Intro to Nursing Profession EXAM

Who was Jeanne Mance?

• created the normal hospital structure, recruited people + funds

• ville marie (montreal), 1641

Who was Florence Nightingale?

• considered founder of modern nursing

• "lady with the lamp"

• in crimea, ukraine

Who were the Grey Nuns?

• Marguerite D'Youville (1738)

• non-cloistered nuns who combined their possessions to help the poor

• known as the "tipsy nuns" - sold alcohol + tabacco to fund

• canoe trip from quebec to manitoba in 1844 to help the sick

How did Florence Nightingale influence nursing education?

• she formalized it (apprentinceship model)

• university education

• hosptial schools

• 1932 Weir Report

Weir report (year + what it did)

• 1932

• reccomended university level education for nursing

Who is Tommy Douglas?

"father of medicare" in canada

British North America Act

• united the three separate territories of Canada, Nova Scotia and New Brunswick into a single dominion called Canada.

• 1867

Criteria of the Canada Health act (5)

1.comprehensiveness: health care insurance plan of a province or territory must cover all insured health services provided by hospitals, physicians and dentists.

2. universality: must be entitled to the health services provided by the provincial / territorial health care plan.

3. public administration: provincial and territorial health care insurance plans be administered and operated on a non profit basis by a public authority.

4. portability: will be transferable from province to province, does not allow person to travel outside province specifically for care.

5. accessibility: reasonable access.

(CUPPA)

What are the 5 sanitary practices Florence Nightingale

• pure air

• pure water

• efficient drainage

• cleanliness

• light

UNB Faculty of Nursing 5 Abilities

• Knowledge and Its Application

• Communication

• Critical Thinking

• Professional Identity/Ethics

• Social Justice/Effective Citizenship

What is Primary Health Care?

• meeting people’s health needs through promotive, protective, preventive, curative, rehabilitative, and palliative care throughout the life course.

• prioritizing health care services aimed at individuals and families through primary care and the population through public health functions

• systematically addressing the broader determinants of health (including social, economic, environmental, as well as people’s characteristics and behaviours) through evidence-informed public policies and actions

• empowering individuals, families, and communities to optimize their health

What is the difference between Primary Health Care and Primary Care?

Primary care is the delivery of community based clinical health care services.

Primary Health Care is a principle based comprehensive approach. It seeks to improve the health of populations from birth to death, in all settings. PHC stresses population, community and person orientated
strategies for achieving health.

What are the 5 essential principles of Primary Health Care?

• Accessibility

• Public Participation

• Health promotion and chronic disease prevention and management

• Use of appropriate technology and innovation

• Intersectoral cooperation and collaboration

What are the four pillars of Primary Health Care?

• teams (right person right job)

• healthy living (look at factors in ppls lives)

• access (knowing what places need what help)

• information (teaching ppl how to find accurate medical info)

What are the levels of care within Primary Health Care? (5)

1. Health Promotion

2. Disease and injury prevention

3. Diagnoses and treatment

4. Rehabilitation

5. Supportive care

Ottawa Charter for Health promotion actions (5)

1. build healthy public policy

2. develop personal skills

3. strengthen community action

4. create supportive environments

5. reorient health services

What is the definition of caring?

caring is reflecting on your practice, not simply focusing on signs and symptoms, but on the spiritual connections resulting from protecting, enhancing and preserving a person’s health

6 C's of caring

1. Comportment (how you carry yourself)

2. Commitment

3. Conscience (ethics)

4. Competence

5. Compassion

6. Confidence

What are the determinants of health? (13)

•Income and Social Status
•Employment and working conditions
•Education and Literacy
•Childhood experiences
•Physical environments
•Social support
•Individual health practices and coping skills
•Access to health services
•Biology and genetic endowment
•Gender
•Culture
•Race/Racism
•Food security

What is Social Justice?

