Introduction to Professional Nursing Practice PP- Week 1 Question and Answers

Introduction to Professional Nursing Practice PP- Week 1 Question and Answers Intro- Professional nurses... -Assume ultimate accountability for client outcomes -Supervise, educate LPN/LVNs, UAP -Use science as basis for professional practice, art when modifying care approaches Six essential features of professional nursing: -Provide caring relationship that promotes health, healing -Assess, attend to full range of human responses, experiences -Integrate subjective, objective data -Use professional judgment, critical thinking -Use scholarly inquiry -Strive for social justice by influencing social, public policy Characteristics of Professional Nursing Practice: The Hood MODEL- Professional Nurse Contributions Model: Nurses: members of interdisciplinary team -Circular form of model designates how interprofessional health care team surrounds health care consumers -Outer circle emphasizes importance of all team members working cohesively for benefit of care recipients **PP Characteristics of Professional Nursing Practice: The Hood MODEL- Professional Nurse Contributions Model- Outer circle of model: (6) -Altruistic attitude -Caring -Compassion -Commitment -Competence -Confidence **PP Characteristics of Professional Nursing Practice: The Hood MODEL- Professional Nurse Contributions Model- Innermost circle: -Clinical skills -Cognitive skills -Communication skills **PP Hood's professional nurse contributions model *PHOTO You need confidence before you can gain competence How to get confidence?- PRACTICE/ learning Middle circle- what nurses deal with/use in the nursing environment; must learn how to adapt Core Competencies for nurses -Core competency definition: "a defined level of expertise that is essential or fundamental to a particular job; the primary area of expertise; specialty; the expertise that allows an organization or individual to beat its competitors" -Professional nursing core competencies are fundamental knowledge, abilities, and skills that enable nurses to provide safe, effective care to other persons in health care settings (Hood, 2014). -Professional nurses are expected to display competence in an area of practice on an annual basis. -Hospitals and health care organizations deploy activities to verify that nurses possess a certain level of competence with the knowledge and skills appropriate to their clinical practice areas. Core Competencies for nurses- ^ Core competency definition: "a defined level of expertise that is essential or fundamental to a particular job; the primary area of expertise; specialty; the expertise that allows an organization or individual to beat its competitors" Core Competencies for nurses- ^ Professional nursing core competencies are... Professional nursing core competencies are fundamental knowledge, abilities, and skills that enable nurses to provide safe, effective care to other persons in health care settings (Hood, 2014) Core Competencies for nurses- ^ Professional nurses are expected to display... Professional nurses are expected to display competence in an area of practice on an annual basis. Core Competencies for nurses- ^ Hospitals and health care organizations deploy ... Hospitals and health care organizations deploy activities to verify that nurses possess a certain level of competence with the knowledge and skills appropriate to their clinical practice areas. Core Competencies for nurses *PHOTO "Nurse of the Future Nursing Core Competencies- The Art and Science of Nursing" Nursing Knowledge in the middle Surrounding Nursing Knowledge -Patient-Centered Care -Professionalism -Leadership -Systems-Based Practice -Informatics and Technology -Communication -Teamwork and Collaboration -Safety -Quality Improvement -Evidence-Based Practice Surrounding ^ Practice Environment; Practice Outside in box -Knowledge -Attitudes -Skills **PP **Patient should be the center of care The Multiple Roles of the Professional Nurse (8) -Caregivers -Client advocate -Teacher -Change agent -Coordinator -Counselor -Colleague -Lifelong learner Challenges to the Professional Nursing Student -Chaos, personal sacrifices -Increased expenses for school needs -Decreased time with family -Lack of support from work environment -Entering unfamiliar learning situations Skills for Educational Success In ideal educational situations, students and faculty interact with each other as colleagues -Traditional education or Authoritarian expert -Educative-caring education or Egalitarian interactions Nurses -Focus educational efforts on refining previously learned skills while establishing theoretical foundations for professional practice Paving the way to success Reading -Reading assigned material Listening, speaking -Effective speaking, listening -Asking questions to avoid making errors in