Professional Nursing

Chapter 5 Social Context of Professional Nursing Nursing’s Social Contract • Society provides the nursing profession with the authority to practice • Society grants the profession authority over functions and autonomy over professional affairs • Profession expected to regulate itself and act responsibly • This relationship is the essence of the nursing’s social contract with society Public Image of Nursing (1 of 2) • Actions to promote the real image: – Educate the public – Describe nurses’ work – Make known the agency of the registered nurse (RN) – Deal with the fear of angering the physician – Accept thanks from others – Be ready to take advantage of openings to promote nursing – Respond to queries with real stories Public Image of Nursing (2 of 2) • Actions to promote the real image: – Tell the details – Avoid using nursing jargon – Prepare ahead of time to tell your story – Do not suppress your enthusiasm – Reflect the nurse’s clinical judgment and competency – Connect work to contemporary issues – Respect patient’s confidentiality – Deal with the fear of failure The Gender Gap • Women in nursing: • Men in nursing: – Avoidance of conflict – Leadership advantage – Multiple roles – Compensation discrepancy – Centeredness on service – Gender bias Changing Demographics and Cultural Competence • Discrepancy between minority population and minority health professionals and faculties • Increasing the number of underrepresented minorities in the health professions and improving the cultural competency of providers are key strategies for reducing health disparities Access to Health Care • Continuity of care – Routine care with provider leads to better health outcomes • Economic barriers – Poverty poses the greatest risk to health • Geographic barriers – Rural and urban • Sociocultural barriers Societal Trends • Incivility • Consumerism • Violence in the workplace • Complementary and alternative approaches • Global aging • Disaster preparedness Trends in Nursing • Nurse shortage • Nurse faculty shortage • Nursing practice and workplace environment • Nurse retention • Complexity of nursing work • Nursing education Closing the Education and Practice Gap • Key messages of The Future of Nursing include: – Nurses should practice to the full extent of their education and training – Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression – Nurses should be full partners, with physicians and other health professions, in redesigning health care in the US – Effective workforce planning and policy making require better data collection and an improved information infrastructure Recommendations from The Future of Nursing (1 of 2) • Remove scope-of-practice barriers • Expand opportunities for nurses to lead and diffuse collaborative improvement efforts • Implement nurse residency programs • Increase the percentage of nurses with a baccalaureate degree to 80% by 2020 • Double the number of nurses with a doctorate by 2020 Recommendations from The Future of Nursing (2 of 2) • Ensure that nurses engage in lifelong learning • Prepare and enable nurses to lead change to advance health • Build an infrastructure for the collection and analysis of interprofessional healthcare workforce data The Future of Nursing: Campaign for Action Video https://youtu.be/V_PnaXjVn2c The Pedagogy Role Development in Professional Nursing Practice, Fifth Edition drives comprehension through various strategies that meet the learning needs of students while also generating enthusiasm about the topic. This interactive approach addresses different learning styles, making this the ideal text to ensure mastery of key concepts. The pedagogical aids that appear in most chapters include the following: World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com. 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Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious but are used for instructional purposes only. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the healthcare provider or reader is responsible for determining FDA status of the drug; reading the package insert; reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications; and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. 16306-3 Production Credits VP, Executive Publisher: Amanda Martin Product Manager: Tina Chen Product Assistant: Anna-Maria Forger Product Specialist: Alex Schab Senior Marketing Manager: Jennifer Scherzay Product Fulfillment Manager: Wendy Kilborn Composition: S4Carlisle Publishing Services Cover Design: Kristin E. Parker Rights & Media Specialist: John Rusk Media Development Editor: Troy Liston Cover Image: © James Kang/EyeEm/Getty Images Printing and Binding: LSC Communications Cover Printing: LSC Communications Library of Congress Cataloging-in-Publication Data Names: Masters, Kathleen, editor. Title: Role development in professional nursing practice / [edited by] Kathleen Masters. Description: Fifth edition. | Burlington, Massachusetts : Jones & Bartlett Learning, 2018. | Includes bibliographical references and index. Professional Nursing

