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The history of nursing where it all begin from
The role of nurses as leaders
The role of nurses as leaders
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In 1952, the nursing leaders formed the National League for Nursing (NLN), due to the unsystematic approach to teaching by physicians (Pollitt & Reesman, 2011). The first goal was to create, teach and evaluate nursing curricula. Eugene Stead believed routine care provided by physicians could be taught and performed by a new type of healthcare provider (Pollitt & Reesman, 2011). Ingles and Stead spearheaded nursing education at a master’s level (Pollitt & Reesman, 2011). In 1958, the first nursing clinical specialist program was introduced at Duke University; however was denied due to lack of structure and medicine was more prevalent than nursing (Pollitt & Reesman, 2011).
The clinical nurse specialist (CNS) role was created largely for the
need of advanced care for the psychiatric population (Denisco & Barker, 2016). Rutgers University was the first to educate nurses in the role of psychiatric clinical specialist (Denisco & Barker, 2016). This role proved to be useful and nursing schools began to educate nurses across different specialties (Denisco & Barker, 2016). Mary Brekenridge founded the first midwifery school in 1925 in response to the high rates of maternal and child death in rural Kentucky (Denisco & Barker, 2016). In 1965, nurse Loretta Ford and Dr. Henry Silver found the first pediatric nurse practitioner program at the University of Colorado in response to the shortage of primary care physicians in rural and urban communities (Stewart & Denisco, 2015). Similarly to the creation of nurse practitioner (NP) programs, there was a shortage of qualified physicians to administer anesthesia during wartimes. Since World War I, nurse anesthetists were the main provider of anesthesia for U.S. military personnel and in rural communities (Denisco & Barker, 2016). The evolution of the roles has set forth defining roles, criteria and scope of practice for APRNs. The APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory committee came together in 2008 to create the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education (Stewart & Denisco, 2015). An advanced practice registered nurse (APRN) role consists of: (1) Certified registered nurse anesthetist, (2) Certified nurse mid-wife, (3) Clinical nurse specialist, and (4) Certified nurse practitioner. I believe professional traits that defines an APRN are: Hold a master’s or higher degree in nursing, ability to critically think/make clinical decisions, strong assessment skills, culturally competent, patient centered, ability to critique evidence-based practices, and professionalism.
In tandem with growing scientific knowledge, programs expanded their length and credit loads. Nurse practitioner specialties such as cardiology and intensive care appeared in graduate programs across the country with educational programs aimed at their specialized knowledge. NAPNAP had been founded as one of the first national specialty nurse advanced practice organizations in 1973. By the end of the 1980s, nurse practitioner care was part of the normal menu of services offered by many health care institutions, supported by the 1986 OTA study that found that NPs “provide care whose quality is equivalent to that of care provided by physicians,” particularly when such care depended on preventative services and communication with patients (Office of Technology Assessment, 1986, 5). In 2003, health care institutions began to hire large numbers of NPs in response to the Accreditation Council for Graduate Medical Education’s Resident Duty Hours standards, which limited the number of hours medical residents could work (Nasca, Day & Amis, 2010). Numerous studies, including a Cochrane review, reports from the Rand Health Foundation, Commonwealth Fund, and Western Governor’s Association all provided positive evidence of the value and quality of NP-provided services. Today, NPs have proven their effectiveness in delivering high quality, lower
Nursing, as a crucial part of the health care system, keeps evolving while dealing with an increasingly complex clinical situation that involves quality of patient care. Therefore, to successfully handle these scenarios, nursing needs to become more advanced, clinically and academically. A DNP degree is needed in this situation because according to Dunbar- Jacob, Navito & Khalil (2013), a DNP degree is considered to have more impact on nursing than a Master’s or Bachelor’s degree due to the advanced clinical education a DNP provides (p. 425). Hence, the DNP degree has an enormous impact in nursing practice especially in terms of improving clinical care, promoting leadership roles, and improving educational status.
Reasons for creation and growth: In the late 1950s and early 1960s, increased specialization amongst physicians was taking place, which led to many doctors exploring other avenues of medicine, resulting in a large shortage of physicians practicing primary care. This left many rural and inner city areas with very limited access to medical care. During this same time, Medicaid and Medicare programs were growing rapidly and increasing the number of individuals covered, such as to low income individuals, the disabled, and the elderly. The abrupt expansion of coverage caused the demand of primary care services to skyrocket. With physicians no longer able to meet the growing demand, nurses stepped to provide medical care, and soon believed that were qualified to broaden their role and scope of abilities. In 1965, a nurse and physician, Loretta Ford and Henry Silver, recognized the need for a training program, and developed the first curriculum for nurse practitioners. Since then, the role of nurse practitioner has rapidly increased in response to the expanding and growing need for accessible and affordable care and is currently ranked as one of the fastest growing professions in healthcare.
Certified Nursing Assistants (CNA) are a vital element of the health team. Serving as a middleman between patients and other members of the health team nursing assistants play many different, yet equally important roles in patient care. Nursing assistants provide emotional, physical, and social support for patients, and residents. I will inform readers about the role of certified nursing assistants in long-term care centers (LTC) and their importance as a member of the health team.
