Chapter 2- Growth of Nursing Flashcards
Florence Nightingale
“Lady with the lamp”
Cared for soldiers Crimean War
38 nurses to Turkey improve filthy conditions she found in British hospitals
Carried oil lamps on nightly rounds
Symbol: pin
1st pin given to Florence Nightingale
Awarded each of her nurses w/”badge of excellence”
Pinning ceremony: acknowledges nursing graduates as belonging to unique group and identifies them as new members of health-care community
Symbol: cap
Women were required to keep their heads covered
Prevalent in Hebrew, Greek, Roman cultures
Wisdom,faith, honesty, trust, dedication
Kept women long hair up and out of face and from being soiled
Symbol: service
Veil to white cap “service to others”
Florence Nightingale practiced during Victorian Era, her cap was similar to cleaning ladies because it covered her head better
Lillian Wald
Graduated from NY hospital training school in 1901
Henry Street Settlement: storefront health clinic in poorest sections of NY
Social reformer
American Red Cross Town and Country Nursing Service
1912 1st president of National Organization for Public Health Nursing
1st to put nurses in public schools
Isabel Robb
1881 NY to train as nurse
Director for raising standards of nursing in US
Implement grading policy
Reduced long training hours
Chairwoman for American Society of Superintendents of Training Schools for Nurses
1st president of group in Nurses Associated Alumnae of US and Canada later (ANA) American Nurses Association
Developed the American Journal of Nursing (1st for improvement)
Lavinia Lloyd
Professionalization and equality of women
Wrote 1st medication textbook
Believer poverty and squalor contributed to poor health- Social reformer to address problems
20 yrs women right to vote
Considered most influential leaders of early 20th century
Annie Goodrich
Educator
School inspector
US army own nursing school: serve as model for others established WW1
Vassar College: theoretical information
Dean at Yale School of Nursing
Loretta Ford
Officer in US Army Air Force 1943
Accepted into BS program at Colorado after war later became assistant professor here
Worked as pediatrician
Extending the role of nurse in health care community: blueprint for educational curriculums for NPs
Founding dean of University of Rochester School of Nursing
Director of Nursing Service at University Hospital
2003 Awarded Blackwell Award (1st female doctor in America)
2011 Women’s Hall of Fame transformed profession and made healthcare more accessible to public
Position
Group of tasks assigned to an individual
Job
Group of positions similar in nature and level of skill
Occupation
Group of jobs similar in type of work that are usually found throughout an industry or work environment
Profession
Occupation that requires prolonged preparation and formal qualifications
Meets higher level above occupation
Professional
Person who belongs to practice a profession
Professionalism
Demonstration of high level personal, ethical, and skill characteristics of a member of a profession
Process approach
All occupations are points of development into profession situated along continuum
ranging from position to profession
Power approach
How much independence of practice does this occupation have?
How much power does this occupation control?
Evidence based practice
Practice of nursing in which interventions are based on data from research
Appropriate and successful
Uncovering, evaluating, using info from research as basis for making decisions
National league of nursing (NLN)
Regulates quality of educational programs that prepare nurses for the practice of nursing
American Nurses Association (ANA)
Quality of nursing practice in the daily health-care setting
Powerful professional organizations
American Hospital Association
American Medical Association (AMA)
American Bar Association (ABA)
Specialty organizations
Represent specific area of practice
Lack sufficient political power to produce changes in healthcare laws and policies at national level
National Licensure Exam
Conducted by state under regulations contained in state’s nurse practice act
Job vs career
Nursing? Job or career
Job: group of positions similar in skill, carried out by more than one individual
Career: persons major life work, progresses and develops as person gets older
RN
Associates, diploma, baccalaureate
LPNs and UAPs
Licensed practical nurses and unlicensed assistive personnel work under RN supervision
NP
Direct client care
Focus on health promotion, prevention, early diagnosis, treatment of common health problems
Certified by American Nurses Credentialing Center (ANCC)
Responsibility: diagnosis disease, prescribe treatment and medications
Clinical Nurse Specialist (CNS)
Secondary or tertiary care
Acute illness or chronology condition
Graduate level and ANCC certified
High tech environments seriously ill
Educators & physician collaborators
Goal: combine CNS with NP
Advocates:
NLN
American Association of Colleges of Nursing (AACN)
ANA
Case managers
Coordinate services for clients high-rock or long-term health problems
Goal: coordinate health-care services in the most efficient and cost-effective manner as possible
ANCC developed certification eligibility criteria for nurse case managers
-physicians, social workers, RNs, well intentioned lay persons
Power
Ability or capacity to exert influence over another group or ppl
Getting people to do things they don’t want to
Power exerted by 1 person, another is affected
