NURSING
REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE
IS NURSING A PROFESSION?
PROFESSION
• is defined “as an occupation that
requires extensive education or a calling that
requires special knowledge, skill, and preparation
which provides service to society”.
CRITERIA OF A PROFESSION
A profession is generally distinguished from other
kinds of occupations by:
1. Requirement of specialized training to
acquire a body of knowledge.
2. An orientation of the individual toward
service, either to a community or to an
organization.
3. ONGOING RESEARCH
• The ultimate goal is to improve client
care.
4. CODE OF ETHICS
• Philosophical ideals of right and wrong
that define the principles you will use to
provide care to your patients.
5. AUTONOMY
• Independence at work, responsibility,
and accountability for one’s actions.
6. PROFESSIONAL ORGANIZATION
• presence of governance in which there
is the establishment and maintenance
of social, political, and economic
arrangements by which practitioners
control their practice, their self-
discipline, their working conditions, and
their professional affairs.
EXAMPLE OF PROFESSIONAL ORGANIZATION
Philippine Nurse Association (PNA)
• The nationally recognized and
accredited professional organization of nurses in
the Philippines.
• It was organized on October 22, 1922,
upon the initiation of Mrs. Anastacia Giron-Tupas
• The first president was Mrs. Rosario
Delgado.
• Before, it was called “Filipino Nurses
Association”.
BACHELOR
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OF SCIENCE IN NURSING
1 YEAR COLLEGE
PRELIMS
• Its journal, the “Filipino Nurse”, now is
called “The Philippine Journal of Nursing”.
SCIENCE AND ART OF NURSING PRACTICE
• Nursing practice requires a blend of the
most current knowledge and practice standards
with an insightful and compassionate approach
to patient care.
Ability to interpret clinical situations & make
complex situations.
• Foundation of nursing care & the basis for
the advancement of nursing practice &
development of nursing science.
COMPETENCIES OF CRITICAL THINKING
• Integrating knowledge from basic science
and nursing.
• Applying knowledge from past and
present experiences.
• Applying critical thinking attitudes to a
clinical situation.
• Implementing intellectual and professional
standards.
LEVEL OF PROFICIENCY OF DR. PATRICIA BENNER
1. NOVICE
• Beginner with no previous level of
experience (Student nurses & new
professional registered nurse).
2. ADVANCE BEGINNER
• Principles, based on experiences,
begin to be formulated to guide
actions.
3. COMPETENT
• With 2-3 years’ experience on the job
in the same area or in similar day-to-
day situations.
4. PROFICIENT
• With more than 2 to 3 years of
experience in the same clinical
position.
• More holistic understanding improves
decision-making.
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5. EXPERT 4. Nursing is client-centered

• No longer relies on principles, rules, or 5. Nursing is holistic
guidelines to connect situations and 6. Nursing is adaptive
determine act. 7. Nursing is concerned with health
promotion, health maintenance, and
DEFINITIONS OF NURSING health restoration.
“Nursing is the act of utilizing the environment 8. Nursing is a helping profession
of the patient to assist him in his recovery.” STANDARDS OF PRACTICE
“Nursing is to assist the individual, sick or well, in
• describes competent level of nursing care
the performance of those activities which are demonstrated by a critical thinking
contributing to health or its recovery (or to model known as the Nursing Process (ADOPIE)
peaceful death) that he would perform
unaided if he had the necessary strength, will, NURSING PROCESS
or knowledge, and to do this in such a way to
help him gain independence as rapidly as • foundation of clinical decision making &
possible”. includes all significant actions taken by nurses in
providing care to patients.
“Nursing is the protection, promotion, and
optimization of health and abilities, preventions ANA STANDARDS OF NURSING PRACTICE
of illness and injury, alleviation of suffering 1. ASSESSMENT
through the diagnosis and treatment of human 2. DIAGNOSIS
response, and advocacy in the care of 3. OUTCOMES IDENTIFICATION
individuals, families, communities, and 4. PLANNING
populations”. 5. IMPLEMENTATION/INTERVENTION
“Nursing encompasses autonomous and 6. EVALUATION
collaborative care of individuals of all ages, STANDARDS OF PROFESSIONAL PERFORMANCE
families, groups, and communities, sick or well,
and in all settings. Nursing includes the • describe a competent level of behavior in
promotion of health; prevention of illness; and the professional role.
the care of ill, disabled, and dying people. • this provide a method to assure patients
Advocacy, promotion of safe environment, that they are receiving a high-quality care, that
research, participation in shaping health policy the nurses must know exactly what is necessary to
and in patient and health systems provide nursing care, & that measures are in
management, and education are also key place to determine whether nursing care meets
nursing roles”. the standards.

