Introduction to nursing Introduction to nursing practicepractice

A definition of nursingA definition of nursing

According to the American Nurses Association, According to the American Nurses Association,

““Nursing is the protection, promotion, and Nursing is the protection, promotion, and optimization of health and abilities, optimization of health and abilities, prevention of illness and injury, alleviation prevention of illness and injury, alleviation of suffering through the diagnosis and of suffering through the diagnosis and treatment of human response, and treatment of human response, and advocacy in the care of individuals, advocacy in the care of individuals, families, communities and populations.”families, communities and populations.”

What does it take to be a What does it take to be a nurse? nurse?

• KnowledgeKnowledge- biology, chemistry, math, - biology, chemistry, math, psychologypsychology

• SkillSkill- ability to start IV’s, insert catheters, take - ability to start IV’s, insert catheters, take blood pressuresblood pressures

• Cool head- Cool head- needed in times of crisisneeded in times of crisis• IntegrityIntegrity- high moral and professional standards- high moral and professional standards

• PatiencePatience- ability to take the time to listen to - ability to take the time to listen to patients and their familiespatients and their families

• EmpathyEmpathy- ability to understand another - ability to understand another person’s feelingsperson’s feelings

• KindnessKindness- consideration, caring and compassion- consideration, caring and compassion

Nursing is an art and a Nursing is an art and a sciencescience

• Nursing is a combination of scientific Nursing is a combination of scientific knowledge, compassion, and respect for knowledge, compassion, and respect for human dignity. human dignity.

• Nurses integrate science into practice Nurses integrate science into practice with patients in order to provide high-with patients in order to provide high-quality, effective health care quality, effective health care

• Nursing is hard work but provides many Nursing is hard work but provides many personal and professional rewardspersonal and professional rewards

Nursing is a professionNursing is a profession

• Nursing is not simply a collection of Nursing is not simply a collection of specific skillsspecific skills

• Nurses are not simply workers trained Nurses are not simply workers trained to carry out patient care tasksto carry out patient care tasks

• Nurses are trained professionals who Nurses are trained professionals who provide quality health care for patients, provide quality health care for patients, families, and communitiesfamilies, and communities

Nursing is a profession Nursing is a profession because…because…

• Nursing requires extensive education Nursing requires extensive education and trainingand training

• Nursing has a body of knowledge all its Nursing has a body of knowledge all its ownown

• Nurses provide a specialized serviceNurses provide a specialized service

• Nurses have autonomy to make Nurses have autonomy to make decisions in their practicedecisions in their practice

• Nursing has a code of ethics for practiceNursing has a code of ethics for practice

Professional performance Professional performance standardsstandards

• To ensure that the nursing To ensure that the nursing profession continues to provide high-profession continues to provide high-quality care to patients, families, quality care to patients, families, and communities, standards were and communities, standards were developed by the ANAdeveloped by the ANA

• These standards serve as These standards serve as benchmarks to define what is the benchmarks to define what is the professional practice of nursingprofessional practice of nursing

ANA ANA Professional Performance Professional Performance

StandardsStandards

• Describes expected professional Describes expected professional behavior for nursesbehavior for nurses

• Expectations for high-quality care and Expectations for high-quality care and collaboration among nurses and health collaboration among nurses and health care professionalscare professionals

• Serve as objective criteria for nurses to Serve as objective criteria for nurses to be responsible for their practicebe responsible for their practice

ANA ANA Standards of Nursing Standards of Nursing

PracticePractice

• Describe the proficient level of nursing Describe the proficient level of nursing carecare

• Describe expectations for use of nursing Describe expectations for use of nursing process in clinical practiceprocess in clinical practice

• Include nursing accountability for Include nursing accountability for patient teaching, culturally appropriate patient teaching, culturally appropriate care, planning of care, and collaborationcare, planning of care, and collaboration

Nursing educationNursing education

• Two types of undergraduate nursing Two types of undergraduate nursing programs are currently offered in the U.S.:programs are currently offered in the U.S.:• 2-year associate degree2-year associate degree• 4-year baccalaureate degree4-year baccalaureate degree

• Both programs prepare students to take Both programs prepare students to take the NCLEX-RN examthe NCLEX-RN exam• The national licensing exam for registered The national licensing exam for registered

nursesnurses• The NCLEX-RN exam is the same across the The NCLEX-RN exam is the same across the

U.S., so nurses can easily transfer licenses U.S., so nurses can easily transfer licenses from state to statefrom state to state

Nurse Practice ActsNurse Practice Acts• States have Nurse Practice Act documents States have Nurse Practice Act documents

that define the practice of nursing for that define the practice of nursing for that that particular state.particular state.

