CSUS Nursing N111 MT1 – Flashcards
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Why is a nursing shortage projected through 2022?
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- ACA - retirees from nursing (55%) - population growth (immigration) - aging population (baby boomers, longer life expectancy) - shortage of schools (faculty, facilities, cost)
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List internet search terms you can use to focus search results
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AND OR NOT (don't use this often) .edu .gov .us
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What is the best place to research diseases?
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MedlinePlus
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Should you start research in Google or through Sac State library? Why?
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- Sac State library databases are more efficient - Have guides that are organized by subject (i.e. nursing, psychology)
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What is CINAHL?
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Cumulative Index to Nursing and Allied Health Literature
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What is EBSCO?
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A multi-disciplinary database that provides access to full-text articles
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What is NCBI?
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PubMed. Indexes worldwide biomedical literature including research, clinical practice, administration, policy issues, and health care services. Articles indexed from 5,663 journals
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When would you utilize Google Scholar?
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To search for an article when you have the exact title
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What is cultural competence?
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"developing an awareness of one's own existence, sensations, thoughts, and environment without letting it have an undue influence on those from other backgrounds; demonstrating knowledge and understanding of the client's culture; accepting and respecting cultural differences"
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What is "culturally competent care?"
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- The provision of appropriate, sensitive care to people from diverse back rounds different from that of their own - Adapting care to be congruent with the client's culture
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What does "cultural mismatch" mean?
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What occurs when people violate each others' cultural expectations
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What is "ethnocentrism"?
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- The universal tendency of all humans to think that their ways of thinking, acting, & believing are the only right way - The belief that one ethnic group is superior to all others Judging other groups from our own cultural point of view
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What is "stereotyping"?
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- An oversimplified opinion or belief about a group of people - Tendency to believe that all members of a group are the same - Generalizations have value because it gives nurse a starting point - Starting point only...not the end point
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What are factors affecting assimilation?
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- Length of time in U.S. - Education - Social status - Living within a group or separate - Desire to assimilate to mainstream
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What is a "subculture"?
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Group within a culture that differentiates itself from the parent culture to which it belongs, often maintaining some of its founding principles Groups that have values and norms that are distinct from those held by the majority
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What are attributes of team players?
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-Appreciation for value of team decisions -Respect for team members -Openness to feedback -Shared vision/goal -Appreciation of each others skills, abilities -Being positive & constructive in feedback
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What are stages of team development?
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- Forming - Storming - Norming - Performing
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Define "morals"
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- What is right & wrong - Laws represent the minimum standard of morality, but nurses have higher calling than the law - Established rules or standards that guide behavior in situations where decision about right or wrong must be made
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Define "ethics"
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- Guide to decision making - What should be done? Exceptions to the rule - Branch of philosophy that studies propriety of certain course of action
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Define "bioethics"
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Area of ethical inquiry focusing on dilemmas inherent in modern health care
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Characteristics of ethical dilemmas
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- Choice is between equally UNDESIRABLE alternatives - The real choice exists between possible courses of action - People involved place significant DIFFERENT value judgement on decision - Data alone will NOT help resolve dilemma
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What is ethical decision making?
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Process of choosing between actions based upon a SYSTEM OF BELIEFS AND VALUES
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What are the principles of ethical behavior?
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Autonomy Justice Fidelity/Privacy Beneficence Nonmaleficence Veracity/Truth-telling Standard of Best Interest Obligations Rights
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Define "Autonomy"
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Self governing, FREEDOM TO MAKE DECISIONS about issues that affect one's life; has capacity to make decision and is free to act on choices
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Define "justice"
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FAIR, EQUITABLE and appropriate treatment in light of what is due or owed to persons; giving to some will deny receipt to others
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Define "fidelity"
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Faithfulness and PROMISE KEEPING; nurses must faithfully uphold the profession's code of ethics: - Practice within established scope of practice - Practice competently - Keep promises to patients
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Define "beneficence"
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Requires one to act in a way that BENEFITS others: - Do or promote GOOD for others - PREVENT harm - REMOVE evil or harm
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What are the steps in ethical decision making?
