all right so if you are listening to these recordings in order then this is going to be the your introduction to this course and how to listen to these recordings and how to interact with this I'm going to give you guys a couple of tips um you can take them or leave them obviously but I just want you guys to have an idea of how I'm hoping you utilize these recorded lectures to prepare to come into class and engage with the material a little bit deeper in there so my hope is that you're not a detached Observer just kind of letting the slides go by and saying oh pretty picture and not really listening to them so I want you really to try and engage with it's really easy to tune out on a recorded lecture and I totally get that so my suggestion is that you have your book open you'll hear me as we go through these lectures you'll hear me flipping Pages because I have the book open in front of me um I encourage you to either print out the slides and take notes on them use notability have a notepad take notes on your iPad whatever works for you but take some kind of notes that when we get together and we do to kind of the deeper work on this so we're either going to do case studies or group work have discussions we're going to do something to engage with this material a little bit more so that it kind of comes to life I want you guys to bring your questions in as well because not all of this is going to be clear to you the first time around so what questions did this bring up did it bring up something that you've seen in practice during your own work or volunteer time that doesn't quite align with what I'm saying I'm very open to all of that you're going to get out of this class what you put into it so I want you guys to be as engaged with the material as possible and then come into class and be as engaged as possible some of the content is more straightforward than others so for some of it all I'm going to say is what questions do you have and if nobody has any questions then that's all we get we don't have any more conversations we don't dig any deeper so I really want you guys again to bring in questions even if they're contrary to what I'm saying or what the book is saying that's healthy so you know having a little bit of debate and discussion and clarifying A little bit that's all very good so please come into class prepared with that and if you find yourself zoning out on these recorded lectures the nice thing that's different from you know your actual in-person lectures is you can hit pause on this walk away go get yourself a soda get a glass of water whatever that is Shake It Off come back and be refreshed so if you find yourself tuning out please just give yourself a break and then come back so that you stay engaged with the material while you're actually listening so it's time well spent um all right so the other thing that I'll have you guys take a look at this before we jump into the chapter too much so you'll notice the two murals on the front they're beautiful um they depict nursing in a very positive light I would say these are murals that popped up during the pandemic um but I want you guys to look at them and just think we're not I'm not trying to say that nurses are angels or heroes or you know anything along that line um but I think it's nice to see that the community respected what nurses did and really recognized that during a time when everybody else was kind of standing back and cowering nurses were stepping forward and taking care of everybody but I don't want you to feel like this picture on the right where you feel as if you have the weight of the entire world as your response responsibility as a nurse because by no means should we be taking that on the other thing on this slide that I include and you'll see I include this lots of places whether it's in our in-person lectures or our recorded lectures it's a quote from Florence Nightingale and I tend to include a lot of quotes because I just think people are able to say things a little bit more eloquently than I am and I appreciate looking at those What's significant about this one here is that Florence Nightingale was a nurse a very very long time ago um she was a very very Progressive woman in not a very Progressive time and so for her to look and say that unless we're really taking efforts to move ourselves forward and to learn and to keep learning that we're going backwards is really a unique statement when you consider the fact that when she came into nursing there were no nursing schools there were no nursing textbooks there was no nursing research those are all things that have come as a result of her starting all of that basically but now this is even more true than it was in her time in that things changed so quickly we have to stay relevant we have to keep learning so if you came into this thinking that the end of your program you've got rnbsn after your name and you're done learning thank goodness let's throw all that stuff out I'm Never Gonna Learn again you're going to be so disappointed because in nursing you're always learning whether it's learning on the job or it's your continuing education units that you're required to do whether it's your specialty certifications that you should be getting or whether it's formal education are you going back for a master's are you going back for a nurse practitioner all of us are going to keep learning a really unique example of that again going back to the pandemic is the learning that we had to do through that they changed how we did almost everything in nursing so we really had to learn on the go we had to adapt it even changed how we as Educators had to educate our students when we're you know including virtual simulations instead of in-person simulations so definitely as nurses you have to be willing to be adaptable and be willing to change and to continue learning we're going to move into the objectives here in just a second um and we're also going to take a look I wanted to show you guys before we move into that I wanted to have you guys because I'm hoping you'd listen to me and had your book open I want you to take a look down at chapter one and look at the very first sentence nursing is an art and science you will see this throughout this course we'll talk about those two components the art and the science because we have to balance those um so once you kind of keep an eye on that because we'll talk about that in this lecture too um and then um we'll move in and look at the objectives next so when you look at the objectives if I can show them to you you'll see that those align with the objectives that are in chapter one so generally the objectives for the recorded lectures will generally come from your Potter and Perry I sometimes will pull something even though your API book doesn't have specific objectives I might make an objective out of a section that they cover that your Pottery book doesn't or something that I think is important that isn't covered in your book so they don't always align in this case they actually do a line pretty well I'm not going to read them to you but I want you to use them as a guide so at the end of this if you still have no idea what the professional roles or career options are for nurses then I'm going to say you zoned out for a minute here so go back and listen to the recorded lecture again go back into your book um and and we'll kind of move forward that way so hopefully that will help you guys organize how you study the other thing I'll tell you is for test questions which again I I don't want to teach to the test but I want you guys to have a little bit of an idea of what you're going to be tested on these objectives are a lot of what I think is really important in these chapters and generally what I think is really important is what I write to ask questions about so I'm going to say that a fair number of your test questions are going to be based around these objectives so they're a pretty good study guide for you as well doesn't mean that the other objectives that I don't have highlighted in my book or aren't included on this slide are not important and that there wouldn't be a question from those but there's definitely going to be areas that focus on the things that I have selected as objectives so hopefully that helps you guys a little bit so if you look at that very first page in your book the first thing that your book does is talk about nursing as a profession and it talks about the patient being the center of your practice and that definitely we have to keep in mind all along but it also talks about what it takes to be a professional nurse and how you have to use your critical thinking skills and ultimately we'll talk about clinical judgment um he talks about how you have to administer patient-centered care absolutely be responsible accountable we'll look at some of those terms and if we move through this content as well and make sure you understand truly what that means another really important part of nursing as a profession and success as a professional nurse is knowing what you can and cannot do so that second bullet point that talks about scope of professional nursing practice is huge so scope of practice means what you are legally allowed to do so you want to make sure that you know as a nurse what you are legally allowed to do you want to make sure that you know as a nursing student what you are legally allowed to do if you work as a nursing assistant or a PCT and you also are a nursing student you have to know what you can do when you're a nursing student and what you can do when you're at ECT because those are two different things and that's under your scope or practice for each of those roles so we'll spend some time especially in our final week when we talk about legal we'll spend some a lot of time talking about scope of practice but it's going to be important for you guys throughout you also have to be aware how your nursing care can impact and influence the life of your patient the family the community that's a big deal so knowing that you're not just working in a silo what you do what you say how you act that's going to affect your patient and everyone around them and then also talking about nursing as a profession we really are talking about again this is kind of a higher level but that it's important for us to um recognize that high quality nursing care plays a role in our nation's health care and we'll talk when we get into the definitions