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Stanford ANTHRO 48S - Nursing theory and process

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NursingTheory and processNursing practice is the actual provision of nursing care. In providing care, nurses implement the nursing care plan using the nursing process. This is based around a specific nursing theory which is selected in consideration with the care setting and the population served. In providing nursing care, the nurse uses both nursing theory and best practice derived from nursing research.[67] The nursing process is made up of five steps: 1.evaluate, 2. implement, 3. plan, 4. diagnose, and 5. assess. Nurses are able to use this process from the American Nurses Association to determine the best care they can provide for the patient. There are many other diverse nursing theories as well.[68]In general terms, the nursing process is the method used to assess anddiagnose needs, plan outcomes and interventions, implement interventions,and evaluate the outcomes of the care provided. Like other disciplines, theprofession has developed different theories derived from sometimesdiverse philosophical beliefs and paradigms or worldviews to help nursesdirect their activities to accomplish specific goals.Scope of activitiesActivities of daily living assistanceNurses manage and coordinate care to support activities of daily living(ADL). Often the provision of such care is delegated to nursing assistants.This includes assisting in patient mobility, such as moving an activityintolerant patient within bed.MedicationMedication management and administration are a part of most hospitalnursing roles, however, prescribing authority varies between jurisdictions.In many areas, registered nurses administer and manage medicationsprescribed by a professional with full prescribing authority such as a nursepractitioner or a physician. As nurses are responsible for evaluatingpatients throughout their care - including before and after medicationadministration - adjustments to medications are often made through acollaborative effort between the prescriber and the nurse. Regardless of theprescriber, nurses are legally responsible for the drugs they administer.There may be legal implications when there is an error in a prescription,and the nurse could be expected to have noted and reported the error. Inthe United States, nurses have the right to refuse any medicationadministration that they deem to be potentially harmful to the patient.[69] Inthe United Kingdom there are some nurses who have taken additionalspecialist training that allows them to prescribe any medications from theirscope of practice.[Patient educationThe patient's family is often involved in the education. Effective patienteducation leads to fewer complications and hospital visits.[71] Many times,nurses are very busy and have a hard time giving information to the patientbecause they have so many other things going on. Educating the patientand their family increases the chance for a better patient experience.[72]Giving the best care requires informing the patient of what is going on andsupport. While explaining procedure, recovery, and taking care of thepatient, nurses also have to help patients and their families cope withdifferent medical situations.[73]When speaking with the patient, nurses have to be able to communicate ina way that can be understood by the patient. Informing the patient mayinvolve speaking in broad, general terms, using visuals or different readingmaterials, and even including demonstrations if necessary. The more thepatient and their family understand what the nurse is saying, the betterhealthcare the patient can receive without the assistance of a nurse.Specialties and practice settingsNursing is the most diverse of all health care professions. Nurses practicein a wide range of settings but generally nursing is divided depending onthe needs of the person being nursed.The major populations are:● communities/public● family/individual across the lifespan● adult-gerontology● pediatrics● neonatal● women's health/gender-related● mental health● informatics (eHealth)● acute care hospitals● ambulatory settings (physician offices, urgent care settings, camps,etc.)● school/college infirmariesNurses with higher degrees allow for specialization within the medical field.There are many specific nursing professions that can be separated intocategories of care type, age, gender, certain age group, practice setting,etc. Nurses are able to specialize with a combination of these categories aswell.[1] There are also specialist areas such as cardiac nursing, orthopedicnursing, palliative care, perioperative nursing, obstetrical nursing, oncologynursing, nursing informatics, telenursing, radiology, and emergencynursing.Nurses practice in a wide range of settings, including hospitals, privatehomes, schools, and pharmaceutical companies. Nurses work inoccupational health settings[74] (also called industrial health settings), free-standing clinics and physician offices, nurse-led clinics, long-term carefacilities and camps. They also work on cruise ships and in the militaryservice. Nurses act as advisers and consultants to the health care andinsurance industries. Many nurses also work in the health advocacy andpatient advocacy fields at companies such as Health Advocate, Inc. helpingin a variety of clinical and administrative issues.[75] Some are attorneysand others work with attorneys as legal nurse consultants, reviewingpatient records to assure that adequate care was provided and testifying incourt. Nurses can work on a temporary basis, which involves doing shiftswithout a contract in a variety of settings, sometimes known as per diemnursing, agency nursing or travel nursing. Nurses work as researchers inlaboratories, universities, and research institutions. Nurses have also beendelving into the world of informatics, acting as consultants to the creation ofcomputerized charting programs and other software. Nurse authors publisharticles and books to provide essential reference


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