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Conceptual Basis for

ADN Practice
NUR1020C Fundamentals of Nursing
Jamzie Firestone MSN, RN

Describe the different educational paths to become a registered nurse.

Discuss what is meant by a Conceptual Basis for Associate Degree

Nursing practice.

Identify the major components and ideas found in the Seminole State
College Nursing Program philosophy and conceptual framework.

Discuss the 5 major components of the Seminole State College Nursing

program philosophy upon which the curriculum is based: the 5
Cs/student learning outcomes

Caring Interventions

Clinical Competence and Decision Making


Commitment to Professionalism uniform

Collaboration and Management of Care

Educational Paths*
Practical/Vocational Nursing:

Part of US healthcare system for more than 100 years

Early programs varied widely in length, quality, and focus

3-month graduates provided help for the nursing shortage after

WWI after receiving on-the-job training


Functioned at fairly high level of skill

Much reduced cost

1938: licensure required

1960: licensure examination required

LPN/LVN today

Most programs 9-12 months

Measured in clock hours, not academic hours

Offered in hospitals, high schools, vocational schools, trade

schools, and community colleges

Curriculum is highly technical and is skills oriented, rather than

Scope of Practice: provide care for clients with stable conditions in
hospital, nursing home, or home care settings must be under the supervision of an RN or licensed physician
May continue studies in a ladder program and be eligible to take RN
exam in I year

Educational Paths
Ladder Programs: career ladder, educational ladder, articulation, or
educational mobility

Allow nurses to move from one educational level to another

without loss of credits

Advanced placement

Granting credit

May provide competency-based education

Allows student to proceed at own pace

Often Web-based



Two plus two (2+2) programs


Diploma (RN) to BSN



Nurse Practitioner (MSN /Doctorate)

Diploma Schools:

3 year course of study

Pass National Council Licensure Examination:

o National Council Licensure Examination (NCLEX)

o 115 National League of Nursing (NLN) programs remain
o Prepare nurses highly competent in technical skills
o Extensive hands-on practice in clinical setting
Associate Degree Nursing (ADN) program:

Mildred Montague devised in 1952 as short-term solution to

nursing shortage after WWII
Originally provided technical training
Offered through community colleges
Emphasized skills necessary to provide high-quality bedside care
in less time than BSN programs
Debate ensued as to whether they should be LPN/LVNs or RNs
Due to college setting, were allowed to sit for RN exam

ADN today:

1048 schools in 2012 (NLN 2013.Survey data)

169,511students (NLN 2008.Survey data)

ADN graduates number more than RN and LPN/LVN programs


Graduates able to provide safe bedside care from day of hire

Good team members

After orientation, can care for more acutely ill clients

Baccalaureate Education

1909 University of Minnesota School of Nursing

Growing pains

Lack of uniformity in content, curriculum, length

Lack of qualified faculty (doctorate degree non-existent,

few with masters)

NLN developed strict criteria for accreditation

BSN or BS Nursing

2012 approx. 696 BSN programs (NLN. 2013 Survey data)

Masters Degree

Baccalaureate degree is generalist degree

Masters is specialists degree with an area of concentration

Usually require minimum of 1 year clinical experience

36-46 credit hours

Most require 3.0 GPA and satisfactory score on GRE or Millers

Analogy Test for admission

Doctoral Degree

Generalists degree on higher academic level

Types of degrees

Doctor of Philosophy (PhD): prepares individual to conduct


Doctor of Education (EdD): focuses on administration in

educational setting

Doctor of Nursing Science (DNSc) and doctor of science in

nursing (DSN): clinically oriented

Advanced Practice

Must obtain certification

Allowed to practice at higher level set by BON

Diagnose illnesses

Prescribe medications

Conduct physical examinations

Refer clients to specialists

Practice under own license as independent practitioners

Types: nurse practitioner, certified registered nurse anesthetist,

nurse midwife, clinical nurse specialist

Conceptual Basis for Nursing Models


Client (patient)

Collective (family, community)
Need not have an illness
Clearest distinction between medical models and nursing
models nurses are more holistic
A continuum ranging from no disease to death
Perception varies with individual
Reflects the person's interrelationship of mind, body, and


The environment is the combined internal and external forces physical, emotional, interpersonal, social, cultural, and spiritual - through and
in which the person constantly interacts.

o The function and role nurses have in relation to their

o Partnership with clients for care planning and health

o May include manipulation of the environment
Nursing Practice:

Nursing - is an evidenced-based practice discipline which integrates

a body of specialized knowledge drawn from the physical, biological,
and psychological and social sciences.

