Week 1 midterm

INTRODUCTION TO NURSING
What Is Nursing?
o Provider  Encompasses “Autonomous
o Truly knows her/his patients (individuality) and collaborative
o Professional who works care (with physician) of individuals
independently of all ages, families, groups and
o Health educator communities, sick or well and in all
o Companion of the physician in the setting.
care of pt Nursing Function
o Selfless person
o Life saver Has two dimensions:
o Promoters of Health a. Those aspects are inherent in nursing
o Role model diagnosis (when we say inherent it
o Support development and wellbeing could be taking vital signs)
of other b. The other dimension is concerned
o Prevents illness with the manner in which she carries
out any of her duties as a registered
What is Nurse? nurse, whether this be a dependent
 Comes from Latin word “nutrix” or interdependent.
meaning to “nourish” Nursing function includes:
Nursing means nurturing of others. The - Independent nursing functions
true meaning of nurturing is to provide - Dependent nursing functions
nourishment and to support the development - Interdependent functions
and wellbeing of others as well as to provide
education. 1. Independent Nursing Functions

This does not only occur in the context of  Direct and indirect patient care
disease but extends to the broader human services that ensure safety, comfort,
experience and honors the culture, mind, personal hygiene and protection of
body, and spirit of all people. patients, and the performance of
disease prevention and restorative
Nursing According to International Council measures.
of Nursing (ICN)  Bedside care (hygiene and comfort
 Includes PROMOTION OF measure)
HEALTH, PREVENTION OF  Health education
ILLNESS, and CARE OF ILL,  Observation of signs and symptoms
DISABELD AND DYING of illness, reaction to treatment,
PEOPLE general physical condition and
 determining whether observations
exhibit abnormal characteristics .
2. Dependent Nursing Functions
 It is not based on what which the
doctor prescribes, requests or directs
for the patient
 In accepting such direction or
prescription the registered nurse act
as a professional person responsible
and accountable for her own acts and
omissions
 Administration of medication and
therapeutic agents
 Direct and indirect patient care
services necessary to implement a
treatment, disease prevention or
rehabilitative regimen ordered by
and within the scope of licensure of
a physician, dentists, podiatrist or
clinical psychologist
 Implementation based on observed
abnormalities of appropriate
reporting or referral or initiation of
emergency procedures
3. Interdependent Nursing Functions
 Relates to the inter-relationship of
the nurse with the patient and with
other members of the health team
 Registered nurse functions to
coordinate and evaluate the care of
the client and independently revises
the plan and delivery of nursing care
Nursing functions
Whatever she does, she does on her own
responsibility and accountability for in law
she is personally liable for her acts of
omission or commission,
She and she alone remain accountable of her
actions. She is legally able or
knowledgeable and competent
Only she can decide whether enough, to
accept a specific prescription or direction
from a doctor, or is able to participate in the
care provided by other members of the
health care team
Once she indicated acceptance, she has
made an independent decision and accept
full responsibility and accountability for her
decision and actions.
Nursing (according to American Nurses
Association)
 Is the diagnosis and treatment of
human responses to actual or
potential health problems
 Focuses on the person receiving
care, their response to illness rather
than on their illness
 Emphasizes human responses to
health and health problems
Disease is the domain
physician
Nursing according to Florence Nightingale
 Is providing the most favorable
environment to an individual for
nature to act in order to promote
“reparativeness” and maintenance of
health and wellbeing
Nursing according to Virginia Henderson
 Is “to assist clients in the
performance of activities
contributing to health, its recovery or
peaceful death that clients will
perform unaided, if they had the
necessary will, strength or
knowledge (training the individual
 to reach his/her body’s normal  Is committed to personalized
function) services for all persons regardless of
color, creed or social or economic
status
 Is client centered
 Is adaptive
Nursing According to ADPCN
Aims of Nursing
 Is a dynamic discipline
 An art and science of caring for 1. Promotion of health
individuals, families, group and 2. Prevention of illness
communities geared toward 3. Alleviation of suffering
promotion and restoration of health, 4. Restoration of health
prevention of illness, alleviation of 5. Care of the dying- maintaining
suffering and assisting clients to face dignity and peaceful death
death with dignity and peace
Activity Aims of nursing
 Utilizes nursing process and guided
Assist surgeon 2,3,4
by ethico-moral principle removal of
Nursing damaged organ
Exercise 1,2
 Is assisting individuals in learning to Physiotherapy 3,4
care for themselves whenever Immunization 1,2
possible and caring for them when End of life 5, 3 for relatives
they are unable (Orem classifying
the patient)
Recipient of Nursing
Characteristics Nursing….
