Nursing Social Policy Statement: the essence of the profession

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Social Concerns in Health Care & Nursing / 6 areas of health care:
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Nursing has an active & ending leadership role in public & political determination about 6 areas of health care: 1. organization, delivery and financing 2. provision for the public’s health 3. Expansion of nursing & healthcare knowledge 4. Expansion of healthcare resources 5. Planning for health policy 6. Duties under extreme conditions
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Organization, delivery & financing of healthcare
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ANA states quality healthcare is a human right to all. To improve quality of care health professionals must address these issues
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Provision for Public health
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Increase responsibility for self-care, by individuals, families, groups, communities or populations complements the use of health promotion, disease prevention and environmnetal measures. Whole country taking care of when your working with medicare and medicaid for example.
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Expansion of Nurisng and healthcare knowledge and appropriate application of technology
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Incorporation of research and evidence into practice helps inform selection, implementation and evaluation of processes associated with the generation and application of knowledge and technology to healthcare outcomes.
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Expansion of healthcare resources & health policy
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expanded facilities & workforce capacity for personal care and community health services are needed for support and enhance the capacity for self-help and self-care of individuals, families, groups, communities & populations.
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Definitive planning for health policy and regulation
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collaborative planning is responsive to consumer needs and provides for best resource use in the provision of health care for all. ex. 1. works with other disciplines 2. getting good feedback from patients 3. use those resources to meet their needs
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Duties under extreme conditions
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Healthcare professionals will weigh their duty to provide care with obligations to their own health and that of their families during disasters, pandemics and other extreme emergencies. -Washington DC couldnt leave for 2 days -Transport Nurse, flight nurses -small box outbreak, immunized against small pox and not get it ourselves.
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Authority for Nursing Practice for Nurses
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*social contract between society and the profession * under its terms, society grants the professionals authority over functions, vital to itself and permits them considerable autonomy in the conduct of their own affairs. * professionals are expected to act responsibly, always mindful of public trust. *self-regulation to assure quality & performance is at the heart of this relationship *authentic hallmark of a mature profession *Nurses regulate themselves * ENCLAS exam to help public be assured. the public has a right for you to expect this knowedge. confidency.
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Elements of Nursing’s Social Contract/ Patient and Your beliefs and respect
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*Humans manifest an essential unity of mind, body and spirit * Human experience is contextually and culturally defined *Health and illness are human experiences * relationship between nurse and patient occurs w/ in context of the values & beliefs of the nurse and patient. *we are not expected to give up on our own beliefs but respect other patients. – in Hong kong, Bird flu wear surgical masks. -here itd be weird if we did that. -dont like abortion, dont work in that ward.
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More on social contract i believe.
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*public policy and healthcare delivery system influence the health and well-being of society and professional nursing. *individual responsibility & interprofessional involvement are essential -remember what the physican said, what the pt said. it is the nurses responsibiility to know what and why things are happening to the patient.
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Definition of Nursing
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*….\”the protection, promotion & optimization of health and abilities, prevention of illness & injury, alleviation of suffering through the diagnosis & treatment of human response and advocacy in the care of individuals, families, communities and populations. *encompassess four essential characteristics of nursing. *What separates us from physicians? – we treat human responses to diseases – the physicians treats a disease – focus on what we can treat & what outcomes will be.
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Human responses
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*response of individuals to actual or percieved health problems & which are the phenomena of concern to nurses *include only observable need, concern, condition, event or fact of interest to nurses that may be the target of evidence-based nursing practice. *evidence based practice. Provide scientific rationale, why turning the patient every 2 hours rather than every 4 hours.
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Theory Application
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Theory= a set of interrelated concepts, definitions or propositions used to systematically describe, explain, predict or control human responses or phenomena of interest to nurses.
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Nursing Actions
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Aims of nursing actions, (aka) interventions are to: 1. promote, protect and optimize health 2. prevent illness and injury 3. alleviate suffering 4. advocate for individuals, families, communities and populations. All of our actions and interventions at various levels.
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Outcomes
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purpose of nursing actions is to produce beneficial outcomes in relation to identified human responses. 1. actions arnt producing any benificial outcomes, then it is worthless. 2. buisness vs. Nurses playing with children with aids. specific goals in mind.
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Knowledge for nursing based practice
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1. nursing is both a science and an art 2. knowledge base for professional nursing includes: -athstetics of nursing.
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Nurses partner with individuals, families, communities and populations to address issues such as..
