Nursing Today: Transition and Trends

Front Cover
Nursing Today: Transitions and Trends
Copyright Page
Contributors
Reviewers
Preface
Acknowledgments
Contents​
Unit I. Professional Growth and Transition
1 Role Transitions
Transitions
What Are Transitions?
What Are Important Factors Influencing Transitions?
Transitions in Nursing
Reality Shock
What Is Reality Shock?
What Are the Phases of Reality Shock?
What Is Transition Shock?
Role Transformation
When Does the Role Transition to Graduate Nurse Begin?
How Can I Prepare Myself for This Transition Process?
Begin Increasing Independence
More Realistic Patient-Care Assignments
Clinical Hours That Represent Realistic Shift Hours
Perform Nursing Procedures Instead of Observing
More Truth About the Real Work-Setting Experience
Look for Opportunities to Problem Solve and Practice Critical Thinking
Request Constructive Feedback From Staff and Instructors
Request Clinical Experience in an Area or Hospital of Interest
Think Positively
Be Flexible
School-learned ideal.
Workplace reality.
Compromise.
Get Organized
Stay Healthy
Find a Mentor
Find Other New Graduates
Have Some Fun
Know What to Expect
What Is the Future of Role Transition?
Conclusion
Bibliography
2 Personal Management: Time and Self-Care Strategies
Managing Your Time
Balance Is the Key
What Are Your Biological Rhythms, and How Do You Use Them?
What Is Meant by Right and Left Brain Dominance, and Where Is My Brain?
Which Are You?
How Can I Manage My Physical Environment?
Compartmentalize
Color Code
Convenience
Declutter the Clutter
What About All the Paperwork and Electronic Requests—How Can I Manage Them?
What About Managing the Telephone?
What About All That E-mail, Texting, or Social Media?
How Can I Manage My Time?
Managing Tasks
How Do I Deal With Procrastination?
Consider the Consequences
The Earlier, the Better
“By the Inch, It’s a Cinch”
Reward Yourself
Avoid the Myth of Perfection
Managing Others
What About Delegation and Time Management?
Managing Your Goals
Begin by Listing
Prioritize With the ABCD System
Keep It Going
Self-Care Strategies
Is Burnout Inevitable for Nurses?
Cultivating Mindfulness
Are You Living on “Automatic Pilot”?
What Are Mindfulness Exercises?
Empowerment and Self-Care
Suggested Strategies for Self-Care Based on the Holistic Self-Assessment Tool
Am I Emotionally Healthy or Emotionally Intelligent?
What About Friends and Fun? How Do I Find the Time?
How Do I Take Care of My Physical Self?
Self-Care Activities
Physical Exercise.
Laughter.
Mental Exercise.
Motivate Yourself.
Schedule Idle Time.
Strategies to Foster My Spiritual Self: Does My Life Have Meaning?
How Do I Increase My Mental Potential? Is It Okay to Daydream?
What Are My Choices, and How Do I Exercise Them?
Conclusion
Bibliography
3 Mentorship, Preceptorship, and Nurse Residency Programs
Ashley
Historical Background
What Mentoring is and is not
What Is Preceptorship?
What Is a Dedicated Education Unit?
What Happens if I Experience a Challenge During My Preceptorship or Clinical Rotation?
Lead
Follow
Get Out of the Way
What Is a Nurse Residency Program?
How to Find a Mentor
What Are the Characteristics of a Successful Mentor?
What Is a Mentoring Moment?
When Do We Need Mentors?
What Is the Role of the Mentee?
What Are the Characteristics of the Mentee?
What Are the Types of Mentoring Relationships?
Mentoring Through Reality Shock
Honeymoon Phase
Shock or Rejection Phase
Recovery Phase
Resolution Phase
Transitioning from Mentee to Mentor
What Does the Future Hold?
Conclusion
Bibliography
4 Employment Considerations: Opportunities, Resumes, and Interviewing
What is Happening in the Job Market?
Self-Assessment
What Are My Clinical Interests?
What Are My Likes and Dislikes?
What Are My Personal Needs and Interests?
What Are My Career Goals?
Researching Prospective Employers
What Employment Opportunities Are Available?
What About Advanced Degrees in Nursing?
How do i go about Researching Prospective Employers?
Employment Considerations: How Do You Decide on an Employer?
Media Information
Newspapers.
Online Searches.
Social Networking.
Job Fairs and Open Houses.
Employee Contacts.
Recruitment Contacts
Letter-Writing Campaign.
Telephone Contact.
Personal Contact.
