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128 Cards in this Set

  • Front
  • Back
Profession of nursing
- Client center of practice
- respect for human dignity
- uses biological principles and technologies
- uses social science principles
- caring and compassion mixed with technology, advancements , teamwork and leadership
Discipline
Branch of knowledge or teaching
Occupation
Source of livelihood
Profession
- Requires training in liberal arts and sciences
- technical and scientific knowledge
- evaluated by a community of peers
- service orientation
- code of ethics
Practice
The carrying out or exercise of a profession
Calling
A strong urge toward a particular way of life or career
Professional Roles
Caregiver
Advocate
Educator
Communicator
Manager
Researcher
Career Paths
Clinician, Advanced Generalist, Advanced Practice
Clinician
Acute, chronic, specialty, critical care, community health, hospice
Advanced Generalist
Clinical Nurse Leader
Advanced Practice
CNS, NP, Midwife, NA, Educator
ANA definition of nursing
The protection promotion and organization 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 and communities and populations
ANA Standards of practice
Assessment
Diagnosis
Outcomes Identifications
Planning
Implementation
Evaluation
ANA Standards of Professional Performance
Quality of Practice
Education
Professional Practice Evaluation
Collegiality
Collaboration
Ethics
Research
Resource Utilization
Leadership
Nursing Education
Diploma Nursing
LVN
Associate Degree in Nursing
Baccalaureate degree in Nursing
International degrees in Nursing
Nursing Education
Masters Degree in Nursing
Post Master Certificates
Doctorates: EdD, PhP, DNP, DNS
LVN
Technical Role, task oriented
RN
Professional role
Leader
Decision maker
Evidence and standards based
Educator
American Association of Colleges of Nursing
Accredits Nursing School
Qualify for NCLEX exam after graduation
Licensure
Accreditation
Practice Readiness
Conformity to minimum education standards
Passing State boards (275 questions – 6 hours)
CEUs
Common themes in history of nursing
Focus on the most vulnerable
Active in social policy and political arenas
Lobby for health care policy
Expanding knowledge for better care
Florence Nightingale/Crimean War
Reduction of infection &Improvement of sanitation
Lead to decrease in mortality
Nightingale Accomplishments
Formulated the Environmental Theory of Nursing
- First Nurse epidemiologist
- Connected sanitation to dysentery
-Considered nurse’s responsibility as being “in charge of somebody’s health”
- Reduced war time mortality from 42% to 2.2% in 6 months
Role of religion in nursing history
- Convents and monasteries served as hospitals for the poor
- All religious frameworks teach compassion, which is often expressed as care for the sick, injured and vulnerable
- Traditional healing methods often offered within a spiritual framework
Role of Military in Nursing History
Civil War stimulated growth in nursing
- Clara Barton founded the American Red Cross
- Nurses oversaw and organized hospitals, appointed nurses to war stations and regulated supplies to the troops
- Nurses walked battlefields looking for wounded soldiers
Legal oversight of the Nursing profession
National Council of State Boards f Nursing
State boards of Nursing
California Board of Registered Nursing
Maintain licensure
CEU Mandate
State Reciprocity
Educational Accreditation Agencies
National League of Nursing
American Association of Colleges of Nursing (CCNE)
BRN
Public Health
1890’s – Lillian Wald, Mary Brewster
- Found that the poor immigrants living in squalor.
- Settlement House, lower East Side of NYC
- Provided care to all, regardless of whether or not they could pay.
“Wild Western” Nursing
1800-s to 1900s
-Public Health nurses traveled by horseback
-often acted as midwives
-carried supplies with them.
Influence of the Women’s Movement
- 1970 – 1980’s through today
- Role of gender in nursing
-Traditional gender roles challenged
-Nursing reclaimed autonomy as profession matured
-Now more women enter medicine, and more men enter nursing
Nursing Education
1870-1970 – Training centered at hospital (Diploma RN)
-1930-s first college programs
-After WWII – community colleges open programs
-1970- Hospital care became more complex, nurses needed more education. School of nursing moved to colleges and universities (AND and BSN)
- As science of nursing developed advanced degrees did to (MSN, PhD, DNP)
Nursing Licensure
1867 – licensure for nurses first considered in England
1901 – New Zealand is the first country to require liensure
-1903
Standardize
Theory
Governs what we do, what we research
Paradigm
Links science, philosophy, and theories accepted and applied by discipline
Nursing paradigm
Direct the activities of the nursing profession, including knowledge development, philosophy, theory and educational experience research and practice.
Definition of nursing
Diagnosis and treatment of the human responses to actual or potential health problems
Nursing theory
Conceptualization of some aspect of nursing communicated for the purpose of describing, explaining, predicting and/or prescribing nursing care.
Theory
A set of concepts, definitions assumptions or propositions to explain a phenomenon
Phenomenon
An aspect of reality that people consciously sense or experience
Grand theories
Broad in scope, complex and require further research
Mid-range theories
Address specific phenomenon and reflect practice
Descriptive theories
First level of theory development, which describes phenomenon and speculates why they occur
Prescriptive theories
Address nursing interventions and predict the consequences of specific nursing interventions
EBP
Evidence based practice
Evidence Based Practice
Problem solving approach to clinical practice that integrates the conscientious use of the best evidence in combination with the clinician experience
Developing PICO Questions
P – Patient Population of interest
I – Intervention of interest
C – Comparison of Interest
O – Outcome
Transcultural perspective
- Madeline Lenininger
- Essence and central unifying domain that distinguishes caring from other health disciplines
Transpersonal Caring
- Watson
- Holistic model for nursing that suggests that a conscious intention to care promotes healing and wellness
Swanson’s Theory of Caring
- Kristen Swanson
- Nurturing way of relating to a valued other, toward whom one feels a personal sense of commitment and responsibility

