Social Context of 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) Social Context of Professional Nursing

• 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 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. Copyright © 2017 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the parties noted herein. Social Context of Professional Nursing

Role Development in Professional Nursing Practice, Fourth Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product. There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only. 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 health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and 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. 08323-1 Production Credits VP, Executive Publisher: David D. Cella Executive Editor: Amanda Martin Acquisitions Editor: Teresa Reilly Editorial Assistant: Danielle Bessette Production Editor: Vanessa Richards Senior Marketing Manager: Jennifer Scherzay VP, Manufacturing and Inventory Control: Therese Connell Composition: Integra Software Services Pvt. Ltd. Cover Design: Kristin E. Parker Rights & Media Specialist: Wes DeShano Media Development Editor: Shannon Sheehan Cover Image: © robertiez/iStock/Getty Images Plus/Getty Printing and Binding: RR Donnelley Cover Printing: RR Donnelley Library of Congress Cataloging-in-Publication Data Role development in professional nursing practice / [edited by] Kathleen Masters.

– Fourth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-284-07832-9 (pbk.) I. Masters, Kathleen, editor. [DNLM: 1. Nursing–standards. 2. Nursing–trends. 3. Nurse’s Role. 4. Philosophy, Nursing. 5. Professional Practice. WY 16] RT82 610.73–dc23 2015022040 6048 Printed in the United States of America 19 18 17 16 15 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. Contents Preface Contributors xv xix UNIT I: FOUNDATIONS OF PROFESSIONAL NURSING PRACTICE 1 1 3 2 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 3 6 8 9 10 13 22 23 25 27 28 39 40 41 43 Frameworks for Professional Nursing Practice 49 Kathleen Masters Overview of Selected Nursing Theories Nurse of the Future: Nursing Core Competencies Overview of Selected Non-Nursing Theories Relationship of Theory to Professional Nursing Practice Conclusion References 51 84 87 88 89 92 X 3 4 5 6

CONTENTS Philosophy of Nursing 99 Mary W. Stewart Philosophy Early Philosophy Paradigms Beliefs Values Developing a Personal Philosophy of Nursing Conclusion References 100 101 103 104 106 110 112 114 Foundations of Ethical Nursing Practice 117 Janie B. Butts and Karen L. Rich Ethics Ethical Theories and Approaches Professional Ethics and Codes Ethical Analysis and Decision Making in Nursing Conclusion References 118 121 126 129 134 135 Social Context of Professional Nursing 137 Mary W. Stewart, Katherine Elizabeth Nugent, Rowena W. Elliott, 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 138 139 143 146 148 151 156 166 166 Education and Socialization to the Professional Nursing Role 173 Kathleen Masters and Melanie Gilmore Professional Nursing Roles and Values The Socialization (or Formation) Process Facilitating the Transition to Professional Practice Conclusion References 174 176 180 181 183 CONTENTS 7 Advancing and Managing Your Professional Nursing Career UNIT II: PROFESSIONAL NURSING PRACTICE AND THE MANAGEMENT OF PATIENT CARE Patient Safety and Professional Nursing Practice 185 187 190 193 194 197 198 199 201 202 205 207 Jill Rushing and Kathleen Masters Patient Safety Critical Thinking, Clinical Judgment, and Clinical Reasoning in Nursing Practice Conclusion References 9 185 Mary Louise Coyne and Cynthia Chatham Nursing: A Job or a Career? Trends That Impact Nursing Career Decisions Showcasing Your Professional Self Mentoring Education and Lifelong Learning Professional Engagement Expectations for Your Performance Taking Care of Self Conclusion References 8 XI Quality Improvement and Professional Nursing Practice 207 216 231 233 237 Kathleen Masters Healthcare Quality Measurement of Quality The Role of the Nurse in Quality Improvement Conclusion References 237 240 249 251 253