What do i Need to know to Assess the Organization?
How Do You Go About Assessing an Organization to Find What You Want?
Talk to People in the Organization
Read and Analyze the Recruitment Materials
Review the Mission, Vision, or Philosophy Statement
Evaluate the Reputation of the Leadership
Portfolios
What Is an E-Portfolio?
Traditional and Employer-Focused Resumes
How Do I Write an Effective Resume?
What Information Is Necessary for a Resume?
Demographic Data: Who Are You?
Summary of Qualifications (Professional Objective): For What Position Are You Applying?
Education: Where Did You Receive Your Education?
Professional Experience: What Do You Know How to Do?
Licensure: What Can You Do, and Where Can You Do It?
Professional Organizations: To Which Do You Belong?
Honors and Awards: For What Did You Receive Recognition?
References: Who Knows About You?
What Else Should I Submit With My Resume?
What Are the Methods for Submitting Resumes?
The Interview Process
How Do I Plan My Interview Campaign?
Set Up Your Schedule
Prepare to Show Your Best Side
Rehearse the Interview
Strategies for Interview Success
Phone Interview Tips
Video Interview Tips
Face-to-Face Interview: Critical First 5 Minutes!
Phases of the Interview
How do i Handle Unexpected Questions or Situations?
Now Can We Talk About Benefits?
Sign-on Bonuses
Job Offers and Possible Rejection
Postinterview Process
Follow-up Communication
Follow-up Letter
Letters of Rejection
Telephone Follow-up
What If I Do Not Like My First Position?
What If It Is Time to Change Positions?
Conclusion
Bibliography
5 NCLEX-RN® Exam and the New Graduate
The NCLEX-RN® Exam
Who Prepares It, and Why Do We Have to Have It?
How Will the Nurse Licensure Compact Affect Your License?
What Is the NCLEX-RN® Exam Test Plan?
What Does Computer-Adaptive Testing Mean?
What Is the Application Process for the NCLEX-RN® Exam Computer-Adaptive Test?
What About Testing Accommodations?
Where Do I Take the Test?
When Do I Take the Test?
How Much Time Do I Have, and How Many Questions Are There?
Do I Have to Be Computer Literate?
How Will I Keep the Computer Keys Straight and Deal With a Mouse?
What Is the Passing Score?
How Will I Know I Have Passed?
What Types of Questions Will Be on the NCLEX-RN® Exam?
What Are Some of the Other Things I Really Need to Know About the NCLEX-RN® Exam?
What If I Need to Change the Time or Date I Have Already Scheduled?
What About Identification at the Testing Site?
What Are the Advantages of the Computer-Adaptive Test for the Candidate?
Preparing for the NCLEX-RN® Exam
Where and When Should I Start?
Six Months Before the NCLEX-RN® Exam
Investigate review courses, review books, and practice tests.
Plan an expense account for the end of school and for the NCLEX-RN® examination.
Two Months Before the NCLEX-RN® Exam: What Do I Need to Do Now?
If you have a job, discuss your anticipated NCLEX-RN® exam test date with your employer.
Decide how you are going to get to the test site and whether it will be necessary for you to stay overnight.
Are you going with a group or by yourself?
Develop a plan for studying.
The Day Before the BIG DAY
Make a “test run” the evening before the test.
Go to bed early do not study, cram, or party!
The BIG DAY Is Here
Dress comfortably but look nice.
NCLEX Rules
How Do I Select an NCLEX-RN® Exam Review Course?
What Types of Review Courses Are Available?
NCLEX-RN® exam online review courses.
What Are the Qualifications of the Review Course Instructors?
What Types of Instructional Materials Are Used in the Course?
Does the Course Include Instruction in Test-Taking Skills and Testing Practice?
How Much Does the Course Cost?
How Long Does It Last?
Where Is the Face-to-Face Course Held?
What Are the Statistics Regarding the Pass Rate for the Company?
Does the Review Company Offer Any Type of Guarantee?
When Is the Course Offered?
NCLEX-RN® Exam Review Books: Which One Is Right for You?
Scan the Table of Contents
Evaluate Chapter Layout
Evaluate Content
Evaluate the Index
Examine Test Questions
Look for Test-Taking Strategies
NCLEX-RN® Practice Exam
Test Anxiety: What Is the Disease? How Do You Get Rid of It?
What Kinds of Questions Can I Expect on the NCLEX-RN® Exam?
What Difference Do Test-Taking Strategies Make?
What Are Strategies for Answering Multiple-Choice Questions?