education, health care settings Writing -Essential mode of communication for nurses -Must use critical, reflective thinking -Learning to evaluate information, especially from world wide web -Effective writing, appropriate writing style **One of the most common errors in medical field is with communication Paving the way to success- Reading: -Reading assigned material Paving the way to success- Listening, speaking: -Effective speaking, listening -Asking questions to avoid making errors in education, health care settings Paving the way to success- Writing: Writing -Essential mode of communication for nurses -Must use critical, reflective thinking -Learning to evaluate information, especially from world wide web -Effective writing, appropriate writing style **One of the most common errors in medical field is with communication Paving the way to success- One of the most common errors in medical field is: One of the most common errors in medical field is with communication A diploma graduate who has been a practicing RN for 5 years is considering returning to school for a BSN. The nurse says she's not sure it is worth the money to return to school. What emotion is this nurse possibly experiencing? A.Discomfort, chaos B.Fear, anger C.Acceptance, certainty Jealousy, resentment A.Discomfort, chaos •Rationale: Nurses who return to school assume the role of student, which results in many lifestyle changes. The added responsibilities of returning to school may result in chaos and personal sacrifices. Diploma graduate= diploma school back then **Imposter syndrome...not thinking you are "good enough"...not confident **Imposter syndrome not thinking you are "good enough"...not confident Image and Physical Appearance -Nursing caps became obsolete in 1970s -White uniforms abandoned for colorful scrub suits, dresses *Cartoons, other distracting designs in scrub attire fail to project professional image -Cleanliness, safety are priorities: *Clean clothing, well-manicured natural nails *Clean shoes decrease spread of infections *Avoid dangling earrings, necklaces to prevent injury *Tongue piercing impairs clarity of nurse's speech *Visible body piercing, extensive tattooing might create distress for some clients Image and Physical Appearance- Nursing caps / white uniforms... -Nursing caps became obsolete in 1970s -White uniforms abandoned for colorful scrub suits, dresses *Cartoons, other distracting designs in scrub attire fail to project professional image Image and Physical Appearance- Cleanliness, safety are priorities: -Clean clothing, well-manicured natural nails -Clean shoes decrease spread of infections -Avoid dangling earrings, necklaces to prevent injury -Tongue piercing impairs clarity of nurse's speech -Visible body piercing, extensive tattooing might create distress for some clients Socialization and Resocialization into the Nursing Profession -Socialization: process of making someone ready for a societal role •Professional socialization •Formation, internalization of professional identity congruent with professional role -Resocialization: occurs when someone adapts role to new setting •Significant environmental changes (changing job, moving to different practice setting, returning to school) stimulate resocialization Socialization and Resocialization into the Nursing Profession- ^ Socialization: -Socialization: process of making someone ready for a societal role •Professional socialization •Formation, internalization of professional identity congruent with professional role Socialization and Resocialization into the Nursing Profession- ^ Resocialization: -Resocialization: occurs when someone adapts role to new setting •Significant environmental changes (changing job, moving to different practice setting, returning to school) stimulate resocialization Role theory Role contains three key pieces: -values, -attitudes, -behaviors -Students must adjust how they meet all current life roles to avoid role conflict -Role conflict: arises when roles assumed by person compete with each other for time, and attention Shane's Returning-to-School Syndrome -Honeymoon -Conflict -Reintegration -Integration Shane's Returning-to-School Syndrome- ^ Honeymoon: nurses feel energetic about learning new things Shane's Returning-to-School Syndrome- ^ Conflict: turbulent negative emotions (anger, helplessness, depression) Shane's Returning-to-School Syndrome- ^ Reintegration: nurses question why they decided to pursue higher degree Shane's Returning-to-School Syndrome- ^ Integration: ability to blend original culture of work with new culture of school Bridge's Managing Transitions -People undergo transitions (psychological adaptations to changes) whenever exposed to changes -Three-step process to facilitate transitions that "starts with ending, finishes with beginning": * Letting go *The neutral zone *The new beginning Developing a Professional Self-Concept- It entails: -Beliefs about oneself, personal interpretations about past, present, future -Development of professional self-concept (how person perceives oneself as a nurse) follows same path as development of personal self -Personal self-concept cannot be separated from professional self-concept Encompasses -Professional self-system emerges from personal self Professional Nursing Roles (7) -Helping -Teaching-coaching -Diagnostic and patient monitoring -Effective management of rapidly changing situations -Administration and monitoring of therapeutic interventions and regimens -Monitoring of and ensuring the quality of health care practices -Organizational and work-role competencies Benner's novice to expert model (Stages I-V) Stage: I Title: Experience level: Characteristics of performance: *PP *Table 1.3 from Benner, P (1984) "From novice to expert (pp.21-34) Title: Novice Experience level: Student Characteristics of performance: Is inflexible; Exhibits rule-governed behavior Benner's novice to expert model (Stages I-V) Stage: II Title: Experience level: Characteristics of performance: *PP *Table 1.3 from Benner, P (1984) "From novice to expert (pp.21-34) Title: Advanced beginner Experience level: New graduate Characteristics of performance: Formulates principles; Needs help with priority setting Benner's novice to expert model (Stages I-V) Stage: III Title: Experience level: Characteristics of performance: *PP *Table 1.3 from Benner, P (1984) "From novice to expert (pp.21-34) Title: Competent Experience level: 2-3 years in same setting Characteristics of performance: Plans; Has feelings of mastery Benner's novice to expert model (Stages I-V) Stage: IV Title: Experience level: Characteristics of performance: *PP *Table 1.3 from Benner, P (1984) "From novice to expert (pp.21-34) Title: Proficient Experience level: 3-5 years in same setting Characteristics of performance: Perceives "wholes"; Interprets nuances Benner's novice to expert model (Stages I-V) Stage: V Title: Experience level: Characteristics of performance: *PP *Table 1.3 from Benner, P (1984) "From novice to expert (pp.21-34) Title: Expert Experience level: Extensive time in one or many settings Characteristics of performance: Has an intuitive grasp Characteristics of a Profession -Credentialing systems to certify competence -Legal reinforcement of professional standards -Ethical practice -Creation of collegial subculture -Intrinsic rewards -Public acceptance -Intellectual Characteristics * -Body of Knowledge * -Specialized Education * -Authority to control its own work -Exclusively unique body of knowledge -Extensive period of formal education and training -Specialized competence -Control over work performance -Service to society Self-regulation Characteristics of a Profession- ^ Intellectual Characteristics: -Body of knowledge on which professional practice is based -Specialized education to transmit body of knowledge to others -Ability to use knowledge in critical, creative thinking Characteristics of a Profession- ^ Body of Knowledge: -Professional practice based on body of knowledge derived from -Experience (leading to expertise) -Research (leading to theoretical foundations for knowledge, practice) -Liberal arts education serves as a hallmark of professional education Characteristics of a Profession- ^ Specialized Education: -NCSBN coordinates efforts to license registered, practical nurses -Graduate nursing education programs offer advanced education -Postgraduate nursing education leads to doctorate in nursing Nursing education levels Three levels of education qualify people to take licensing exam: -Associate's Degree in Nursing (ADN) -Diploma Nursing Program -Baccalaureate Degree in Nursing (BSN) Using Knowledge by Critical Thinking- Nurses as critical thinkers exhibit these habits of mind: (12) -Confidence -Contextual perspective -Creativity -Flexibility -Inquisitiveness -Intellectual integrity -Intuition -Open-mindedness -Perseverance -Reflection -Creative Thinking -Reflective Thinking Using Knowledge by Critical Thinking- Nurses as critical thinkers exhibit these habits of mind ^ Creative Thinking: -Ability to think outside what usually is done -Results in novel approaches to client care -Must be tempered by critical thinking to avoid hazardous solutions Using Knowledge by Critical Thinking- Nurses as critical thinkers exhibit these habits of mind ^ Reflective Thinking: -Purposeful analysis about what one is currently doing, what one has done -Reflection on action a retrospective analysis of action taken Independent Clinical Decision Making -Independent decisions to solve problems in clinical practice -Nurses act prematurely because of inadequate information, insufficient time to generate alternative approaches **ASSESSMENT IS ALWAYS FIRST