N110 Week 2 Flashcards
What social factors influence nursing?
Gender
The image of nursing
National population trends
Technology
Gender vs. Sex
_____ Biological
_____ Social
Sex
Gender
Men in nursing sometimes experience role strain. What is Role Strain?
Emotional reaction felt by a person in a profession that has a social structure dominated by members of the opposite sex
What are the motivations of men AND women for entering the nursing profession?
Help people
Profession with many career paths
Stable career
What is the purpose of the AAMN?
provide a framework for nurses as a group to meet, discuss, and influence factors which affect men as nurses
True or False:
Some nurses fear using formal titles with patients will be harmful to establishing relationships
True
True or False:
Nurses repeatedly score amongst the lowest of all professions in areas such as trust, respect, and prestige.
False “highest”
What was the purpose of the Woodhull Study of Nursing and the Media?
Survey and analyze the portrayal of health care and nursing in U.S. newspapers, magazines, and industry trade publications
What were the key findings of the Woodhull study of nursing and the media?
- Nurses are often invisible in the media
- Nurses were rarely cited in the media
- Often times a nursing source would have been more appropriate to use than the source that was used
What recommendations came out of the Woodhull study of nursing and the media?
- Nursing and the media need to be more proactive in establishing dialogue
- The media should change “ask your doctor” to “ask your health care provider”
- The media should better distinguish research “doctors” from medical “doctors”
- The media should include more information by and about nurses
What was the purpose of the Johnson and Johnson campaign?
enhance the image of nursing
How can nurses improve their image?
- Taking responsibility….
- Nurses must reinforce positive images
- Nurse must speak out against negative images
- Nurses (and nursing students) must always present themselves in a professional manner to reinforce the positive image of nursing
Which population uses a disproportionate share of health services compared to other age groups?
People over age 75 are more likely to be widowed, female, living alone, poor, and suffering from a chronic health condition
How has the nursing profession responded to the increase in the over 75 population?
- Gerontological nursing courses incorporated into pre-licensure nursing curriculum
- Gerontological specialty nursing certifications available as generalist, clinical nurse specialist, and nurse practitioner
True or False:
Projections indicate that the Anglo-American (white) culture will become a minority in the U.S. by the middle of the 21st century
True
How has the nursing profession responded to increased diversification in the US?
- Cultural education incorporated into education programs
- The American Association of College of Nurses recommends that baccalaureate nursing education programs be grounded in liberal education to prepare graduates to work with culturally diverse populations (2008)
- The nursing profession is making efforts to recruit more minorities into the profession
What technologic developments affect nursing?
- Genetics- course requirment
- Biomedical- increased use of high-tech equipment by nurses
- Information- computerized charting and medical records. Obama admin wants healthcare to go paperless.
- Knowledge- Use of technology to generate knowledge
True or False:
Early nursing programs were hospital based and awarded graduates a diploma. They existed to educate students rather than staff the hospitals.
False: existed to staff hospitals not provide education.
There are three different pathways to becoming an RN in the U.S. today. All graduates take the same NCLEX-RN to earn licensure. What are the 3 paths?
Diploma programs
Baccalaureate degree programs
Associate degree programs
What did the Brown report of 1948 recommend about nursing education?
that nursing education take place in colleges and universities rather than hospitals
Why can’t credits earned at diploma program be transferred to a college or university?
because hospital based programs are not part of the U.S. higher education system
What did the ANA recommend in 1965 regarding the minimum degree requirement to enter nursing?
baccalaureate degree
What two agencies perform voluntary accredidation for nursing programs?
- National League for Nursing Accreditation Commission (NLNAC)
- Commission on Collegiate Nursing Education (CCNE)
_______ validates knowledge and competency beyond licensure and is awarded by a certifying body.
Certification
_______ is required by most states to renew licensure and required by most certifying bodies to earn recertification
Continuing Education (CE)
What standards describe scholarship in nursing?
Scholarship of Discovery
Scholarship of Teaching
Scholarship of Practice (Application)
Scholarship of Integration
What is Scholarship of Disovery?
Inquiry that produces the disciplinary and professional knowledge that is at the very heart of academic pursuit
Provide examples of documentation of discovery.
