Intro to Nursing Block 2

What is superior to all of the Branches of the U.S. Government?

The U.S. Constitution

What does the U.S. Constitution ensure?

Ensures order, protection of individuals, resolution of disputes, and promotes the general welfare

What are the branches of the American Legal System?

Judicial, Executive, and Legislative

What is the role of the Judicial branch?

Resolves disputes, amends the common law, interprets statutory law

What is common law?

Where unwritten rules are established by judges’ decisions on specific cases (judge-made law)

What is statutory law?

Refers to written laws passed by a legislative body like Congress 

What is the role of the Executive branch?

Implements law through government agencies

What is the role of the Legislative branch?

Makes statutory law, delegates authority to governmental agencies to create rules and regulation to meet the intent of statutes (administrative law)

What is an example of an administrative law as it pertains to nursing?

SBON (State Board of Nursing, LSBN)

What are the State Boards of Nursing?

The regulatory bodies by which nursing practice acts are administered and enforced. They publicize rule and regulations that expand the law, giving full meaning to the nursing practice act in each state.

What objectives does the nurse practice act in each state accomplish?

1. Defines the standards and scope of professional nursing

2. Describes the authority, power, and composition of the board of nursing

3. Defines educational program standards

4. Sets the minimum educational qualifications and other requirements for licensure

5. Determines and protects the legal titles and abbreviations nurses may use

6. Provides for disciplinary action of licensees for certain causes

NCSBN Model Nursing Practice Act (2012) Urges the Inclusion of what?

1. A clear differentiation between advances and generalist nursing practice

2. Authority for boards of nursing to regulate advanced nursing practice, including authority for prescription writing

3. Authority for boards of nursing to oversee unlicensed assistive personnel (UAP)

4. Clarification of the nurse’s responsibility for delegation to and supervision of their personnel

5. Support for mandatory licensure for nurses while retaining sufficient flexibility to accommodate the changing nature of nursing practice

What is the Executive function of SBNs?

Authority to administer the nursing practice act

What is the Legislative function of SBNs?

Authority to adopt rules necessary to implement the act (rules are different from laws, which are made by state’s legislative body)

What is the Judicial function of SBNs?

Authority to deny, suspend, or revoke a license or to otherwise discipline a license or to deny an application for licensure

A mandatory law requires any person who practices the profession or occupation of nursing to be _________

licensed

What are some sanctions for nurses performing professional functions in a manner that is dangerous to patients or the general public?

Probation, suspension, or revocation (of licensure)

SBN grants licenses, but it also has the power to ________ a nurse for performing professional functions in a manner that is dangerous to patients or the general public

sanction

What is the most common reason nurses are disciplined by SBNs?

Practicing while under the influence of alcohol or other substances, often narcotics

What is the goal of SBNs related to nurses that were suspended?

To return nurses who have been identified as having a problem with drugs and/or alcohol use safely back into practice

What occurs if you are unsuccessful on the NCLEX exam the first time?

Must pay fees and wait 45 days to retake the exam

Describe the NCLEX.

Tests critical thinking and nursing competence in all phases of the nursing process. Computer adaptive testing (CAT). Minimum number of questions is 75, maximum is 256. 6 hours to complete the exam including breaks.

What does Endorsement mean?

That RNs may practice in different states without having to take another licensing examination

What are the mutual recognition models for licensure?

National Licensure Compact (NLC) and enhanced NLC (eNLC)

Why was licensure by endorsement developed?

To improve mobility of nurses while still protecting the public health, safety, and welfare

What is the primary legal concern of health care professionals?

Malpractice

What are all important in terms of risks in professional nursing practice?

Delegation, informed consent, and confidentiality

What are the Six Major Categories of Negligence that results in Malpractice Lawsuits?

1. Failure to follow standards of care

2. Failure to use equipment in a responsible manner

3. Failure to communicate

4. Failure to document or note in the patient’s medical record

5. Failure to assess and monitor

6. Failure to act as patient advocate

Who can nurses delegate to?

