chapter 1 nursing foundations

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Chapter 1

Nursing Foundations

Chapter 1

Nursing Foundations


Nursing Origins Nursing Origins

• Youngest profession but oldest art

• During the Middle Ages in Europe

• Schism between King Henry VIII and the Catholic Church


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


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


Question Question

• Is the following statement true or false?

Florence Nightingale advocated that nursing education should be lifelong.


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.


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


Nursing in the United States (cont’d)Nursing in the United States (cont’d)


Contemporary Nursing Contemporary Nursing

• Combining nursing art with science

• Integrating the nursing theory

– Nursing theories and application


Contemporary Nursing (cont’d)Contemporary Nursing (cont’d)


Contemporary Nursing (cont’d)Contemporary Nursing (cont’d)

• Defining nursing

– Nursing definitions by:

o Florence Nightingale

o Virginia Henderson

o American Nurses Association


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


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



• 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



• Practical/vocational nursing

– Abbreviated nursing program created during World War II

– Length: average between 12 and 18 months

– Shortest, most economical program



• 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



• 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




– 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




– 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




– Baccalaureate program

o Greatest flexibility in qualifying for nursing positions

o Preferred in areas requiring substantial independent decision making




– 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


The Educational Program (cont’d)The Educational Program (cont’d)


– Continuing education

o Planned learning experience beyond the basic nursing program

o Rationale for acquiring continuing education


The Educational Program (cont’d)The Educational Program (cont’d)


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.


Answer Answer

False.

Geographic location of a school is one of the factors that influences the selection of a nursing program.


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


• 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)



• 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



• Governmental response (cont’d)

– Grants to incorporate gerontology into nursing curricula

– Loan repayment programs for nursing students who agree to teach following graduation


• 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




• 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



• 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


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


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.


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


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


• Counseling skills

– Communicating with client

– Actively listening

– Offering pertinent health teaching

– Providing emotional support

– Using therapeutic communication techniques



• 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




• Comforting skills

– Provide stability and security during a health-related crisis

chapter 1 nursing foundations

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