INTRODUCTION There are many things that affect a student’s enrolment as a nurse the student must be competent in the many registration standards that the Nursing Midwifery Board of Australia have set. The stigmas attached to students with Impairments and or Criminal histories and the ineligibility to register. Nursing is defined by the International Council of Nursing (2014) as collaborative care of individual’s any age health or ill of all communities, groups, in all situations. Health promotion, illness prevention and the care of unwell, disabled and dying people are included in the nursing practice. Encouraging a safe environment, research, contributing to shape health policies and health systems management, and education are also key nursing
Healthcare is a continuous emerging industry across the world. With our ever changing life styles and the increased levels of pollution across the world more and more people are suffering from various health issues. Nursing is an extremely diverse profession and among the highest educated with several levels ranging from a licensed practical nurse (LPN) to a registered nurse (RN) on up to a Doctorate in Nursing. Diane Viens (2003) states that ‘The NP is a critical member of the workforce to assume the leadership roles within practice, education, research, health systems, and health policy’.
The infamous nursing pioneer, Dorothea Elizabeth Orem, set the bar for nurses worldwide. She was born and raised in Baltimore, Maryland, where she graduated from high school in 1931. While in college, she pursued her Bachelor’s of Science in Nursing Education and she also earned her Masters of Science in Nursing Education. When she first began practicing, she worked at Providence Hospital in Washington D.C. She then continued her early career at St. John’s with the position of administration. Once she achieved her advanced degrees, she became director of the Providence Hospital School of Nursing in from 1945-1948 in Detroit, Michigan. While directing at this particular school of nursing, Orem also taught biological sciences...
The NLN’s purpose is to promote excellence in nursing education (Mason, Gardner, Outlaw, & O’Grady, 2016). Good education is the foundation of stronger
I started nursing on the cusp of the transition from wearing all white and reciting “yes, doctor” to wearing scrub or lab coats and having collegial conversations with providers and making recommendations to providers to improve patient outcomes. I ask myself, “when did this happen”? Maybe, it wasn’t so much a cultural shift in nursing but maybe it was my own understanding of the role a nurse plays in patient care. Or, maybe it was both. Either way, this shift has played an instrumental role in my perception of nursing and my own career development. Nursing theory has been around since the time of Florence Nightingale but in recent years it has played an integral role in the way nursing is perceived. Nursing theories allow nursing to be purposeful by stating not only the focus of practice but specific goals and outcomes (McEwen, Wills, 2014). Gone are the days of completing tasks and orders but instead using theory to guide our plan of care. In my own practice theory has helped guide the role of the nurses in the ambulatory
...ies of the nursing care was provided by drunkards and former convicts. What was also reported was that their city’s courts were giving the prostitutes of going to prison or going into hospital service. Long before social reforms and some physicians in the United States espoused the idea that provisions of safe nursing care was important and best delivered by persons who received a formal education in nursing. At the end of the 19th century wealthy philanthropists, nurses provided care to the sick poor patients in their homes and provided them with food and medical supplies. In 1919 a Committee for the study of Nursing Education was established to examine the state of both public health and nursing education. The committee’s published report that nurse educators receive the advanced education that is required for them. No one cared to make all the changes just some.
The nursing profession has changed drastically over time. The roles and responsibilities that nurses take on have increased and become far more complicated. Nurses are managers, leaders, supervisors and have become experts in many areas of care. Every day nurses are faced with the task of improving and strengthening professional leadership within their work environment. Managing good quality and eliminating risk is the major challenge in health care. All members of the team must work together to accomplish outstanding patient care. Budget cuts and nursing shortage in all areas of health care leads to less licensed staff, where use of unlicensed personnel have been used widely, where delegation is not an option, but a necessity. Nurses must be aware of delegation guidelines, what tasks to delegate,when to delegate for the safety of patients, liability of nurses and the facility.
Since the start of the colonies in the United States nursing has been at the forefront of patient care. It all began in the home and moved to the battlefield during any time that Americans where in need. Since that time nursing has evolved from nurses just trying to provide basic care into nurses being a doctors eyes and ears when he cannot be around his patients and even providing primary care. Nurses have always stepped forward to be on the front lines of medical care. This process is continuing with nurses now continuing their educations to achieve the highest levels possible so they can help the most patients.
Over one hundred years after Florence Nightingale’s death nursing has come a very long way. Today, it is more complex than could have ever been imagined over a century ago. In fact, the profession of nursing has evolved considerably in just the last fifty years of practice. According to Kathleen Stevens (2013), it was not until the 1960s that nursing education was established as an applied science. Now, not only are nurses educated, but also they have ethical standards to uphold, have autonomy in their practice, and are recognized by the government through
This journal is a reflection of my experiences and lessons learned thus far within this course. Upon my reflecting, there were lessons that stood out the most. Also, there are nursing practices in my associate’s degree of nursing program (ADN) that correlates with the standard of care that was recently discussed. This reflection also prompt me to consider more in depth the necessary skills and attributes to become a competent nurse.
In the healthcare setting, a systematic process to ensure maximum care and maximum recovery in patients is needed, which is called the nursing process. This process consists of four steps: assessment, diagnosis, planning, implementation, and evaluation (Walton, 2016). The nursing process is important to ensure quality care and to get the preferred outcome. In the nursing process, critical thinking is used to recognize the issue and come up with a logical solution to solving it. One important aspect of the nursing process is that the plan is not set in stone; it is meant to be manipulated in order to better suit the patient. Nurses must be able to think critically in order to recognize the issue, develop a way to correct it, and be able to communicate the issue to others. Throughout the nursing process, critical thinking is used to determine the best plan of care for a patient based on their diagnosis.