Topics Nursing - Test 1

Chapter 3 - Nursing’s Pathway to Professionalism

Profession vs Occupation ! Profession - work requiring advanced training and usually involving mental rather ! ! than manual effort. Usually has a code of ethics - a professional ! ! organization! Occupation - a person’s personal work or business

Occupation Profession

Training may occur on the job Education takes place in a college or university

Length of training varies Education is prolonged

Work is largely manual Work involves mental creativity

Decision making is guided largely by experience pr by trial and error

Decision making is based largely on science or theoretical constructs (EBP)

Values, beliefs, and ethics are not prominent features to preparation

Values, beliefs and ethics are an integral part of preparation

Commitment and personal identity vary

Commitment and personal identity are strong

Workers are supervised Workers are autonomous

People often change jobs People are unlikely to change professions

Material reward is main motivation Commitment transcends material rewards

Accountability rests primarily with employer

Accountability rests with individual

Kelly’s Criteria ! - The services provided are vital to humanity - the welfare of society ! ! Caring is the core of professional nursing; using the services of nursing interventions! - There is a special body of knowledge that is continually enlarged through ! ! research ! ! Use Evidence-Based Practice (theory and research) for nursing care! - The services involve intellectual activities, individual responsibility !! ! ! (accountability) is a strong feature! ! Use the nursing process to think creatively and critically - “The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligation to provide optimum patient care.”! - Practitioners are educated in institutions of higher learning ! ! Nursing education is primarily based in universities and colleges ! - Practitioners are relatively independent and control their own policies and ! ! activities (autonomy) ! ! Nurses are responsible for their own practices (autonomy) ! - Practitioners are motivated by service (altruism) and consider their work an ! ! important component of their lives ! - There is a code of ethics to guide the decisions and conduct of practitioners ! - There is an organization (association) that encourages and support high ! ! standards of practice ! ! ANA is the official voice of nursing and therefore is the primary advocate for nursing interests in general

Stages of develop in professionalism ! 1) Professional preparation ! 2) Professional commitment ! 3) Interprofessionailty !(Formal training, credentialing, creation of a subculture, legal right to practice, public acceptance, ethical practice, discipline of incompetent/unethical practitioners, relationship to other practitioners of the profession to users of the practitioners’ services)

Chapter 4 - Legal Aspect of Nursing

State vs. national board of nursing jurisdictions ! State Board of Nursing - ONLY under your state! ! 1) Define the practice of professional nursing ! ! 2) Set the minimum educational qualifications and other requirements for ! ! ! licensure ! ! 3) Determines the legal titles and abbreviations nurses may use! ! 4) Provides for disciplinary action of licenses for certain causes !! National board of Nursing ! ! 1) A clear differentiation between advanced and generalist nursing ! ! ! practice ! ! 2) Authority for boards of nursing to regulate advanced nursing practice, ! ! ! including authority for prescription writing ! ! 3) Authority for boards of nursing to oversee unlicensed assistive personal ! ! ! (UAP) !! ! 4) Clarification of the nurse’s responsibility for delegation to and ! ! ! supervision of other personal ! ! 5) Support for mandatory licensure for nurses while retaining sufficient ! ! ! flexibility to accommodate the changing nature of nursing practice

What is malpractice, what constitutes malpractice? ! - Malpractice - an act resulting in injury that occurs when a professional fails to ! ! act as a reasonably prudent professional would under similar ! ! circumstances ! 1) The professional (nurse) has assumed the duty of care (responsibility for the ! ! pts. care) ! 2) The professional (nurse) breached the duty of care by failing to meet the ! ! standard of care ! 3) The failure of the professional (nurse) to meet the standard of care was the ! ! proximate cause of injury ! 4) The injury is ignored

What is assault vs. battery and what constitutes each: ! assault - a threat or an attempt to make bodily contact with another person with ! ! or without the person’s consent

! battery - the impermissible, unprivileged touching of one person to another

Informed Consent ! - The process of asking individuals who are scheduled to undergo diagnostic procedures or surgeries or who are potential research subjects to sign a consent form once the procedures and risks have been explained and their privacy has been ensured. ! 1) Consent must be given voluntarily ! 2) Consent must be given by an individual with the capacity and competence to ! ! understand ! 3) The patient must be given enough information to beth ultimate decision maker

Patient Rights = Patient self determination act, HIPPA: ! patient rights - responsibility that a hospital and its staff have toward patients and ! ! their families during hospitalization ! patient self-determination - effective Dec. 1, 1991 - this law encourages patients ! ! to consider which life-prolonging treatment options they desire and to ! ! document their preferences in case they should later become incapable of ! ! participating in the decision-making process !! Health Insurance Portability and Accountability Act (HIPPA) - federal law passed ! ! in 1996, designed to protect health insurance coverage for worker’s and ! ! their families when they change or lose their jobs

Chapter 5 - Ethics: Basic Concepts for Nursing Practice

4 theories (definitions): ! !! Deontology: the ethical theory that the rightness or wrongness of an action ! ! depends on the inherent moral significance of the action

! Principalism: use of multiple ethical principles, such as beneficence, autonomy, ! ! nonmaleficence, veracity, justice, and fidelity, in the resolution of ethical ! ! conflicts rather than a single principle

! Utilitarianism: an ethical theory asserting that it is right to maximize the greatest ! ! good for the greatest number of people

! Virtue Ethics: the system of ethics based on a person’s natural tendency to act, ! ! feel, and judge but developed through training; ethics based on the natural ! ! traits of the decision maker

Ethical Principles of (definitions): !! Justice = an ethical principle stating that equals should be treated the same and ! ! that non-equals should be treated differently !! Autonomy = self-determination; control over one’s own professional practice

! Nonmaleficence = the duty to inflict no harm or evil

! Death with dignity = the philosophical concept that a terminally ill client should be ! ! allowed to die naturally and comfortably, rather thanexperience a ! ! comatose, vegetative life prolonged by mechanical support systems.

! Fidelity = an ethical principle that values faithfulness to one’s responsibilities !! Veracity = truthfulness

! Beneficence = the ethical principle of doing good

What is the code of ethics? ! = a statement of professional standards used to guide behavior and as a framework for decision making

Cohen’s Model = professional socialization consisting of four stages ! Stage I) Unilateral dependence ! Stage II) Negativity/Independence, students critical thinking abilities and ! ! knowledge bases expand ! Stage III) Dependence/Mutuality, students’ more reasoned evaluations of others ! ! ideas ! Stage IV) Interdependence, students needs for both independence and mutuality ! ! come together !

Chapter 6 - Becoming a Nurse !Reality Shock = the feelings of powerlessness and ineffectiveness often experienced ! by new nursing graduates! - usually occurs as a result of the transition from the educational setting to the ! ! “real world” of nursing in an actual health care setting

Harassment = the act of systematic and/or continued unwanted and annoying actions of one party or a group, including threats and demands. The purposes may vary, ! including racial prejudice, personal malice, an attempt to force someone to quit a ! job or grant sexual favors, apply illegal pressure to collect a bill, or merely gain ! sadistic pleasure from making someone fearful or anxious. Such activities may ! be the basis for a lawsuit if due to discrimination based on race or sex, a violation ! on the statutory limitations on collection agencies, involve revenge by an ! ! ex-spouse, or be shown to be a form of blackmail ("I'll stop bothering you, if you'll ! go to bed with me"). The victim may file a petition for a "stay away" (restraining) ! order, intended to prevent contact by the offensive party. A systematic pattern of ! harassment by an employee against another worker may subject the employer to ! a lawsuit for failure to protect the worker.

Burnout = a state of emotional exhaustion attributable to cumulative stress