Fundamentals of Nursing Practice

Enhancement Class
Maria Irene Dayon, RN, MAN
Learning Objectives:

1. Correlate the 11 key areas of nursing responsibility

to area of practice

2. Substantiate personal and professional discipline

knowledge

3. Discuss laws and ethical principles in nursing.

4. Recall concepts relevant to professional adjustment.

  Profession- a calling or a vocation

 Professionalism- a set of attributes, a way of life that implies

responsibility and commitment.

Definition of  Professional adjustment- development of all capabilities to

Terms make a nurse fit to assume a role. Or it can mean the growth of
an individual towards efficient and effective performance of
profession.

 Professional accountability-an occupation, calling, or vocation

that requires advance training and experience in some
specialized body of knowledge.
 Formal Education Continuing Education In-Service Education
Enrollment in Graduate By own initiative, you Initiated by employer
School (School after will get a :
graduating from a Certificate of Hospital-based e.g. Fire
baccalaureate course. completion. (e.g. IV safety program, CPR
Training, Dialysis training.
MAN training, Oncology
How nurses MSN nursing training) Academe: test
can improve PhDN
Purpose: To update
construction strategies
Laboratory and animal
and update? knowledge & skills of
the nurse in their field
handling

of interest.
e.g. Nurse Anesthetist
  1. Specialized education. CHED memo #5 series
of 2008
BSN is a 4-year course with a competency and
community-based curriculum. – This is a basic
Criteria of a requirement to become a nurse.
profession Goal: to provide a fully functional nurse: Nurse
generalist

Specialization= Hallmark of matured discipline.

  2. Body of knowledge or theories
The concepts and building blocks of theories are: Person,
environment, health and nursing.
3. Service-oriented rather than profit-oriented- selfless concern for
the welfare of others.
Criteria of a Altruism – Hallmark of a profession.
profession 4. Comprise of a professional organization
ICN – International Council of Nurses founded in 1899
Founder: Ms. Ethel Gordon Bedford Fenwick
Founding members: US, UK, and Canada
HQ: Geneva, Switzerland
  PNA – Philippine Nurses’ Association
Founded on September 2, 1922- after 7 years, PNA became a
member of the ICN in 1929.
Founder of PNA: Anastacia Giron Tupas
First President: Francisca Delgado
First male president: Marco Antonio Sto. Tomas
Criteria of a Formerly named: Pambansang Samahan nang mga Nars na Pilipino
profession and in 1966 it was named Filipino Nurses Association (FNA).

Sigma Theta Tau- honor society of nurses.

Qualification: RN and academic achiever
Motto: Storga (love), Tharos (courage), Tima (honor)
HQ: Indianapolis
  5. Code of ethics for Filipino Nurses
A systematic guide for developing ethical and professional actions.
Promulgated by BON resolution #220 series of 2004
Primary body: BON in close coordination with PNA

Criteria of a Principal basis: Code of Good Governance EO 220

profession Sec 1: The fundamental right of an individual is HEALTH.

Primary responsibility of nurse: to preserve health and life at all
cost.
Sec 6: Accurate documentation-Hallmark of nursing accountability.
Sec 11: Decline any gift, favor, hospitality which may be interpreted
as capitalizing the patient.
  Section 14: Establish linkages with the public (promotion of
health) – noble concern of a nurse.
Criteria of a  Section 18: Violation of code of ethics will result in
suspension/revocation of license or COR.
profession
 6. Autonomy – self governance or the ability to regulate itself and
self standards and principles to its members.
 It defines the roles of a nurse to help the nurse focus on their job
roles and perform better.
Aims:
1. Provides sound decision making in the care of individuals and
groups.
Key areas of 2. It promotes wholeness and wellbeing including safety and
comfort of patients.
nursing 3. It sets priorities in nursing care based on patient’s needs.
responsibility 4. Ensures continuity of care.
5. Administers medication and other health therapeutic
treatments.
11 nursing key
areas of
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
11 key areas of
nursing
responsibility
Personal &
Professional
Development
Laws
 and
 Ethics
 Objectives: o