of nursing a little bit about how we're now looking at nurses in kind of a bigger role not just taking care of patients in the clinic or in the home or in the hospital but looking at what our role can be in National policy National advocacy and that's that's a big deal when you look at I put the Robert Wood Johnson foundation on here because they're really huge within nursing and health care of Advance trying to advance what we do especially what we do as nurses they're very active with that and they published a paper it's quite a mouthful that they published a paper not too long ago called Catalyst for change harnessing the power of nurses to build population Health in the 21st century and again I know that's a mouthful but what they really looked at and what they tried to to reinforce is that nurses are educated to consider Health Care issues within a much broader text and so we're really well positioned to look at what can we do to impact the nation's health care what kind of policies do we need in place and that's not a role that nurses have seen themselves in previously so that's kind of interesting to think about but it is a big deal we're going to look at next a couple of things that make nursing a profession not a couple of few more so there's definitely as your book says there's not one factor that absolutely differentiates a job from a profession but the difference is still really important in terms of how you practice so nursing is a profession because we share the characteristics of a profession and those characteristics are the things that you see on your slide there so as nurses we're definitely educated and trained to care for others we use a theoretical body of knowledge to guide develop our skills Define abilities of practice within clear Norms sorry there's a trash can rolling down the street so I'm going to take just a pause to let that trash can have its parade foreign then we'll go to bullet point three and definitely you're providing a service to others right you'll notice that's the only one I didn't bold because that alone doesn't none of these alone Define a profession but that is shared with everybody who does anything right if you're a barista you provide a specific service if you are a dog walker so while it's important to have that these other things are kind of the things together that make it more of a profession so you definitely will have autonomy and decision making in practice so anybody who entered nursing thinking that you were if someone was always going to be telling you what to do so it's kind of a safe career I'm going to tell you that's not the case a lot of times we're making decisions on our own and we have to use our clinical judgment and our critical thinking and then also take accountability and responsibility for the decisions that we make definitely you must adhere to the standards of professional practice and performance and we'll go over again what those look like and then we have a code of ethics that guide our um our practice so that's a big deal as well so if your book actually says it very well it says nursing is not simple it's not a simple collection of specific skills and you're not simply a person trained to perform specific tasks and that's very very true right so you it's this whole piece all these different pieces that come together that make you a nursing professional not just that you know how to start an IV or hand somebody a bill um so making sure that we look at that um all right so I'm going to move into I have plot the plot the Florence Nightingale quote in here just um because I wanted to kind of highlight again the same thing that I said at the very beginning of nurse being nursing being an art and a science so as we go through these we're going to look at the next slide at the scope and standards of practice we're going to look at definitions we're going to look at all of that but I wanted you to keep in mind that again that Art and Science piece of it so if you look at the quote from Florence Nightingale here she's talking about how we as nurses need to be even more devoted and even more prepared for what we do because we're not dealing with Canvas OR marble we're dealing with the living body the Temple of God's spirit so we're really we're taking care of living people that is a big deal and so yes it's an art it's one of the finest arts and again in her time nursing was much more art than it was science she was actually one of the Pioneers who brought it from art towards science but that's been a gradual progression so if you look at the art of it that involves learning how to deliver care with compassion and empathy caring the respect for each person's dignity and individuality and so that's what we call kind of the art of it the science of it is more where we base our practice on a body of knowledge on evidence-based practice and that's continually changing with new discoveries and new Innovations and we have to like I said before be flexible and willing to change with that it's interesting when you think of like I said it was much more of an art in Florence nightingale's day it stayed that way for a while and then we started to have all these technical advances and if you look at what a nurse in an ICU does these days you know we can be running a continuous dialysis machine at the same time as a ventilator at the same time as having you know seven eight nine ten vasoactive drips that are keeping your patients alive and also providing the art of it but that science of it is huge right now um so one of the things that we're trying to do in nursing in a nursing education is making sure that those who come into nursing know that it takes both parts it's not just enough to be a lovely person and to be kind and to love people that's great but you also need to be able to understand the pathophysiology how to work your equipment but it's also not enough to be a brilliant scientist and understand pathophysiology and be able to work every piece of equipment but not really like people so much so we have to find a balance and we all have strengths more on one side or the other and sometimes they change as we go through our career or through our life and that's okay you don't have to be 50 50. but you do need to find some kind of a balance and a respect for both sides of that so hopefully that's something that you will see and I think this program does a really good job of not just focusing on skills but also incorporating care and compassion and empathy and that whole piece of it through our tie to Gene Watson and to her nursing Theory and her territos processes I think that really helps us come to have a Unique Edge all right so now we're going to hop into what I was talking about before the scope and standards of practice and the definitions so I brought you three different definitions two of them come from your book The a a definition and the um ICN definition those both come from your book or actually you come from them they're listed in your book and then I also have a definition of Christian nursing which I think since you are in a Christian nursing program is important for you to see as well and then we'll look at the standards of professional nursing practice the standards of professional performance and the code of ethics so really kind of just the beginning of what is nursing what is expected of you so the first definition takes up a full slide and looks a little bit busy here but the definition is the definition I can't you know cut it out to make it easier to look at so if we look at this definition here and I'm not going to read it to you but you can see it has elements of what we've already talked about it recognizes that nurses is an art and a science it talks about protection promotion and optimate optimization of of health and abilities it goes through that compassionate presence so a lot of the art side of it then it gets into the diagnosis and treatment of human response that's more of the science part of it and then it even gets into that advocacy part right so what we talked about being an advocate for individuals groups communities populations so this is a current definition and this is sort of the recognized definition at least in our realm of what nursing is so that's the American Nurses Association I'm not positive that I told you guys already but abbreviations are fair game for the first test so anywhere that you see an abbreviation after something so American Nurse Association and then a a in parentheses that's because I want you to know people don't usually say the American Nurse Association they say a a and I want you to know what we're talking about with that so I'm kind of trying to introduce you to the language that you're going to be hearing around you and so that's why I have those on the test so please make note of any of these abbreviations and know that most of the time we say the abbreviation and not the full out words of it all right the other definition again this is one that was included in your book as well comes from the international Council of nurses the definition itself up top is fairly similar to the American Nurses Association but again this is international so this is recognized throughout the world the part that I want to draw your attention to is a focus from the ICM which is they really are looking at how nurses can Advocate and promote a safe environment research participation in shaping Health policy patient Health Systems and education so they're really looking at not just what we do as nurses in our primary nursing role of either you know being an ICU nurse being an emergency department nurse being a nurse practitioner but they're looking at what we as a group of nurses can also accomplish and I think that's that's huge and that's like I told you part of what's being recognized with the unique position that nurses are in now um the final definition that I have for you and it's not the definition of Christian nursing because there are many um it's one that I found in a book that I read um not too long ago and it really kind of resonated with me and I think that it's definitely a good definition by all means again not the definition um but it talks about nursing being a Ministry of compassionate care for the whole person in response to God's grace towards a sinful World which aims to Foster Optimal Health and bring comfort and suffering and death for anyone in need and I think that's a nice kind of way of