Empowerment
Increase in power that individual or group is either given or gains
Origins of power
Referent Expert Reward Coercive Legitimate Collective
Referent power
Establishing and maintaining close personal relationship with someone
Ability to change actions of another is an exercise of power
Good therapeutic relationships
Expert power
Knowledge, skill, expertise
Education and experience
Demonstrating knowledge of clients condition, recent laboratory tests, and other vital elements to patient recovery
Teach, counsel, motivate clients to follow plan of care
Power of rewards
Personal favors, money, expanded privileges, eradication of punishments
Influence client behavior and behavioral modification
Coercive power
Reprimand, withhold rewards, threaten punishment
Can destroy therapeutic and personal relationships
Unethical and often illegal
Legitimate power
Legislative or legal act giving individual or organization the right to make a legal decision
Political figures and legislatures
State board of Nursing: has access, established under nurse practice act of the state
Collective power
Underlying source for many other sources of power
Large group individuals have similar beliefs, desires, needs become organized
Politicians and lobbyists
Elements of reward, coercive, expert, referent sources
Increasing nursing power
Professional unity
Political activity
Accountability and professionalism
Networking
Professional unity
Most powerful groups are organized and united
Nurses need to belong to national nursing organization
Political activity
If nurses don’t make decisions legislatures will
Nurses know clients rights, national health insurance, quality of nursing care, third-party reimbursement, expanded practice roles
Accountability and Professionalism
Establish high quality client care
Accepting responsibility and setting standard to guide care
Nurses take power to govern nursing away from non-nursing groups
Networking
Never criticize “old boy” in public
Presentation of united front
Watson model of Human Caring
Jean Watson
Philosophical approach
Balance impersonal aspects of nursing care in technological and scientific aspects of practice
Personal and interpersonal elements of care that grow from humanistic belief in life
Client and family’s spiritual beliefs is essential element of health
Dorothy E. Johnson
Johnson model
See human behavior as being goal directed
Key to illness prevention: restore health when illness occurs
Client behavioral system: 7 distinct behavioral subsystems (4 structural elements each)
Credentialing
Process whereby individuals, programs, institutions are designated as having met minimal standards for safety and welfare of public
Early attempts at licensure: Florence Nightingale
First to establish formal list or register for graduates for nursing school
Early attempts at licensure: 1st organized attempt
1896
Nurses Associated Alumnae of US and Canada (now known as ANA)
Failed
Early attempts at licensure: international council of nurses
Required state to establish a licensure and examination procedure for nurses
Early attempts at licensure: NY
3 years
Licensure bill that passed legislature
North Carolina, New Jersey, Virginia followed
ANA Council of State Boards of Nursing
1945
Oversee development of uniform examination for nurses that could be used by all state board of nursing
NCLEX-RN
Origin: state board examination
National Council Licensure Examination
Mutual recognition Model for Nursing Licensure
Nurses licensed in one state to practice nursing in other states that belong to regional agreement
Eventual goal: universal license
Registration
Listing of license with a state for a fee
Licensure
Protect public health, safety, welfare by establishing professional standards
Minimal level of competency and safety
Permissive Licensure
Cannot write RN after name
Only protects “registered nurse”
Health-care administrators support idea because they can hire less educated and lower paid employees
Quality of care decreases
CNA/UPA
Mandatory Licensure
Licensure examination
Registered by SBN
technical level: LPN/LVN examination
Professional level: RN examination
Institutional Licensure
Rejected by major organizations
Individual healthcare institutions to determine which individuals are qualified to practice nursing without general guideline
Allow foreign graduate nurses to work in US without taking US Licensure exam
Lower cost & decrease quality of care
Reciprocity
Nurses move state to state can obtain Licensure by endorsement by having state recognize nursing license from original Licensure state
Certification
Granting credentials to indicate that individual has achieved a level of ability higher than the minimal level of competency
Individual certification
Most Common
Obtained by certain level of ability above and beyond basic level required
Written and practical exam required
American Nurses Credentialing Center (ANCC)
Certificates in 40+ areas
CEUs
Continuing education units
Organizational certification
External agency
Referred to as accreditation
Institution has met standards established by gvt or non gvt agency
Most hospitals: joint commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) JCAHO
Midwives
Prenatal examinations
Prenatal teaching
Deliver babies in uncomplicated pregnancies
APRNs
Advance practice registered nurses
Masters degree
21st century
ACA recognizes APRNs as equal partners in providing health care at multiple levels especially PRIMARY CARE
