CANS Exam 1 With 100% Correct Answers
2024
Nursing's Pathway to Professionalism
by Lucie Kelly
8 characteristics:
1. Vital to humanity and welfare of society
2. Special body of knowledge enlarges over time
3. Services involve intellectual activities
4. Education in institution of higher learning
5. Practitioners relatively independent
6. Motivated by service and importance of work
7. Code of ethics to guide practice
8. Organization support high practice standards
Miller's Wheel of Professionalism 1985
Foundation and 8 spokes:
1. Competence and continuing education
2. Adherence to code of ethics
3. Participation in professional organizations
4. Publication and communication
5. Orientation toward community services
6. Theory and research development and utilization
7. Self-regulation and autonomy
Accountability
The hallmark of nursing practice.
ANA's 2004 Nursing: Scope and Standard of Practice
Includes collegiality as one of nine standards of professional performance.
Essence of collegiality includes:
1. Supportive and healthy work environments
2. Cooperation
3. Recognition of interdependence among members of the nursing profession
External barriers to Professionalism
1. conflicts with medicine have arisen as nurses are able to provide services that were formerly part of
medical practice by physicians
2. The legal scope of nursing practice must be protected through lobbying and legislation.
3. Nurses must strive for cooperation with other medical disciplines.
Internal Barriers to Professionalism
1. Nursing's power and influence is fragmented by dissension, including difference in educational
levels and proliferation of organizations that compete for nurses' membership.
2. Nursing's roots in altruism - when a nurse feels guilty for expecting good pay for work.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
,Nightingale's Definition of Nursing
1. Contains many concepts that remain contemporary
2. Includes importance of observational skills, unique body of knowledge, understanding that patient
must be put in best condition possible that nature allows.
3. Also includes concepts about the impact of the patients' immediate environment, nutrition,
hygiene, comfort
4. Nursing schools should be affiliated with a teaching hospital
5.Students should be selected to create a diverse student body
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Early twentieth-century definitions of Nursing
1.Many were basic and spare.
2.Virginia Henderson's definitions represented the emergence of contemporary nursing.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Post WWII - definition of nursing
WWII helped advance technologies available for nursing, influencing nursing and requiring changed
definitions.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Peplau's definition of nursing
Defined nursing in interpersonal terms, reinforcing the idea of the patient as an active collaborator in
his or her care
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Orem's definition
Orem's definition hinges on the belief that nurses should do for a person only those things the person
cannot do without assistance, emphasizing patient's active role.
Example: Assisting a disoriented patient with a bath
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
International Council of Nurses (ICN) adopted Henderson's definition 1960
This definition has been widely accepted in the United States and worldwide
Many believe it remains the most comprehensive and appropriate definition of nursing in existence
The unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery ( or to a peaceful death) that he would perform
unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help
him gain independence as rapidly as possible.
, American Nurses Association (ANA) definition of nursing
"Nursing is 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."
Includes 6 essential features of contemporary nursing practice.
Professional nursing socialization
Absorbing and assimilating the culture of nursing: its rites, rituals, and valued behaviors
Formal and informal nursing socialization includes:
Formal
1. Classroom lectures
2. Assignments
3. Lab experiences
4. New vocabulary
Informal
This includes unplanned observations, participating in a student nurse association, and hearing nurses
discuss patient care.
Informal experiences are often the most powerful
Cohen's Model of Basic Student Socialization
Cohen developed a model in 1981 based on developmental theory and studies of beginning nursing
students' attitudes.
Four stages to be experienced in sequence
Stage 1: Unilateral dependence - reliant on external authority and limited questioning or critical
analysis
Stage 2: Negativity/independence- Cognitive rebellion and diminished reliance on external authority
Stage 3: Dependence/mutuality - Reasoned appraisal and begins integration of facts and opinions
following objective testing
Stage 4: Interdependence - Collaborative decision making and commitment to professional role and
self concept now includes professional role identity
Benner's Stages of Nursing Proficiency developed in 1984 to explore how nurses make the transition
to become expert practitioners
Student Socialization
Stage 1: Novice
Stage 2: Advanced beginner period
Stage 3: Competent practitioner
Stage 4: Proficient practitioner
Stage 5: Expert practitioner
Several issues contribute to "reality shock" for new nurses. These include:
Nursing shortages
Difficult working conditions
Nursing staff retention
Older, more chronically ill patients
Absence of positive reinforcement
Lack of frequent communication
Lack of preceptorship
2024
Nursing's Pathway to Professionalism
by Lucie Kelly
8 characteristics:
1. Vital to humanity and welfare of society
2. Special body of knowledge enlarges over time
3. Services involve intellectual activities
4. Education in institution of higher learning
5. Practitioners relatively independent
6. Motivated by service and importance of work
7. Code of ethics to guide practice
8. Organization support high practice standards
Miller's Wheel of Professionalism 1985
Foundation and 8 spokes:
1. Competence and continuing education
2. Adherence to code of ethics
3. Participation in professional organizations
4. Publication and communication
5. Orientation toward community services
6. Theory and research development and utilization
7. Self-regulation and autonomy
Accountability
The hallmark of nursing practice.
