Evolution Of Nursing And Nursing Education Exams

Evolution Of Nursing And Nursing Education

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Study Questions

Practice Exercise 1

Question 1 :

What historic event in the 20th century led to an increased emphasis on nursing and broadened the role of nurses?

A. Religious reform B. Crimean War C. World War II D. Vietnam War

Explanation

Major societal events-especially wars-often accelerate changes in healthcare workforce needs, training programs, and scope of practice. The 20th century saw several conflicts and social changes that shaped modern nursing roles.

Rationale for correct answer:

3. World War II: WWII created massive demand for nurses in military and civilian settings, led to accelerated training programs (e.g., Cadet Nurse Corps in the U.S.), widened clinical responsibilities, increased visibility and professional recognition, and spurred innovations in trauma care.

Rationale for incorrect answers:

1. Religious reform: Religious reform movements influenced charity and early caregiving historically, but they are not the defining 20th-century catalyst that expanded professional nursing roles and training on a national/international scale.

2. Crimean War: The Crimean War (1850s) was crucial for Florence Nightingale’s work and helped modernize nursing in the 19th century, but it is not a 20th-century event.

3. Vietnam War: The Vietnam War (mid-20th century) influenced emergency and trauma nursing and highlighted the role of nurses in combat zones, but the larger, systemic expansion of nursing education, numbers, and roles across society occurred most dramatically during and immediately after World War II.

Take home points

World War II greatly expanded the nursing workforce, accelerated formal training programs, and broadened clinical responsibilities-key drivers of modern nursing practice.
Major conflicts and public health crises often catalyze rapid advances in healthcare delivery and professional roles.

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Question 2 :

Which nurse in history is credited with establishing nursing education?

A. Clara Barton B. Lillian Wald C. Lavinia Dock D. Florence Nightingale

Explanation

Nursing as a profession developed through the work of several pioneers, but the formal, secular training model that became the foundation for modern nursing education began in the 19th century.

Rationale for correct answer:

4. Florence Nightingale: Nightingale established the first secular nursing school (the Nightingale School at St. Thomas’ Hospital, London, 1860) and set standards for nursing training, sanitation, record-keeping, and professional conduct.

Rationale for incorrect answers:

1. Clara Barton: Barton is best known for founding the American Red Cross and for her Civil War nursing and humanitarian work. She advanced disaster relief and public service.

2. Lillian Wald: Wald was a pioneering public-health nurse who founded the Henry Street Settlement and expanded community nursing and social reform. She influenced nursing practice and public health education, but she is not credited with founding formal nurse training.

3. Lavinia Dock: Dock was an influential nurse, author, and activist who worked to professionalize nursing and wrote textbooks and articles. She contributed to nursing education and organizations, but she did not establish the first training school.

Take home points

Florence Nightingale founded the first formal, secular nursing school and set standards that professionalized nursing education.
Other leaders (Barton, Wald, Dock) made major contributions to public health, humanitarian nursing, and nursing advocacy,

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Question 3 :

A nurse is studying the foundational principles of modern nursing. Which of the following are some of Florence Nightingale’s beliefs regarding nursing? Select all that apply

A. A holistic framework inclusive of illness and health B. The need for a theoretical basis for nursing practice C. The importance of creating an environment that promotes healing D. The need for fresh air and light E. The need to support the individual’s adaptation to stimuli F. The need to assist persons attain a higher degree of harmony

Explanation

Florence Nightingale is widely regarded as the founder of modern nursing. Her pioneering work during the Crimean War and her writings on health and sanitation laid the groundwork for professional nursing. Nightingale’s philosophy emphasized environmental and hygienic practices as key factors in recovery and well-being.

Rationale for correct answers:

1.A holistic framework inclusive of illness and health: Florence Nightingale viewed nursing as caring for the whole person, not just treating illness. She believed in promoting wellness and preventing disease-principles aligned with holistic care.

3.The importance of creating an environment that promotes healing: Central to Nightingale’s philosophy was the idea that a clean, well-ventilated, and quiet environment supports the body’s natural healing processes.

