- considered founder of modern nursing; influential in developing nursing education, practice, admin ("notes on nursing")
- nursing is the act of utilizing the environment of the patient to assist in recovery
environment and interacting with healthy/unhealthy individuals (14 fundamental needs)
human caring theory
Systems Model: based on individual's relationship to stress, the rxn to it, and reconstitution factors that are dynamic in nature
General theory of nursing: self-care, self-care deficit, and nursing systems
science of unitary human beings; whole person is greater than its parts; humans are dynamic energy fields
Sr Calista Roy
Adaptive model: focuses on increasing complexity of person & environment self-organization; and on the relationship betwn/among ppl, universe, and a higher being
goal attainment theory
-conceptual framework: theorist moves from looking at a broad perspective (conceptual framework) to a more specific model
- model of transactions: nurse interacts w pt and set/explore means to achieve a goal; model exists within the environment (interaction btwn pt and client)
interpersonal relations model
cultural care diversity and universality theory: care is the essence of nursing and the dominant, distincting, and unifying feature of nursing. Culture care preservation/maintenence: culture care accomadation, negotiation (both); culture care restructuring and repatterning
human becoming theory: freely choosing personal meaning, co-creating rhythmic patterns, contrascending multidimensionally with the emerging possibilities
-supposition or system of ideas proposed to explain a phenomenon (idea about something impt experienced in reality)
-explains phenomenon, relationships, and conceptualizes central interest
practice disciplice (focuses on performing the professional role)
belief system; early effort to define nursing phenomena (nightingale, henderson, watson)
object of a person's perception (what the senses/mind notice)
pattern of shared understandings about reality and the world (unconscious ideas of reality - become apparent when they clash w accepted notions ie evolution & creationism)
person, health, environment, nursing
group of related ideas or statements
building blocks central to the theory (definitions are specific to the theory)
three essential elements: beliefs about the central phenomena of the discipline, mechanisms by which phenomena can be known/addressed, and values of discipline
public health services
primary care, routine health screening, dx and tx
ambulatory care centers
diagnostic tx facilities, minor surgery
occupational health clinics
run by companies for employees, health promotion activities
acute inpatient services, outpatient and ambulatory care, ER dept, hospice care
variation of inpatient care, technically complex treatments
extended care facilities (nursing homes)
independent living, assisted, skilled, rehab, custodial care
clients unable to stay home but don't require hospital/nursing home
restore/recuperate health (drug/alch)
home health care agencies
education to pts/family, care to acute, chronic or terminally ill
rural care hospitals
federal funding, services for rural residents
Level of abstraction, conceptualization of client, nurse, health and environment, ability to describe/explain/predict, vary in broadness of scope (very broad- to more limited)
moses of her people; nursed sick of her own race in the underground railroad during the civil war
abolitionist, underground railroad agent, preacher, womens rights, nurse and counselor for the freemen's relief assoc after war
unions superintendent of female nurses during civil war
organized american red cross
knights of saint lazarus
cared for ppl w leprosy, syphillis. chronic skin coniditions
mary mahoney (& richards)
first african american trained nurse
founder of public health nursing (henry st settlement, visiting nurse service)
lavina l dock
nursing leader, suffragist; active in protest for womens right (voting)
founder of planned parenthood
roles/functions of nursing
- caregiver, communicator, teacher, client/advocate, counselor, change agent, leader, manager, case manager, research consumer
- nurse practitioner, administrator, educator, anesthetist, midwife, researcher, clinical nurse specialist - pediatric, operating room, geriatric, home, community
-prolonged specialized education
- orientation toward service
- ongoing research
- code of ethics
- professional organization
Benner's Model of Socialization
Benner's five stages of novice serves as a guideline to establish phase/extent of a person's socialization
2. advanced beginner
Influences of Nursing Practice
economics, changing demands for nurses, consumer demand, family structure, science and technology, information and telecommunications, legislation, demographic and social changes, the nursing shortage, collective bargaining, and the work of nursing associations.
Major Nursing Orgs.
- American Nurses Assoc: developed standards of nursing practices
- NLN: fosters nursing services/education
- American Assoc of Colleges of Nursing: focuses on advancement/maintenance of America's education programs
- National Student Nurses Assoc: developed the Code of Academic/Clinical conduct for nursing
National SNA's code of academic and clinical conduct
1.Advocate for the rights of all clients.