After the review, the students will be able to:

a. Internalize the importance of Nursing
Jurisprudence.
b. Recall concepts on ethics and morals.
c. Internalize the Code of Ethics for Nurses.
d. Trace the history of Nursing law
 Ethics

-- system of moral principles or moral

standards governing a conduct.
-System or principles and rules
concerning a duty.
- system of rules of practice applied to
a single class of human actions
e..g. legal ethics, medical ethics,
nursing ethics
-Moral philosophy- furnishes norms or
standards
 Ethics and Moral
- essentially synonymous.
Ethics is the study of moral conduct or
the principles underlying the
desirable type of human conduct.
While
Morals – human conduct itself
thus
Ethics- is a science of ideals which guides our
judgment concerning the morality of
human acts, whereas,
Morals is the human conduct in the light of
ethics; it is the application of ethics.
 1. The Golden Rule

Moral
Principles 2. The Two Fold Effect
- good or bad situation
- basis of action
 3. Principle of Totality
- The whole is greater than any of
its parts
Moral
Principles

4. The Rule Of Epikia- exception to the

general Rule
 5. One who acts through an agent is himself responsible.
- The nurse become liable to a crime if she recommends and
become accomplice even if not done herself.
Moral
Principles 6. No one is obliged to betray himself/herself.
 7. The end does not justify the means.

Moral
Principles 8. Defects of nature may be corrected.
- corrective through plastic surgery e.g. cleft lip surgery
 9. If one is willing to cooperate in an act, no injustice is done to
Moral him/her.

Principles
10. A little more or less does not change the substance of an act.
 11. The greatest good for the greatest number
- the use of immunization in cases of epidemic/pandemic.
Moral
Principles 12. No one is held to the impossible.
  both are behavior which tends to become customary due to
Ethics and
Morals approval or practices of the group .
 Importance of Ethics

 Ethics makes clear why one is better than

another
 Ethics keep an orderly social life by having
agreements, understanding of principles, rules
or procedures.
 Ethics seeks to point out to man the true value
of life to stimulate moral sense and inspire men
to gain in for quest for these values.
Basic principles of biomedical ethics
 1. Autonomy – “freedom to choose”
- make choices about issues
that affects one’s life.
- Right to choose what will
happen to one’s own person.
- right to determine personal care
given and by whom.
 Nurses should support client’s
independence to make decisions and take
actions for themselves.
Nursing
Implication:

What are the restrictions?

2. Beneficence – “do only what is good”
- requires nurses to act in ways
that benefit the client.

-acts of kindness and mercy

- acts should:
promote health,
prevent illnesses and complications
alleviate suffering
assists towards peaceful deaths
Nursing  Nurses have the responsibility to
implication: help others by doing what is best
for them.
3. Non maleficence –
“Do no harm”
Requires nurses to act in
such a way to avoid causing harm
to clients.
-stated in negative form
 - seeks to do no harm in situation
requiring nursing actions
 - the need to avoid harm regardless of
reasons for negative actions.
 **
 Nurses should act with empathy
Nursing without bad faith or ill will, nor
Implication: make false accusations.
Non  Do not assist in abortion, Euthanasia
malefiscence  Do not submit patient to experimental drugs
examples  Do not reveal confidential information
4. Veracity –
“tell the truth”
- engenders respect, open
communication, trust and
shared responsibility.
- universal value

***Restrictions:
-benevolent deception
Nursing Nurses should
implication: communicate truthfully
and accurately.
5.  Nursing Implication:
Confidentiality
-
“keep  ** Safeguard client’s right to
private” privacy.
 6. Justice – Be fair!


 Premise: Health is a basic human right.