Other nursing personnel (LPNs)

What is the nurses responsibility when delegating?

Retain full accountability for acts delegated to another person, meaning that the RN is responsible for determining that the delegated person is competent to perform the delegated act

What are the three major conditions of informed consent?

1. Consent must be given voluntarily

2. Consent must be given by an individual with the capacity and competence to understand

3. The patient must be given enough information so that the locus of the decisions lies with the patient and not the provider; in other words, the provider cannot influence the patient by giving incomplete information

What is the Health Insurance Portability and Accountability Act (HIPAA) of 1996?

Requires all aspects of healthcare providers to ensure the privacy and confidentiality of patients

Who was the president when HIPAA was enacted?

Bill Clinton

What is assault?

A threat or an attempt to make bodily contact with another person without the person’s consent

What is battery?

Assault carried out, the impermissible touching of one person by another

What are the evolving legal issues that affect nursing?

Role changes in health care, Prescriptive authority, Supervision of Unlicensed Assistive Personnel (UAPs), Payment Mechanisms for Nurses, and Patient Self-Determination Act (PSDA)

Ways to protect yourself from legal problems:

• Practice in a safe setting

• Communication with other health professionals, patients, and families

• Meet the standard of care

• Carry and understand Professional Liability Insurance

• Promote positive interpersonal relationships

What are the four documents that you should own as a nurse?

1. A copy of the nursing practice act of the state in which you practice

2. Nursing’s Social Policy Statement: The Essence of the Profession

3. Nursing: Scope and Standards of Practice

4. ANA’s Code of Ethics for Nurses with Interpretive Statement

What are the basic types of professional liability insurance policies?

Occurrence policies: cover injuries that occur during the period covered by the policy

Claims-Made Policies: cover injuries only if the injury occurs within the policy period and the claim is reported to the insurance company during the policy period or during the tail.

What is the tail in claims-made policies?

An uninterrupted extension of the policy period and is also known as the extending reporting endorsement

What is Input in relation to the Components of Systems?

The first component of a system, the raw material such as information that enters a system

What is Throughput in relation to the Components of Systems?

The second component, consists of the processes a system uses to convert raw materials (input) into a form that can be used

What is Output in relation to the Components of Systems?

The end result or product of the system

What is Evaluation in relation to Components of Systems?

Measuring the success of failure of the output and the effectiveness of the system

What is Feedback in relation to Components of Systems?

The final component of a system, the process of communicating what is found in evaluation of the system

The success of a system depends on the functioning of many _________

subsystems

What is an Open System?

Promotes the exchange of information with other systems and the environment

What is a Closed System?

Does not interact with other systems or surrounding environment

What is a Suprasystem?

The larger environment outside a system

What is Synergy?

When all the various subsystems work together to create a result that is not independently achievable

The dynamic balance within and between the subsystems, the system, and the suprasystems help create and maintain ___________, also known as internal stability

homeostasis

What three basic concepts are essential to understanding practice and are the Foundation of Nursing?

Person, Health, and Environment

Explain Maslow’s human needs theory.

Rejected earlier ideas of Freud and Pavlov, instead states that humans are motivated by intrinsic needs and presents them as a hierarchy

What is Self-Actualization in Maslow’s Hierarchy of Needs?

The highest level of needs, maximum potential is reached. People do not stay in a state of self-actualization but may have “peak experiences” during which they realize self-actualization for some period.

What are Esteem needs in Maslow’s Hierarchy of Needs?

Self worth, respect, and reliance

What are Physiological needs in Maslow’s Hierarchy of Needs?

Most basic needs like food and water

Why is it important to determine a person’s perception of their own needs in healthcare?

To be able to provide appropriate, individualized nursing care

What is the most direct systemic influence on a person?

Family

What is a nuclear family?

Parents and their children only

What is an extended family?

Parents, children, and relatives

Family systems have greatly changed since what?

World War II, with a dramatic increase in single parent households

Why do nurses need to develop cultural competence?

To meet the needs of culturally diverse patients

What is Ethnocentrism?

