Hey guys, today we're going to be discussing nursing today, which is the first chapter of Fundamentals of Nursing. I'll try to make this lecture as quick and painless as possible, so let's get started. So in this chapter, you'll pretty much be introduced to general concepts of the nursing profession, the history of nursing, and where nursing stands today.
But what is nursing? Well, nursing is both an art and a science. Being able to show compassion, care, and respect is a type of art. And being able to sustain an organized body of knowledge about nursing, that's a science. So both these, art and science, will impact the quality of care you show to your patient throughout your career as a nurse.
As a nurse, your patient is always the center of your profession, so it's important to remain and act professionally by giving quality care to your patient. This care you administer to your patient will influence their health even long after leaving your supervision. So this is a profession in which you are responsible for your patients, your peers, and yourself. The ANA, which is the American Nurses Association, defines nursing as having knowledge of behavioral and social sciences, biological and psychological sciences, and nursing theories.
And we'll talk more about the American Nurses Association in just a second and the impact they have on the profession of nursing. There are some advocacy groups out there that magnify the impact that nursing has on America's health care system. For example, there is the Robert Wood Johnson Foundation Future of Nursing Campaign for Action. And this campaign works to transform the health care system through nursing. This group was developed in response to the Institute of Medicine publication on the future of nursing.
But both these groups work to promote healthcare, illness prevention, and other needs of the human population. So let's discuss the science and art of nursing and what's required of you as a nurse. To be a nurse, you definitely have to acquire current knowledge.
And we say current because the nursing profession is always changing. You need to be aware of the practice standards of nursing, which we'll discuss those in just a few. This profession also requires you to have thorough understanding of the health and safety standards of the person. and a compassionate approach to patient care. And of course, critical thinking, being able to critically think and make decisions, is going to be the foundation of the care you'll provide.
Nursing skills and expertise take a while to develop. You don't just come out of nursing school as an expert. It takes time, it takes dedication. Benner's stages of nursing proficiency describes the five levels a nurse goes through when developing nursing skills. There is a novice, which is a beginner nursing student with no previous experience.
An advanced beginner is a nurse with some level of experience. A competent is a nurse who has been in the same clinical position for two to three years. This could be an emergency nurse or cardiovascular nurse, for example. This nurse understands the care that is required for a specific type of patient.
A proficiency level is when a nurse has had more than two to three years of experience in a clinical position. An expert nurse has experience in different clinical settings and is skilled in identifying problems within the healthcare system and when identifying patient-centered problems. The Scope and Standards of Practice and Code of Ethics are statements published on how a professional nurse should practice.
These statements are published by organizations in accordance with the American Nurses Association, both the ANA and the International Council of Nurses. have their own meanings as to what nursing is. The ANA describes nursing as the protection, promotion, and optimization of health, illness and injury prevention, alleviation of one's suffering through diagnosis and treatment, the advocacy of care for individuals, this can include families, our communities, or the overall population.
The ICN defines nursing as the encompassing of autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health, illness prevention, care of the ill, disabled, and dying people, advocacy, promoting a safe environment, research, participation in shaping healthcare policies, participation in shaping patients, and healthcare system management and education are key roles in nursing, according to the ICN. So as you guys can see, both definitions are similar and illustrate the prominence and importance that nursing holds.
The scope and standards of practice, as we briefly stated earlier, was published by the ANA in 1960. The goal of these standards is to pretty much guide nurses into improving the health care system and well-being of all individuals, communities, and populations. And then there's the standards of professionalism. So let's talk about what the two are.
The Standards of Practice describes a highly skilled level of nursing care. The levels of care are designed by a critical thinking model. Altogether, there are six levels to this model that set the foundation for decision making and actions when providing care to your patient.
So let's talk about those six levels. Starting with number one of the Standards of Practice, assessment. Assessment requires the registered nurse to collect comprehensive data about the patient's health or situation.