4.The need for fresh air and light: Nightingale strongly emphasized the value of fresh air, natural light, and cleanliness as essential elements in patient recovery.

Rationale for incorrect answers:

2.The need for a theoretical basis for nursing practice: While Nightingale’s work became a foundation for future nursing theories, she did not formally advocate for a theoretical framework. Later theorists like Hildegard Peplau and Virginia Henderson developed structured nursing theories.

5.The need to support the individual’s adaptation to stimuli: This reflects Sister Callista Roy’s Adaptation Model, not Nightingale’s environmental theory. Nightingale didn’t frame nursing care in terms of adaptation to stimuli.

6. The need to assist persons attain a higher degree of harmony: This idea stems from Jean Watson’s Theory of Human Caring, which focuses on spiritual and emotional harmony. Nightingale emphasized physical environment and hygiene more than abstract harmony.

Take-Home Points:

Florence Nightingale’s core nursing beliefs centered on the healing power of the environment, including sanitation, fresh air, and light.
Knowing the historical roots of nursing helps professionals understand the evolution of practice and the continued importance of foundational care principles.

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Practice Exercise 2

Question 4 :

Which of the following nursing degrees prepares a nurse for advanced practice as a clinical specialist or nurse practitioner?

A. LPN B. ADN C. BSN D. Master’s

Explanation

Advanced Practice Registered Nurses (APRNs), such as nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives, require graduate-level education and specialized clinical training.

Rationale for correct answer:

4. Master’s: A master’s degree in nursing (MSN) is the minimum requirement for most APRN roles, with additional certification in the chosen specialty.

Rationale for incorrect answers:

1. LPN (Licensed Practical Nurse): LPNs complete a practical/vocational program and provide basic nursing care under RN supervision; they are not eligible for advanced practice roles.

2. ADN (Associate Degree in Nursing): ADN-prepared RNs can provide comprehensive care but cannot practice as APRNs without graduate education.

3. BSN (Bachelor of Science in Nursing): A BSN offers broader nursing knowledge and leadership skills but is still entry-level professional nursing; advanced practice requires further study.

Take home points:

APRNs require at least a master’s degree and national certification in their specialty.
Entry-level nursing degrees (ADN, BSN) prepare for RN licensure but not for advanced independent clinical practice.

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Question 5 :

A school nurse is teaching a class of junior-high students about the effects of smoking. This educational program will meet which of the aims of nursing?

A. Promoting health B. Preventing illness C. Restoring health D. Facilitating coping with disability or death

Explanation

Nursing aims include promoting health, preventing illness, restoring health, and facilitating coping. Educational interventions, such as anti-smoking programs, can align with more than one aim, but the primary aim depends on the intent of the teaching.

Rationale for correct answer:

2. Preventing illness: The lesson is designed to reduce the risk of developing smoking-related diseases, which is a direct illness prevention activity.

Rationale for incorrect answers:

1. Promoting health: While teaching about smoking could support overall wellness, the focus here is on preventing disease before it occurs, not enhancing an existing state of health.

3. Restoring health: Restoring health applies to interventions that return someone to baseline after illness or injury has already occurred.

4. Facilitating coping with disability or death: This aim focuses on helping patients and families adapt to chronic conditions or terminal illness, which is not the case here.

Take home points:

Illness prevention aims to stop disease before it starts, often through education and risk-reduction strategies.
School health programs are a frontline approach to preventing long-term chronic illnesses like COPD, cancer, and cardiovascular disease.

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Question 6 :

Which phrase best describes the science of nursing?

A. The skilled application of knowledge B. The knowledge base for care C. Hands-on care, such as giving a bath D. Respect for each individual patient

Explanation

The science of nursing refers to the systematic body of knowledge that underpins nursing practice. It is built from nursing research, evidence-based practice, and knowledge from biological, behavioral, and social sciences. This scientific foundation guides decision-making, helps predict patient outcomes, and ensures that nursing care is safe, effective, and grounded in proven principles.