encompassing also our role as Christians and I realize that all of you may not be um but you are attending a Christian University so I feel like that definition is important for you because you're going to be representing a Christian University so just kind of be aware of that um the Proverbs down below is actually it's a proverb that we as a department selected because we think it really speaks to what nurses do um but interestingly enough at the same time that we as a department were selecting a proverb to represent our department our nursing student Association was also coming up with a Proverbs to put on the back of all of your name cards um and when I met with them after we as a department had decided um and I looked at what they had selected it was exactly the same one and I just thought wow you know of all of the things that we could have chosen from you know volumes and volumes of different things that speak to um these types of things we both selected the same Proverbs so I thought that was really cool and so I feel like we have a very good representation there so hopefully that resonates with you all right now we're going to look a little bit more at the standards of nursing practice so this is if you move a little bit further into your book um so you've got a couple boxes in your book that talks about um one the standards of nursing practice and then the next one will be the Professional Standards uh the standards of professional performance when we go through um this one here the Ana has to find six standards of nursing practice and if you look at chapter one which is also a signed reading from your nursing care plan nursing diagnosis book you'll see that this mimics that nursing nursing process sorry I had a little brain freeze for a moment there so it mimics that ad pie assessment diagnosis planning intervention and evaluation so very similar to what we have in here talking about this is really what we do this is our professional performance so you know we as a registered nurse we collect pertinent data and information relative to the Health Care status or situation we then [Music] all right hopefully that wasn't too awkward I had to pose that pause that for a second because there was a truck backing up outside and I didn't think you'd be able to hear much so hopefully that wasn't too awkward um we then as the nurse we analyze and assess that data to determine what the actual potential diagnosis is and so on and so forth as we go through this so this is pretty much how we um practice nursing how we do everything in nursing and we'll kind of talk a little bit more about that in class so if you have not read chapter one of your nursing diagnosis book you're going to want to pull that one out and read that as well because you'll see the alignment there when we then get into the standards of professional performance you'll see that there are the Ana has has identified 10 different standards of performance and these really describe what a competent level of behavior in professional nursing role in compasses so when you look at ethics it talks about how the registered nurse integrates ethics into all aspects of care well I certainly hope so right if you look at number 11 collaboration the registered nurse collaborates with Healthcare consumers and key stakeholders and so on and so forth so it goes down to talk about quality nursing practice all the way down into resource stewardship which is a mouthful to say and environmental health so it kind of talks about all these different things that are part of our professional performance so make sure that you take a look at these standards because they serve as objective guidelines for what nurses for nurses to follow and help nurses be accountable for their actions their patients their peers all of that so they really are an important part of what we do as nurses the final component that we're going to look at for this section is the code of ethics um so it definitely this is part of what makes a profession again these the other parts are as well but the code of ethics is kind of a philosophical ideal of right or wrong and um it defines the principles that we use to provide care it reflects our role as an advocate for the sick the injured the vulnerable as well as our role in supporting social justice and so I think that's a really big deal there's Provisions in the code of ethics that describe what our ethical duties are what our obligations are what our commitments to patients to families to society it's posted in your learning management system so I'm not on a test or anywhere else going to say you know what is provision number two um just as I would probably say this in our in the recorded lecture for Gene Watson as well I'm never going to ask you what is keratos process number four um I may say something about that process and want you to understand what that is but I don't think knowing the number of it is important right so same thing for the code of ethics I'm not going to say what is you know provision number two in the code of ethics but I want you to have an understanding of it as a whole um I think it's really important for you to know that you're using this to clarify goals values obligations I'll show you what the book looks like when we come into class because what's posted in your learning management system is a one-page pretty nice and neat summary but you'll see this is an actual book of you know this so there's different the provisions are broken down inside of that it core also it's important for you to incorporate your own values and ethics and to ask yourself how your ethics values are going to impact your practice and how they go along with those established standards that we saw in the previous slides and this code of ethics because all of that has to be taken into consideration as you start your own practice the words down on the bottom down here are words that I have pulled basic terms that relate back to the code of ethics you'll hear this as a lot as we go through the course there will be examples on the test as well it's not going to be matching so I'm not going to say advocacy and then have a line and you're going to draw to the definition it's going to be an example of you know the nurses doing this is that an example of advocacy responsibility accountability or confidentiality that's going to be more the way those are structured so you have to have an understanding of it not just understand what the definition is but we'll start with that so you know for advocacy we're talking about a nurse who will support and defend a client's Health Wellness safety wishes and rights for responsibility that's your willingness to respect obligations and to follow through on your duties accountability that is taking accountability no no kidding but answering for your own actions so being willing to be accountable I can't use another word I'm so sorry um being willing to be responsible for your definitions and to say yes this is I I take responsibility for that this is what I did um that is your personal accountability and then confidentiality that um I think is pretty straightforward but again it is making sure that you are protecting privacy but not diminishing access to high quality care and we'll talk about these a little bit more in class and if you have questions on any of those or what an example might look like then bring that in with you when we come into class all right um the final thing that I'll say about professional responsibilities is that um you know to meet the the needs of our patients we have to be again autonomous and accountable um we have to maintain our knowledge our skills um we have to be willing to provide care Comfort to emphasize health promotion illness prevention um and we have to um in essence we have to be willing to um you know do the right thing even when nobody's watching so when you're in nursing school somebody's always going to be watching right your instructor is there even when you think your instructor is not there um so when you're in the clinical setting with your nursing instructor you have your nursing instructor watching you you have the other nurses watching you but once you have RN after your name you don't um so we're hoping that by the time you sit for your nursing boards that you have um that you have kind of ingrained this and that you know what's right or wrong and that you know that you are going to do what is right even though somebody may not be watching you um the other section that your book now goes into are the professional um roles and responsibilities so it talks about um all these different sections right here um when we talk about autonomy we're talking about um you know the initiation of independent nursing interventions without medical orders so sometimes we are able to do things that um are within our scope of practice where we don't need a physician order to do that um some things we do need a physician order so it's part of your um you know your scope of practice to know which is which but if you're doing something that is independent which is what autonomy speaks to then it's really important that you tie that to accountability so if I decide to do something I need to take full accountability or responsibility for why I did that and be able to say this is why I did that and this is why I thought it was the right thing to do at that moment and not say cheese that didn't turn out so well um hey yeah I I didn't do that or oh yeah so-and-so told me to so if you're going to be autonomous you also have to be accountable for the decisions that you make caregiver I think is the most straightforward so you know yes nurses are caregivers I think that's the kind of the media portrayal the you know if you ask what does a nurse do caregiver is going to come out of almost everybody's mouth some of these others are not as straightforward so when we talk about Advocate I don't know that the general public knows how much nurses advocate for their patients so it's really important to protect the human and the human and legal rights of your patients and to help your patient assert those rights when needed so sometimes people don't listen to what the patient is saying they listen to what the family is saying they kind of speak over them it's our role as the nurse to say hey did everybody just hear what the patient said the patient said they did not want this or the patients said I need so you really have to be