NURSING AS a PROFESSION

Profession is a calling that requires special knowledge, skill and preparation. An occupation that requires advanced knowledge and skills and that it grows out of societys needs for special services.

5.

Nursing is committed to personalized services for all persons without regard to color, creed, social or economic status.

6.

Nursing is committed to involvement in ethical, legal, and political issues in the delivery of health care.

Personal Qualities of a Nurse:

1. 2. Must have a Bachelor of Science degree in nursing. Must be physically and mentally fit. Must have a license to practice nursing in the country .

Criteria of Profession:
1. 2. 3. To provide a needed service to the society. To advance knowledge in its field. To protect its members and make it possible to practice effectively.

3.

A professional nurse therefore, is a person who has completed a basic nursing education program and is licensed in his country to practice professional nursing.

Characteristics of a Profession:
1. A basic profession requires an extended education of its members, as well as a basic liberal foundation. 2. A profession has a theoretical body of knowledge leading to defined skills, abilities and norms. 3. 4. A profession provides a specific service.

Roles of a Professional

1. Caregiver/ Care provider the traditional and most essential role functions as nurturer, comforter, provider mothering actions of the nurse provides direct care and promotes comfort of client activities involves knowledge and sensitivity to what matters and what is important to clients show concern for client welfare and acceptance of the client as a person

Members of a profession have autonomy in decision-making and practice.

5.

The profession has a code of ethics for practice .

NURSING >is a disciplined involved in the delivery of health care to the society. >is a helping profession >is service-oriented to maintain health and well-being of people. >is an art and a science. NURSE - originated from a Latin word NUTRIX, to nourish .

2. Teacher provides information and helps the client to learn or acquire new knowledge and technical skills Encourages compliance with prescribed therapy. promotes healthy lifestyles interprets information to the client

Characteristics of Nursing:
3. Counselor 1. 2. 3. Nursing is caring. Nursing involves close personal contact with the recipient of care. Nursing is concerned with services that take humans into account as physiological, psychological, and sociological organisms. 4. Nursing is committed to promoting individual, family, community, and national health goals in its best manner possible . helps client to recognize and cope with stressful psychologic or social problems; to develop an improve interpersonal relationships and to promote personal growth provides emotional, intellectual to and psychologic support Focuses on helping a client to develop new attitudes, feelings and behaviors rather than promoting intellectual growth.

Encourages the client to look at alternative behaviors recognize the choices and develop a sense of control.

1.

2. Nurse Practitioner- is a nurse who has completed either as certificate program or a masters degree in a specialty and is also certified by the appropriate specialty

4. Change agent Initiate changes or assist clients to make modifications in themselves or in the system of care.

organization. She

is

skilled

at

making

nursing

assessments, performing P. E., counseling, teaching and treating minor and self- limiting illness.

5. Client advocate Involves concern for and actions in behalf of the client to bring about a change. Promotes what is best for the client, ensuring that the clients needs are met and protecting the clients right. Provides explanation in clients language and support clients decisions.

4.

Nurse-midwife- a nurse who has completed a program in midwifery; provides prenatal and postnatal care and delivers babies to woman with uncomplicated

pregnancies. 5. Nurse anesthetist- a nurse who completed the course of study in an anesthesia school and carries out preoperative status of clients.

6. Manager makes decisions, coordinates activities of others, allocate resource evaluate care and personnel Plans, give direction, develop staff, monitor operations, give the rewards fairly and represent both staff and administrations as needed.

6. Nurse Educator - A nurse usually with advanced degree, who beaches in clinical or educational settings, teaches theoretical knowledge, clinical skills and conduct research.

7.

Nurse Entrepreneur- a nurse who has an advanced degree, and manages health-related business.

7. Researcher 1. 2. participates in identifying significant researchable problems participates in scientific investigation and must be a consumer of research findings 3. must be aware of the research process, language of research, a sensitive to issues related to protecting the rights of human subjects. 8. Nurse administrator- a nurse who functions at various levels of management in health settings; responsible for the management and administration of resources and personnel involved in giving patient care.

Fields and Opportunities in Nursing Expanded role as of the nurse

1. 1. 1 Clinical Specialists- is a nurse who has completed a masters degree in specialty and has considerable clinical expertise in that specialty. She provides expert care to individuals, participates in educating health care 2. Public Health Nursing/Community Health Nursing usually deals with families and communities . (no confinement, OPD only) Hospital/Institutional Nursing a nurse working in an institution with patients Example: rehabilitation, lying-in, etc.

professionals and ancillary, acts as a clinical consultant and participates in research.

Example: brgy. Health Center

 3. 4. Private Duty/special Duty Nurse privately hired Industrial/Occupational Nursing a nurse working in factories, office, companies

Deficiencies in these 5 factors produce illness or lack of health, but with a nurturing environment, the body could repair itself.