“Nursing is the initiation and/or performance of ANA STANDARDS OF PROFESSIONAL

nursing services, singly or in collaboration with PERFORMANCE
another, to individuals, families, and
communities and in any healthcare setting”. 1. ETHICS 6. LEADERSHIP
2. EDUCATION 7. COLLABORATION
OTHER DEFINITIONS OF NURSING (COMMON 3. EVIDENCED-BASED 8. PROFESSIONAL
THEMES) PRACTICE AND PRACTICE
1. Nursing is caring RESEARCH EVALUATION
2. Nursing is an art 4. QUALITY OF 9. RESOURCES
3. Nursing is a science PRACTICE 10. ENVIRONMENTAL
5. COMMUNICATION HEALTH

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CODE OF ETHICS • this involves achieving improved physical,

emotional, spiritual, and social well-being.
• a philosophical ideal of right and wrong
that define the principles you will use to provide ADVOCATE
care to your patients.
• you protect your patient’s human and
THE CODE OF ETHICS FOR NURSES WITH legal rights & provide assistance in asserting
INTERPRETIVE STATEMENTS these rights if the need arises.
• you act on behalf of your patient & secure
• a guide for carrying out nursing your patient’s health care right.
responsibilities that provide quality nursing care;
also outlines the ethical obligations of profession. EDUCATOR
PROFESSIONAL PREPARATION • explaining the concepts & facts about
health, describe the reason for routine care
✓ have a license to practice nursing in the
activities, demonstrate procedures, reinforce
country learning or patient behavior, & evaluate the
✓ have a Bachelor of Science degree in patient’s progress in learning.
nursing • always use teaching methods that match
✓ be physically and mentally fit your patient’s capabilities & needs.
✓ be a part of professional organization
COMMUNICATOR
PROFESSIONAL RESPONSIBILITIES & ROLES
• effective communication is central to the
1. AUTONOMY AND ACCOUNTABILITY
nurse-patient relationship.
2. CAREGIVER
• quality communication is a critical factor in
3. ADVOCATE meeting the needs of individuals, families, &
4. EDUCATOR
communities.
5. COMMUNICATOR
6. MANAGER MANAGER
AUTONOMY AND ACCOUNTABILITY • coordinates the activities of members of
the nursing staff in delivering nursing care and
AUTONOMY
has personnel, policy, & budgetary
• an essential element of responsibility for a specific nursing unit or
professional nursing that involves the agency.
initiation of independent nursing CARRER DEVELOPMENT
interventions without medical orders.
I. PROVIDER OF CARE (CLINICIAN)
ACCOUNTABILITY
• Hospital Setting
• you are responsible professionally • Community-Based Care
& legally for the type & quality nursing care • Ambulatory Care
provided. • Nursing Homes/Extended Care Setting
CAREGIVER
• helping patients maintain & regain
health, manage disease & symptoms, & attain
a maximal level of function & independence
through the healing process.

