Framework Assignment

7/29/2019 Framework Assignment

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FrameworkSociety and its health care needs are always evolving. As a result , health care faces many

challenges , includingrising costs, shortage ofprofessionals, an aging population.The

introduction of new technology and difficulties with access to care is also challenge. The

demand forcollaborative , innovative clinical practitioners to act as leaders in healthcare has

never been stronger. Nurses inadvanced nursing practice are well positioned to respondto

the evolution of health care. In particular advancednursing plays a key role in meeting the

health needs bybuilding the nursing knowledge , advancing the nursingprofession and

contributing to a sustained and effective health-care system.

Definition of Nursing PracticeAdvanced nursing practice is an umbrella term describing an advanced level of clinical nursing

practicethat maximizes the use of graduate educationalpreparation, in depth nursing knowledge &expertise in meeting the health needs of the individuals, families, groups, communities &

populations.

It involves

Analyzing & synthesizing knowledge.

Understanding, interpreting & applying nursing theory& research.

Developing & advancing nursing knowledge & theprofession as the whole.

Characteristics of Nursing Practice In advanced nursing practice, nurses build on theirexpertise in a specialty area, integrating

and consistentlydisplaying the following features and characteristics:

Provision of effective and efficient care, delivered with a high degree of autonomy .

Demonstration of leadership and initiation of changeto improve client, organization and system

outcomes.

Deliberate, purposeful and integrated use of in-depthnursing knowledge, research and clinicalexpertise.

Depth and breadth of knowledge that draws on a wic,orange of strategies to meet the needs ofclients and ':improve access to and quality of care.

Ability to explain and apply the theoretical, empiricc.ethical and experiential foundations of

nursing practio =

evidence-based nursing knowledge.

Ability to initiate or participate in planning

coordinating, implementing and evaluating

programmes to meet client needs and support nursing practice.

Demonstration of advancedjudgment and decisionmaking skills .

Critical analysis ofand influence on health policy.Development of the Framework

One ofthe first priorities of the vice president and CNO(ChiefNursing Officer) of the Calgary

Health Region wato develop a vision for nursing in the region. Through thEdevelopment of thisvision, it became apparent that cmission for nursing was also essential. As this progressed,an evident need emerged to establish c.definition of professional practice and a guideline -

framework that nurses could utilize on a daily basis cachieve the vision and mission of nursing

in the region.


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Approval of the FrameworkAfter several months of consultations with nurse-across the Region,discussion at Regional

Nursing Counand numerous revisions, the final draft of the professionPractice Framework wasapproved by Nursing Councilan:distributes during Nurses Week 2003. The ProfessioNursingPractice Framework fortheCalgary Health Regi -

is depicted in Figure 1.

_.

The Art of NursingNurses demonstrate ethical , insightful , caring practice by focusing on the health and well-being of

individuals, families and communities is health and during episodes of illness and transition.

Attributes of PracticeAutonomous professional practice in nursing requires taking personal responsibility for excellence in

practiceand effective collaboration with multidisciplinary teammembers in meeting the health needs of the

population.

Competence

Nurse's competence is grounded upon nursing theory, scientific knowledge and experience, and isreflected in everyday practice . It is enhanced through continuous learning, shared through mentorship and

supported throughintra and inter-professional dialogue.

Personal CommitmentNurses demonstrate commitment to the profession byvaluing nurses and nursing , contributingto theadvancement of the profession and continually striving forexcellence in patient care.The framework is congruent with the values of the Calgary Health Region.Honesty , Integrity, Dignity, Trust , Respect ,Responsiveness , Creativity and Learning). It reflectselements that are common to other professionalpractice frameworks described in the literature

. The framework reinforces the prerequisites for the promotion of safe , competent and ethical

nursingpractice that are inherent in the standards of practice& the professional body that regulatesthe practice ofregistered nurses in the province .


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The framework logo depicted in Figure 1 was designed by one of the members of Regional

Nursing council and is an expression of her belief that the nurse's cap has traditionally been an

important symbol ofprofessionalism in nursing.

Implementation of the Framework

Numerous sessions were held to familiarize nursing staff with the framework when it was first

launched.