Identifiers: LCCN 2018023086 | eISBN 9781284152920 Subjects: | MESH: Nursing–trends | Nursing–standards | Professional Practice | Nurse’s Role | Philosophy, Nursing Classification: LCC RT82 | NLM WY 16.1 | DDC 610.73–dc23 LC record available at https://lccn.loc.gov/2018023086 6048 Printed in the United States of America 22 21 20 19 18 10 9 8 7 6 5 4 3 2 1 Dedication This book is dedicated to my Heavenly Father and to my loving family: my husband, Eddie, and my two daughters, Rebecca and Rachel. Words cannot express my appreciation for their ongoing encouragement and support throughout my career. © James Kang/EyeEm/Getty Images CONTENTS Preface Contributors UNIT I: FOUNDATIONS OF PROFESSIONAL NURSING PRACTICE 1 A History of Health Care and Nursing Karen Saucier Lundy and Kathleen Masters Classical Era Middle Ages The Renaissance The Dark Period of Nursing The Industrial Revolution And Then There Was Nightingale . . . Continued Development of Professional Nursing in the United Kingdom The Development of Professional Nursing in Canada The Development of Professional Nursing in Australia Early Nursing Education and Organization in the United States The Evolution of Nursing in the United States: The First Century of Professional Nursing The New Century International Council of Nurses Conclusion References 2 Frameworks for Professional Nursing Practice Kathleen Masters Overview of Selected Nursing Theories Overview of Selected Nonnursing Theories Relationship of Theory to Professional Nursing Practice Conclusion References 3 Philosophy of Nursing Mary W. Stewart Philosophy Early Philosophy Paradigms Beliefs Values Developing a Personal Philosophy of Nursing Conclusion References 4 Competencies for Professional Nursing Practice Jill Rushing and Kathleen Masters Overview Nurse of the Future: Nursing Core Competencies Critical Thinking, Clinical Judgment, and Clinical Reasoning in Nursing Practice Conclusion References 5 Education and Socialization to the Professional Nursing Role Kathleen Masters and Melanie Gilmore Professional Nursing Roles and Values The Socialization (or Formation) Process Facilitating the Transition to Professional Practice Conclusion References 6 Advancing and Managing Your Professional Nursing Career Mary Louise Coyne and Cynthia Chatham Nursing: A Job or a Career? Trends That Affect Nursing Career Decisions Showcasing Your Professional Self Mentoring Education and Lifelong Learning Professional Engagement Expectations for Your Performance Taking Care of Self Conclusion References 7 Social Context and the Future of Professional Nursing Mary W. Stewart, Katherine E. Nugent, and Kathleen Masters Nursing’s Social Contract with Society Public Image of Nursing The Gender Gap Changing Demographics and Cultural Competence Access to Health Care Societal Trends Trends in Nursing Conclusion References Professional Nursing

UNIT II PROFESSIONAL NURSING PRACTICE AND THE MANAGEMENT OF PATIENT CARE 8 Safety and Quality Improvement in Professional Nursing Practice Kathleen Masters Patient Safety Quality Improvement in Health Care Quality Improvement Measurement and Process The Role of the Nurse in Quality Improvement Conclusion References 9 Evidence-Based Professional Nursing Practice Kathleen Masters Evidence-Based Practice: What Is It? Barriers to Evidence-Based Practice Promoting Evidence-Based Practice Searching for Evidence Evaluating the Evidence Implementation Models for Evidence-Based Practice Conclusion References 10 Patient Education and Patient-Centered Care in Professional Nursing Practice Kathleen Masters Dimensions of Patient-Centered Care Communication as a Strategy to Support Patient-Centered Care Patient Education as a Strategy to Support Patient-Centered Care Evaluation of Patient-Centered Care Conclusion References 11 Informatics in Professional Nursing Practice Kathleen Masters and Cathy K. Hughes Informatics: What Is It? The Effect of Legislation on Health Informatics Nursing Informatics Competencies Basic Computer Competencies Information Literacy Information Management Current and Future Trends Conclusion References 12 Leadership and Systems-Based Professional Nursing Practice Kathleen Masters and Sharon Vincent Healthcare Delivery System Nursing Leadership in a Complex Healthcare System Nursing Models of Patient Care Roles of the Professional Nurse Conclusion References 13 Teamwork, Collaboration, and Communication in Professional Nursing Practice Kathleen Masters Interprofessional Teams and Healthcare Quality and Safety Interprofessional Collaborative Practice Domains Interprofessional Team Performance and Communication Conclusion References 14 Ethics in Professional Nursing Practice Janie B. Butts and Karen L. Rich Ethics Ethical Theories and Approaches Professional Ethics and Codes Ethical Analysis and Decision Making in Nursing Relationships in Professional Practice Moral Rights and Autonomy Social Justice Death and End-of-Life Care Conclusion References 15 Law and Professional Nursing Practice Kathleen Driscoll and Kathleen Masters The Sources of Law Classification and Enforcement of the Law Nursing Scope and Standards Malpractice and Negligence Nursing Licensure Professional Accountability Conclusion References Appendix A Appendix B Glossary Index Provisions of Code of Ethics for Nurses The ICN Code of Ethics for Nurses © James Kang/EyeEm/Getty Images PREFACE Although the process of professional development is a lifelong journey, it is a journey that begins in earnest during the time of initial academic preparation. The goal of this book is to provide nursing students with a road map to help guide them along their journey as professional nurses. This book is organized into two units. Professional Nursing

