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How has society influenced the history of nursing?
Early nurses were looked at as criminals. Late 1900 the nurse was looked at as an angel. After WWI many advancements in inflectional control were introduced.
What is meant by the phrase "the scope of nursing"?
- Healthy Choices (involved c community programs to promote health & wellness
- Prevent Illness by preventing disease
- Restore Health (direct care, dx activities, hcp consults)
- Care of the dying (home, hospice)
What is the purpose of Nurse Practice Act?
- NPA regulates the practice of a nurse in US and Canada.
- "To Protect The Public"
Identify the Roles of a nurse.
Caregiver, Communicator, Teacher, Client Advocate, Counselor, Change Agent, Leader, Manager, Case Manager, Research Consumer, Expand Career Roles
What are professional Boundaries?
Acting in the best interest of client, respect their dignity. Knowing what to say and how to act with each client
Violations of Personal Boundaries
excessive personal disclosure, Secrecy, Reversal of roles, Sexual Misconduct, Breach of Trust. Anything that results in client distress
What are some factors that influence nursing?
- Consumer Demands
- Family Structure
What is the purpose of the nursing code of ethics?
Inform the public of minimum standards. Provide a sign of the profession's commitment to public it serves. Outline the major ethical considerations. Guide the profession is self regulation. Remind nurses of the special responsibility they assume
Define values clarification. Behaviors that may indicate unclear values.
- ignoring HCP advice
- Inconsistent communication or behavior
- Numerous admissions for the same thing
- confusion or uncertainty about course of action to take
How can the nurse clarify his/her own values?
Nurse will need to reflect on the values they hold about their personal and professional life.
Know essential nursing values and behaviors.
- Human Dignity
- Social Justice
the concern for the welfare and wellbeing of others.
- the right of self-determination
- (the nurse must respect the clients right to make their own decisions about healthcare)
the respect for the inherent worth of and uniqueness of individuals and populations (A nurse must respect the values of the clients and colleagues)
acting in accordance with an appropriate code of ethics and accepted standards of practice (honest and care based)
acting in accordance with fait treatment regardless of economic status, race ethnicity, age, religion, disability or sexual orientation
Know the moral principles associated with nursing and the code of nursing ethics.
the specific accountability or liability associated with the performance of duties of a practice role
answerable to oneself and others for ones own actions
Telling The Truth
Faithful to Promise or Agreement
Do No Harm
One's Own Decision
What is an Advocate?
Someone who expresses and defends the cause of another
What are advocacy Roles.
- Inform Client of their rights
- Support Clients Decision
- Remain Objective
- Intervene on clients behalf, often by influencing others
Why do nurses need to practice critical thinking skills?
Clinically thinking nurses use clinical reasoning and clinical decision making to practice safe and effective nursing. They need CT to be safe, competent, skillful practioners
What are critical thinking skills?
- Inductive Reasoning
- Deductive Reasoning
- Critical Analysis
technique of questioning to look beneath the surface (questioning oneself)
Interpret Facts and form generalizations
Use generalized ideas, identify the facts
Question Oneself (Socratic Method)
Identify Critical Thinking Attitudes
- Self Aware
- Accepts Holistic Approach
- Fair and Open minded
- Intellectual Courage
- Confident and Resilient(sensitive to diversity)
- Courageous, flexible improvement oriented
What are ways a nurse problem solves?
- Trial and Error
- Research Process
Be able to identify Attitudes that Foster CT in a professional nurse.
- Intellectual Humility(aware of limit of knowledge)
- Intellectual Courage (willing to consider and examine ones own ideas or views)
- Perseverance (try and try again)
what is "s" subjective data?
What a client tells you (symptoms, feelings, perception of personal health)
What is "o" objective Data?
Data the nurse can measure, see or verify.
What is a primary source of data?
Data that client gives themselves
What is secondary data?
Data that comes from family members or medical records
What is the primary reason for interviewing?
to get information and set a rapport with the client
What types of interviewing techniques can be used to collect data?
What type of data is collected with Directive Interviewing?
highly structured ran by the nurse to get specific information (Triage)
What is nondirective interviewing? What Data is collected?
Open ended questioning that allows the patient to talk. "Builds Rapport"
Identify sources of client data.
Medical Records, Physical Exam, Lab reports, Documentation from other HCP
What is a FACT?
Something known to be true
the nurse's interpretation or conclusion made based on the cues.
subjective or objective data that can be directly observed by the nurse (what client says or what nurse can see)
Why does the nurse validate the client's assessment data?
Ensure data is complete, Obtain any info that was missed, Differentiate between cues and inferences, Avoid jumping to conclusion & focusing on the wrong direction
What are the Phases of the nursing process?
How does each phase influence the other?
each phase depends on the accuracy of the other phases
The difference between Nursing process and Medical Process
- Nursing Dx is the statement of nursing judgments, refers to a condition
- Medical Dx refers to disease
What are the sources of data collection?
- Primary-client Secondary-Family, friends, medical records
- Observation, Assessment, Interviewing,
What is a goal?
something that the client and hcp work towards
what is the difference between Goals and Desired Outcomes?
- goals are broad-improve nutritional status
- desired outcomes more narrow-client to gain 5lbs before April 25
What is the priority setting criteria?
- client's health
- clients priorities
- resources available to the nurse and client
- urgency of the health problem
- medical treatment plan
How are goals prioritized?
- Priority Setting
- Most important first
When does the evaluation phase occur?
What is the purpose of the evaluation phase?
To see if the desired outcome was met. Was the potential problem prevented? Does the care plan need revised?
What is conceptual model or conceptual framework?
- a model that organizes assessment data. A framework for health history to help see problems.
- ADPIE a systematic way to assess your client
What are the four sources of Law?
- Common Law
How do sources of law relate to the Nurse Practice Act?
NPA originates from Legislation, enforced by administrative law
Where is law created?
Where is the lae enforced
What is the purpose of the Nurse Practice Act?
NPA is designed to protect the public by defining nursing practice
How are standards of care used?
- internal and external job standards.
- internal- job desc, education, expertise, and policies
- external- NPA, specialty practice organizations, federal guidelines
What are Standards of Care?
skills and knowledge based by professional members. Protects consumers. Are legal guidelines for nursing practice. Evaluates quality of nursing care
What is informed consent?
- agreement by a client to accept a course of treatment or procedure.
- after being proved with complete info regarding benefits and risks
What are the 3 major elements that have to be satisfied before informed consent can be considered legal?
- Client must give consent of their own free will
- Client must have mental capacity & be competent to understand
- Client must be given enough info to make educated decision
Know the nurses responsibility regarding delegation of tasks
making sure the delegated task is given to a qualified person and making sure task is completed
What is the nurses responsibility regarding abuse/neglect and unprofessional conduct?
Nurse are mandated to report. they are legally required to report any situation to appropriate authorities
places client in unsafe position, committed when a nurse conducts their practice below standards
Extreme lack of knowledge, skill or decision-making that a nurse should have but did not display
professional negligence that occurs while a person is performing as a professional.
what are the six elements of malpractice?
- breach of duty
- harm or injury
The impaired nurse
If you now that a nurse is working under the influence of drug alcohol or mental issue you have to report it to protect clients, coworkers and the impaired nurse
The Americans with Disabilities Act
Prevents discrimination against persons with disability
- Health Information Privacy laws
- Laws that prevent people from sharing your personal information
Prevents retaliation to an employee if they report unsafe working conditions
Good Samaritan Act
laws designed to protect HCP who provide assistance outside of their workplace.
How can a nurse reduce their chance of liability?
Provide competent care. Be familiar with various job descriptions, make sure education id adequate for the position