willing to speak up on your patient's behalf if they're not able to do it themselves or if they're kind of being railroaded educator not necessarily talking about educator like I'm an educator but you are an educator of your patient you're an educator of your patient's family you might be a formal educator but you're going to be an educator no matter what your role in nursing is there's always a component of Education there's always a component of communication so that next one Communicator that's Central to the nurse patient relationship so it's important to develop a communication style that you can use with your patients with their family members with your team that you're working with there's no aspect of nursing that doesn't involve communication so it becomes really important for you to develop that and not all of us are natural communicators so if that's not a strength that you already have then you need to figure out how can you boost that and we can talk about that a little bit in class it certainly was not my strength going into nursing so I'm very familiar with that I the whole Advocate role the communicator role those were not strengths that I had um but they definitely are things that you can build and I feel very very confident in those roles now so if that's something that you need to talk about a little bit then definitely let's talk about that in class and then manager like I said before it's not um necessarily the manager of the unit that I'm referring to every nurse is a manager you have to collaborate with others to help your patient meet their established outcomes you have to evaluate that you're the manager of their care you the patient's assigned to you you are their manager you're going to decide what happens to them and that becomes a really important role and you have to be able to again be a great communicator understand patient advocacy to be that manager to be in that role and we will do our very best to prepare you for that all right so let's look at all right so we're going to look at um some skills so this came not some of it came from your book so banners comes um from your book as well but some of these other came from some articles that I read and some different stuff so um you know it was interesting to me to think about um some of these articles that talked about what were essential skills for nursing because obviously I'm preparing you guys to be nurses so the number one thing that's and this is a combination of several articles that I read um but the number one thing that I saw repeatedly said was Compassionate Care so that's again that art of Nursing and I think we can all agree with that then some of the more practical things that were listed were things like time management and patient education so it becomes really important as a nurse to have time management when you're assigned four or five patients who all have medications due at nine o'clock who all needs to have assessments done first thing in the morning that's really overwhelming so you need to figure out how to prioritize how to use your time wisely so even though it may not seems so related the time management skills that you learn in this accelerated program for how you're going to study for the program how you're going to manage having several tests a week how you're going to manage your clinical along with your courses that all is helping to prepare you for that time management that you're going to need as a nurse it's a different type of time management but it helps you to look at priorities and set those things forward so I think we're doing a good job I think you actually have an advantage over some other traditional programs like what I went through where I didn't have to hone my time management skills that much because it was a four-year program I had plenty of time um don't get me wrong I thought it was hard then um but you guys have that extended pressure of having to do this under a shorter period of time so you have much more on your plate at a time and it will help you refine your time management so definitely work on that patient education also a little bit more technical right but again it highlights that role of the educator it's really really important for you to be able to educate in your role as a nurse and then there therapeutic communication we'll cover that a little bit I believe it's uh next week I'm not so sure um but that's a really specific type of communication that helps you really hone in on what your patient is saying and your patients needs and really being there for your patient and that's an essential skill that was identified as well um and then um I'm trying to read this quote this number that I have down here this hundred percent um okay so that was the communication part that they said no matter what your role in nursing is you will always be using that communication piece of it and particularly that therapeutic communication when I draw your attention over to Benner's stage as a nursing proficiency I do this because throughout the book there's going to be things where you think you understand what the words mean so if you look at this and you look at novice Advanced beginner content proficient and expert if I gave you this without you having read what's in the book and I said where do you think that you will be when you graduate as a nursing student when you graduate as a new graduate you pass your NCLEX I would assume that most of you would say that you think that you will be competent because isn't that what you're paying for you're paying for somebody to help you to be competent right that that makes sense to me if you look at the definitions that Benner has for novice Advanced beginner and competent you will see that no you will not in fact according to her definition be competent as a new graduate nurse um I want you guys with any of these when I bring you these terms you need to look at what that researcher is saying that means because that's what I'm going to refer to when I ask give you an example and I say okay so we have a nurse who has been in the same clinical position for two to three years she understands the organization and specific care required for that type of patient is she novice Advanced beginner competent proficient or expert by Benner's definition she is competent you as a new graduate would be novice um perhaps Advanced beginner if you come with a good background but mostly novice which is not what you would think if you just look at these terms so I want you whenever we talk about anything that somebody has done some research on to go back and look at those definitions specifically so go back into your book and read what does Benner mean by novice what does Banner mean by Advanced beginner because there will definitely be a test question on there that will tie back to those and if you go with just what you think it means then you're not going to be prepared so by novice she means any nurse entering a situation in which there is no previous level of experience so a different part of nursing would bring you to that novice level all right we're going to look a little bit at Career Development here um so your book covers all of this in more detail let me see if I can get to that page sorry I didn't flip my page fast enough um all right missed a few pages there all right okay so it talks about um how you have these different areas of nursing that you can go into so whether it is your role your clinician roles whether it is becoming an advanced practice registered nurse so a clinical nurse specialist a nurse practitioner a nurse Midwife a nurse anesthetist a first assist so these all may be roles that you are looking to this might have been why you went into nursing you might want to be a nurse practitioner you might want to be a certified nursing nurse an ethicist Step One is becoming a nurse but these are then those advanced practice roles that you can take on you might have gone into nursing because you just you want to be a clinician so there's no right or wrong in this there's just different roles that you can take on you can take on a formal nurse educator role so again not just educating your patient but educating nurses in the hospital that's where I started out my education career or educating future nurses you can go into being a nurse administrator or a nurse researchers so there's and there's many many more options those are just the ones that your book highlighted so my suggestion is um you know to take a look at those see if there's something that might interest you or if there's something specific that you think you're interested in take a look in your book it's not a you know it's a one paragraph that talks about that but it gives you a little bit of an idea of what exactly is encompassed in that the next thing we're going to take a look at is some of the historical influences and your book does a pretty good job of taking a look at that as well so we really want to look at um you know what we know from history because it helps us kind of understand where nursing has been and where it's going what you see on the side right here this is actually something that I'm really proud of or I think that's really cool this is a shadow box that I made with you'll see the glass syringe in there and the little nursing pins and the pictures and stuff that's all my husband's grandmother who was a nurse and you can see in the graduation picture you know she was a nurse back in the day when they wore the very impractical nursing outfits with the little heeled boots and the long dresses and the headpieces and all of that and then if you see the picture in the Middle where she's sitting at her kitchen counter you know that was probably in the 60s or 70s so at that point um you know she's wearing a little bit more modern Nursery attire and then if you think of what nursing looks like now we've come a very long way yes she legitimately had her own glass syringe that she kept in that little box in the bottom right hand corner with little interchangeable needles that were reused over and over and over she had her own scalpel which is up at the top I have no idea what she used her own scalpel for um but I just thought it was really interesting to find these um you know relics of what nursing was in the past um so again nothing has anything to do with anything but I think history does have something to do with what we what we do as nurses so we'll kind of take a look at a few