BEFORE INTERVENTION Independent Clinical Decision Making- NOTE __1_______ IS ALWAYS FIRST BEFORE ___2______ 1. Assessment 2. Intervention Nursing Process -Systematic thinking method to process information about specific client care situations -Problem-solving approach that consists of five steps: Assessment Diagnosis Planning Implementation Evaluation -Effective use of nursing process requires critical, creative, reflective thinking Nursing Process- ^ Effective use of nursing process requires Effective use of nursing process requires critical, creative, reflective thinking Question- To avoid hazardous solutions, the professional nurse must temper creative thinking with_________. A. contextual perspective B. reflective thinking C. reflective action D. critical thinking D. critical thinking Rationale: Creative Thinking or the ability to think outside what usually is done must be tempered by critical thinking to avoid hazardous solutions. Autonomy and Self-Regulation Autonomy -Independence, willingness to take risks, accountability for one's actions, self-determination, self-regulation. State Boards of Nursing (SBN) -Regulates professional nursing practice by issuing professional licenses to qualified individuals National Council of State Boards of Nursing (NCSBN)—*WRITES/ADMINISTERS NCLEX -Developed licensure examinations for professional, practical nursing International Council of Nurses (ICN), American Nurses Association (ANA) Autonomy and Self-Regulation- ^ Autonomy: -Independence, willingness to take risks, accountability for one's actions, self-determination, self-regulation. Autonomy and Self-Regulation- ^ State Boards of Nursing (SBN): -Regulates professional nursing practice by issuing professional licenses to qualified individuals **State boards of nursing provides copies of nurse practice act upon initial licensure **Provide legal reinforcement against incompetence **Specifies legal definition of nursing practice, minimal education preparation for licensure **Imposes penalties for illegal, unethical, negligent practice Autonomy and Self-Regulation- ^ National Council of State Boards of Nursing (NCSBN): National Council of State Boards of Nursing (NCSBN)—*WRITES/ADMINISTERS NCLEX -Developed licensure examinations for professional, practical nursing Professional Nursing Organizations Professional nursing organizations: two categories: -General-purpose nursing organizations -Specialized nursing organizations Participation in specialty nursing organization links nurses who practice in particular area -Creates subcultures of nurses with common interests within nursing profession Professional Nursing Organizations- ^ Professional nursing organizations: two categories: -General-purpose nursing organizations -Specialized nursing organizations Professional Nursing Organizations- ^ Participation in specialty nursing organization links nurses who practice in particular area: -Creates subcultures of nurses with common interests within nursing profession Examples of Professional and Student Nursing Organizations (7) -National League for Nursing -American Association of Colleges of Nursing -National Council of State Boards of Nursing -American Nurses Association -The International Council of Nurses -Sigma Theta Tau International - *NURSING HONORS SOCIETY BASED ON GPA -National Student Nurses' Association Question- What is the purpose for nurses to participate in professional organizations? A. Links to other nurses in specific area of practice B. Creates sense of moral belonging, imperative C. To have regulation of professional nursing practice D. Boost ability to make ethical practice decision A. Links to other nurses in specific area of practice Rationale: Professional nursing organizations foster the development of collegial relationships among nurses. Participation in a specialty nursing organization links nurses who practice in a particular area and creates subcultures of nurses with common interests within the nursing profession. Ethical Practice- Guiding Principles: (10) -Respect for human dignity, uniqueness -Protection of confidential information -Acts to safeguard persons -Responsibility, accountability for nursing actions -Maintenance of nursing competence -Use of informed judgment -Participation in research, other activities -Participation in activities to improve, implement nursing standards -Integrity to profession -Collaboration with other health care professionals, consumers Societal Acceptance: Legal Reinforcement of Professional Standards Emerging profession because of barriers to fulfilling all criteria for professional stature -Multiple levels of education for entry to practice -Specialists in particular area of practice -Failure to unite, lack of working collectively -Nurses viewed as hired help -Disparity in salary related to multiple levels of education