Introduction to the framework is now routinelyincorporated into the orientation of all new nurses whojoin the Region.

The frame-work also gives the development ofpreceptors and change nurses.

The major elements of the framework have been linked to the expected RN, LPN and RPN

competencies articulated in job descriptions , and application of the framework in pract ice is not

incorporated into nurse's ongoing professional development and continuing education plans.

Further elaboration of frame work will be ongoing. Forexample use of the framework has exposed theneed to clarify some of its terms ; such has. insightfulpractice.

Evaluation and ResearchNow that the Professional Practice Framework has beenarticulated , it will be important to

determine theeffectiveness with which it is being implemented acrossthe many sites and

settings in this large regional healthauthority and measure its impact on practice and patient

outcomes . Over the course of the next several years,specific implementation initiatives willbe targeted forevaluation and research. An over changing framework willbe developed to guide

the evaluation of specific initiativesScope in Nursing Practice

Nursing is responsible for articulating anddisseminating clear definitions of the roles nurses engage in, and

the profession's scope of practice. National professional organizations bear the responsibility for defining

nursing and nurse's roles that are consistent with acceptea international definitions articulated by the

International Council of Nurses, and relevant to their nation's health care needs. While nurses, through

professional, labour relations and regulatory bodies, bear primary responsibility for defining, monitoring and

periodically evaluating roles and scope of practice, the views of others in society should be sought and

considered in defining scope of practice.

The scope of practice is not limited to specific tasks , functions or responsibilities but includes direct care

giving and evaluation of its impact, advocating for patients and for health, supervising and delegating to others,

leading, managing,teaching, undertaking research and developing health policy for health care systems.

Furthermore, as the scope of practice is dynamic and responsive to health needs, development of knowledge ,

and technological advances, periodic review is required to ensure that it continues to be consistent with

current health needs and supports improved health outcomes. National nursesassociations (NNAs) have a

responsibility to seek supportfor legislation which recognizes the distinctive andautonomous nature of nursing

practice,including a definedscope of practice.

BackgroundThe scope of practice is defined within a legislative regulatory framework, and communicates to others

theroles, competencies (knowledge , skills and attitudes) and the professional accountability of the nurse

Nursing's authority comes from evidence-basedknowledge related to its sphere of practice.However, nursing is also allied to

other healthprofessions through its collaborating, referring, and cocoordinating

activities , and thus has developed a distinct as well as a shared body of

knowledge and practice .

The practice and competence of an individual nurse within the legal scope of practiceis influenced by a variety of factors including education, experience, expertise and

interests as well as the context ofpractice.

Therefore , definitions of roles and scope of practice need to reflect what isdistinctly nursing, whilecommunicating the multidisciplinary and


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N

interdiscip)inarynature of health care.

Nurses req!d]re appropriate initial and ongoing education and training as well as lifelonglearning to practice competently within their scope of practice. Therefore, nursing must

ensure that nurse educators and nurses managing nursing services are experienced

nurses with suitable qualifications and understanding of the competencies and

conditions required to deliver qualitynursing care in the current health care environment.

To enable the profession to provide competentleadership , NNAs should be vigilantin assuring that nurses are prepared with the necessary competencies to function in

leadership roles at all levels of the health system .

NNAs are also responsible for ensuring that nurses are major participants in the

planning and direction ofnursing education , nursing services , regulatory bodies

and other health related activities. Nursing is a dynamicprofession that has evolved in

response to changing needs, demands and resources of our society .

The complexity of the health care delivery system today is such that the role andresponsibility of the nurse within this system can change.

Each registere nurse is responsible and accountable for making decisions and

practicing in accordance with his or her educational background and experience in

nursing within the statutory parameters of the Nurse Practice Act.

The Scope of Nursing PracticeNursing, like other professions, is accountable forensuring that its members act in the public interestand

provide the unique service that has beendesignated to them by society. This process is called professional

regulation.

The profession of nursing regulates itself throughdefining practice, establishing an educational system ,providing research to further develop the practice base and developing the standards of practice and a

codeof ethics.

In turn, the state , through statues, attests to the publicthat registered nurses meet minimal standardsforpractice and prohibits unlicensed individuals frompracticing as registered nurses.

