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Chapter 1 Nursing Foundations. Nursing Origins. Youngest profession but oldest art During the Middle Ages in Europe Schism between King Henry VIII and the Catholic Church. The Nightingale Reformation. The Crimean War Nightingale’s contributions Training people for future work - PowerPoint PPT Presentation
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 1
Nursing Foundations
Chapter 1
Nursing Foundations
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Origins Nursing Origins
• Youngest profession but oldest art
• During the Middle Ages in Europe
• Schism between King Henry VIII and the Catholic Church
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Nightingale ReformationThe 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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Nightingale Reformation (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question Question
• Is the following statement true or false?
Florence Nightingale advocated that nursing education should be lifelong.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer 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.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing in the United States Nursing in the United States
• U.S. nursing schools:
– Differences between the Nightingale Training Schools and U.S. Training Schools
• Expanding horizons of practice
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing in the United States (cont’d)Nursing in the United States (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Contemporary Nursing Contemporary Nursing
• Combining nursing art with science
• Integrating the nursing theory
– Nursing theories and application
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Contemporary Nursing (cont’d)Contemporary Nursing (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Contemporary Nursing (cont’d)Contemporary Nursing (cont’d)
• Defining nursing
– Nursing definitions by:
o Florence Nightingale
o Virginia Henderson
o American Nurses Association
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational LadderThe Educational Ladder
• Basic educational options available:
– Practical (vocational) nursing
– Registered nursing
• Factors that influence choice of nursing program:
– Career goals
– Geographic location of schools
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)The Educational Ladder (cont’d)
• Registered nurse (cont’d)
– Three paths
o Hospital-based diploma program
Traditional route for nurse
Lowest number of diploma programs compared to other basic nursing educational programs
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)The Educational Ladder (cont’d)
• Registered nurse (cont’d)
– Hospital-based diploma program (cont’d)
o Reasons for decline
Movement to increase professionalism in nursing
Hospitals no longer financially able to subsidize schools of nursing
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)The Educational Ladder (cont’d)
• Registered nurse (cont’d)
– Associate degree program
o Aimed at shortening nursing education
o Originally-proposed title of “technical nurse”
o Would not be expected to work in a management position
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Ladder (cont’d)The Educational Ladder (cont’d)
• Registered nurse (cont’d)
– Baccalaureate program
o Greatest flexibility in qualifying for nursing positions
o Preferred in areas requiring substantial independent decision making
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The Educational Ladder (cont’d)The Educational Ladder (cont’d)
• Registered nurse (cont’d)
– Graduate nursing program
o Master’s-prepared nurses: Clinical specialist, nurse practitioner, administrator, educator
o Doctoral degree: Conduct research; advise, administer, and instruct nurses pursuing graduate and undergraduate degrees
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Program (cont’d)The Educational Program (cont’d)
• Registered nurse (cont’d)
– Continuing education
o Planned learning experience beyond the basic nursing program
o Rationale for acquiring continuing education
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Program (cont’d)The Educational Program (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
• 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.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer Answer
False.
Geographic location of a school is one of the factors that influences the selection of a nursing program.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Future TrendsFuture Trends
• Factors contributing to nursing shortage:
– Retirement rate exceeds replacement
– Increased aging population requires health care
– Disappointing salaries with longevity employment
– Job dissatisfaction
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• 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
Future Trends (cont’d)Future Trends (cont’d)
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Future Trends (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Future Trends (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• 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
Future Trends (cont’d)Future Trends (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Future Trends (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Future Trends (cont’d)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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question 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
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
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.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Unique Nursing SkillsUnique Nursing Skills
• Assessment skills
– Following activities requires use of assessment:
o Interviewing, observing, examining client and family; reviewing client’s medical record; obtaining facts from other health care workers
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Unique Nursing Skills (cont’d)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
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• Counseling skills
– Communicating with client
– Actively listening
– Offering pertinent health teaching
– Providing emotional support
– Using therapeutic communication techniques
Unique Nursing Skills (cont’d)Unique Nursing Skills (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• 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
Unique Nursing Skills (cont’d)Unique Nursing Skills (cont’d)
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Unique Nursing Skills (cont’d)Unique Nursing Skills (cont’d)
• Comforting skills
– Provide stability and security during a health-related crisis