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138 Cards in this Set
- Front
- Back
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Florence Nightingale
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Recognized the importance of the environment on the health of the patient
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Florence Nightingale
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Demonstrated that trained nurses, clean water and air, nutritious food, and organized care could reduce the mortality of soldiers wounded in the Crimean War
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Florence Nightingale
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Engaged in the first known nursing research by keeping mortality and other records for the hospital in Scutari
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Florence Nightingale
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Published several volumes advocating reforms in hospitals workhouses, and infirmaries
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Florence Nightingale
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Advocated improved patient care including hygiene, sanitation, nutrition, equipment, and supplies
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Florence Nightingale
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Advocated improved conditons for nurses including housing conditions, salaries, holidays, and retirement benefits
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Florence Nightingale
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Recognized that a body of knowlege was the necessary foundation for nursing.
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Florence Nightingale
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Established a nurses' training school at St Thomas, London, which became a model for nursing training worldwide.
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Florence Nightingale
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Advocated careful selection of students, paid instructors, and a curriculum that included theory, supervised practice and the writing of case studies
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Florence Nightingale
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Advocated "holism," suggesting that the whole patient must be treated.
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Believed there were two types of nursing:
the care of the sick the promotion of health |
Florence Nightingale
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Published
"Notes on Nursing: What it is and What it is not" |
Florence Nightingale
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The founder of professional nursing, she developed a model for training schools that was eventually used in the United States
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Florence Nightingale
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Clara Barton
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Founded the orgainzation that would later become the American Red Cross
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Established a public health nursing in the United States through her work at the Henry Street Settlement house
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Lillian Wald
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Code of ethics
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with the development of licensure and a Code of Ethics for nurses, the profession moved toward greater self-regulation. Collegiate education for women became more popular, paving the way for women to select degree conferring nursing programs
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Nursing practice is guided by a code of ethics. This is a written public document that outlines the professional responsibilities of the practicing nurse. The code of ethics defines the fundamental values and commitment of the nuse and also the boundaries of duty and loyalty toward the patient and the profession.
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Code of Ethics
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Code of Ethics
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Strengthen and guide nurses decision making as they navigate the troubled waters that now exist in many practice settings
Empowers nurses to maintain their focus on the patient as the center of health care |
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Written, public document that reminds practitioners and the public they serve of the specific responsiblilties and obligations accepted by the profression's practitioners
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Code of Ethics
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A tool that guides a group toward professional self-determination and provides evidence of professional legitimacy
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Code of Ethics
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Recognize characteristic behaviors of professional nurses
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Characteristics Behaviors of Professional Nurses
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Develops own philosophy of Nursing
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Characteristics Behaviors of Professional Nurses
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Characteristics Behaviors of Professional Nurses
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Uses self-determination
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Uses critical thinking
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Characteristics Behaviors of Professional Nurses
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Collaborates and communicates with other professionals
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Characteristics Behaviors of Professional Nurses
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Characteristics Behaviors of Professional Nurses
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Demonstrates accountability for self and others
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Commited to lifelong learning
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Characteristics Behaviors of Professional Nurses
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Active in proffessional organizaitons
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Characteristics Behaviors of Professional Nurses
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Mentors aspring professionals
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Characteristics Behaviors of Professional Nurses
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Recognizes own limitations: seeks necessary help
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Characteristics Behaviors of Professional Nurses
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Contributes to expansion of nursing's body of knowlege
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Characteristics Behaviors of Professional Nurses
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Provides leadership
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Characteristics Behaviors of Professional Nurses
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Uses principles of time management
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Characteristics Behaviors of Professional Nurses
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Represents the profession to the public
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Characteristics Behaviors of Professional Nurses
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Characteristics Behaviors of Professional Nurses
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Delegates responsibility wisely
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Models altruism
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Characteristics Behaviors of Professional Nurses
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Possesses self-awareness
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Characteristics Behaviors of Professional Nurses
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Demonstrates commitment to the profession
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Characteristics Behaviors of Professional Nurses
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Models healthy coping behaviors
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Characteristics Behaviors of Professional Nurses
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Demonstrates collegiality
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Characteristics Behaviors of Professional Nurses
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Characteristics of Professions
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Education takes place in a college or university
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Education is prolonged
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Characteristics of Professions
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Work involves mental creativity
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Characteristics of Professions
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Decision making is based largely on science or theoritcal constructs
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Characteristics of Professions
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Values, beliefs, and ethics are an integral part of preparation
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Characteristics of Professions
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Commitment and personal identification is strong
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Characteristics of Professions
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Workers are autonomous
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Characteristics of Professions
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People are unlikely to change professions
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Characteristics of Professions
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Commitment transcends material reward
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Characteristics of Professions
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Accountability rests with individual
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Characteristics of Professions
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Obtained from patients as they describe their needs, feelings, strengths, and preceptions of the problem
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Subjective Data
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Objective Data
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other types of data the nurse collects through observation, examination, or consultation with other care providers.
