Transcript 17. Nursing profession as new graduate nurses

Nursing profession as
new graduate nurses
• To
provide a process that supports
quality nursing care to the public.
• To support nurses in their professional
commitment to lifelong learning and
excellence.
• To provide annual reporting on the
Continuing Competence Process as a
means to demonstrate the nursing
profession’s accountability to the
public.
•Lifelong learning is a process that represents
both a value of the health professions and a
complex, critical competency of health
professionals.
•It presents as multiple facets:
–May be viewed as a value embraced by the broad
health professional community, or
–It may be seen as a behavior advocated by health
professional organizations and adopted by
individual health professionals.
•Defined by an Expert Panel, from Lifelong Learning in
Medicine and Nursing, Final Conference “Macy” Report,
as:
– The “lifelong, life wide, voluntary and self-motivated“ pursuit
of knowledge for either personal or professional reasons.
–Competencies of Lifelong Learning Include:
•reflect on one’s practice and thereby determine learning needs,
•efficiently and accurately search for learning resources and critically
appraise them,
•apply these resources to clinical and other questions,
•manage large and changing bodies of evidence,
•evaluate one’s competencies and practice based on internal and external
feedback,
•understanding of evidence-based healthcare and critical appraisal,
•familiarity with informatics and literature search and retrieval strategies,
•practice-based learning and improvement methods,
•self-reflection and assessment, and
•other skill sets related to knowledge management
•In making the transition from student nurse to practicing RN, the
importance of CE and LLL will become clear.
•It is our RESPONSIBILITY to ourselves, the profession, and patients.
–Inherent to their role, nurses have a professional, moral, and legal
responsibility to obtain and demonstrate continuing education and
lifelong learning throughout their career.
•Nursing is a fast-paced profession that is constantly changing, keeping
up with these changes through lifelong learning and continued
education, is essential to maintain competence to practice nursing safely
and ethically.
–CE and LLL promote evidence-based nursing practice, prevent
poor or substandard care, and contribute to safe and quality nursing
practice that aims to provide the best possible outcomes for patients.
•Healthcare worker shortages and under-funding of CE
programs within healthcare systems.
•1989 survey in Canada, and 1993 survey in Texas
–Lack of perceived need for CNE
–Time constraints at work
–Negative impressions regarding the course, course topic
–Lack of confidence in one’s learning ability
–Low personal priority
–Professional disengagement (burnout)
–Cost
–Travel
–Family and child care responsibilities
–Lack of employer support
•The most important element of lifelong learning is
probably the attitude toward information acquisition
•Encouragement of self-evaluation modalities:
–Self-assessment, discussion with peers, in-service examinations
•Create learning contracts
•Other habits to be successful as a lifelong learner:
–Begin with the end in mind – set goals
–Accept responsibility for your own learning
–View problems as challenges to learn from
–Have confidence in yourself as a competent, effective learner
–Create your own learning toolbox
–Use technology to your advantage
–Teach and mentor others
•Innovative in their practice
•Flexible to changing demand
•Resourceful in their methods of working
•Able to work as change agents
•Able to share good practice and
knowledge
•Adaptable to changing healthcare needs
•Challenging and creative in their practice
•Self-reliant in their way of working
•Responsible and accountable for their
work
•You can maintain competence by
using several methods of lifelong
learning:
–Reflection
–Attending workshops
–Reading nursing health journals
–Participating in workplace discussions
–Research online
–CEU’s
–Graduate Education
•There will be several resources at
your disposal including nursing
websites, libraries, and in-services at
your workplace. Take advantage of
this.
“In order to maintain current licensure the board requires a
nurse to renew their license on time and complete all of their
continuing education requirements. The board does not require
that a nurse practices in order to maintain current licensure.”
-Melissa Fure, MN Board of Nursing
- A unit of credit equal to ten hours of participation in
an accredited program designed for professionals with
certificates or licenses to practice various professions.
- Proof of credits earned is necessary in order to renew
a license to practice. The number of credits required
varies by industry and state.
-During a typical continuing education participation
period (24 months) an RN must participate in 24
contact hours of continuing education.
Many professions organize national conferences to
provide members with an opportunity to meet, network
and learn.
Activities which may meet continuing education
requirements may be fulfilled in one of three ways:
1. Obtain a current nursing specialty certificate
2. Participate in continuing education activities
offered by providers of continuing education, or
3. Participate in certain professional activities
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Publication of an article or book on nursing or health
related issues
Delivery of a professional paper related to nursing or
health care
Participation on a professional panel that addressed
nursing or health related issues
Participation in quality assurance or risk management
studies
Participation in nursing or health care research
o You cannot claim more than 10 contact hours for
professional activities
o Complete the professional activity during your
participation period
o Maintain a copy of the evidence of the professional
activity for two years after using the activity for
renewal.
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Be designed to enhance your ability to practice
nursing.
