Chapter 1-Evolution Of Nursing Flashcards
Accreditation
Process whereby a professional association or nongovernmental agency grants recognition to an institution or agency for demonstrated ability in a special area of practice.
For 20 years both NLN &NAPNES provided accreditation services, however recently NAPNES has stopped this service.
Approved program
Program that meets the minimum standards established by the state agency responsible for overseeing educational programs.
Articulation
Allows nursing programs to plan their curricula collaboratively, meant to reduce duplication of learning experiences and support process of progressive buildup.
One program is the foundation for another program.
Certification
Process in which an individual or institution, agency, or educational program is evaluated and recognized as meeting certain predetermined standards.
Health
A condition of physical, mental, and social wellbeing and the absence of disease or other abnormal conditions.
Health Care System
The complex network of agencies, facilities, and all providers of healthcare in a specific geographic area.
Holistic
Pertaining to the total patient care that considers the physical, emotional, social, economic, and spiritual needs of the person.
Holistic Health Care
A system of comprehensive or total patient care that considers the physical, emotional, social, economic, and spiritual needs of the person. The response to the illness and the effect of the illness on the person’s ability to meet self-care needs.
Illness
An abnormal process in which aspects of the social, emotional, or intellectual condition and function of a person are diminished or impaired.
Licensure
The granting of permission by a competent authority (usually a government agency) to an organization or individual to engage in a practice or activity that would otherwise be illegal.
In 1903 NC, NJ, NY & VA became the first states to require a license.
Patient
A recipient of health care services, usually thought of as a recipient who is ill or hospitalized.
Pesthouses
An overcrowded, dirty hospital.
Care was limited in scope, poor hygiene, providers were not trained resulting in high infection & mortality rates.
Portfolio
An organized account of an individuals education and professional accomplishments.
Wellness
A dynamic state of health in which an individual progresses toward a higher level of functioning, achieving an optimum balance between internal and external environments.
Factors that influence wellness include age, gender, family relationships, and economic status.
First school of nursing.
Who, where & when?
Theodore Fliedner
A German pastor in Kaiserwerth, Germany
In the mid 1800s
Established by the Lutheran Order of Deaconesses
Florence Nightingale
1820-1910
Joined Kaiserwerth program in 1851 at 31 years old. She became the superintendent of a charity hospital for ill governesses.
During the Crimean War, she & 38 other nurses went to Turkey to care for the wounded soldiers.
She changed the way soldiers were cared for in the Barrack Hospital. Units were cleaned and clothes were washed regularly.
She became known as the lady with the lamp because she carried a lamp during her night rounds.
She’s the first nursing theorist.
Nightingale (cont)
In 1860 she started the transformation for the nursing profession. Training lasted a year and records were kept on each student.
It became the model for for nursing in the 20th century.
Pastor Theodore Fliedner
From Germany. He established Nightengale’s alma mater. He came to the US with 4 trained deaconesses.
He helped establish the 1st Protestant hospital in the US. Called the Pittsburg Infirmary and is now called the Passavant Hospital.
The deaconesses began the first formal education of nurses.
American Medical Association
In 1869 recommended that every large hospital establish & support its own nursing school. Schools of nursing became established at the turn of the century & were modeled after the Nightingale plan.
Bellevue Hospital of Nursing
In New York in May of 1873 became established as the foremost proponent of the Nightingale Plan in the US.
Connecticut Training School
October 1873 opened in New Haven CT
Boston Training School
In November 1873, it began operating out of Massachusetts General Hospital.
Isabel Hampton Robb
They organized the American Society of Superintendents of Training Schools of Nursing in 1893.
They set educational standards for nurses.
American Society of Superintendents of Training Schools
In 1911 it became the National League for Nursing Education (NLNE, n.d.)
The organization developed & released their first curriculum plan.
Army & Navy Nurse Corps
Formed in 1917 during WWI
Army School of Nursing
Formed during WWI to help provide training to care for soldiers.
Cadet Nurse Corps
Formed during WWII to provide a shortened training program to meet the war efforts. Federally subsidized programs were also developed to offer men (for first time) and women an education.
The Association of Practical Nurse Schools
Founded in 1941 and was exclusively for PN. A multidisciplinary team of nurses, doctors, administrators, students & public figures, planned the first standard curriculum for PNs.
National Association of Practical Nurse Education
Changed in 1942 from the Association of Practical Nurse Schools. They focused on education & practice and came up with an accrediting service for schools of Practical Nursing and vocational nursing in 1945.
National Association for Practical Nurse Education and Services
Changed from National Association of Practical Nurse Education in 1959 to include Service. NAPNES is still in practice today.
Lillian Kuster
She founded National Federation of Licensed Practical Nurses in 1949.
It’s limited to Practical & Vocational Nursing.
NAPNES works with NFLPN to set standards, promote & protect interests of the PN/VNs, and educate & inform the public about them.
NLN
National League of Nursing
In 1961 they increased their scope of service and then established the Department of Practical Nursing Programs and developed an accreditation for them now called the Council of Practical Nursing Programs.
Mandatory Laws
New York was the first state to require mandatory testing for licensing. A state pool of test questions was adopted in 1945 by the state boards of 25 states. In 1950 it was required in all 50 states.
The Department of Vocational Education
In 1944 they made a complete study of PN/VN Nursing tasks. The end result being the difference between PN/VN and RN. As a result individual state boards of nursing started to specify the responsibility and duties of each nurse group.
ANA’s first position on education for nursing
Released in 1965. In it outlines for educational levels for nurses to enter practice.
2 year technical to be provided in technological & community colleges earn an associate’s.
Professionals could earn a BA.