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II. ADVANCE PRACTICE REGISTERED NURSES (APRN) HISTORICAL INFLUENCES

• Most independently functioning nurse.
FOUR CORE ROLES:
• Clinical Nurse Specialist
• Nurse Practitioner
• Certifies Nurse-Midwife
• Certified Registered Nurse Anesthetist
III. NURSE EDUCATOR
• works primarily in schools of nursing, staff
development, patient education
departments.
PRIMARY FOCUS
• Teach & coach patients & their families
how to self-manage their illness or
disability and make positive choices or
change their behaviors to promote
their health.
IV. NURSE ADMINISTRATOR
• manages patient care & delivery of
specific nursing services within a health
care agency.
• often have master’s degree (MHA, MPH,
MBA)
• needs to be skilled in business &
management and understand all aspects
of nursing & patient care
FUNCTIONS:
• budgeting, staffing, strategic planning
of programs & services, employee
evaluation, and employee
development.
V. NURSE RESEARCHER
• improve nursing care and further define
and expand the scope of nursing
practice through evidenced-based
practice and research.
• preferred educational requirement is
doctoral degree, with at least a master’s
degree in nursing.
WORLD HISTORY OF NURSING
1. WOMEN’S ROLES
• Traditional female roles of wife,
mother, daughter, and sister have
always included the care &
nurturing of other family members.
• From the beginning of time, women
have cared for infants and children;
thus, nursing could be said to have
its roots in “the home”.
• Women were called on to care for
others in community who were ill.
2. RELIGION
SAINT FABIOLA
• a matron of Roman Empire who
converted to Christianity and used
their wealth to provide houses of
care and healing for the poor, the
sick, and homeless.
CRUSADES
formed several orders of knights providing
nursing care to the sick and injured
comrades, like:
• Knights of Saint John of Jerusalem
(also known as the Knight
Hospitalers)
• Teutonic Knights
• Knights of San Lazarus
THEODOR FLIEDNER
reinstituted the Order of
Deaconesses & opened a small
hospital and training school in
Kaiserswerth, Germany, where
Florence Nightingale received her
“training” in nursing.

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3. WAR
During the Crimean War (1853 – 1856)
SIR SIDNEY HERBERT
of the British War Department asked
Florence Nightingale to recruit a
contingent of female nurses to
provide care to the sick and injured
in the Crimean.
Nightingale is credited in improving the
sanitation quality; the mortality rate in the
Barracks Hospital in Scutari, Turkey was reduced
from 42.7% to 2.2% in 6 months.
During the American Civil War (1860 – 1865)
Several nurses emerged who were notable for
their contributions to a country torn by internal
strife:
HARRIET TUBMAN & SOJOURNER TRUTH
provided care and safety to over 300 slaves
fleeing to the North on the Underground
Railroad movement.
HARRIET TUBMAN
known as “The Moses of Her
People” for her work with the
Underground Railroad.
SOJOURNER TRUTH
is an abolitionist, Underground
Railroad agent, preacher, and
women’s rights advocate, a nurse
for over 4 years during the Civil War
and worked as a nurse and
counselor for the Freedmen’s Relief Association
after the war.
CLARA BARTON
founder of the American Red Cross,
searched the battlefields and gave
care to injured and dying soldiers.
BACHELOR
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OF SCIENCE IN NURSING
1 YEAR COLLEGE
PRELIMS
FUNDAMENTALS OF NURSING PRACTICE
MOTHER BICKERDYKE
organized ambulance services and
walked abandoned battlefields at
night, looking for wounded soldiers.
MARY ELIZA MAHONEY (1845 – 1926)
was the first African American
professionally trained nurse. She
graduated from the New England
hospital for Women and Children in
1879.
LILIAN WALD (1867 – 1940)
considered the Founder of Public
Health Nursing. together with Mary
Brewster, they opened the Henry
Street Settlement and Visiting Nurse
Service, which provided nursing
and social services and organized educational
and cultural activities to the poor in New York
slums.
WALT WHITMAN & LOUISA MAY ALCOTT
volunteered as nurses to give care to injured
soldiers in military hospitals.
DOROTHEA DIX
became the Union’s
Superintendent of Female Nurses
responsible for recruiting nurses &
supervising the nursing care of all
women nurses working in the army
hospital.
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WORLD WAR 1 TWENTIETH CENTURY

“THE SPIRIT OF NURSING”
• stands in Arlington National Cemetery
that honors the nurses who served in the
U.S. Armed Services in World War I
• many of whom are buried in Section 21
which is called the “Nurses Section”.
WORLD WAR 2
CADET NURSE CORPS
• Casualties created an acute shortage
of caregivers, and the Cadet Nurse
Corps was established in response to a
marked shortage of nurses.
• Practical nurses, aides, and technicians
provided much of the actual nursing
care under the instruction and
supervision of better prepared nurses.
• A movement toward developing scientific,
research-based defined body of nursing
knowledge & practice evolved.
• Nurses began to assume expanded &
advanced practice roles.
• Army and Navy Nurse Corps were
established to expand nursing practice.
• Nursing specialization began on 1920s.
• Graduate nurse-midwifery programs
began.
• Specialty-nursing organizations were
created.
MARY ADELAIDE NUTTING
first nursing professor at Columbia
Teacher’s College in 1906. Was
instrumental in moving nursing
education into universities.