Social Justice is the equitable of fair distribution of society’s benefits, responsibilities and their consequences.
It focuses on the relative position of the social advantage of one individual or social group in relation to others in society as well as on the root causes of inequities and what can be done to eliminate them

What is Health Equality?

Health equality aims to ensure that everyone gets the same things in order to enjoy full, healthy lives.

What is Health Equity?

Health equity is a social justice goal focused on pursuing the highest
possible standard of health and healthcare for all people, paying
special attention to those in the context of greater risk of poor
health, and taking into account broad social, political, and economic
influences and access to care

What is Trauma and Violence informed care?

focuses on understanding the impacts of trauma and creating environments that promote emotional and physical safety

What is Structural Violence?

societies are organized in ways that grossly disadvantage some groups over others

What is Cultural Safety?

It takes into account the inherent power imbalance between the health care or social service provider and the person coming to you for care

What is Cultural Humility?

A lifelong process of self-reflection and self-critique to understand
personal bias and to develop and maintain mutually respectful
partnerships based on mutual trust

What is Harm Reduction?

• Is a philosophy AND a set of programs and services AND a practice

• Focuses on preventing the harms of behaviours, not reducing or eliminating those behaviours

• Views substance use (and other potentially harmful behaviours) as a public and personal health issue

• Is an evidence-based approach

What are the characteristics of a profession? (9)

1\. Specialized training

2. Well defined body of knowledge

3. Code of ethics/standards of practice

4\. Ongoing research

5\. Autonomy /Self- regulation

6\. Service

7\. Commitment to lifelong learning

8\. Advocacy

9\. Collegiality and collaboration

What is the difference between RNs and LPNs? (3)

• education

• level of responsibility

• autonomy

How is scope of practice determined? (5)

1. Legislation

2. Standards of Practice

3. Employer policies

4. Individual competencies

5. Client needs

What is delegation?

• the extension of authority by a nursing professional to another nursing professional who does not have the authority to perform the task for ONE client, ONE time.

• does not transfer accountability

What is the definition of assignment?

describes the distribution of work that each staff member is to acomplish

What is NANB's mandate?

regulation for safe, competent, and ethical nursing care, in the interest of the public

What are NANB’s regulatory framework? (3)

• promotion

• prevention

• intervention

What are NANB's standards of practice? (4)

1. Responsibility and Accountability

2. Knowledge based practice

3. Client centred practice

4. Professional Relationships and Leadership

What are the key points of Professional Relationships and Leadership? (2)

• Understanding the similarities and differences of health care providers

• Advocating for change in practice/policies

What are the key points of Client centred practice? (3)

• Interacting in a respectful manner

• Cultural humility

• Maintaining privacy

What are the key points of Knowledge based practice? (2)

• Knowledge of diseases, medication etc

• Recognizing change in condition and how to respond

What are the key points of Responsibility and Accountability? (3)

• Yearly registration

• Admitting mistakes

• Duty to report witnessed unsafe practice

What NANB standard of practice does "Yearly registration" fall under?

Responsibility and Accountability

What NANB standard of practice does "Admitting mistakes" fall under?

Responsibility and Accountability

What NANB standard of practice does "Duty to report witnessed unsafe practice" fall under?

Responsibility and Accountability

What NANB standard of practice does "Knowledge of diseases, medication etc" fall under?

Knowledge based practice

What NANB standard of practice does "Recognizing change in condition and how to respond" fall under?

Knowledge based practice

What NANB standard of practice does "Interacting in a respectful manner" fall under?

Client centred practice

What NANB standard of practice does "Cultural humility" fall under?

Client centred practice

What NANB standard of practice does "Maintaining privacy" fall under?

Client centred practice

What NANB standard of practice does "Advocating for change in practice/policies" fall under?

Professional Relationships and Leadership

What NANB standard of practice does "Understanding the similarities and differences of health care providers" fall under?

Professional Relationships and Leadership

What is a nursing theory?

a nursing theory is a conceptual framework that provide principles that underpin practice

What is the nursing metapardigm?