Read the Question (Stem) Carefully
Create a Pool of Information
Look for Critical Words
Evaluate All the Options in a Systematic Manner
Eliminate Options You Know Are Not Correct
Identify Similarities in the Options
Evaluate Priority Questions Very Carefully
Select Answers That Focus on the Client
What Are Alternate Item Format Questions?
What Are the Different Types of Alternate Item Format Questions?
Fill-in-the-blank.
Multiple-response item.
Hot spot.
Ordered response (drag and drop).
Chart or exhibit item.
Audio item.
Graphic options.
What Is the Next Generation NCLEX Project?
Let’s Look a Little Closer at the NGN
Types of NGN Test Questions
NCLEX-RN® Exam Testing Tips
NCLEX Hospital
NCLEX Clients
Medication Administration
Calling for Assistance
Positioning
Delegation and Supervision
Setting Priorities With a Group of Clients
Prescriber’s Orders
Conclusion
Bibliography
Unit II. Nursing: A Developing Profession
6 Historical Perspectives: Influences on the Present
Nursing History: People and Places
Where Did It All Begin?
Why Deacons, Widows, and Virgins?
How Did Knighthood Contribute to Nursing?
What About Revolts and Nursing?
Florence Nightingale: The Legend and the Lady
American Nursing: Critical Factors
What Was It Like in Colonial Times?
What Happened to Nursing During the US Civil War?
How Did the Roles of Nurses and Wives Compare During the Victorian Era?
Who Were the Reformers of the Victorian Era?
What Were the Key Challenges and Opportunities in 20th- and 21st-Century Nursing?
How Did the Symbols (Lamp, Cap, and Pin) of the Profession Evolve?
What Are the Key Events and Influences of the 21st Century?
History of Nursing Education
What Is the History of Diploma Nursing?
What Is the History of Associate Degree Nursing?
What Is the History of Baccalaureate Nursing?
What Is the History of Graduate Nursing Education?
The Nurse’s Role: the Struggle for Definitions
What Do Nurses Do?
What Is the Traditional Role of a Nurse?
Did You Know You Would Be a Teacher or Educator?
When Did the Nurse Become an Advocate? Nurse in the Role of Advocate
What Is the Role of Manager of Care?
Can Nurses Be Colleagues?
Where Does This Leave the Role of Colleague?
What About Experts?
Conclusion
Bibliography
7 Nursing Education
Path of Diploma Education
What Is the Educational Preparation of the Diploma Graduate?
Path of Associate Degree Education
What Is the Educational Preparation of the Associate Degree Graduate?
Path of Baccalaureate Education
What Is the Educational Preparation of a Baccalaureate Graduate?
Other Types of Nursing Education
What Are the Other Available Educational Options?
What Is a Concurrent Enrollment BSN Completion Program?
What is a BSN/MSN Completion Program?
What Is an External Degree Program?
What is an Online (Web-Based) Program?
What is a Proprietary Nursing School?
What Is an Accelerated Program?
Nontraditional Paths for Nursing Education
What About a Master’s Degree as a Path to Becoming a Registered Nurse?
Graduate Education
What About Graduate School?
Why Would I Want a Master’s Degree?
How Do I Know Which Master’s Degree Program Is Right for Me?
Why Would I Want a Doctoral Degree?
How Do I Know Which Doctoral Program Is Right for Me?
Credentialing: Licensure and Certification
What Is Credentialing?
What Is Nursing Licensure?
What Is Certification?
What is Accreditation?
Nursing Education: Future Trends
The Changing Student Profile
Educational Mobility
A Shortage of Registered Nurses
A Shortage of Qualified Nursing Faculty
Technology and Education
Changing Health Care Settings
The Aging Population
Conclusion
Bibliography
8 Nursing Theories
Nursing Theory
What Is Theory?
What Nursing Theory Is Not
Why Theory?
What Is the History of Nursing Theory?
Who Are The Nursing Theorists?
Selected Nursing Theorists
Dorothea Orem—Self-Care Nursing Theory
Martha Rogers—Science of Unitary Human Beings
Sister Callista Roy—Adaptation Model
Dorothy Johnson—Behavioral Systems Model
Betty Neuman—Systems Model
Imogene King—Goal Attainment Model
Jean Watson—Theory of Human Caring
Madeleine Leininger—Culture Care Theory
Future of Nursing Theory
Conclusion
Bibliography
9 Professional Image of Nursing
Professional Image of Nursing
What Do We Mean by the “Image” of Nursing?