Diagnosis requires the RN to analyze the assessment data to determine the diagnosis or issue. Outcomes identification is when the registered nurse identifies the outcome of putting the patient on a certain care plan. Number four, planning.
The RN will develop a plan to receive that outcome. In implementation theory, the nurse puts that plan into action. In this level, the implementation level has four sub-levels, and that is coordination, How will the RN deliver this plan? Health teaching and promotion of a safe environment.
Consultation when an advanced practice RN, also known as an APRN, will help to construct the identified plan. Prescriptive authority and treatment is when an advanced practice RN, like a nurse practitioner, for example, prescribes the patient to prescriptions, therapies, procedures, treatments, or may give them a referral to see a specialist. And lastly, evaluation. This is when the registered nurse evaluates if the patient is progressing as a result of being on that plan.
The standards of professional performance is another method for nurses to maintain their professional roles. This also gives the nurse standards to determine if they are giving their patient high quality care. There are 10 levels to the standards of professional performance.
There is 1. The RN must perform ethically. 2. Education, the RN must attain knowledge, evidence-based practice, and research. Three, as a RN, you must include evidence and research findings into your practice. Four, quality practice.
Make sure you're administering quality nursing. Number five, be able to communicate in all areas. Number six, leadership.
The nurse must conduct leadership in a practice or professional setting. Seven, collaboration. The RN must be able to work.
well with the patient, family, and their peers. Eight, evaluate your own nursing practice. While delivering nursing care, you could ask yourself, am I distributing care to my patient that's meeting professional standards?
Number nine, resources. The RM must use appropriate resources to provide nursing care. You're making sure that this resource is safe for your patient, effective, and financially responsible.
And ten. The last level, environmental health, the RN is practicing in an environmentally safe and healthy manner. The code of ethics is another type of scope and standard of nursing practice.
It pretty much involves the ideals of what's considered right and what's considered wrong in terms of providing care to your patient. And it's important for you to incorporate your own values and ethics into your practice because it gives you a feel of what type of nurse you'll be. In this case, you could ask yourself things like, am I treating my patient the way I would like my loved one to be treated? Or simply, am I treating my patient the way that I would like to be treated? As a nurse, you're going to have a lot of different roles and responsibilities to make sure that your patient's needs are met.
Let's start with autonomy and accountability. These terms pretty much mean that as the nurse, you should be able to make responsible decisions without the doctor's instruction. Your role as a caregiver is to help your patient regain their physical, emotional, spiritual, and social well-being. As an advocate, you promote your client's human rights, and this may require you to defend your patient against anything that may violate their rights.
Educator, explaining concepts to your patient about their health. demonstrating procedures. This may require you to educate in your communities, your households, and plus it's always that one person at a gathering that will find out that you're a nurse and then just flood you with questions about their health.
So being an educator isn't limited to a classroom nor your work setting. Being able to communicate effectively is the foundation of building relationships in the nursing profession. You have to be able to clearly and concisely communicate with your patients, their families, and co-workers. The manager role requires the nurse to plan, guide staff, monitor, and give rewards. In the nursing profession, new roles are always being created because the profession is always changing and expanding.
This gives us so many different career opportunities. So we're going to discuss just some of those different career paths because, again, in the nursing profession, there is a limitless amount of different career paths you can take. You could be a provider of care. This allows you to give direct care to the patient. Usually when a nurse pursues their master's degree, they study a specialized area, making them an advanced practice RN, also known as an APRN.
For example, a clinical nurse specialist may specialize in a type of problem like pain, a population such as geriatric or pediatric, a certain setting such as critical care, a disease or a type of care. A nurse practitioner specializes in diagnosing and treating patients. A nurse midwife provides care for women during labor, delivery, and post-delivery. A nurse midwife may also offer services such as pap smears, family planning, or treatment for vaginal infections. A certified nurse anesthetist is an APRN that administers surgical anesthesia.