The legal boundaries of the scope of practice are determined by the definition of nursing found inthe Nurse Practice Act (NPA) and provide the basis for terpreting the practice of the individualregistered nurse.

Since each state has legal authority for the regulation of nursing, the definition, and therefore the scope

ofnursing practice may vary from state to state.

However, the purpose of the law remains consistent toprotect the public .

Nurse Practice Act

The Nurse Practice Act was enacted by the legislature to regulate the practice of nursing and to definethe parameters of nursing practice for the purpose ofprotecting the public .

The act does not address specific nursing duties that are proper to be performed by nurses , orhospital staffing patterns,labor practices or employment criteria.

The Nurse Practice Act is designed to protect the public from incompetent nursing practice, not to protect

nurses from discriminatory or questionableemployment practices.

Each nurseis responsible and accountable for making decis ions and practicing in accordance with thatindividual's educational background and experience innursing.

Nursing Practice in Different Settings

Individual RNs ResponsibilityThe registered nurse is responsible and accountable , professionally and legally, for

determining his/herprofessional scope of nursing practice.

Since the role and responsibilities of nurses, andconsequently the scope of nursingpractice, is everchanging and increasing in complexity, it is importantthat the nurse makes


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decisions regarding his/her ownscope of practice

Nurse Manager & Nurse Executive 'sresponsibility

As a registered nurse, the nurse manager isresponsible and accountable, professionally

and legally, for determining his/her professional scope ofpractice.

The nurse manger makes decisions regarding the rolesand responsibilities for nurses within the

institution oragency in order to provide quality care.

The nurse executive , in a changing and complex health delivery system , is knowledge

practice,in-addition to evaluation

of the boundaries specified in the Nurse Practice Act. The nurse executive and/or the nurse

manager facilitatechanges to assure quality patient care outcomes anddevelop mechanisms

that will promote the same .

Mobile Nursing Practice

In 1984 a need was seen to offer more extensive home health care for local res idents whopreferred to receive needed care in their own homes.

This enabled many to reduce costs and remain in their homes, at least for a longer period of time. This organization became known as Mobile Health Care , Ltd. and was later changed to

Mobile Nursing Services , Ltd. This was the area's first private home health care delivery

system.

It was the first to offer such services at all times of the day and night. Previously uch care was

available onlyduring regular business hours

Mobile Nursing Services has been a leader and innovator in the field of home health care and

hastransformed this important method of healthcare delivery in the southeast Iowa area.

It is the largest and oldest home health care system in the area , except for public organizations , and it

has had a favorable competitive effect on those , resulting in overall improved care for the area

residents from avariety of public and private sources.

Mobile nursing services

These services provide horne teaching and care for patientswith varied needs and health problems.

Patients discharged early from hospitals.

Patients suffering from chronic and acute medical problems.

Surgical Patients.

Patients requiring IV therapy.

The elderly.Respiratory patients.The-seriously ill.

Patients in need of medication management (includingpain control) . Hospice Concept.

Ventilator Dependent.

Assistance with Bathing, Dressing , Meals ,Transportation, Light, Housekeeping.

Services may be covered by Medicare, Medicaid, private insurance,private payment, VA or other third party

payers.

Military Nursing Services

First World War

The Military Nursing Service has its origin from the ArmyNursing Service formed in 1881 part of Royal Army . The

Army nurses served in Flanders, the Mediterranean, the Balkans, the Middle East and onboard hospital


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ships.After, the war on 1st October1926, the Nursing Services was granted permanent status in Indian

Army. This date is formally recognized as the formation day of Military N,ursingService, though in actual its origins

occurred 45 five years before.

Second World War With the outbreak of second world war, nurses once again found themselves serving all

over the world.

During the middle of the war in 1943, the Indian arm of the Nursing Services wasseparated through Indian Military Nursing Service Ordinance , 1943 and re designated it,

there by constituting the Military Nursing Service (MNS) in its present form.

The Officers of the Military Nursing Service are governed by Indian Military Nursing Service

Ordinance 1943 and Military Nursing Service Rules, 1944.