The chapters in the first unit focus on the foundational concepts that are essential to the development of the individual professional nurse. The chapters in Unit II address issues related to professional nursing practice and the management of patient care, specifically in the context of quality and safety. In the Fifth Edition, the chapter content is conceptualized, when applicable, around nursing competencies, professional standards, and recommendations from national groups, such as Institute of Medicine reports. All chapters have been updated, several chapters have been expanded, and two new chapters have been added in this edition. The chapters included in Unit I provide the student nurse with a basic foundation in such areas as nursing history, theory, philosophy, socialization into the nursing role, professional development, the social context of nursing, and professional nursing competencies. The social context of nursing chapter has been expanded to incorporate not only societal trends but also trends in nursing practice and education that are changing the future landscape of the profession. The chapters in Unit II are more directly related to patient care management and, as stated previously, are presented in the context of quality and safety. Chapter topics include the role of the nurse in patient safety and quality improvement, evidence-based nursing practice, the role of the nurse in patient education and patient-centered care, informatics in nursing practice, the role of the nurse related to teamwork and collaboration, systems-based practice and leadership, ethics in nursing practice, and the law as it relates to patient care and nursing. Unit II chapters have undergone revision, with a refocus of the content on recommended nursing and healthcare competencies as well as recommendations from faculty using the text in the classroom. The Fifth Edition incorporates the revised Nurse of the Future: Nursing Core Competencies: Registered Nurse throughout each chapter. The 10 essential competencies that are intended to guide nursing curricula and practice emanate from the central core of the model that represents nursing knowledge (Massachusetts Department of Higher Education, 2016) and are based on the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing Practice, National League for Nursing Council of Associate Degree Nursing competencies, Institute of Medicine recommendations, Quality and Safety Education for Nurses (QSEN) competencies, and American Nurses Association standards, as well as other professional organization standards and recommendations. The 10 competencies included in the model are patient-centered care, professionalism, informatics and technology, evidence-based practice, leadership, systems-based practice, safety, communication, teamwork and collaboration, and quality improvement. Professional Nursing

Essential knowledge, skills, and attitudes (KSAs) reflecting cognitive, psychomotor, and affective learning domains are specified for each competency. The KSAs identified in the model reflect the expectations for initial nursing practice following the completion of a prelicensure professional nursing education program (Massachusetts Department of Higher Education, 2016). This new edition has competency boxes throughout the chapters that link examples of the KSAs appropriate to the chapter content to Nurse of the Future: Nursing Core Competencies required of entry-level professional nurses. The competency model is explained in detail in Chapter 4 and is available in its entirety online at http://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pd The Fifth Edition also includes applicable AACN essentials incorporated as key outcomes throughout each chapter to assist faculty with the alignment of curricular content with criteria required by accreditors. The key outcomes also demonstrate for students the link between expectations included in the competency model, the expectations embodied in the essentials document, and the chapter content. A discussion of the AACN (2008) Essentials of Baccalaureate Education for Professional Nursing Practice is also included in Chapter 4. This new edition continues to use case studies, congruent with Benner, Sutphen, Leonard, and Day’s (2010) Carnegie Report recommendations that nursing educators teach for “situated cognition” using narrative strategies to lead to “situated action,” thus increasing the clinical connection in our teaching or that we teach for “clinical salience.” In addition, critical thinking questions are included throughout each chapter to promote student reflection on the chapter concepts. Classroom activities are also provided based on chapter content. Additional resources not connected to this text, but applicable to the content herein, include a toolkit focused on the nursing core competencies available at Professional Nursing http://www.mass.edu/nahi/documents/NursingCoreCompetenciesToolkitMarch2016.pdf and teaching activities related to nursing competencies available on the QSEN website at http://qsen.org/teaching-strategies/. Although the topics included in this textbook are not inclusive of all that could be discussed in relationship to the broad theme of role development in professional nursing practice, it is my prayer that the subjects herein make a contribution to the profession of nursing by providing the student with a solid foundation and a desire to grow as a professional nurse throughout the journey that we call a professional nursing career. Let the journey begin. —Kathleen Masters References American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Retrieved from http://www.aacnnursing.org/Education-Resources/AACNEssentials Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurs … Professional Nursing