Now I know a lot of people may think, that a CRNA has to practice under supervision, but that isn't always true. In some states, a CRNA is actually able to practice independently. A nurse educator teaches. This requires a master's degree or higher.
A nurse administrator manages patient care. This requires the nurse to at least have a bachelorette degree, but may also have a master's degree in some type of administration. And a nurse research specializes in research and as I said earlier guys these are just some of the career paths you could take as a nurse.
There are so many more out there because this profession is constantly advancing and evolving. So I know you guys heard of the nursing shortage and because of the shortage a lot of times you may have to take on multiple roles and duties in your nursing career due to the lack of nurses available to work in the healthcare setting. This is going to require you to use your time wisely and professionally throughout your shifts.
And some ways you can do this is by managing your time, therapeutic communication, making sure you're educating your patient, making sure they have a complete understanding about their condition or situation. their treatment, and things of that nature. And making sure you're implementing compassion.
There are a lot of challenges in the nursing profession, but it is a very rewarding profession, and we can't let the hecticness of our job reflect in our patient care. Historical influences play a big role in where we stand in nursing today. Even in the past, nurses have always had an obligation to make sure they respond to the needs of their patient, just as we do now. And today we're actively involved in research and we're able to make decisions about what practices will be best for our patients. So let's talk about some of the leaders and milestones that led up to our current place in the nursing profession.
Let's start with Florence Nightingale. Florence Nightingale viewed the role of nursing as having charge over someone's health. She organized the first school of nursing called the Florence Nightingale at St. Thomas Hospital. She also improved sanitation, making her the first nurse to practice epidemiology. There are many other women who powerfully impacted the nursing profession during the Civil War to the 20th century.
There is Clara Barton. She found the American Red Cross. She provided wound care to soldiers on the battlefield and the ones that Clara Barton couldn't save, she comforted them during death. Mother Bickerdike organized ambulance services on the battlefield.
She was also a nurse for the American Red and she searched empty battlefields for wounded soldiers. Harriet Tubman, not only did she organize the Underground Railroad, but she also provided nursing care for Black soldiers and freed slaves. And I find it interesting that both Clara Barton and Harriet Tubman had near-death experiences as children and both suffered with epilepsy and then they grew up to be nurses.
Like, I think that's really cool and really interesting. Mary Mahoney was the first professionally trained Black nurse. She advocated for equality amongst the nursing profession. And then there's Lillian Wald and Mary Brewster.
These women provided free nursing care to the poor and homeless people of New York City. In the 20th century, the profession of nursing started to advance and move towards scientific based research to improve nursing practice. In 1906, Murray Adelaide Nutting became the first nursing professor at Columbia Teachers College. She also advocated for nursing to get moved into universities.
And in the 1920s, midwifery began, Army and Navy nurse corps were established, and toward the end of the 20th century, other specialization opportunities began to emerge for nurses to study. Today, the nursing profession is always changing to meet the needs of society. And due to how advanced technology has become, nurses today are required to have a strong body of knowledge in the nursing practice. And today, organizations are working toward decreasing the nursing shortage, supporting nursing students, and improving the overall health of the country's population.
And today, more is expected of nurses. Very important, self-care as a nurse. Again, this is a very demanding profession, so it's important that you take care of yourself and balance your work and personal life. Nurses may experience constant grief and loss of a patient, and without even having time to recover, nurses can experience loss and grief from another patient.
Especially nurses in acute care settings, they can constantly face draining situations on the job without having time to recover. This consistent exposure to grief and loss could cause a nurse to experience something called compassion fatigue. It occurs from giving excessive amounts of compassion and energy to suffering patients. And some symptoms of compassion fatigue usually results in the nurse feeling hopeless, anxiety, a loss of interest in things they usually enjoy. And compassion fatigue can lead to lateral violence in nurse-to-nurse interactions.