The goal of Nursing is to assist clients in attaining their maximum

health potential.

Holistic Nursing:

Care of the client as a whole

Recognition of the importance and interdependence of the needs of

individuals and families
o Physical
o Emotional
o Social
o Cultural
o Spiritual

*The Department of Nursing at Seminole State College shares the mission of

the College in its pursuit of learner-centered, quality education that
anticipates the needs of the students and the community it serves.
Student Learning Outcomes:

Successful completion of the NCLEX-RN

Ability to function as an adaptive generalist in diverse care settings

consisting of individuals, families, or community aggregates

Seminole State College Of Florida: Student Learning Outcomes*

Graduates of Seminole State College Associate Degree Nursing

program - will meet the core learning outcomes of the philosophy of
nursing education developed by the nursing faculty, and the core
competencies for graduates of Associate Degree programs formulated
by the National League for Nursing

Caring Interventions

Clinical Competence and Decision Making


Commitment to Professionalism

Collaboration and Management of Care

5 Cs:
These 5 Cs can be found in:

Every course description

Course objectives

The clinical evaluation tools

They are the framework: for the SSC nursing curriculum

ADN Student Learning Outcomes*

Caring Interventions
o Provides and coordinates humanistic, altruistic, compassionate,
and empathetic client-centered care that protects and promotes
the clients dignity.
o Implements care with consideration for the cultural diversity,
spirituality, developmental level, and uniqueness of each client
and significant support person(s).
o Provides a safe physical and psychosocial environment for the

Clinical Competence and Decision Making cant become too

reliant on technology
o Utilizes critical thinking skills and evidenced based information in
making clinical judgments and management decisions to ensure
accurate and safe care.
o Uses the nursing process to assist clients and significant support
person(s) in meeting biopsychosocial needs in health promotion,
restoration and health maintenance
o Performs comprehensive physical, cognitive, functional, and
psychosocial assessments/reassessments to determine the
clients health status.
o Collects and analyzes relevant data to establish a plan for
nursing care
o Develops implements, evaluates and modifies teaching plans
based on individual client and significant support person(s)
health status and educational capabilities.

o Performs nursing skills accurately and safely in a variety of

clinical settings.
o Evaluates and modifies care in meeting individualized client

Communication uses interpreters, understanding med terms

o Utilizes therapeutic communication skills with clients and
significant support person(s).
o Maintains organizational and client confidentiality.
o Communicates (including reporting and documentation) relevant,
accurate, and complete information in a concise and clear
o Utilizes appropriate channels of communication.
o Utilizes information technology within approved guidelines to
ensure effective communication regarding the clients status.

Commitment to Professionalism stepping out of your comfort

zone. Recognize when somethings not working and do
something to change it
o Practices nursing within the legal, ethical, and regulatory
standards of professional nursing practice.
o Reports unsafe practices of healthcare providers using
appropriate channels of communication.
o Participates in ongoing professional development that supports
personal and professional growth
o Advocates for client rights
o Practices within the parameters of individual knowledge and
o Recognizes the impact of economic, political, social, and
demographic forces on the delivery of healthcare
o Serves as a role model for nursing

Collaboration and Management of Care

o Prioritizes client care.
o Demonstrates accountability for nursing care given by self and/or
delegated to others if you dont know something ask. Report
o Delegates appropriately, supervises adequately, and evaluates
tasks assigned to assistive personnel

o Provides assistive personnel with relevant instruction to support

achievement of client outcomes
o Collaborates with health care team to assure the clients access
to available community resources
o Collaborates cooperatively, creatively, and openly with the
health care team in meeting client and organizational outcomes
o Coordinates the decision making process with the client,
significant support person(s), and the other members of the
health care team
o Coordinates the implementation and continuity of client care
within and across health care settings when the patients leave
the hospital your work is not over
o Participates in problem identification and data collection for
research, quality control, or improvement process to meet client
o Demonstrates competence with current technologies

Nursing= life long learning