Evolution of Nursing Thought and Action

a process; consists of recognizing and analyzing the cues, prioritizing hypotheses, generating solutions, taking actions, and evaluating outcomes

consists of collecting and analyzing info and carefully considering options for action

considers an issue and attempts to find a satisfactory outcome

“The diagnosis and treatment of human responses to actual and potential health problems.”

Nursing practice is individualized, Nurses care by establishing partnerships, Caring is central to the practice of the RN, RNs use the nursing process to plan and provide individualized care to the healthcare consumers, A strong link exists between the professional work environment and the RN’s ability to provide quality healthcare and achieve optimal outcomes

“Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatments of human responses, and advocacy in the care of individuals, families, groups, communities, and populations.”

Helps public understand value of nursing, Helps differentiate activities of nursing from those of medicine, Helps students understand what’s expected of them

Critical-thinking skills, Caring and compassionate, Detail-oriented, Organizational skills, Speaking skills, Listening skills, Patience, Competence, Emotional stability, Physical stamina

Technical and scientific knowledge; be evaluated by a community of peers; have a service orientation and a code of ethics (Starr, 1982)

Nursing is often described as an occupation or job, Most nurses are hourly wage earners, The employer, not the nurse, decides the conditions of practice and the nature of the work, Nurse practice acts do not prevent nurses from functioning more autonomously

Nursing is the scientifically based and self-governed profession that focuses on the ethical care of others, Nursing is a discipline, driven by aspects of theory and practice, Nursing demands mastery of both theoretical knowledge and clinical skills

Standardizing education requirements, Uniform continuing educational requirements, Increased participation of nurses in professional organizations, Educating the public about the true nature of nursing practice

Diploma programs (3-year program, hospital-based), Associate degree programs (2-year program, community college), Baccalaureate degree programs (8 semesters, colleges, and universities), RN to BSN program (Associate degree to BSN degree), Master’s (2 years, must have baccalaureate degree first), Doctorate

Professional strategy to maintain current clinical knowledge, Many states require CE courses for renewal of a nursing license

Programs offered at the worksite

Novice, Advanced beginner, Competent, Proficient, Expert

Nurse practice acts, State board of nursing, Standards of practice

American Nurses Association (ANA), National League for Nursing (NLN), International Council of Nurses (ICN), National Student Nurses’ Association (NSNA), Sigma Theta Tau International (STTI), Specialty

Individuals (referred to as patients, clients, persons), Groups, Families, Communities, Types of care (Direct and Indirect)

Health promotion, Illness prevention, Health restoration, End-of-Life care

one to one care, used in intensive care units, labor delivery, and private duty

each task assigned to a staff member with the appropriate knowledge and skills

licensed nurse, paired with a nursing assistant or assistive personal assigned to a group of clients

one nurse manages to care for a group of clients

individual nurses with specific and similar expertise are put together to take care of clients

acute care (the goal is to prevent deterioration and restore health), long-term support services (encompass “human assistance, assistive technologies and devices, environmental modifications, care and service coordination” on a regular or intermittent basis, Hospitals, Extended care facility (assisted living facilities and rehabs), Ambulatory care centers, Home healthcare agencies, Community or public health centers

primary healthcare providers, clinics, diagnostic centers, preventing illness and promoting illness prevention activities

surgery centers, offices, outpatient centers, early diagnosis and treatment of illness, disease, and injury

home, outpatient settings, rehab, hospice, long term rehab or care for dying

Physicians (MDs or DOs), Advanced practice nurses (APNs)/nurse practitioners (NPs), Physician assistants (PAs), RNs and LPNs, Unlicensed assistive personnel (UAPs), Pharmacists, Therapists

Smartphones, computers, and the internet, Mobile care units, Convenience care and retail clinics, Urgent care, Freestanding emergency departments, Work-based clinics, Primary care clinics, Specialty care and high-tech centers

Individual, Individual private insurance, Employment-based private insurance, Government (Medicare/DRGs and Medicaid), Charitable organizations

Health maintenance organizations (HMOs), Preferred provider organizations (PPOs), Point of service (POS), Integrated delivery systems (IDNs)

Process reviews, Outcome reviews, Structure reviews

National economy, Growing proportion of older adults in the U.S., Changes in healthcare consumer, Legislation, Women’s movement, Collective bargaining