Professional Nursing Concepts and Challenges Questions & Answers

Professional Nursing Concepts and Challenges Questions & Answers WHAT IS NURSING -TO BE IN SERVICE -IT IS ALL ABOUT THE PX -TO PUT YOUR OWN PERSONAL ISSUES ASIDE TO CARE FOR PXS THAT LIVES ARE ON NURSE'S HANDS How many nurses are at the work force? 4 million 4.7 million now due to ABSN programs The average age of nurses is? 44 years old Need more Nurses - There is a shortage of nurses d/t Older population increasing Baby boomers are living longer Stretching the resources and economy Nursing Educators They can work at clinical and academic settings Nowadays need a Maters or PhD to teach MAGNUM STATUS High standard certification that Hospital can get Hospitals need to have a certain number of nurses with BSN degrees Patient Ratio Only state of California have it Staffing ratios impact quality of care NIGHTINGALE SANITATION METHODS HOSPICE CARE - LADY WITH THE LAMP LILLIAN WALD NY - HENRY STREET SETTLEMENT FEARLESS, ACTIVIST DURING TIME OF SEGREGATION SHE EMBRACED AFRICAN AMERICAN NURSES PIONEER ON COMMUNITY HEALTH NURSING MARGARET SANGER REPRODUCTIVE RIGHTS TEACH BIRTH CONTROL FOUNDED PLANNED PARENTHOOD CARED FOR IMMIGRANTS IN NY ISABEL HAMPTON ROBB AMERICAN NURSES ASSOCIATION FOUNDER - ANA DOROTHEA DICKS MENTAL HEALTH PIONEER CARRED FOR HOSPITAL SANITATION/CONDITIONS CLARA BARTON CIVIL WAR FOUNDED THE RED CROSS MARY ELIZABETH MAHONEY FIRST TRAINED AFRICAN AMERICAN NURSE IN THE US Back in Dark Ages, during The Plague, one wanted to do nursing services: Before there was the profession of nurse or training: Prostitutes and Alcoholics were the ones taking care of sick people. They were given a choice to care for the sick or go to jail. EBP (Evidence Based Practice) A problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinician's expertise and client preferences and values in making decisions about client care. Allows nurses to structure how to make accurate, timely, and appropriate clinical decisions. CHATER 1 NURSING IN TODAY'S EVOLVING HEALTH CARE ENVIRONMENT A professor is presenting a lecture on the age of nurses in the work force today. Which statement by one of the student nurses indicates that the teaching has been effective? Older nurses are likely to remain in the workforce because the nursing field is reasonably protected from layoffs experienced by other professions." An international nurse recruiter is looking at factors that would push nurses to seek employment in another country. What should the recruiter expect to push nurses toward migration? Poor working conditions The nurse manager has hired a nurse from another country. What action should the nurse manager take, in order to make the new nurse's transition easier? Educate the current staff about the new nurse's background. What action should the nurse recruiter take to successfully recruit (pull) a nurse from a foreign country? Offer personal incentives such as increased pay. The nurse educator is providing a lecture on practice settings for nurses. Which statement from a new nurse indicates that the teaching has been effective? "Hospitals remain the primary worksite for RNs." The nurse professor is giving a lecture on the origin of nursing practice and care. Which statement by one of the students indicates that the teaching has been effective? "Nursing care originated in the home and community settings." The nurse manager wants to encourage staff nurses to enroll in an RN-BSN program. Which patient centered outcomes are likely to encourage the staff nurses to obtain a higher degree level? Patients cared for by BSN (or higher) prepared nurses have more positive outcomes. The nurse educator is giving a presentation on military nursing. Which statement by one of the attendees indicates that the teaching has been effective? "Military nurses have great opportunities for advanced education." The hospice nurse is caring for a patient who is actively dying. Which actions are supported by the Hospice Standards of Practice? Provide culturally sensitive care to the patient and family. The nurse is attending a lecture on the advancements in telehealth. Which statement from a colleague indicates that the teaching has been effective? "Telehealth expands health care access to underserved populations." You are a new graduate nurse starting in a pediatric intensive care unit. You know rapid advances in science and treatments, improved disease management with integration of new technologies, and interdisciplinary care delivery models are driving the need for contemporary nurses to be well educated and competent. You also know that stereotypes exist in nursing and want to prepare yourself to respond appropriately when you start your new career. PAGE 16 1. The media has played a huge role in the way the nursing profession has been portrayed. Which of the following ways have nurses been most commonly portrayed? (Select all that apply.) Sexualized roles Harsh disciplinarians with an unyielding, even sadistic, worldview Female-only profession Heroes and heroines 2. The nursing profession consists of individuals with unique values and experiences. However, there is only one set identity for nurses. True or false? False 3. According to Gardner, there are 10 lessons in collaboration. Name at least five of these lessons. (short answer) 1 - know thyself 2 - learn to value and manage diversity 3 - develop constructive conflict resolution skills 4 - use personal power to create win-win situations 5 - master interpersonal and process skills 6 - recognize that collaboration is a journey 7 - leverage