1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 1 Nursing Foundations

2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Origins Youngest profession but oldest art During the Middle Ages in Europe Schism between King Henry VIII and the Catholic Church

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Florence Nightingale advocated that nursing education should be lifelong.

6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. Florence Nightingale advocated that nursing education should be lifelong due to continual technological advances, to demonstrate competence and ensure the public’s confidence, and to facilitate practice consistent with current nursing standards.

7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing in the United States U.S. nursing schools: –Differences between the Nightingale Training Schools and U.S. Training Schools Expanding horizons of practice

8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing in the United States (cont’d)

9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contemporary Nursing Combining nursing art with science Integrating the nursing theory –Nursing theories and application

10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contemporary Nursing (cont’d)

11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Contemporary Nursing (cont’d) Defining nursing –Nursing definitions by: oFlorence Nightingale oVirginia Henderson oAmerican Nurses Association

12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 re: Medical conditions –Delegates client care to LPN and UAP

17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Ladder (cont’d) Registered nurse (cont’d) –Three paths oHospital-based diploma program  Traditional route for nurse  Lowest number of diploma programs compared to other basic nursing educational programs

18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Ladder (cont’d) Registered nurse (cont’d) –Hospital-based diploma program (cont’d) oReasons for decline  Movement to increase professionalism in nursing  Hospitals no longer financially able to subsidize schools of nursing

19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Ladder (cont’d) Registered nurse (cont’d) –Associate degree program oAimed at shortening nursing education oOriginally-proposed title of “technical nurse” oWould not be expected to work in a management position

20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Ladder (cont’d) Registered nurse (cont’d) –Baccalaureate program oGreatest flexibility in qualifying for nursing positions oPreferred in areas requiring substantial independent decision making

21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Ladder (cont’d) Registered nurse (cont’d) –Graduate nursing program oMaster’s-prepared nurses: Clinical specialist, nurse practitioner, administrator, educator oDoctoral degree: Conduct research; advise, administer, and instruct nurses pursuing graduate and undergraduate degrees

22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Program (cont’d) Registered nurse (cont’d) –Continuing education oPlanned learning experience beyond the basic nursing program oRationale for acquiring continuing education

23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins The Educational Program (cont’d)

24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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.

25. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Geographic location of a school is one of the factors that influences the selection of a nursing program.

26. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Future Trends Factors contributing to nursing shortage: –Retirement rate exceeds replacement –Increased aging population requires health care –Disappointing salaries with longevity employment –Job dissatisfaction

27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 Future Trends (cont’d)

28. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

29. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

30. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 Future Trends (cont’d)

31. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

32. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

33. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

34. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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.

35. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Unique Nursing Skills Assessment skills –Following activities requires use of assessment: oInterviewing, observing, examining client and family; reviewing client’s medical record; obtaining facts from other health care workers

36. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

37. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Counseling skills –Communicating with client –Actively listening –Offering pertinent health teaching –Providing emotional support –Using therapeutic communication techniques Unique Nursing Skills (cont’d)

38. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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 Unique Nursing Skills (cont’d)

39. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Unique Nursing Skills (cont’d) Comforting skills –Provide stability and security during a health-related crisis