Fundamentals of Nursing

11th Edition
 Nursing is ….
Art
Science
• Learning to deliver care with compassion, caring, • Nursing practice is based on a body of
and respect for each patient’s dignity and knowledge and evidence-based practices
individuality • Continually changing with new discoveries
• As you gain more experience and witness how and innovations
patients respond to your actions

Through integration of the art and science of nursing, the quality of care you provide meets
the highest standards and benefits patients and their families
Your care reflects your patients’ needs as well as the needs and values of society and
professional standards of care
Nursing offers personal and professional rewards every day
Nursing as a profession
• The patient is the center of your practice
• Including individuals, families, and/or communities
• Patients have a wide variety of health care needs, knowledge, experiences, vulnerabilities, and
expectations

Nursing is a profession:
To act professionally, you will use critical thinking, to administer high-quality evidence-based
patient-centered care in a safe, prudent, and knowledgeable manner
• Aka -person-centered care -focuses on needs and concerns of each pt​,treating patients with
dignity and respect- involving them decisions

You are responsible and accountable to yourself, your patients, and your peers
Career Options: clinical practice, education, research, management, administration, and
entrepreneurship
 Health Care Advocacy
• Groups recognize the importance of the role high-quality professional nursing plays in a nation’s health
care
• Robert Wood Johnson Foundation Future of Nursing: Campaign for Action (RWJF, 2014)
• Multifaceted campaign to transform health care through nursing
• Response to the Institute of Medicine publication -The Future of Nursing (IOM, 2010)
• In 2017 a new RWJF initiative- Catalysts for Change: Harnessing the Power of Nurses to Build
Population Health in the 21st Century
• Reinforces the fact that nurses are educated to consider health care issues within a broader context
• As a result -nurses identify factors outside of health care that affect a person’s level of health
• These initiatives prepare a professional workforce to:
• meet health promotion, illness prevention, and complex care needs of the population in a changing
health care system
Examples of Health Care Advocacy
• Future of Nursing: Campaign for Action • Stress First Aid Program to Enhance Nurse
• Pathway to Nursing-NJ Resilience and Retention Rates
• Grantee: University Hospital
• Grantee: RWJ University Hospital
Foundation, Inc. • Goals-raise awareness & resources for projects
• Goals-create a healthy work environment to reduce stress increase nurse well being
among RN mentors • Catalysts for Change: Harnessing the Power
• Increase the number of Hispanic RNs of Nurses to Build Population Health in the
21st Century

https://youtu.be/V_PnaXjVn2c?s
i=qUhSbJ2u9zzRzfNq
 Benner: Levels of Proficiency
Clinical expertise takes time and commitment
• According to Benner (1984), an expert nurse passes through five levels of proficiency

• Novice: Beginning nursing student /nurse with is no previous experience, learns via a specific set of rules
or procedures
• Advanced Beginner: A nurse with some level of experience may be only observational but is able to
identify meaningful aspects or principles of nursing care
• Competent: A nurse in the same clinical position for 2 to 3 years, understands the organization and
specific care required, is a competent practitioner, can anticipate nursing care & establish long term goals
• Proficient: A nurse with more than 2 to 3 years of experience in the same clinical position, is able to
assess an entire situation, can transfer knowledge from previous experiences, focuses on managing care as
opposed to managing and performing skills
• Expert: A nurse with diverse experience who has an intuitive grasp of an existing or potential clinical
problem, able to zero in on the problem, is skilled at identifying patient-centered problems and problems
related to the health care system & needs of the novice nurse
 Professional Practice:
American Association of Nurses (ANA )& International Nursing Council
(INC)

ANA Standards of Nursing Practice ANA Standards of Professional Performance

1. Assessment
• 15. Quality of Practice
2. Diagnosis • 7. Ethics
• 16. Professional Practice
3. Outcomes Identification • 8. Advocacy
Evaluation
4. Planning • 9. Respectful and Equitable Practice
• 17. Resource Stewardship
5. Implementation • 10. Communication
• 18. Environmental
5a. Coordination of Care • 11. Collaboration
Health
5b. Health Teaching & Promotion • 12. Leadership
6. Evaluation • 13. Education
• 14. Scholarly Inquiry
The Professional Nurse

Responsibilities and Roles Career Development

• Autonomy • Clinician
• Accountability • APRN
• Nurse Educator
• Caregiver • Nurse Midwife
• Advocate • Nurse Anesthetist
• Nurse Administrator
• Educator • Nurse Researcher
• Communicator • DNP
• Clinical Nurse Specialist
Historical Influences