VIETNAM WAR
• Approximately 90% of the 11,000 American TWENTY-FIRST CENTURY
military women stationed in Vietnam were Revision of nursing practice & school
nurses.
curricula to meet the ever-changing needs
• Youngest group of medical personnel ever of society:
to serve in wartime.
✓ Aging population
VIETNAM WOMEN’S MEMORIAL ✓ Bioterrorism
• is a monument established to “honor the ✓ Emerging infections
women who served and also for the ✓ Disaster management
families who lost loved ones during the ✓ Advances in technology &
war… to let them know about the informatics
women who provided comfort, care, ✓ High acuity level of care of
and a human touch for those who were hospitalized patients
suffering and dying”. NURSING LEADERS
SOCIETAL ATTITUDES FLORENCE NIGHTINGALE (1820 – 1910)
• Before the mid-1800s, nursing was without Earned her title as “Lady with the
organization, education, or social status;
Lamp”. She was the first nurse to
the prevailing attitude was that a woman’s exert political pressure on
place is in the home and that no government. She is also
respectable woman should have a career. recognized as nursing’s first
• Nurses in hospitals during this period were scientist-theorist for her work Notes on Nursing:
poorly educated; some were even What It Is and What It Is Not (1860 – 1969).
incarcerated criminals.

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LINDA RICHARDS (1841 – 1930)
was America’s first trained nurse.
She graduated from New England
Hospital for Women and Children
in 1873. Was known for introducing
nurse’s notes and doctor’s orders.
She initiated the practice of nurses
wearing uniform.
LAVINIA L. DOCK (1858 – 1956)
a feminist, prolific writer, political
activist, suffragette. She
participated in protest movements
for women’s rights that resulted in
the 1920 passage of the 19th
Amendment to the U.S. Constitution, which
granted women the right to vote.
DOCK, NUTTING, & ROBB
In 1893, Dock, with the assistance
of Mary Adelaide Nutting & Isabel
Hampton Robb, founded the
American Society of
Superintendents of Training Schools
for Nurses of the United States and Canada, a
precursor to the current National League for
Nursing.
MARGARET HIGGINS SANGER (1879 – 1966)
A public health nurse in New York,
has had a lasting impact on
women’s health care. She is
considered the founder of Planned
Parenthood, was imprisoned for
opening the first birth control information clinic in
Baltimore in 1916.
MARY BRECKINRIDGE (1881 – 1965)
A nurse who practiced midwifery in
England, Australia, and New
Zealand. Founder of the Frontier
Nursing Service (FNS) in Kentucky in
1925 to provide family-centered
primary health care to rural populations.
BACHELOR
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OF SCIENCE IN NURSING
1 YEAR COLLEGE
PRELIMS
FUNDAMENTALS OF NURSING PRACTICE
CONTEMPORARY INFLUENCES
MULTIPLE EXTERNAL FORCES AFFECTS NURSING:
• Nurse’s Self Care
• Affordable Care Act (ACA) & rising
healthcare costs
• Demographic Changes of Population
• Increasing Numbers of Medically
Underserved
1. IMPORTANCE OF NURSE’S SELF CARE
COMPASSION FATIGUE
• a state of burnout & secondary
traumatic stress.
• this occurs without warning & often
results from giving high levels of
energy & compassion over a
prolonged period to those who are
suffering, often without experiencing
improved patient outcomes.
• Frequent, intense, or prolonged
exposure to grief & loss.
BURNOUT
• condition that occurs when
perceived demands outweigh
perceived resources.
• state of physical & mental exhaustion
that often affects health care
providers because of nature of their
work environment.
• lack of social support, organizational
pressures influencing staffing, &
inability of nurse to practice self-care.
SECONDARY TRAUMATIC STRESS
• the trauma that health care providers
experience when witnessing and
caring for others suffering trauma.
REMINDER!!!
Nursing students report feeling initially
hesitant and uncomfortable with their first
encounters with a dying patient and identify
feelings of sadness, anxiety, and discomfort.
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LATERAL VIOLENCE
• can result from compassion fatigue
occurs in nurse-nurse interactions and
include behaviors such as:
✓ withholding information
✓ making snide remarks
✓ demonstrating nonverbal
expressions of disapproval (raising
eyebrows, making faces)
WHAT TO DO?
• Nurses need to be self-aware,
allowing them to identify their own
vulnerability to secondary traumatic
stress & burnout.
• Participating in health promotion
activities
2. ACA & RISING HEALTH CARE COSTS
• affects how health care is paid for and
delivered.
• have greater emphasis on health
promotion, disease prevention, & illness
management.
3. DEMOGRAPHIC CHANGES
• to effectively meet all health care needs of
expanding & aging population, changes
need to occur as to how care is provided
(outpatient-, community-, & home-based
services)
4. MEDICALLY UNDERSERVED
• unemployment, underemployment and
low-paying jobs, mental illness,
homelessness, and rising healthcare costs
all contribute to increase the medically
underserved population. Caring for this
population is a global challenge; social,
political, economic, and health literacy
factors affect both access to health care-
related resources.
BACHELOR
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OF SCIENCE IN NURSING
1 YEAR COLLEGE
PRELIMS
FUNDAMENTALS OF NURSING PRACTICE
TRENDS IN NURSING
EVIDENCE-BASED PRACTICE
• Practice must be based on evidence, not
just according to education & experiences
& the policies and procedures of health
care facilities.
• Reduces health care errors & improve
patient safety.
QUALITY & SAFETY EDUCATION FOR NURSES (QSEN)
addresses the challenge to prepare nurses
with competencies needed to continuously
improve the quality of care in work
environments.
• Patient-Centered Care
• Teamwork & Collaboration
• Evidence-Based Practice
• Quality Improvement
• Safety
• Informatics
PATIENT-CENTERED CARE
• Involve family and friends in care.
• Elicit patient values and preferences.
• Provide care with respect for diversity of
human experience.
TEAMWORK & COLLABORATION
• Recognize the contributions of other
health team members & patient’s family
members.
• Discuss effective strategies for
communicating & resolving conflicts.
• Participate in designing methods to
support effective teamwork.
EVIDENCE-BASED PRACTICE
• Demonstrate knowledge of basic scientific
methods.
• Appreciate strengths & weaknesses of
scientific bases for practice.
• Appreciate the importance of regularly
reading relevant journals.
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QUALITY IMPROVEMENT GENOMICS:

• Use tools such as flow charts & diagrams to • PRECONCEPTION AND PRTENATAL TESTING
make process of care explicit. • NEWBORN SCREENING
• Appreciate how unwanted variation in • DISEASE SUSCEPTIBILITY
outcome affects care. • SCREENING AND DIAGNOSIS
• Identify gaps between local & best • PROGNOSIS AND THERAPEUTIC DECISIONS
practices. • MONITORING DISEASE BURDEN AND
RECURRENCE
SAFETY
PROFESSIONAL RN (REGISTERED NURSE)
• Examine human factors& basic safety EDUCATION
design principles and commonly used
unsafe practice. BACCALAUREATE DEGREE PROGRAM
• Value own role in preventing errors.
• Includes 4 years of study in
INFORMATICS college/university.
• Navigate an electronic health record. MASTER’S DEGREE IN NURSING
• Protect confidentiality of protected health
• Provides the advanced clinician with
information in EHR (Electronic Health
strong skills in nursing science & theory.
Record).
• Important for the roles of educators &
IMPACT OF EMERGING TECHNOLOGIES administrators
ELECTRONIC HEALTH RECORD (EHR) PROFESSIONAL DOCTORAL PROGRAMS IN
NURSING
• offers an efficient method to record &
manage patient health care information. • Prepare graduates to apply research
findings to clinical nursing.
COMPUTERIZED PHYSICIAN/PROVIDER ENTRY
ORDER (CPEO)
• a key patient safety initiative. PADAYON NURSING!!!
3 SETS OF SKILLS NEEDED
1. Use technology to facilitate mobility,
communication & relationship (telehealth &
telemedicine)
2. Develop an expertise to acquire & distribute
knowledge (evidence-based practice, case-
based reasoning)
3. Understand & use genomics
GENOMICS
• Newer term that describes the study of all
the genes in a person and interactions of
these genes with one another and with
the person’s environment

BACHELOR
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