COLLEGE OF NUR
SING
NCM103 FNP
Fundamentals of Nursing
Practice
Nursing as a
Profession,
an Art and Science
Profession (9 wermomemewear
Criteria of a Profession
A profession is defined as a
vocation or occupation that
requires specialized
education,training,and
expertise,along with a
commitment to ethical
conduct and the application
of specialized knowledge to
serve society or meet the
needs of clients.
> A profession is generally
distinguished from other kinds of
occupations.
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a.Its requirement of prolonged,
specialized training.
b.An orientation of the individual
toward service,either to a community
or to an organization.
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c.Ongoing research
d.Code of ethics.
e.Autonomy.
f.Professional organization
Two terms related to profession need to be differentiated:
· PROFESSIONALISM
-refers to professional character,
spirit or methods.It is a set of
attributes,a way of life that implies
responsibility and commitment.
· PROFESSIONALIZATION
-is the process of becoming
professional,that is of acquiring
characteristics considered to be
professional.
Factors Influencing
Contemporary Nursing
Practice:
1.Health care reform
2.Quality and safety in health
care
*Consumer Demands
3.Family Structure
4.SCIENCE and TECHNOLOGY
OAdvance in science and technology affect
nursing practice.
5.Information,Telehealth
and Telenursing
6.Legislation
>Legislation about nursing practice
and health matters affects both the
public and nursing.
>Changes in legislation relating to
health also affect nursing.For
example,the Patient Self-
Determination Act (PSDA)requires
that every competent adult be
informed in writing on admission to a
health care institution about his or
her rights to accept or refuse medical
care and to use advance directives
7.Demography
is the study of Demog
population, aV
including
statistics about
AGI
DEAT
NG
distribution
HS
by age and place
of residence,
mortality(death), RIP
and morbidity
(incidence of
disease).
8.Nursing Shortage
9.Collective
Bargaining
10.Nursing Associations
Professional nursing associations have
provided leadership that affects many areas of
nursing.(ACEN and CCNE)
As a result,nurse graduates are
better
prepared to meet the demands of society
CANADIAN NURSES ASSOCIATION
(CNA)
Describe nursing as a
dynamic,caring, CANADIAN
helping relationship in NURSES
which the nurse assists ASSOCIATION ⑥
the client to achieve
and
obtain optimal health.
AMERICAN NURSES ASSOCIATION
(ANA)
“direct,goal oriented,and adaptable to
the needs od the individual,the family,
and the community during health and
illness”(ANA,1973).
FLORENCE NIGHTINGALE
“The act of utilizing the
environment of the patient to
assist him in his
recovery”(Nightingale,1860).
□Nightingale considered a
clean,well-ventilated and
quiet environment essential
for recovery.
VIRGINIA HENDERSON
“The unique function of
the nurse is to assist the
individual,sick or well,
in the performance of those
activities contributing to
health or its recovery or the
peaceful death.”
CER TAIN THEMES ARE COMMON TO
MANY OF THESE DEFINITIONS:
□Nursing is caring.
□Nursing is an art.
□Nursing is a
science.
□Nursing is a client
centered.
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□Nursing is holistic.
□Nursing is adaptive .
□Nursing is concerned
with health
promotion,health
maintenance,and
health restoration.
□Nursing is a helping
profession.
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kec
Nursing
The Recipients of Nursing are
sometimes called consumers,
sometimes patients,and sometimes
clients.
consumer is an
individual,
a group of people,or a
community that uses a
service for community.People
who use health care products
or services are consumers of
health care.
who is waiting for or
undergoing medical
treatment and care.The
word patient comes from
a Latin word (patiens)
meaning "to suffer"
or“to bear”.
Traditionally,the person
receiving health care has
been called a patient.
(armorceWa
A client is a person who
engages the advice or
services of another who is
qualified to provide this
service.The term client
presents the receivers of
health care as
collaborators in the care,
that is,as people who are
also responsible for their
own health.
Scope of
Nursing
THREE TYPES OF
Nurses provide care for three
CLIENT
types of clients:individuals,
families,and communities.
Nursing practice involves four
areas: promoting health and
wellness,preventing illness,
restoring health,and care of the
dying.
FOUR AREAS OF NURSING
PRACTICE
□Promoting health and
wellness
Preventing illness Financial Physical
∈
Restore Health Soc Spiritual
C are of the
(
WELLNESS
Oeatpatfonal Environmental
dying
Intellectual Emofional
I.Promoting health and wellness
mWellness is a state of well-
being.It means engaging in
attitudes and behavior that
enhance the quality of life
and maximize personal
potential.
