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Nursing As Profession
-Nursing, an art and science
-Art; you learn to deliver care with compassion, caring, respect for each patients diginit and
individuality
-Science; nursing practice is based on bodt of knowledge and evidence based practic that are
continually changing. New discoveries / innovations
-Nursing is a profession
-To act professionally, use critical thinking skills to administer quality evidence based, patient
centered care in a safe, prudent, knowledgeable manner
-You are responible and accountable to yourself, your patients, and peers

Science and Art of Nursing

-Nursing practice requires a blend of current knowledge, practice standards with a
compassionate approach to patietns health needs
-According to Benner, an expert nurse passes through five levels of proficinecy when acquiring /
developing generalist or specialized nursing skills

Novice:(5+)
-Beginning nursing student ‘ nurse enter a situation in which there is no previous level of
experience (experienced operating room nurses chooses to practice in home health care)
-Learner learns via specific set of rules or procedures, which are usually stepwise and
linear

Advanced Beginner:(5+)
-A nurse who has some level of experience with the situation
-Experience may be only observational in nature, but nurse is able to identify meanful aspects /
principle of nursing care

Competent:(5+)
-A nurse who has been in the same clinical position for 2 to 3 years
-Nurse understands organization and specific care required by type of patients (surgical,
oncology, orthopedic)
-He or she is competent practitioner who isable to anticipate nursing care and establish long
range goals
-In this phase the nurse has usually had expeirence with all types of psychomotor skills required
by this specific group of patients

Proficient:
-A nurse with more than 2 to 3 years of experience in same clinical position (5+)
-Nurse perceives patient clinical situation as a whole, is able to assess an entire situation, and
can transfer knowledge gained from previous experiences
-Nurse focues on managing care, instead of their performing skills
Expert:
-Diverse experience with an intuitive grasp of existing or potential clinical problem (5+)
-Able to focus on problem, and focus on multiple dimensions of a situation
-Skilled at identifying both patient centered problems and problems related to health care
system or perhaps needs of novice nurse

American Nurses Assoication (ANA) definition of nursing

-Nursing, the protections, promotion, optimization of health and abilities; prevention of illnee and
injurt, alleviation of suffering through diagonsis and treatment of human response, and advocacy
in care of individualsm families, communities and population

The International Council of Nurses (ICN 2018) has another definition

-Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well, in all settings. Nursing includes promotion of health,
prevention of illness and care of ill, disabled, dying people. Advocacy, promotion of safe
environment, research, participation in shaping health policy and in patient and health systems
management and education are also key nursing roles

ANA Standards of Nursing Practice

1.Assessment: Registered nurse collects pertinenet data / information relative to healthcare
consumers health / isutation
2.Diagnosis: RN analyzes assessment data to determine actual / potential diagnosis, problems,
issues
3.Outcomes Identification: RN identifies expected outcomes for plan individualized to health
care consumer or situation
4.Planning: RN develops a plan toat prescribes strategies to attain expected, measureable
outcomes
5.Implementation: RN implements identified plan.
Coordination of care: RN coordinates care delivery
Health teachinf / Health promotion: RN emplys stragties to promote health and safe
environment
6.Evaluation: RN evalauates progress towards attainment of outcomes

Professional Responibilites and Roles

1. Autonomy and Accountbility
-Essential element of professional nursing. Involves initiation of indepdent
nursing intervention with medical order (5+)
-With increased autonomy comes greater responibility and accountability
-Accountability; being responible professionally and legally for the type and
quality of nursing care provided (5+)
-Must remain current and competent in nursing and scientific knowledge and in technical
skills
2. Caregiver: (5+)
-Help patients maintain and regain health, manage disease, symptoms, attain a
 maximal level of fuction and independence through healing process
3. Advocate: (5+)
-As a advocate you protect you patients human and legal rights and provide
assistence in asseting these rights if needed
-You act on behalf of your patient and secure you patients health care rights
4. Educator:(5+)
-You explain concepts, facts about health, describe reason for routine care
activities, demonstrating procedures such as self-care, reinforce learning / patient
behavior and evaluate patient progress in learning.
5. Communicator:(5+)
-Effective communication is central to nurse patient relationship
-Allows you to know patient, including their preferences, strengths, weaknesses
and needs
6. Manager: (5+)
-Nurse manager coordinates activties of members in nursing staff for delivering
nursing care and has personnel, policy, and budgetary responbilty for specific
nursing unit