Rationale for correct answer:

2. The knowledge base for care: The science of nursing is defined as the body of knowledge, derived from research and theory, that informs nursing interventions and guides practice. It provides the evidence and rationale for why nurses perform specific assessments, interventions, and evaluations.

Rationale for incorrect answers:

1. The skilled application of knowledge: This describes the art of nursing rather than its science. It’s about how nurses creatively and skillfully use knowledge in practice, but it does not define the actual scientific knowledge base itself.

3. Hands-on care, such as giving a bath: Hands-on care is an example of a nursing skill, but it does not represent the science of nursing. Without understanding the why behind the care, the action is mechanical rather than scientifically informed.

4. Respect for each individual patient: Respect for patients reflects nursing’s ethical principles and the art of caring, not the science. While essential to holistic care, it does not define the scientific foundation of nursing practice.

Take home points:

The science of nursing is the knowledge base-built from research and theory-that supports safe, evidence-based care.
The art of nursing is the skillful, compassionate application of that knowledge in a way that honors patient individuality.

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Question 7 :

The nurses on an acute care medical floor notice an increase in pressure injury formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure injury risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career?

A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher

Explanation

When a nurse systematically compares two assessment/treatment approaches to determine which works better, that activity is investigative and focused on generating evidence to change practice.

Rationale for correct answer:

4.Nurse researchers design, implement, and analyze studies to answer clinical questions (for example, comparing an existing assessment procedure with a new instrument to detect pressure-injury risk).

Rationale for incorrect answers:

1. Clinical nurse specialist: A CNS is an advanced-practice clinician who provides expert consultation, implements evidence-based practice, leads quality improvement, and often evaluates outcomes.

2. Nurse administrator: Administrators focus on leadership, staffing, budgeting, policy, and system-level management. They may respond to trends (e.g., more pressure injuries) by changing resources or policies, but they do not typically design and carry out comparative research studies.

3. Nurse educator: Educators design and deliver learning (orientation, in-service, curricula) and may teach staff how to use an assessment tool.

Take home points:

A nurse who designs and conducts a systematic comparison between clinical tools or treatments is functioning as a researcher.
Other advanced roles (CNS, educator, administrator) often translate, implement, or manage the evidence.

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Question 8 :

The examination for RN licensure is the same in every state in the United States. This examination:

A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Provides the minimal standard of knowledge for an RN in practice D. Guarantees standardized education across all prelicensure programs

Explanation

To practice as a Registered Nurse (RN) in the United States, graduates of nursing programs must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

Rationale for correct answer:

3. Provides the minimal standard of knowledge for an RN in practice: The NCLEX-RN is designed to assess whether a nursing graduate has the minimum level of competency necessary for safe entry-level nursing practice.

Rationales for incorrect answers:

1. Guarantees safe nursing care for all patients: The exam does not guarantee safe care - it ensures that the nurse has the minimum knowledge required. Safe care depends on many other factors, including continuing education, workplace environment, and experience.

2. Ensures standard nursing care for all patients: The exam ensures standard knowledge, not necessarily standardized care, which can vary depending on facility protocols, patient needs, and geographic location.

4. Guarantees standardized education across all prelicensure programs: The NCLEX-RN is independent of nursing education programs. Educational standards vary by school and state; the NCLEX only verifies whether graduates meet the minimum threshold for safe practice.

Take-home points:

The NCLEX-RN is a national standardized exam that ensures all licensed nurses meet minimum competency standards for safe practice.
While important, the NCLEX does not guarantee safe care or standardize education - it serves as a protective mechanism for public health by identifying competent new nurses.

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Question 9 :

A nurse is aware that Nurse practice acts are administered by their:

A. health care facility. B. school of nursing. C. licensing bureau. D. individual state.

Explanation

The Nurse Practice Act (NPA) is a vital legal framework that governs nursing practice in the United States. It defines the scope of practice, standards for education, licensure, and discipline for nurses.

Rationale for correct answer:

4. Individual state: Each individual U.S. state administers its own Nurse Practice Act through a State Board of Nursing. These boards are responsible for licensing nurses, regulating practice, and enforcing disciplinary actions.

