NU 211-Chapter 1: Evolution of Nursing: Thought & Action

Florence Nightigale

Founder of modern nursing

Dorothea Dix

Superintendent of United’s States Army Nurses

Clara Barton

Founded the American Red Cross

Lavinia Dock

Co-founder of National League for Nursing

Mary Mahoney

First African American professional nurse

Critical Foundations: Clinical judgement

recognize and interpret patient cues, prioritize concerns, make safe decisions, take actions and evaluate

Critical Foundations: Technical expertise

To ensure safe, effective interventions

Critical Foundations: Critical thinking

To collect and analyze information, evaluate accuracy and relevance, consider options, and determine nursing actions

Critical Foundations: Advocacy

To protect patient rights, promote their needs and preferences, prevent harm, and ensure safe, appropriate, and person centered care

Critical Foundations: Communication skills

For patient advocacy and teem collaberation

Critical Foundations: Leadership qualities

To guide healthcare teams

Essential Thing Skills: Clinical judgement

Knowledge based decision making

Essential Thinking Skills: Critical thinking

Reflective analysis

Essential Thinking Skills: Problem solving

Solution focused approach

Nursing is…

The protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in the care of individuals, families, groups, communities, and populations.- ANA(2015)

Important Qualities for Nurses- Critical thinking

Analytical reasoning and sound judgement

Important Qualities for Nurses- Caring and Compassionate

Empathy and genuine concern

Important Qualities for Nurses- Detail-Oriented

Meticulous attention to accuracy

Important Qualities for Nurses- Organizational Skills

Efficient time and resource management

Important Qualities for Nurses- Communication

Clear speaking and active listening

Important Qualities for Nurses- Patience

Calm demeanor under pressure

Important Qualities for Nurses- Competence

Technical and clinical proficiency

Important Qualities for Nurses- Emotional Stability

Resilience in challenging situations

Important Qualities for Nurses- Physical Stamina

Endurance for demanding shifts

Improving Recognition- Standardize Education

Establish uniform educational requirements across all states and institutions to ensure consistent baseline competencies

Improving Recognition- Continuing Education

Implement consistent counting education requirements to maintain currency in clinical knowledge and skills

Improving Recognition- Professional Participation

Increase active enrollment in nursing organizations to strengthen collective advocacy and influence

Improving Recognition- Public Education

Educate the public about the true scope, depth, and complexity of modern nursing practice

Improving Recognition- Standard Language

Adopt uniform professional terminology too enhance communication and professional identity

Entry Into Practice- Diploma Programs

Hospital based training programs, historically the foundations of nursing

Entry Into Practice- Associate Degree (ADN)

Two year community college programs focused on technical nursing skills

Entry Into Practice- Bachelor of Science (BSN)

Four year university degree emphasizing leadership, research, and community health

Entry Into Practice- RN to BSN

Bridge programs for licensed nurses seeking bachelors degree advancement

Entry Into Practice- Masters Degrees

Advanced degree fir many different specialties

Entry Into Practice- Doctoral Programs

Advanced degrees for research, practice or academic leadership roles

Nurse Practitioner (NP)

Diagnose, treat, and prescribe medications

Clinical Nurse Specialist (CNS)

Expert clinicians in specialized areas

Nurse Educator

Teach in academic or clinical settings

Nursing Informatics

Integrate technology and healthcare data

Nurse Administor

Lead healthcare organizations

Direct Entry Masters

For non nursing bachelors graduates

Doctor of Nursing Practice (DNP)

Clinical practice focus

Doctor of Nursing Science

Scientific inquiry emphasis

Doctor of Philosophy (PhD)

Research and theory development

Direct Entry Doctoral

Accelerated pathway for career changers

Continuing Education

Crucial professional strategy to maintain current clinical knowledge and evidence based practice competency

In Service Education

Programs offered at the worksite to enhance staff competence in knowledge, skills, and attitude

License Renewal

Many states require a specific number of CE contact hours for license renewal. Always verify requirements for each state where you hold licensure

Novice

Beginning students with no experience. Rely on rules and written procedures, following sequential steps rigidly without flexibility

Advanced Beginner

New graduates with minimal experience. Begin to recognize recurring patterns and similarities in clinical situations, using more contextual facts