Lateral violence includes nurses withholding information from one another, snide remarks, aggressive facial expressions. And this is something that's more likely to happen to a new nurse or nurses new to a certain unit. And secondary traumatic stress is a type of trauma a nurse experiences from giving care to those who are suffering from trauma.
Burnout is a state of being mentally and physically exhausted because demands are outweighing resources. For example, it may be a busy week on the job, but a short supply of staff. Disengagement occurs when the nurse is frequently exposed to stressful nurse-patient relationships. All nurses do require resilience to be able to manage stressful situations and conflict, but at the end of the day, we are still human.
So it's important to build good relationships with your colleagues, openly express how you feel to one another. Also, there are tons of articles online full of self-care ideas for nurses and nursing students. So take care of yourself, guys.
Changes in society such as nurses self-care, the Affordable Care Act, also known as the ACA, rising health care costs, demographic changes, and the medically undeserved all play a huge role in impacting the nursing practice. The ACA affects how and where health care is paid for and provided. More nurses are going to be needed in community-based health care settings such as schools, senior centers, and community care centers.
Rising healthcare costs, of course, is a challenge because this can stop consumers from wanting to receive healthcare. Demographic changes such as an increasing population presents challenges to the nursing profession. Plus, today more people are living with chronic illnesses, which calls for a higher demand of healthcare resources. And of course the medically undeserved.
These are individuals that may be unemployed, homeless, have low-paying jobs, or mental illnesses. And due to rising health care costs, this could discourage these individuals from coming in to receive health care. So just briefly guys, the different types of degrees you can obtain as a nurse.
There is the two-year associate's degree. There is the four-year BSN degree. Then there's the graduate education in which a nurse can obtain their master's degree and become an advanced practice RN or AP RN.
There are two types of doctorate degrees a nurse can obtain, a PhD. A PhD in nursing focuses mainly on the research findings and theory development of the nursing profession. A DMP degree, on the other hand, focuses mainly on evidence-based practice.
Continuum education is a lifelong learning education that is constantly updating and educating nurses in new skills and research findings. The Nursing Practice Acts in the U.S. are overseen by the State Boards of Nursing. The MPAs regulate the scope of nursing practice.
They protect public health, safety, and welfare. They also shield the public from unsafe nurses and make sure that nurses are qualified to work in healthcare settings. In order for a nurse to become licensed, he or she has to take their NCLEX RN examination.
Now, if a nurse wants to become certified in a specific practice like a medical surgical nurse or a certified pediatric nurse, of course they have to be a licensed RN. But the steps you have to take may vary based on which state you're looking to become certified in. Professional nursing organizations address concerns for nurses and work to improve the standards of nursing, the well-being of nurses, and expand nursing roles.
There are some organizations out there for nursing students as well that address issues such as career development, licensure preparation. This is called the National Students Nurses Association, also known as the NSNA, and for Canadian students, the CSNA. Let's talk about some trends in nursing, and I'm going to let you guys go. Today the public is more aware of their health care needs and because of that your practice as a nurse should be based on current evidence. The Quality and Safety Education for Nurses, also known as the QSEN, addresses the challenge to prepare nurses with the characteristics needed to improve the quality of care in their work environments.
Emerging technologies also impact the health care system. Now on the bright side, these emerging technologies help nurses to use more accurate assessment tools and programs to collect patient data. Genomics is the study of all genes in a person, how these genes interact with one another, and with that person's environment. Genomic information allows nurses to determine how genomic changes impact a person's condition and influence what kind of treatment their patient should receive.
Also, it's important to maintain professional during your practice because your approach to care can influence the public's opinion of nursing. Politics and health policies also impact nursing. Nurses are more politically involved in their profession today.
We are working for health care legislation to meet the needs of our patients and get better health care delivered to the medically undeserved. Alright guys, that's the end of our lecture on Chapter 1 of Fundamentals of Nursing. If you haven't already, please like, comment, share, and subscribe. Check out the link below to shop for some cool merchandise.
Good luck in nursing school and remember to never give up. Thanks for watching!