PATIENT vs CLIENT
 Is continuous caring
Patient
 Involves close, personal contact with
recipient of care  The one who is stay or admit
 Is concerned with services that takes  Comes from Latin word meaning to
human into account as physiological, suffer or to bear
psychological and sociological  A person who is waiting for or
organism (holistic) undergoing medical treatment
 Is autonomous  Ill or well, who receives services from
 Is empowered (ability to do a health practitioner
according to nurse’s potential)  Implies passive acceptance (nag agree
 Is committed to promoting sa treatment/procedure na gagawin) of
individual, family, community and decisions and care of health
national health goals in the best professionals
manner possible throughout life
Client
experiences from birth until the end
of life.  They can come and go
  A person, ill or well receiving services
in an ambulatory setting when health
maintenance rather than illness care is
the primary service being offered
 Receivers of healthcare as
collaborators, people who are
responsible for their own health
Florence’s Contribution to Nursing
Profession
(Proper education of nurses)
 She was the founder of modern nursing
and pioneered the concept of education
for nurses
 She first gained fame by leading a
team of 38 nurses to staff an overseas
hospital of the British army during the
Crimean War
1. Infection control- she made it her
mission to improve the hygiene
practices of the facility, which ended
up significantly reducing mortality at
the hospital.
2. Self-care (requiring patients to do
things for themselves in order to gain
independence and promote healing)
Nightingale required the least infirm
patients at the hospital to assist in cleaning
3. Assessment- She made rounds with
her lamp, talking to and assessing the
condition of her patient. Nursing
assessment are the core of nursing,
and all nursing action are based on
them. With that in mind, it’s only
fitting that her habit of making
assessment rounds was the reason why
the soldiers nicknamed her “the lady
with the lamp”
4. Therapeutic communication- during
her rounds Nightingale talked to her
patients, offering them empathy and
compassion in their moment of
despair.
5. Spiritual nursing- Nightingale
ministered to patients who were dying,
bringing them comfort in their last
hour.
6. Public health advocacy- Nightingale
wrote an 830-page report analyzing
and proposing reforms for military
hospitals operating under poor
conditions.
Nursing as Science
Nursing
 Systematic knowledge
 Scientific practice in a discipline of
study
 Based on nursing theories and
principles
 Guided by legal and ethical standards
5 types of cognitive process in Nursing
knowledge
1. Perception- using your senses you
can identify the problem
2. Association- Combining
3. Leaning- Through practice and
training
4. Reasoning- Justifying/ rationale
(research)
5. Communication
Carper’s
4 Levels of Knowledge
 Empirical
 Aesthetics
 Personal
 Ethics
(Empirical/Factual)
  Obtained from textbooks, lectures,
journals and online resources
 Focuses on evidence-based research
for effective and accurate nursing
practice
 Factual and descriptive knowing
 Can be done through learning from
scientific research and objective
experiences
Practice- ex: scrubbing the fingers before
assisting in OR
(Aesthetics)
 Used to mean “relating to the here
and now”
 Not to the consideration of beauty art
and taste
 Ability to decipher a patient’s qualities
 Embodies the nurse’s creative ability
to individualize care and expressive
styles of the nurses
 To understand what is of significance
to particular patients such as feelings,
attitudes, points of view
 Process of giving appropriate nursing
care through understanding the
uniqueness of every patient, thus
emphasizing use of creative and
practical styles of care
(Personal or Self Knowledge)
 Embodies interpersonal interaction
between nurses and client
 Recognizes individual’s unique
humanness
 Most difficult to master and teach
 Involves therapeutic use of self
(Nursing ethics)
 Ability to do the right thing in terms of
legal, social and moral issues
 Includes all deliberate nursing actions
involving and the jurisdiction of ethics
and professionalism
Four ways of knowing
 Empirical- the scientific discipline of
nursing
 Ethics- the moral directions of nursing
 Personal- method by which nurses
approach their patients
 Aesthetic- deals with the emphatic
aspect of nursing
Nursing as an Art
Nursing
 Is concerned with skills that required
proficiency and dexterity
 The skilled application of the
knowledge to help others reach
maximum health that quality of life