The Section 5 of the ordinance provides that , all members of the Indian MilitaryNursing Service shall be of commissioned rank and shall be appointed asofficers of the

Indian Military Nursing Service by the Central Government by notification in the Official

Gazette.

The Nursing Service Officers are also subject to ArmyAct 1950,Army Rul 1954, DefenseService Regulations and vari Government Orders , Army Instructions, Army Orders ,

issued from time to time.

The Military Nursing Service stands out as one of the oldest services where women havecontributed directly to the nation's war effort by providing care to the sick and wounded

soldiers. This is also true for all the armedforces of the world.

The army nurses have made a permanent place in every Nation 's heart by nursingmillions of sick and wounded soldiers back to health.

The Officers of Military Nursing Service had distinguished themselves in the Second

World War,through the care of the sick and wounded soldiers in India and also at many

foreign theatres of war.

Post independence , the Nursing Officers cared for the wounded soldiers in five major

bloody conflicts withthe neighboring countries .

Tele-nursing

Refers to the use of Telecommunication and informa_tiontechnology for providing nursing services inhealth carewhenever a large physical distance exists-b_etweenpatient and nurse, or between any

numbers of nurses.

As a field it is part of Tele-health , and has many points of contacts with other medical and non-medicalapplications, such as Tele-diagnosis , Tele-consultation,

Tele-monitoring, etc.

Tele-nursing is achieving a large rate of growth in manycountries , due to several factors: the preoccupationindriving down the costs of health care, an increase in

the number of aging and chronically ill population , and the increase in coverage of health care to distant,

rural,small or sparsely populated regions.

Among its many benefits , Tele-nursing may help solve increasing shortages of nurses; to reducedistances and save travel time , and to keep patients out of hospital. A greater degree of job

satisfaction has beenregistered among,Tele-nurses

Applications

One of the most distinctive Tele-nursing applications is home care. , In normal home health care , onenurse is able to visit up to 5-7 patients per day. Using Telenursing, one nurse can visit , 12-16 patients in

the sameamount of time. [Needs source]

A common application of Tele-nursing is also used by call centers operated by managed care organizations,

which are staffed by registered nurses who act as case .managers or perform patient triage, informationandcounseling as a means of regulating patient access and flow and decrease the use of emergency

rooms.


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The Nursing Robot

"Development of a Nursing Robot System" included the development of a mobile robot system (theNursingRobot) to help physically handicapped people

.Completed in 1986, the Nursing Robot was one of the first fully functioning mobile robots

equipped with a manipulator arm. Also integrated were seven differentsensor systems.

The system was controlled by four networked onboard Sinclair Spectrum Computers and an off-

board IBM PC.

This document describes the features of the mobile Nursing Robot System develpoedat the

Technion.

The Nursing Robot System comprises three major components: a self-propelled vehicle , a

robotic arm mounted on it , and a communications post (workstation) next to the disabled

person's bed.

Onboard the mobile robot, low-cost microcomputersare interconnected as a hierarchical network,

in order to control a variety of activities: Sensor data processing, motion control , path-

planning ,communication,and others

The vehicle can move autonomously in a room withunexpected obstacles

Nursing in Occupational Health

Occupational Health Nurses (OHN)

. OHN are registered nurses who independently observe and assess the worker's health status with

respect to jobtasks and hazards. Using their specialized experience and education, these registered nurses

recognize and preventhealth effects from hazardous exposures and treat workers'injuries/illnesses .

OHN ActivitiesObservation and assessment of both the worker and the work environment.

Interpretation and evaluation of the worker's medicaland occupational history, subjective complaints,and physical examination, along with any laboratory values or other diagnostic screening tests , industrial

hygiene and personal exposure monitoring values.

Interpretation of medical diagnosis to workers and theiremployers.

Appraisal of the work environment for potentialexposures. Identification of abnormalities . Description of the worker's response to the exposures. Management of occupational and non-occupational

illness and injury.

Documentation of the injury or illness

Academic Preparation

OHNs with varying degrees of academic preparation from entry level to PhD work in capacities

commensurate with their experience and academic preparation: clinicalnurse, clinical nurse manager, nursemanager, corporate nurse, nurse researcher, nurse educator and nurseconsultant

School health nurses

School nurses are primary care nurses for school children. They work with individual children ,young

peopleand families , schools and communities to improve healthand tackle inequality. In addition they

are recognized ascontributing to raising education standards

A school nurse is a qualified , experienced professional and the only trained nurse working across

health and education boundaries. They also provide the link between school, home and the

community.