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Last at least one contact hour (50 minutes). Every
additional five minutes is one-tenth of a contact hour.
An academic course can be converted to contact
hours. A quarter credit is equivalent to 10 contact
hours. A semester credit is equivalent to 15 contact
hours.
•
Be approved by a health licensing board or association
or the provider of the continuing education must
identify the objectives of the continuing education.
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Be taught by an individual qualified to teach the
subject matter of the continuing education.
**It is your responsibility as an licensed RN to
determine whether a current nursing certificate, a
continuing education activity, or a professional activity
meets the continuing education requirements.
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A nurse educationally prepared at the postgraduate level with advanced didactic and
clinical education, knowledge, skills, and scope
of practice applied within the nurse/patient
relationship to achieve optimal outcomes
through clinical analysis, problem solving, and
evidence based decision making.
4 types of APN degrees
 Certified Registered Nurse Anesthetist (CRNA)
 Certified Nurse Midwives (CNM)
 Clinical Nurse Specialist (CNS)
 Nurse Practitioners (NP)
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Educated differently depending on specialty, yet require attainment
of at least a master’s degree in respected concentration (Masters of
Science in Nursing).
In 2004, The American Association of Colleges of Nursing (AACN)
in collaboration with the National Council of State Boards of Nursing
(NCSBN) recommended that APN’s move the entry level degree to
the doctorate level by 2015.
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All APRN training programs are required to convert master’s
degree to a clinical/practice doctorate degree by 2015.
American Association of Nurse Anesthetist (AANA) program
compliance by 2025.
Programs will then offer a Doctor of Nursing Practice (DNP).
(Grandfather Exception)
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Education and experience required to become a CRNA include:
 BSN degree or other appropriate bachelors degree
 Current license as a registered nurse
 One year minimum experience in an acute care nursing setting
 Graduation from a graduate school of nurse anesthesia (Programs
are 24-36 months)
 Programs include training in university-based or large
community hospitals
 Pass a national certification examination following graduation
*Minimum 7 calendar years of education and experience to prepare a
CRNA.
*Avg. student nurse = 1,694 clinical hours and administers more than
790 anesthetics.
*Avg. annual salary= $154, 567
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ANP with specialized education and training in both Nursing and
Midwifery.
Midwives are primary health care providers to women throughout
the lifespan. This means that midwives perform physical exams,
prescribe medications including contraceptive methods, order
laboratory tests as needed, provide prenatal care, gynecological care,
labor and birth care, as well as health education and counseling to
women of all ages.
Certified Nurse Midwives may work closely, or in collaboration, with
an Obstetrician & Gynecologist, who provides consultation and/or
assistance to patients who develop complications or have complex
medical histories or disease(s).
Currently 2% of Nursing Midwifes are men
*Avg. annual salary= $ 90,231
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Clinical nurse specialist programs provide skilled nurses with advanced theoretical knowledge and
practical experience for work with targeted population groups. Areas of specialization include
community health, gerontology, adult medical/surgical and mental health. Clinical nurse specialists are
trained to work directly with patients as well as in supervisory or administrative roles.
Experts in a specialized area of nursing practice and in the delivery of evidence-based nursing
interventions
Coursework will depend on area of focus.
24-26 months for completion of degree
Avg. annual salary= $ 85, 858
CNS-Core Competencies
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Direct clinical practice includes expertise in advanced assessment, implementing nursing care, and
evaluating outcomes.
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Expert coaching and guidance encompasses modeling clinical expertise while helping nurses integrate
new evidence into practice. It also means providing education or teaching skills to patients and family.
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Collaboration focuses on multidisciplinary team building.
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Consultation involves reviewing alternative approaches and implementing planned change.
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Research involves interpreting and using research, evaluating practice, and collaborating in research.
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Clinical and professional leadership involves responsibility for innovation and change in the patient
care system.
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Ethical decision-making involves influence in negotiating moral dilemmas, allocating resources,
directing patient care and access to care
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At least Master’s degree needed (phasing-out to DNP)
2-4 years education in specialty area
Licensed independent practitioners who practice in ambulatory,
acute, and long-term care as primary and/or specialty care providers
Education provides theoretical and evidence-based clinical
knowledge for role development as an NP.
Emphasis on development of clinical and professional expertise
necessary for comprehensive primary care and specialty care practice
in a variety of settings.
Apprx. 350 universities nation-wide have NP programs
NP’s specialize: Acute care, Adult Health, Family Health,
Gerontology Health, Neonatal Health, Oncology, Pediatric/Child
Health, Psychiatric/Mental Health, Women’s Health
Subspecialties: Cardiovascular, Dermatology, Emergency,
Neurology, Orthopedics, Urology, Sports Medicine
*Avg. annual salary= $ 87,721
Both require and original research project and the
completion/defense of a dissertation or linked research
papers.
Minimum 12 months post master’s studies necessary to acquire
the additional doctorate level competencies.
