Chapter 1 Nursing Foundations

1. Chapter 1 Nursing Foundations

2. Nursing Origins • Youngest profession but oldest art • During the Middle Ages in Europe • Schism between King Henry VIII and the Catholic Church

3. The Nightingale Reformation • The Crimean War • Nightingale’s contributions • Training people for future work • Selecting those with upstanding character • Improving sanitary conditions for sick and injured

4. The Nightingale Reformation (cont’d) • Nightingale’s contributions (cont’d) • Reducing death rate of British soldiers • Providing classroom assistance and clinical teaching • Advocating nursing education should be lifelong

5. Question • Is the following statement true or false? Florence Nightingale advocated that nursing education should be lifelong.

6. Answer True. Florence Nightingale advocated that nursing education should be lifelong due to continual technological advances, to demonstrate competence and ensure the public’s confidence, and to facilitate practice consistent with current nursing standards.

7. Nursing in the United States • U.S. nursing schools: • Differences between the Nightingale Training Schools and U.S. Training Schools • Expanding horizons of practice

8. Nursing in the United States (cont’d)

9. Contemporary Nursing • Combining nursing art with science • Integrating the nursing theory • Nursing theories and application

10. Contemporary Nursing (cont’d)

11. Contemporary Nursing (cont’d) • Defining nursing • Nursing definitions by: • Florence Nightingale • Virginia Henderson • American Nurses Association

12. The Educational Ladder • Basic educational options available: • Practical (vocational) nursing • Registered nursing • Factors that influence choice of nursing program: • Career goals • Geographic location of schools

13. The Educational Ladder (cont’d) • Factors that influence choice of nursing program (cont’d): • Costs involved • Length of program • Reputation and success of graduate • Flexibility of course scheduling

14. The Educational Ladder (cont’d) • Factors that influence choice of nursing program (cont’d): • Opportunity for part-time versus full-time employment • Ease of movement into next level of education

15. The Educational Ladder (cont’d) • Practical/vocational nursing • Abbreviated nursing program created during World War II • Length: average between 12 and 18 months • Shortest, most economical program

16. The Educational Ladder (cont’d) • Registered nurse • Works under direction of physician or dentist • Manages or provide direct care to client • Educates clients and the public re: Medical conditions • Delegates client care to LPN and UAP

17. The Educational Ladder (cont’d) • Registered nurse (cont’d) • Three paths • Hospital-based diploma program • Traditional route for nurse • Lowest number of diploma programs compared to other basic nursing educational programs

18. The Educational Ladder (cont’d) • Registered nurse (cont’d) • Hospital-based diploma program (cont’d) • Reasons for decline • Movement to increase professionalism in nursing • Hospitals no longer financially able to subsidize schools of nursing

19. The Educational Ladder (cont’d) • Registered nurse (cont’d) • Associate degree program • Aimed at shortening nursing education • Originally-proposed title of “technical nurse” • Would not be expected to work in a management position

20. The Educational Ladder (cont’d) • Registered nurse (cont’d) • Baccalaureate program • Greatest flexibility in qualifying for nursing positions • Preferred in areas requiring substantial independent decision making

21. The Educational Ladder (cont’d) • Registered nurse (cont’d) • Graduate nursing program • Master’s-prepared nurses: Clinical specialist, nurse practitioner, administrator, educator • Doctoral degree: Conduct research; advise, administer, and instruct nurses pursuing graduate and undergraduate degrees

22. The Educational Program (cont’d) • Registered nurse (cont’d) • Continuing education • Planned learning experience beyond the basic nursing program • Rationale for acquiring continuing education

23. The Educational Program (cont’d)

24. Question • Is the following statement true or false? The geographic location of a school does not have any implication in the choice of a nursing program.

25. Answer False. Geographic location of a school is one of the factors that influences the selection of a nursing program.

26. Future Trends • Factors contributing to nursing shortage: • Retirement rate exceeds replacement • Increased aging population requires health care • Disappointing salaries with longevity employment • Job dissatisfaction

27. Future Trends (cont’d) • Factors contributing to nursing shortage (cont’d): • Heavier workloads and sicker clients • Publicity about mandatory overtime • Downsizing nursing staff from dwindling revenues and managed care policies • Negative stereotypes

28. Future Trends (cont’d) • Governmental response • Loan repayment programs and scholarships for nursing students • Funding for public service announcements • Career ladder programs • Establishment of nurse retention and client safety enhancement grants

29. Future Trends (cont’d) • Governmental response (cont’d) • Grants to incorporate gerontology into nursing curricula • Loan repayment programs for nursing students who agree to teach following graduation

30. Future Trends (cont’d) • Proactive strategies • Pursuing post-licensure education • Training for advanced practice roles • Becoming cross-trained • Learning more about multicultural diversity • Supporting legislative efforts toward national health insurance

31. Future Trends (cont’d) • Proactive strategies (cont’d) • Promoting wellness: home health and community-based programs • Helping clients with chronic diseases • Referring clients with health problems • Coordinating nursing services across health care settings

32. Future Trends (cont’d) • Proactive strategies (cont’d) • Developing and implementing clinical pathways, standardized multidisciplinary plans for a specific diagnosis or procedure • Participating in quality assurance • Concentrating on knowledge and skills: manage health needs of older Americans

33. Question Which of the following is a factor contributing to nursing shortage? a. Job dissatisfaction b. Geographic location of schools c. Length of programs d. Reputation and success of graduate

34. Answer a. Job dissatisfaction Job dissatisfaction is a factor that has contributed to nursing shortage. Geographic location of schools, length of programs, and reputation and success of graduate are factors that influence the selection of a nursing program.

35. Unique Nursing Skills • Assessment skills • Following activities requires use of assessment: • Interviewing, observing, examining client and family; reviewing client’s medical record; obtaining facts from other health care workers

36. Unique Nursing Skills (cont’d) • Caring skills • Assisting with ADLs • Safe care of clients who require invasive or highly technical equipment • Helping client become self-reliant

37. Unique Nursing Skills (cont’d) • Counseling skills • Communicating with client • Actively listening • Offering pertinent health teaching • Providing emotional support • Using therapeutic communication techniques

38. Unique Nursing Skills (cont’d) • Counseling skills (cont’d) • Use active listening • Clarify client’s perspective • Teach clients: promote healing processes, staying well, preventing illness, and carrying out ADLs • Use empathy

39. Unique Nursing Skills (cont’d) • Comforting skills • Provide stability and security during a health-related crisis