Charter One Flashcards
Nursing
“Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from birth to death.”
Crimean War (1854)
British Army cared for the sick and wounded soldiers was abominable
Florence Nightingale, offered to take a group of 38 nurses to the Crimea to are for the wounded soldiers
As a result of Nightingale’s observations and reporting, social welfare programs for soldiers was created and mortality rates declined to 1%
Florence Nightingale received the Order of Merit from the Queen of England in 1907, for her contributions.
American Civil War (1861)
The start of formalized nursing training
Dorthea Dix, “Secretary of War
Clara Barton
Religious orders also provided volunteer care during the war.
World War I (1914-1918)
Army Nurse Corps and Navy Nurse Corps
Introduction of male nurses in US nursing programs
The American Red Cross served as the unofficial reserve corps of the Army Nurse Corps
The development of the Army School of Nursing, a formal, three year training program.
World War II (1941-1945)
In 1943, the Cadet Nurse Corps was formed
1943 Bolton Act: provided tuition and a stipend
Prohibition of discrimination on the basis of race & marital status
Nursing programs reduced from 36 months to 30 months.
Part-time nursing was acceptable
Volunteer training was offered
Military Nursing Changes:
Full commissioned statuses were granted
Male nurses were admitted as officers
The Nurse Training Act of 1964
Signed by President Johnson to combat the nursing shortage of the time.
4 principle elements:
Authorized a program of grants to build and renovate nursing schools
Established a program to help strengthen and improve nurse training programs and to help diploma schools meet the costs, hence, increasing enrollment
Expanded the existing program of advanced training of professional nurse
Established a loan program to help students tuition
Phases of Nursing
Phases of transition Role conflict Stages of change Factors motivating change Adjusting to change Transition phase: Novice Advanced beginner Competent Proficient Expert
The Evolution of the Nurse from Novice to Expert
Stage 1: Novice
Little, limited knowledge and experience; adheres to principles and rules; rigid or limited interventions. Clinical judgement is analytical and requires effort.
Stage 2: Beginner
Possesses a certain level of knowledge and experience which allows her to recognize the relevant aspects of a situation. Clinical judgement is analytical and guided by principles in a register of leads which is greater than that of the novice.
Stage 3: Competent
Nurse possesses 2-3 years of experience. Clinical judgement is faster, interventions are effective and planning is made in a long-term perspective. Nurse consciously and deliberately takes actions in anticipation of unforeseen events.
Stage 4: Proficient
Able to modify her actions to face unanticipated events. Knowledge can be transferred and applied in new circumstances. The overall judgement process is faster and requires less effort. Identifies priorities logically.
Stage 5: Expert
After 5 years of experience. Less analytical in approach; greater ability to summarize; greater intuition; faster and more self-confident in judgement.
Essential Nursing Knowledge
Empirical: stems from data perceived by the senses
•Conceptual: arises by associating
this data
•Rational: developed by applying thought to data
•Decision-making: used to make responsible decisions
Bloom’s 3 Learning Domains
Cognitive – Knowledge, or mental skills
Affective – Self, or emotional growth – having to do with feelings
Psychomotor – Skills, or the physical aspects of skills
Kurt Lewin Theory of Change
A German-American psychologist developed a 3-step process in regards to a model used to make changes within an organization.
Unfreeze:
Ensures that employees are ready for change
Change:
Execute the intended change
Refreeze
Ensures that the change becomes permanent
William Bridges, American author
3 Phases of Transitions:
Ending: (or losing, letting go), may experience denial, shock, anger
Neutral Zone: Accept, have hope, enthusiasm
New Beginning: and then on to this part
What are the characteristics of a professional?
Possesses a unique body of knowledge Specialized expertise Professional autonomy Educational requirements Unique code of ethics Accountability and responsibility Service to society
Mentors vs Preceptors
Role of a Mentor: encourage, support, and help with personal and professional growth.
Mentors can be set up either formally or informally
Preceptors: Formal, used during a specific period, responsible for training
A preceptor helps explain key policies and procedures for the nursing position specific to the organization.
National Council of State Boards ofNursing, (NCSBN, 2018),
the nurse will abstain from attaining personal gain at the patient’s expense and refrain from jeopardizing the therapeutic nurse–patient relationship.
Role differences between the LPN and the RN
The LPN contributes to the development of the plan of care while the RN designs and evaluates
Hildegard Peplau (1909-1999)
Psychiatric nurse: Developed “Interpersonal Relations Model”
4 phases of the educational, therapeutic, and interpersonal processes
Orientation - The person and the nurse mutually identify the person’s problem
Identification – The person identifies with the nurse, thereby accepting help
Exploitation – The person makes use of the nurse’s help
Resolution – The person accepts new goals and frees themselves from the relationship.
Dorothea Orem: Self-Care Model
Self-Care Model
The patients want to care for themselves; they are able to recover quickly and holistically by performing their own self-care.
The disadvantage: how time consuming the process is for the nurse. Staffing ratios don’t allow for such an extensive initial plan of care.