Patient Interactions
Personal Interaction With the Public
Public Speaking and Community Activities
Participation in Political Activities
What Constitutes a Profession?
Is Nursing a Profession?
1. A Profession Has Relevance to Social Values
2. A Profession Has a Training or Educational Period
3. Elements of Self-Motivation Address the Way in Which the Profession Serves the Patient or Family and Larger Social Syste ...
4. A Profession Has a Code of Ethics
5. A Professional Has a Commitment to Lifelong Work
6. Members Control Their Profession
7. A Profession Has a Theoretical Framework on Which Professional Practice Is Based
8. Members of a Profession Have a Common Identity and a Distinctive Subculture
Nursing Organizations
What Should I Know About Professional Organizations?
What Organizations Are Available to Recent Graduates?
American Nurses Association
American Nurses Foundation and the American Academy of Nursing
International Council of Nurses
National League for Nursing
National Student Nurses’ Association
Organization for Associate Degree Nursing
American Association of Colleges of Nursing
American Board of Nursing Specialties
American Assembly for Men in Nursing
The American Red Cross
Conclusion
Bibliography
Unit III. Nursing Management
10 Challenges of Nursing Management and Leadership
Management Versus Leadership
What Is the Difference Between Management and Leadership?
The Functions of Management
What Are the Characteristics and Theories of Management?
What Is Meant by Management Style?
What Are the Characteristics and Theories of Leadership?
Management Requires “Followership”
The 21st Century: A Different Age for Management and for Leadership
The Silent or Veteran Generation
The Baby Boomers
Generation X
Generation Y
Generation Z or Generation Now
Generation Alpha
Power and Authority in Nursing Management
Do You Know the Difference Between Power and Authority?
What Are the Different Types of Power?
Management Problem Solving
How Are Problem-Solving Strategies Used in Management?
Evidence-Based Management Protocols and Interventions
How Are Problem Solving and Decision Making Related?
What Effect Does the Leader Have on the Group?
Who Is the Clinical Nurse Leader?
The Challenge of Change
Who Initiates Change and Why?
System
Management
Patient
Yourself
Conclusion
Bibliography
11 Building Nursing Management Skills
Communication and Patient Safety
How Can I Improve My Verbal Communication for Patient Safety?
How Can I Improve My Written Communication for Patient Safety?
Transcribing Written Orders
Communicating When It Is Critical—What Do You Need To Do?
Critical Patient Tests
Critical Hand-Off Communication
Shift Change—So Much to Say . . . So Little Time
Other Communications: Discharge Planning and Teaching
How Can I Deal With All the Interruptions?
What Skills Do I Need to Use the Telephone Effectively?
Managing Time in the Clinical Setting
Get Organized Before the Change-of-Shift Report
Prioritize Your Care
Organize Your Work by Patient
Managing Others
What About Delegating and Time Management?
Supervising and Evaluating the Care Provided by Others
Conclusion
Bibliography
12 Effective Communication, Team Building, and Interprofessional Practice
Communication in The Workplace
How Can I Communicate Effectively With My Supervisor?
How Can I Communicate Effectively With Other Nursing Personnel?
What Does My Image Communicate to Others?
What Should I Know About the “Grapevine”?
How Can I Handle Cultural Diversity at Work?
Components of Effective Communication
How Can I Communicate Effectively in Writing?
How Can I Learn to Speak Effectively?
Analyze Your Audience
Do Your Homework
Plan the Presentation
Add Spice to the Presentation
Create Cheat Sheets
The Closing
Final Details
What Listening Skills Do I Need to Develop?
Make Sure You Can Hear What Is Being Said
Focus Your Attention on What Is Being Said
Recognize and Control Your Emotional Response to What Is Being Said
Make the Decision to Listen and Accept the Other Person’s Needs and Feelings, Whatever They Are
Pay Attention to Nonverbal Communication as You Listen to the Words
Fight Off Distractions
Take Notes
Let the Speaker Tell the Whole Story
React to the Message, Not the Person
Respond Positively to the Feelings Being Communicated
How Can I Use Nonverbal Communication Effectively?
Make Eye Contact With the Person With Whom You Are Talking
Stand Up Straight, With Shoulders Back
To Suggest Confidence, Use an Assertive Voice Without Pauses
Watch for Distracting Behaviors
How Can I Communicate Effectively by Using Technology?
