FUNDAMENTALS IN NURSING PRACTICE  WHAT IS AN ART?
NCM 122 LECTURE  Composed of skills that require
NURSING AS AN ART AND SCIENCE
JANUARY 15, 2020
 LEVELS OF PREVENTIVE CARE
1. PRIMARY PREVENTION
 Is true prevention; it precedes
disease or dysfunction and is
applied to patients considered
physically and emotionally healthy
 (Aim: health promotion) Health
education programs,
immunizations, nutritional
programs, and physical fitness
activities
2. SECONDARY PREVENTION
 Focuses on individuals who are
experiencing health problems or
illness and are at risk for
developing complications or
worsening conditions
 Activities: diagnosing and prompt
intervention, thereby reducing
severity, and enabling the patient
to return to a normal level of
health as early as possible
 Includes screening techniques and
treating early stages of disease to
limit disability by averting or
delaying consequences of
advanced diseases
3. TERTIARY PREVENTION
 Occurs when a defect or disability
is permanent or irreversible
 Minimizing the effects of long-term
diseases or disability by
intervention directed or preventing
complications and deteriorations
 Activities: rehabilitation rather
than diagnosis and treatments
 NURSING AS AN ART AND SCIENCE
 As a professional nurse, you will learn
to deliver care artfully with
compassion, caring, and respect for
each patient’s dignity and personhood
 As a science, nursing practice is based
on a body of knowledge that is
continually changing with new
discoveries and innovations
expertise and proficiency for their
competent education
 It is the creative use of knowledge
in service to other
 SCIENCE AND ART OF NURSING PRACTICE
 Because nursing is both an art and
science, nursing practice requires a
blend of the most current
knowledge and practice standards
with an insightful and
compassionate approach to patient
care
 Nursing has a specific body of
knowledge, however, it is essential
that you socialize within the
profession and practice to fully
understand and apply this
knowledge and develop
professional expertise
 Clinical exposure takes time and
commitment
 DR. PATRICIA BENNER: FROM NOVICE TO
EXPERT (BENNER’S STAGES OF CLINICAL
EXPOSURE)
STAGE 1: NOVICE
 This would be a nursing student in
his/her first year of clinical
education; behavior in the clinical
setting is very flexible and inflexible
 Novices have a very limited ability
to predict what might happen in a
particular patient situation
STAGE 2: ADVANCED BEGINNER
 These are new graduates in their
first job; nurses have had more
experiences that enable them to
recognize recurrent, meaning
components of a situation
 They have the knowledge and the
know-how but not enough
in-depth experiences
STAGE 3: COMPETENT
 These nurses lack the speed and
flexibility of proficient nuses, but
they have some mastery and can
rely on advanced planning and
organizational skills
 Competent nurses recognize
patterns and nature of clinical
situations more quickly and
accurately than advanced
beginners
STAGE 4: PROFICIENT  ANA’S STANDARDS OF PROFESSIONAL
 At this level, nurses are capable to PERFORMANCE
see situations as “wholes” rather 1. Ethics
than parts 2. Education
 Proficient nurses learn from 3. Evidence-Based Practice and Research
experience what events typically 4. Quality of Practice
occur and are able to modify plans 5. Communication
in response to different levels 6. Leadership
 Can modify, twist, or tweak 7. Collaboration
situations 8. Professional Practice Evaluation
STAGE 5: EXPERT 9. Research Utilization
 Nurses who are able to recognize 10. Environmental Health
demands and resources in
 AUTONOMY
situations and attain their goals
 Is an essential element of
 These nurses know what needs to
professional nursing that involves
be done. They no longer rely solely
the initiation of independent
on rules to guide their actions
nursing interventions without
under certain situations. They have
medical orders
an intuitive grasp of the situation
 ACCOUNTABILITY
based on their deep knowledge
 Means that you are responsible
and experience
professionally and legally for the
 SCOPE AND STANDARDS OF PRACTICE
type and quality of nursing care
 When giving care, it is essential to
provided
provide specified service according
 ADVANCED PRACTICE REGISTERED NURSE
to standards of practice and to
(APRN)
follow a code of ethics
 Is the most independently
 ANA’S DEFINITION OF NURSING
functioning nurse
 “Nursing is the protection,
 An APRN has an advanced
promotion, and optimizations of
education in pathophysiology,
health and abilities, prevention of
pharmacology, and physical
illness and injury, alleviation of
assessment and certification and
suffering through the diagnosis and
expertise in a specialized area of
treatment of human response, and
practice
advocacy in the care of the
Four core roles for the APRN are:
individuals, families, communities,
1. Clinical Nurse Specialist
and populations”
2. Nurse Practitioner
 STANDARDS OF PRACTICE
3. Certified Nurse-Midwife
 Describe a competent level of
4. Certified Registered Nurse Anesthetist
nursing care
Educational preparation is intended in at least
 The levels of care are
one of the following six populations:
demonstrated by a critical thinking
1. Adult-gerontology
model known as the nursing
2. Pediatrics
process
3. Neonatology
 The nursing process is the
4. Women’s health/gender related
foundation of clinical decision
5. Family/Individual across the life span
making and includes all significant
6. Psychiatric mental health
actions taken by nurses in
providing care to patient
 FIELDS OF PRACTICE
1. Hospital or Institutional Nursing
 First level position – staff nurse
2. Community Health Nursing or Public
Health Nursing
3. Private Duty or Special Duty Nursing
4. Industrial or Occupational Health
Nursing
5. Nursing Education
6. Military Nursing
7. School Nursing
8. Entrepreneur-care centers, nursing
homes, review centers
9. Independent Nursing Practice