School health nurses responsibilitySchool nurses have specialresponsibility for:

Promoting healthy lifestyles and schools. Child and adolescent mental health.


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Chronic and complex health care needs in childrenand young people.

Activities of school health nursesThe school nurses work includes:-

Health assessments for children at entrance to school as required. Individual health interviews offered to young people aged 13-14 years . Immunization programmes . Child protection. Health education.Space Nursing Society (SNS)

Is an international space advocacy organization devoted to space nursing and the

contribution to spaceexploration by Registered Nurses. SNS is an affiliated,non-p rofit special

interest group associated with the National Space Society.

The SNS provides a forum for the discussion andexploration of issues related to nursing inspace and its impact upon the understanding of earthbound nursing throug h conference

participation and itsnewsletter expanding horizons.

The information being learned in the microgravity environment of space has tremendousapplications forthe bed-bound patient on earth.Bed rest is considered analogous to some of the reactions the astronauts have experienced in

space , which include inner ear fluid shifts , loss of plasma volume , muscle atrophy,

demineralization and calcium/bone loss.

Legal RegulationNursing practice in Connecticut is regulated byConnecticut statutes. The professional nurse is responsibleand

accountable for making decisions that are based uponthe individual's educational preparation and experience in

nursing. Behaviors and activities of the nurse relating to the scope of practice that could lead to disciplinary

action are:-

Performing acts beyond the authorized scope ofpractice for the level of nursing for which the individual

is licensed.

Assuming duties and responsibilities within the scope of nursing practice without adequate preparation

orwhen competency has not been maintained.

Failing to take appropriate action or to follow policies and procedures in the practice situation designed

to safeguard the patient

Willfully or negligently failing to take appropriate action in safeguarding a patient or the public from

incompetent practice performed by a registered professional nurse or a licensed practical

nurse."Appropriate action"may include reporting to the StateBoard of Examiners for Nursing (SBEN).

Connecticut State Board of Examiners for Nursing (SBEN) The SBEN was established in 1905 by

thestate government to protect the public 's health and safety by overseeing certain aspects of thepractice of nursing of licensed practical nurses, registered nurses and advanced practice registered

nurses, butnot certified nurse aide

The SBEN achieves this mission pursuant toConnecticut General Statutes Section 20-88 and 20-90

by advising the commissioner of public health about regulations for nursing programs and approving

programs within schools of nursing and by adjudicatingcomplaints filed against l icensed practitioners and

imposing sanctions when appropriate.

The SBEN takes action against the licenses of those nurses who have exhibited unsafe nursing

practice. In addition , the SBEN reviews and provides advisory guidance regarding scope of

practice questions using the "Nursing Competency/ Scope of PracticeDecision- Making Model.

The SBEN has the authority to suspend or revoke alicense or discipline a nurse for misconduct ,incompetence or negligence. The burden is upon the

nurse, the licensee,to act at all times as a reasonable and prudent professional should act, in

accordanc with the prevalent professional standards.


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The SBEN can give direction before a given act is performed about whether it is permissible toperform that particular act. However, this direction must bespecifically requested.

A routine function of the SBEN is to respond to or comment upon practice questions. Themajority ofsuch requests are for clarification of a given activity with regard to the nurse 's "proper"

scope of practice.

In specific instances specific guidance is given in aposition statement.

It is not a reasonable expectation that the SBEN can respond to each and every nurse 's specific

practice questions with position statements.

Nurses need to recognize that , because they are individually licensed, they are liable for

nursingjudgment and action and obligated to make responsiblepractice decisions .

The SBEN is authorized by the state to discipline nurses who are unable or unwilling to pract

icecompetently,but it has no authority over health facilitiesorotherhealth care providers.

TRENDS IN NURSING PRACTICE

Trends in nursing are closely tied to what is happening to healthcare in general. Trends are fascinating

phenomena , but they do not exist in vacuums. Most are interrelated; one trend often spawns another.