Do Not Misuse or Overuse E-mail and Text Messaging
Learn to Use Computer Software
When You Send E-mail Messages
Do Not Send an Emotional Outburst in an E-mail
When You Leave a Voice Mail Message for Someone, Speak Slowly and Distinctly
If You Are Using Call Waiting, Do Not Leave Callers on Hold
When You Call Someone, Ask if He or She Has Time to Talk, and Offer to Call Back at a More Convenient Time if Necessary
If You Are Conducting a Conversation or a Meeting on a Speaker Phone or by Means of a Teleconference, Make Sure That Each P ...
When You Must Send a Personal Message, Especially a Reminder or a Thank-You Note, the Most Powerful Way Is to Send a Handwr ...
Group Communication
What Is Group Process?
How Can You Improve Communications in Group Meetings?
Team Building And Interprofessional Practice
What Is Team Building?
What Is Interprofessional Practice?
Assertive Styles of Communication
How Can Nurses Be More Assertive?
What Are the Benefits of Assertiveness?
What Are My Basic Rights as a Person and as a Nurse?
How Can I Begin to Practice Assertive Communication?
What Are the Components of Assertive Communication?
When to Use Assertive Communication
Conclusion
Bibliography
13 Conflict Management
Conflict
What Causes Conflict?
Role Conflict
Communication Conflict
Goal Conflict
Personality Conflict
Ethical or Values Conflict
What Are Common Areas of Conflict Between Nurses and Patients—and Between Nurses and Patients’ Families?
Conflict Resolution
What Are Ways to Resolve Conflict?
Competition
Avoidance
Accommodation
Compromise
Collaboration
What Are Some Basic Guidelines for Choosing the Technique to Use?
Dealing With Difficult People
What Are Some Techniques for Handling Difficult People?
What Is Anger?
What Is the Solution for Handling Anger?
Stop
Look
Change
Get Active
Refocus on Something Positive
Pay Attention to Your Breathing
Sexual Harassment in The Workplace
What Can I Do About It?
Conclusion
Bibliography
14 Delegation in the Clinical Setting
What Does Delegation Mean?
The Delegation Process
Who Is Accountable Here?
The Right Task
What Can I Delegate or Assign?
Is There Anything I Cannot Delegate?
The Right Circumstances
How Can I Determine the Strengths and Weaknesses of Team Members?
What Are the Causes of Performance Weaknesses?
The Right Person
How Can I Use Outcomes in Delegating?
The Right Direction and Communication
How Can I Get the Delegate to Understand What I Want?
The Right Supervision and Evaluation
How Can I Give and Receive Feedback Effectively?
Conclusion
Bibliography
Unit IV. Current Issues in Health Care
15 The Health Care Organization and Patterns of Nursing Care Delivery
What Are Some Important Challenges Currently Facing Health Care?
Cost of Health Care
Managed Care
What Impact Has Managed Care Had on Costs?
Affordable Care Act
Strategies to Control Costs
Value-Based Care, Pay for Performance, and Accountable Care Organizations
What Is Value-Based Care?
What Is Pay for Performance?
What Are Accountable Care Organizations?
Case Management
Nurse Navigator Programs
Disease Management
Do Disease Management Programs Reduce the Cost of Health Care?
What Tools Are Used to Support Care Coordination?
Clinical Guidelines
Evidence-Based Practice
How Do We Know That Critical Pathways and Disease Management Protocols Reflect the Latest and Best Practice?
Shortage of Nurses
How Can Health Care Organizations Retain Nurses?
Magnet Hospitals
The Impact of the 2010 Institute for Medicine Future of Nursing Report
Quality of Care and Patient Safety
Institute for Healthcare Improvement
The Effects of Various Patterns of Nursing Care Delivery
What Is the Total Patient Care or Private-Duty Model?
What Is Functional Nursing?
What Is Team Nursing?
What Is Primary Nursing?
What Is Patient-Focused Care?
What Is the Most Effective Model of Nursing Care?
Nurse Staffing
What Is the Impact of Staffing Patterns on the Quality of Care?
How Are Nursing Work Assignments Determined?
What About Scheduling Patterns?
What About the Use of Overtime?
Conclusion
Bibliography
16 Economics of the Health Care Delivery System
What Are the Trends Affecting the Rising Costs of Health Care?
Intrinsic Factors
Extrinsic Factors
WHY Is cost expenditure the Effect of the Changing Economic Environment on Clinical Practice?
How Is the Us Health Care System Financed?
The Affordable Care Act of 2010
Employer-Sponsored Health Insurance
Introduction to Economics
Government Allocation Decisions
Payer Allocation Decisions
Marketplace Allocation Decisions
Unpredictability of Demand
Consumer Knowledge
Barriers to Entry to the Market
Lack of Price Competition
Budgets
What Are the Basic Concepts of Budgets?