Competent

Nurses with 2-3 years experience. Demonstrate ability to prioritize care while maintains compassion and organization efficiency

Proficient

Experienced nurse who “see the big picture”. Quickly integrate multiple date sources, cluster information, and adapt interventions based on holistic assessment

Expert

Deep, intuitive understanding of patient situations, recognize problems without classic symptoms, demonstrating mastery through experience and reflection

Nurse Practice Acts

State based governing that define the legal boundaries and requirements for nursing practice, each state maintains its own nurse practice act

State Boards of Nursing

Regulatory agencies responsible for approving education programs, defining scope of practice, establishing licensure criteria, creating rule and regulations, and enforcing standards

Standards of Practice

Competency guidelines that describe the knowledge, skills, and attitude required to deliver safe, quality care. These standards serve as benchmarks for professional accountability

Which organization if directly responsible for regulating the practice of nursing in each state?

The state board of nursing

American Nurses Association (ANA)

Promotes high quality care, advocate for the profession, and works toward licensure adherence to establish standards

International Council of Nurses (ICN)

Establishes global health policies, advances nursing worldwide, and improves international health outcomes

Sigma Theta Tau International (STTI)

International honor society recognizing nursing scholarship, leadership, and excellence in practice

National League for Nursing (NLN)

Advances nursing education programs, conducts workforce studies, and participates in healthcare policy development

National Students Nurses Association (NSNA)

Represents nursing students throughout the United States, fostering professional development and leadership

Specialty Organizations

Focus on specific nursing specialties such as critical care, pediatrics, oncology, and emergency nursing

Health Promotion

Optimizing wellness and healthy lifestyles

Illness Prevention

Reducing risk factors and disease occurrences

Holistic Approach

Addressing physical, emotional, social, and spiritual dimensions

Health Restoration

Treating illness and facilitating recovery

End of Life Care

Providing comfort and dignity in final days

Individuals

Referred to as patients, clients, or persons receiving care

Families

Family units requiring support, education, or interventions

Groups

Specific populations with shared characteristics or needs

Communities

Geographic or social communities requiring health services

Direct care

Face to face interaction and hands on nursing interventions

Indirect Care

Activities supporting patient care such as documentation, coordination, and advocacy

1. Case Method

Total Care: One on one nursing care where a single nurse provides all care for one patient

2. Functional Nursing

Task Oriented: Care is compartmentalized by tasks, with each nurse assigned specific duties for multiple patients

3. Team Nursing

Collaborative: Multiple nurses work together to care for a group of patients, led by a team leader

4. Primary Nursing

Comprehensive: One nurse assumes responsibility for a group of patients

5. Differentiated Practice

Competency Based: Care delivery is based on the nurses education level and clinical experience

Acute Care

Treats sudden, urgent, or emergent episodes. Goal: Prevent deterioration and restore health

Long term Support Services

Ongoing assistance through human support, assistive technologies, environmental modifications, and coordinated care

Hospitals

Inpatient acute care facilities

Extended Care Facilities

Skilled nursing, assisted living, and rehabilitation

Ambulatory Care Centers

Outpatient clinics and surgical centers

Home Healthcare Agencies

In home nursing and therapy services

Communities Health Centers

Public health and preventative care facilities

Physicians (MD/DO)

Diagnose and treat medical conditions

Physician Assistants

Practice medicine under physician supervision

UAPs

Unlicensed assistive personnel supporting patient care

Therapists

Physical occupational, respiratory, and speech specialists

APNs/NPs

Advanced practice registered nurses

RNs/LPNs

Licensed nursing professionals providing direct care

Pharmacists

Medication experts and therapeutics advisors

Technologists

Diagnosis imaging and laboratory professionals

Which healthcare provider dispenses medications and therapeutic solutions in hospitals, community pharmacies, and various health settings?

Pharmacist

Complementary and Alternative Medicine

Integration of CAM therapies with conventional treatments for holistic patient care

Expanded Care Location

Growing variety of practice settings including tele health, schools, and retail clinics

Inter professional Collaboration

Enhanced teamwork across healthcare disciplines for comprehensive patient outcomes

Expanded Career Roles

New specializations of UAPs requiring effective delegation and supervision

Health Policy Influence

Growing nurse involvement in shaping healthcare legislation and organization policy