Evaluation/judgments of other cultures based on previous beliefs of said culture

What are parts of a Social system?

Social support, social change, and poverty

What does life in poverty mean for those under that social system?

One of the most influential determinants of health. Diminished access to health care, inadequate nutrition and lack of basic health care, food insecurity and hunger, poor transportation, inability to pay rent.

What is one of the largest producers of waste in the nation?

Healthcare facilities

What is Health Care Without Harm?

An organization with the mission to reduce hazardous waste produced from healthcare facilities. 

What is High Level Wellness Health?

A continuum with high-level wellness at one end and death at the other. Shows the interconnectedness of these parts.

What are the 6 interrelated dimensions of the health continuum?

Intellectual, emotional, environmental, social, physical, and spiritual

Nursing embraces a ______ view of health

holistic

What is Healthy People 2030?

Started in 2000, national objectives every 10 years, provides an agenda to improve health of Americans. Looks at a multitude of factors, provides national disease prevention and heath promotion. Diverse groups form a team and work together.

What is health affected by?

Health beliefs and health behaviors

What are the 3 components of Rosenstock (1966) Health Beliefs Model?

1. Evaluation of one’s vulnerability to a condition and the seriousness of that condition

2. Evaluation of how effective the health maintenance behavior might be

3. The presence of a trigger event that precipitates the health maintenance behavior

What are the 4 components needed for effective program of lifestyle change according to Bandura?

1. Information

2. Skill development

3. Skill enhancement through practice and feedback

4. Social support

What is self efficacy?

The belief in one’s ability to perform tasks and meet challenges to achieve goals

What did Bandura believe?

That self-efficacy leads to efforts to change, whereas low perceived self-efficacy leads to lack of effort to change

What is a Cyberchondria?

Someone that believes they have a disease they read about online

When assessing health related sites, you should do what?

Look into who sponsors the site, determine whether there is self interest, check credentials, look at date of revision, ensure editorial review, ensure site is unbiased

Nurses should recognize what when it comes to health belief models?

• Health is constantly changing

• Health impact the entire person

• Individuals health beliefs are powerful

• Individuals desiring change may lack knowledge or motivation

• Knowledge does not always lead to change

• Change is often very slow

_____ evolve with aging

Values

What is the cognitive aspect of valuing?

Choosing

What is the affective (emotional) aspect of valuing?

Prizing

What is the behavioral aspect of valuing?

Acting

What are descriptive beliefs?

Beliefs shown to be true or false - “The sun will come up tomorrow morning”

What are evaluative beliefs?

Judgement about good or bad - “Advanced life support for 90 year old is immoral”

What are prescriptive beliefs?

Actions are judged to be desirable or undesirable - “Every voting citizen should vote in every election”

What is Philosophy?

The study of the principles underlying conduct, thought, and nature of the universe. Contemplate or wonder about something.

What is Epistemology?

Theory of knowledge itself

What is Logic?

The study of proper and improper methods of reasoning

What is Aesthetics?

The study of what is beautiful, differs from person to person

What is Ethics?

The branch of philosophy that studies standards of conduct

What is Politics in the context of Philosophy?

The area that deals with the regulation and control of people living in society, recommends improvements for conditions in society

What is Metaphysics?

The consideration of the ultimate nature of existence, reality, human experience, and the universe

Up to 80% of serious medical errors can be attributed to _____________

miscommunication

Why is Joseph Priestley’s quote “The more elaborate our means of communication, the less we communicate,” important?

Due to how the many forms and avenues of communication create opportunities for communication to break down

What are the three phases of communication?

Orientation, Working, and Termination

What occurs during the Orientation Phase?

Introducing self, active listening, building the foundation of trust, time-line is set

What occurs during the Working Phase?

Work on tasks identified during the Orientation Phase, but keep note that making and sustaining change is difficult

What occurs during the Termination Phase?

The end of communication, but the time frame is set during the Orientation Phase

What is self awareness in relation to nursing?

Basic to effective interpersonal relationships, nurse must get their own emotional needs met outside of the nurse-patient relationship