- peer-reviewed publications
- presentations of research, theory, or philosophical essays,
- grant awards in support of research or scholarship
What is Scholarship of Teaching?
Inquiry that produces knowledge to support the transfer of the science and art of nursing from the expert to the novice, building bridges between the teacher’s understanding and the student’s learning
Provide examples of scholarship of teaching.
presentations related to teaching and learning, published textbooks or other learning aids
What is Scholarship of Practice?
Critical component in the maintenance of clinical competency and the advancement of clinical knowledge in the discipline
Provide examples of scholarship of practice.
professional certifications, degrees, and other specialty credentials, compiling and analyzing patient or health services outcomes
What is scholarship of integration?
- Refers to writings and other products that use concepts and original works from nursing and other disciplines in creating new patterns, placing knowledge in a larger context, or illuminating the data in a more meaningful way
- Emphasizes the interconnection of ideas, and brings new insight
Provide examples of scholarship of integration.
development of interdisciplinary educational programs and service projects
What are the Components of Scholarship in Nursing?
- Research
- Theory
- Evidence-Based Practice
- Nursing as a Body of Knowledge
What is Research?
Systematic investigation of phenomena (events or circumstances) related to improving patient care
Differs from problem solving
_____ ______ is specific to given situation and focuses on immediate action
Problem solving
________ is generalizable (transferable) to other situations and deals with long-term solutions to problems
Research
What are the priorities of the National Institute of Nursing Research (NINR)?
- chronic illness
- quality and cost effectiveness of care
- health promotion and disease prevention
- management of symptoms
- adaptation to new technologies
- health disparities
- palliative care at end of life
What are the 8 steps in the Research Process?
- Identify Problem
- Review literature
- Form question or hypothesis
- Design Study
- Implement
- Draw conclusion
- Discuss
- Disseminate
What is Theory?
Group of related concepts, definitions, and statements that describe a certain view of nursing
______ Encompasses Nursing Philosophies and Conceptual Models of Nursing
Theory
______ Theory of Interpersonal Relations in Nursing is Based on premise that relationship between patient and nurse is focus of attention, rather than the patient only as unit of attention
Peplau’s
What are the Goals of the therapeutic interpersonal patient-nurse relationship?
- survival of patient
- patient’s understanding of his or her health problem and learning from these problems as he or she develops new behavior
________ beleived nurses assist patients to develop new behaviors, but the nurse also develops a better understanding of the patient’s life stressors.
Hildegard Peplau
Who’s Theory:
-Focus is how nurses process their observations of patient behavior and also how they react to patients on the basis of inferences from patients behavior.
-Goal is to determine and meet patient’s immediate needs and improve their situation by relieving distress or discomfort.
-Nurse uses deliberate action to meet patient needs and provide care which will then achieve predictable patient outcomes.
Improves effectiveness of nurse
Orlando’s Theory of Nursing
______ Theory of Culture Care Diversity and Universality:
- Goal is transcultural nursing; Respecting culture of patient and recognizing the importance of it’s relationship to nursing care.
- Planning nursing care based on knowledge that is culturally defined, classified and tested and used to provide care in a culturally format.
- Encourages nurse to use creativity to discover cultural aspects of human need and use findings to make therapeutic decisions.
Leininger’s
Paplau’s main premise
relationship between patient and nurse is focus of attention
Orlando’s main focus
how nurses process their observations of patient behavior and also how they react to patients
Leininger’s goal
is transcultural nursing; Respecting culture of patient and recognizing the importance of it’s relationship to nursing care.
Philosophies are a _____ _____ of how something should work or be viewed.
broad explanation
_________ Philosophy (1859, Notes on Nursing: What It Is and What It is Not)
- Focuses on relationship of patients to their surroundings
- Set forth principles that were foundational to nursing including importance of observing the patient, accurately recording information, and principles of cleanliness
Nightingale’s
What does the metaparadigm of nursing include?
Person (rather than patient)
Health (as opposed to illness)
Nursing (as opposed to medicine)
Who’s philosophy?
(1966, The Nature of Nursing: A Definition and It’s Implications for Practice, Research, & Education)
“nurses do what patients would do for themselves”
-“unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or a peaceful death) that he would perform unaided if he had the necessary strength will or knowledge” (1966, p 15)
-Linked definition of nursing with list of 14 basic patient needs that are focus of nursing care.