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1) Clarify the ethical dilemma - What is specific issue? Who should make the decision? Time frame? 2) Gather additional data - legal cases 3) Identify options - brainstorm with others and consider every possible alternative 4) Make a decision - determine impact of each option and make decision; do not refuse to make a decision (irresponsible) 5) Act - Implement decision 6) Evaluate - Reflect; determine if another course of action would have yielded better outcomes
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Cohen's Model of Socialization
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1) Unilateral dependence 2) Negativity/Independence 3) Dependence/Mutuality 4) Interdepenence
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Define "unilateral dependence". What model? What stage is this?
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First stage in Cohen's Model of Socialization. - Inexperienced - Total reliance on authority - Does not question or analyze; does exactly as told
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Define "negativity/indepence". What model? What stage is this?
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Second stage in Cohen's Model of Socialization: - Thinking starting to expand - Begin to question - Cognitive rebellion like small child - May overestimate ones' abilities
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Define "dependence/mutuality". What model? What stage is this?
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Third stage of Cohen's Model of Socialization: - More reasoned evaluation of others' ideas - More realistic appraisal process - Accept some ideas, reject others - Appreciate usefulness of nursing process - Begin using more critical thinking
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Define "interdependence". What model is this? What stage?
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Fourth stage in Cohen's Model of Socialization: - Collaborative decision making - Works independently but can also collaborate - Develops role identity - Self-directed - Seeks out learning experiences to maximize learning
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List Benner's stages of nursing proficiency
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1) Novice 2) Advanced beginner 3) Competent practitioner 4) Proficient practitioner 5) Expert practitioner
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Describe Benner's 'novice' stage
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- Limited skills - Relies totally on others - Depends rigidly on rules and expectations established for them
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Describe Benner's 'advanced beginner' stage
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- Some skills - Performance is marginally competent - Difficulty prioritizing; views many activities as equally important - Knows that particular order exists in clinical
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Describe Benner's 'competent practitioner' stage
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- 2-3 years experience - Feels competent, organized, efficient - Coordinates several tasks - Understands situations can change quickly so wants to plan to prepare in case of emergency
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Describe Benner's 'proficient practitioner'
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- 3-5 years experience - Sees pt situations holistically rather than in parts - Recognizes subtle changes, absence of normal - Sets priorities easily - Focuses on long-term goals - Likely to be leaders, committed to nursing profession
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Define Benner's 'expert practitioner'
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- Reached only after extensive practice experience - Performs intuitively without conscious thought - Moves fluidly - Expertise comes naturally
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Define 'civil law'
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- Deals with violation of a person's rights by another - Dispute is resolved by third party & compensation given - Tort law is one type of civil law where nurses are often involved
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Define 'negligence'
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- Omission of an act of care that a reasonably prudent person would exercise in like circumstance - Involves hard caused by carelessness, not intentional
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Define 'tort'
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French word = 'injury' or 'wrong': - Wrongful act against a person or property - Intentional or unintentional
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Define 'malpractice'
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- Negligence, but applied to a professional - A professional FAILS TO ACT as a reasonably prudent professional would have acted in a similar situation - Expert witnesses often testify
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Define 'assault'
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Conduct making another person fearful of violence; may not actually carry it out
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Define 'battery'
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Contact with a person that involves injury or offensive act; actual touching
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Define 'informed consent'
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- Process of communication that results in pts authorization or agreement to undergo a specific medical intervention - Nurse responsibility
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What is the Nurse Practice Act?
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- Outlines scope of practice and responsibilities for RNs within each state - Most important law affecting nursing practice - Authoritative statements of the duties that all RNs are expected to perform competently
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How do you protect yourself from getting sued?
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- Document, document, document - Ensure competency (stay up-to-date thru CEUs, reading current literature); know limits and agency's policies - Communicate effectively with h/c team - Be in control of your practice - Practice in safe settings - Perform frequent assessments - Delegate responsibly - Avoid medication errors - Carry liability insurance - Promote positive interpersonal relationships
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What are 3 routes for nursing education?
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1) Diploma program 2) Associate degree 3) Baccalaureate degree
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Define 'certification'
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- Nurses may choose a speciality and become certified in that area - Requires experience + exam
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Who is Mildred Montag
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- Proposed Associate's Degree during WWII to cover nursing shortage - Meant as a temporary fix until BSN students were ready
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Who is Florence Nightingale?