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Nurses promote wellness in clients who are both
healthy and ill .
√ This may involve individual and community activities to
enhance healthy lifestyles.
mrmomcreian
Il.Preventing Illness
>The goal of illness
preventing programs is to
maintain optimal health
by
preventing disease.
> Nursing activities that
prevent illness include:
√ immunizations
√ Prenatal and infant care
√ prevention of sexually
transmitted disease
Nursing Activities
Include the following;
■Providing direct care to the ill person,such
as administering medications,baths,and
specific procedures and treatments.
■Performing diagnostic and
assessment procedures,such as
measuring blood pressure and
blood
examining feces for occult
.
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■ Consulting with other health care
professionals about client
problems.
'Teaching clients about recovery
activities,such as exercises that
will accelerate recovery after a
stroke.
■Rehabilitating clients to
their
optimal functional level
following physical or mental
illness,injury,or chemical
addiction.
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II.Restore Health
is a core focus of nursing practice,aiming to help
individuals recover from illness,injury,or health
challenges to achieve optimal functioning.
4 Examples of nursing practices aimed at
restoring
health:
■ Direct Patient Care
-Administering medications,performing wound care,or
providing treatments to address acute or
chronic
conditions.
Health Monitoring and
Assessment
-Regularly assessing patients'
conditions,monitoring vital
signs,and recognizing changes
that may require intervention.
■ Patient Education
-Teaching patients and families
about managing illnesses,
medications,and lifestyle
changes to facilitate recovery.
■Rehabilitation Support
-Helping patients regain strength,
mobility,and independence after
illness or injury through physical,
occupational,or speech therapy
**Nurses play a critical role in
supporting patients physically,
emotionally,and psychologically
during the process of restoring
health.
IV.Care of the Dying
>This area of
nursing practice
involves
comforting and
caring for
people of all
ages who
are dying.
■Nurses have different degree of
nursing autonomy and nursing
responsibility in the various settings.
They may provide direct care,teach
clients and support persons,serve
as nursing advocates and agents of
change,and help determine health
policies affecting consumers in the
community and in hospitals.
Standards of Clinical Nursing
Practice
■Establishing and implementing
standards of practice are major
functions of a professional
organization.The standards:
■Reflect the values and priorities of
the nursing profession.
■Provide direction for professional
nursing practice.
■Provide a framework for the
evaluation of nursing practice.
MDefine the profession's
accountability to the public and
client outcomes for which nurses
are responsible.
About a Nursing Student
"Yes,it's a sterile bubble.Since I'm
in nursing school,and I work,I
can't afford to get sick.”
(ANA)Standards of Clinical Nursing
Practice:
Assessment: the nurse collects patient
health data.
Diagnosis: the nurse analyzes the
assessment data in determining diagnoses.
Outcome identification: The
nurse identifies expected
outcomes
individualized to the patient.
Planning: the nurse develops a plan of
care that prescribes interventions to
attain expected outcomes.
Implementation: the nurse implements
the interventions identified in the plan
of care.
Evaluation: the nurse evaluates
the
patients progress toward attainment of
outcomes.
ASSESSMENT
EVALUATION THE DIAGNOSIS
NURSING
PROCESS
Nurseslabs
IMPLEMENTATION PLANNING
Roles and Functions of the
Nurse
■Caregiver encompasses the
physical, psychosocial,
developmental,
cultural, and spiritual levels. The
nursing process provides nurses with
a framework for providing care.a
nurse may provide care directly or
delegate it to other caregivers.
Communicator
■Communication is integral to
all
nursing roles.Nurses
communicate with the client,
support persons,other health
professionals,and people in the
Teacher
As a teacher,the nurse
helps clients learn about their
health and the health care
procedures they need to
perform to restore or
maintain their health.
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√ Counselor
√ Client advocate
Leader
MANAGER
The nurse manages the nursing care of
4
□individuals,
□ families,and
□communities.
The nurse also delegates nursing
activities to other nurses and
supervises and evaluates
their
performance.
Managing requires knowledge
about organizational structure
and dynamics,authority and
accountability,leadership,
delegation and supervision and
evaluation.
Case manager
■Nurses case managers work with
the multidisciplinary health care
team to measure the effectiveness of
the case management plan and to
monitor outcomes.Each agency or
unit specifies the role of the nurse
case manager.