What Are the Types of Budgets?
Capital Budget
Operating Budgets
Personnel Budget
Hours per Patient Day.
Full-Time Equivalent.
Productive Time.
Nonproductive Time.
What Are the Economics of Caring?
Fiscal Responsibility to the Patient
Fiscal Responsibility to the Employing Organization
Fiscal Responsibility to the Payer of Care
Conclusion
Bibliography
17 Political Action in Nursing
What Exactly is Politics?
What Other Strategies Would You Suggest?
What Are the Skills That Make Up a Nurse’s Political Savvy?
Ability to Analyze an Issue (Those Assessment Skills Again!)
Ability to Present a Possible Resolution in Clear and Concise Terms
Ability to Participate in a Constructive Way
Ability to Voice One’s Opinion (Understand the System)
Ability to Analyze and Use Power Bases
What Is Power, And Where Does It Come From?
A Way to Look at Power and Where to Get It
Networking Among Colleagues
Building Coalitions
What About Trade-Offs, Compromises, Negotiations, and Other Tricks of the Trade?
How Do I Go About Participating in the Election Process?
What Is a Political Action Committee?
After Getting Them Elected, Then What?
Controversial Political Issues Affecting Nursing
Uniform Core Licensure Requirements
What Is It?
Nursing and Collective Bargaining
Equal Pay for Work of Comparable Value or Comparable Worth?
Safe Nurse Staffing
Nursing Workforce Development Programs
Health Care Reform
Conclusion
Bibliography
18 Collective Bargaining: Traditional (Union) and Nontraditional Approaches
When Did the Issues Leading to Collective Bargaining Begin?
The Evolution of Collective Bargaining in Nursing
Legal Precedents for State Nursing Associations as Collective Bargaining Agents
Who Represents Nurses for Collective Bargaining?
Traditional and Nontraditional Collective Bargaining
Collective Bargaining: Perspectives of the Traditional Approach
Where Does Collective Bargaining Begin?
What Can a Union Contract Do?
Wages
Job Security Versus Career Security
Seniority Rights
Resolution of Grievances
Arbitration
Strikes and Other Labor Disputes
What Are the Elements of a Sound Contract?
Membership
Retirement
Other Benefits Issues
Traditional Collective Bargaining: Its Risks and Benefits
Collective Bargaining: Perspectives of the Nontraditional Approach
Nontraditional Collective Bargaining: Its Risks and Benefits
American Nurses Association and National Nurses United: What Are the Common Issues?
Health Care Reform and Expanding Advanced Practice Nurses’ Scope of Practice
Workplace Safety
Safe Nurse Staffing
Objection to an Assignment
Is There a Place for Collective Bargaining in Nursing?
Collective Bargaining: The Debate That Continues
Registered Nurse Participation in Collective Bargaining
How Can Nurses Control Their Own Practice?
Nurse Practice Committees
Future Trends
Conclusion
Acknowledgment
Bibliography
19 Ethical Issues
Understanding Ethics
What Are Your Values?
Moral and Ethical Principles
What Is the Best Decision, and How Will I Know?
Autonomy: A Patient’s Right to Self-Determination Without Outside Control.
Beneficence: Duty to Actively Do Good for Patients.
Nonmaleficence: Duty to Prevent or Avoid Doing Harm, Whether Intentional or Unintentional.
Fidelity: Duty to be Faithful to Commitments.
Justice: Duty to Treat All Patients Fairly, Without Regard to Age, Socioeconomic Status, Immigration Status, or Other Varia ...
Veracity: The Duty to Tell the Truth.
Which Principle or Rule Is Most Important?
So How Do I Make an Ethical Decision?
Teleological.
Situational.
How Do I Determine Who Owns the Problem?
First, Determine the Facts of the Situation.
Second, Identify the Ethical Issues in the Situation.
Third, Consider Possible Courses of Action and Their Related Outcomes.
What About an Interdisciplinary Ethics Committee?
Fourth, After a Course of Action Has Been Taken, Evaluate the Outcome.
What Other Resources Are Available to Help Resolve Ethical Dilemmas?
Controversial Ethical Issues Confronting Nursing
Abortion
How Does the Abortion Issue Affect Nursing?
Euthanasia
Futile Care and Physician-Assisted Suicide
What Is Medical Futility?
Physician-Assisted Suicide.
What Are the Ethical Issues Regarding Transplantation?