of the historical figures the first one we're going to look at is Florence Nightingale she was affectionately called the lady with the lamp um just because of you can see kind of the picture in the bottom left the Crimea Crimean War I'm not even sure I'm pronouncing that correct um but this is where she went around in the battlefield hospitals and that was her only source of light when she was checking on the patients when she was she was sort of the manager so when she was checking on her nurses that type of thing um she is um really really impressive because she saw the role of nurses as having charge of somebody's Health um based on the knowledge of how to put the body in such a state to be free of disease and recover from disease so previous to her I'm going to say nurses were just kind of handmaidens they just kind of walked around made sure you you know felt comfortable they didn't really have a specific role other than just caregiver and she kind of looked at we need to have other roles she developed our first nursing Theory it was based again on that Health maintenance and restoration um she organized the first school of nursing um so she became a nurse before there was nursing school right so she did actually go to um different she was from the UK and she did go to schools in other European countries and kind of look at what they were doing but she developed the first school in nursing in the UK and then the first School of Nursing in the U.S was built on her principles she also was the first practicing epidemiologist um she decreased the mortality rate from 47.7 to 2.2 in just six months by showing how we could effectively use fresh air hygiene which is the little picture on the side here washing hands nutrition all those things in the care of those soldiers during the Crimean War decreased that mortality percentage and part of it was she told Physicians doing Battlefield amputations that they needed to wash their hands that was not standard practice before that um so some of those things um really made some huge lasting impacts if you think of how important that is now so she definitely had an impact on nursing and like I said you'll hear me talk about her a ton because I think she really brought us to a place where we were ready to move in the direction of where nursing is now the next thing we're going to look at is um you know in the U.S starting in the Civil War time and then moving forward so there's some really notable nurses I think and again I have quotes from them because again quotes speak to me so Clara Barton she um she founded the American Red Cross but it wasn't straightforward for her the U.S Congress ratified the Red Cross in 1882 after she had lobbied for 10 years and there was not even such a thing really as lobbying um so I'm going to say I think she was the first nurse lobbyist um but she for 10 years so for you know year after year after year they said nah we don't need that nah we don't need that and she kept going back she's like we do need something like this I know I mentioned the year 1882 so I want to make sure I tell you guys that there will not be any years on the test I don't think it's important for you to know that in 1882 the Congress ratified the American Red Cross I think it's important for you to know that there was a nurse who was behind this I think it's important for you to know who that nurse is but the specific year I don't think that's important either and then the quote that I have from her is I may be compelled to face danger but never fear it and while our soldiers can stand and fight I can stand on my feet and nurse them and I think that's just kind of a very brave statement Dorothea Dix was a supervisor of all the female nurses in the Union Army and similarly a quote from her and then the other one mentioned in your book here is Marianne ball who worked with Dorothea Dix and to organize those Battlefield hospitals and ambulances and you know this is by no means an easy thing to do and she appointed nurses to care for the wounded and regulate supplies and one of the things that she was famous for saying was if I have no one to send I'll go myself and nurse the sick and that's a pretty powerful statement too interestingly she was about 45 years old when the Civil War broke out and she broke all protocol and allegiances and her tombstone I looked it up because I didn't know a whole lot about her I looked it up and her tombstone says something along the lines of Rebel Union and colored soldiers all received the same attention so she was very um not taking sides right a nurse who's going to take care of everybody who comes into her path which is what we should all vote to be right you don't have to like the people you don't have to like their lifestyle but if you're the nurse who's going to care for them then you need to care for them and that's where she saw herself and I think that's a pretty powerful example for us to look at a few more examples from your book I thought it was really interesting this is something that I didn't know until reading Potter and Perry is that you know Harriet Tubman who I think we all know from the Underground Railroad and all of that she was also considered a nurse I couldn't really see if she was formally educated as a nurse and I didn't look at the dates to see if there even was formal Nursing education at that point but she definitely was recognized for um using skills to care for people and a lot of it was using home remedies that she had learned from her family and boiling things that I don't even know what they are Cranesville and Lily root and making bitter tasting Brews that would help treat fevers and smallpox and infectious diseases so really she was just rolling with what she knew and trying to help people with it and I think that's kind of interesting to look at too Mary Mahoney was the first professionally educated African-American nurse and she really focused on cultural awareness um and I love the quote from her work more and better the coming year than the previous year it sounds like she almost read Florence nightingale's quote and was like I can say that too so I think it's interesting that you hear kind of the same themes from a lot of these different people um Isabel Hampton Rob I am in awe of this this woman she started the American Nurse Association American Journal of Nursing she published tons of um of textbooks for nursing of research um so she was very influential in that aspect and if you think of like the American Nurses Association you know they are still very relevant they are still putting out position papers they're still doing research the same thing with the American Journal of Nursing like if you have published something in the American Journal of Nursing you have arrived like that is the Pinnacle of where you would want to have your nursing research published um so I think that's pretty cool to think that one person established all of those and then Lily and Walt and Mary Brewster um they were really interesting because they expanded nursing into the community so if you look at this picture down here it looks like just a ton of people but these were Community nurses um in New York so they had a um a program so there are nurses were the first to demonstrate really autonomy because they frequently as they were going into the community they encountered situations that required quick and Innovative problem solving and critical thinking and there was no physician there to tell them what to do they kind of had to decide so they were really important in developing that autonomy for nursing um and important in bringing forward the um you know the whole going into the community and caring for poor people they cared for the people who were living in tenements and ten ten amendments in New York City um so again different people who brought different aspects of nursing forward um all of which we can take advantage of now we're going to look to now the 20th century and again the dates don't matter they're just there for you to kind of have some perspective um we look at um the different parts if you look at Mary Adelaide um nutting she was the first professor of nursing um 1906 the first time we had an actual nursing Professor um so with this we look at some different things so if you look at the Rockefeller study for nursing education I don't know if you guys are familiar with the name Rockefeller but the Rockefeller Foundation is very influential they were a very very wealthy um well-positioned family back in the day and the Rockefeller Foundation is still in play and they did a study of Nursing education way back in 1920 and what they found when they did that is that nursing education needed financial support and should be centered in a university or School of Nursing and so this is where we then saw the movement of trying to move Nursing education into universities it previously was done in hospitals they were sort of an indentured servant and you became a oh I can't remember the name of it darn it it's not an associate degree nurse it's a diploma nurse so you would get a diploma from whichever hospital so like the picture that I showed you of my husband's grandmother she was a diploma nurse from a hospital in Utah um which you know again now there's not a lot of those diploma programs you are either an associate degree nurse or a bachelor's level nurse but there's usually some college education involved in that then we move forward to the 1940s and 50s and then this is where the more nursing association so the um the association of critical care nurses an association of psychiatric nurses or whatever that is so those specialty associations which are huge now really really important for us as nurses so whichever specialty you end up in you should 100 look at becoming part of that Association because they publish journals focusing just on your specialty in nursing um so if you're in labor delivery um you know whatever that is they're gonna especially they're going to publish stuff that is specific to what you do they're going to set standards they're going to advocate for that type of nurse so it's important to become part of those associations and then also look at certification within that specialty right it wasn't until 1965 which I know you guys you know most I can't imagine many of you were around in 1965 um but that it was really when we started looking at that nurse practitioner role and those Advanced roles