Virginia Henderson (1897-1996)
In 1937, co-created a basic nursing curriculum for the NLN
Education was “patient-centered & organized around nursing problems rather than medical diagnoses”
Conceptualized nursing role
A patient is a person who requires help toward independence
Importance of collaboration
14 components of Henderson’s Definition of Nursing
Breathe normally.
Eat and drink adequately.
Eliminate body wastes.
Move and maintain desirable postures.
Sleep and rest.
Select suitable clothes-dress and undress.
Maintain body temperature within normal range by adjusting clothing and modifying environment
Keep the body clean and well groomed and protect the integument
Avoid dangers in the environment and avoid injuring others.
Communicate with others in expressing emotions, needs, fears, or opinions.
Worship according to one’s faith.
Work in such a way that there is a sense of accomplishment.
Play or participate in various forms of recreation.
Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.
Martha Rogers
Nursing is a science and a art
Influenced by systems theory and electromagnetic theory
Person is a unified energy field which is continually interacting and exchanging matter and energy with its environment
Well being is reflected in patterns and the organization of an energy field
Nursing role to act, promote and facilitate symphonic interactions between man and environment by re-patterning the human and environmental energy field.
Sister Callista RoyThe Adaptation Model
Individual adapt to cope with stimuli from environmental
Stressors disrupt the state of equilibrium and illness results.
Physiological needs, self-concept, role function, and interdependent relations.
Assess patient’s coping and make changes if needed.
Systems Model: Betty Neuman
Focuses on the response a client has to an actual or potential stressor.
Stability/homeostasis occurs when the amount of energy that is available in a system exceeds the amount being used by the system.
The use of primary, secondary and tertiary nursing interventions
Nursing role: is to reduce the stress factors which threaten optimal functioning and assist individuals to respond by strengthening their normal and flexible lines of defense.
Theory of Caring: Jean Watson
This theory is based on three assumptions:
Caring is a universal social behavior
Care for the self is necessary before care for others
Care and love are the cornerstones of humanness
The nursing role in Watson’s theory is to emphasize the humanistic dimension of nursing that can only be practiced interpersonally.
Transcultural Nursing TheoryMadeline Leininger
Based on humanistic discipline and designed to serve individuals, organizations, communities, and societies.
Human care/caring is defined
Culturally competent care can only occur when culture care values are known and serve as the foundation for care planning
Ultimate goal: provide culturally congruent care
Theory of Goal AttainmentImogene King
3 open systems that interact with the environment:
Personal
Individual
Social
Nurses Role: assist individuals in performing daily activities, which include health promotion and maintenance.
King’s theory offers insight into nurses interactions with individuals and groups within the environment.
Sojourner Truth (1797-1883)
Abolitionist who worked with the Underground Railroad
Advocate for Women’s rights
Worked as a nurse 4+ years during the Civil War
After the war, Ms. Truth worked as a nurse and counselor for the Freedman’s Relief Association
Clara Barton (1821-1912)
American Civil War and directed relief operations.
Founded the American Red Cross
Influential in persuading Congress to ratify the Treaty of Geneva so the Red Cross could carry out humanitarian efforts in peace time.
Founded a Mission Soldiers Office to search for missing in action Civil War Soldiers
Dorethea Lynde Dix (1802-1887)
A key figure during the Civil War era.
Taught Sunday school in a jail and within that environment where she began to study the needs of mentally ill people.
Credited for the construction of state psychiatric institutions.
State mental institutions were built in an effort to insure more humane care for the mentally ill than could be delivered in prisons.
Named superintendent of the 1st Nurse Corp of the US army.
Mary Eliza Mahoney (1845-1926)
1st African-American graduate nurse in America.
Improved working and educational conditions for black nurses and combating racial discrimination.
An inspiration to the men and women of color who are part of the nursing profession.
Mildred Montag (1909-2004)
Development of the ADN program
ADN programs shorten the time needed to become a nurse
Proposed educating a technical nurse for 2 years to assist the professional nurse, whom she envisioned as having a BSN prepared RN.
Florence Nightingale (1820 – 1910)
A risk taker, advocate for patients, a planner, administrator, educator, researcher and healthcare reformer, a user of data to improve quality patient care, a professional nurse.
Differentiated care for the sick and well; emphasized the need for illness prevention.
Founder of modern nursing and the first nurse theorist.
Over 100 years ago, she defined nursing as, “the act of utilizing the environment of the patient to assist him in his recovery.”
She linked health with five environmental factors with health: pure or fresh air , pure water, efficient drainage, cleanliness, light, especially direct sunlight
Harriet Tubman (1820 -1913)
She was an abolitionist who was active with the Underground Railroad. aka “Moses of her people.”
She provided nursing care to both enslaved and former slaves in the Southern and Northern regions of the US.
Lavinia Dock (1858 – 1956)
A feminist, writer, and political activist.
She campaigned for legislation to allow nurses, rather than physicians, to control the nursing profession.
Ms. Dock was one of the founders of the National League for Nursing.