all multidisciplinary forums 8 - appreciate that collaboration can occur spontaneously 9 - balance autonomy and unity in collaborative relationships 10 - remember that collaboration is not required for all decisions 4. _____________________________ is a vital aspect of plans designed to increase the effectiveness of delivery of health care. Interprofessional Collaboration 5. The role of nurse ________________ is essential to ensure universal access to care and for the improvement of public health. d. advocate CHATER 2 THE HISTORY AND SOCIAL CONTEXT OF NURSING The nurse is presenting a lecture on nursing image, and how to keep this image positive. Which statement by the students indicates that further education is needed? "Ignore negative images in nursing." The nurse educator is presenting a lecture on the contributions of Florence Nightingale. Which statement by one of the students indicates that the teaching has been effective? "Nightingale founded the first school of nursing." The nurse educator is presenting a lecture on the contributions of Dorothy L. Dix. Which statement by one of the students indicates that the teaching has been effective? "Dix was a long-time advocate for the mentally ill in the prewar years." The nurse is attending a lecture on Susie King Taylor. Which statement by the nurse indicates that the teaching has been effective? "Taylor taught soldiers, both African American and White, how to read." The nurse is listening to a presentation on Harriet Tubman. Which statement by one of the other attendees indicates that the teaching has been effective? "Tubman established the Underground Railroad, and led numerous slaves to freedom." The nurse has just finished listening to a lecture on the contributions of Sojourner Truth. Which statement by the nurse indicates that the teaching has been effective? "Truth was a famous abolitionist who took care of injured union soldiers." The nurse professor is presenting a lecture on Clara Barton. Which statement by one of the nurses indicates that the teaching has been effective? "Barton founded the American Red Cross." The nurse educator is giving a presentation about Phoebe Pember during nurse's week. Which statement by one of the attendees indicates that the teaching has been effective? "Pember was appointed matron of Chimborazo hospital in Richmond, Virginia." The nurse is presenting a lecture on the first nursing schools in the United States. Which statement by one of the attendees indicates that the teaching has been effective? "Linda Richards was the first trained nurse in the United States." The nurse is listening to a lecture regarding the nursing education of African Americans during the early 1900s. Which statement indicates that the teaching has been effective? "Mary Eliza Mahoney was the first professionally trained African American nurse in the United States." The history of American nursing from the middle of the 19th century to the present day has changed quite a bit. Reflect on how Florence Nightingale's ideas about nursing and nurse training, issues surrounding the development of professional and educational standards for nurses, and the role of nurses in war have influenced the development of professional nursing education and practice. Nursing has also faced significant challenges over the past 150 years. Nightingale: - Infection control - Hospice care - Lady with the lamp - took 38 nurses to the British hospital in Scutari, Turkey - organized and cleaned the hospital and provided care to wounded soldiers - excellent education in Statistics collected detailed data on morbidity and mortality of soldiers - using supporting evidence, argued the case for reform of the entire British Army medical system - influence today extends beyond the impact on the field of modern nursing to infection control, hospital epidemiology, hospice care - 1860 founded the first English training school for nurses at St. Thomas' Hospital in London - most famous publication 1859: Notes on Nursing: What is it and What it is not - influenced development of nursing in the US 1. The early Nightingale model had "pupil" nurses training on hospital wards under the direction of a nursing superintendent. This "pupil" nurse provided: a. hospitals with an inexpensive workforce. b. hospitals with a skilled workforce. c. working-class women with an opportunity for employment outside the home that was an alternative to factory work. d. All of the above All of the above 2. The training in hospital-based schools was arduous, requiring long days of patient service on the wards, after which students attended classes. In addition to providing direct patient care, students performed which tasks? (Select all that apply.) a. Housekeeping tasks b. Prepared meals d. Cleaned the wards and operating rooms e. Sterilized instruments g. Assisted physicians 3. Later community health nursing was developed. Why was this important to the nation and to the nursing profession? (short answer) - brought essential health services to the public outside the hospital environment - opportunities to integrate epidemiological knowledge, sanitation, and nursing science to the public - community health nurses pioneered activities in health promotion and disease prevention - political activities for health and welfare issues 4. What was the purpose of the Association of Collegiate Schools of Nursing in 1935? b. Establish collegiate nursing programs in American universities. 