1. Educational Pathways and Expanded Roles

2. Educational preparation Diploma in Nursing Associate’s Degree in Nursing Baccalaureate Degree in Nursing Master’s Degree in Nursing Doctoral Degrees in Nursing

3. Educational Pathways and Expanded Roles Accreditation of programs of nursing National League for Nursing Accrediting Commission (NLNAC) Commission on Collegiate Nursing Education (CCNE) Specialty nursing certification American Nurses Credentialing Center (ANCC), subunit of the American Nurses Association (ANA) ANA offers 39 different certification programs for RNs

4. Licensure NCLEX-RN ® National Council of State Boards of Nursing (NCSBN) Four main categories of testing Safe effective care environment Management of care 13%-19% Safety and infection control 8%-14% Health promotion and maintenance 6%-12% Psychosocial integrity 6%-12% Physiological integrity Basic care and comfort 6%-12% Pharmacological and parenteral therapies 13%-19% Reduction of risk potential13%-19% Physiological adaptation11%-17% (NCSBN, 2007)

5. Educational Pathways and Expanded Roles Licensed Practical Nursing Considered “directed” in that an LPN/LVN functions under the direction of an RN, physician, or other health care provider Provide care in settings where patients are experiencing common health problems and focuses on meeting basic needs Considered the technical nurse

6. Educational Pathways and Expanded Roles Registered Nursing In 1955, Virginia Henderson stated that: The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge and to do this in such a way as to help him gain independence as rapidly as possible

7. Educational Pathways and Expanded Roles Registered Nursing In 2004, the ANA defined nursing as: The protection, promotion, and optimization 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, communities, and populations

8. Three Primary Roles Provider of care Manager of care Member of the profession

9. American Nursing Association: Nursing’s Agenda for the Future Leadership and planning Delivery systems Legislation/regulation/policy Professional/nursing culture Recruitment/retention Economic value Work environment Public relations/communication Education Diversity

10. Professional Nursing Organizations American Nurses Association (ANA) represents the nation’s 2.9 million registered nurses Advances the profession of nursing by Fostering high standards of nursing practice Promoting the rights of nurses in the workplace Projecting a positive and realistic view of nursing Participating in lobbying efforts on health care issues that affect nurses and the public

11. Professional Nursing Organizations There are many organizations dedicated to specialty practice Belonging to one or many professional organizations provides education and socialization in nursing

12. Scope of Practice Identify the responsibilities of nurses, depending on their educational preparation and licensure Defined by individual state nurse practice acts Individual state boards of nursing, which are located within varying government organizations at the state level, commonly exist to protect the consumers of nursing care by regulating the profession

13. Scope of Practice The NCSBN is the unifying body for the state boards of nursing ANA’s publication Nursing: Scope and Standards of Practice (2004) Addresses the scope of practice and delineates the practice and professional performance standards and measurement criteria for RNs Six standards of practice Nine standards of professional performance

14. Six Standards of Practice (ANA) Assessment Diagnosis Outcomes identification Planning Implementation Evaluation

15. Nine Standards of Professional Performance (ANA) Quality of practice Education Professional practice evaluation Collegiality Collaboration Ethics Research Resource utilization Leadership

16. Multistate Licensure The Nurse Licensure Compact, developed by the National Council of State Boards (NCSBN) and adopted in 1998 Allows nurses in compact states to work in other compact states without obtaining a license in that state The nurse licensed in one compact state and practicing in another must adhere to the laws of that compact state, and this requires that the nurse stay abreast of any changes to multistate licensure

17. Delegation Basic principles of delegation Delegating the right task, under the right circumstances, to the right person, with right direction and communication, and with the right supervision

18. Delegation According to the ANA (1995), the three elements of nursing that may not be delegated The initial and subsequent nursing assessments that require professional judgment The determination of nursing diagnoses, goals, plans of care, and progress Interventions that require the application of professional knowledge and skills

19. Decision Making and Problem Solving Closely related and use a similar process to arrive at a decision Problem solving involves making a decision that is focused on trying to solve an immediate problem Decision making is a purposeful and goal-directed process aimed at identifying and selecting options as part of problem solving, planned change, or improvement

20. Decision Making and Problem Solving Steps for effective decision making and problem solving (Yoder-Wise, 2003) Gather data from many sources Learn different approaches to problem situations Observe positive role models in action Talk to a colleague or superior who is an effective problem solver and decision maker Perform research to increase your knowledge base Take risks using new approaches to problem solving

21. Ethics and Leadership Leadership has a moral or ethical dimension Five principles of ethical leadership Serving others Showing justice Respecting others Honesty Building community

22. Ethics and Leadership Leaders have the ethical responsibility to treat followers with dignity and respect and be sensitive to their interests, needs, and concerns

23. Professional Advocacy An advocate Defends or promotes the rights of others Changes systems to meet the needs of others Empowers and promotes self-determination in others Promotes autonomy of diverse cultures and social groups Ensures respect, equality, and dignity for others Cares for the humanness of all