Rationale for incorrect answers:

1.Health care facility: While healthcare facilities establish internal policies and procedures, they do not have the legal authority to administer or enforce Nurse Practice Acts. Their rules must align with state laws but are not a substitute for them.

2. School of nursing provide education and training aligned with the NPA but do not administer or regulate the act itself. They help prepare students to meet licensure requirements as set by the state.

4. Licensing bureau: The authority over the NPA is not a generic licensing office but a nursing-specific board governed by each state.

Take home points:

The Nurse Practice Act is administered by each individual state, through its Board of Nursing, which regulates licensure and scope of practice.
Understanding who governs nursing practice legally helps nurses maintain compliance and avoid professional misconduct.

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Exams on Evolution Of Nursing And Nursing Education

Practice Exercise 1

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Lessons

Table of Contents

Objectives
Introduction
Historical Evolution Of Nursing
Practice Exercise 1
Nursing Education
Contemporary Nursing Education
Roles And Functions Of The Nurse
Criteria Of A Profession
Practice Exercise 2
Socialization To Nursing
Factors Influencing Contemporary Nursing Practice
Nursing Organizations
Practice Exercise 2
Summary
Comprehensive Questions

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Objectives

Discuss historical roots of nursing and its emergence as a profession
Discuss the evolution of nursing education and entry into professional nursing practice.
Describe practice guidelines and the educational background required for nursing.
Identify the four major areas of nursing practice.
Identify the purposes of nurse practice acts and standards of professional nursing practice.
Describe the roles of nurses.
Discuss the criteria of a profession and the professionalization of nursing.
Discuss Benner’s levels of nursing proficiency.
Describe factors influencing contemporary nursing practice.
Explain the functions of national and international nurses’ associations.

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Introduction

Nursing today is far different from nursing as it was practiced years ago, and it is expected to continue changing during the 21st century.

The increasing reliance on technology in nursing education and practice, the pressures of health care reform, and the continuing crisis of noninsured or underinsured persons have combined to make nursing practice more complex than ever.

Recurring influences include: women’s roles, religion, war, societal attitudes, and visionary leaders have influenced nursing practice in the past and still exert their influences today.

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Historical Evolution Of Nursing

2.1 Historical influences on Nursing:

Women’s roles:

From the beginning of time, women have cared for infants and children; thus, nursing could be said to have its roots in “the home.”

Religion:

The Christian value of “love thy neighbor as thyself” and Christ’s parable of the Good Samaritan that had a significant impact on the development of Western nursing.

Wealthy Roman women like Fabiola, converted to Christianity and founded care houses. Religious orders (Knights, Alexian Brothers, Deaconesses) provided structured care.

War:

Throughout history, wars have accentuated the need for nurses.

Crimean War: Florence Nightingale reduced mortality with hygiene practices.

American Civil War: Harriet Tubman, Clara Barton, Dorothea Dix, etc., gave battlefield care. WWI & WWII: Advances in surgery, anesthetics, prosthetics. Nurse shortage led to Cadet Nurse Corps.

Vietnam War: 11,000 young female nurses served-youngest wartime medical staff.

Societal attitudes:

Society’s attitudes about nurses and nursing have significantly influenced professional nursing.

Early perception: Nurses were untrained or criminals; considered low status.

Literature (e.g., Dickens’ Sairy Gamp) depicted nurses negatively.

Nightingale improved nursing’s image-"angel of mercy."

Later images in the 1900s: doctor’s handmaiden, heroine, sex object, tyrannical mother.