5. The concept of the intensive care unit (ICU) was initiated because of all of the following factors except c. the 20th century brought forth new disease processes and sicker patients. CHAPTER 3 NURSING'S PATHWAY TO PROFESSIONALISM The nurse professor is giving a lecture on autonomy. Which statement indicates that the teaching has been effective? "Autonomy means that the nurse has control over his/her own practice." "Autonomy means that the nurse has control over his/her own practice." "Magnet status recognizes nursing excellence." Using Flexner's criteria of professionalism, which attributes make nursing a profession? (Select all that apply.) Is practical, in addition to being theoretical. Has practitioners who are motivated by altruism. Has practitioners who are responsive to public interest. Is basically physical and is accompanied by a high level of personal responsibility. The nurse educator has given a lecture on the difference between the term "profession" and "occupation." Which statement(s) by one of the students indicates that the teaching has been effective? (Select all that apply.) "The two words mean the same thing in nursing." "The words profession and occupation are often used interchangeably." Which actions can the nurse take to demonstrate collegiality? (Select all that apply.) Become an active member of professional organizations. Share the latest nursing research with colleagues. Publish in professional literature. Assist researchers with data gathering. The nurse professor has just given a lecture on the process of professionalization. Which statement by one of the students indicates that the teaching has been effective? "After determining work standards, legal protection was established." The nurse case manager is discussing the difference between a profession and an occupation with a nursing student. Which statement should the nurse case manager make, to accurately define a profession? "Professionals often feel that they are called to their profession." The nurse professor has just provided a lecture on the influence of Esther Lucille Brown. Which statement by one of the nursing indicates that the teaching has been effective? "Brown called for nursing education to be based in colleges and universities." The student is listening to a lecture on nursing standards of practice. Which statement by the student indicates that the teaching has been effective? "Standards of practice determine responsibilities to which nurses are held accountable." How can the nurse manager take the first step to reduce the barriers to professionalism in nursing? Identify the barriers to professionalism in nursing. You have been a registered nurse practicing in the hospital setting for more than 5 years now. You have been asked to mentor a high school senior as she starts planning for her future nursing career. You want to make sure she understands that there are various pathways she can take to obtain several types of nursing credentials. These pathways have been linked to the historical social, political, and economic forces that influenced the development of nursing as a profession. No other profession allows entry into practices at less than a bachelor's level, yet nursing has 3 entry levels: BSN, ADN, and a diploma in nursing. Professional status and power increase with education. "Never-ending fracas" -- over the varying credentials for entry into nursing practice contributing with the continuing subordination of nursing in the health care arena Page 66 1. In 1965, the American Nurses Association (ANA) designated the associate degree as the educational entry point into professional nursing practice (ANA, 1965). True or false? FALSE In 1965 ANA published a significant position paper, taking official position that all nursing education should take place in institutions of higher education. Despite ANA's long held position, ADN programs remain the major source of entry-level RNs entering work force today. 2. What caused the accelerated BSN program to emerge after the 1990s? (short answer) As the nursing shortage gained national recognition during the 1980s and 1990s, accelerated BSN programs emerged to hasten the time to graduation for select groups of students. 3. The clinical nurse leader (CNL) is a master's-prepared nurse who oversees the care coordination of a distinct group of patients and actively provides direct patient care in complex situations. True or false? True The CNL role was developed in collaboration with leaders from education and practice settings. The American Association of Colleges of Nursing (AACN) (2003) further describes the CNL role: "Along with the authority, autonomy, and initiative to design and implement care, the CNL is accountable for improving individual care outcomes and care processes in a quality cost-effective manner" (p. 7). The CNL role differs from advanced practice nursing roles in that the CNL is a generalist and not a specialist as are nurse practitioners and clinical nurse specialists. 