Saturday, January 31, 2009
Bachelor of Science Nursing (BS/BSN)
A four-year program offered at colleges and universities that prepares nurses to practice across all health care settings. BSN graduates have the greatest opportunity for advancement. For instance, a BSN is required for entry into a Master's program, which may in turn lead to a career in management, or on to more specialized nursing positions such as clinical nurse specialist, nurse practitioner, nurse educator, or nurse researcher. A BSN is preferred and often required for military nursing, case management, public health nursing, overseas/development nursing, forensic nursing and school nursing. Some countries (the European Union, Australia, and New Zealand) require a BSN before being able to sit for the RN exam.
Associate's Degree
A two-to-three year program offered at junior and community colleges, an Associate's degree trains and prepares nurses to provide direct patient care in numerous settings. ADN is an affordable education that provides the student opportunities to bridge into a BSN program and to progress onto a Masters or above. Some hospital nursing schools, colleges, and universities also offer ADN programs.
Hospital Diploma
A two- to three-year hospital-based nursing program that prepares you to deliver direct patient care in a variety of environments. Many diploma schools are affiliated with junior colleges, where you may also take basic science and English requirements, thereby earning an Associate's Degree along with a diploma in nursing.
Licensed Practical Nurse
LPNs, or Licensed Vocational Nurses (LVNs), as they are called in Texas and California, care for the sick, injured, convalescent, and disabled under the direction of physicians and registered nurses. They provide basic care, taking vital signs, temperature, blood pressure, and pulse, and assist with bathing patients, monitoring catheters, and applying dressings. Most LPN or LVN programs are about a yearlong and are offered by technical and vocational schools.
Accelerated Programs (Accelerated BSN, Accelerated MSN)
Many universities offer nursing programs for students who already have a Bachelor's Degree or even a Master's Degree in a field other than Nursing. These programs, which are often of shorter length than generic programs, are ideal for individuals who are looking to do something more meaningful with the education that they already have, or for those who have graduated college and found that their degree does not afford as many opportunities as they had hoped, but are unenthusiastic about returning to school for four additional years.
Degree Completion Programs for RNs (RN to BSNRN to MSN)
Hundreds of bridge programs are offered for nurses with diplomas and ADN degrees who wish to complete a Bachelor’s or Master’s degree program in nursing. Many programs are offered online and in flexible formats designed for working nurses.
Master’s Degree (MSN)
Master's degree programs prepare nurses for more independent roles such as Nurse Practitioner, Clinical Nurse Specialist, Nurse-Midwife, Nurse Anesthetist, or Nurse Psychotherapist. Master’s-prepared nurses serve as expert clinicians, in faculty roles, and as specialists in geriatrics, community health, administration, nursing management, and other areas.
Doctoral Degree (PhD, EdD, DNS)
Doctoral programs prepare nurses to assume leadership roles within the profession, conduct research that impacts nursing practice and health care, and to teach at colleges and universities. Doctorally-prepared nurses serve as health system executives, nursing school deans, researchers, and senior policy analysts.
Post-Doctoral Programs
Post-Doctoral programs provide advanced research training for nurses who hold doctoral degrees. Currently, 24 research-focused universities across the country offer post-doctoral programs in nursing.
IS NURSING CAREER RIGHT FOR YOU?
Are your favorite TV shows "Grey's Anatomy," "E/R,” and "Scrubs?" Or maybe you were the student who breezed through Biology and Chemistry in college while everyone else struggled to get a passing grade. If you have been dreaming of a career in the Healthcare field, does that mean it is right for you? Here are a few things to consider before moving forward with your career plan in the medical field.
What is your Motivation to Pursue a Healthcare Career?
What are you hoping to gain? Do you want to help others? Do you love math and science? Is money motivating you? These are all good reasons that may prompt you to consider a career in healthcare.
However, if you are more interested in meeting Dr. McDreamy, think twice. Although a medical career is extremely rewarding and often lucrative, healthcare professionals experience high levels of stress, and the field requires a great deal of commitment, endurance, and hard work.
Also, if you are thinking about healthcare because of a family member or friend that is fine, as long as your goals and objectives are in line with theirs. You are ultimately the one who has to live with your decision. Knowing your motives will help you stay focused later.