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- Most influential person in nursing education - Professionalized nursing by requiring advanced education - Opened SON at St. Thomas' Hospital, London (1860)
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What is the Goldmark Report?
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- Authored by Josephine Goldmark (1922) - Pushed for university based nursing programs - Started battle over whether nurses should be seen as professionals or technicians
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What was the Brown Report?
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- Sponsored by Carnegie Foundation in 1948 - Recommended schools of nursing be placed in universities and colleges - Effort to recruit men and minorities
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What is the Nursing Training Act of 1964?
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- Passed under Kennedy administration - $300 million into nursing education, especially at collegiate level - Most significant milestone in nursing education!`
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What was the IOM Report?
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Institute of Medicine report (2010) called "The Future of Nursing: Leading Change, Advancing Health" - Calls for increasing number of baccalaureate-prepared nurses to 80% and doubling number of nurses with doctoral degrees by 2020
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What is "BSN in 10"?
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NY, NJ and RI introduced legislation requiring RNs to earn a BSN within 10 years of initial licensure - Does not affect practicing nurses
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What is "articulation"?
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Facilitating movement of graduates of one type of program into a higher level (ie. ADN --> BSN)
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What nursing programs does CSUS offer?
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- Traditional BSN - RN to BSN - MSN
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POLST vs AD vs DNR
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Physician Orders for Life-Sustaining Treatment (POLST): portable, actionable medical order that travels with pt; advance care planning that ensures pt's wishes are honored. Advance Directive (AD): mechanism for naming a health care agent or durable power of attorney for health care and general treatment wishes. Do Not Resuscitate (DNR): applies when a person does not have a pulse, is not breathing and is not responsive; can be part of a POLST.
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What are steps to helping pts with end-of-life planning?
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1) Initiate discussion 2) Clarify prognosis 3) Identify end-of-life goals 4) Develop a treatment plan
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Define what it means to think critically in nursing
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* Ability to think in a systematic and logical manner, solve problems, make decisions and establish priorities in the clinical setting. * It is open-minded and recognizes alternative ways of seeing problems and has the ability to assess the assumptions, implication and consequences of alternative views of problems.
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Critical thinking is ...
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- Purposeful - Goal-directed - Problem-solution seeking But ideally, should PREVENT a problem from occuring.
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What abilities does a critical thinker possess?
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- Recognize problems - Gather evidence - Evaluate alternative solutions - Communicate effectively - Implement solutions
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What is the difference between an academic discipline and an applied one? Which discipline does nursing fall into?
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ACADEMIC: problem is well-structured; right answer found by applying right formula (ie. math) APPLIED: problems are confusing, insufficient or conflicting data, no signal correct solution. (nursing)
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What is the nursing process (in context of critical thinking)?
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A framework for critical thinking: Systemic approach to thinking and using series of actions intended to solve problems in order to meet pt needs
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What are the five steps in the nursing process?
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1) Assessment 2) Analyze & identify problem 3) Planning 4) Implementation 5) Evaluation
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What is MIND MAPPING?
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- Using a diagram to arrange ideas & interconnections visually - Gives ability to organize bank of knowledge for application into practice - Main idea in center or top and work outward to produce organized structure - Provides direct, real-time view of thought processes
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How does journaling help develop critical thinking skills?
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- Recording clinical experiences enhances reasoning skills - Form of reflection that allows you to view your own thinking, reasoning and actions - Address: What happened? My role? My feelings? What could I have done different? What should I do next time?
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How do group discussions encourage critical thinking?
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- Group members explore alternatives to draw conclusions - Students question, analyze and reflect - Helps to connect their (classroom learning) with clinical experience **Goal is to maximize learning for all! **
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How does a nurse sharpen critical thinking skills?
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1) Know BASELINES - know what is normal 2) Be SELF-AWARE - know what you do and what you don't 3) Know the WHAT - HPI of pt 4) Know the WHY - why are we doing what we are doing with the pt, why are they experiencing certain effects, why why why! 5) Know the WHY NOT - why am I NOT doing something