Nurses
• Respond to needs of patients
• Actively participate in determining best practices
• Knowledge of the history of the nursing profession increases your ability to understand the
social and intellectual origins of the discipline
Florence Nightingale

• Established first nursing philosophy based on health

maintenance and restoration
• Organized first program for training nurses
• First practicing epidemiologist
• Improved sanitation in battlefield hospitals
• Practices remain a basic part of nursing today

*Notes on Nursing*
Civil War to the Beginning of the Twentieth Century

• Clara Barton
• Dorthea Lynde Dix
• Mary Ann Ball (Mother Bickerdyke)
• Harriet Tubman
• Mary Mahoney
• Isabel Hampton Robb
• Lillian Wald
• Mary Brewster
• Mary Adeline Nutting
 Twentieth Century

• Movement toward scientific, research-based practice and

defined body of knowledge
• Nurses assumed expanded roles
• 1906: Mary Adelaide Nutting was instrumental in moving
nursing education into universities
• Army & Navy Nurse Corps started
• 1920s: Nursing specialization began
• 1990: ANA established Center for Ethics and Human Rights
• 1994: University of Washington Medical Center became the
first Magnet®-designated organization
 Twentieth Century

Nurses are revising nursing practice & school

curricula to meet the ever-changing needs of society
• Aging population
• Cultural diversity
• Bioterrorism
• Emerging infections
• Disaster management
Contemporary Influences

• Importance of nurses’ self-care

• Compassion fatigue
• Secondary traumatic stress
• Burnout
• Lateral Violence
• Health care reform and costs
• Demographic changes
• Medically underserved
Trends in Nursing
Current philosophies of Nursing
• Holistic focus-health and illness
• Interaction with the family and community
• Increasing awareness of patient safety in all care settings
• Evidence-based practice-the best scientific evidence to apply to recurrent
patient health care problems
• Impact of emerging technologies
• EMR
• CPOE
• Genomics
• Public perception of nursing
• Impact of nursing on politics and health policy
• Professional nursing organizations and State Boards of Nursing
 Quality and Safety Education for Nurses
Goal of (QSEN) project is to meet the challenge of preparing future nurses and advanced
practice nurses to have the knowledge, skills, and attitudes (KSAs) necessary to continuously
improve the quality and safety of the health care systems within which they work
Competency
• Patient-centered care
• Teamwork and collaboration
• Evidence-based practice
• Quality improvement
• Safety
• Informatics

*ESSAY*
 Professional Registered
Nurse Education

Prelicensure- must pass NCLEX

• 2-year associate’s degree
• * NJ –BSN in 10*NC
• 4-year bachelor’s degree
Graduate education
• Master’s degree, advanced practice RN
• Doctoral preparation
• DNP
• PhD
• Continuing ED and in-service education
• State requirements

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 American Association of Colleges of Nursing (AACN)

The Essentials Domains • Domain 1: Knowledge for Nursing Practice

• Core Competencies for Professional • Domain 2: Person-Centered Care
Nursing Education • Domain 3: Population Health
• 10 Domains BSN guides faculty on the • Domain 4: Scholarship for Nursing Practice
structure and evaluation of the
curriculum • Domain 5: Quality and Safety
• Should be in the nursing curriculum. • Domain 6: Interprofessional Partnerships
• Domain 7: Systems-Based Practice
• Domain 8: Informatics and Healthcare
Technologies
• Domain 9: Professionalism
• Domain 10: Personal, Professional, and
Leadership Development
Nursing Practice
Nurse Practice Acts (NPAs) Professional Nursing Organizations
• Overseen by State Boards of Nursing • Address member concerns
• Regulate scope of nursing practice • Include specialty nursing organizations
• Protect public health, safety, and welfare • Present educational programs
• Publish journals
Licensure and certification • Student organizations include:
• Licensure: NCLEX-RN® examination • National Student Nurses Association (NSNA)
• Certification: requirements vary • Canadian Student Nurses Association (CSNA)
Social Media and Nursing

• https://www.ncsbn.org/video/soc • HIPAA violation –risk your and

ial-media-guidelines-for-nurses license &job
• fines ranging from $100 to $50,000

Don’t risk your license or your

reputation—nurses have to be
careful online!
This Photo by Unknown Author is
licensed under CC BY-NC-ND