\- Client and person

\- Environment

\- Health

\- Nursing

What is a grand theory?

global, abstract, don’t provide specific interventions

What is a midrange theory?

more limited scope, less abstract than grand, address specific phenomena and relfect practice, not specific to one area

What is a descriptive theory? (3)

\- describe things

\- practice level theories

\- describes a phenomena and speculates why it occurs and the consequences of the phenomena

What is a prescriptive theory? (3)

\- describes what you do about things

\- practice based theories

\- address nursing interventions and predicts the consequences of those interventions

What is Carper’s ways of knowing theory and what type of theory is it? (5)

\- midrange theory

\- describe how nurses develop the knowledge they have

\- **Ethic**

\- **Emperic** (science of nursing, factual + descriptive)

\- **Personal**

\- **Esthetics** (“art of nursing”, intuition, caring)

\- **Sociopolitical / emancipatory** (newest addition, social justice, social determinants of health)

What is the newest addition to the Carper’s ways of knowing theory?

Sociopolitical / emancipatory

What are the stages in Benner’s novice to expert theory and what type of theory is it?

\- midrange theory

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\-**Stage 1: novice** (no previous experience, skill focused, follow rules, not flexible)

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\-**Stage 2: advanced beginner** (some previous experience, more flexible, poor time management)

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\-**Stage 3: competent** (around graduation, few years of experience, thinks more analytically)

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\-**Stage 4: proficient** (more holistic, can do multiple assessments at once, uses experience to anticipate, proactive rather than reactive)

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\-**Stage 5: the expert** (intuitive, flexible, seems very natural)

What stage in Benner’s novice to expert theory has no previous experience, is skill focused, follows rules, but is not flexible?

Stage 1: novice

What stage in Benner’s novice to expert theory has some previous experience, is a little flexible, and has poor time management?

Stage 2: advanced beginner

What stage in Benner’s novice to expert theory is around graduation, has a few years of experience, and thinks more analytically?

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Stage 3: competent

What stage in Benner’s novice to expert theory is more holistic, can do multiple assessments at once, uses experience to anticipate, and is proactive rather than reactive?

Stage 4: proficient

What stage in Benner’s novice to expert theory is intuitive, flexible, and seems very natural?

Stage 5: the expert

What is the difference between clinical reasoning and clinical judgement?

**Clinical reasoning** is the thinking process, the application of critical thinking to a clinical situation.

**Clinical judgement** is a decision to take action (or not).

What are Tanner’s 5 assumptions of clinical judgement?

1\. Clinical judgements are more **influenced by what nurses bring to the situation** than the objective data about the situation.

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2\. Sound clinical judgement rests on some degree to **knowing the patient and their typical pattern of responses.**

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3\. Clinical judgements are **influenced by** the context in which the situation occurs and the **culture of the hospital.**

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4\. Nurses use a variety of reasoning **patterns alone or in combination.**

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5\. **Reflection on practice** is often **triggered by a breakdown in clinical judgement** (mistake).

What are the 5 steps of the nursing process?

1\. Assessment

2\. Diagnoses

3\. Planning

4\. Implementation

5\. Evaluation

What is the difference between a medical diagnosis and a nursing diagnosis?

**Medical diagnosis** = identification of disease condition based on physical signs & symptoms.

Goal is to identify cause of illness/injury and make a treatment plan.

Remains the same if disease is present.

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**Nursing diagnosis** = clinical judgement about an individual, family, or community in response to actual or potential problems.

Goal is to identify actual or potential responses.

May change from day to day.

What is the difference between outcomes and goals?

**Outcomes** = specific and measurable, start with “client will”

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**Goals** = broad, general statements

What are the 5 leadership styles?

\- Authoritarian

\- Democratic

\- Transactional

\- Laissez-faire

\- Transformational

What leadership style gives full power or authority to the leader?

Authoritarian

What leadership style involves team members, has two way communication, and focuses on quality improvement?