ANA's 2004 Nursing: Scope and Standard of Practice
Includes collegiality as one of nine standards of professional performance.
Essence of collegiality includes:
1. Supportive and healthy work environments
2. Cooperation
3. Recognition of interdependence among members of the nursing profession
External barriers to Professionalism
1. conflicts with medicine have arisen as nurses are able to provide services that were formerly part of
medical practice by physicians
2. The legal scope of nursing practice must be protected through lobbying and legislation.
3. Nurses must strive for cooperation with other medical disciplines.
Internal Barriers to Professionalism
1. Nursing's power and influence is fragmented by dissension, including difference in educational
levels and proliferation of organizations that compete for nurses' membership.
2. Nursing's roots in altruism - when a nurse feels guilty for expecting good pay for work.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
,Nightingale's Definition of Nursing
1. Contains many concepts that remain contemporary
2. Includes importance of observational skills, unique body of knowledge, understanding that patient
must be put in best condition possible that nature allows.
3. Also includes concepts about the impact of the patients' immediate environment, nutrition,
hygiene, comfort
4. Nursing schools should be affiliated with a teaching hospital
5.Students should be selected to create a diverse student body
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Early twentieth-century definitions of Nursing
1.Many were basic and spare.
2.Virginia Henderson's definitions represented the emergence of contemporary nursing.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Post WWII - definition of nursing
WWII helped advance technologies available for nursing, influencing nursing and requiring changed
definitions.
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Peplau's definition of nursing
Defined nursing in interpersonal terms, reinforcing the idea of the patient as an active collaborator in
his or her care
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
Orem's definition
Orem's definition hinges on the belief that nurses should do for a person only those things the person
cannot do without assistance, emphasizing patient's active role.
Example: Assisting a disoriented patient with a bath
Evolution of Definitions of Nursing (Nightingale, Early 20th Century, Post- WWII, Peplau, Orem, &
Henderson)
International Council of Nurses (ICN) adopted Henderson's definition 1960
This definition has been widely accepted in the United States and worldwide
Many believe it remains the most comprehensive and appropriate definition of nursing in existence
The unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery ( or to a peaceful death) that he would perform
unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help
him gain independence as rapidly as possible.
, American Nurses Association (ANA) definition of nursing
"Nursing is 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."
Includes 6 essential features of contemporary nursing practice.
Professional nursing socialization
Absorbing and assimilating the culture of nursing: its rites, rituals, and valued behaviors
Formal and informal nursing socialization includes:
Formal
1. Classroom lectures
2. Assignments
3. Lab experiences
4. New vocabulary
Informal
This includes unplanned observations, participating in a student nurse association, and hearing nurses
discuss patient care.
Informal experiences are often the most powerful
Cohen's Model of Basic Student Socialization
Cohen developed a model in 1981 based on developmental theory and studies of beginning nursing
students' attitudes.
Four stages to be experienced in sequence
Stage 1: Unilateral dependence - reliant on external authority and limited questioning or critical
analysis
Stage 2: Negativity/independence- Cognitive rebellion and diminished reliance on external authority
Stage 3: Dependence/mutuality - Reasoned appraisal and begins integration of facts and opinions
following objective testing
Stage 4: Interdependence - Collaborative decision making and commitment to professional role and
self concept now includes professional role identity
Benner's Stages of Nursing Proficiency developed in 1984 to explore how nurses make the transition
to become expert practitioners
Student Socialization
Stage 1: Novice
Stage 2: Advanced beginner period
Stage 3: Competent practitioner
Stage 4: Proficient practitioner
Stage 5: Expert practitioner
Several issues contribute to "reality shock" for new nurses. These include:
Nursing shortages
Difficult working conditions
Nursing staff retention
Older, more chronically ill patients
Absence of positive reinforcement
Lack of frequent communication
Lack of preceptorship