Nothing about PN/VN was mentioned.
This paper helped bring a change in influence towards PN/VN.
Licensure for PN/VN Nursing.
Licensing laws have been made to protect the public from unqualified practitioners. In the mid 50s states moved towards mandatory licensing.
Nurse practice acts
Provides specific information about the scope of practice for the different nursing levels.
NCLEX-PN
National Council Licensing for Practical Nursing
Once passed licensure is given by the state of application.
Laws that monitor PN/VNs
Began in 1914 when state legislature in MS passed the first laws. The first laws were for RNs. PN/VN followed by 1955 all states had passed laws. After WWII, and more & more PN Programs.
Pass/fail no numerical grade given.
The State Board Test Pool of the NLN Education Committee
Established a testing mechanism for all the states and administered the test several times a year through out the country.
Once graduating from a state approved program students were able to sit for the exam. Once passing they became PN. VN in CA & TX
Today students are eligible to apply, the application needs to be approved by each state’s board of nursing.
Wellness-illness continuum
The range of a person’s total health. It’s forever changing and is influenced by the individual’s physical and mental condition and social well being.
Wellness at one end of scale and illness at the other end of spectrum.
Maslow’S model of health and illness
Developed in 1940s by Abraham Maslow. He believed that a person’s behaviour is formed by the person’s attempts to meet essential human needs, identified as physiologic, safety and security, love and belongingness, and esteem and self-actualization. He placed them on a pyramid raking to how essential each one is. Higher on the scale is not essential to life but to enhance life.
Physiologic
Nutrition, elimination, oxygenation, sexuality
The base of the pyramid. Essential for life.
Safety and security
Second in the hierarchy pyramid.
Stability, protection, security, freedom from fear an anxiety.
Love and belongingness
Third in the hierarchy scale.
Affection, acceptance by peers and community
Esteem
Forth in the hierarchy scale.
Self-respect, self-confidence, feelings of self worth.
Self-actualisation
The top of the hierarchy pyramid
Full use of individual talents.
Primary prevention
Illness prevention
Seeks to avoid disease through wellness activities and preemptive screening processes.
Secondary prevention
Recognizes the presence of disease but seeks to reduce the impact of the condition by encouraging behaviours to promote health.
(Dietary teaching to diabetics)
Tertiary prevention
The management of care for people with severe health problems who seek out to improve their quality of life and reduce further function loss.
3 levels of health promotion; promoting health through maintaining wellness, preventing disease related complications and reducing infirmity associated with disease states.
Primary prevention, secondary prevention and tertiary prevention.
Texhnologist
Refers to people with a BA
Technician
Refers to people with some training, who have an associate’s degree or a certificate.
Economic factors that affect health and illness
Rising healthcare costs, increased in senior people, advances in technology, health care insurance and malpractice insurance. And changes in the delivery system.
HMO
Health Maintenance Organisations
Multi system health care chains or networks that may include hospitals, clinics, nursing homes and pharmacies.
They share expenses and generally make the cost of operating expenses less.
Patient’s Bill of Rights
Issued in 1972 by the American Hospital Association. It ensures the patient’s fundamental rights for treatment with dignity and compassion.
It was revised again in 1990s and was replaced in 2003 when the AHA adopted the patient care partnership.
Patient care partnership
Patients get high quality hospital care, a clean and safe environment, get involved with their care & decisions, protection of privacy, and help with billing.
Health care providers’ rights
Patients will take an active role in the planning process, have understanding of the care and treatment given, ask questions, follow treatment plans, act responsibly with respect to their own conditions and give health care workers respect in order to actively participate in their care.
Interdisciplinary approach to healthcare
Health care personnelle work together to meet the needs of the patient.
Care plan
A document that outlines the individual needs of the patient and the approach of the health care team to have these needs met.
The plan is developed with the patient and with the patient’s family. It identifies who will assist in the treatment plan and is updated as the patient’s needs change.
Documentation
A permanent record of the patient’s progress and treatment.
It provides a progress of record treatment to everyone knows what treatments are being issued. It provides a chronicle of events that can be referenced throughout the patient’s healthcare needs.
Nursing models of care
Nursing, patient, health and environment
Nursing
Encompasses the roles and actions of the nurse
Patient
The individual who receives the care
Health
The area along the wellness-illness continuum that the patient occupies
Environment
The setting for the nurse patient interaction
Practical/Vocational nursing
The activity of providing specific services to patients under direct supervision of a RN or Dr.
Perform basic therapeutic, rehabilitation and preventive care.
Objectives & Characteristics of a PN/VN
Acquire specialized knowledge and skills needed to meet the healthcare needs of patients.
To graduate a state approved pn/vn
Program.
To take & pass the NCLEX-PN exam.
Assume responsibility of education, intensive study, and dedication to duty.
Roles and responsibilities of a PN
In 2007 NAPNES thèse responsibility:
Demonstrate professional behaviour of accountability and professionalism according to legal and ethical standards.
Effectively communicate with patients, families, And interdisciplinary health care teams- incorporating interpersonal & therapeutic communication skills.
Collect holistic assessment data from multiple sources, communicate to healthcare providers and evaluate patient responses.
Collaboration with RN or other members of the healthcare team and revise/plan treatment established by a nursing diagnosis, nursing protocols, assessments and evaluations.
Demonstrate a caring and empathic approach to the safe, therapeutic and individualized care of each patient.
Implement patient care, at the direction of an RN, Dr, or dentist through performance of nursing interventions or directing aspects of care to UAP.
PN never works independently. Only work independently when they offer input to the RN about the effectiveness for care or offer suggestions to improve care of the patient.