2.Maintain client confidentiality.
3.Take appropriate action to ensure the safety of clients, self, and others.
4.Provide care for the client in a timely, compassionate and professional manner.
5. Communicate client care in a truthful, timely and accurate manner.
6. Actively promote the highest level of moral and ethical principles and accept responsibility for our actions.
7. Promote excellence in nursing by encouraging lifelong learning and professional development.
8.Treat others with respect and promote an environment that respects human rights, values and choice of cultural and spiritual beliefs.
9.Collaborate in every reasonable manner with the academic faculty and clinical staff to ensure the highest quality of client care.
10. Use every opportunity to improve faculty and clinical staff understanding of the learning needs of nursing students.
11. Encourage faculty, clinical staff, and peers to mentor nursing students.
12. Refrain from performing any technique or procedure for which the student has not been adequately trained.
13.Refrain from any deliberate action or omission of care in the academic or clinical setting that creates unnecessary risk of injury to the client, self, or others.
14.Assist the staff nurse or preceptor in ensuring that there is full disclosure and that proper authorizations are obtained from clients regarding any form of treatment or research.
15.Abstain from the use of alcoholic beverages or any substances in the academic and clinical setting that impair judgment.
16.Strive to achieve and maintain an optimal level of personal health.
17. Support access to treatment and rehabilitation for students who are experiencing impairments related to substance abuse and mental or physical health issues.
18.Uphold school policies and regulations related to academic and clinical performance, reserving the right to challenge and critique rules and regulations as per school grievance policy.
ANA code of nursing
1.The nurse, in all professional relationships, practices with compassion and
respect for the inherent dignity, worth, and uniqueness of every individual,
unrestricted by considerations of social or economic status, personal
attributes, or the nature of health problems.
2. The nurse's primary commitment is to the patient, whether an individual,
family, group, or community.
3. The nurse promotes, advocates for, and strives to protect the health,
safety, and rights of the patient.
4. 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.
5. The nurse owes the same duties to self as to others, including the
responsibility to preserve integrity and safety, to maintain competence, and
to continue personal and professional growth.
6. The nurse participates in establishing, maintaining, and improving health
care environments and conditions of employment conducive to the provision
of quality health care and consistent with the values of the profession
through individual and collective action.
7. The nurse participates in the advancement of the profession through
contributions to practice, education, administration, and knowledge
8. The nurse collaborates with other health professionals and the public in
promoting community, national, and international efforts to meet health
9. The profession of nursing, as represented by associations and their
members, is responsible for articulating nursing values, for maintaining the
integrity of the profession and its practice, and for shaping social policy.
Downstream mechanism r/t stress:
-Neuroendocrine: HPA, SAM, HPG, E, NE, OT, DA, 5HT, estrogen, testosterone, GH, prolactin
-Immune mechanisms: cellular immune response, NKCC/CTL, T-cell activities, humoral mechanisms, tumor growth factors, wound healing
2 Major Human Needs Models
-Maslow's hierarchy of needs (physiology, safety, love belonging, esteem, self actualization)
Stages of Change Model (prochaska)
precontemplation, contemplation, preparation, action, maintenance, termination (useful way of understanding how to assess the client's readiness for change, and also to help support the client throughout change. It helps clients understand that change is not easy, that it may be cyclic, and that many people have to recycle or relapse in order to make a final change)
behavior mediated by the desire to increase wellbeing and to actualize human health potential
Health protection (disease prevention)
behavior motivated by the desire to avoid illness, detect the presence of illness, or maintain function once illness has already occured
Levels of Health protection
-primary: desire to avoid illness (education about injury, poison prevention, immunization)
-secondary: detect illness early (screening, reg med checkup)
- tertiary: maintain functioning within constraints of illness (refer pt to support group/rehab, teach about disease)
Pender's Health promotion model
designed to understand important influences for health promotion behaviors. In Pender's health promotion model, individual characteristics, and behavior-specific cognitions and affect result in behavioral outcomes
Determinants of Healthy Ppl 2020
-Policy (^ taxes on tobacco, seatbelt laws)
- Individual (change physical behaviors)
-Social (conditions in environ, transportation)
- Health Services (access, quality, cost, insurance of health services)
-Biology (aging, gender, sickle cell, hemophilia, BRCA1/2)