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This is just something good to read after studying your book and your notes.

Contents: Concepts of nursing profession Republic acts, scope of nursing, ethical principles CARPERs patterns of knowing Types of nursing Fields of Nursing Communicating to person of a specific age bracket FUNDAMENTALS OF NURSING Concepts of Nursing The four major concepts in nursing theories are the person, environment, health, and nursing Nightingale- act of utilizing the environment of the patient to assist him in his recovery The function of the nurse is to ASSIST(assist the well and sick to recovery and even to peaceful death)

Caring involves five processes: Knowing- understanding an event in the life of other Being with being emotionally present to the other Doing for- assisting Enabling- facilitating a client through transitions and unfamiliar events Maintaining belief- sustaining faith through spiritual support Concepts of Profession - A profession is an organization of an occupational group based on the application of special knowledge which establishes its own rules and standards for the protection of the public and the professionals - Serves all society and not the specific interest of the group - Altruistic rather than materialistic Characteristics and attributes of a professional Person are as follows: 1. Concerned with Quality 2. Self directed, responsible 3. Able to make, independent, sound moral judgment 4. Dedicated to improvement of human life 5. Aims for continuous studies and research to improve knowledge Nursing as a Profession

As a profession, Nursing possesses the following primary characteristics: 1. Education- requires specialized knowledge and training 2. Theory-follows different theories for defined skills, abilities and norms 3. Service-provides service needed by the society 4. Code of Ethics- Has self impelling power to retain its members throughout life(ex. Philippine Nurses Association) 5. Caring- the most unique and distinctive role of a nurse making it different to other profession 6. Autonomy-Members has autonomy in making decisions and practice FOUR VIRTUES EMANATING FROM THE PRACTICE OF CHARITY Justice- the quality of being righteous Prudence- permits us to live with good sense and perspective Fortitude-Assists in the control of feelings, thoughts and emotions Temperance- constructive use of pleasure of senses ATTRIBUTES OF CHARACTER Honesty Motivation Loyalty Resourcefulness Tolerance Moderation Judgement Reliability ATTITUDES OF A NURSE TOWARDS A PATIENT Acceptance of the patient Helpfulness Friendliness Firmness in approach and implementation of rules Permissiveness-being sensitive to a clients needs and allowing them to do what they want to do Limit Setting- limiting unacceptable behavior Sincerity Competence- approaching problems intellectually CARPERS PATTERN OF KNOWING Empiric knowing- based on the assumption that what is accessible through physical senses, particularly seeing, touching, and hearing, and as pattern of knowing draws on traditional ideas of science Ethical knowing- involves making moment moment judgments about what to ought to be done, what is good, what is right, and what is responsible. Ethical knowing guides and directs how we conduct and work, what we consider important, where our loyalties are placed, and what priorities demand advocacy

Personal Knowing- Concerns the inner experience of becoming a holistic, authentic self-capable of unifying the plural dimensions in which that self lives in an honest and open manner. Full awareness of the self, the moment, and the context of interaction with others makes possible meaningful, shared human experience Aesthetic (Esthetic knowing) knowing- Involves deep appreciation of the meaning of a situation and calls forth, inner creative resources that transform experience into what is not real, bringing to reality something that would not otherwise be possible. Overview of Professional Nursing Practice 1. Novice 2. Advanced Beginner 3. Competent 4. Proficient 5. Expert Roles and functions of a Professional Nurse Care Provider Leader Communicator / Helper Manager Teacher Researcher Counselor Case Manager Client Advocate Collaborator Change Agent



This Act shall be known as the Philippine Nursing Act of 2002 ARTICLE II Section 2. Declaration of Policy -the state should assume responsibility for the protection and improvement of the nursing profession by instituting measures that will result

