Nursing Today

Historical Perspective Highlights Nurses: Respond to needs of patients Actively participate in policy Respond and adapt to challenges Make clinical judgments and decisions about patients’ health care needs based on knowledge, experience, and standards of care Nursing: Care is provided according to standards of practice and a code of ethics. •

Florence Nightingale First practicing epidemiologist Organized first school of nursing Improved sanitation in battlefield hospitals Her practices remain a basic part of nursing today.

Civil War to the Beginning of the Twentieth Century The growth of nursing in the United States: Clara Barton founded the American Red Cross. Dorothea Lynde Dix Mother Bickerdyke Harriet Tubman Mary Mahoney Isabel Hampton Robb Lillian Wald and Mary Brewster: Henry Street Settlement

The Twentieth Century Movement toward scientific, research-based practice and defined body of knowledge 1901: Army Nurse Corps established 1906: Mary Adelaide Nutting, first professor of nursing at Columbia University 1908: Navy Nurse Corps established 1920-1923: Study of nursing education 1940s and 1950s: Associations emerged 1970: Emergency Room Nurses Organization

The Twenty-First Century Nursing code of ethics Changes in curriculum Nursing in multiple care settings Advances in technology and informatics End-of-life care

Influences on Nursing Changes in society lead to changes in nursing: Health care reform Demographic changes Medically underserved Threat of bioterrorism Rising health care costs Nursing shortage

Nursing as a Profession A profession has characteristics: Requires an extended education Requires a body of knowledge Provides a specific service Has autonomy Incorporates a code of ethics

Scope and Standards of Practice Nursing: Scope and Standards of Practice 1960: Documentation began Standards of Practice Standards of Professional Performance Goal To improve the health and well-being of all individuals, communities, and populations through the significant and visible contributions of registered nursing using standards-based practice

Standards of Practice Nursing standards provide the guidelines for implementing and evaluating nursing care. Six standards of practice: Assessment Diagnosis Outcomes identification Planning Implementation Evaluation

Standards of Professional Performance Ethics Quality of Practice Professional Practice Evaluation Education Communication Resources Evidence-Based Practice and Research Leadership Environmental Health Collaboration

Code of Ethics A code of ethics is the philosophical ideals of right and wrong that define principles used to provide care. It is important for you to incorporate your own values and ethics into your practice. Ask yourself: How do your ethics, values, and practice compare with established standards?

Quick Quiz! 1. Nursing is defined as a profession because nurses A. Perform specific skills. B. Practice autonomy. C. Utilize knowledge from the medical discipline. D. Charge a fee for services rendered.

Nursing Education Professional registered nurse education 2-year associate’s degree 4-year baccalaureate degree Graduate education Master’s degree, advanced practice RN Doctoral degrees Continuing and in-service education

Case Study Ming graduated with an associate’s degree in nursing last year and currently works in a long-term care facility. Although Ming enjoys his work and has been promoted to shift supervisor on his unit, he finds that he’d like to pursue a nursing career that offers a regular schedule and more autonomy than he currently experiences at the long-term care facility. Ming considers returning to school for an advanced degree. [

Nursing Practice Nurses practice in a variety of settings. Nurses: Protect, promote, and optimize our patients’ health Prevent illness and injury Alleviate suffering through the diagnosis and treatment of human responses Advocate for the care of our patients

Nursing Practice Nurse Practice Acts Licensure and certification Science and art of nursing practice Benner’s stages of nursing proficiency: Novice Advanced beginner Competent Proficient Expert

Professional Responsibilities Nurses are responsible for obtaining and maintaining specific knowledge and skills. In the past: To provide care and comfort Now: To provide care and comfort and to emphasize health promotion and illness prevention

Autonomy and Accountability Professional Roles Autonomy and Accountability Caregiver Advocate Educator Communicator Manager

Career Development Nursing provides an opportunity for you to commit to lifelong learning and career development. {Fig 1-2 here}

Case Study (cont’d) Ming is particularly drawn to the idea of becoming an advanced practice registered nurse (APRN). Ming’s career options for becoming an APRN include which of the following? (Select all that apply.) A. Physician assistant (PA) B. Clinical nurse specialist (CNS) C. Certified nurse midwife (CNM) D. Certified RN anesthetist (CRNA)

Professional Nursing Organizations National League for Nursing (NLN) American Nurses Association (ANA) International Council of Nursing (ICN) National Student Nurses Association (NSNA) or Canadian Student Nurses Association (CSNA) Other professional organizations focus on specific areas.

Quick Quiz! 2. The NLN and the ANA are professional organizations that deal with A. Nursing issues of concern. B. Political and professional issues affecting health care. C. Financial issues affecting health care. D. All of the above issues. Answer: D

Case Study (cont’d) If Ming decides to pursue a career as an APRN, which patient populations may he serve? (Select all that apply.) A. Adult-gerontology B. Prison inmates C. Neonatology D. Psychiatric mental health

Quality and Safety Education for Nurses (QSEN) Competency: Patient-Centered Care Teamwork and Collaboration Evidence-Based Practice Quality Improvement Safety Informatics

Case Study (cont’d) If Ming decides to choose a career as a critical care CNS, then his specialty is identified by which means? A. Population B. Setting C. Disease specialty D. Type of care E. Type of problem

Additional Nursing Trends Genomics Public perception of nursing Impact of nursing on politics and health policy Future trends