NUR 308

What is nursing?
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Terms in this set (57)
What is 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.
What are the standards of professional performance?
•Ethics
•Culturally Congruent Practice
•Communication
•Collaboration
•Leadership
•Education
•EBP & Research
Responsibility and roles of the professional nurse
•Autonomy and Accountability
•Caregiver
•Advocate
•Educator
•Communicator
•Manager
•Provider of care
•Researcher
•Lobbyist
Kelly's criteria for nursing as a profession
•Services vital to humanity
•Special body of knowledge
•Intellectual activities with accountability
•Higher learning
•Autonomy
•Altruism
•Code of ethics
•association
Miller's wheel of professionalism
-Center of wheel is nursing education and institution of higher learning.
-Eight spokes represents behavior necessary in maintaining professionalism.
What guides nursing practice?
-Nursing social policy statement
-Nursing scope and standards of practice
-Code of ethics for nurses
Nursing: Scope and Standards of Practice
Outlines the expectations of the professional role within which all RNs must practice and delineates the standards of care and associated competencies for professional nursing
Nursing Social Policy Statement
describes the profession of nursing and its professional framework and obligations to society .what we agree as nurses to do for the society as a whole.
Nursing Code of Ethics (ANA)
set of principles that reflect the primary goal, values, and obligations of the profession
(9 provisions)
Cohen's Model of Basic Student Socialization
1. unilateral dependence
2. negativity/independence
3. dependence/mutuality
4. interdependence
what is healthState of complete physical, mental, and social well-being, not merely the absence of disease or infirmityWhat are the social determinants of health?conditions in which people are born, grow, live, work and agewhat are health behaviors-A person's ideas, convictions, and attitudes about health and illness -May be based on facts or misinformation, commons sense, or myths -Can positively or negatively affect a client's level of healthinternal variables that influence health and health behaviors?Developmental Stage Intellectual Background Perception of Functioning Emotional Factors Spiritual Factorsexternal variables that influence health and health behaviorsFamily Psychosocial and Socioeconomic Factors CultureWhat is health promotion?Healthcare now is more focused on health promotion. Help clients maintain or enhance their present level of health Wellness education teaches people how to care for themselves in a healthy waywhat are the levels of preventative care?primary=prevention secondary=screening tertiary=treatmentWhat are risk factors?Variables that increase the vulnerability of an individual or a group to an illness or accidentexamples of risk factorsGenetic and physiological factors Age Environment LifestyleWhat is illness?a state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impairedWhat are illness behaviors?How people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the health care systemsWhat affects illness behavior?Personal history, social situations, social norms, and past experienceswhat internal variables influence illnessPerception of illness and nature of illnesswhat external variables influence illnessVisibility of symptoms Social group Cultural background Economics Accessibility to health careimpact of illness on the client and familyBehavioral and emotional changes Body Image Self-Concept Family Roles Family DynamicsNurses role in health and illnessFirst, take care of yourself Educate, Encourage, Support, Advocate Provide care and support during illnessesPrinciples of Communication•Communication is a process •Communication is not linear, but circular •Communication is complex •Communication is irreversible •Communication involves the total personalityLevels of Communication- intrapersonal - interpersonal - transpersonal - small-group - publicZones of Personal Space- intimate zone (0-18 inches) - personal zone (18 inches to 4 feet) - social zone (4 to 12 feet) - public zone (12 feet and greater)Zones of Touch- social zone (permission not needed) hands, arms, shoulders, back - consent zone (permission needed) mouth, wrists, feet - vulnerable zone (special care needed) face, neck, front of body - intimate zone (great sensitivity needed) genitalia, rectumElements of Professional Communicationcourtesy, use of names, privacy and confidentiality, trustworthiness, autonomy and responsibility, assertivenessBarriers to effective communication•language barrier •cultural considerations •conflict •setting in which care is provided •internal noise, mental/emotional distress •perception •difficulty with speech and hearing •medication •noisecommunication technique: ISBARintroduction situation background assessment recommendationAdult Learning Theory•Link new education to prior experiences •Readiness to learn •Immediately useful to learner •Learning environment must be arranged to facilitate learning •Physical needs are met before teaching sessionDirect care interventionstreatments performed through interactions with patientsIndirect care interventionsTreatments performed away from the patient but on behalf of the patient or group of patientsTypes of Interventionsnurse initiated physician initiated collaborativeSteps of the Nursing ProcessAssessment Diagnosis Planning Implementation EvaluationTheory-based nursing practicebasic human needs developmental psychosocialMetaparadigm of Nursingperson, environment, health, nursing, caringlevels of nursing theoryabstract to specific: -nursing metaparadigm -grand theories -middle-range theories -practice-level theoriesflorence nightingale philosophy of nursing•Focused on the relationships of patient and their environment. •Importance of clean air, water, and ventilation. •Recognized nurse's role in protecting patient.virginia henderson philosophy of nursing"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 a peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge"Jean Watson's theory•Carative Factors •Caritas Processes •Transpersonal Caring Relationship •Caring occasion/caring momentDorothea Orem's theoryDefining Self-Care: •a learned, goal-oriented activity directed toward the self in the interest of maintaining life, health, development, and well-being.imogene king theory•Theory of Goal Attainment •Personal, interpersonal, and social systems. •Nursing focus is the care of human beings. Nursing's goal is attaining or regaining healthsister callista roy theory•Adaptation Model Goal of nursing - Adapting to changeHildegard Peplau•The focus of attention is on the relationship between the patient AND the nurse, not just solely on the patient. •Goals of this therapeutic relationship: -Patient survival -Patient's understanding of health problemIda Orlando•Nursing Process Theory •Specific to nurse-patient interactions. •Emphasis on deliberate action and observation.Madeleine Leininger•Paved the way for the concept of cultural care that has become critical to holistic nursing care today. •The goal of transcultural nursing is more than simply being aware of different cultures.Betty Neuman's Theory•The nurse assesses the stressor and the patient's response to the stressor, identifies nursing diagnoses, plans patient-centered care, implements interventions, and evaluates the patient's response to determine whether the stressor is resolved.Challenges to Health CareReducing health care costs while maintaining high-quality care for patients Improving access and coverage for more people Encouraging healthy behaviors Earlier hospital discharges result in more patients needing nursing homes or home care.Health Care RegulationRegulatory and competitive approaches Professional standards review organizations (PSROs) - Utilization review committees (URs) Prospective payment system (PPS) Diagnosis-related groups (DRGs) Capitation Resource utilization groups (RUGs) Profitability Managed careHealthcare accreditationReasons: To demonstrate quality and safety standards are met To evaluate performance, identify problems, and develop solutions Accreditation earned by the entire organization Specific programs or services within an organization earn certifications. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and other governing bodies.healthcare settings and servicespreventative primary secondary tertiary restorative continuingfactors of the task considerationPredictability of outcome Potential for harm Complexity of care Need for innovation Level of interactionFive Rights of Delegationright task right circumstance right person right direction/communication right supervision/evaluation