202 Exam 1

THE HISTORY OF NURSING EDUCATION

• 100 years ago, most American nurses received on-the-job training in diploma schools. Students

• worked 12-hour shifts with little or no clinical supervision.

• Around 1950, hospitals moved their schools to universities – the 4-year BSN became standard.

• However, the nursing shortage led to the ADN program (Associate’s degree), which was meant to be a short-term solution.

• In the 1980s there was an increase in PhD programs following the formation of the NINR.

• The 2010 report The Future of Nursing calls, by 2020, for

  • Increasing the number of BSN- prepared nurses to 80%

ENTRY NURSING PATHWAYS AND PROFESSIONAL ROLES

• 4 ROLES (HIGHEST TO LOWEST)

• 1. APRN (MSN, SNP), 2. RN (ADN, BSN), 3. LVN OR LPN (CERTIFICATION), 4. CNA (CERTIFICATION)

HISTORICAL EVOLUTION OF NURSING PERCEPTIONS

• Pre-19th century- early nursing roles 

  • Perception: nursing was seems a womans domestic roles, it was not appreciated ans undermined

  • Context: being a nurse was associated with low status, it was viewed as menial labor and not as a profession

• 19th century- emergence of modern nursing 

  • Florence Nightingales impact: she established nursing as respected profession emphasizing cleanlines., care, and scientific approach. 

  • Perception shift: this transformed the menial task to noble, known as a scienifcially-grounded profession

• Late 20th century- media influence and covid-19 

  • Media portrayals: confilciting images from backgrounds like greys anatomy 

  • Public confusion: these portrayals often misrepresent nursing responsibilities and capabilities, which lead to the public confusion.

• Covid-19 pandemic- Heroic recognition

  • Global crisis impact: the pandemic highlights nurses dedication to helping their patients , which improved the publics appreciaiton. 

  • Public perception shift: nurses celebrated as front line heroes, essential for patient care and crisis managemnet, altering long-held sterotypes

REDIFINING OUR IMAGE

• Project a positive image: emphasize the importance of nursing as a preofesion and project image daily 

• Act professionally: take the role seriously, maintaining a professional appearance and demeanor at all times

• Recognize our effect on patient care: acknowledge the significant impact of nursing on patient care and health outcomes

• Team collaberation: foster a culture of confidence and support among nurses, believing in their capabilities and those of their colleagues.

FAAN- A PIONEERING LEADER IN NURSING 

• Vice chair of the initiative on the Future of Nursing: DR. Bolton

  • Spearheaded major reforms in nursing education and practice as outlined in the landmark 2010 report, "The Future of Nursing: Leading Change, Advancing Health," which set forth recommendations for an improved nursing profession capable of handling an evolving healthcare landscape.

• Past President of the American Academy of Nursing and the National Black Nurses Association: 

  • Championed diversity and leadership within the nursing community, focusing on policy, healthcare improvement, and public health advocacy

THE FUTURE OF NURSING

• Nurses should practice to the full extent of their education and training.

• Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

• Nurses should be full partners, with physicians and other health care professionals, in

redesigning health care in the United States.

• Effective workforce planning and policy making require better data collection and information infrastructure.

• Education enhancements: increase the proportion of nurses with a baccalaureate degree to 80% by 2020. Promote seamless academic progressional to higher degrees. 

EMOTIONAL INTELLIGENCE COMPONENTS

• Empathy: 

• Decision making:

• Motivation: 

• Self-esteem: 

• Commitment:

• Interpersonal awareness: 

EMOTIONAL INTELLIGENCE & NURSING 

• Enhanced patient care:

• Effective communication:

• Stress management:

• Teamwork and leadership:

• Adaptability and problem solving:

EMPATHTIC STATEMENT

Scenario 1: Patient Receiving a Difficult Diagnosis

•Example Situation: A patient has just been diagnosed with a chronic illness.

•Empathetic Statement: “I can see this news is overwhelming for you. It’s completely normal to feel this way, and I’m here to support you through every step of this journey.”

Scenario 2: Family Member Concerned About a Loved One's Surgery

•Example Situation: A family member is anxious about their loved one’s upcoming surgery.

•Empathetic Statement: “I understand how worrying this must be for you. Your concern shows how much you care, and we’ll do everything we can to ensure the best possible outcome.”

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FROM NOVICE TO EXPERT- dr. banner? Theory 

• Novice:

  • Beginning nursing student or any nurse entering a situation in which there is no previous level of experience.

• Advanced beginner

  • The nurse who has had some level of experience with the situation. May have experience in the field for a year or so 

• Competent

  • A nurse who has been in the same clinical position for 2-3 years. The nurse understands thr organization and specific care required by the type of patients. For example, surgical oncology or orthopedic pateints 

• Expert 

  • A nurse with a diverse experience who is intuitive of the existing or potential clinical problem. This nurse is able to 0 in on the problem and focus on multiple dimensions of the situation.

SCOPE AND STANDARDS OF PRACTICE

• A-  ASSESMENT

  • subjective: current complaint, history, medication, etc

  • Objective: vital signs, intake and output of fluids, height/weight

• D-  DIAGNOSIS 

  • RN’s clinical judgment about actual or potential health problems to help prioritize & plan care 

• P- PLANNING 

  • Goals & outcomes formulated, personalized to individuals unique needs 

• I- IMPLEMENTATION 

  • Carrying out interventions outlined like cardiac monitor or oxygen, medication, & standard protocols 

• E- EVALUATION

  • Evaluate implementation to ensure desired outcome has been met; continuous reassessment may be needed 

CODE OF ETHICS 

• A code of ethics is a statement of philosophical ideas of right and wrong that define principles used to provide care 

PROFESSIONAL RESPONSIBLITIES AND ROLES

1. Autonomy and accountability

2. Caregiver 

3. Advocate 

4. Educator 

5. Communicator

6. Manager   

HISTORICAL INFLUENCES 

• FLORENCE NIGHTINGALE 

  • Founder of modern nursing: pioneer if modern nursing practices 

  • Revolutionizing healthcare: improved sanitary conditions in hospitals, significantly reducing mortality rates during the Crimean war.