Data is measureable. |
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Pulse rate, Blood Pressure, Often called signs
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Objective Data
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Often called symptoms
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Subjective Data
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A universal intellectural standard by which problems are addressed and solved
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Nursing Process
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A method of critical thinking focused on solving patient problems in professional practice. A designated series of actions intended to fulfill the purposes of nursing, to maintain the patient's wellness
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Nursing Process
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Assessment
Analysis and Diagnosis Planning Implementation of planned interventions Evaluation |
Steps of the Nursing Process
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Early Definition of Nursing by Nightingale
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The importance of the observational skills of the nurse and the impact of the environment on health. Her definition recognized health promotion and health maintenance as important functions for nursing
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Nursing may be defined as that service to an individual that helps him to attain or maintain a healthy state of mind or body
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Virginia Henderson
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Her definition of nursing is perhaps the best known in the world due to its adoption by the International Council of Nurse
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Virginia Henderson
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"The unique function of the nuse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perfom unaided if he had the necessary stength, will or knowlege. And to do this in such a way as to help him gain independence as rapidly as possible
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Virgina Henderson
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The ANA position paper (1965)
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Educational preparation for nurse practitioners and assistants to nursing concluded that the BSN should be the minimum credential for entry into practice
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The actual contact with another person or the person's body or his or her property in an offensive, insulting, or physically injurious manner
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Battery
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Law that affects individuals (rather than state entites)
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Civil law
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Law that affects the state in its political capacity and so affects society as a whole
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Criminal Law
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Professional Negligence
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Malpractice
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Negligence in which the standards of a resonable and prudent person are elevated to the status of those of a professional person
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Malpractice
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Negligence
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(a) the commission of an act that a reasonable and prudent person would not do in a given stituation
(b) the failure to act when a reasonable and prudent person would do so |
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The licensure process is a police of the state
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Licensure
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A mandatory licensure law requires any person who practices the profession or occupation to be licensed
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Licensure
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What do all states have that is mandatory for the practice of nursing
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Licensure
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Negligence applied to the acts of a professional
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Malpractice
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A professional fails to act as a reasonable and prudent professional would have acted in similar circumstances
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Malpractice
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A nurse's actions will be judged against the nursing standard of care. This is a higher standard of care than a reasonably prudent layperson would be expected to uphold. This standard represents the minimum that would be expected of a nurse in a similar circumstance
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In determining Malpractice
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The responsibility of a nurse or other health professional for the care of a patient
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Malpractice
Duty of Care |
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Failure to perform the duty of care according to accepted standards of care
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Malpractice
Breach of Duty of Care |
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the failure to meet the standard of care resulted in an injury
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Malpractice
Proximate Cause |
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The injury is Proved
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Malpractice
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Major Categories of Neglience that result in Malpractice Lawsuits
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-failure to follow standards of care
-failure to use equipment in a responsbile manner -Failure to communicate - failure to document, including failure to note in the patient's medical record -failure to assess and monitor -failure to act as a patient advocate |
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Touching without consent or consent is present unless informed consent is given or implied by the patient. The patient may withdraw consent at any time
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Battery
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An implied contract through which a group (profession) informs society of the rules and principles of how they will function
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Code of Ethics
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Informs new professionals of the ethical positions accepted by other members of the profession and guides professional behavior
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Code of Ethics
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Modified intermittently to meet the changing demands of health care and society
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Code of Ethics
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Ethical Theories
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Deontology
Utilitarianism Virtue Ethics Principalism |
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An act is moral if it originates from good will
Doing one’s duty or honoring one’s obligations to human beings The intention of the action is important, not the consequences even if the consequence is negative |
Deontology
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Act Deontology – gather all facts and make a decision
Rule Deontology – principles guide our actions |
Deontology
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The moral value of an action is wholly independent from the consequences of an action
Rather than focusing on consequences, deontological methods emphasize duty as the basis of moral value Emphasize a principle of right action, or the right, over the good. |
Deontology
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Moral rightness of an action is determined solely by its consequence
Useful actions bring about the greatest good for the greatest number of people Example – triage in healthcare |
Utilitarianism
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Individual moral actions are based on innate moral value
Based on the virtues of faith, hope, charity and wisdom |
Virtue Ethics
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the emphasis is more on one’s character, the states of character from which actions flow, and actions that are in accordance with these states of character, rather than on any foundational principles from which practical judgments can be deduced.