DOROTHEA OREMS SELF-CARE THEORY

5. Nursing Education nurses working in school, review center and in hospital as a CI. Defined Nursing: The act of assisting others in the provision and management of self-care to

maintain/improve human functioning at home level of 6. Military Nurse nurses working in a military base. effectiveness.

7.

Clinic Nurse nurses working in a private and public clinic.

Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being.

8.

Independent Nursing Practice private practice, BP monitoring, home service. Independent Nurse Practitioner.

Has a strong health promotion and maintenance focus.

Identified 3 related concepts: Self-care activities an Individual performs

independently throughout life to promote and

Nursing Theory and Theorists

4 Essential concepts common among nursing theories:

maintain personal well-being. Self-care deficit results when self-care agency (Individuals ability) is not adequate to meet the known self-care needs. Nursing System nursing interventions needed when Individual is unable to perform the necessary self-care activities:

Health Environment Nursing

Wholly compensatory nurse provides entire selfcare for the client. Example: care of a new born, care of client recovering from surgery in a post-anesthesia care unit

FLORENCE NIGHTINGALESS ENVIRONMENTAL THEORY

Defined Nursing: The act of utilizing the environment of the patient to assist him in his recovery. Focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. Identified 5 environmental factors: fresh air, pure water, efficient drainage, cleanliness/sanitation and light/direct sunlight. Considered a clean, well-ventilated, quiet environment essential for recovery.

Partial

compensatory

nurse

and

client

perform care; client can perform selected selfcare activities, but also accepts care done by the nurse for needs the client cannot meet independently. o Example: Nurse can assist post

operative client to ambulate, Nurse can bring a meal tray for client who can feed himself

Supportive-educative nurses actions are to help the client develop/learn their own self-care abilities through knowledge, support and

MADELEINE LEININGERS TRANSCULTURAL CARE THEORY AND ETHNO NURSING

encouragement. Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.

Nursing is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death.

VIRGINIA HENDERSONS DEFINITION OF THE UNIQUE FUNCTION OF NURSING

Transcultural nursing as a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health-

Defined Nursing: Assisting the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength, will or knowledge.

illness caring practices, beliefs and values with the goal to provide meaningful and efficacious nursing care services to people according to their cultural values and healthillness context.

Focuses on the fact that different cultures have different caring behaviors and different health and illness values, beliefs, and patterns of behaviors.

Identified 14 basic needs : Breathing normally Eating and drinking adequately Eliminating body wastes Moving and maintaining desirable position Sleeping and resting Selecting suitable clothes Maintaining body temperature within normal range Keeping the body clean and well-groomed Avoiding dangers in the environment Communicating with others Worshipping according to ones faith Working in such a way that one feels a sense of accomplishment Playing/participating in various forms of recreation Learning, discovering or satisfying the curiosity that leads to normal development and health and using available health facilities.

Awareness of the differences allows the nurse to design culture-specific nursing interventions.

CALLISTA ROYS ADAPTATION THEORY

Viewed humans as Biopsychosocial beings constantly interacting with a changing environment and who cope with their environment through Biopsychosocial

adaptation mechanisms. Focuses on the ability of Individuals., families, groups, communities, or societies to adapt to change. The degree of internal or external environmental change and the persons ability to cope with that change is likely to determine the persons health status. Nursing interventions are aimed at promoting

physiologic, psychologic, and social functioning or adaptation.

or in need of health services and a nurse especially educated to recognize, respond to the need for help.

MARTHA ROGERS CONCEPT OF SCIENCE OF UNITARY HUMAN BEINGS, AND PRINCIPLES OF HOMEODYNAMICS
Nursing is a instrument Identified 4 phases of the Nurse Patient relationship: maturing force and an educative

Nursing is an art and science that is humanistic and humanitarian. It is directed toward the unitary human and is concerned with the nature and direction of human development. The goal of nurses is to participate in the process of change...

Orientation individual/family has a felt need and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase.

Nursing interventions seek to promote harmonious interaction between persons and their environment, strengthen the wholeness of the Individual and redirect human and environmental patterns or organization to achieve maximum health.

Identification where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate

professional assistance.

5 basic assumptions:

Exploitation the nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services.

1.

The human being is a unified whole, possessing individual integrity and manifesting characteristics that are more than and different from the sum of parts. Resolution where patients needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic

2.

The individual and the environment are continuously exchanging matter and energy with each other

relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person.

3.

The life processes of human

beings evolve

irreversibly and unidirectional along a space-time continuum 4. Patterns identify human being and reflect their innovative wholeness 5. The individual is characterized by the capacity for abstraction and imagery, language and thought, sensation and emotion Nursing is participation in care, core and cure aspects of patient care, where CARE is the sole function of nurses,

LYDIA

HALLS

KEY

CONCEPTS

OF

THREE

INTERLOCKING CIRCLES THEORY

HILDEGARD

PEPLAUS

INTERPERSONAL

whereas the CORE and CURE are shared with other members of the health team.

