51 terms

Nursing Part 1

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
nursing activities:
-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
-mediate ethical conflicts
-use legal safeguards
1 year program, mostly clinical
diploma, ADN, BSN, Masters (18-24 mo), Doctoral (4-10 years), National certification for specialties
american nurse's association= SOP, research, represents nursing for legislative acts
founded in 1896 by Isabel Hampton Robb
national league for nursing= nursing education, professional testing, accredits LPN, associate programs
american association of colleges in nursing= nursing education, accredits BSN, graduate programs
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
science of teaching (kids)
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
clinical nurse specialist. masters in specialized area such as oncology
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)
clinical nurse leader = masters. oversee & manage care delivery in various settings
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