Intro to Professional Nursing Exam 1

LSUHSC is a school of

Nursing, Medicine, Allied Health, Dentistry, Graduate Studies (own school), and Public Health

Dean

Dr. Demertrius Porche

Chancellor

Dr. Steve Nelson

Approved by ______ annually

LSBN

Member of

National Council of State Boards of Nursing

LSBN doesn't care to protect you, only to protect ______

the public (safety and welfare)

Institutional Accredittation

SACS

CCNE & COA are important to be able to

take the NCLEX, and receive scholarships, loans, military service, grad school acceptance

Philosophies of Nursing

Beliefs, expression, values in nursing about person, environment, health, caring

To make a philosophy, start with

theoretical framework

SON Core Values

Stewardship, Organizational Citizenship, Nursing Innovation, Caring, Professionalism, Respect, Integrity, Diversity, and Excellence (SON C PRIDE)

Stewardship

advocating & protecting resources trusted in our care through service, dedication, & enthusiasm.

Organizational Citizenship

the responsibility of all faculty, staff, and students to be a contributing member of our unified educational community committed to a culture of connection and engagement.

Nursing Innovation

the conversion of knowledge and ideas into meaningful work through creativity, entrepreneurship, and pushing beyond the boundaries of status quo.

Caring

encompasses the interest, concern, compassion and mentoring we demonstrate for our students, our patients, our communities and each other.

Professionalism

the consistent demonstration of and strict adherence to accountability, responsibility, dependability, and commitment.

Respect

acknowledging the value of ourselves and others by treating them with dignity, courtesy, and consideration.

Integrity

acting with honesty, fairness, and sincerity in all endeavors with an ethical and professional manner.

Diversity

fostering the potential of every individual through sensitivity, social justice and cultural competence.

Excellence

supporting the highest quality in an environment of collaboration, shared knowledge, innovation, scholarship, leadership, and competence.

the NLN (national league for nursing)

Promotes excellence in nursing education to build a strong and diverse nursing workforce

AACN (The American Association of Colleges of Nursing

Mission)

The national voice for America's baccalaureate and higher-degree nursing education programs

Commission on Collegiate Nursing Education (CCNE)

is the autonomous accrediting agency Ensures the quality and integrity of baccalaureate and graduate education programs

What do nurses do before making critical decisions?

perform physical exams and health histories

What cna nurses provide?

health promotion , counseling, and education

Incorporate interactions between providers and clients with financial and regulatory agents

Health Care delivery System

Diploma (3-4% decreasing, 2 year accelerated), ADN (30-40%, 2 years), and BSN (60% and increasing, 4 year) are the three

RN Licensure Programs

more than _______ hospitals were critically short-staffed in November 2020

1,000

What is the percentage of male nurses?

9.4%

1/3 of current nurses are how old?

50+

How many nurses are estimated to retire in the next 10-15 years?

1 million

Nurses can find roles in:

Hospitals (primarily), Ambulatory care, Extended care, Education, Administration, Research, and Politics.

Use of current knowledge from research and other credible sources on which to base clinical judgement and client care. Patient outcomes are more positive.

EBP (Nurse Researcher)

Direct patient care, staff nurses, clinical nurse specialists, charge nurses, educators, managers, and administrators.

Nursing Hospital Roles

Ambulatory clinics, health departments, hospices, homes, and community

Nursing Community Roles

Functions of APNs and doctors are similar and equal - Primary Care

Substitutive Application

Functions of APNs and doctors are different and equal - Acute Care

Complementary Application

Why is studying the history of nursing important?

identity, learn from mistakes, pride, framework for today.

How long has nursing existed?

since humans have been ill

Low period of nursing: monks and nuns disappeared as caregivers, untrained women were nurses, and "nurse" was no longer a respectable term.

Reformation

Pioneer that started the professional nursing status during the Crimean War, transformed mortality rate from 60% to 2%. Recruited high-character nurses. Established 1st formal nursing ed. (schools base ed. off her)

Florence Nightingale

Using her own money to establish "hotel for soldiers", closer to front lines of war than Nightingale, was denied twice to join Nightingale's team.

Mary Seacole

Superintendent of Women's Nurses of the Union (during the Civil War) that helped mentally ill

Dorothea Dix

tended to Union soldiers, "angel of the battlefield", founded American Red Cross

Clara Barton

Only woman in Confederacy to hold military rank was superintedent

Sally Tompkins

1st trained African American Nurse in the US - New England Hospital for Women in 1879. Member of ANA. Co-founded National Association of Colored Graduate Nurses

Mary Mahoney

Significantly improved nursing eduction by lengthening John Hopkins ed. from 2 to 3 years. Helped est. American Journal of Nursing in 1900

Mary Adelaide Nutting

Founded the Henry Street Settlement in NYC 1893, formally trained nurses, colleague of Lavinia Dock, Started with immigration community, helped insurance reimbursement for n=home nursing, national Org. of Public Health, Founder of NACCP

Lillian Wald

worked with tenants to help densely populated areas

Jessie Sleet Scales

Nurse and midwife, frontier Nursing Service 1925, helped nutrition, hygiene, and prenatal care.

Mary Breckenridge

1/3 of world was infected

Flu Epidemic of 1917

Which city is in the forefronts (making the advancements) in nursing?

New York

First profession using same licensure exam nation-wide

nursing!

