Foundations of Professional Nursing
Characteristics of a Profession (8) - ANS>>1. The service is vital to humanity and
society
2. Specialized knowledge expanded through research
3. The service is intellectual in nature; Strong individual responsibility for practice
4. Educated in institutions of higher learning
5. Practitioners are relatively independent and autonomous
6. There is a code of ethics to guide decisions and member's conduct
7. There is an organization/ association that encourages and supports high standards of
practice
8. Working identity based on values and mission of the profession
ANA - ANS>>-Founded in 1896
-The ANA is the only full-service professional organization representing the interests of
the nation's 3.6 million registered nurses
-National Organization (ANA)
State-level Constituent Organizations (e.g.: ANA-New York)
-In 2013 the American Nurses Association had 163,011 registered members
definition of nursing - ANS>>"Nursing is the protection, promotion, and optimization of
health and abilities, prevention of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in the care of individuals,
families, communities, and populations."
scope of practice - ANS>>-The "who," "what," "where," "when," "why," and "how" of
nursing practice.
-Each of these questions must be answered to provide a complete picture of the
dynamic and complex practice of nursing
-Scope of practice bound by state regulations, organizational policies, patient needs
-Trend to expand nurses' scope of practice to take advantage of their education and
expertise
scope of practice- ask yourself - ANS>>-Did I learn this skill in my basic nursing
program?
-Did I learn this skill as part of a comprehensive training program which included clinical
experience?
-Is the skill commonplace in nursing literature and in nursing practice that it can
reasonably and prudently be assumed within scope?
-Is the skill outlined in the organization's policy and procedure manual?
-Does this skill pass the "reasonable and prudent" standard of nursing?
,the goals of the nursing profession (social compact)
Nursing has an active and enduring leadership role six areas of health care: - ANS>>1.
Organization, delivery, and financing of quality health care
2. Provision for the public's health
3. Expansion of nursing knowledge and appropriate application of technology
4. Expansion of healthcare resources and health policy
5. Planning for health policy and regulation
6. Duties under extreme conditions
workforce issues and trends - ANS>>IOM Future of Nursing Report -goal that 80% of
the RN workforce holds a bachelor's degree
Promote racial and ethnic diversity of the workforce so it more closely matches the US
population
Wave of retirement, impending shortage, new career opportunities
Four generations of nurses in the workplace each with different values and expectations
Mid-Nineteenth-Century Nursing
in England:
The Influence of Florence Nightingale - ANS>>She was the founder of modern nursing.
May 12, 1820
She was the daughter of a privileged, aristocratic family.
Stifled by her social position, she entered nurses' training at age 30.
She spurred reform of the British Army medical system based on her efforts during
Crimean War.
She wrote Notes on Nursing: What It Is and What It Is Not to establish nursing's unique
body of knowledge.
She founded first training school for nurses in London (1860).
After the Civil War: Moving Toward Education and Licensure Under the Challenges of
Segregation - ANS>>The Civil War prompted a move toward formal education of nurses
Three American schools were modeled after Nightingale's school and opened in 1873:
Bellevue Training School for Nurses (New York City)
Connecticut Training School for Nurses (New Haven)
Boston Training School for Nurses at Massachusetts General Hospital
The Feminization of Nursing - ANS>>Requirements for early nursing school applicants
were based on Victorian stereotypes of female qualities.
"Good breeding" and "ladylike behavior"
Submission to authority
Sensitivity
Intelligence
Professionalization Through Organization - ANS>>Chicago World's Fair (1893)
Several nursing leaders emerged after gathering there to share ideas.
Isabel Hampton Robb
,Lavinia Lloyd Dock
Bedford Fenwick
Paper by Florence Nightingale
What became the National League for Nursing (NLN; with its early name) was formed at
this meeting.
1896: American Nurses Association (ANA)
Founded by Isabel Hampton Robb
Name changed to ANA in 1911
1899: International Council of Nurses (ICN)
1908: National Association for Colored Graduate Nurses
1916: African-American students admitted to ANA through constituent states in the
North
Professionalism and Standardization of Nursing Through Licensure - ANS>>1903: Four
states created permissive licensure.
Established "title protection" for nurses in these states
1923: All states require examinations for "title protection," though not standardized.
1947: Fully mandated licensure, as started in New York in 1930, became the norm.
1950: NLN administered the first nationwide State Board Test Pool Examination.
Nursing's Focus on Social Justice: The Henry Street Settlement - ANS>>Margaret
Sanger
Henry Street Settlement
Addressed plight of immigrant women in New York
Fought for safe contraception and family planning
Dangerous, controversial work
Renowned for preserving reproductive and contraceptive rights for women
1931-1945: Challenges of the Great Depression and World War II- CWA, social security
act, WWII - ANS>>1933: The Civil Works Administration (CWA) nurses provided rural
and school health services for families who could no long afford nursing services.