TOP THREE (NON-MANAGEMENT) CLINICAL NURSING ROLES
Over 2.5 million nurses are practicing nationwide, according to the Bureau of Labor Statistics (BLS), making nursing the largest workforce within the healthcare industry. There are so many different types and levels of nurses; it can be overwhelming to decide which nursing field to choose.
If compensation and job security are at the top of your list of deciding factors, this list may help you narrow the field of options for you. Below are the top three nursing fields, based on annual salary, and industry demand. Because they are the highest paid, these nursing roles also require the most education and training as compared to some other types of nurses. This list also includes clinically practicing nurses, and does not include roles, which primarily consist of management or supervisory responsibilities.
All of the below are advanced practice nurses, meaning they are highly specialized and educated at a graduate level.
Certified Registered Nurse Anesthetist (CRNA)
CRNAs have one of the highest salaries among the nursing field. If you are already a licensed registered nurse (RN), you may be qualified to enter a graduate education program to become a CRNA.
CRNAs basically work as an extension of anesthesiologists, delivering anesthesia during surgery. Becoming a CRNA could be a great option for someone who has an interest in surgery or who has good technical skills and is less interested in patient interaction or ongoing patient rapport or continuity, since as a CRNA your patients are “out cold” for most of the time you’re with them. Also in a surgical field, you often do not see the same patient twice.
Nurse Practitioner (NP)
A nurse practitioner is a mid-level provider who provides patient care under the supervision of a licensed physician. NPs are qualified and authorized to do patient exams and some minor procedures and tests. NP practices are regulated at the state level, and state laws vary widely from state to state. In some states, NPs are legally required to practice under the supervision of a physician, and must have a licensed physician to sign off on their work. However, in other states, NPs practice independently of physicians, providing primary care, and may prescribe medications as such. Becoming a nurse practitioner could be an excellent choice for someone who wants to earn as much as a CRNA, and would also like to experience some continuity of care, and build relationships and rapport with returning patients over time.
Clinical Nurse Specialist (CNS)
A clinical nurse specialist is an advanced practice nurse who also assists with specialized research, education, advocacy, and sometimes management. In addition to being Registered Nurses, Clinical Nurse Specialists also hold a Master’s of Science degree in Nursing (MSN) and they have completed the additional CNS certification for their respective area of expertise.
Clinical Nurse Specialists are, as the name implies, trained, and educated in a particular medical specialty. For example, a CNS of oncology would be highly trained in the treatment of cancer patients. A CNS of oncology may assist with clinical trials, and hold informational or educational meetings for cancer patients or other oncology nurses. Additionally, the CNS for oncology may assist in developing nursing protocols or quality improvement methods within the oncology department of a hospital.
NURSING THEORIES
Theory can be defined as "an internally consistent group of relational statements (concepts, definitions and propositions) that present a systematic view about a phenomenon and which is useful for description, explanation, prediction and control" (Bodie & Chitty, 1993).
Nursing theories are used to describe, develop, disseminate, and use present knowledge in nursing.
Nursing theories provide a framework for nurses to systematize their nursing actions:what to ask, what to observe, what to focus on and what to think about. They provide a framework to develop new and validate current knowledge. They help to describe, explain, predict and prescribe.
Nursing Theory is used to: Define commonalities of the variables in a stated field of inquiry; guide nursing research and actions; predict practice outcomes; and predict client response.
Theory is used to describe, explain, predict, and prescribe.
Uses of Nursing Theories
- Descriptive theory identifies properties and components of a discipline. They identify meaning and observations and describe what elements exist in that discipline.
- Explanatory theory identifies how the properties and components relate to each other and accounts for how the discipline functions.
- Predictive theories predict the relationships between the components of a phenomenon and predict under what conditions it will occur.
- Prescriptive theories address nursing therapeutics and consequences of interventions.
Four Levels of Theory
- Metatheory being the most abstract and not easily tested;
- Grand Theory is a conceptual framework that defines broad perspectives for nursing practice. Examples are: Leininger’s Cultural Care Diversity; Newman’s Health as Expanding Consciousness, and Parse’s Theory of Human Becoming.