Although trends are more than fads , they are far from money-back guarantees. We watch to anticipate the

direction that aparticular trend will take ' us, to remove the element ofsurprise . When we look back ontrends, however, some will have heralded permanent changes, but others might have been no more than blips

on the radar screen.

Scientific basis

In the past nursing largely was either intuitive or relied on experience or observation rather than on

research. Through trial and error the individual nurses discovered with measures that would assist

the client and many nurses became highly skilled in providing care through experience .

Technology

Technology or mechanization is being applied in the health field extensively. Certain areas of a

hospital are more technologic than others. Nurses find themselves in the midst of this rapidly

changing, increasingly technologicenvironment in hospital and in client's homes.

Indicators Of Increasing Technology

a. The proliferation of technologic equipment used in case of clients in hospitals and homes.

b. The increasing home and self care equipment.

c. Use of computers in many areas of health care.

Many nurses feel they need more education to obtain the knowledge and skills necessary to use the

newtechnology . High technology has enabled nurses to gatherclient assessment data through non-invasive

techniques

Renewed focus in caringThe increasing use of ted-mology in hospitals and homes has created an increasing need to

humanize. Nursing has traditionally been a caring and humanizing profession.

Indicators of this trend

a. The increasing number of professionals, articles andbooks about balancing of caring and technical

skills.

b. Many studies regarding caring as an aspect of nursing.

c. Increasing recognition in nursing of needs of clients in

technology and environment.

Expansion of employment opportunities


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Nursing practice trends include a growing variety of employment setting in which nurses have greater

independence , autonomy, and respect as member of the health care team. Nursing roles continue to expand

anddevelop, broadening the focus of nursing care and providinga more holistic and all-encompassing domain.

Nursing therapies are not only drawing from traditional nursing and medicine, spiritual and emotional realms, but

alsoexpanding into alternative therapies such as healing touch,massage therapy and use of natural herbs and

vitamins

Nursing's public perception

Any member of society who has been ill, hospitalized or visited an emergency department has

experienced nursing campaign noted .everybody needs a nurse .. The Johnson and Johnson foundation

has developedcompelling, attention getting media campaign on the nursing profession . These

media clips show nursingpractice, and the nurses featured in the advertisement and described their

satisfaction in the profession. Nursing is a pivotal health care profession , as frontline health care

providers, nurses' practice in all health care settings and constitute the largest number of professionals. Nurses

areessential to provide skilled, specialized, knowledgeable care, to improve the health status of the public ,

and to ensure safe, effective quality care. In addition,the American public rated nurses high in honesty and

ethics in theirprofessional role.

Nursing's impact on politics and health policy

The ability to influence or persuade an individual holdinga government office to exert the power of that office to

affect a desired outcome is known as political power.

Nurse's involvement in politics is receiving greater emphasis in nursing curricula , professionalorganizations,and health care settings.

Professional nursing organizations have employed lobbyists to urge State legislatures and the USCongress to improve the quality of health care.

The ANA works for the improvement of health standardsand the availability of health care services for all

people . Fosters high standards of nursing , stimulates and promotes the professional developments of

nurses, and advances . The purposes are unrestricted by considerations of nationality , race,creed , lifestyle ,colour, sex or age. The ANA employees RNs as lobbyists at the federal level and State nursingorganizations also hire lobbyists and legislative specialties to work on State nursing issues and assist with

federal efforts. . This groups aim to removefinancial barrier to health care , increase the quality ofnursing

care available , to increase economic rewards to nurses, expand professional nursing roles. In addition ,individual nurses can influence policy decisions at all governmental levels. If nurses become serious

students of social needs, activist in influencing policies to meet those needs and generous contributors of

time and moneyto nursing and their organizations.

Changing Trends In Nursing

Nursing has originated from the word = nurturing' ,which means nourishing , helping in growthanddevelopment of a human being. In the past , nursing was family-based work.

Modern nursing began in the 19th century under the leadership of Florence Nightingale.

The aim of nursing was only to promote the recovery of patients . Even now, the central concern of

nursing is nurturing the human beings.