1935: Social Security Act enhanced public health nursing.
World War II
The inadequate supply of nurses prompted Congress to budget for nursing education.
124,000 volunteer student nurses were certified by the Cadet Nurse Corps.
Technological Developments- (4) - ANS>>Four types: genetics, biomedical, information,
and knowledge
Genetics: Genomics, epigenetics, and pharmacogenetics will shape the foreseeable
future of health care and nursing practice.
Biomedical: Nurses take responsibility for monitoring and responding to data generated
by complex machines or implantable devices.
The ANA Advances the Nursing Profession by: - ANS>>1. Fostering high standards of
nursing practice,
, 2. Promoting the rights of nurses in the workplace,
3. Projecting a positive and realistic view of nursing,
4. Lobbying the Congress and regulatory agencies on health care issues affecting
nurses and the public.
Becoming a nurse (3) - ANS>>Socialization - school, work/organization, professional
activities
Evolution from Novice to Expert -trajectory of clinical reasoning skills that develop over
time and with experience
Working Identity -how you see yourself as a professional nurse.
May be challenged by other's perceptions about nursing
Florence nightinglae notes on nursing (12) - ANS>>-ventilation and warming
-health of the house
-professional demeanor
-noise reduction
-variety
-food and nutrition
-bed and bedding
-light
-cleanliness of rooms and walls
-personal lceanliness
-hopes and advice
-observation of the sick
"quality" defined - ANS>>The Oxford English Dictionary (1988) defines quality as "the
degree or grade of excellence".
Agency for Health Care Research and Quality (AHRQ) defines quality as "the degree to
which health care services for individuals and populations increase the likelihood of
desired health outcomes and are consistent with current professional knowledge."
Quality in healthcare: Two Components - ANS>>1. Technical
-Evidence based practice
-Correct diagnosis
-Correct treatment plan
-Competent providers
-Data-based decision making about care processes and patient outcomes
-Standardization/care pathways, protocols (i.e.: right person at the right time)
-Coordination across providers and units
2. Service
-Client-Centered Care
-Goal is to surprise and delight the customer /consumer/client
Characteristics of a Profession (8) - ANS>>1. The service is vital to humanity and
society
2. Specialized knowledge expanded through research
3. The service is intellectual in nature; Strong individual responsibility for practice
4. Educated in institutions of higher learning
5. Practitioners are relatively independent and autonomous
6. There is a code of ethics to guide decisions and member's conduct
7. There is an organization/ association that encourages and supports high standards of
practice
8. Working identity based on values and mission of the profession
ANA - ANS>>-Founded in 1896
-The ANA is the only full-service professional organization representing the interests of
the nation's 3.6 million registered nurses
-National Organization (ANA)
State-level Constituent Organizations (e.g.: ANA-New York)
-In 2013 the American Nurses Association had 163,011 registered members
definition of nursing - ANS>>"Nursing is the protection, promotion, and optimization of
health and abilities, prevention of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in the care of individuals,
families, communities, and populations."
scope of practice - ANS>>-The "who," "what," "where," "when," "why," and "how" of
nursing practice.
-Each of these questions must be answered to provide a complete picture of the
dynamic and complex practice of nursing
-Scope of practice bound by state regulations, organizational policies, patient needs
-Trend to expand nurses' scope of practice to take advantage of their education and
expertise
scope of practice- ask yourself - ANS>>-Did I learn this skill in my basic nursing
program?
-Did I learn this skill as part of a comprehensive training program which included clinical
experience?
-Is the skill commonplace in nursing literature and in nursing practice that it can
reasonably and prudently be assumed within scope?
-Is the skill outlined in the organization's policy and procedure manual?
-Does this skill pass the "reasonable and prudent" standard of nursing?
,the goals of the nursing profession (social compact)
Nursing has an active and enduring leadership role six areas of health care: - ANS>>1.
Organization, delivery, and financing of quality health care
2. Provision for the public's health
3. Expansion of nursing knowledge and appropriate application of technology
4. Expansion of healthcare resources and health policy
5. Planning for health policy and regulation
6. Duties under extreme conditions
workforce issues and trends - ANS>>IOM Future of Nursing Report -goal that 80% of
the RN workforce holds a bachelor's degree
Promote racial and ethnic diversity of the workforce so it more closely matches the US
population
Wave of retirement, impending shortage, new career opportunities
Four generations of nurses in the workplace each with different values and expectations
Mid-Nineteenth-Century Nursing
in England:
The Influence of Florence Nightingale - ANS>>She was the founder of modern nursing.