and it really wasn't until much later that that really became an active role I would say even until the last 20 30 years where nurse practitioners have been recognized and nobody questions that you know my primary care provider is a nurse practitioner not a physician you know so a lot of us see that now but that wasn't common in 1970 and then you look at 1990 is when the Ana established the center for ethics and human rights and this helps nurses address complex ethics and human rights issues and then in 1994 was the first magnet hospital this was at the University of Washington so here in the U.S a magnet is international so that's interesting that it was here in the U.S we'll talk a little bit more about what magnet hospitals are as we move forward all right now we're going to move on into the 21st century we're making progress here um so we have a couple tough slides that talk about this so some of the challenges and opportunities definitely the Aging population is a huge challenge for us our nurses are aging and the people that we're taking care of are aging um so as you can see in this quote here from the aacn it's a perfect storm um you know we're going to have nurses retiring and we're going to have older people coming into the population and they're going to have all these chronic diseases and we're going to have to figure out how to use our resources really well um cultural diversity definitely both a challenge and an opportunity we certainly can do a lot better in recognizing cultural diversity and the richness that that provides in so many different levels but it also provides challenges to Hospital Systems of how can we care for everyone and be respectful of everyone even though we may not understand their practices or their needs and how do we figure that out um bioterrorism you know unfortunately yes that is something we have to look at and there's huge Specialties within nursing um I have a friend who works with our city here um and she's a nurse she is a doctorally prepared nurse and her job essentially is really just looking at how do we prepare the city for emerging infections for bioterrorism disaster management those are all under her scope of practice and that's a really big deal looking at a huge city of you know thousands and thousands of people and looking at how can we prepare this city to take on whatever those challenges are the really gory picture in the center here that's all fake so don't worry about that um that is that's my arm it was a drill that we did for the city to see that all our emergency um that our EMS system was capable of dealing with like a mass casualty incident so in this case I wasn't a provider I was assigned the role of a patient and it was supposed to be an arterial bleed and so I had a little pump in a purse that I would keep pumping until they were finally able to put that tourniquet on that you see and turn that tightly enough to stop the bleeding from my fake wound there and as you can see it took them a while the entire ambulance ride the entire bottom of the ambulance was covered in blood um it wasn't really until the end of that that they finally figured out oh shoot we need to get that a little bit tighter but that's because there was four of us in the ambulance there wasn't one patient there was four and you have one paramedic in the back trying to deal with four critical patients but that's what it's going to look like in a mass casualty incident so that's what we were trying to stress that system a little bit um the picture on the left down there um that is from our um Orange County uh what is I can't remember the name of it um that is from one of our disaster preparedness um Warehouse is basically where we have all our extra ventilators where we have all our extra antibiotics all of that stuff and that's their command truck that has like this whole drawer in the back just like you see on TV that you pull out it has all the maps and all the different things in there so that if something happens in the County of Orange they're able to mobilize those resources to where they need to go um the picture on the right is one of the first nurse practitioners the girl with the red hair down there Vicky she's a nurse practitioner that I worked with years ago in the hospital and she now works with um one she doesn't work there anymore but she did work with the city of Anaheim to set it up so that on our rigs we could have a nurse practitioner if the call is so if the call is that um that I'm having a heart attack and I I my chest is hurting and I can't breathe we're not going to send a nurse practitioner you're going to send EMS you're going to get them to the hospital as quick as you can but if the call is I was released from the hospital yesterday I had pneumonia I'm having a little bit of a hard time breathing and I'm coughing up some stuff they can send a nurse practitioner who can prescribe antibiotics who can prescribe lab work and save another trip to the hospital that program was so hugely hugely um effective that now throughout the country she's traveled throughout the country and set up these programs in tons and tons of cities so again another innovation of Nursing in a more recent term than what you saw on the other slides and then the picture in the center down there with all the lines and just kind of super confusing that's just talking about how quickly diseases can emerge and because we are so International now and so mobile you think that something in Zimbabwe isn't going to be a problem for you but 100 it is because people come from here to there and there to here and so we have to look at how anything that's happening anywhere in the world is going to affect somewhere else in the world some other things that influence contemporary nursing one of the things that I was really glad to see that your book is looking at now is the importance of self-care as nurses we recognize this a hundred percent and the pandemic so stressed this to us that nurses in general are not good at taking care of themselves and then when you add on things like a pandemic then you see people really crumble under that and so it's important for us to set up internal ways that we take care of ourselves and set boundaries and to look at what could happen if we don't do that so compassion fatigue is one of the main things that can happen that is a really big deal and it is a state of basically burnout and secondary traumatic stress and when you look at burnout that occurs when basically there's more thrown at you than you know how to deal with um which the pandemic a hundred percent was doing to people right just here keep doing more with less keep doing more with less that can lead to burnout and then secondary traumatic stress is you as a caregiver taking on and witnessing the trauma and suffering of people you're taking care of so if you're thinking of an ICU nurse during the pandemic who has one ventilator and four patients that need a ventilator and having to try and figure out how to make that work and watching people suffer who you know need to be on a ventilator but you don't have a ventilator to put them on or you have a ventilator it's not enough our traditional means of taking care of these patients it's not enough and they're gasping for air and they're very uncomfortable that is hugely traumatic so those two things together can kind of build up and at that point maybe the person just doesn't have the the resources to take care of themselves and it really negatively impacts health and wellness of the nurse and their ability to care for their patients and like I said I'm really glad that our book is talking about that and I will talk about it throughout the course I want you to read that section not so much because I'm going to have a ton of test questions on it um but because I think it's really important for you to be aware of what this is they talk about lateral violence they talk about a lot of different things in here that I think it's important to have some type of an awareness of coming into nursing and then I put these simplified tips and they're pretty much no-brainers but again when you're in the middle of this you don't necessarily think about hey is there somebody that I can reach out to and talk to um is there you know am I eating a healthy well-balanced meal am I taking the time to exercise and sleep because I guarantee you most nurses during that were not taking time to exercise and sleep but figuring out you know how can we do these things for ourselves because nobody else is going to do it for you so again important some other contemporary influences um we'll talk about this more when we go into um the second chapter which is your Healthcare delivery system um but we really are looking more now at um a bigger emphasis on health promotion and prevention um because the more energy we focus there the less we're going to be seeing those really acutely critically ill patients because we're managing it earlier there's always going to be accidents and fluke things that happen but if we're able to manage somebody's hypertension diabetes asthma whatever that is through health promotion or disease prevention then we're not going to have the patients get as sick as we have seen them there's also the demographic changes so again obviously those aging populations which have the chronic diseases that definitely is something that we are dealing with right now um the graphic that I have in here is just talking about global population over the age of 65 and you can see each year that is expected to increase so we need to figure out how to how to care for those people we're going to spend a little bit of time when we come into class looking at some of the resources that you have for your medically underserved patients and again these are your patients who either are unemployed who are underemployed which means that maybe they're employed but they don't get benefits such as health care medical insurance dental insurance time off to go to the doctor those types of things and then also the impact of mental illness homelessness Rising health care costs those are all things that impact the patients that you're going to be seeing the two Graphics here the findhelp.org and the 2-1-1 you're welcome to just go on Google and look up 211.org or find help.org and then when we come into class you can kind of tell me what you found there I will also call them up during class so you can see the