Intro to Nursing Final Exam

Virginia Henderson

Believed nurses should help patients worship according to their faith.

International Council of Nurses' Code

Recognizes the importance of spirituality in health.

AACN

States nursing education should include spirituality's role in health.

Leadership in Nursing

Involves influencing people to achieve goals.

Management in Nursing

Coordinates resources to meet institutional goals.

Typical Hospital Structure

Hierarchy: CNO, director, nurse managers, staff RNs.

Negligence

Failure to meet care standards causing harm.

Assault

Threatening bodily contact without consent.

Battery

Unauthorized physical contact with another person.

Informed Consent

Voluntary agreement by a competent individual.

Confidentiality

Protecting patient information in care provision.

HIPAA

Ensures patient data privacy and confidentiality.

Patient Self-Determination Act

Encourages patients to consider and document life-prolonging treatment options

POLST

Physicians Orders for Life-Sustaining Treatment; in Massachusetts, it is called MOLST

Nursing Informatics

Specialty integrating nursing, computer, and information science for data management

Skills Lab

A setting to practice and enhance nursing skills

Healthcare Technologies

Includes mobile health and telehealth services

Informatics Nurse Specialist

Utilizes informatics theories and tools to support decision-making in healthcare

Benner's Stages

Describes nursing proficiency levels from Novice to Expert Practitioner

Carper's Ways of Knowing

Includes Empirical, Aesthetics, Personal, and Ethical knowledge in nursing

Nursing Process - Assessment

Obtaining subjective or objective information about a patient, family, or community

Maslow Hierarchy of Needs

Hierarchical model from physiological to self-actualization needs

Interventions - Independent

Actions initiated by the nurse without supervision

Evidence-Based Practice

Decision-making based on research, patient preferences, and provider expertise

Therapeutic Interpersonal Relationship

A relationship focused on patient survival and behavior change

Four-Pronged Approach

Nurse roles: counselor, resource, teacher, technical expert, surrogate, leader

Ida Orlando's Nursing Process Theory

Theory on how nurses react to patient behavior and needs

Madeleine Leininger's Theory

Theory focusing on culture care preservation, accommodations, re-patterning

Medicare

Federal health insurance for elderly, disabled, and certain conditions

Medicaid

State health insurance for low-income individuals

Children's Health Insurance Program (CHIP)

Health insurance program for children

Private Health Insurance

Health insurance offered by private companies

Healthcare Spending

Expenditure on hospital, physician services, prescription drugs

Affordable Care Act (ACA)

Legislation expanding Medicaid and private health insurance coverage

Value-Based Payment

Reimbursement based on care quality and patient outcomes

Healthcare Coverage Gaps

Areas not always covered by health insurance plans

Health Insurance Plans

Types include HMO, PPO, with premiums, deductibles, co-insurance, co-pay

Delivery System Reform

Innovations to shift from fee for service to value-based care

Nurses in Congress

Significance of nurses in healthcare policy and delivery

Physicians in Congress

Representation of physicians in legislative roles

Cross-Cultural Influences on Nursing

Impact of diversity and cultural care theories on nursing practice

Patient-Centered Care

Focus on knowledge, skill, and attitudes for individualized care

Social Determinants of Health

Factors influencing health beyond medical care

Homelessness in the US

1.5 million people experience lack of housing

Transportation Barrier to Medical Care

3.6 million people face challenges accessing healthcare due to transport issues

Hunger in the US

40 million people experience food insecurity

Food Insecurity Rate

11.8% of US households lack consistent access to enough food for an active, healthy life

Loneliness Epidemic

Loneliness poses a significant public health threat

Socioeconomic Impact

40% contribution to health outcomes

Physical Environment Impact

10% contribution to health outcomes

Health Behavior Impact

30% contribution to health outcomes

Healthcare Impact

20% contribution to health outcomes

Health Disparities in Boston

Significant variation in social determinants between different zip codes

Upstream Impact

Community-level influence on health determinants

Midstream Impact

Individual-level influence on health determinants

Downstream Impact

Medical care-related influence on health determinants

Health Inequality

Disparity where some receive more than needed while others lack essential support

Health Equity

Ensuring everyone receives necessary support

Health Justice

Ensuring support is provided to address systemic inequities

Access to Running Water in US

2 million lack access to running water in their homes

Native American Water Access

6.5% of Native American homes lack safe drinking water

Conceptual Framework

Synthesis of components aiding in solving real-world problems

WHO Recommendations

Improve living conditions, address power distribution, measure impact

How did nursing become a science?

improving nursing education & nursing theories were established

core competencies in nursing

KAS : knowledge, attitude, skill

Professional socialization

process of internalization and development modification of an occupational identity
- this begins when students are in a formal nursing program, and continues in the real world

autonomy/self-regulation

the ability to control your own work
- this is because of nursing boards

formal socialization

building block fashion of school
nursing faculty is your first mentor

informal socialization

hearing stories from nurses

professional socialization

absorbing the culture of nursing, rites, rituals, valued behaviors

what is the purpose of nursing?

prevention of illness, alleviation of suffering, protection, promotion & restoration of health

emotional intelligence

the ability to perceive, control, and evaluate emotions of yourself and others

5 components of EI

1. self awareness
2. self regulations
3. internal motivation
4. empathy
5. social skill

self-awareness

the ability to recognize and be aware of how our emotions affect others and the ability to monitor these emotions

self-regulation

think before you act, you are in tune with how you feel, but you won't let your emotions take control of your life

internal motivation

the ability to achieve goals, you are capable of managing behaviors to achieve long term success

empathy

the ability to understand emotions of others, in order to interact with other people you have to be able to understand their feelings

social skill

you are invested in healthy social relationships, you want to help those around you succeed

resilience

having the capacity to adapt over time and bounce back

self care

the need to pay attention to yourself in order to care for you patient

what is nursing ethics?

nursing actions related to professional goals

what is medical ethics?

medical actions related to professional goals

bioethics

impact of bio/technical advances on humans

healthcare ethics

incorporates all ethics, highlights a shared goal, and has distinct perspectives

All ethical decision making in nursing practice uses ______________ as an anchor

goals

in nursing, the terms moral and ethical are __________

synonyms

moral/ethical mean

the good related to the goals of patient care
- a moral action IS an ethical action

code of ethics

1-9 in ethics powerpoint

principles in healthcare

autonomy, beneficence, non-maleficence, justice

autonomy

the right to determine ones own decision

autonomy is based on :

human capacity to reason
formulation of personal goals
self knowledge

restriction of autonomous actions

we need to have decision making capacity
this includes :
- the ability to understand information
- the ability to reason about a choice
-personal set of values
- convey what one desires in line with previous life choices
- expression of choice

substituted judgement standard

what would the patient want if they were making the decision based on their known values and wishes

best interest standard

we do not know their values/wishes, so what would be in their best interest based on beneficence and non-maleficence

beneficence

promotion of a "good"
onligation to provide good action

beneficence involves :

- consideration of the goals of nursing and medicine
- consideration of the patients best interests
- maximize the good and minimize the harms to the patient

non-maleficence

no intentional or needless harm

non maleficence involves :

- professional competence
- ability to foresee consequences
- accountability
- advocacy
- supervision of delegated tasks
- good should outweigh foreseeable harm

justice

- fair allocation of goods and services
- fair distribution of benefits/burdens
- inequity favors the disadvantaged
- no undue burdens

ethical dilemma

- no clear choice between 2 or more undesirable options
- tends to be negative
- we have to make a decision but all choices are problematic