Professional Nursing Practice 10 Evidence-Based Kathleen Masters 255 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 255 257 258 259 262 265 268 270 XII 11 CONTENTS Patient-Centered Care and Professional Nursing Practice 273 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 in Professional Nursing Practice 12 Informatics Kathleen Masters and Cathy K. Hughes Informatics: What Is It? The Impact of Legislation on Health Informatics Nursing Informatics Competencies Basic Computer Competencies Information Literacy Information Management Current and Future Trends Conclusion References and Collaboration in Professional Nursing Practice 13 Teamwork Sharon Vincent and Kathleen Masters Healthcare Delivery System Nursing Models of Patient Care Roles of the Professional Nurse Interprofessional Teams and Healthcare Quality and Safety Interprofessional Collaborative Practice Domains Interprofessional Team Performance and Communication Conclusion References Issues in Professional Nursing Practice 14 Ethical Janie B. Butts and Karen L. Rich Relationships in Professional Practice Moral Rights and Autonomy Social Justice Death and End-of-Life Care Conclusion References 274 276 278 293 294 295 301 301 302 304 307 311 314 319 320 321 325 326 328 332 335 338 339 343 344 347 348 353 355 360 370 371 CONTENTS and the Professional Nurse 15 Law Kathleen Driscoll, Kathleen Masters, and Evadna Lyons XIII 375 The Sources of Law Classification and Enforcement of the Law Nursing Scope and Standards Malpractice and Negligence Nursing Licensure Professional Accountability Conclusion References 376 378 381 384 387 392 400 402 Appendix A Standards of Professional Nursing Practice Appendix B Provisions of Code of Ethics for Nurses Appendix C The ICN Code of Ethics for Nurses Glossary Index 405 407 409 411 429 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 a professional nurse. This book is organized into two units. 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 fourth edition, the chapter content is conceptualized, when applicable, around nursing competencies, professional standards, and recommendations from national groups, such as Institute of Medicine reports. The chapters included in Unit I provide the student nurse with a basic foundation in areas such as nursing history, theory, philosophy, ethics, socialization into the nursing role, and the social context of nursing. All chapters have been updated, and several chapters in Unit I have been expanded in this edition. Revisions to the chapter on nursing history include the addition of contributions of prominent nurses and achievements related to nursing in the United Kingdom, Canada, and Australia. The theory chapter now includes additional nursing theorists as well as a brief overview of several non-nursing theories frequently used in nursing research and practice. The social context of nursing chapter now incorporates not only societal trends, but also trends in nursing practice and education. The chapter related to professional career development in nursing has been completely rewritten for this edition. The chapters in Unit II are more directly related to patient care management. In the fourth edition, Unit II chapter topics are presented in the context of quality and safety. Chapter topics include the role of the nurse in patient safety, the role of the nurse in quality improvement, evidence-based nursing practice, the role of the nurse in patient-centered care, informatics in nursing practice, the role of the nurse related to teamwork and collaboration, ethical issues in nursing practice, and the law as it relates to patient care and nursing. Most Unit II chapters have undergone major revisions with a refocus of the content on recommended nursing and healthcare competencies. PrEfaCE The fourth edition continues to incorporate the Nurse of the Future: Nursing Core Competencies throughout each chapter. The Nurse of the Future: Nursing Core Competencies “emanate from the foundation of nursing knowledge” (Massachusetts Department of Higher Education, 2010, p. 4) and are based on the American Association of Colleges of Nursing’s 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. Essential knowledge, skills, and attitudes (KSA) BOARD OF HIGHER EDUCATION NURSING INITIATIVE NURSING CORE COMPETENCIES im Qu pr alit ov y em en t Safety s Leade rship Nursing knowledge d ication Commun ali sio n PR A CT IC E ofe s Team w colla ork and bora tion ed as -b e em tic st ac Sy pr sm re nte -ce t n ie are Pat c Pr d e bas ce- e n e tic id Ev prac ENVIRONMENT TICE AC PR ic at rm fo In PR AC TI CE The science and practice of nursing PRACTICE ENVIRO NM EN T XVI K-Knowledge S-Skills A-Attitudes Source: Modified from Massachusetts Department of Higher Education. (2010). Nurse of the future: Nursing core competencies (p. 5). Retrieved from http://www.mass.edu/currentinit /documents/NursingCoreCompetencies.pdf PrEfaCE reflecting cognitive, psychomotor, and affective learning domains are specified for each competency. The KSA 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, 2010, p. 4). The Nurse of the Future: Nursing Core Competencies graphic illustrates through the use of broken lines the reciprocal and continuous relationship between each of the competencies and nursing knowledge, that the competencies can overlap and are not mutually exclusive, and that all competencies are of equal importance. In addition, nursing knowledge is placed as the core in the graphic to illustrate that nursing knowledge reflects the overarching art and science of professional nursing practice (Massachusetts Department of Higher Education, 2010, p. 4). This new edition has competency boxes throughout the chapters that link examples of the KSA appropriate to the chapter content to Nurse of the Future: Nursing Core Competencies required of entry-level professional nurses. The competency model in its entirety is available online at www.mass .edu/currentinit/documents/NursingCoreCompetencies.pdf. 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 www.mass.edu/nahi/documents/Toolkit-First%20Edition -May%202014-r1.pdf and teaching activities related to nursing competencies availab … Social Context of Professional Nursing