in relevant nursing education, humane working conditions, better career prospects and dignified nurse existence ARTICLE IV Ssection 28. The Scope of Nursing Practice - Perform nursing service to individuals families, and other communities in any health care setting - Nursing actions include care during conception, labor and delivery, infancy, childhood, toddler, pre school, school age, adolescence, adulthood, and old age. - Promotion of health and prevention of illness - It is the duty of nurse to COLLABORATE and COORDINATE with other health care providers or health care team - It is the duty of the nurse to provide nursing care through the utilization of the nursing process. - Provide health education to individuals, families and communities - Teach, guide and supervise students in nursing education programs - Undertake Nursing and health human resource development training and research Sec 29. Qualification of Nursing Srvice Administrators a. A registerd nurse in the Philippines b. Have atleast 2 years of experience in general service administration c. Degree of Bachelor of Science in Nursing, with at least 9 units in management and administration courses at the graduate level d. Be a member of good standing of the accredited professional organization of nurses Or a. Atleast 5 years of experience in a supervisory or managerial poition in nursing b. A masters degree major in nursing Ethical Principles 1. Values, customs, and spiritual beliefs held by individuals shall be respected. 2. Individual freedom to make rational and unconstrained decisions shall be respected 3. Personal information acquired in the process of giving nursing care shall be held in strict confidence 4. Human life is inviolable 5. Quality and excellence in the care of the patients are the goals of nursing practice 6. Accurate documentation of actions and outcomes of delivered care is the hallmark of nursing accountability 7. Registered nurses are advocate of patients

8. Nurses should be aware that their actions have professional, ethical, moral and legal dimensions. 9. Solidarity with other workers of the health care team in working for the patients interest 10.The registered nurse maintains collegial and collaborative working relationship with colleagues and other healthcare providers 11.Respect for the patients bill of rights DIFFERENT FIELDS OF NURSING 1. Institutional Nursing (Hospital Staff Nursing) - the nurse provides direct client care using the nursing process - focus is restorative and curative - provision of education to the family to promote health maintenance and self care - A nurse may be assigned as an Emergency unit nurse, Critical Care Nurse, Oncology Nurse, etc. 2. Community health Nursing/ Public health Nursing - Focuses on understanding the needs of the population - A public health nurse merges the science of professional nursing theories and public health sciences to improve the health of the whole community - It may include schools Nursing and Industrial nursing 3. Independent Nursing Practice - Involves advanced nursing practice and a Masters degree - Requires advanced education in Pharmacology and physical assessment and certificate of expertise in a specialized area of practice - A nurse may function as a Clinician, Educator, Case Manager, consultant or researcher - They will manage health care of a group of clients by monitoring their health and assess developing problems then make necessary referrals for acute problems and complications to physicians and healthcare facilities 4. Other fields a. Nurse practitioner -Has masters degree and is a graduate of nurse practitioner program -Function with more independence than other nurses -Highly skilled in performing nursing skills in treating minor health problems -E.g. obstetrics, pediatrics, family care b. Clinical Nurse Specialist - With masters degree and advanced experience and expertise in a specialized area of practice -E.g. Clinical Nursing (Critical care, Oncology, Endocrinology, cardiovascular, Pulmonary diasease, etc.) -Clinician, educator, manager, consultant, or researcher

c. Nurse Midwife -Licensed to provide independent care for women during normal pregnancy, lab or and delivery -Can perform papanicolaou (pap) smears and breast examinations and assist clients with family planning d. Nurse Anesthetist -Provides general anesthesia for clients undergoing surgery under the supervision of a physician prepared in anesthesiology -Nurses with advanced education in anesthesiology e. Nurse researcher -Responsible for continued development and refinement of nursing knowledge and practice through investigation of nursing problems. f. Nurse Administrator -Manages and controls client care -Serves as liaisons between staff members and directors of nursing g. Nurse Educator -Nurses designed to teach, BSN students, Masters and Doctorate degree students -Must have in depth knowledge of curriculum development and higher education and expert knowledge of theory

Types of Nursing interventions 1. Independent or Nurse Initiated interventions autonomous actions based on the rationale that is executed to benefit the client in predicted way related to nursing diagnosis and client-centered goals. -actions a nurse can do without orders from a physician 2. Dependent Nusing or Physician initiated Nursng- based on the doctors orders 3. Interdependent or Collaborative Interventions therapies that require the knowledge, skill, and expertise of multiple health care professionals. Nursing Care Delivery Models Total Patient care - The nurse works directly with the client, family, physician, and health team members - Shift based focus - The same nurse does not necessarily care for the same client over time - For continuity of care, the staff needs to communicate clearly the clients needs to one another from shift to shift Functional Nursing - Involves division of tasks, with one nurse assuming responsibility for certain tasks, with one nurse assuming responsibility for certain tasks( e.g.