 - equitable and appropriate treatment

according to what is due or owed to persons
with the understanding that giving to some
will deny receipt to others who might
otherwise have received those things.
 Accessibility to health insurance
Examples Senior citizen act
Other benefits
Nursing ** Nurses should make use of available
Implication: resources fairly and reasonably.
 7.7. Fidelity- “keep your word”
You can be
trusted with - faithfulness
your words. - practice of keeping
promises.
Nursing  Nurses should attend to the details of
implication; what they say they do.
Nursing as a
Helping
Profession
GOALS:
 Help clients manage their problems in
living more effectively and develop
unused or underused opportunities more
fully.
 Help clients become better at helping
themselves in their everyday lives.

The keys to the helping relationship are:

 The development of trust and acceptance
between the nurse and the client
 An underlying belief that the nurse cares
about and wants to help the client
 Is an intellectual and emotional bond between
the nurse and the client and is focused on the
client
 Respect the client as an individual
 Respect client confidentiality
 Focuses on client’s well being
 Is based on mutual trust, respect, and
acceptance
  1.) Pre-interaction Phase

Phases of the  2.) Introductory Phase – also known as

Helping orientation or pre-helping phase.
Relationship Important because it sets the tone for the rest
of the relationship. Activities:
 Getting to know each other
 Developing a degree of trust
 May display resistive behaviors: due to
difficulty in acknowledging the need for
help, fear of exposing and facing feelings,
anxiety about the discomfort involved in
changing problem-causing behavior
patterns, fear and anxiety in response to
the nurse’s approach.
 Resistive behaviors can be overcome by
conveying a caring attitude, genuine
interest in the client, and competence
 Opening the relationship
 Clarifying the problem
 Structuring and formulating the
contract (obligation to be met by both
the nurse and client)
 By the end of this phase, the
client should begin to:
 Develop trust in the nurse
 View the nurse as a competent professional capable of
helping
End of  View the nurse as honest, open, and concerned about their
welfare
Introductory  Believe the nurse will try to understand and respect their
cultural values and beliefs
Phase  Believe the nurse will respect client confidentiality
 Feel comfortable talking with the nurse about feelings and
other sensitive issues
 Understand the purpose of the relationship and the roles
 Feel that they active participants in developing a mutually
agreeable plan of care
 3.) Working Phase
 Exploring and understanding thoughts and
feelings – empathetic listening, respect,
genuineness, concreteness, confrontation
Phases of the
Helping  Facilitating and taking action
Relationship
4.) Termination Phase
  GROUP DYNAMICS – communication
that takes place between members of any
group
 HEALTH CARE GROUPS
 Task groups – most common type of work-
GROUP related groups to which nurses belong.
COMMUNICATION
 Teaching groups
 Self-help groups
 Self-awareness/ Growth groups
 Therapy groups
 Work-related social support groups
  Nursing practice demands a discipline-
specific, reflective reasoning process that
guides a nurse in:
CRITICAL  generating, implementing, and evaluating
THINKING approaches for dealing with client care and
professional concerns.
 Critical thinking, problem solving, and decision
making are interrelated processes
Nurses use  Nurses use knowledge from other
critical subjects and fields.
thinking skills  Nurses deal with change in stressful
in a variety of environments.
ways:  Nurses make important decisions.
  Is a major component of critical thinking.
 When nurses incorporate creativity into
their thinking, they are able to find unique
solutions to unique problems.

Creativity  It is a thinking that results in the

development of new ideas and products.

 The ability to develop and implement new

and better solutions.
  CRITICAL ANALYSIS – the application of a
set of questions to a particular situation or
idea to determine essential information
and ideas and discard unnecessary
SKILLS IN information and ideas.
CRITICAL  INDUCTIVE REASONING –
THINKING: generalizations are formed from a set of
facts or observations; moves from specific
examples to generalized conclusions.
 DEDUCTIVE REASONING – reasoning
from general premise to specific
conclusion.
  Independence
 Fair-mindedness
 Insight into egocentricity
ATTITUDES  Intellectual humility
THAT FOSTER  Intellectual courage to challenge the status
CRITICAL quo and rituals
THINKING:  Integrity
 Perseverance
 Confidence
 Curiosity
Goodluck God bless

Thank you

You can do it!