RELATIONS THEORY
Defined Nursing: An interpersonal process of therapeutic interactions between an Individual who is sick

The major purpose of care is to achieve an interpersonal relationship with the individual that will facilitate the development of the core.

15. To promote the development of productive interpersonal relationship 16. To facilitate progress toward achievement of personal spiritual goals

DOROTHY

JOHNSONS

KEY

CONCEPTS

OF

17. To create and maintain a therapeutic environment 18. To facilitate awareness of self as an individual with varying needs.

BEHAVIORAL SYSTEM

19. To accept the optimum possible goals Each individual has patterned, purposeful, repetitive ways of acting that comprises a behavioral system specific to that individual. 20. To use community resources as an aid in resolving problems arising from illness. 21. To understand the role of social problems as influencing factors

FAYE GLENN ABDELLAHS CONCEPT OF TWENTY ONE NURSING PROBLEMS

Nursing is broadly grouped into 21 problem areas to guide care and promote the use of nursing judgement. Nursing is a comprehensive service that is based on the art and science and aims to help people, sick or well, cope with their health needs. Nursing is a process of action, reaction, and interaction whereby nurse and client share information about their perception in the nursing situation

IMOGENE KINGS GOAL ATTAINMENT THEORY

21 Nursing Problems 1. 2. 3. 4. 5. 6. 7. 8. 9. To maintain good hygiene. To promote optimal activity; exercise, rest and sleep. To promote safety. To maintain good body mechanics To facilitate the maintenance of a supply of oxygen To facilitate maintenance of nutrition To facilitate maintenance of elimination To facilitate the maintenance of fluid and electrolyte balance To recognize the physiologic response of the body to disease conditions 10. To facilitate the maintenance of regulatory mechanisms and functions 11. To facilitate the maintenance of sensory functions 12. To identify and accept positive and negative expressions, feelings and reactions 13. To identify and accept the interrelatedness of emotions and illness. 14. To facilitate the maintenance of effective verbal and non-verbal communication

JEAN WATSONS THE PHILOSOPHY AND SCIENCE OF CARING

Nursing is concerned with promotion health, preventing illness, caring for the sick, and restoring health.

Nursing is a human science of persons and human healthillness experiences that are mediated by professional, personal, scientific, esthetic and ethical human care transactions

She defined caring as a nurturant way or responding to a valued client towards whom the nurse feels a personal sense of commitment and responsibility. It is only demonstrated interpersonally that results in the

satisfaction of certain human needs. Caring accepts the person as what he/she may become in a caring environment

Carative Factors:

1.

The promotion of a humanistic-altruistic system of values

2. 3.

Instillation of faith-hope The cultivation of sensitivity to ones self and others 1.

CONTINUING EDUCATION IN NURSING/CONTINUING PROFESSIONAL EDUCATION (CPE )

To encourage nurses as an ethical and moral obligation to

4.

The development and acceptance of the expression of positive and negative feelings.

enhance their knowledge, attitude and skills for competent and safe practice 2. 1988 nurses deciding to renew their PRC license were

5.

The systemic use of the scientific problemsolving method for decision making

6.

The promotion of interpersonal teachinglearning

required to present 20 contact hours per year 3. PRC Resolution No. 99-624 dated Aug. 11, 1999 and PRC

7.

The provision for supportive, protective and corrective mental, physical, socio-cultural and spiritual environment

Resolution No. 507 S. 1997 were repealed and CPE were no longer required for licensure 4. PRC Resolution No. 2004-179 S. 2004 again implements the

8. 9.

Assistance with the gratification of human needs The allowance for existential phenomenological forces.

requirement. Registered professionals are required a total of 60 units CPE credits units for 3 years. Any excess credit shall not be carried over the next 3 year period except credit units earned for

ROSEMARIE RIZZO PARSES THEORY OF HUMAN BECOMING

doctoral and masters degree. This revises Resolution 99-624 which did not require CPE units for renewal of licenses by professionals.

Nursing is a scientific discipline, the practice of which is a performing art

Three assumption about Human Becoming 1. Human becoming is freely choosing personal meaning in situation in the intersubjective process of relating value priorities 2. Human becoming is co-creating rhythmic patterns or relating in mutual process in the universe 3. Human becoming is co-transcending multidimensionally with emerging possibilities.

