NUR 201 Notes Exam 1

What is Nursing?
 “The act of utilizing (cleanliness) the environment of the patient to assist him in recovery”
 Nightingale
o Mother of Nursing
o From England
o Crum-bi-an war
o **First healthcare profession that thought about how hygenie = good health
o Creator of the pie chart
o First nurse scientist
 Virginia Henderson (1966)
o “Unique function of the nurse is to assist the individual, sick or well, in the performance of those
activities contributing to heath or its recovery (or peaceful death) that he would perform unaided if
he had the necessary strength, will or knowledge, and to do this in such a way as to help him gain
independence as rapidly as possible”
o Included environment and nursing shouldn’t only include sick, but also health
o Role of nurse with patients that were going to die
 American Nurses Association
o “Nursing is the protection, promotion and optimization of health and abilities, prevention of illness
and injury, alleviation of suffering through the diagnosis and treatment of human response and
advocacy in the care of individuals, families, communities and populations.”
o Nurse should be advocate
o Nurse – treat pain, teach, support family, whether their healing (lung cancer)– not actually
responsible for treating

 Based on theory and clinical practice

o Theory – it is born in research practice
 Focus on response of individuals and family to health problem
 Attuned to whole person, not just health problem
 Autonomy in decision making
 Profession has a code of ethics

Common Themes of Nursing

 Caring
 An Art – knowing when / how to do it
 Science
 Client Centered
 Holistic
 Adaptive
 Concerned with health promotion, health maintenance, health restoration
 A helping profession

Recipients of Nursing Care

 Consumer – using healthcare service
o Physical therapy – takes medicine (purchasing)
 Patient – (Latin: ‘suffer’) someone you do something ‘to’
 Client – engages healthcare service – active participant in care

Scope of Nursing
 Promoting health and wellness – enchance quality of life
 Preventing illness – Maintain optimal health
1
NUR 201 Notes Exam 1
o Prevent STD
o Teaching
o Immunization
 Restoring Health - Focus on sick – early detection/recovery
o Diagnostic procedure  rehab
 Caring for the dying – Comfort / Caring for dying
o Hospice – provide dignified death

Setting of Nursing
 Acute care hospital
 Home care
 Community agencies
 Ambulatory clinic
 Long term care facilities
 Health maintenance organization
 Nursing practice centers
 Business – wellness clinics
 Military

Nurse Practice Acts

 Legal acts that regulates the practice of nursing in the US and Canada
 Each state has its own
 Purpose: To protect the public
 It regulates what we can do – tells us what we can/ can’t do

Standards of Nursing Practice

 Federal Standards!!!
 Describes responsibilities for which nurses are accountable
 Generic; use nursing process
 Standard – regardless of specialties
 Not open to change – same all the way across the board
 Standards 1 – assessment – collects patients health data
 2. Diagnosis – nurse analyzes the assessment data to determine diagnosis
 3. Outcome Identification – Nurse identifies expected outcomes
 4. Planning – nurse develops a plan of care
 5. Implementation – Nurse implements the interventions
 6. Evaluation – Nurse evaluated the patients progress towards outcomes
 **page 6

Nursing as a Profession
 Distinguished by:
o Prolonged specialized training**
o Orientation of individuals towards service
o Ongoing research (improve practice)
o Code of ethics
o Autonomy (make own decisions)

2
NUR 201 Notes Exam 1

Role of a Nurse
 **Teaching* – helps maintain health
 *Communication
 Caregiving, educator, client advocate, counselor, leader, manager

Sources of Nursing Knowledge

 Tradition: passed from generation to generation
 Authoritative: from experts
 Clinical experience
 Trial and Error
 Intuition
 Logical reasoning
 Scientific: research

Evidence Based Practice in Nursing

 Started in England
 Practice based on evidence can decrease the uncertainty that patients and clinicians experience in a
complex healthcare system
 Allows us to give highest quality care
 *Way to standardize care*
 Patients have fewer problems
Why Evidence based Nursing Practice
 Patients who receive care with the best and latest evidence from well-designed studies experience 28%
better outcome.
 People who receive EBP have higher satisfaction than those based on tradition
Evidence Based Practice
 3 pieces – if one is missing it’s not EBP
o Best current evidence
o Clinical expertise
o Patient/family preference
 Read over page 11
Five Steps of EBP
1. Ask the burning clinical question – “How come we do it this way”
2. Collect the most relevant and best evidence. – What’s the evidence?
3. Critically appraise the evidence. – Is this good evidence
4. Integrate all evidence with one’s clinical expertise, patient expertise, and values in making a practice
decision or change
5. Evaluate the practice decision or change - Is it worth the change?
6. Share the outcome of EBP changes with others

Iowa Model of EBP

 Problem focused or knowledge focused – identify a question you need a answer for
 Is the problem a priority? If yes, then... --- will this help the patient?
 Form a team
 White the question (PICO)
 *Review and critique relevant literature

3
NUR 201 Notes Exam 1
PICO
 P – population
 I – Intervention or issue
 C – Comparison = either doing something or nothing
 O – outcome – what you want

Therapeutic Relationship
The foundation of all nursing care is the Therapeutic Relationship, a close and helping relationship based on trust.
 Good relationship with patients = good health outcomes
 Therapeutic Relationship:
o Partnership with nurse and patient
o Goal for what your doing
o Good relationship = better nurse
Social vs. Therapeutic
 Social – personal, ongoing, *focus on needs of both (reciprocal)*
 Therapeutic – boundaries, focus is on client, good oriented ** NEVER focuses on nurse**
Requirements for successful relationship
 Interpersonal skills – needs to know how to communicate
 Personal insight – what your values/beliefs are
 Accountability
 Mutual respect
 Supportive working
 Milieu – therapeutic environment – patient is confrontable where they are

Unconditional Regard – You learn to values and care for clients simply because their humanity warrants you care –
you understand most important task as a nurse is to have therapeutic relationships – don’t have stereotypes

Value – Personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence
behavior – they guide us in making decisions.