Democratic

What leadership style works well in emergency situations where one person needs to take control?

Authoriatarian

What leadership style blames when mistakes are made instead of looking why the mistake was made?

Authoritarian

What leadership style believes that knowledge equals power?

Authoritarian

What leadership style looks for mistakes and has rewards/punishments?

Transactional

What leadership style delegates responsibility to team members with little to no direction, has a hands off approach, but promotes innovation and flexibility?

Laissez-faire

What leadership style leads by example, inspires to perform beyond expectations, where the needs and skills of others are considered?

Transformational

What is point of care nursing leadership?

\- Leadership activites relate to the care process.

\- Modeling, leading, and advocating for quality, safe patient care based on the best evidence.

What is nursing informatics?

the use of information technology in combination with information management methods to support the delivery of health care.

What is health informatics?

the umbrella term encompassing medical, nursing, dental, and pharmacy informatics among others. It focuses on the recipient of care rather than the discipline of the caregiver. Includes decision support, online clinical documentation, and provider order entry applications

What is consumer informatics?

focuses on the empowerment of consumers to manage their own health through the use of information and communication technologies

What is digital health?

technology solutions that support the delivery of clinical care

What are some benefits of digital health solutions? (4)

\- The ability to easily monitor and review patient health.

\- Decrease incidence of duplicative diagnostic testing.

\- Increased engagement of clients and their families in their care.

\- Improved access to care for individuals in remote communities.

What are some challenges posed by digital health? (2)

\- More focused on computer than patient.

\- Needs nursing imput for better design

ICNP

International Classification for Nursing Practice

CT

Clinical Terminology

C-HOBIC

Canadian Health Outcomes for Better Information and Care

LOINC

Logical Observations Identifiers Names and Codes

What are the 4 P’s of personalized health care?

\- Predictive

\- Preventative

\- Personalized

\- Participatory

What is the difference between privacy and security?

**Privacy** = right of individuals to determine how, when, to whom, and for what purposes any personal information will be transmitted to others.

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**Security** = focused on maintaining the confidentiality of information

What are the 4 key areas of risk related to the use of Electronic Health records?

\-Access

\- Accuracy

\- Theft

\- Disposal

What are the benefits of ICTs in health care? (4)

\- improve safety related to clinical tasks like medication administration and clinical documentation/

\- empowerment of clients in managing their health.

\- improved accuracy and speed.

\- large scale aggregation of data in health care decision making

What are the challenges of ICTs in health care? (3)

\- extra work burden on nurses.

\- rapid evolution of technology that can make various platforms obsolete in a matter of years.

\- finding a balance between technoloy driven care and human driven care.

What are the 7 parts of the CNA Code of Ethics?

1\. Providing Safe, Compassionate, Competent and Ethical Care.

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2\. Promoting health and Well-being.

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3\. Promoting and respecting Informed Decision Making.

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4\. Honouring Dignity

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5\. Maintaining Privacy and Confidentiality

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6\. Promoting Justice

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7\. Being Accountable

What is the difference between global health, public health, and international health?

**Global health** = the optimal wellbeing of all humans, considered a fundemental human rights.

**Public health** = focuses on protecting and improving the health of individuals and communities, by promoting healthy lifestyles and injury prevention.

**International health** = focus on health issues of countries other than ones own.

What is the purpose of the UN SDGs?

promote prosperity while correcting the environment

What is intersectionality?

the influence of social characteristics on a particular phenomena such as health.

What are the benefits of reflective practice? (4)

\- improved critical thinking

\- empowerment

\- greater self awareness

\- reflect on personal biases and beliefs

Define relflection in action vs. reflection on action

Reflection in action = the nurses ability to “read” the patient - how they know the patient is responding to the nursing intervention.

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Reflection on action = reflecting after the fact, how nurses learn from experiences.

What are the steps of Gibb’s reflective cycle? (5)

1\. Description

2\. Feelings

3\. Evaluation

4\. Conclusions

5\. Action