Henderson’s Philosophy
Who’s philosophy?
- Work is recognized as human science that emphasized the caring aspects of nursing
- Proposed 10 Carative Factors which were contrasted with curative to differentiate nursing from medicine
- Viewed nature of nursing as human-to-human relationship
- Nurse and patient change together through transpersonal caring
- Equated health with harmony, resulting from unity of body, mind, and soul, for which the patient is primarily responsible
- Illness or disease is from lack of harmony
- Nursing based on human values and interest in welfare of others and concerned with health promotion, health restoration, and illness prevention
Watson’s Philosophy (1979, The Philosophy and Science of Caring)
Who?
Equated health with harmony, resulting from unity of body, mind, and soul, for which the patient is primarily responsible
Watson
What are Watson’s 10 Carative Factors?
- Formation of humanistic-altruistic system of values
- Installation of faith-hope
- Cultivation of sensitivity to one’s self and others
- Development of a helping-trust relationship
- Promotion and acceptance of the expression of positive and negative feelings
- Systematic use of the scientific problem-solving method for decision making
- Promotion of interpersonal teaching-learning
- Provision for a supportive, protective, and/or corrective mental , physical, sociocultural, and spiritual environment
- Assistance with the gratification of human needs
- Allowance for existential-phenomenological forces
Models make more specific ____ between concepts than philosophies
connections
Who’s model?
- focuses patient’s self-care capacities and process of designing nursing actions to meet the patient’s self care needs
- When a patient/client is not able to meet their self care demand, there is a self care deficit
- Goal of nursing is to help patients meet their self care needs
- Assumption is people want to be in control of their lives
Orem’s Self Care Model
Who’s Theory/Model?
- Emphasis on interactions between personal, interpersonal and social systems which influence behavior
- Health is continuous adjustment to stressors through the use of one’s resources
- Illness is a deviation from normal
- Focus of nurse is on phenomena of importance to the patient; unless attention is paid to concerns of the patient, mutual goal setting is unlikely to happen
- View whole person in their family and social contexts
- Nursing outcome is goal attainment
King’s Theory of Goal Attainment
King’s Theory of Goal Attainment
Nursing outcome is goal attainment
Who’s Model?
- Focuses on individual as a biopsychosocial adaptive system; Human beings adapt to their internal and external environments
- Effective adaptation responses promote integrity of individual by conserving energy, and promoting survival, growth, mastery of human system
- Person is adaptive system with physiologic, self-concept, role function, and interdependent roles
- Model may be used with individuals, family, group, social organization, or communities
- Nursing is humanistic discipline that emphasizes the person’s person’s adaptive or coping abilities
Roy’s Adaptation Model
Roy’s Adaptation Model
Nursing is humanistic discipline that emphasizes the person’s person’s adaptive or coping abilities
- _____ approach: choose the one theory that is consistent with your beliefs
- ______ approach: develop your own model by integrating several theories
- ______ approach: choose the best theory for the situation
- Coherence
- Integrative
- Reflective
What?
- using the best available research findings to make clinical decisions that are most effective and beneficial for patients (Cope, 2003)
- Bridges gap between research and practice
- Requires nursing to be cognizant of the research that supports specific interventions
- Base practice on published work or reliable sources
Evidence-Based Practice
How can Nursing support it’s own evidenced based practice?
- Pursue continuing education
- Attend conferences, read journals, become member of professional organizations
- Raise questions regarding best practices related to procedures and routines in your role as direct caregiver
What are the 7 levels of Evidence?
Level 1- ideas, editorials, letters, opinion papers
Level 2- case reports, case studies, reports
Level 3- information based on lab studies
Level 4- information based on animal studies
Level 5 & 6- studies involving human subjects i.e. systematic research reviews, research based protocols, clinical practice guidelines
Level 7- clinical trials “gold standard”
Why is Level 7 of Evidence difficult to achieve?
due to the ethical issues surrounding hospital settings and patient care (IRB approval and placebo use)
What key factor indicates nursing as a body of knowledge?
Nursing uses own research, theory, and evidence-based practice as cornerstone of professional knowledge and foundation of scientifically based nursing practice
