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Chapter 1 Nursing Foundations
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Nursing Origins Youngest profession but oldest art
During the Middle Ages in Europe Schism between King Henry VIII and the Catholic Church
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The Nightingale Reformation
The Crimean War Nightingale’s contributions Training people for future work Selecting those with upstanding character Improving sanitary conditions for sick and injured
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The Nightingale Reformation (cont’d)
Nightingale’s contributions (cont’d) Reducing death rate of British soldiers Providing classroom assistance and clinical teaching Advocating nursing education should be lifelong
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Question Is the following statement true or false?
Florence Nightingale advocated that nursing education should be lifelong.
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Answer True. Florence Nightingale advocated that nursing education should be lifelong because of technological advances, to demonstrate competence and ensure the public’s confidence, and to practice according to current nursing standards.
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Nursing in the United States
U.S. nursing schools: Differences between the Nightingale Training Schools and U.S. Training Schools Expanding horizons of practice
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Nursing in the United States (cont’d)
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Contemporary Nursing Combining nursing art with science
Integrating the nursing theory Nursing theories and application
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Contemporary Nursing (cont’d)
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Contemporary Nursing (cont’d)
Defining nursing Nursing definitions by: Florence Nightingale Virginia Henderson American Nurses Association
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The Educational Ladder
Basic educational options available: Practical (vocational) nursing Registered nursing Factors that influence choice of nursing program: Career goals Geographic location of schools
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The Educational Ladder (cont’d)
Factors that influence choice of nursing program (cont’d): Costs involved Length of program Reputation and success of graduate Flexibility of course scheduling
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The Educational Ladder (cont’d)
Factors that influence choice of nursing program (cont’d): Opportunity for part-time versus full-time employment Ease of movement into next level of education
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The Educational Ladder (cont’d)
Practical/vocational nursing Abbreviated nursing program created during World War II Length: average between 12 and 18 months Shortest, most economical program
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The Educational Ladder (cont’d)
Registered nurse Works under direction of physician or dentist Manages or provide direct care to client Educates clients and the public: medical conditions Delegates client care to LPN and UAP
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The Educational Ladder (cont’d)
Registered nurse (cont’d) Three paths Hospital-based diploma program Traditional route for nurse Lowest number of diploma programs compared to other basic nursing educational programs
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The Educational Ladder (cont’d)
Registered nurse (cont’d) Hospital-based diploma program (cont’d) Reasons for decline Movement to increase professionalism in nursing Hospital no longer financially subsidizes school of nursing
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The Educational Ladder (cont’d)
Registered nurse (cont’d) Associate degree program Aimed at shortening nursing education Referred to as nurse Would not be expected to work in a management position
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The Educational Ladder (cont’d)
Registered nurse (cont’d) Baccalaureate program Greatest flexibility in qualifying for nursing positions Preferred in areas requiring substantial independent decision making
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The Educational Ladder (cont’d)
Registered nurse (cont’d) Graduate nursing program Master’s-prepared nurses: clinical specialist, nurse practitioner, administrator, educator Doctoral degree: conduct research; advise, administer, and instruct nurses pursuing graduate and undergraduate degrees
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The Educational Program (cont’d)
Registered nurse (cont’d) Continuing education Planned learning experience beyond the basic nursing program Rationale for acquiring continuing education
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The Educational Program (cont’d)
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Question Is the following statement true or false?
The geographic location of a school does not have any implication in the choice of a nursing program.
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Answer False. Geographic location of a school is one of the factors that influences the selection of a nursing program.
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Future Trends Factors contributing to nursing shortage:
Retirement rate exceeds replacement Increased aging population requires health care Disappointing salaries with longevity employment Job dissatisfaction
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Future Trends (cont’d)
Factors contributing to nursing shortage (cont’d): Heavier workloads and sicker clients Publicity about mandatory overtime Downsizing nursing staff from dwindling revenues and managed care policies Negative stereotypes
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Future Trends (cont’d)
Governmental response Loan repayment programs and scholarships for nursing students Funding for public service announcements Career ladder programs Establishment of nurse retention and client safety enhancement grants
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Future Trends (cont’d)
Governmental response (cont’d) Grants to incorporate gerontology into nursing curricula Loan repayment programs for nursing students who agree to teach following graduation
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Future Trends (cont’d)
Proactive strategies Pursuing post-licensure education Training for advanced practice roles Becoming cross-trained Learning more about multicultural diversity Supporting legislative efforts toward national health insurance
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Future Trends (cont’d)
Proactive strategies (cont’d) Promoting wellness: home health and community-based programs Helping clients with chronic diseases Referring clients with health problems Coordinating nursing services across health care settings
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Future Trends (cont’d)
Proactive strategies (cont’d) Developing and implementing clinical pathways, standardized multidisciplinary plans for a specific diagnosis or procedure Participating in quality assurance Concentrating on knowledge and skills: manage health needs of older Americans
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Question Which of the following is a factor contributing to nursing shortage? a. Job dissatisfaction b. Geographic location of schools c. Length of programs d. Reputation and success of graduate
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Answer a. Job dissatisfaction
Job dissatisfaction is a factor that has contributed to nursing shortage. Geographic location of schools, length of programs, and reputation and success of graduate are factors that influence the selection of a nursing program.
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Unique Nursing Skills Assessment skills
Following activities requires use of assessment: Interviewing, observing, examining client and family; reviewing client’s medical record; obtaining facts from other health care workers
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Unique Nursing Skills (cont’d)
Caring skills Assisting with ADLs Safe care of clients who require invasive or highly technical equipment Helping client become self-reliant
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Unique Nursing Skills (cont’d)
Counseling skills Communicating with client Actively listening Offering pertinent health teaching Providing emotional support Using therapeutic communication techniques
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Unique Nursing Skills (cont’d)
Counseling skills (cont’d) Use active listening Clarify client’s perspective Teach clients: promote healing processes, staying well, preventing illness, and carrying out ADLs Use empathy
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Unique Nursing Skills (cont’d)
Comforting skills Provide stability and security during a health-related crisis
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