2.2 Key Nursing leaders:

Name	Contributions
Florence Nightingale	- Transformed military hospitals during the Crimean War. - Advocated for sanitation, public health, and nurse education. - Founded Nightingale Training School (1860). - First to exert political influence as a nurse. - Authored Notes on Nursing (1860).
Clara Barton	Founded the American Red Cross; cared for Civil War soldiers.
Linda Richards	Introduced nurse’s notes and doctor’s orders. She also initiated the practice of nurses wearing uniforms.
Dorothea Dix	Union Superintendent of Nurses during the Civil War; recruited and managed female nurses.
Lillian Wald	Pioneer in public health nursing.
Mary Mahoney	First African American professional nurse in the U.S.
Margaret Higgins Sanger	Opened the first birth control information clinic in America, she is considered the founder of Planned Parenthood.
Mary Breckinridge	Founded the Frontier Nursing Service, bringing care to rural areas.
Virginia Henderson	Defined modern nursing practice and needs-based care.
Martha Rogers	Influential in the development of nursing theories.

Nursing insight: Men in Nursing

Men do experience barriers to becoming nurses. The ANA denied membership to male nurses until 1930 and many state nursing associations did not allow men to join until the 1950s.

The nursing image is one of femininity, and nursing has been slow to neuter this image.
Many people may believe that only homosexual men enter nursing, which is not true.
The lack of male role models in nursing and caring (e.g., differences in caring styles between men and women).
Suspicion surrounding intimate touch

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Nursing Education

The practice of nursing is controlled from within the profession through state boards of nursing and professional nursing organizations.

These groups also determine the content and type of education that is required for different levels or scopes of nursing practice.

As nursing roles have evolved in response to new scientific knowledge; advances in technology; and cultural, political, and socioeconomic changes in society; nursing education curricula have been revised to enable nurses to work in more diverse settings and assume more diverse roles.

There are two types of entry-level generalist nurses:

the registered nurse (RN)
the licensed practical or vocational nurse (LPN or LVN)

Although educational preparation varies considerably, all RNs in the United States take the same licensure examination, the National Council Licensure Examination (NCLEX-RN).

All U.S. nursing programs must be approved by their state board of nursing.

In addition to state approval, the Accreditation Commission for Education in Nursing (ACEN), formerly called the National League for Nursing Accrediting Commission (NLNAC), provides accreditation for all levels of nursing programs, and the Commission on Collegiate Nursing Education (CCNE) accredits baccalaureate and higher degree programs.

4.1 Types of Education programs:

Education programs available for nurses include practical or vocational nursing, registered nursing, graduate nursing, and continuing education.

Each has a unique scope of practice and by working collaboratively can help meet the often complex needs of clients.

Program Type	Duration	Educational Setting	Licensure/Outcome	Key Features	Career Opportunities
Licensed Practical/Vocational Nurse (LPN/LVN)	9–12 months	Community colleges, vocational schools, hospitals	NCLEX-PN → LPN or LVN	Basic nursing care, under RN supervision. May articulate to RN programs.	Long-term care, home health, rehab, limited hospital roles
Diploma RN	~3 years	Hospital-based programs (some affiliated with colleges/universities)	NCLEX-RN → RN	Historically dominant model; now less common. Strong clinical focus, limited academic coursework.	Staff nurse roles, often continue to BSN
Associate Degree in Nursing (ADN)	~2 years	Community colleges	NCLEX-RN → RN	Entry-level RN preparation. Developed for rapid workforce entry. Often a step toward BSN or higher.	Acute care, community settings, RN-to-BSN or RN-to-MSN pathways
Baccalaureate Degree (BSN)	~4 years (or 12–18 months for accelerated)	Colleges/universities	NCLEX-RN → RN	Broader scope of education: liberal arts, sciences, and leadership Required for many specialties.	More autonomy, leadership, eligibility for certification/specialties, Magnet roles
Master’s Degree (MSN)	1.5–3 years	Graduate schools/universities	Advanced Practice RN (APRN)	Prepares nurses for CNS, NP, CRNA, CNM roles. Includes leadership, education, and specialized clinical training.	Advanced clinical practice, management, education, research
Doctoral Programs (DNP/PhD)	Varies (3–6 years)	Universities	Advanced research or clinical leadership	DNP for practice leadership; PhD for research and academia.	Executive leadership, faculty, research, policy roles
Continuing Education (CE)	Varies (hours to weeks)	Online, conferences, professional workshops	CE credits for license renewal	Keeps nurses updated with current practice standards, often mandatory for license maintenance.	Ongoing professional development

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Contemporary Nursing Education

5.1 Definitions of Nursing

Most definitions of nursing describe the nurse as a person who nourishes, fosters, and protects and who is prepared to take care of sick, injured, and aged people.