Rather than deducing what it is good to do, an agent must be practiced in the performance of virtuous action in order to be able to judge right and wrong, good and bad. In this way, the order of moral knowledge is reversed in virtue ethics in so far as we must first do what is good in order to be able to recognize what is good. |
Virtue Ethics
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Based more on ethical principles versus ethical theory
Draws on the key principles of beneficence, nonmaleficence, autonomy, and justice |
Principalism
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begins with students entering nursing school. They have little background. They depend on rules and expectations because their practical skills are limited.
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Benner Stage of Nursing Proficiency
Novice or Stage 1 |
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learners have become marginally competent, can use theory and principles, and may have difficulty setting priorities.
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Benner Stage of Nursing Proficiency
Advanced beginners Stage II |
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learners have 2 to 3 year’s experience and begin to feel organized and efficient most of the time. They have mastered planning and goal-setting skills and can think abstractly and analytically. They can coordinate several complex demands simultaneously.
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Benner Stage of Nursing Proficiency
Competent practioners or Stage III |
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learners have begun to view patients holistically. They can recognize subtle changes in patient condition, set priorities with ease, and can focus on long-term goals, not merely the task at hand.
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Benner Stage of Nursing Proficiency
Proficient practitioners or Stage IV |
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learners perform fluidly. They grasp patient needs automatically. Their responses are integrated with actions and their expertise comes naturally. They have a “sense” of what needs to be done based on knowledge and prior experience
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Benner Stage of Nursing Proficiency
Expert practitioners or Stage V |
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(funded by the Carnegie Foundation in 1948), which recommended that basic schools of nursing be in universities and colleges and that efforts be made to recruit men and minorities into nursing education programs
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The Brown Report
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a process by which an agency of government grants permission to qualified persons to engage in a given profession or occupation. It is required of all who practice professional nursing.
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Licensure
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the validation of specific qualifications demonstrated by a registered nurse in a defined area of practice. It is voluntary and is sought by an individual nurse who wishes to demonstrate that his/her qualifications exceed minimal competence
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Certification
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Based more on ethical principles versus ethical theory
Draws on the key principles of beneficence, nonmaleficence, autonomy, and justice |
Principalism
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begins with students entering nursing school. They have little background. They depend on rules and expectations because their practical skills are limited.
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Benner Stage of Nursing Proficiency
Novice or Stage 1 |
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learners have become marginally competent, can use theory and principles, and may have difficulty setting priorities.
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Benner Stage of Nursing Proficiency
Advanced beginners Stage II |
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learners have 2 to 3 year’s experience and begin to feel organized and efficient most of the time. They have mastered planning and goal-setting skills and can think abstractly and analytically. They can coordinate several complex demands simultaneously.
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Benner Stage of Nursing Proficiency
Competent practioners or Stage III |
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learners have begun to view patients holistically. They can recognize subtle changes in patient condition, set priorities with ease, and can focus on long-term goals, not merely the task at hand.
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Benner Stage of Nursing Proficiency
Proficient practitioners or Stage IV |
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learners perform fluidly. They grasp patient needs automatically. Their responses are integrated with actions and their expertise comes naturally. They have a “sense” of what needs to be done based on knowledge and prior experience
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Benner Stage of Nursing Proficiency
Expert practitioners or Stage V |
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(funded by the Carnegie Foundation in 1948), which recommended that basic schools of nursing be in universities and colleges and that efforts be made to recruit men and minorities into nursing education programs
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The Brown Report
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a process by which an agency of government grants permission to qualified persons to engage in a given profession or occupation. It is required of all who practice professional nursing.
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Licensure
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the validation of specific qualifications demonstrated by a registered nurse in a defined area of practice. It is voluntary and is sought by an individual nurse who wishes to demonstrate that his/her qualifications exceed minimal competence
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Certification
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The Study of Nursing and Nursing Education in the United States, published in 1923, focused on the clinical learning experiences of student nurses, the hospital control of schools, and the lack of prepared nursing teachers.
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The Goldmark Report
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Significant signs and symptoms that are relatively short lived
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Acute Illness
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Symptoms tend to appear suddenly and progress steadily
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Acute Illness
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Recovery is typically rapid depending on the patient’s general condition
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Acute Illness
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Illness tends to develop gradually
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Chronic Illness
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Consists of ongoing health problems of a generally incurable nature, such as diabetes
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Chronic Illness
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May go through periods of remission and exacerbation
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Chronic Illness
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Stages of Illness
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Stage I: Disbelief and Denial
Stage II: Irritability and Anger Stage III: Attempting to Gain Control Stage IV: Depression and Despair Stage V: Acceptance and Participation |
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difficulty believing that the signs and symptoms are actually related to illness. Denial as a defense mechanism can cause a delay in seeking treatment
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Stage 1: Disbelief and Deniel
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Stage II: Irritability & Anger
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changes in ability to function results in anger either toward self or others.