1- knowing : striving to understand
2- being with: emotionally present
3- Doing for: as she/he would if possible
4- Enabling: facilitiating
5- Maintaing

Listening
Touch
Providing presense
……
Presence
Person to person encounter conveying closeness and a sense of caring
Caring theory
- Assists with the ways we communicate
- absolutely central to nursing practice
- action to promote healing
Threats to caring
- Acuity
- Time constraints
- Chaotic environment
- Technology
- Cold and indifferent
Pain theory
Assists with was to choose an appropriate pain assessment tools
- physical
- emotional
Fluid and electrolyte theory
Assists with understanding patient’s response to surgery
Dorthea Orem’s theory
Assists with ways to assess level of efficacy with self care.
- (make up for unmet needs due to illness)
Nightingale
Hygiene, clean air, nutrition and rest.
-put the patient in a healing environment. Each human being has the capacity to heal themseles
Four domains of nursing care
Person
- receipient of care
Health
- dynamic and continually changing
Environment/situation
- all possible conditions affecting health and care Nursing
- diagnosis and treatment of the human response to actual or potential health problems
Nursing theory components
- Phenomenon
- Concepts
- Definitions
- Assumptions
Why have Nursing Theories
-Guide Nursing care
-Help us to plan care
-Improve nursing administration
-Guide Research studies
-Formulate legislation governing nursing
-Develop curriculum
-Guide development of care delivery systems
-Provide rationale for nursing activities.
Nightengale (1860)
“facilitation of the body’s reparative processes"
Neumans Systems Theory of Nursing
- Systems theory as a transdisciplinary
- Humans are open systems
- Person interacts with environment, environment is both internal and external, stressors from the environment may effect the well being of the patient
Goals for Healthy People 2010
- Increase quality and years of healthy life
- Eliminate health disparities
Four areas of concentration for Healthy People 2010
1) Promote healthy behaviors
2) Promote healthy and safe communities
3) Improve Systems for personal and public health
4) Prevent and reduces disease and disorders
Health
State of complete physical, mental and social well being, not merely the absence of disease
Health Beliefs
A person’s ideas, convictions, and attitudes about health and illness
Health Belief Model
- Rosenstoch, Becker & Mainman
- addresses the relationship between a person’s belief and behaviors
3 Components of the Health Belief Model
) perception of susseptabilty to an illness
2) perception of the seriousness of the illness
3) liklihood of the person to take preventative action
Health Promotion Model
- Pender
- defines health as a positive dynamic state
- directed at increasing the level of well being
3 Areas of focus in Health promotion Model
) Individual Characteristics and experiences
2) behavior specific knowledge and effect
3) behavioral outcomes
Basic Human Needs Model
- based on Maslow’s Hierarchy of need
-physical
-safety and security
-love and belonging
- self esteem
- self actualization
Internal Variables effecting health and health beliefs
- Developmental phase
- Intellectual background
- Perception of functioning
- Emotional and spiritual factors
External variables effecting health and health beliefs
- Family Practice
- Socioeconomic factors
- Cultural background
Holistic Health Model
- create conditions that promote optimal health
- clients considered ultimate expert regarding their health
- clients involved in healing process and are responsible
-recognizes the bodies natural healing abilities
- complement to traditional medical care
Health promotion activites
Help clients maintain and enhance their present level of health
Wellness education
Teaches people how to care for themselves in a healthy way

ie physical awareness, stress management
Illness Prevention Activites
Protect from actual or potential threats to health

ie immunizations
Passive Strategies of Health Promotion
Individuals gain from the activities without acting themselves

Fluoridation of water, fortification of milk
Active Strategies of Health Promotion
Individuals are motivated to adopt specific health programs