Research consumer
Nurses often use research
to improve client care.In
a clinical area,nurses
need to:
■Awareness of the process and
language of research.
■Be sensitive to rights of human
subjects.
■Identification of significant
researchable problems.
■Be a discriminating consumer
of research findings.
Expanded career roles
Isuch as those of nurse
practitioner,clinical nurse
specialist,nurse midwife,nurse
educator,nurse researcher,and
nurse anesthetist,all of which
allow greater independence and
autonomy.
(9 wermomcmeweart
NURSING AS A
SCIENCE
meraopmcrEWeaFH
THE NURSING
PROFESSION
.…IS IT AN ART OR A
SCIENCE?
Introduction
DNursing began as a desire to keep people
healthy and to provide comfort and
assurance to the sick.
Although the general goals of nursing have
remained relatively the same over the
centuries, ever-advancing science and the
changing of society's needs have deeply
influenced the practice of nursing.
EverуЬоdу knows thatthe nursing'
profession has two dijfferent sides—йt i5
botD science and art
S Ci
What is a Science?
lkrequires systemizel knowlelge derved from observaton,
oiical thinking stay an cxanch
‘ Nursing is an art;and
if it is to be made an
art,it requires as
exclusive a devotion,
as hard a preparation,
as any painter's or
sculptor's work?
-Florence Nightingale
Nursing as a'Science'….Gradually,as the body of scientific
knowledge grew,nurses aware of the basic principles for
practice.
Nursing borrowed its science'from other discipline
What was unique to nursing?- Leeds to develop nursing
(9 Merao BAcFe HEAFH
epted.The science has
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I
y.Hence nursing is both a
N
science and an art.
”the science of nursing is the kmowledge base for
he care that is given,and the art of nursing is the
skilled application ofthat knowledge to help
others achieve maximum health and quality of
lie”
ART
SCIENCE
DEGREE
·CARE
QUALIFIED
·COMPASSION
·COMMUNICATION ·SKILLED AND
KNOWLEDGEABL
·SUPPORT
E
·REASURANCE
·PROFESSIONAL
·A SPIRITUAL
·CAPABLE AND
CALLING
COMPETENT
Conclusion:Nursing is indeed an art and
science.
Science helps to explain the work of a nurse,
while art addresses the human connections,
empathetic communication,and dedicated care
and compassion that make nursing a critical
element of healthcare.
rac xemeHe
NURSING AS A SCIENCE
OUTLINE:
A.Critical Thinking /Problem Solving
B. Nursing Process Process
1.Assessment
2.Nursing Diagnosis
3.Outcome Identification &Planning
4.Intervention
5.Evaluation
6.Documentation
DEFINITION OF KEY TERMS
Nursing Process
“A systematic,creative approach to thinking and doing that
nurses use to obtain,categorize and analyze patient data
and to plan actions to meet patient needs."
Nursing Process
“Atype ofproblem solving process requiring the use of
decision making,clinical judgment and variety of critical
thinking skils.”
Critical Thinking
“Goal-oriented,purposeful thinking that involves many
mental attitudes and skills,such as determining which data
are relevant and making inferences.“
Essential when a problem is ill defined and does not have
a
single best'solution.
Problem solving
“The mental activity of identifying a problem
(unsatisfactory state)and finding a reasonable solution to
it.“
"Requires decision making;
may or may not require the use of critical thinking.
Decision Making
“The process of choosing the best action to take -the action
most likely to produce the desired outcome.Involves
deliberation,judgment,and choice.“
Decision must be made whenever there are mutually
exclusive choices,but not necessarily problems.
Clinical Reasoning
“Logical thinking that links thoughts together in meaningftul
ways.Climnical reasoning is reflective,concurrent and
creative thinking about patients and patient care.”
Rellection or Refective Judgment
“Akind of crtical thinking that considers a broad aray of
possibilties and retlects on the merits of each in a given
situation.”
'Esential when a problem is compler and has no simple
“correct”solution.
Clinical Judgment
“The use of values or other criteria to evaluate or draw
conclusion about information.”
“Clinical judgments are conclusions and opinions about
patient's health,drawn from patient data.They may or may
not be made using critical thinking.“
Analysis/Critical Analysis
Analysis:
“The process of breaking down materials into component
parts and identifying the relationship among them.”