- Middle Range Theory is moderately abstract and has a limited number of variables. They are able to be tested directly. Mid-range is very useful in nursing research and practice. Theory concepts include Huth and Moore’s Pain Management (Children); Barnard’s Child Interaction; Ruland and Moore’s End of Life Care; Ulbrich’s Exercise as Self Care; Pender’s Health Promotion, and; Younger’s Mastery of Stress.
- Practice Theory traces the outline for practice. Objectives are set and actions are set to meet the objectives. Four steps in the development of practice theories are: Factor isolating; factor relating, situation relating, and; situation producing control.
Theories can also be analyzed by types. In nursing, there are four types of theories:Needs; Interaction; Outcome and; Humanistic.
THE NURSING PROCESS
The nursing process is a process by which nurses deliver care to patients, supported by nursing models or philosophies. The nursing process was originally an adapted form of problem solving and is classified as a deductive theory.
Characteristics of the nursing process
The nursing process is a cyclical and ongoing process that can end at any stage if the problem is solved. The nursing process exists for every problem that the patient has, and for every element of patient care, rather than once for each patient. The nurse's evaluation of care will lead to changes in the implementation of the care and the patient's needs are likely to change during their stay in hospital as their health either improves or deteriorates. The nursing process not only focuses on ways to improve the patient's physical needs, but also on social and emotional needs as well.
- Cyclic and dynamic
- Goal directed and client centered
- Interpersonal and collaborative
- Universally applicable
- Systematic
The nursing process is not something foreign or unusually complex. On the contrary, we use the nursing process method on a daily basis without even realizing it. For example, a trip to the gas station to get fuel requires Assessing the various prices and the number of people waiting to get gas among other things. A subsequent decision, or Diagnosis, is made based on the former criteria. This may include pulling into the gas station to fuel up or going down the road for better prices and/or less of a crowd. The price is right and there is not much of a crowd, we are pulling in. Now the Planning can take place. This may include which pump to use, how much gas to put in the tank, whether or not to clean the windows along with other things. We are at the pump and ready to fuel up. We must now Implement what we planned prior to pulling up to the pump. We have pulled up on the passenger side because the gas tank resides on this side, part of our plan. We have also given ourselves enough room to exit without being blocked in by another vehicle, part of our plan also. We now unscrew the gas cap and begin fueling or Implementing what we planned. Things went well. We are fueled up and have exited the gas station without complication. Our Evaluation of the trip to the gas station would be a good one. We may choose to use this method in the future. The Nursing process is that simple in theory. However, as a nurse, the nursing process tool will be used for more complex and difficult situations but is applied the same way as the gas station analogy.
Assessing Phase
The nurse should carry out a complete and holistic nursing assessment of every patient's needs, regardless of the reason for the encounter. Usually, an assessment framework, based on a nursing model or Water low scoring, is used. These problems are expressed as either actual or potential. For example, a patient who has been rendered immobile by a road traffic accident may be assessed as having the "potential for impaired skin integrity related to immobility.”
Models for data collection
The following nursing models are used to gather the necessary and relevant information from the patient in order to effectively deliver quality nursing care. This will help the nurse determine the ranking of the problems encountered.
- Gordon's functional health patterns
- Roy's adaptation model
- Body systems model
- Maslow's hierarchy of needs
- How to collect data
- Client Interview
- Physical Examination
Diagnosing Phase
Nursing diagnoses are part of a movement in nursing to standardize terminology, which includes standard descriptions of diagnoses, interventions, and outcomes. Those in support of standardized terminology believe that it will help nursing become more scientific and evidence based. The purpose of this stage is to identify the patient's nursing problems.
Maslow's hierarchy of needs is used when the nurse prioritizes identified nursing health problems from the patient.
Types of Diagnosis
Actual Diagnosis — a judgment on clients response to a health problem that is present
High Risk — based on most likely to develop
A Possible Nursing Diagnosis — a health problem is unclear and causative factor is unknown
Wellness Diagnosis — indicating a well response of the patient
Components of a Nursing Diagnosis
Problem Statement (diagnostic label) — describes the clients health problem
Etiology (related factor) — the probable cause of the health problem
Defining Characteristic — a cluster of signs and symptoms
e.g. Ineffective airway clearance related to the presence of tracheo-bronchial secretion as manifested by thick tenacious sputum upon expectoration.
