Introduction to Introduction to NursingNursing

A definition of nursingA definition of nursing

According to the American Nurses Association, According to the American Nurses Association,

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

What does it take to be a What does it take to be a nurse? nurse?

• KnowledgeKnowledge- biology, chemistry, math, - biology, chemistry, math, psychologypsychology

• SkillSkill- ability to start IV’s, insert catheters, take - ability to start IV’s, insert catheters, take blood pressuresblood pressures

• Cool head- Cool head- needed in times of crisisneeded in times of crisis• IntegrityIntegrity- high moral and professional standards- high moral and professional standards

• PatiencePatience- ability to take the time to listen to - ability to take the time to listen to patients and their familiespatients and their families

• EmpathyEmpathy- ability to understand another - ability to understand another person’s feelingsperson’s feelings

• KindnessKindness- consideration, caring and compassion- consideration, caring and compassion

Nursing scienceNursing science

Nursing is an art and a Nursing is an art and a sciencescience

• Nursing is a combination of scientific Nursing is a combination of scientific knowledge, compassion, and respect for knowledge, compassion, and respect for human dignity. human dignity.

• Nurses integrate science into practice Nurses integrate science into practice with patients in order to provide high-with patients in order to provide high-quality, effective health care quality, effective health care

• Nursing is hard work but provides many Nursing is hard work but provides many personal and professional rewardspersonal and professional rewards

Preparing Nurses to Preparing Nurses to Succeed in a Complex Succeed in a Complex

EnvironmentEnvironment

A Broader RoleA Broader Role

Technology Advances and Technology Advances and ComplicatesComplicates

Safety and Quality A Top Safety and Quality A Top PriorityPriority

High-Tech Simulation and High-Tech Simulation and Skills Training Skills Training

Nursing is a profession Nursing is a profession because…because…

• Nursing requires extensive education Nursing requires extensive education and trainingand training

• Nursing has a body of knowledge all its Nursing has a body of knowledge all its ownown

• Nurses provide a specialized serviceNurses provide a specialized service

• Nurses have autonomy to make Nurses have autonomy to make decisions in their practicedecisions in their practice

• Nursing has a code of ethics for practiceNursing has a code of ethics for practice

Clinical Preceptor – A Clinical Preceptor – A Guide for the Real WorldGuide for the Real World

Professional performance Professional performance standardsstandards

• To ensure that the nursing To ensure that the nursing profession continues to provide high-profession continues to provide high-quality care to patients, families, quality care to patients, families, and communities, standards were and communities, standards were developed by the ANAdeveloped by the ANA

• These standards serve as These standards serve as benchmarks to define what is the benchmarks to define what is the professional practice of nursingprofessional practice of nursing

ANA ANA Professional Performance Professional Performance

StandardsStandards

• Describes expected professional Describes expected professional behavior for nursesbehavior for nurses

• Expectations for high-quality care and Expectations for high-quality care and collaboration among nurses and health collaboration among nurses and health care professionalscare professionals

• Serve as objective criteria for nurses to Serve as objective criteria for nurses to be responsible for their practicebe responsible for their practice

ANA ANA Standards of Nursing Standards of Nursing

PracticePractice

• Describe the proficient level of nursing Describe the proficient level of nursing carecare

• Describe expectations for use of nursing Describe expectations for use of nursing process in clinical practiceprocess in clinical practice

• Include nursing accountability for Include nursing accountability for patient teaching, culturally appropriate patient teaching, culturally appropriate care, planning of care, and collaborationcare, planning of care, and collaboration

Nursing educationNursing education

• Two types of undergraduate nursing Two types of undergraduate nursing programs are currently offered in the U.S.:programs are currently offered in the U.S.:• 2-year associate degree2-year associate degree• 4-year baccalaureate degree4-year baccalaureate degree

• Both programs prepare students to take Both programs prepare students to take the NCLEX-RN examthe NCLEX-RN exam• The national licensing exam for registered The national licensing exam for registered

nursesnurses• The NCLEX-RN exam is the same across the The NCLEX-RN exam is the same across the

U.S., so nurses can easily transfer licenses U.S., so nurses can easily transfer licenses from state to statefrom state to state

Nurse Practice ActsNurse Practice Acts• States have Nurse Practice Act documents States have Nurse Practice Act documents

that define the practice of nursing for that define the practice of nursing for that that particular state.particular state.

• Michigan does not have a “Nurse Practice Michigan does not have a “Nurse Practice Act” with that title- Act” with that title- MI Public Health Code MI Public Health Code and the MI Board of Nursing’s and the MI Board of Nursing’s Administrative RulesAdministrative Rules instead. instead.

• These documents are available from the MI These documents are available from the MI Department of Consumer and Industry Department of Consumer and Industry Services. Services.

Nursing professional Nursing professional organizationsorganizations

• American Nurses AssociationAmerican Nurses Association• Works to promote high standards of Works to promote high standards of

nursing practice and a positive, nursing practice and a positive, realistic view of nursesrealistic view of nurses

• National League for NursingNational League for Nursing• Works to promote excellence in Works to promote excellence in

nursing educationnursing education

Different types of Different types of nurses nurses

LPN:LPN:• Has 1 year of trainingHas 1 year of training• May follow doctors’ orders for simple May follow doctors’ orders for simple

procedures and giving drugsprocedures and giving drugs• May not plan care for patientsMay not plan care for patients• Some facilities allow LPNs to do Some facilities allow LPNs to do

admission assessments, others require admission assessments, others require RN to do so or co-sign LPN assessmentRN to do so or co-sign LPN assessment

Different types of Different types of nursesnurses

Nursing assistantNursing assistant• Also known as “CNA” or “Nurse aide”Also known as “CNA” or “Nurse aide”• Training requirements vary, but Training requirements vary, but

generally is few monthsgenerally is few months• Assist nurses with basic tasks such as Assist nurses with basic tasks such as

bed baths, feeding patients, taking vital bed baths, feeding patients, taking vital signssigns

• Are invaluable to nurses- treat them Are invaluable to nurses- treat them with respect and stay on their good side!with respect and stay on their good side!

