Nursing Past and Future Nursing Today ● competent, caring professionals ● use critical thinking, communication, leadership, and advocacy to ensure patient safety ● Safe and effective nursing care ○ Caring is an essential aspect of nursing role ○ Florence Nightingale made a difference in care of soldiers that increased positive outcomes Nursing is - diagnosis and treatment of human responses to actual and potential health problems ● Thinking skills ○ critical judgement to evaluate patients ○ reflective thinking to analyze information ○ problem solving to find best patient outcome ● Important qualities ○ detail oriented ○ organized ○ listening skills ○ speaking skills ○ patience ○ competence ○ emotional stability ○ physical stamina ○ compassionate ● Recipients ○ patients ○ families ○ communities ● Patient care ○ direct - interaction between nurse and client ○ indirect - working on clients behalf to improve their health status Nursing Education 1) Diploma 2) ADN 3) BSN 4) Masters 5) Doctorate ● Associate degree - 2 years at community college ● RN to BSN bridge program ● Masters degree - 3 year program ○ include Advanced Practical Nurses (APN) who teach and function in independent roles eg. Nurse practitioners, educator and administrator ● Advanced Practice ○ include Doctors of Nursing Practice (DNP) and Doctors of Science in Nursing ● Patricia Benner's Nursing Phases ○ Novice - tasks oriented and focused on learning the rules ○ Advanced Beginner - recognize abnormalities in clinical situations○ competence - earned after 2 to 3 years, can deal with complexity and prioritize situations ○ Proficient - can give meaning to cluster of assessment data, adapt to change ○ Expert - trust their intuition, consulted on when others need help Purpose of nursing care ● goals = health promotion, illness prevention, health restoration, and end of life care eg. ICU nurse goals vs. hospice nurse ● Models of care ○ case method = total care, nurse provides all aspect of cave for one patient eg. intensive care , Labor and delivery ○ Functional Nursing = tasks assigned to a staff member with appropriate Knowledge and skills ○ Tcam nursing = RN assigned a nursing assistant to treat a group of patients ○ Primary Nursing = one nurse provides care for a group of patients ○ Differentiated practice = education and experience lead to differences in care delivered by nurses Healthcare delivery System ● Inpatient - admitted into a Healthcare facility ● Outpatient - person receives treatment at a healthcare facility but does not stay overnight ● Hospitals - most expensive and frequently used site for care ● Extended care facility - care for clients for an extended period of time eg. nursing homes or rehab facilities ● Ambulatory care facility - same day, cost effective care eg. Same day surgery, chemotherapy ● Home Healthcare agencies - care for patients after hospitalization in their homes ● Public health centers - provides care for the community ○ nurses provide care for at-risk populations at schools, church, shelters ● Independent living facility - designed for seniors who are independent and want to live in a community with other seniors ● Primary = health promotion and disease prevention ○ eliminate risk factors for development or exposure to disease ○ includes: prenatal, family planning, nutrition counseling eg. Prevent spread of HIV? Prevent obesity? ● Secondary = focus on early detection and treatment of disease/injury eg. Cancer screenings, genetic disease tests, emergent care ● Tertiary = attempt to eliminate disease or disability ○ provide comfort to terminally ill, maintain quality of life ○ specialized and highly technical care eg. Treatment for diabetes, excise cancer tumor, burn centers ● Preventive = educating clients to reduce and control risk factors ● Restorative = follow up care for restoring health eg. home health care, rehab center, nursing facility ● Continuing = treat chronic needs over a long period of time eg. palliative, hospice, in-home respite care● Funding ○ Medicare ■ clients over 65 years and those with permanent disabilities ○ Medicaid ■ clients with low incomes ○ Patient Protection and Affordable care Act ■ decrease health care cost, increase access to health care ○ State children's health insurance program ■ covers children under 19 at low cost ● Interpersonal Team ○ Nurse Practitioner - NP ■ advanced education and training based on specialty ■ care for patients with acute and chronic conditions ○ Physician Assistant - PA ■ diagnose and treat certain diseases and injuries ■ not individually licensed, practice under physician ○ Registered Nurse - RN ■ use the treatment plan outlined by provider to develop and implement care ■ administers medications, provides education, and modifies nursing plan ○ Licensed Practical Nurse - LPN ■ can giver certain medications, communicate client info to RN ○ Nursing Assistive Personnel -NAP ■ nursing assistive, aides, and technicians ■ under direct care of the RN ○ Pharmacists ■ prepare and dispense medications, included in treatment plan ○ Therapists ■ focus on the rehab of patients History ● 1st Nursing School 1873 ○ Bellevue Training School for Nurses in NYC ○ Connecticut Training School for Nurses in New Haven ○ Boston Training School for Nurses at Mass General in Boston ● Nursing School for Men ○ Mills School for Nursing and St. Vincent's Hospital School for Men in NYC 1888 ● Mary Eliza Mahoney (1845 - 1926) ○ at 33 began nursing training, one of the 1st women to be a doctor ● Henry Street Settlement 1893 ○ not for profit social service agency funded by nurse Lilan ○ rise in public health nursing ● Ancient Rome ○ care provided by Nosocomi men ● Early Religious Orderseg. Knights of Lazarus, St. Benedictine Saints ● Crimean War (1854 - 1856) ○ 38 volunteer nurses ○ Florence Nightingale travels to Turkey to help British soldiers ● American Civil War (1861 - 1873) ○ Sisters of Charity cared for wounded soldiers ○ Walt Whitman notable volunteer hospital nurse ○ President Lincoln established U.S. Sanitary Commission, and appointed Dorthea L. Dix Superintendent of Army Nurses ● Alexian Brothers (1866 - 1869) ○ 1st hospital in Chicago (1866),