Implementing Phase
The methods by which the goal will be achieved is also recorded at this stage. The methods of implementation must be recorded in an explicit and tangible format in a way that the patient can understand should he wish to read it. Clarity is essential as it will aid communication between those tasked with carrying out patient care.
Evaluating Phase
The purpose of this stage is to evaluate progress toward the goals identified in the previous stages. If progress towards the goal is slow, or if regression has occurred, the nurse must change the plan of care accordingly. Conversely, if the goal has been achieved then the care can cease. New problems may be identified at this stage, and thus the process will start all over again. It is due to this stage that measurable goals must be set - failure to set measurable goals will result in poor evaluations.
The entire process is recorded or documented in an agreed format in the patient's care plan in order to allow all members of the nursing team to perform the agreed care and make additions or changes where appropriate.
DEVELOPMENT OF THE NURSING PROCESS
Since its inception, the nursing process has been developed and honed by different authors. Additional detail has been added for each stage of the process, and new or adapted stages have also been suggested. The most recent 'repackaging' of the nursing process comes in the form of the ASPIRE approach to planning and delivering care. This approach — developed within Hull University (UK) as a teaching and learning tool — takes the 5-stage approach outlined above and enhances it. 'Diagnosis' is retitled 'Systematic Nursing Diagnosis' to reflect the process of diagnosis in addition to the final product. An additional stage — 'Recheck' — is placed between Implementation and Evaluation, and reflects the information-gathering activities carried out by nurses, necessary to make an informed judgment about the effectiveness of patient care.
Care plans are formed using the nursing process. First, the nurse collects subjective data and objective data, then organizes the data into a systematic pattern, such as Marjory Gordon's Gordon's functional health patterns. This step helps identify the areas in which the client needs nursing care. Based on this, the nurse makes a nursing diagnosis. As mentioned above, the full nursing diagnosis also includes the relating factors and the evidence that supports the diagnosis. For example, a nurse may give the following diagnosis to a patient with pneumonia that has difficulty breathing: Ineffective Airway Clearance related to tracheobronchial infection (pneumonia) and excess thick secretions as evidenced by abnormal breath sounds; crackles, wheezes; change in rate and depth of respiration; and effective cough with sputum.
After determining the nursing diagnosis, the nurse must state the expected outcomes, or goals. A common method of formulating the expected outcomes is to reverse the nursing diagnosis, stating what evidence should be present in the absence of the problem. The expected outcomes must also contain a goal date. Following the example above, the expected outcome would be: Effective airway clearance as evidenced by normal breath sounds; no crackles or wheezes; respiration rate 14-18/min; and no cough by 01/01/01.
After the goal is set, the nursing interventions must be established. This is the plan of nursing care to be followed to assist the client in recovery. The interventions must be specific, noting how often it is to be performed, so that any nurse or appropriate faculty can read and understand the care plan easily and follow the directions exactly. An example for the patient above would be: Instruct and assist client to TCDB (turn, cough, deep breathe) to assist in loosening and expectoration of mucous every 2 hours.
The evaluation is made on the goal date set. It is stated whether or not the client has met the goal, the evidence of whether or not the goal was met, and if the care plan is to be continued, discontinued or modified. If the care plan is problem-based and the client has recovered, the plan would be discontinued. If the client has not recovered, or if the care plan was written for a chronic illness or ongoing problem, it may be continued. If certain interventions are not helping or other interventions are to be added, the care plan is modified and continued.
Since its inception, the nursing process has been developed and honed by different authors. Additional detail has been added for each stage of the process, and new or adapted stages have also been suggested. The most recent 'repackaging' of the nursing process comes in the form of the ASPIRE approach to planning and delivering care. This approach - developed within Hull University (UK) as a teaching and learning tool - takes the 5-stage approach outlined above and enhances it. 'Diagnosis' is retitled 'Systematic Nursing Diagnosis' to reflect the process of diagnosis in addition to the final product. An additional stage - 'Recheck' - is placed between Implementation and Evaluation, and reflects the information-gathering activities carried out by nurses, necessary to make an informed judgment about the effectiveness of patient care.