What Is the Ethical Issue Regarding the Use of Fetal Tissue?
What Are the Ethical Issues Regarding In Vitro Fertilization?
What Are Genetics and Genomics?
How Should We Use the Ability to Diagnose Genetic Defects Prenatally?
Allocation of Scarce Resources
Impact of a Pandemic
What Are Some of the Possible Solutions Being Debated?
Health Care Rationing.
What Are the Ethical Issues Around Involuntary Commitment?
Professional Boundaries
What Is the Impact of Social Media and Social Networking on Nursing Practice?
Emerging Ethical Issues in Health Care
Conclusion
Bibliography
20 Legal Issues
Sources of Law
Where Does Law Come From?
What Is Constitutional Law?
What Is Statutory Law?
What Is Administrative Regulatory Law?
What Are Nurse Practice Acts?
What Is Criminal Law?
Case Study 1
What Is Case Law?
Civil Actions—Torts
What Are Intentional Torts?
Invasion of Privacy and Breaches of Privacy and Confidentiality
Miscellaneous Intentional Torts and Employment Civil Rights Claims
What Are Unintentional Torts?
Case Study 2
Case Study 3
Court Actions Based on Legal Principles
Nursing Licensure
Disciplinary Actions
Scope of Practice
Multistate Licensure
What About Substance Use Disorder in Nursing?
Negligence
Basic Elements of Negligence
Do You Have a Professional Duty?
Falling Below the Standard of Care: Was There a Breach of the Professional Duty?
What About the Nurse Practice Act?
What Is an Expert Witness?
What Are Established Policies and Procedures?
What About Facility Licensure, Accreditation, and Reimbursement Standards?
What About Textbooks and Journals?
What Are Professional Standards for Nursing Organizations?
Applying the Standard of Care to the Case Study
Did the Breach of Duty Cause an Injury?
Applying “Causation” to Case Study 3
Did the Patient Suffer Damages or Injury?
Damages Applied to the Case Study
Case Study 4
Case Study 5
Who Might Have Liability (Responsibility) in a Claim?
Personal Liability
Supervisory Liability
Institutional Liability
Student Liability
What Defenses Might Be Available in Malpractice Claims?
Common Categories of Negligence
Medication Errors
Provide a Safe Environment
Patient Falls
Equipment Failure
Failure to Assess Adequately, Monitor, and Obtain Assistance
Failure to Communicate Adequately
Failure to Report
Failure to Document
Related Legal Concepts
Informed Consent
Advance Directives
Criminal Actions
What Criminal Acts Pose a Risk to the Nurse?
Theft and Misappropriation of Property
Nursing Practice Violations
Violations of the Food and Drugs Act
Risk Management and Quality Improvement
How Do I Protect Myself and My Patient From Risks?
Malpractice Insurance
What About Individual Malpractice Insurance?
What Is Institutional Coverage?
What Should I Ask About Institutional Coverage?
What Is Professional Licensure Defense Insurance?
What Happens When I Go to Court?
Legal Issues Affecting Nursing
Health Care Costs and Payment Issues
Health Care Delivery Issues
Issues About Life-and-Death Decisions
Termination of Pregnancy
Fetal Rights
Human Experimentation or Research
Patient Rights
Conclusion
Bibliography
Unit V. Contemporary Nursing Practice
21 Cultural and Spiritual Awareness
Culture and Spirituality
What Is Meant by Cultural and Linguistic Competence?
What Practice Issues Are Related to Cultural and Linguistic Competence?
Barriers to Cultural and Linguistic Competence
Social Determinants of Health and Health Care Disparities
Strategies for Providing Culturally Competent Care
A Culturally Diverse Workforce
What Is the Meaning of Spirituality?
Cultural and Spiritual Assessment
What Are Cultural and Spiritual Beliefs Regarding Illness and Cures?
How Do You Assess Spiritual Need?
Conclusion
Bibliography
22 Quality Patient Care
Standards of High-Quality Health Care Management
What Is Root-Cause Analysis?
History and Evolution of Quality in Health Care
What Are Core Measures?
What is HCAHPS?
Just What Is The Joint Commission?
What Are National Patient Safety Goals?
Monitoring the Quality of Health Care
What Is Quality Improvement?
How Do We Monitor Quality?
What Are an Indicator and a Metric?
What Is Performance Improvement?
What Are the Barriers to Quality Improvement?
What Are Some Other Agencies Influencing Patient Safety?
Quality Improvement Methods
Tools and Processes for Continuous Quality Improvement
What Is Six Sigma?
