowledge, education, and literacy levels. Licensure is required by law to practice nursing in each state Certification & Credentialing o Not required by law o Certification of expertise in an area o Offered by specialty organizations and ANA AACN's essential elements of BSN education. • Emphasized patient-centered care • Interprofessional teams • Evidence based practice • Quality improvement • Patient safety • Informatics • Clinical reasoning/critical thinking • Genetics and genomics • Cultural sensitivity • Professionalism the characteristics of a profession and why nursing is a profession • Well-defined body of knowledge • Enlarge the body of knowledge through research • Educated in institutions of higher education • Apply knowledge providing services vital to society • Exalt service above personal gain • Freedom of action, professional growth, economic security • Practice autonomously • Enforce a Code of Ethics the ANA 6 essential features of professional nursing. • Caring relationship • Attention to the range of human experiences and responses • Integration of assessment data with knowledge • Application of scientific knowledge and use of judgment • Advancement of the profession through scholarly inquiry • Influence on social and public policy to promote social justice • Assurance of safe, quality, and evidence based practice the ANA Nursing's Social Policy Statement Expresses the social contract between society and the profession of nursing...a framework for understanding professional nursing's relationship with society and its obligation to those who receive professional nursing care. the IOM's 5 core competencies for Health Care Professionals • Provide patient centered care • Work with interdisciplinary/interprofessional teams • Employ evidence based practice • Apply quality improvement • Utilize informatics essential nursing caring behaviors • Essential and central to nursing, defined by many nurse theorists like Watson • Varies among cultures and differs in individuals • Caring can be doing for other people what they cannot do for themselves, care of medical problem, and competence in carrying out all • Comfort, Compassion, Concern, Coping Behavior, Empathy, Enabling, Health Consultant, Helping, Interest, Involvement, Kindness, Love, Nurturing, Presence, Protective, Restorative, Surveillance, Teaching, Touching, Trust, Sharing, Stimulating, Stress alleviating, Supportive • Comfort Needs are physical, psychological, social, and environment • Caring defined at FSU o Nurse's empathy for and connection with the patient. o The ability to translate these affective characteristics into compassionate, sensitive, appropriate care. professional nursing practice is influenced by standards of professional nursing. Set of nursing actions constituting safe and effective client care agreed on by groups of nurses expert in their area of nursing the purpose and functions of the Nurse Practice Act. • State Statute that defines and regulates the practice of nursing to protect the public o Define the scope and boundaries of practice o Create and empower a Board of Nursing to oversee licensee o Establish the requirements for licensure and entry into practice o Establishes standards for nurses utilized by courts o Violations result in civil or criminal prosecution the relationship between the state Nurse Practice Act and the requirements for nursing licensure and certification. The nurse practice act for each state establishes the requirements for licensure- some states have different requirements than others the role and responsibilities of the State Boards of Nursing. • Made up mostly of nurses • Are given authority by statutory law • Enforce Nurse Practice Acts o Regulate nursing practice, including requirements to enter practice and obtain and maintain a license (NCLEX, education, fee) • Oversee Schools of Nursing • Control Licensure o Requires a minimum degree of competency to ensure that public health, safety, and welfare are reasonably protected. • Discipline nurses Reprimand board issued a letter for a minor violation of the Nursing Practice Act, with no restrictions on the license Probation allows the licensee to practice as an RN under certain restrictions for a set period of time Suspension of License board has ordered the licensee not to practice as a RN for a set or indefinite period of time. Suspensions may be imposed in disciplinary actions, prior to a probation term, or may be imposed as the result of a violation of probation Revocation of License board revoked the license and the licensee no longer has the right to practice as an RN or use the title the practice of professional nursing as defined in the Florida Nurse Practice Act. "Practice of professional nursing" means the performance of those acts requiring substantial specialized knowledge, judgment, and nursing skill based upon applied principles of psychological, biological, physical, and social sciences which shall include, but not be limited to: 1. The observation, assessment, nursing diagnosis, planning, intervention, and evaluation of care; health teaching and counseling of the ill, injured, or infirm; and the promotion of wellness, maintenance of health, and prevention of illness of others. the purpose of and requirements for nursing licensure. Passage of NCLEX, fees, criminal background check, CE contact hours within a specified time period, active employment for a specific number of hours within a specified time period (renewal), and number of hours of professional nursing activities (renewal). what all nurses can do to improve the image of nursing. • Be visible! • Be actively involved in policy and funding decisions, particularly any changes that impact nursing care but also broader healthcare issues Explain professional nursing boundaries • Professional boundaries are the spaces between the nurse's power and the client's vulnerability • Nurse should avoid these behaviors: o Self-disclosure of one's own personal information, secretive behavior between the nurse and a patient, special treatment by nurse, selective communication, super nurse (the nurse thinks he or she is the only one who can care for the patient), you and me against the world thinking, and failure to protect the patient. negative impact on the image of nursing o Insecurity o Role confusion o Lack of professional confidence o Timidity o Fear o Sense of inferiority o Hospital policy o Perceived authority and directives of physicians o Historical role of nurses as handmaiden o Hierarchical structure of healthcare organizations o Threat of disciplinary action or legal action (afraid to speak up) o Nurse's silence may have negative impact on patient care positive impact on the image of nursing o Power and empowerment o Visibility Values personal ideals and beliefs about worth that act as a guide to behavior Morals standards of conduct that represent the ideal in human behavior = how individuals ought to treat others Ethics a branch of philosophy that examines behavior to determine what constitutes good, bad, right and wrong behavior and provide guidance for action the purpose of ethical principles Establish common ground between nurse, patient, family, other health care professionals, and society to discuss ethical questions and make ethical decisions the organization responsible for ethical codes and standards of nursing practice. ANA Autonomy Principle of respect for the person, People are free to form judgments and actions as long as they do not infringe on others Beneficience To promote goodness, kindness, and charity, To abstain from injuring others and to help others further their well-being by removing them from harm Justice Moral rightness, fairness, or equity Nonmaleficence Implies a duty: Not to inflict harm, To abstain from injuring others, To help others further their own well-being by removing harm Veracity Principle of truth-telling Advocacy advocates for dignified and humane care the purpose of the ANA Code of Ethics Explains the primary goals, values, and obligations of the profession. provision 1 of the ANA Code of Ethics The nurse practices with compassion and respect for the dignity, worth, and uniqueness of every individual, unrestricted by social or economic status, personal attributes, or the nature of health problems provision 2 of the ANA Code of Ethics The nurse's primary commitment is to the patient, whether an individual, family, group, or community. provision 3 of the ANA Code of Ethics The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient. (Privacy, Confidentiality, Protection of participants in research, Standards and review mechanisms, Acting on questionable practice, Addressing impaired practice) provision 4 of the ANA Code of Ethics The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care. (Acceptance of accountability and responsibility, Accountability for nursing judgment and action, Responsibility for nursing judgment and action, Delegation of nursing activities)