Modern Trends In Nursing Practice

A Few Therapies Investigated By The OAM- 1995

Biofeedback to control pain. Acupuncture to relieve depression. Imagery to control asthma. Ayurvedic medicine to treat Parkinson's disease.

Music therapy to treat brain injured clients and

Shark cartilage to treat cancer.


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Role Of Professional NurseThe following nurse roles are ways of describing thenurse's activities in practice. Each role

is described as a separate entity for the state of clarity. However the role is not in actuality

exclusive of one another. In practices ,several roles often coincide.

1) Care providerThe goal of nurse in this role is to convey understandingabout what is important and to provide

care.

The nurse supports the client by attitude and actions that show concern for the clientwelfare andacceptance of the client as a person, not merely amechanical being

Caring is central to most nursing intervention and an essential attribute of the expert nurse.

2) Communicator/helper Communications shapes the relationships between nurses and clients , nurses and support

persons, and nurses and colleagues.

Communications facilitates all nursing actions.The nurse communicates to other health care personnel the nursing interventions planned and

implemented foreach client.

Nurses communicates pertinent information verbally at- change of shift reports , when clientsare shifted to another unit, at clients rounds , and when clients are discharged to another

health care agency.

3) TeacherIt is an interactive process between a teacher and one or more learners in which specific

learning objectives or desired behavior changes are achieved. The focus of the behavior

change is acquiring a new knowledge or technical skills.

4) CounselorIt is the process of helping the client to recognize andcope with stressful psychological or

social problems , to develop improved interpersonal relationships , and to promote personal

growth.

It involves providing emotional , intellectual andpsychological support .5) Client Advocate Advocacy involves concern for and defined actions inbehalf of another person or organizing to bring about

achange.

A client advocate is an advocate of client ' right. It involves promoting what is best for the client , ensuring that the client ' needs are met, and protecting the

client's right.

6) Change agent

Is a person or group who initiates change or who assists others in making modifications inthemselvesorin the system.

7) Leader

Nursing leadership is defined as a mutual process of interpersonal influence through nurse helps client

make decision in establishing and achieving goals to improve the client's wellbeing.

To improve the health status and potential of individualsor families

Increasing the effectiveness and level of satisfaction among the professional colleagues providing


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care.

8) Manager

Management is planning , giving direction, developing staff, monitoring operations , giving rewards fairly

andrepresenting both staff members and administrations as needed.

The nurse manages the nursing care of individuals ,

groups, families, and communities .

The manager delegates nursing activities to ancillary workers and other nurses and supervises and

evaluatestheir performance.

9) Researcher

Nurse who will engage in research , there is a growingexpectation that all nurses will be able

to criticallyappraise research reports and will utilize the scientificstudies as a basis for making

decisions in their work.10)Expanded nursing roles

An expanded role is one that a nurse assumes by virtue of education and experience. The

nurse who assumes an expanded role has increased responsibility and, usually greater

autonomy. Nurses are assumingexpanded roles in both hospitals and communitysettings.


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ConclusionEach nurse must determine his/her own individual scopeof practice. To determine one's scope of practice, the nurse

must understand the Nurse Practice Act and assess his/ her own evolving set of competencies. A nurse's scope

ofpractice will change over time, with additional experience and education. Determining scope of practice is an

obligation and responsib ility jointly shared by individual nurses, nurse managers , nurse executives and

educators , as well as the regulatory agencies and profess ional organizations. This article is intended toprovide nurses with information and tools to assist them in determining their scope of practice. The processof developing a Professional Practice Framework for the Calgary Health Region demanded considerable t ime

and effort on the part of a multitude of nurses. The resolve to reflect accurately the language of nurses in

developing the framework wasvital to defining professional practice in a manner than promoted ownership of

the final product by nurses in theRegion. It will now be important to examine the extent towhich elaboration of

this framework helps nurses achieve increased meaning and continually string to attain higher levels of

excellence in their work. It is hoped that the development ofan explicit model to guide practice will ultimate

help nurses feel pride is their profession and valuethe tremendous contribution .


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BIBLIOGRAPHY

Basheer P. Shebeer Advanced Nursing Practice 1st

edition.Manjunath S.Hegde..647-

659

www.google.com


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Documents

Framework Assignment