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functional nursing

efficient but fragmented. one does all blood draw, etc.

team nursing

delegation to LPN & PCT, but RN is still responsible

primary nursing

identified nurse for each patient, consistent, comprehensive care

case management nursing

identified diagnostic groups, cost focused, work with significant other, health ins. can follow patient from beginning (diagnostic to rehab to home)

patient centered care

humanistic, team approach, beauty focused
- patients' right to individualized care, patients' beliefs & values, patient needs over institutions needs

nursing responsibilities (4)

1. promote health
2. prevent illness
3. restore health
4. facilitate coping w/disability & death

responsibility: promote health

1. health=wellness
-optimal functioning & well being
-not the absence of disease
-subjective & personal
2. nurse activities
-help patient make lifestyle decisions to improve quality of life
-teach about behaviors/factors that effect health
-teach health is more than not being ill

responsibility: preventing illness

1. reduce risk of illness or avoid illness
2. early detection
3. maintain function when ill
4. nursing activities
-education: prenatal, stop smoking, ex.
-health assessments screenings (HTN, depression)

responsibility: restoring health

nursing activities
-assessments w/referrals of abnormal to others
-direct care (treatment, med, physical care)
-collaboration w/other healthcare providers
-rehabilitation (heart attacks, stroke, etc)

responsibility: facilitating coping w/disability & death

-altered function: decreased (ADL's) activities of daily living
-life crises
-death
nursing activities:
-referrals
-maximize strengths
-EOL care

4 essential skills of nursing

1. cognitive skills
2. technical skills
3. interpersonal skills
4. ethical & legal skills

4 essential skills of nursing: cognitive skills (4)

1. scientific rationale
2. evidence based practive (EBP) = nursing care you provide is support by reliable research based evidence
3. select appropriate nursing interventions
4. critical thinking (all answers are right, but which is best)

4 essential skills of nursing: critical thinking (7)

1. systematic way to form one's thinking
2. purposeful
3. exacting
4. disciplined
5. comprehensive
6. based intellectual standards
7. well reasoned

4 essential skills of nursing: technical skills (2)

1. use equipment safely & appropriately w/minimal distress to patients
2. creatively adapt equip & technology procedures

4 essential skills of nursing: interpersonal skills (3)

1. caring relationships w/colleagues, patients, significant others
2. advocate for the patient: comm. patients goals & expectations
3. collaborate w/others

4 essential skills of nursing: ethical & legal skills (2)

1. personal moral code
2. scopes & standards of nursing practice
-professional role & response
-accountable
-advocate
-mediate ethical conflicts
-use legal safeguards

LPN

1 year program, mostly clinical

RN

diploma, ADN, BSN, Masters (18-24 mo), Doctoral (4-10 years), National certification for specialties

ANA

american nurse's association= SOP, research, represents nursing for legislative acts
founded in 1896 by Isabel Hampton Robb

NLN

national league for nursing= nursing education, professional testing, accredits LPN, associate programs

AACN

american association of colleges in nursing= nursing education, accredits BSN, graduate programs

NSNA

national student nurse association= advocates student & patient rights, social & political issues

SOP (4)

1. protect the RN, patient, institution in legal & practice issues
2. used to provide safe, knowledgeable comprehensive care
3. authoritative stmts, describes responsibilities for which nurses are accountable
4. applies to all RNs regardless of educational preparation, practice setting, clinical specialty

8 fundamental themes of SOP

1. age appropriate, culturally & ethnically sensitive care
2. maintaining a safe environment
3. educating patiens
4. continuity of care
5. coordination across settings & caregivers
6. managing information
7. effective communication
8. using technology

6 standards of practice (SOP)

1. assessment
2. diagnosis
3. identify outcomes
4. planning
5. implementation
-coordination, health teaching/promotion, consultation (APRN), prescriptive authority & treatment (APRN)
6. evaluation

SOP: competent behaviors

1. quality of practice & practice evaluation
2. education
3. collegiality
4. collaboration
5. ethics
6. research
7. resource utilization
8. leadership