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patient seeks medical attention or tries to control symptoms with home remedies or over-the-counter medications
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Stage III: Attempting to Gain Control
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illness leads to feelings of loss, resulting in depression. May experience loss of ability to work or play
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Stage IV: Depression and Despair
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Stage V: Acceptance and Participation
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patient acknowledges the reality of the illness and is ready to participate in treatment decisions. Ideally, this leads to feelings of mastery over the illness
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Influence of Culture on Illness Behaviors
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Meanings attached to health, illness, and perceptions of treatment
Timing of treatment-seeking behavior and choice of practitioner consulted The illness behaviors the individual is likely to use Customs of responding to people who are sick |
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What is Culture?
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The totality of socially transmitted behavioral patterns, arts, beliefs, values, customs, lifeways, and all other products of human work and thought characteristics of a population that guides its worldview and decision-making. These patterns may be explicit or implicit, are primarily learned and transmitted within the family, and are shared by the majority of the population
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Influence of Culture on Illness Behaviors
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Patterns of communication used by the sick individual
The role expectations of both the nurse and the patient Level of family involvement in the care Response to health care providers by patient and family members |
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Culturally Competent Nurse
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Takes cultural differences into consideration
Usually interprets patient behavior accurately Recognizes problems that need to be managed |
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Culturally Competent Nurse Cont'd
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Realizes that cultural norms must be included in the plan of care to prevent conflict between nurse’s goals and patient and family goals
Believes the time spent in cultural assessment is well spent and enhances positive patient outcomes Respectful of the attitudes and behaviors of patients of other cultures |
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Having the knowledge and skills about another culture to communicate effectively and know what questions to ask (Purnell)
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Culturally Competence
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Fatigue
Muscle tightness Tension Increased blood pressure Increased pulse rate Sleep disturbances Appetite disturbances |
Symptoms of Physical Stress
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Patient Center Nursing
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Do I refrain from taking about myself and my problems to patients and their families?
Do I always introduce myself to patients and families when I first meet them? When a patient or family member approaches me, do I immediately acknowledge them and turn my attention to them asap? Do I really listen when patients and family members attempt to express a problem or concern? Do I clarify patients’ reasons for refusing medications or treatments without becoming defensive or taking the refusal personally? Do I give prompt attention to all my patients, even those who are “difficult”? Do I make every effort to be pleasant and polite to patients, family members, co-workers, and students, even when I am having a bad day? Do I explain procedures to patients and take every opportunity to educate them about their medications and conditions? Am I alert to patient anxiety and attempt to “talk them through” anxiety-laden procedures? Do I project high self-regard through my professional image, which includes tidy hairstyle, clean and polished shoes, neat uniform, short nails, and conservative makeup/grooming. Do I recognize that I am accountable for both my actions and my omissions? Do I take every opportunity to lean, grow, and enhance my competence as a nurse? |
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Dorothea Orem
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Her 1959 definition captures the flavor of her later, more completely elaborated self-care theory of nursing: “Nursing is perhaps best described as the giving of direct assistance to a person, as required, because of the person’s specific inabilities in self-care resulting from a situation of personal health”
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Dorothea Orem
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She continued to develop her conceptual model over several decades, with the 6th edition of her work Nursing: Concepts of Practice published in 2001
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belief that nurses should do for a person only those things the person cannot do without assistance emphasized the patient’s active role
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Dorothea Orem
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Theory of Self-Care
Theory of Self-Care Deficit Theory of Nursing System |
Dorothea Orem
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Her model focuses on the patient’s self care capacities and the process of designing nursing actions to meet the patient’s self-care needs. In this model, the nurse prescribes and regulates the nursing system based on the patient’s self-care deficit, which is the extent to which a patient is incapable of providing effective self-care
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Dorothea Orem
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Orem's Model
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Diagnostic – the nurse initiates a diagnostic operation that begins with the establishment of the nurse-patient relationship.
Prescriptive – prescriptive operations occur when therapeutic self-care requisites are determined and the nurse reviews various methods, actions, and priorities with the patient. Regulatory – in regulatory operations, the nurse designs, plans, and produces a system for care. Systems range from wholly compensatory, which is the most comprehensive form of care for patients with few abilities to provide care for self, to supportive-educative, in which the patient has the ability to provide effective self-care, but needs to work with the nurse to further develop these abilities or acquire additional information to promote self-care |
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Orem's Model
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Prescriptive – prescriptive operations occur when therapeutic self-care requisites are determined and the nurse reviews various methods, actions, and priorities with the patient
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Orem's Model
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Regulatory – in regulatory operations, the nurse designs, plans, and produces a system for care. Systems range from wholly compensatory, which is the most comprehensive form of care for patients with few abilities to provide care for self, to supportive-educative, in which the patient has the ability to provide effective self-care, but needs to work with the nurse to further develop these abilities or acquire additional information to promote self-care
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Sojourn Truth
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African-american
A famous abolitionist Served the Union Army forces |