Nursing as a Vocation
 Is more than a profession a vocation of
compassionate
 To be of service to God through
service of the needy and suffering
fellow- beings
 The inner disposition to do good and to
be of service
Vocation Identified
 Vocation is go’s call to a particular
state of life
 God’s own choice of a way of life in
which man will best serve God and
neighbor
  The responsibility of an individual
or group to serve the divine purpose
in every condition, work or
relationship of life; one’s delegation
and responsibility under God
involves the total orientation of a
man’s life and work in terms of his
ultimate sense of mission
Nursing as a Profession
Nursing profession
 From the Latin word “profession”
which means public declaration with
force of promise
 The authority for the practice of
nursing is based upon a social contract
that delineates professional rights and
responsibilities as well as mechanism
for public accountability
 Is a calling that requires special
knowledge, skills and preparation
 Guided by nursing research, and is
governed by a code of ethics
Professionalism
 Refers to professional character,
responsibility and commitment
 Nursing requires discipline, patience,
compassion, responsibility,
punctuality and commitment
Criteria of Profession
1. Body of Knowledge- well defined
body of specific and unique
knowledge and expertise in its field
that undergo continual growth
through research
2. Clear standard of educational
preparation for entry into
practice- practitioners receive
educational institution of higher
learning
3. Service orientation (altruism)-
Practitioners are motivated by
commitment to service they provide
and consider their work vital to
human beings and welfare of the
society
4. Autonomy and Legal authority-
granted legal authority to define the
scope of its practice function and
roles and responsibility in the
delivery of its service
5. Accountability- regulates itself and
set standards for its members.
Control their own policies and
activities. Protects its members and
make it possible to practice
effectively.
6. Organized- Recognized authority
by a professional group
- Professional organization sets high
standard of practice
- Monitors performance behavior of
its member
- Unites for strength in achieving
larger purposes.
7. Code of ethics- Practitioners
decision and conduct are guided by
the code of ethics
- Places high value on integrity, worth
and dignity of others
- A member is expected to do what is
considered right regardless of the
personal cost
- Accepts its responsibility for
safeguarding the public it serves
8. Skill-based- requires competencies
with scientific basis for its
application
Professional Practice is…
 Scientific
 Systematic
  Dynamic
 Interdisciplinary
 Team-based
Components of Professional Role
 Accountability
 Authority
 Autonomy
 Advocacy
Qualification of Professional Nurse
 A bachelor of science in nursing degree
 License to practice nursing in the
country
 Physically and mentally fit
Primary types of Educational Programs that
leads to licensure
 Associate degree
- 2-year educational program
 Diploma
- 3-year in length
- Hospital-based programs
 Baccalaureate Degree
- 4-year degree
- Receives BSN
- Broader preparation for practice
Requirements to Practice Nursing
 Philippine Nursing Act of 2002 known
as R.A. 9173 Article lV Sec. 12-24
 Philippine Nursing Act of 2002 known
as R.A. 9173 Article Vlll Sec. 35
 Need for licensure
 The primary purpose of registration
is to protect the health of the people
by establishing minimum standards
which qualified practitioners must
meet
 Licensure discourages certain
persons who may be tempted to
misrepresent themselves as nurses
 It is the most important tool for legal
control and enforcement of nursing
practice
 It is also used to gather statistical
data about nurses and nursing in the
country
Personal and Professional Qualities of
Nurses
1. Respect
 Great nurses respect people and rules,
mindful of confidentiality
requirements and different cultures
and traditions
 Respect the wishes of the patient
2. Communication skills
 Excellent communication skills that
include speaking and listening
 Able to follow directions without
problem and can easily communicate
 With patients and families to
understand their needs and explain
treatments
 Able to keep information private
3. Emotional Stability
 Nursing is a stressful job and nurses
encounter many traumatic situations,
suffering, and death
 A great nurse is very stable
emotionally
 Able to work without allowing the
stress to cause great personal harm
 Able to work well under pressure and