Different types of nursesDifferent types of nurses

Different types of Different types of nursesnurses

Different types of Different types of nursesnurses

Different types of Different types of nursesnurses

Theory Guides the Theory Guides the Professional Professional Nurse in….Nurse in….

• Organizing and analyzing patient dataOrganizing and analyzing patient data• Understanding connections between Understanding connections between

pieces of datapieces of data• Discriminating between important and Discriminating between important and

less pertinent dataless pertinent data• Making sound clinical judgments based on Making sound clinical judgments based on

evidenceevidence• Planning effective nursing interventionsPlanning effective nursing interventions• Predicting and evaluating outcomes of Predicting and evaluating outcomes of

interventionsinterventions

Florence NightingaleFlorence Nightingale• Notes on Nursing: What It Is Notes on Nursing: What It Is

and What It Is Not and What It Is Not (1969, (1969, originally published in 1859)originally published in 1859)• Her philosophy of Her philosophy of

health, illness, and the health, illness, and the nurse’s role in caring for nurse’s role in caring for patientspatients

• Focused on the relationship Focused on the relationship of patients to their of patients to their surroundingssurroundings

• Importance of observing the Importance of observing the patient and recording patient and recording informationinformation

• Importance of cleanlinessImportance of cleanliness• Health and recovery from Health and recovery from

illness is related to illness is related to environmentenvironment

Virginia HendersonVirginia Henderson• The “Unique function of The “Unique function of

he nurse… is to assist he nurse… is to assist the individual, sick or the individual, sick or well, in the performance well, in the performance of those activities of those activities contributing to health or contributing to health or its recovery (or a its recovery (or a peaceful death) that he peaceful death) that he would perform unaided if would perform unaided if he had the necessary he had the necessary strength, will or strength, will or knowledge.”knowledge.”

• Nurse’s role = substitute Nurse’s role = substitute for the patient, a helper for the patient, a helper to the patient or a to the patient or a partner with the patientpartner with the patient

Jean WatsonJean Watson• Studied at CUStudied at CU• The Philosophy and Science of The Philosophy and Science of

Caring Caring (1979)(1979)• Emphasized the caring aspects Emphasized the caring aspects

of nursingof nursing• 10 Carative factors (see Box 10 Carative factors (see Box

13-4 on pg. 309); these factors 13-4 on pg. 309); these factors differentiate nursing from differentiate nursing from medicine (curative)medicine (curative)

• Illness or disease equated with Illness or disease equated with lack of harmony within the lack of harmony within the mind, body, and soulmind, body, and soul

• RN responsible for creating and RN responsible for creating and maintaining an environment maintaining an environment supporting human caring while supporting human caring while recognizing and providing for recognizing and providing for patient’s primary human patient’s primary human requirementsrequirements

Dorothea OremDorothea Orem• Concept of self-careConcept of self-care• ““Ordinary people in Ordinary people in

contemporary society contemporary society want to be in control want to be in control of their lives.”of their lives.”

• Patient’s baseline Patient’s baseline ability to provide ability to provide adequate self-care is adequate self-care is assessedassessed

• Systems of careSystems of care• Wholly compensatoryWholly compensatory• Partially compensatoryPartially compensatory• Supportive-educativeSupportive-educative

Imogene KingImogene King• A Theory for Nursing: A Theory for Nursing:

Systems, Concepts, Systems, Concepts, Process Process (1981)(1981)

• Focused on persons, Focused on persons, their interpersonal their interpersonal relationships, and social relationships, and social contexts with three contexts with three interacting systemsinteracting systems• PersonalPersonal• Interpersonal Interpersonal • SocialSocial

• Emphasizes goal Emphasizes goal attainment and patient’s attainment and patient’s involvement in setting involvement in setting goals (Goal Attainment goals (Goal Attainment Model)Model)

Sister Callista RoySister Callista Roy• Introduction of Nursing: Introduction of Nursing:

An Adaptation Model An Adaptation Model (second edition 1984)(second edition 1984)

• Individual as a Individual as a biopsychosocial adaptive biopsychosocial adaptive systemsystem

• Nursing is a humanistic Nursing is a humanistic discipline that discipline that emphasizes the person’s emphasizes the person’s adaptive and coping adaptive and coping abilitiesabilities

• The environment can be The environment can be manipulated by the RN to manipulated by the RN to further patient’s further patient’s adaptationadaptation

Hildegard PeplauHildegard Peplau• Interpersonal Relations in Interpersonal Relations in

Nursing Nursing (1952 & 1988)(1952 & 1988)• Relationship between Relationship between

patient and nurse is the patient and nurse is the focus of attentionfocus of attention

• Therapeutic interpersonal Therapeutic interpersonal relationshiprelationship• Survival of the patientSurvival of the patient• Patient’s understand his or Patient’s understand his or

her health problems and her health problems and learn from them as they learn from them as they develop new behavior develop new behavior patternspatterns

• 6 roles of the nurse: 6 roles of the nurse: counselor, resource, counselor, resource, teacher, technical expert, teacher, technical expert, surrogate, and leadersurrogate, and leader