  • Establishment of nursing education: founded the nightingale school of nursing in 1860, setting the foundation for professional nursing education 

  • Environmental theory: emphazised the importance of a clean, well-ventilated environemnt for patient recovery, forming the basis of her environment theory.

  • Advocate for health reform: worked tirelessly to imrove hospital hygience, public health, and nursing standards in the UK and beyond 

  • Author and educator: wrote “notes on nursing: what it is and what it is not,” a foundational text for nursing education

  • Promoter of compassionate care: advocate for holistics, patient-centered care, focusing on both the physical and emotional well-being of pateints.

  • Nickname “the lady with the lamp”: earned this title for her nighttime rounds for wounded soldiers during the crimean war

• CLARA BARTON

  • Founder of the american red cross: established the american red cross in 1881, leading humanitarian efforts in disaster relief and emergency response

  • Civil war nurse:known for her work as a nurse during the American civil war, providing care and supplies to soldiers in the battlefield 

  • “Angel of the battlefield”:earned this nickname for her fearless efforts to tend to wounded soldiers during combat, often at great personal risk.

  • Advocate for missing soldiers:organized efforts to locate and identify missing soldiers after the civil war, leading to the identification of thousands of soldiers’ remain

  • Pioneer in disaster relief:led american red cross in its first major diaster relief effort after the johnstown flood in 1889 

  • Promoter of internation humanitarian aid:worked to expand the red cross 

  • Educator and womans right advocate:before her work with the red cross, barton was a teacher and advocate for public education and womens rights 

• DOROTHEA LYNDE DIX

•Civil War Service: Served as the Superintendent of Army Nurses for the Union Army during the American Civil War, organizing and training nurses to care for wounded soldiers.

•Advocate for the Mentally Ill: Fought for the humane treatment of individuals with mental illness, leading to widespread reforms in mental healthcare.

•Pioneer of Mental Health Reform: Instrumental in establishing and improving mental hospitals across the United States and Europe, advocating for better living conditions and treatment.

•Humanitarian Efforts: Worked tirelessly to improve the conditions in prisons, almshouses, and asylums, focusing on the treatment of society’s most vulnerable populations.

•Political Lobbyist: Successfully lobbied state legislatures and the U.S. Congress for the establishment of public mental hospitals, resulting in the construction of more than 30 institutions.

•Legacy in Mental Health: Left a lasting impact on the mental healthcare system, significantly improving the care and treatment of those with mental illnesses. 

• MARRY ANNE BALL “MOTHER BICKERDYKE”

•Civil War Nurse: Served as a nurse during the American Civil War, providing care on the front lines and in field hospitals.. Also worked on the first ever hospital boat along Ulysses S. Grant.

•"Mother Bickerdyke": Earned the affectionate nickname "Mother Bickerdyke" from the soldiers she cared for, due to her motherly demeanor and dedication.

•Advocate for Soldiers: Known for her relentless advocacy for the well-being of Union soldiers, often clashing with military officers to ensure proper care and supplies for the wounded.

•Innovator in Battlefield Care: Introduced sanitary practices and improved nutrition in field hospitals, reducing infection rates and improving recovery outcomes.

•Humanitarian Efforts: After the Civil War, she continued to work on behalf of veterans, helping them secure pensions and land grants.

•Companion to General Sherman: Accompanied General William Tecumseh Sherman's troops on their "March to the Sea," setting up hospitals along the way. 

• HARRIET TUBMAN 

• Leader of the Underground Railroad movement

• During the Civil War she worked for the Union Army as a nurse, cook and spy.

• Disguised herself as an aging women and would gain intel from informants regarding Confederate plans.

• June 1 1863, alongside Colonel James Montgomery she led 300 black soldiers to raid rice plantations, freeing more than 700 slaves. 

• She is the 1^st woman in American History to plan and lead a military operation. 

• MARY MAHONEY

• First professionally educated African American nurse

• Advocated for cultural awareness- having respect for each individual regardless of their race, color or religion. 

• ISABEL HAMPTON ROBB

• Pioneer in Nursing Education: Played a crucial role in advancing nursing education standards, emphasizing the importance of formalized training for nurses.

• First Superintendent of Nurses at Johns Hopkins Hospital: Implemented rigorous training programs and established the first graded course for nursing students.

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Founder of the American Nurses Association (ANA): Instrumental in founding the ANA in 1896, serving as its first president and advocating for the professionalization of nursing.

• Author and Thought Leader: Wrote several influential textbooks, including "Nursing: Its Principles and Practice", which became foundational texts for nursing education.

• Advocate for Nursing Licensure and Standards: Championed the need for state registration and licensure of nurses to ensure consistent standards of practice across the profession.

• Founder of the National League for Nursing Education (NLNE): Helped establish the NLNE (now the NLN), which set educational standards and guidelines for nursing schools.

• LILLIAN WALD & MARY BREWSTER

• Influencers of public health nursing

• Opened the Henry Street Settlement, which focused on the health needs of poor people who lived in tenements in the lower east side of New York City.