Weight loss, smoking cessation
Primary Prevention
Prevention of disease before the onset of symptoms
Secondary Prevention
Focuses on individuals who are experiencing health problems and who are at risk of developing complications of worsening conditions
Tertiary Prevention
When a condition is permanent and irreversible.
- minimizing effects
Risk factor
Any situation, habit, social or environmental concern that increases the vulnerability of an individual or group to an illness or accident
Types of Risk Factors
- Genetic and physiological factors
- Age
- Environment
- Lifestyle
Illness
A state in which a person’s physical, emotional, intellectual, social, developmental or spiritual functioning is diminished when compared with previous experience
Evidence Based Practice
- The age of accountability, the old adage of health care provided based on tradition is no longer accepted
- Use problem solving steps to find the best practice
-guide for clinical decisions
- Ask the question “Where is the evidence for this?”
Five Steps
1. Ask the clinical question
2. Collect the most relevant data
3. Critically appraise the evidence you gather
4. Integrate all evidence into practice
5. Evaluate the practice decision or change
PICO Questions:
P- Population
I – Intervention
C- Comparison (What is the usual standard of care)
O - Outcome (What is the result you wish to achieve)
Traditional definition of health
Wholeness of body, parts functioning properly, mental balance…harmony with nature…yin and yang
WHO definition of health
A state of complete physical, mental social well-being, not merely the absence of disease
Biological definition of health
Absence of diagnosable disease; “normal” physical findings
Modern definition of health
Health and illness must be defined in terms of the individual
Illness
A state in which a person’s physical, emotional, intellectual, social, developmental or spiritual function is diminished compared with a previous experience
Maslow’s Hierarchy of Needs
Physiological
Safety
Love/belonging
Esteem
Self-actualization
Health – Illness continuum
Health is a moving state as a person adapts to changes to maintain a state of complete well-being. The continuum is personal and dynamic
Becker and Maiman Health Belief Model
Health beliefs area a person’s ideas, convictins and attitudes about health ans illness

Three components
1. individuals perception of suseptibiltiy to illness
2. perception of the seriousness
3. likelihood that a person will take preventive action
Pender’s Health Promotion Model
Health is positive dynamic state and not just the absense of disease
- prior related behavior
-perceived self efficacy
Internal variable influence health
Developmental stage
Intellectual background
Perception of functioning
Emotional factor
Spiritual factor
External variables influencing health
Family practice
Socioeconomic factors
Cultural background
Risk Factors
Genetic and physiological factors
Age
Environment
Lifestyle
Levels of preventative care
Primary-precedes disease
Secondary – experiencing symptoms
Tertiary – chronic illness
Primary level of preventative care
Health promotion (approach)
Illness prevention (avoidance)
Secondary level of preventative care
- Currently experiencing symptoms
- Activities aimed at diagnosis and intervention
- Screening test
- Treatment of acute stages of illness
Tertiary Level of Preventative care
- Chronic illness
- minimize effects
- Rehab
who may leaglly use the title nurse
lvn + rn
Collaborative Problem
- Problems requiring several disciplines
- complications that nurses monitor to detect the onset of changes
Medical diagnosis
Identification of a disease
Nursing Diagnosis
Classification of health problems within the domain of nursing
Clinical Criteria
Objective or selective signs and symptoms, or risk factors
Goal
Broad statement that describes a desired change in status
Expected outcome
Specific measureable change in status
Client centered goal
Reflects a clients highest possible level of wellness
7 guidelines for writing goals and outcomes
1. Client centered
2. Singular
3. Observable
4. Measureable
5. Time limited
6. Mutual
7. Realistic
Nursing Intervention
Any treatment based on clinical judgement & knowledge that a nurse performs to enhance clinical outcomes
Direct Care
Treatments performed via interactions with client
Indirect Care
Treatment performed away from but on behalf of the client (charting, collaboration
Nursing Process
Assessment
Diagnosis
Planning
Implementation
Evaluation
NANDA
North American Nursing Diagnosis Association
Nursing paradigm
person health environment and nursing
Four components of nursing theory
Concepts , definitions, phenomenon and assumptions
PICO
P - patient
I - intervention
C –comparison to standard
O- outcome
Presence in the nursing contact
involves a person to person encounter that convey closeness and a sense of caring
Listening is not only taking in what the client says
but also includes interpreting and understanding.
There is a contemporary move towards nursing as EBP
– nursing researchers will test theories to describe or predict patient outcomes
In the US, Nurse practice acts are overseen by
BRN
What is the primary characteristic of professional nurse
a theoretical body of knowledge body of knowledge
The NCLEX for RN licensure ensures
I minimum body knowledge
Most California nurse are practicing at the
associate level.