Nursing Associations in the Philippines

1. Ang Nars 2. Association of Deans of Philippine Colleges of Nursing (ADPCN) 3. Association of Diabetes Nurse Educators of the Philippines (ADNEP) 4. Association of Nursing Service Administrators of the Philippines (ANSAP) 5. Association of Private Duty Nurse Practitioners Philippines (APDNPP) 6. Critical Care Nurses Association of the Philippines (CCNAPI) 7. Gerontology Nurses Association of the Philippines (GNAP) 8. Military Nurses Association of the Philippines (MNAP) 9. Mother and Child Nurses Association of the Philippines (MCNAP) 10. National League of Philippine Government Nurses (NLPGN) 11. Occupational Health Nurses Association of the Philippines (OHNAP) 12. Operating Room Nurses Association of the Philippines (ORNAP) 13. Philippine Hospital Infection Control Nurses Association (PHICNA) 14. Philippine Nurses Association (PNA) 15. Philippine Nursing Informatics Association (PNIA) 16. Philippine Nursing Research Society (PNRS) 17. Philippine Oncology Nurses Association (PONA) 18. Philippine Society of Emergency Care Nurses (PSECN) 19. Renal Nurses Association of the Philippines (RENAP) 20. Society of Cardiovascular Nurse Practitioners of the Philippines (SCVNPPI) 21. Philippine Association of Public Health Nursing Faculty 22. Psychiatric Nursing Specialists Foundation of the Philippines 23. Integrated Registered Nurses of the Philippines (IRNUP)

11 CORE COMPETENCIES

KEY AREAS OF RESPONSIBILITY:

CORE COMPETENCY STANDARDS FOR NURSING PRACTICE IN THE PHILIPPINES

Safe & quality nursing practice Management of resources & environment Health education Legal responsibility Ethic moral responsibility Personal & professional development Quality improvement Research Record management Communication Collaboration & teamwork

LEGAL BASES

Article 3 Sec.9 (c) of R.A. 9173/ Philippine Nursing Act 2002 Board shall monitor & enforce quality standards of nursing practice necessary to ensure the maintenance of efficient, ethical and technical, moral and professional standards in the practice of nursing taking into account the health needs of the nation.

ROLES AND FUNCTION OF A NURSE

1. Caregiver

6. Change agent

The caregiver role has traditionally included those activities that assist the client physically and psychologically while preserving the clients dignity.Caregiving encompasses the physical, psychosocial, developmental, cultural and spiritual levels.

The nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own behavior. Nurses also often act to make changes in a system such as clinical care, if it is not helping a client return to health.

7. Leader

2. Communicator

Communication is an integral to all nursing roles. Nurses communicate with the client, support persons, other health professionals, and people in the community. In the role of communicator, nurses identify client problems and then communicate these verbally or in writing to other members of the health team. The quality of a nurses communication is an important factor in nursing care.

A leader influences others to work together to accomplish a specific goal. The leader role can be employed at different levels; individual client, family, groups of clients, colleagues, or the community. Effective leadership is a learned process requiring an understanding of the needs and goals that motivate people, the knowledge to apply the leadership skills, and the interpersonal skills to influence others.

8. Manager

3. Teacher

As a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health.The nurse assesses the clients learning needs and readiness to learn, sets specific learning goals in conjunction with the client, enacts teaching strategies and measures learning. advocate

The nurse manages the nursing care of individuals, families, and communities. The nurse-manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance.

9. Case manager

Nurse case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes.

4. Client

10. Research consumer nurses often use research to improve client care. In a clinical area nurses need to:

Client advocate acts to protect the client. In this role the nurse may represent the clients needs and wishes to other health professionals, such as relaying the clients wishes for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves.

5. Counselor

Have some awareness of the process and language of research Be sensitive to issues related to protecting the rights of human subjects Participate in identification of significant researchable problems Be a discriminating consumer of research findings

Counseling is a process of helping a client to recognize and cope with stressful psychologic or social problems, to developed improved interpersonal relationships, and to promote personal growth. It involves providing emotional, intellectual, and psychologic support.

EXPANDED ROLE OF THE NURSE

1. Clinical Specialists

Is a nurse who has completed a masters degree in specialty and has considerable clinical expertise in that specialty. She provides expert care to individuals, participates in educating health care professionals and ancillary, acts as a clinical consultant and participates in research.

2. Nurse Practitioner

Is a nurse who has completed either as certificate program or a masters degree in a specialty and is also certified by the appropriate specialty organization. She is skilled at making nursing assessments, performing P. E., counseling, teaching and treating minor and selflimiting illness.

3. Nurse-midwife

A nurse who has completed a program in midwifery; provides prenatal and postnatal care and delivers babies to woman with uncomplicated pregnancies.

4. Nurse anesthetist

A nurse who completed the course of study in an anesthesia school and carries out pre-operative status of clients.

5. Nurse Educator

A nurse usually with advanced degree, who beaches in clinical or educational settings, teaches theoretical knowledge, clinical skills and conduct research.

6. Nurse Entrepreneur

A nurse who has an advanced degree, and manages health-related business.

7. Nurse administrator

A nurse who functions at various levels of management in health settings; responsible for the management and administration of resources and personnel involved in giving patient care.