• Michigan does not have a “Nurse Practice Michigan does not have a “Nurse Practice Act” with that title- Act” with that title- MI Public Health Code MI Public Health Code and the MI Board of Nursing’s and the MI Board of Nursing’s Administrative RulesAdministrative Rules instead. instead.

• These documents are available from the MI These documents are available from the MI Department of Consumer and Industry Department of Consumer and Industry Services. Services.

Nursing professional Nursing professional organizationsorganizations

• American Nurses AssociationAmerican Nurses Association• Works to promote high standards of Works to promote high standards of

nursing practice and a positive, nursing practice and a positive, realistic view of nursesrealistic view of nurses

• National League for NursingNational League for Nursing• Works to promote excellence in Works to promote excellence in

nursing educationnursing education

Different types of Different types of nurses nurses

LPN:LPN:• Has 1 year of trainingHas 1 year of training• May follow doctors’ orders for simple May follow doctors’ orders for simple

procedures and giving drugsprocedures and giving drugs• May not plan care for patientsMay not plan care for patients• Some facilities allow LPNs to do Some facilities allow LPNs to do

admission assessments, others require admission assessments, others require RN to do so or co-sign LPN assessmentRN to do so or co-sign LPN assessment

Different types of Different types of nursesnurses

Nursing assistantNursing assistant• Also known as “CNA” or “Nurse aide”Also known as “CNA” or “Nurse aide”• Training requirements vary, but Training requirements vary, but

generally is few monthsgenerally is few months• Assist nurses with basic tasks such as Assist nurses with basic tasks such as

bed baths, feeding patients, taking vital bed baths, feeding patients, taking vital signssigns

• Are invaluable to nurses- treat them Are invaluable to nurses- treat them with respect and stay on their good side!with respect and stay on their good side!

Different types of Different types of nursesnurses

• Associate’s vs. Bachelor’s prepared Associate’s vs. Bachelor’s prepared RNsRNs• Both take same licensure exam Both take same licensure exam

(NCLEX-RN) to become RNs(NCLEX-RN) to become RNs• Same basic job dutiesSame basic job duties• May have the same pay scale in some May have the same pay scale in some

facilitiesfacilities• Major Major debate raging: that BSN should debate raging: that BSN should

be minimum for RN statusbe minimum for RN status

Associate’s degree RNAssociate’s degree RN

• 2-year program at a community college2-year program at a community college

• Fewer liberal arts classes required for Fewer liberal arts classes required for degreedegree

• No leadership content, minimal focus on No leadership content, minimal focus on critical thinking, professionalismcritical thinking, professionalism

• No nursing research content, minimal No nursing research content, minimal community health contentcommunity health content

Associate’s degree RNAssociate’s degree RN

• Generally expected to function in the Generally expected to function in the hospital, doctor’s office, or nursing hospital, doctor’s office, or nursing home settinghome setting

• Generally restricted to staff duties in Generally restricted to staff duties in hospitals- BSN usually required for hospitals- BSN usually required for management and supervisory positionsmanagement and supervisory positions

• Must complete BSN before starting work Must complete BSN before starting work on advanced practice nursing degreeon advanced practice nursing degree

Why BSN?Why BSN?

• A 2003 study by the AACN showed that A 2003 study by the AACN showed that patients in hospitals with mainly BSN-patients in hospitals with mainly BSN-prepared nurses had better outcomes prepared nurses had better outcomes than patients at hospitals with mainly than patients at hospitals with mainly ADN-prepared nurses.ADN-prepared nurses.

• BSN RNs are better prepared for BSN RNs are better prepared for complex decision making and critical complex decision making and critical thinking to handle patient emergenciesthinking to handle patient emergencies

Aiken, L., Clarke, S., Cheung, R., Sloane, D., & Silber, J. (2003). Aiken, L., Clarke, S., Cheung, R., Sloane, D., & Silber, J. (2003). Educational levels of hospital nurses and surgical patient Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, mortality. Journal of the American Medical Association, 290(12), 1617-1623.290(12), 1617-1623.

BSN-prepared nursesBSN-prepared nurses

• BSNs are better prepared to handle BSNs are better prepared to handle patient care, including:patient care, including:• Case managementCase management• Patient emergenciesPatient emergencies• Supervising nursing assistantsSupervising nursing assistants• Functioning as charge nurseFunctioning as charge nurse

• More career opportunities for BSN More career opportunities for BSN nurses:nurses:• Management and administrationManagement and administration• Specialty units and practiceSpecialty units and practice