4. ____________________ is directed toward attesting to or endorsing the demonstrated knowledge base and clinical practice behaviors associated with high-quality performance in an area of specialization. a. Certification b. Specialized accreditation c. Bachelor's degree d. License a. Certification The certification of individual nurses is a growing quality-control activity being implemented by a variety of nursing and nursing-related organizations. Certification is directed toward attesting to or endorsing the demonstrated knowledge base and clinical practice behaviors associated with high-quality performance in an area of specialization. CHAPTER 5 BECOMING A PROFESSIONAL NURSE: DEFINING NURSING AND SOCIALIZATION INTO PRACTICE The nurse is listening to a lecture on the pioneers of early nursing, including the works of Hildegard Peplau. Which statement by the nurse indicates that teaching has been effective? "Peplau developed the self-care theory of nursing." A group of nursing students are listening to a lecture on nursing history and the many definitions of nursing. Which statement(s) by one of the students indicates that the teaching has been effective? (Select all that apply.) "A definition establishes boundaries." "Giving nursing a clear definition encourages higher wages." "Having a definition clarifies the functions of nursing." "A definition clarifies the purpose of nursing." Which formal socialization activities can the student nurse take part in to build skills? (Select all that apply.) Nursing clinicals Attending lectures Which factors can the student nurse expect to influence socialization? (Select all that apply.) The student's personal feelings Short staffing on the nursing unit The patient's unwillingness to engage in a healthy lifestyle The nursing professor is giving a lecture on Lai and Lim's conditions that are part of professional socialization in nursing. Which statement by one of the students indicates that the teaching has been effective? "Structural conditions that influence how one becomes a professional nurse include workplace policies." The nurse professor has just given a lecture on informal socialization. Which statement indicates that the teaching has been effective? "An example of informal socialization is assessing a patient after a fall." The student is attending a lecture on biases. Which statement indicates that further education is needed? "I don't need to worry about biases." The student nurse has self-identified with stage one of Cohen's Model of Basic Student Socialization. Which actions are expected for this nurse? The student will rely on external limits established by the clinical instructor. The nursing instructor is planning assignments for a group of nursing students. Which characteristics should the nurse expect from students in Benner's novice stage? Student who relies rigidly on rules The nurse is caring for a terminally ill patient in the hospital. Which action shows that the nurse is in Benner's expert practitioner's stage, or stage IV? "Suggests that the patient's wife bring the family dog for a visit." You are a nursing instructor, and this semester you have the task of teaching your students the concept of socialization within the nursing profession. You want to make sure that your class understands some of the key factors required for nurses to develop a deep sense of professional identity with commitment to the values and ethics of the profession. Cohen: 5 stages Page 105 Benner: 5 stages page 106 1. From the landmark document The Future of Nursing: Leading Change, Advancing Health, describe four key recommendations provided for the nursing profession. (short answer) Affirm and encourage professional nurses to practice fully, achieve higher levels of education, become full partners in providing and reforming health care, and develop an infrastructure for workforce data collection. 2. Having an understanding of the professional identity of nursing—both at the individual and disciplinary levels—empowers the nurse to do what? (Select all that apply.) a. Assume a professional identity that reflects a more responsible and equitable role. b. Obtain jobs in the hospital setting more easily. c. Challenge the traditional way nurses perceive themselves and are perceived by others. d. Develop a more relevant notion of professional identity. e. Easily enroll in postgraduate studies. a. Assume a professional identity that reflects a more responsible and equitable role. c. Challenge the traditional way nurses perceive themselves and are perceived by others. d. Develop a more relevant notion of professional identity. A robust understanding of the professional identity of nursing—both at the individual and disciplinary levels—empowers nurses to (1) assume a professional identity that reflects a more responsible and equitable role, (2) challenge the traditional way nurses perceive themselves and are perceived by others, and (3) develop a more relevant notion of professional identity (Crigger & Godfrey, 2011). 3. ____________________ is one strategy to strengthen nursing education and enhance the roles of nurses as collaborative leaders in the health care system. Interprofessional education Interprofessional education is one strategy to strengthen nursing education and enhance the role of nurses as collaborative leaders in the health care system. Rigorous, structured inter-professional education experiences can be one of the tools used for nurses to practice at the highest level for which they are educated, for there to be uniformly high standards for nursing education, and for nurses to successfully partner with physicians and other health professionals in redesigning our health care system. CHAPTER 8 CONCEPTUAL AND PHILOSOPHICAL FOUNDATIONS OF PROFESSIONAL NURSING PRACTICE Which action by the nurse shows an understanding of Maslow's second level of needs? Allowing the patient to use pillows and blankets from home. Using Bandura's model, how can the nurse help the patient stop smoking? Provide the patient with information on the dangers of smoking. PAGE 185 The nurse is listening to a lecture on open and closed systems. Which statement indicates that the teaching has been effective? "An open system promotes the exchange of information with other systems."