How Do We Use DMAIC?
The Define Phase
The Measure Phase
The Analyze Phase
The Improve Phase
The Control Phase
Health Care Provider Credentialing for Quality Improvement
Health Literacy
Conclusion
Bibliography
23 Nursing Informatics
Nursing Informatics
Nursing Informatics: Why Do I Care?
What Is Nursing Informatics?
Experience and Education
Role of Informatics Nurses and Informatics Nurse Specialists
Barriers to Success
The Certification Process
Professional Practice, Trends, And Issues
What Are Regulatory and Accreditation Requirements?
Privacy and Confidentiality
Health Insurance Portability and Accountability Act of 1996
HIPAA and the Use of Mobile Computing Devices
The Joint Commission
Cybersecurity
Electronic Health Records
The e-World Is Coming . . . Wait, It’s Here
Electronic Medical Record and Electronic Health Record
Personal Health Record
Technology Changing Workflow for the Better—Medication Fulfillment
Computerized Provider Order Entry and Clinical Decision Support
Barriers to Health Information Technology Still Remain
Trends
The Next Generation of Health Care Delivery
Patient Engagement
Telemedicine, Telehealth, and Health Monitoring
Cloud Computing
Big Data
Robotics in Patient Care
Artificial Intelligence in Health Care: The Time Is Almost Here
Patients and the Internet
What Do I (and Patients) Need to Know to Evaluate an Internet Resource?
The CARS Checklist
Patient Portals
Data Access at the Point of Care
Computers in the Nurses’ Station
Mobility in the Clinical World
Smartphones
Using Data to Improve Care at the Bedside
Nursing Informatics and You
Conclusion
Bibliography
24 Using Evidence-Based Practice and Nursing Research
What is Evidence-Based Practice?
Step 1: Define the Problem
Step 2: Identify, Review, and Evaluate the Data Applicable to the Problem
Step 3: Design a Practice Change Based on the Data While Incorporating the Clinical Expertise of the Nurse and Patient Pref ...
Step 4: Implement the Change in Nursing Practice
The Need For Nursing Practice Based on Research
What Is Nursing Research Utilization?
What Are the Steps for Nursing Research Utilization?
Step 1: Preutilization
Step 2: Assessing
Step 3: Planning
Step 4: Implementing
Step 5: Evaluating
Research Utilization: What Is It Not?
Research Utilization Compared with Nursing Research and the Conduct of Research
How Is the Use of Research in Practice Different From Conducting Research?
Steps for Conducting Research
What Is the Relationship Between Nursing Theory and Research Utilization?
Defining Your Practice Context
What Are the Health, Social, and Cultural Characteristics of the Patient Population Being Served?
What Are the Health Care Delivery Characteristics of Your Setting?
What Are the Motivators and Barriers for Incorporating Nursing Research into Your Practice?
The National Institute of Nursing Research
What Is Its Function?
The Agency for Healthcare Research and Quality
What Is Its Function?
Conclusion
Bibliography
25 Workplace Issues
Questions to Ask When Starting a New Position
Ergonomic Hazards for Health Care Workers
Back Injury
Safe Patient Handling and Mobility
Ergonomic Workstations
Repetitive Motion Disorders
Workplace Violence: A Growing Concern in Health Care
Lateral Violence (Bullying) and Other Forms of Workplace Harassment
Other Workplace Issues
Needlestick and Sharps Safety
Handling Staffing Shortages
Document Your Concerns
Mandatory Overtime
Making a Mistake—What Do I Do Now?
Conclusion
Bibliography
26 Emergency Preparedness
What Is Public Health Preparedness?
Clinical Preparedness
What Are Biologic Agents?
What Are Chemical Agents?
What Are Radiologic or Radioactive Agents?
What Is a Pandemic?
What Is Personal Protective Equipment in Disaster Response?
What Is Disaster Nursing?
What Are the Levels of Disasters?
What Is Triage?
Public Health Preparedness and Administrative Efforts
Community Health Nurse Issues and Public Health Preparedness
Epidemiologic Aspects
What Is the Strategic National Stockpile?
What is a CHEMPACK?
What is ESAR-VHP?
Medical Reserve Corps
Disaster Medical Assistance Teams
What Do I Need to Know About Community Preparedness Issues?
What Do I Need To Know About Disaster Mental Health?
Individual and Family Preparedness Issues
Emerging Trends and Issues in Emergency Preparedness
The 2010 Institute of Medicine Report
Conclusion
Bibliography
Index
Answers to NGN Test Questions
Bibliography