Career Development
-Majority of nurses practice in hospital settings. Followed by community based care, ambulary
care, home care and nursing home.extended care settings
1.The advanced practice registered nurse (APRN)
-Most independently functioning nurse
-APRN, has a masters degree / doctor of nursing practice (DNP) degree in nursing;
advanced education in pathophysiology, pharmcaology, physical assessment and
certification, expertise in specialized area of practice
-Title of APRN for nurses with advanced grdauate 0 level knowledge rprepared in on eof four
roles: Clinical nurse specialist (CNS), nurse practitioner (NP), certified nurse midwife (CNM),
certified registered nurse anesthetist (CRNA)

A clinical nurse specialists:

-Clinical nurse specialist (CNS) is an APRN. Expert clinican in a specialized area of
practice
-Speciality may be identified by population, setting (critical care), disease speciality (diabetes),
type of care (rehabilitation) or type of problem (pain)

Nurse Practitioner:
-Nurse practitioner (NP) is an APRN. provides comprehensive health care to group of
patients in an inpatient, outpatient, ambulatory care, or community based setting
-Care includes assessment diagonsis, planning, and treatment, monitoring ongoing health
status, evaluation of therapues and health education
*Prescribe medication
Certified Nurse Mid-Wife:
-(CNM) is a APRN. Educated in midwifery and is certified by american college of nurse
midwives (ACNM)
-Services include primary care; gynecologic, family planning, preconception care, care
during pregnancy, childbirthm postpartum period, care of normal newborn during first 28
days of lifem treatment of male partners for sexually transmitted disease

Certified Register Nurse Anesthetist:

(CRNA) is an APRN with advanced education from a nurse anesthesia accreditied
program

Nurse Educator:
Works primarily in schools of nursing, staff development departments of health care
agencies and patient education departments
Nurse Administrator
Manages patient care and the delivery of specific nursing serviece within a health care
Nurse Researcher
-Evidence based practice and research to improve nursing care and further define and expand
the scopre of nursing practice

Florence Nightingale
-Established the first nursing philosophy based on health maintenanace and restoration
-Developed first organized program for training nurses, the nightingale training school
for nurses at St. Thomas Hospital in London (5+)
-Nighting gale was the first practicing nurse epideiologist. Her statistical analyses connected
poor sanitation with cholera and dysentery
-Volunteered during crimean war in 1853 and traveled the battle fiels hospital in the night
carrying the lamp, thus known as lady with the lamp
*british women
*founder of nursing
*first epidemiologist
*Spoke about hygiene

The Civil War to the beginning of twength century

-Civil war (1860 - 1865) stimulated growth of nursing in US
- Clara Barton, founder of American REd Cross cared for soliders on the battle field.
Cleansing wounds, meeting their basic needs and comforting them till end of life (5+)
-Dorothea Lynde Dix, Mary Ann Ball and Harriet Tubman influenced nursing during civil
war (5+)
-Dix and Bickerdyke organized hospitals and ambulances, applinted nurses, cared for
wounded soldiers and oversaw and regulated supplies to the troops (5+)
- Tubman, active in underground railroad movement assisted in leading 300 slaves to freedom
-Lillian wald and Mary Brewster opened the Henry Street Settlement. Focused on health needs
for poor people who lived in tenements in NYC
Twentieth Century
-Early twenthirf century a movement toward developng scientific, research based defined
body of nursing knowledge and practice evolved
-Nurses assumed expanded and advanced practice roles
-1906: Mary Adelaide Nutting, first nursing professor at Columbia Teacher College
-Army Navy Nurse Corps established
-1920s:Nursing specialization began
-1990: ANA established Center for Ethics and Human Rights

Professional Registered Nurse Education

Prelicensure
-2 years associates
-4 year baccalaureate
Graduation education
-Masters advanced practice RN
-Doctoral degree
Continuing and inservice education