Pavalko's 8 dimensions of a profession

1. relevance to social values
2. training/educational period
3. self motivation to serve
4. code of ethics
5. commitment to lifelong work
6. members control their profession
7. theoretical framework
8. common identity/subculture

professional socialization: cohen's model

1. unilateral dependence= external authority, limited questioning, limited critical thinking
2. negativity/independence= cognitive rebellion, diminished reliance on authority
3. dependence/mutuality= reasons, objective testing of facts, integrates
4. interdependence= professional role identity, collaborative decision making

benners stages nursing proficiency

1. novice=begin school, rules focuses
2. advanced beginner=marginally competent, cannot prioritize
3. competent learners=2-3yrs practice, organized, abstract thinking
4. proficient=3-5yrs practice, holistic
5. expert=intuitive

dorothea dix

-civil war era
-Advocate for mentally ill in prewar years
-women Nurses of the union army
-created month long training at 2 NY hospitals, including sojourner truth, harriet tubman

sojourner truth

-civil war era
abolitionist, attended training created by dorothea dix

harriet tubman

-civil war era
former slave who established underground railroad, attending nursing training created by dorothea dix

susie king taylor

-civil war era
taught african american & white soldiers how to read & write

MaryAnn Bickerdyke

-civil war era
went to a hospital camp in illinois to bring order and create clean conditions. this was opposed by camp surgeons

Clara Barton

-civil war era
-campaign to provide relief for soldiers, own distribution center (refused help from D. Dix)
-american red cross

Phoebe Pember

-civil war era
- one of earliest to be named matron of hospital in richmond VA

florence nightingale contributions

1. identified personal needs of patient & role of nurse in meeting them
2. est. standards for hospital management
3. est. nursing éducation & respected occupation
4. 2 components of nursing: health & wellness
5. believed nursing is separate & distinct from medicine
6. recognized nutrition as important to health
7. occupational & recreational therapy for the sick
8. need for continuing education for nurses
9. maintained records/begin of nursing research

nursing actions: independent interventions

-assessments & nursing responses
-standard protocols for routine aspects of care
-standing orders for all patients by medical staff. (modify for patient/use judgment. ex. something stronger than tylenol)

phases of nurse/patient relationship (3)

1. orientation phase = assess, roles & responsibilities, develop trust
2. working phase = tasks
3. termination phase = end relationship

pedagogy

science of teaching (kids)

androgogy

study of teaching adults

nursing challenge to teaching (3)

1. teach a lot of information
2. limited time, with limited resources
3. patients may or may not be ready, willing & able

3 learning domains

1. cognitive = patient can store & recall knowledge (the way you think, gather info & facts) acquisition, comprehension, application, analysis, synthesis, evaluation. Evaluation = as direct questions
2. psychomotor = use mental & muscular activity. Evaluation - return demonstration
3. affective = patient has changes in their attitude, feelings or value, more confident. Evaluation = listen to patients comments & responses

TEACH acronym

T = tune into patient
E = edit patient information
A = act on every teaching moment
C = clarify often
H = honor patient as a partner in process

CNS

clinical nurse specialist. masters in specialized area such as oncology

APN

advance practice nursing = advanced education beyond 4 years. these include NP (nurse practioner), CNS (clinical nurse specialist), CNM (certified nurse midwife), CRNA (certified registered nurse anesthetists), CNL (clinical nurse leader)

CNL

clinical nurse leader = masters. oversee & manage care delivery in various settings

NP

nurse practioner = physical exams, take medical histories, diagnose & treat common acute & chronic diseases, order & interpret X-rays & lab test

effective communication techniques

empathy, open ended questions, giving info, reflection, silence

ineffective communication techniques

fail to see uniqueness of individual, don't see covert meaning, use cliches, false reassurances, fail to clarify

major categories of what nurses do

1. caregiver
2. teacher
3. advocate
4. manager
5. colleague-collaborator
6. expert
7. counselor
8. researcher

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