calm emergencies
4. Empathy
  Great nurse has empathy for the pain
and suffering of patients
 They are able to feel compassion and
provide comfort
 Sensitive to the needs of people from
a variety of cultures and backgrounds
5. Flexibility
 A great nurse is flexible with regards
to working hours and responsibilities
 Nurses are often required to work long
periods of overtime, late or overnight
shifts and weekends
6. Good Attention to Detail
 A great nurse understands that every
step in the medical field is one that can
have far-reaching consequences
 A great nurse pays excellent attention
to detail and is careful not to skip steps
or make errors
7. Interpersonal skills
 A great nurse has excellent
interpersonal skills and works well in a
variety of situations with different
people
 They work well with other nurses,
doctors, and other members of a staff
8. Physical endurance
 A great nurse is able to tolerate
standing for a long period of time,
lifting heavy objects (or people), and
performing a number of taxing
maneuvers on a daily basis
9. Problem solving skills
 A great nurse can think quickly and
address problems as- or before- they
arise
 Nurses’ decisions and actions may
involve human life and wellbeing
 They must be constantly vigilant to
avoid errors that could endanger
patient’s life or reduce the
effectiveness or treatments
10. Quick Response
 A great nurse can respond quickly to
emergencies and other situation that
arise
 Quite often, healthcare work is
simply the response to sudden
incidences and nurses must always
be prepared
11. Excellent time-management
 Spend time wisely
 Do not waste time
 Plan effectively
Others
Genuine concern for people and their health
- A strong desire to become a nurse
- Nursing is a calling
- If it is your heart’s desire to serve
your fellow-man in need, chances
are that you will make a success of
nursing career
Mature- Physical and emotional
Responsible
Attributes of a nurse
 Characters
- Honesty
- Loyalty
- Tolerance
 - Judgement Competent nurses can…
- Reliability
 Formulates nursing diagnosis
- Motivation
 Formulates a nursing care plan
- Resourcefulness
 Performs essential skills
- Moderation
 Explain treatment and teaches care
 Charity
 Delegates and supervises care by
- Justice
subordinates
- Prudence
 Evaluates effectiveness of care plan
- Fortitude
 Modifies plan as needed
- Temperance
 Act as client advocate
Benner’s Five Levels of Proficiency in
Proficient nurse
Socialization Process
 Perceives situation as a whole rather
 Novice
than just its individual aspects
 Advance beginner
 Holistic understanding improves
 Competent
decision making
 Proficient
 Expert  Focuses in long term goals

Novice (nagiging head/chief nurse)

 Maybe a nursing student Expert nurse

 No experience  No longer relies on rules, guidelines
 Extremely limited ability to connect an understanding of
 Inflexible situation to an appropriate action
 Governed by structured rules and  Inclined to say that certain action
protocols was taken because “it felt right”
 Have highly developed perceptual
Advanced beginner
acuity or recognitional ability
 Demonstrate marginally accepted  Highly flexible, analytical, and
performance skilled
 Had experience with enough real
Nursing Roles
situations to be aware of the
meaningful aspects of a situation  Caregiver
 Advocate
Competent Nurse
 Teacher
 Manifested by a nurse who has been on  Manager
the job in a similar situation for 2-3  Researcher
years  Rehabilitator
 Can apply nursing process  Change agent
 Knows how to prioritize care  Counselor
requirement Nursing Competencies
 Demonstrates organizational ability
1. Patient centered care
Recognize a patient as the source of control
and dull partner in providing compassionate
and coordinated care based on respect for
patient references, values and needs
2. Teamwork and collaboration
Function effectively within nursing and
interprofessional teams, fostering open
communication, mutual respect and shared
decision making to achieve patient care
3. Evidence-based Practice
Integrate best current evidence with clinical
expertise and patient/family preferences and
values for delivery of optimal health care
4. Quality Improvement
Use data to monito outcomes of care
process and use improvement methods to
design and test changes to continuously
improve the quality and safety of health care
systems
P-plan
D-do
C-Check
A-Act
5. Safety
Minimizes risk or harm to patient and
providers through both system effectiveness
and individual performance
6. Informatics
Use information and technology to
communicate, manage knowledge, mitigate
error and support decision making