Critical analysis:
“Is the questioning applied to a situation or idea to
determine essential information and ideas and discard
superfluous information and ideas.”
CRITICAL THINKING
“The art of thinking about your thinking while you are
thinking so as to make your thinking more clear,precise.
accurate,relevant,consistent and fair.”
(Paul,1988)
Wilkinson,J.(2001)Nursing Process and Critical Thinking.3 Edition.New Jersey:Prentice Hall.
Are you a
critical
thinker?
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ask for clarificaotion when you don't
understand?
turnyour mistakes into learningopportunifies:
CHARACTERISTICS OF CRITICAL
THINKING
1.Rational and reasonable
"based on reasons;not on prejudice,preferences,self-
interest,or fear
2.Involves conceptualization
Concept-mental image of reality,ideas about events,
objects or relationship between them
CRITICAL THINKING ATTITUDES
Intellectual Humility
Means being aware of the limits of your knowledge and
realizing that the mind can be self-deceptive
Admitting lack of knowledge or skill can will enable you
to grow professionally
'Rethinking conclusions in light of new knowledge
4.Involves both cognitive (thinking)and
attitude(feelings)
5.Involves creative thinking
"It results in innovative ideas and products
6.Involves knowledge
Nursing knowledge
Scientific knowledge -facts,information,principles,
theories,research findings and conceptual models
used to describe,explain,and predict.
Ethical knowledge
"Knowledge of professional standard of conduct
Personal knowledge
knowing and actualizing one's self
Practice wisdom
acquired from intuition,tradition,authority,trial and error,
clinical experience
CRITICAL THINKING ATTITUDES
1.Independent Thinking
2.Intellectual Humility
3.Intellectual Courage
4.Intellectual Empathy
5.Intellectual Integrity
6.Intellectual Perseverance
7.Intellectual Curiosity
8.Faith in reason
9.Fairmindedness
10.Interest in exploring thoughts and
feelings
Intellectual Humility
"Means being aware of the limits of your knowledge and
realizing that the mind can be self-deceptive
"Admitting lack of knowledge or skill can will enable you
to grow professionally
"Rethinking conclusions in light of new knowledge
Intellectual Courage
Being willing to consider and examine fairly your own
beliefs and the views of others,especially those to which
you may have a strongly negative reaction
Intellectual Empathy
the ability to imagine yourself in the place of others in
order to understand them and their actions and beliefs.
HCS
HONESTY
Intellectual Integrity
INTEGRITY
'Being consistent in the thinking standards you apply(eg
clarity,accuracy,completenes)-holding yourselfto the
same rigorous standards of proof to which you hold
others
Intellectual Curiosity
"An attitude of inquiry
Having a mind filled with questions
Faith in reason
"Implies that people can,and should learn to think
logically
for themselves
Not afraid of disagreement
Fairmindedness
'Making impartial judgments
'Treating all viewpoints alike,without reference to one's
own feelings or vested interests,or those of one's friends,
community or nation
hterestineplorng thought and ieelng
The crical thinker knows that emotons cantene
hiikingand that alltonghs cae so l l
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Critical Thinking Skills
Analysis Communication
Creativity 0pen-Mindedness
Problem Solving
k the balance
CRITICAL THINKING SKILLS
1.Using language (RITICAL
THNKINC
'Precise,specific
'Avoid cliches,jargon, 9
euphemisms 中
problem solution
thinking
2.Perceiving
"Avoiding selective perception
"Recognizing differences in perception
3.Believing and knowing
Distinguishing facts from interpretation
Supporting facts,opinions,beliefs and preferences
Inference Opinion Judgment
·a conclusion reached on the -aview or judgment formed -the ability to make considered
basis ofevidence and about something,not necessarily decisions or come to sensible
based on fact or knowledge conclusions.
reasoning
4.Clarifying
Questioning to clarify meaning of words and
phrases
Questioning to clarify issues,beliefs,and points of
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5.Comparing
Noting similarities and differences
'Clasiying
'Comparing and contrasting ideals and actual practice
'Transferring insights to new context
6.Judging/Evaluating
'Providing evidence to support judgments
'Develop evaluation criteria
7.Reasoning
'Recognizing assumptions
'Distinguishing between relevant and irrelevant data
'Evaluating sources of information
Generating and evaluating solutions
'Exploring implications,consequences,
advantages/disadvantages
THAT'S ALL FOR
TODAY… .
ANY QUESTION??
#rciconnect
s
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