resources on there they're really really powerful organizations that have pulled together a ton of resources and I'll show you how I think you can incorporate that into your practice not that I think you are looking for the resources but your patients maybe and there's a way to incorporate that into your practice all right and then your book calls this Trends in nursing I always think of Trends as trendy so I'm not sure I really like that word but that's the word that they use so current things that are happening in nursing is what I'm going to say evidence-based practice for sure right so when I first started nursing a lot of times if I would ask somebody why they were doing something the way that they were doing it I would be told because that's the way we've always done it which is a pretty crappy answer right so now hopefully when you ask somebody why we're doing something they're going to be able to say well because there's some research done and it was shown that this is really effective in this population of patients so when we look at evidence-based practice and we'll talk about this more our final week we're looking at that scientific evidence we're looking at your clinical experience what you know from what you've seen and then also your patients values so your patient has to be part of that that all makes up evidence-based practice the things that are bolded on here the focus on advanced practice the quality and safe safety education for nurses and the impact of emerging Technologies those are all things that we're going to look at on the following slide so I'll kind of glance over those right now and just cover these other ones that your book went into that I didn't create additional slides for so genomics is really interesting because when we combine technology with that type of stuff we can really look at really improving Health outcomes if we know that somebody has a family with a history of breast cancer we screen them entirely different than we do somebody who doesn't have a history of breast cancer so just kind of those things that we can learn from somebody's genetic makeup makes a big difference and can ultimately help reduce health care costs because if we can screen for something earlier versus having somebody come in with a stage four that's a really big deal right the public perception of Nursing um that is a big deal the nurses are really well trusted um by the public there's been a Gallup survey that's been done for years and years and years and nurses are almost always at the top of that um I want to ask you guys and I'll see if anybody can come back to class with the answer for this of how many years in a row have nurses been the most trusted what year was it not nursing and who was it that year so that's a little Google search for you guys and don't get lost in it but just kind of look for that information and then again I talked about this a little bit previously and towards the beginning the impact of nursing on politics and health policy so if you remember that ICN definition of nursing it really talks about that the picture here to the side is a group of nurses who were um you know marching in Washington to talk about the importance of safe Staffing ratios here in California we're really fortunate we have safe Staffing ratios so as a regular med surg nurse you shouldn't have more than five patients that is not the case in many many states throughout the nation you get however many patients you get and that is not safe for you and it's not safe for your patients so now as nurses we're starting to see people band together and really try to impact public policy which is a really really big deal all right we're going to skip to some of those bolded ones so the first one we're going to look at is the focus on advanced practice so there it was a study done years ago back back I think in 2010 or so a report from The Institute of medicine that talked about how nurses need to be transformed it was really an important study because it was done by The Institute of medicine it wasn't done by The Institute of nursing it was Physicians saying here's how we think nursing needs to be transformed the organization name the academy has been changed to the National academies of Sciences engineering and Medicine you will still hear people talk about the Institute of medicine or the ilm it's the same thing just rebranded basically so some of the things that they said in there um findings was that nurses nursing should be practiced to the full extent of Education and Training they're talking here a lot about nurse practitioners which in some states are not able to practice independently are not able to prescribe medications so talking about you know if you're going to educate somebody then you should allow them to practice at that level huge the Physicians are saying that because in many areas the people who are fighting against this are Physicians who don't want competition from nurse practitioners so that was a really really big deal also talking about how we should achieve higher levels of education and how it should be easier to go from one level to the next so you shouldn't have to repeat all your Sciences when you're coming from an ADN program and you're trying to get your BSN and same thing when you're going from your BSN program you shouldn't have to repeat all your sciences and different courses to be able to be eligible to take an MSN it should be going seamlessly and it is pretty close to that now talks about how they want nurses to be full partners with Physicians to be part of who's redesigning the Health Care System that's huge in many countries throughout the world there is definitely not partnership between nurses and Physicians so we're very fortunate that that's a goal here and then improving data collection that is huge we definitely saw in nursing especially when nursing started to look at trying to achieve magnet status that we don't do a very good job of data collection so that is that you'll see that as a focus that we still are working on but much much better at it than we were the second thing we're going to look at is cusin and again this stands for quality and safety education for nursing no one ever says that out straight we just say Houston um but this Houston kind of addresses the challenges of how we prepare nurses and it looks at some competencies that are needed to continually improve the quality of care and again this is more within nursing schools So This Is Us trying to prepare you to become nurses in the hospital cusin isn't really a thing it is how we're preparing you and um one of the big things that it looks at is these ksas so the knowledge skills and attitudes that you would need in each area so if we look at patient-centered care we recognize that patients or the designees are the source of control in a full partner and that care should be based on respect for the patient's preference values and needs and then we look at what knowledge skills and attitudes would you need to have in order to fulfill that so there's more detail when you look in your book there is a table that has that all outlined as well so you can kind of look through each one of those sections and look at what does that mean what does cousin mean by quality improvement how do they see informatics as a role so make sure that you read that and familiarize yourself with that as well the next couple of slides are the next slide at least I think is really exciting so I love all the technology and nursing as you get to know me you'll know that I truly appreciate both the art and the science of nursing but my background is a critical care nurse I really love the technology of Nursing and we've seen even just through the last few years through this pandemic a huge move forward in emerging Technologies so you know there was telemedicine before this but telemedicine is now huge probably most of you at some point during the pandemic had a telemedicine visit with your physician and we're we're seeing those being Incorporated now even if you're in an in-person meeting with your physician but maybe your physician needs to talk to a specialist that can be incorporated and you all can be included in that some of the things that we did for you guys during the pandemic for Education was these virtual simulations so if you look down on the bottom left this is from one of the virtual simulations that we used where we have an avatar and you go in and you're the nurse and you say to the patient hi I am so and so I'm here to do this this and this and then the patient responds to you and it certainly isn't as robust as it could be there were only certain responses that you could give or certain responses the patient would give back to you but it did give you some sense of reality and some sense of urgency when that patient starts coughing and saying I can't breathe I need help like it becomes pretty real you got to figure out oh no what am I going to do um so that was a good way for us to simulate nursing experience when we weren't able to provide full-time nursing experience the one in the center is a different system that does the same thing as a computerized um documentation system so you can look at that and then the most interesting thing I was literally at the dentist yesterday and I saw a flyer on the wall about teledentistry and I was like what is Talent Dentistry are you kidding me and actually it is just if they need to consult just like I said before a specialist then they can do that in-house in the place that I went to the day it was one of the most technologically advanced places I've ever been so pretty cool the technology that they had there and then the picture at the top here this is um something that I got during the pandemic literally sent to me through my email that hey if you want to contact your physician just you know here's a number you can text and just text in 24 7 tell them what your issues are and we'll get back to you um and I thought wow that's you know a great advancement that we've seen as well so certainly we've seen a lot of advancements there this next slide talks about nursing education and I think it's super interesting this one here um you know that it does it doesn't talk about um it still kind of talks about just a few ways to become a nurse going through an accelerated bachelor's program or an entry-level master's program still isn't in your book and I think we're in the 11th Edition now I