May 12, 1820
She was the daughter of a privileged, aristocratic family.
Stifled by her social position, she entered nurses' training at age 30.
She spurred reform of the British Army medical system based on her efforts during
Crimean War.
She wrote Notes on Nursing: What It Is and What It Is Not to establish nursing's unique
body of knowledge.
She founded first training school for nurses in London (1860).
After the Civil War: Moving Toward Education and Licensure Under the Challenges of
Segregation - ANS>>The Civil War prompted a move toward formal education of nurses
Three American schools were modeled after Nightingale's school and opened in 1873:
Bellevue Training School for Nurses (New York City)
Connecticut Training School for Nurses (New Haven)
Boston Training School for Nurses at Massachusetts General Hospital
The Feminization of Nursing - ANS>>Requirements for early nursing school applicants
were based on Victorian stereotypes of female qualities.
"Good breeding" and "ladylike behavior"
Submission to authority
Sensitivity
Intelligence
Professionalization Through Organization - ANS>>Chicago World's Fair (1893)
Several nursing leaders emerged after gathering there to share ideas.
Isabel Hampton Robb
,Lavinia Lloyd Dock
Bedford Fenwick
Paper by Florence Nightingale
What became the National League for Nursing (NLN; with its early name) was formed at
this meeting.
1896: American Nurses Association (ANA)
Founded by Isabel Hampton Robb
Name changed to ANA in 1911
1899: International Council of Nurses (ICN)
1908: National Association for Colored Graduate Nurses
1916: African-American students admitted to ANA through constituent states in the
North
Professionalism and Standardization of Nursing Through Licensure - ANS>>1903: Four
states created permissive licensure.
Established "title protection" for nurses in these states
1923: All states require examinations for "title protection," though not standardized.
1947: Fully mandated licensure, as started in New York in 1930, became the norm.
1950: NLN administered the first nationwide State Board Test Pool Examination.
Nursing's Focus on Social Justice: The Henry Street Settlement - ANS>>Margaret
Sanger
Henry Street Settlement
Addressed plight of immigrant women in New York
Fought for safe contraception and family planning
Dangerous, controversial work
Renowned for preserving reproductive and contraceptive rights for women
1931-1945: Challenges of the Great Depression and World War II- CWA, social security
act, WWII - ANS>>1933: The Civil Works Administration (CWA) nurses provided rural
and school health services for families who could no long afford nursing services.
1935: Social Security Act enhanced public health nursing.
World War II
The inadequate supply of nurses prompted Congress to budget for nursing education.
124,000 volunteer student nurses were certified by the Cadet Nurse Corps.
Technological Developments- (4) - ANS>>Four types: genetics, biomedical, information,
and knowledge
Genetics: Genomics, epigenetics, and pharmacogenetics will shape the foreseeable
future of health care and nursing practice.
Biomedical: Nurses take responsibility for monitoring and responding to data generated
by complex machines or implantable devices.
The ANA Advances the Nursing Profession by: - ANS>>1. Fostering high standards of
nursing practice,
, 2. Promoting the rights of nurses in the workplace,
3. Projecting a positive and realistic view of nursing,
4. Lobbying the Congress and regulatory agencies on health care issues affecting
nurses and the public.
Becoming a nurse (3) - ANS>>Socialization - school, work/organization, professional
activities
Evolution from Novice to Expert -trajectory of clinical reasoning skills that develop over
time and with experience
Working Identity -how you see yourself as a professional nurse.
May be challenged by other's perceptions about nursing
Florence nightinglae notes on nursing (12) - ANS>>-ventilation and warming
-health of the house
-professional demeanor
-noise reduction
-variety
-food and nutrition
-bed and bedding
-light
-cleanliness of rooms and walls
-personal lceanliness
-hopes and advice
-observation of the sick
"quality" defined - ANS>>The Oxford English Dictionary (1988) defines quality as "the
degree or grade of excellence".
Agency for Health Care Research and Quality (AHRQ) defines quality as "the degree to
which health care services for individuals and populations increase the likelihood of
desired health outcomes and are consistent with current professional knowledge."
Quality in healthcare: Two Components - ANS>>1. Technical
-Evidence based practice
-Correct diagnosis
-Correct treatment plan
-Competent providers
-Data-based decision making about care processes and patient outcomes
-Standardization/care pathways, protocols (i.e.: right person at the right time)
-Coordination across providers and units
2. Service
-Client-Centered Care
-Goal is to surprise and delight the customer /consumer/client