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Doctor of Philosophy in Nursing (PhD)
 Focus on academic research and teaching (research
focused) theory, meta-theory, research methodology, and
statistics
Doctor of Nursing Practice (DNP)
 Focuses on clinical aspects of nursing (practice focused)
 Advanced practice, leadership, application of clinical
research
Med/Surg
Oncology
CMSRN-Clinical Med Surg
RN
AOCNP-Advanced
Oncology Certified Nurse
Practitioner
OB
Pediatric
RNC-OB
RNC-MNN-Maternal
Newborn
RNC-LRN-Low Risk
Neonatal
NNP-BC-Neonatal NP
WHNP-BC-Women's
Health NPRNC-NICNeonatal Intensive Care
CPN-Certified Pediatric
RN
CPEN-Certified Pediatric
Emergency RN
CPNP-Certified Pediatric
NP
ACPNP-Acute Care
Pediatric NP
Critical Care
Mental Health
CCRN-Critical Care RN
PCCN-Progressive Care
RN
CMC-Cardiac Medicine
RN
CSC-Cardiac Surgery RN
ACNPC-Acute Care Nurse
Practitioner
CCNS-Critical Care Nurse
Specialist
APRN,BC-Advanced
Practice RN, Board
Certified
RN,BC-Registered Nurse,
Board Certified
RN,C-RN, Certified
APRN, BC in child and
adolescent mental and
behavioral health
What is it? Validates knowledge of nursing care of
acutely and critically ill patients
Requirements1. Current RN or APRN in the U.S.
2. 1,750 hours in direct bedside care of acutely
and/or critically ill patients during 2 year period prior
to application.
3. 875 hours need to be accrued in most recent year
of application.
How long is certification effective? 3 years
How many CEU's are required each year?
-Complete a minimum of 100 CEU hours in a 3 year
period
-60 CEU's in category A, 10 CEU's in both category
B and C, and the other 20 CEU's in category A, B, or C.
Category A: Lab values, BLS, ACLS, PALS, NRP, ECG, IV
therapy, heart failure, pharmacology, assessment,
pathophysiology, statistics, clinical research, evidencebased practice, exam reviews, practice protocols, and
CCRN self-assessment exam.
Category B: Safety, legal or ethical issues,
charting/documentation, reducing medication errors,
public policy, HIPPA, end-of-life care, advance
directives, stress management, medical Spanish,
therapeutic communication, cultural and psychosocial
aspects of care, diversity, and
preceptorship/mentoring.
Category C: Communication skills, teamwork, healthy
work environments, redesigning hospital care,
committees, management, leadership, community
resources, case management, and ACCN membership.
-Provides a competitive advantage against others vying
for the same position.
-Even though the pay raise is not significant, the
knowledge gained will benefit patient care and increase
self-confidence (in 2006, nurses with advanced
certification receive on average 7,000 more a year).
-Respect gained from other coworkers.
-Demonstrates a commitment to life-long learning.
-Assuring consumers that you are meeting evidencebased practice.
-Advancement in clinical practice (86% of managers
said they would hire a CCRN vs a BSN RN.
-Increased satisfaction and confidence.
Purpose:
To support and demonstrate the ongoing
competence of nurses who are practicing
as Registered Nurses
The interest in the continuing
competence of nurses has developed
locally, nationally and internationally as
the public demands for accountability of
professionals has increased.
•A
method used to measure
the on-going competence
and lifelong learning of
graduate nurses
• It is intended to be a tool
that is relatively easy to use,
and recognizes and builds
on the fact that most nurses
are already taking advantage
of learning opportunities
and continuing education
whenever possible.
Self Assessment – ask
yourself the questions:
1.“What do I need to learn
this year?”
2.“What would I like to
learn more about this
year?”
2. Identification of learning activities – ask yourself:
3.“What can I do to learn more about…?
“What activities, reading, courses could help me learn
about…?”
(These activities can include formal training or nonformal, self-directed learning)
Evaluation – ask yourself:
1. “Was I successful in meeting my
learning goals?”
2. “How do I know – what changes can I
see in my practice/knowledge”?”
Our goal is to encourage
nurses to be proactive about
meeting their learning needs
by developing an annual plan
identifying learning needs
including the steps to be
taken to meet those needs
and an evaluation of the
success of the learning.
We also encourage nurses to
keep a portfolio to record
professional development
activities – the planned
activities and the “incidental”
activities.
A. SELF-ASSESSMENT
To learn more about treatment options for chronic pain
syndrome.
B. PROPOSED LEARNING ACTIVITIES
Attend a workshop on CPS
Review the current research on CPS from the Institute for
Work and Health
C. COMPLETED LEARNING ACTIVITIES
Completed pre-reading package for workshop
Attended CPS workshop on (date)
Read online articles from Institute of Work and
Health (specify title and date retrieved)
D. EVALUATION
I feel confident in helping staff to understand the causes
and treatments for Chronic Pain Syndrome.