don't even know um but they still aren't recognizing those Pathways so I think that's interesting so it talks about how you can have a two-year associate or for your bachelor's um and I'm gonna say we kind of know there's other ways to become a nurse right um so I'm going to ask you guys since you did choose a bachelor's program why you think a BSN is important and why you chose that um I'm going to ask you also if any of you guys can find out when the first absn program was developed and it wasn't Concordia I can tell you that um so I'll check back with you on class on that again why you chose the bachelor's program why you think that's important and if any of you can figure out when the first absn program was put into place and then it talks about all the different graduate education um that you can do as well um which of course is important you can be doctorally prepared you can get a master's degree you can do advanced practice roles when we talked about that a little bit already so yes that is important and then the continuing and in service education as I said before you're never done learning the goal of 80 BSN by 2020 was um came out of that iom report that I told you about so that was part of that advancing nursing we unfortunately are not quite there so currently um I think it says the current estimate is that the nation is somewhere around 57 and California is just over 60 and that kind of changes and it creeps up each year so hopefully we'll start making progress towards that but we're not there yet um the thing on the bottom here that talks about New York they put into practice what they call a BSN and 10 which means you can graduate with an ABN degree but within 10 years of achieving that ADN degree if you have not achieved a BSN then you are no longer eligible to be a registered nurse um very generous 10 years that's a really long time um when I taught at the community college level I don't think there was any student who didn't achieve a BSN within probably three years because it just it's important for your employment it's usually a condition of employment I'm surprised that California doesn't have something like this in place yet I'm thinking maybe it's coming pretty soon um but again maybe that speaks to why you chose a BSN I I don't know you guys are going to tell me that on the next section that your book goes into is nursing practice and it really stresses the importance and this is really important that you understand what the nurse Practice Act is in your state and I'll bring in a copy of the California nurse Practice Act and it is not a thin book and you don't need to memorize the whole thing but you need to have an understanding again of the scope of practice of what you can do and it's different from state to state so if you go to school in California and then decide to practice in Tennessee you better take a peek at the nurse practice act so that you know what a nurse in that area can do you also need to know what the policies and procedures at your hospital and all that but you need to know that it varies from state to state the licensing exam does not right so the NCLEX that establishes the minimum standard for RNs and practice Across the Nation it doesn't change from state to state um but each of the state boards of Registered Nursing have their own standards for how many hours you need to have in Pediatrics how many hours you need to have in mental health to be able to sit for that exam and then as you move from state to state you will have to get re-licensed in different states there are some states which is the picture down here um that have what we we call them compact States so that means that um you will be able to get a compact license which allows you to practice in any of those States so if I have a Texas license I can practice in Wyoming or Utah or Georgia as you can see California is not one of those States New York is not one of those States um so the cha the group of states is Ever Changing every time I go in and look at this it's a new conglomeration of either pending meaning they're thinking about some legislation for it or new ones that have been approved so this may not be the current one when you look at it because it changes every five minutes so obviously if you really want to know then you need to go in and look that up and it's easy information to get to um but just kind of an idea if you look at the middle of the country lots more maneuverability between States versus if you look at kind of the outer edges of the nation the next thing that I'm going to show you guys is the Bill of Rights for nurses so there's a Bill of Rights for everybody there's a Bill of Rights for patients there's a Bill of Rights for nurses the Bill of Rights is really not a um it's not a legal document it is really just established to protect the dignity and autonomy of nurses in the workplace so it's a what you should expect you can't march into your manager's office and say you know I have the right to Fair compensation for my work consistent with my knowledge experience but you know that that's what you should have so if you're not getting it maybe you're in the wrong place any magnet hospital is required to have this posted it's a lot harder to ignore these things if they are posted throughout your hospital and your nurses are walking past it every day so that was the goal with the magnet organization when they said that so again not necessarily legal but more a statement of professional rights and it establishes that informal Covenant between the nurses and their employing institution to kind of dig up to guide that development of policy and focus the discussions between the nurses and their employer on what should and shouldn't be available within that organization and there is a copy of this on your learning management system as well all right and then I talked a little bit about when we're looking at the Historical that development of specialty nursing and then professional nursing organizations these are some of those professional nursing organizations so the national league for nursing the nln the a a the ICN those are all important and they all come out with position statements that talk about um you know how whether their stance on different things they Advocate they try to set policy so this these are important organizations the nln for example they set standards for excellence and innovation in nursing throughout the nation they're not a specialty organization so it's not they um the emergency Nurses Association or anything like that it's it's nurse nursing as a whole and then there's more specific ones that focus on or Ed Critical Care holistic nursing whatever that is um some of the things that I have the two that I have bolded on here so there's Sigma Theta Tau International which is an international Honor Society for nursing and then we have a chapter here at Concordia called PSI Theta at large which is in conjunction with Vanguard University um and as a senior you may get an invitation to join that if your GPA is in the top third of students and above a set point then you may get that invitation I would highly encourage you guys to take advantage of that there's tons of professional development resources that you get continuing education courses that you have access to different Journal clubs and community events that we do um so I think it's a really good organization to be involved with I've been involved with it since the start I was a student at Vanguard in my master's program um and working at Concordia at the time that we developed the chapter between the two and I've been involved with the leadership for that group ever since because I think it is just such an important group there's also the national students Nurses Association and the California students Nurses Association we at Concordia decided to develop the Concordia students nurses associations so cnsa because we you in an accelerated program you don't necessarily have the time to devote to go to conferences and do all those different things that cnsa and NSA do because those are you know generally students who are in a four-year program and have a little bit more time to take a week to go do these things we're a little bit more of an accelerated program but we wanted you guys to have some opportunity for some leadership as well so you'll hear me talk about that a little bit more as we get closer to the end of the semester and I'm going to encourage you guys to join this picture right here is one of our current groups of cnsa leaders you see they're all smiling it hasn't killed them yet so maybe you'll consider joining that as well when your time comes just a couple more slides and then we are done with this and we'll transition into chapter two um as far as Career Development I'm sure you guys all are curious um you know did I pick a good choice what's going on here um and yes absolutely nursing provides you the opportunity to commit to lifelong learning um you have lots of opportunities for career changes for career development and it is one of the nation's fastest growing occupations so if you look at this map down here this kind of talks about um how many nurses there are for the population in California is one that has less nurses for the population there's definitely some room for growth there we need more nurses in California and it's the third most in-demand profession in the U.S with a pretty good 12 is a pretty good job growth prediction and I actually personally think it's probably higher than that um but I can't put my personal opinions on up here oh I gave you the amp actually that may not be current so that may not be the answer to um to how how long nurses have been in a row you have to look at look there all right so we're going to transition into doing um your second chapter which just focuses more on um the Healthcare delivery system but also your role as a nurse within that so that will be the next thing that we look at I will leave you guys here um and like I said if you go back and look at those objectives if you don't feel like you have it then you know please listen to this again go through your book again I think your book should be full of highlights and marks and all of that but you know that's my opinion and how I learn so you figure out how you learn but please don't come in blank without having taken anything away from the recorded lecture or from your book all right I will see you in class