Transcript Introduction into Nursing

Introduction into Nursing
Part Two
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Nursing
An ART and SCIENCE
• Caring: nursing is caring for and about
people
• Individualized: nursing is adapting to each
persons needs
• Holistic: nursing views the ENTIRE person
including physical, spiritual, social,
psychological and economic needs
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Nursing
An ART and SCIENCE
• Interpersonal: nursing involves individuals,
families, groups - each interrelated
• Reasoning: nursing is a science that requires
critical thinking
• Comprehensive: nursing involves health
promotion, disease prevention, health
restoration and care of the dying
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Code of Ethics
• The Code of Ethics for Nurses was developed
as a guide for carrying out nursing
responsibilities in a manner consistent with
quality in nursing care and the ethical
obligations of the profession.
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Code of ethics at KSA
• http://www.moh.gov.sa/depts/NursingDepts/
Ethics/Pages/default.aspx
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CODE OF ETHICS
American Nurses Association
1. The nurse provides services with respect for human dignity and
the uniqueness of the client unrestricted by considerations of social
or economic status, personal attributes, or the nature of health
problems.
2. The nurse safeguards the client’s right to privacy by judiciously
protecting information of a confidential nature.
3. The nurse acts to safeguard the client and the public when
health care and safety are affected by the incompetent, unethical,
or illegal practice of any person.
4. The nurse assumes responsibility and accountability for
individual nursing judgments and actions.
5. The nurse maintains competence in nursing.
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CODE OF ETHICS
American Nurses Association
6. The nurse participates in activities that contribute to the
ongoing development of the profession’s body of knowledge.
7. The nurse participates in the profession’s efforts to implement
and improve standards of nursing.
8. The nurse participates in the profession’s efforts to establish
and maintain conditions of employment conducive to high-quality
nursing care.
9. The nurse participates in the profession’s effort to protect the
public from misinformation and misrepresentation and to
maintain the integrity of nursing.
10. The nurse collaborates with members of the health
professions and other citizens in promoting community and
national efforts to meet the health needs of the public.
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Challenges of the past
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Chronic shortage employed nurses
Negative practice environment
Education service gap
Evidence based practice
Heavy administration/ workload
Weak management
Poor work forces planning
Dr.Mirellina kingma, ICN
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Health Care System
• Complex of facilities, organizations, and
trained personnel engaged in providing health
care within a geographical area.
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Nursing and health care system
– With more than 3 million members, the nursing
profession is the largest segment of the nation’s
health care workforce.
– Working on the front lines of patient care, nurses
can play a vital role in helping realize the
objectives.
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Current Trends & Issues in Healthcare
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Nursing Shortage
Patient Satisfaction
Transcultural Nursing
National Patient Safety Initiatives
Evidence-Based Practice
Genetics
Globalization of Health
Aging Population
Legal & Ethical Issues
Terrorism/Bioterrorism/Disaster Nursing
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Types of Health Care Services
• Primary prevention
– Focus on health promotion and illness prevention
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Childhood obesity/nutrition
Physical activity across lifespan
Dental/oral health
Tobacco use/smoking cessation
Health screening recommendations
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Types of Health Care Services, continued
• Secondary prevention
– Focus on early disease detection, treatment
– Prevent progression of disease
– Early detection provided through screening
• Tertiary prevention
– Focus on restoring function, decreasing diseaserelated complications of already established
disease
– Includes rehabilitation and palliative care
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Nursing Theory
• Theory helps provide knowledge to improve
practice
• Theoretical knowledge provides nurses with
increased power
• Theory provides autonomy
• Theory helps develop critical thinking
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Health and Wellness
• Traditionally health and illness were viewed
as two separate entities
• WHO (World Health Organization) defines
health as “the state of complete physical,
mental, and social well-being and not
merely the absence of disease or infirmity”
• Currently viewed as:
Health-Illness Continuum
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Health - Illness Continuum
• Measures a person’s
perception of health
• Constantly changing
state
• High level wellness at
one end, normal health
in the center and
illness-death at the
opposite end
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Stress and Adaptation
• Stressors = disruptive forces
• Adaptations = reactions to stress and stressors
• Nursing acts to develop interventions to
reduce or prevent stressors
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What IS Critical Thinking?
• is a process for identifying underlying assumptions
and variables in order to draw conclusions and
make decisions.
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What IS Critical Thinking?
• Critical thinking involves the use of several
concepts, including: exploring, analyzing,
prioritizing, explaining, deciding, and
evaluating to identify solutions and
determine a course of action to solve patient
care problems.
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What IS Critical Thinking?
• Exploring encourages you to identify all the
variables within a situation.
• Analyzing is the process of studying each
variable to understand its meaning and its
relationship to the other variables.
• Prioritizing requires you to weigh the relative
importance of each variable to the others, at a
given point in time.
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What IS Critical Thinking?
• Explaining the variables involves the exercise
of amplifying each variable to understand its
meaning in the situation and to the involved
parties.
• Deciding means to choose a specific course of
action.
• Evaluating requires the thinker to assess how
correct the thinking process was, and if
further action is needed.
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Exercise
• Mrs. A , a 67-year old patient who suffers from COPD has
been admitted to your unit. Upon admission you note her to
be alert, oriented and appropriate. She provides you with
information to complete her history. After completing &
charting your assessment, you leave her to see to your other
patients. An hour later when you return, you note that Mrs.
A does not seem as alert, and appears to be confused.
• On each of the 5 components of critical thinking, write down
what could be going on with your patient.
Mrs.
A
Mrs. A
• Exploring: what could be causing this
previously alert woman to be so suddenly
confused?
• Hypoxia
• Hypotension
• Fatigue
• Infection
• Medications
• Unfamiliar Surroundings
• Stroke
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Mrs. A
• Analyzing: what other information can I
gather to help me narrow down the possible
causes of her confusion?
• Vital Signs
• Oxygen Saturation/ ABG
• Medications taken & last dose time
• Further assessment of confusion level
• Previous history of confusion?
• Potential infection sites & their appearance
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Mrs. A
• Prioritizing/Deciding: is this change significant
to this patient, and do I need to even look
further? This also includes the decision that is
made whether to inform the physician of the
change in their patient’s status. What would you
say?
• Considering that Mrs. A is a new patient, and
that this is a sudden change, it is potentially
clinically significant, and should be investigated
thoroughly, and reported to the Physician right
away.
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Mrs. A
• Evaluating: after reporting the alteration to the
patient’s Physician, he orders the following:
• STAT ABG & STAT Portable CXR
• Blood Cultures
• Urine & Sputum Cultures
• Head CT in the morning if confusion doesn’t resolve
• Discontinue all medications that could cause
confusion
• At this point, the Physician’s orders indicate to you
that he is thinking along the same lines as you did,
and your thinking process was complete
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Mrs. A
• Now the next time you have a patient who
suddenly presents with confusion, you
have a “history” with that experience, and
have a knowledge base to draw from.
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Side-by-Side
NURSING
PROCESS
Assessment
CRITICAL
THINKING
Exploring
Diagnosis
Analyzing
Planning
Prioritizing/decision
making
Prioritizing and
deciding
Evaluating
Implementation
Evaluation
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References
• http://www.rn4cast.eu/attachments/Challeng
es%20-%20MKingma.pdf
• http://www.moh.gov.sa/depts/NursingDepts/
Ethics/Pages/default.aspx
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