NURSING RESEARCH
Nursing research is the term used to describe the evidence used to support nursing practice. Nursing, as an evidence based area of practice, has been developing since the time of Florence Nightingale to the present day, where many nurses now work as researchers based in universities as well as in the health care setting.
Nurse education places emphasis upon the use of evidence from research in order to rationalize nursing interventions. In England and Wales courts may determine whether or not a nurse acted reasonably based upon whether or not their intervention was supported by research.
Nursing research falls largely into two areas:
- Quantitative research, is based in the paradigm of logical positivism and is focused upon outcomes for clients that are measurable, generally using statistics. The dominant research method is the randomized controlled trial.
- Qualitative research, is based in the paradigm of phenomenology, grounded theory, ethnography and others, and examines the experience of those receiving or delivering the nursing care, focusing, in particular, on the meaning that it holds for the individual.
The research methods most commonly used are interviews, case studies, focus groups and ethnography.
Recently in the UK, action research has become increasingly popular in nursing.
NURSING INFORMATICS
Various definitions of Nursing Informatics have been proposed; perhaps the most widely currently accepted definition comes from the International Medical Informatics Association - Nursing Informatics Special Interest Group adopted August 1998, Seoul, Korea: Nursing informatics is the integration of nursing, its information, and information management with information processing and communication technology, to support the health of people world wide.
A more recent definition of Nursing Informatics comes from the American Nurses Association's Scope and Standards for Nursing Informatics Practice (2008): Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.
An early definition was proposed by Hannah (1985): The use of information technologies in relation to any of the functions that are within the purview of nursing and are carried out by nurses in the performance of their duties. This comprises the care of patients, administration, education and research. This definition focused on the interaction with technology that is now (2008) part of virtually every nurse's environment. The specialty of Nursing Informatics is concerned with understanding and improving the nurse's and patient's interaction with technology.
Other definitions also exist. For example, William Goossen, from The Netherlands, developed a more comprehensive definition:
Goossen WTF (1996). Nursing information management and processing: a framework and definition for systems analysis, design, and evaluation. International Journal of Biomedical Computing, 40, 187-195.
Goossen WTF (1996). Nursing information management and processing: a framework and definition for systems analysis, design, and evaluation. International Journal of Biomedical Computing, 40, 187-195.
"Nursing informatics is the multidisciplinary scientific endeavor of analyzing, formalizing, and modeling how nurses collect and manage data, process data into information and knowledge, make knowledge-based decisions and inferences for patient care, and use this empirical and experiential knowledge in order to broaden the scope and enhance the quality of their professional practice. The scientific methods central to nursing informatics are focused on:Using a discourse about motives for computerized systems,Analyzing, formalizing and modeling nursing information processing and nursing knowledge for all components of nursing practice: clinical practice, management, education and research,Investigating determinants, conditions, elements, models and processes in order to design, and implement as well as test the effectiveness and efficiency of computerized information, (tele)communication and network systems for nursing practice, andStudying the effects of these systems on nursing practice."
NURSING DIAGNOSIS
A nursing diagnosis is a standardized statement about the health of a client (who can be an individual, a family, or a community) for providing nursing care. Nursing diagnoses are developed based on data obtained during the nursing assessment.
The main organization for defining standard diagnoses in North America is the North American Nursing Diagnosis Association, now known as NANDA-International. Other international associations are AENTDE (Spanish), AFEDI (French language), and ACENDIO (Europe).
Nursing diagnoses are part of a movement in nursing to standardize the terminology involved. This includes standard descriptions of diagnoses, interventions, and outcomes. Nurses who support of standardized terminology believe that it will help nursing become more scientific and evidence-based. Other nurses feel that nursing diagnoses are an ivory tower mentality and help neither in care planning nor in differentiating nursing from medicine.
Subscribe to:
Posts (Atom)
WOW! I just signed up for free load with Aryty.com.ph. Sign up by using this link 