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1.promotion of health and wellness 2. promotion of saftey and quality of care 3. care, self-care process, and care coordination 4. physical, emotional and spiritual comfort, discomfort and pain 5. adaptation to physiological (normal) and pathophysiological (abnormal) processes. 6. emotios related to the experience of birth, growth and development, health, illness, diesease and death.
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More issues continued.
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7. menings ascribed to health, illness and other concepts 8. linguistic and cultural sensitivity 9. health literacy 10. decision making and ability to make choices 11. relationships, role of performance and chance processes w/in relationships. 12. social policies and their effects on health 13. healthcare systems and other relationships to access, cost and quality of healthcare 14. environment and prevention of disease and injury.
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Scope of Nursing Practice.
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single scope of practice involves the range of activities from those of beginning RN thru the most advanced level of nursing practice * Docgtor of Nursing practice= nurse practicioner scope desrcibes who what where when why how
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Scope
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*all nurses are responsible for practicing in accordance with recognized standards of professional nursing practice and recognized professional code of ethics. * each nurse remains accountable for the quality of care w/in his or her scope of nursing practice * scope is dynamic and constantly evolving * individually liable quality of care you provide.
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Our scope of practice overlaps with those of other professions, whose boundaries are also evolving.
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*sharing knowledge, techniques, and ideas about how to deliver and evaluate quality & outcomes in health care *sharing some functions and a common focus on the same overall mission *recognizing the expertise of others w/in and outside the profession, reffering patients to other providers as needed. *much of what we do might be perscribed by others but we cary out actions safely and accountably. * need to know our own limits, beyond our own capabilities need outside consultations.
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Nursing Practice Necessities/ 4 step process
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neccessities include 1. critical thinking 2. apply best available evidence to caregiving 3. promotion of human functions and responses 4 step process: 1. assess 2. plan 3. action 4. evaluate
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We not only independently establish plans of care but also cary out interventions perscribed by other authorized providers so these concepts are central:
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1. advocacy- maybe a med is not working, advocate for patient 2. communication 3. collaboration 4. coordination- sick children amount of rest.
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RN and Nursing Education
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*all RNs are educated in the art & science of nursing, w/ the goal of helping individuals, families, groups, communities and populations to promote, attain, maintan and restore health or experience of a dignified death. * may also specialized but he ANA emphasizes that the that the baccualete degree in nursing is the perferred educational requirement for any entry into professional nursing. 1. manage hospitals 80% doctoral degree 2. associate nurses work in nursing homes.
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Specialization in Nursing
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A nursing specialty 1. defines itself as nursing 2. adheres to the overal licensure requirements of the profession 3. subscribes to the overall purposes and functions of nursing 4. is clearly defined 5. can identify a need and demand for itself 6. it has a well-derived knowledge base particular to the practice of nursing specialty *dont need extra education to specialize * Nurse practicioners must be licensed seperately 7 is concerned with phenomena of the discipline of nursing 8. defines competencies for the area of specialty nursing practice 9. existing mechanisms for supporting, reviewing, and disseminating research to support its knowledge base. 10. has educational criteria for speciality baccuraltte or graduate degree. 11. continuing education programs or continuuing competence mechanisms for nurses in the speciality..require graduate degree.
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Specialities and nation
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*organized and represented by a national or international speciality association or branch of parent organization. *practiced nationally/internationally * includes a substantial # of RNs who devote most of their practice to this specialty -might be a small number of nurses devoted to a particular genetic disorder, but not enough nurses to make it a specialization
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Advanced Nursing Practice
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1. Builds on competencies of the RNS and is characterized by… intergration and application of a broad range of theoretical and evidence-based knowledge that occurs as part of graduate nursing education Advanced programs in adult acute care -adult primary care -neonatal nurse practicioner, first 28 days of life.
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APRN
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1.master or doctoral degree in nursing. 2. certification in their designated specialty, practice area. 3. recognized and approved to practice in their roles by state boards of nursing or other regulatory oversight bodies, often through the special professional licensure * nurse practicioner–> masters degree *Doctor of nursing-same professional level as medicine and PT.
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Professional Roles for APRNs (advanced practice register nurse)
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1. certified nurse practicioners 2. certified RN anethestetics 3. certified nurse midwives 4. clinical nurse specialists. – like nurse practicioners BUT dont perscribe.
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Populations for APRNS
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1. family/individual across lifespan 2. adult/gerology 3. neonatal 4. pediatrics 5. women’s health/ gender-related health 6. psychiatric/ mental health 6. occupational health.
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Additional APRN specialists
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1. Nurse educator 2. Nurse administrator 3. Nurse policy analyst 4. Advanced public health nurse 5. Informatics Nurse specialists (IT people )

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