administration of medications) while another nurse assumes responsibility for others (e.g. hygiene, nurse therapies) Team Nursing - The team members provide direct client care to group of clients under the direction and coordination of the RN team leader. In this model, Rn and assistive personnel are often given client assignments rather than nursing needs Primary Nursing - An RN assumes responsibility for a caseload of clients over time - Primary nursing is a care delivery model designed to maintain continuity of care across shifts, days, or visits Case management nursing - This involves a professional nurse assuming responsibility for client care from admission through and following discharge

COMMUNICATION IN NURSING Communication- process by which people affect one another by exchange of information in accurately, timely and effective manner. It also includes documentation or recording.

Modes of Communication Verbal Non-Verbal Characteristics of Communication 1. Simplicity- use of commonly understood words 2. Clarity-saying exactly what is meant 3. Timing and relevance-require choice of appropriate time and consideration of the clients interests and concern 4. Adaptability- Involves adjustment on what the nurse says and how it is said depending on moods and behavior of the client 5. Credibility-worthiness of belief. To become credible, the nurse must have adequate knowledge about the topic being discussed Criteria for effective Verbal Communication 1. Vocabulary 2. Denotative and Conotative meaning 3. Pacing 4. Intonation

5. Clarity and Brevity 6. Timing and Relevance Guideline for effective and Active Listening -S O L E R Developmental considerations in Communication 1. Older Adults with communication Barriers a. Check if the client uses hearing aid b. Amplify voice c. Get the clients attention before speaking d. Minimize visual and auditory distractions(turning off the radi0, closing windows, etc) e. Dont expect to communicate the same way as you would with a nonimpaired person f. Dont assume a communication breakdown is a result of the client being uncooperative, remember their deficit g. Match your body language to yoiur speech h. Summarize the most important points i. Give client time to think and ask questions j. Allow them to make errors k. Be a good listener(patience, patience, patience) l. Stick to one topic at a time m. Whenever possible have a family care giver available in the room with you because this person must be more familiar with the clients communication pattern 2. Communicating with infants a. Use firm but gentl;e touch when cuddling the client b. Hold infant in a way that he or she can see parents c. Talk softly 3. Toddlers and Preschoolers a. Interact with parents before talking to the client b. Assume a position that is at childs eye level c. Allow children to touch and examine the objects that you have with you d. Focus communication with the child and not to his mother 4. School Aged Children a. Allow child to feel comfortable first b. Avoid sudden or rapid advances, broad smiles, staring, or other threatening gestures c. Talk to the parents if client is shy d. Give children opportunity to discuss concerns without patient e. Speak in a quiet unhurried voice f. Explain any procedure that you will do






g. Be honest h. Use variety of communication techniques like drawing or play Adolescents a. Give undivided attention b. Listen, listen, listen c. Be calm and courteous d. Choose important issues when making a stand e. Make expectations clear f. Respect their privacy views g. Praise good points h. Encourage ideas and feelings i. Allow them to talk without the parents Physically challenged a. Listen attentively b. Ask simple questions c. Allow time for understanding and do not interrupt d. Give visual cues e. Allow only one person speak at a time f. Do not shout g. Encourage client to converse h. Use communication aids Cognitively impaired(deaf) a. Reduce environmental distractions b. Get clients attention before speaking c. Use simple sentences d. One question at a time e. Allow time for response f. Be attentive g. Include family and friends during conversation Unresponsive a. Call client by name during interactions b. Communicate both verbally and by touch c. Modulate voice d. Provide orientation to time, place, and person e. Avoid talking about client to others in his presence f. Avoid saying things client should not hear Aggressive a. Keep the door of the room open b. Avoid touching the patient c. Dont leave the patient alone d. Adapt calm non confrontational approach e. Acknowledge the patients state of feeling f. Allow patient to ventilate anger g. Be polite

10. a. b. c. d. e. f. g.

General guidelines Be polite and formal Pronounce name correctly Use simple words Proceed in an unhurried manner Speak in a low moderate voice Know and understand clients culture Provide an interpreter or translator as needed.