Chapter 1
Nursing Today
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
Historical Perspective Highlights
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Nurses:
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Respond to needs of patients
Actively participate in policy
Respond and adapt to challenges
Make clinical judgments and decisions about
patients’ health care needs based on knowledge,
experience, and standards of care
Nursing:
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Care is provided according to standards of
practice and a code of ethics.
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Florence Nightingale
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First practicing epidemiologist
Organized first school of nursing
Improved sanitation in battlefield hospitals
Her practices remain a basic part of nursing
today.
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Civil War to the Beginning of the
Twentieth Century
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The growth of nursing in the United States:
 Clara
Barton founded the American Red
Cross.
 Dorothea Lynde Dix
 Mother Bickerdyke
 Harriet Tubman
 Mary Mahoney
 Isabel Hampton Robb
 Lillian Wald and Mary Brewster: Henry Street
Settlement
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The Twentieth Century
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Movement toward scientific, research-based
practice and defined body of knowledge
1901: Army Nurse Corps established
1906: Mary Adelaide Nutting, first professor of
nursing at Columbia University
1908: Navy Nurse Corps established
1920-1923: Study of nursing education
1940s and 1950s: Associations emerged
1970: Emergency Room Nurses Organization
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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The Twenty-First Century
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Nursing code of
ethics
Changes in
curriculum
Nursing in multiple
care settings
Advances in
technology and
informatics
End-of-life care
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Influences on Nursing
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Changes in society lead to changes in
nursing:
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Health care reform
Demographic changes
Medically underserved
Threat of bioterrorism
Rising health care costs
Nursing shortage
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Nursing as a Profession
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A profession has characteristics:
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Requires an extended education
Requires a body of knowledge
Provides a specific service
Has autonomy
Incorporates a code of ethics
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Scope and Standards of Practice
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Nursing: Scope and Standards of Practice
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1960: Documentation began
Standards of Practice
Standards of Professional Performance
Goal
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To improve the health and well-being of all
individuals, communities, and populations through
the significant and visible contributions of
registered nursing using standards-based practice
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Standards of Practice
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Nursing standards provide the guidelines for
implementing and evaluating nursing care.
Six standards of practice:
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Assessment
Diagnosis
Outcomes identification
Planning
Implementation
Evaluation
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Standards of Professional
Performance
Ethics
Quality of
Practice
Professional
Practice
Evaluation
Education
Communication
Resources
EvidenceBased Practice
and Research
Leadership
Environment
al Health
Collaboration
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Code of Ethics
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A code of ethics is the philosophical ideals of
right and wrong that define principles used to
provide care.
It is important for you to incorporate your own
values and ethics into your practice.
Ask yourself: How do your ethics, values, and
practice compare with established standards?
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Quick Quiz!
1. Nursing is defined as a profession because
nurses
A. Perform specific skills.
B. Practice autonomy.
C. Utilize knowledge from the medical
discipline.
D. Charge a fee for services rendered.
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Nursing Education
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Professional registered nurse education
associate’s degree
 4-year baccalaureate degree
 2-year
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Graduate education
 Master’s
degree, advanced practice RN
 Doctoral degrees
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Continuing and in-service education
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Case Study
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Ming graduated with an associate’s degree in
nursing last year and currently works in a
long-term care facility. Although Ming enjoys
his work and has been promoted to shift
supervisor on his unit, he finds that he’d like
to pursue a nursing career that offers a
regular schedule and more autonomy than he
currently experiences at the long-term care
facility.
Ming considers returning to school for an
advanced degree.
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Nursing Practice
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Nurses practice in a variety of settings.
Nurses:
 Protect,
promote, and optimize our patients’
health
 Prevent illness and injury
 Alleviate suffering through the diagnosis and
treatment of human responses
 Advocate for the care of our patients
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Nursing Practice
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Nurse Practice Acts
Licensure and certification
Science and art of nursing practice
Benner’s stages of nursing proficiency:
 Novice
 Advanced
beginner
 Competent
 Proficient
 Expert
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Professional Responsibilities
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Nurses are responsible for obtaining and
maintaining specific knowledge and skills.
In the past:
 To
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provide care and comfort
Now:
 To
provide care and comfort and to emphasize
health promotion and illness prevention
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Professional Roles
Autonomy and Accountability
Caregiver
Advocate
Educator
Communicator
Manager
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Career Development
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Nursing provides an
opportunity for you
to commit to lifelong
learning and career
development.
{Fig 1-2 here}
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Case Study (cont’d)
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Ming is particularly drawn to the idea of
becoming an advanced practice registered
nurse (APRN).
 Ming’s
career options for becoming an APRN
include which of the following?
(Select all that apply.)
A. Physician assistant (PA)
B. Clinical nurse specialist (CNS)
C. Certified nurse midwife (CNM)
D. Certified RN anesthetist (CRNA)
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Professional Nursing Organizations
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National League for Nursing (NLN)
American Nurses Association (ANA)
International Council of Nursing (ICN)
National Student Nurses Association (NSNA)
or Canadian Student Nurses Association
(CSNA)
Other professional organizations focus on
specific areas.
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Quick Quiz!
2. The NLN and the ANA are professional
organizations that deal with
A. Nursing issues of concern.
B. Political and professional issues affecting
health care.
C. Financial issues affecting health care.
D. All of the above issues.
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Case Study (cont’d)
If Ming decides to pursue a career as an
APRN, which patient populations may he
serve?
(Select all that apply.)
A. Adult-gerontology
B. Prison inmates
C. Neonatology
D. Psychiatric mental health
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Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Quality and Safety Education for
Nurses (QSEN)
Competency:
Patient-Centered Care
Teamwork and Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Case Study (cont’d)
If Ming decides to choose a career as a
critical care CNS, then his specialty is
identified by which means?
A. Population
B. Setting
C. Disease specialty
D. Type of care
E. Type of problem
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Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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Additional Nursing Trends
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Genomics
Public perception of nursing
Impact of nursing on politics and health policy
Future trends
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc.
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