Notoriously underpaid, could no longer afford nursing, unemployment spiked durign

Great Depression

Promotes public health and old-age insurance

1935 Social Security Act

Segregation of African American and male nurses in military ended

1947

trauma care (PTSD starting to be identified)

Vietnam war

Public demand for better health care --> specialty units (special care). **______ was 1st to recognize NPs

Idaho

movement that helped and hurt nursing

Feminism

Prevented insurance companies denial to minors - signed in March 2010

Affordable Care Act (ACA)

Social Context - why are you a nurse?, image of nursing - "sexy, mean, or caring?", Gender, National pop. trends, technology (less nurses due to tech.), and aging

Influences of Nursing Shortage

take nurses from poorer countries, training people (licensed practical nursing)

Attempted Solutions to help Nursing Shortage

How have exclusionary practices affected nursing?

nursing shortage, diversity (patient outcomes), salaries, and leadership

Spanish American War: people preferred male nurses, _____ volunteered to be bitten by carrier mosquitoes to prove how disease (yellow fever, typhoid, malaria, and dengue) was spread.

Clara Maass

Full-time work in discipline, code of ethics on how to practice by providing standards/organization.

The Process of Professionalism

Nursing is a constant learning experience. Providing practice foundations, Mastery of knowledge, and developing Identity.

Occupation-Practice Continuum

Personal identification derived from their profession (career). Profession as "calling", Commitment --> material reward, Strong Professional Identity

Professional Commitment

Training done on the job, length of training varies, values and beliefs are not prominent, varied commitment, supervised workers, Material Reward (money) is main motivation, Accountability = Employer

Occupation

Training in educational setting, invested Commitment, Values and Beliefs, Autonomous workers (unsupervised), Commitment transcends material reward, Accountability = Individual

Profession

4 Main Areas of Competency

1. Values/Ethics, 2. Roles/Responsibilities, 3. Communication amongst team (doctor, nurses, family), 4. Team/Teamwork

1. Services should meet care expectations, 2. Research/theory as a basis for practice, 3. Accountability, 4. Education in higher ed., 5. Autonomy (control over one's practice), 6. Altruism (value on career), 7. Code of Ethics, and 8. Association (high standards).

Kelly's Criteria (1981)

Documents to guide Nurses' Commitment to demonstrate ethical values and standards

Nursing Social Policy Statement

Being a support system and mentor

Collegiality

Variations of levels of education and Gender Issues

Barriers in IPN

What statement best supports nursing as a profession?

Code of ethics

3 multiple choice options

The hardest job you will ever love

Nursing!

Mode of thinking in subject content, or problem. Have to take into account previous medical history, ed. background, cultural background. Reflective thinking.

Critical Thinking

Organizing knowledge as separate facts, Rely on Resources, Lack knowledge from acting, Focus on actions and not fully assess before actions, clear-cut rules.

Novice Thinking

Highly organized knowledge and manner, Assess options for intervening, Know flexibility, Aware of and use resources.

Expert Thinking

Framework to think systematically and process patient information in order to produce high level care. Basis of interventions needed to provide care. Universal Intellectual Standard.

Nursing Process

Using standardized nursing terminology to improve the healthcare of the people

North American Nursing Diagnoses Association (NANDA)

Assessment, Analysis/Identify problem, Planning, Implementation, and then Evaluation

Steps of Nursing Process

Organize/Collect data while maintaining confidentiality (HIPAA)

Assessment

Validate and cluster data acquired in order to find patient problem

Analysis/Identification

Interventions depending on an accurate diagnosis. Obtain goal for patient.

Diagnostic Accuracy

1. Nurses as effective diagnosticians, 2. How nurses are educated about nursing diagnoses, 3. Complexity of a patient's situation, and 4. Degree to which a hospital's policy and environment supports the use of nursing diagnosis

4 Domains affecting Nurses' Accurate Documentation of Diagnoses:

Writing Nursing Diagnosis

P = Problem (NANDA-I diagnostic label), E = Etiology (causal factors), and S = Signs and symptoms (defining characteristics)

Breaking down Bloom's taxonomy (viewing cognitive, psychomotor, and affective domains) and Realistic/Measurable Goals.

Planning

Standardized plan of care based on common and recurring problems and Multidisciplinary plans (multiple HC team members).

Writing the Plan of Care

Planned interventions, Nursing orders actually carried out. Continually assessing patient throughout.

Implementation

Examines patient progress using goals/outcome. May reveal data, diagnosis, and goals.

Evaluation

Reduce chance of readmission and optimize health

Nursing Goals

What are major outcomes (beneficial results)? What problem/issues will need to addressed after outcome? What are circumstances? What knowledge is required by patient? How much room for error? How much time? What resources will help? Whose perspectives should be considered? What is influencing my thinking?

Clinical Judgement: 9 Key Questions

A novice nurse would most likely:

Use a checklist when inserting a nasogastric tube

The nursing process is a systematic, problem-solving approach that provides the framework for nursing practice in the United States and Canada. Put the five steps of the nursing process in order. (Select all that apply.)

Diagnosis, Implementation, Planning, Assessment, and Evaluation

Having an accepted definition of NURSING provides a framework for

nursing practice

Educational Paths to Become a Registered Nurse

- Diploma Programs (not really anymore)

- Associate Degree Programs

- Baccalaureate Programs

1800-early 1900s diploma programs provided _____________________ and jobs to woemn

formal education

WHy was there a dramatic decline in diploma programs in the mid 1960s?

Growth of ADN/BSN programs, inability of hospitals to finance nursing ed., accreditation standards make it difficult to attract faculty, and increasing complexity of health care

Associate Degree Programs based on a model developed by

Mildred Montag