The current definition of nursing remains unchanged from the 2003 edition of Nursing’s Social Policy Statement: “Nursing is the protection, promotion, and optimization of health and abilities, preventions of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”

5.2 Recipients of Nursing

The recipients of nursing are sometimes called consumers, sometimes patients, and sometimes clients.

A consumer is an individual, a group of people, or a community that uses a service or commodity. People who use health care products or services are consumers of health care.

A patient is a person who is waiting for or undergoing medical treatment and care.

Nursing insight:

Some nurses believe that the word patient implies passive acceptance of the decisions and care of health professionals. Additionally, with the emphasis on health promotion and prevention of illness, many recipients of nursing care are not ill. For these reasons, nurses increasingly refer to recipients of health care as clients.

A client is a person who engages the advice or services of another who is qualified to provide this service. The term client presents the receivers of health care as collaborators in the care, that is, as people who are also responsible for their own health.

5.3 Scope of Nursing

Nursing practice involves four areas:

promoting health and wellness
preventing illness
restoring health
caring for the dying.

Promoting health and wellness:

Nurses promote wellness in clients who are both healthy and ill. This may involve individual and community activities to enhance healthy lifestyles, such as improving nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and preventing accidents and injury in the home and workplace.

Preventing illness:

Nursing activities that prevent illness include immunizations, prenatal and infant care, and prevention of sexually transmitted infections.

Restoring health:

It extends from early detection of disease through helping the client during the recovery period.

Caring for the dying:

It includes helping clients live as comfortably as possible until death and helping support persons cope with death.

Settings for Nursing:

Today many nurses work in hospitals, but increasingly they work in clients’ homes, community agencies, ambulatory clinics, long-term care facilities, health maintenance organizations (HMOs), and nursing practice centers.

5.4 Nurse Practice Acts

Nurse practice acts, or legal acts for professional nursing practice, regulate the practice of nursing in the United States with each state having its own act. This protection includes protecting the public from unqualified and unsafe nurses.

Nurses are responsible for knowing their state’s nurse practice act as it governs their practice.

5.5 Standards of Nursing Practice

The purpose of the ANA Standards of Practice is to describe the responsibilities for which nurses are accountable.

The ANA Standards of Professional Performance describe behaviors expected in the professional nursing role.

American Nurses Association (ANA) Standards of Nursing:

1. Assessment: The registered nurse collects pertinent data and information relative to the healthcare consumer’s health or the situation.

2. Diagnosis: The registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues.

3. Outcomes Identification: The registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation.

4. Planning: The registered nurse develops a plan encompassing strategies to achieve expected outcomes.

5. Implementation: The registered nurse implements the identified plan.

Coordination of Care: The registered nurse coordinates care delivery.
Health Teaching and Health Promotion: The registered nurse employs strategies to teach and promote health and wellness.

6. Evaluation: The registered nurse evaluates progress toward attainment of goals and outcomes.

American Nurses Association (ANA) Standards of Professional Performance

1. Ethics: The registered nurse integrates ethics in all aspects of practice.

2. Advocacy: The registered nurse demonstrates advocacy in all roles and settings.

3. Respectful and Equitable Practice: The registered nurse practices with cultural humility and inclusiveness.

4. Communication: The registered nurse communicates effectively in all areas of professional practice.

5. Collaboration: The registered nurse collaborates with health care consumers and other key stakeholders.

6. Leadership: The registered nurse leads within the professional practice setting and the profession.

7. Education: The registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking.

8. Scholarly Inquiry: The registered nurse integrates scholarship, evidence, and research findings into practice.

9. Quality of Practice: The registered nurse contributes to quality nursing practice. 16. Professional Practice Evaluation: The registered nurse evaluates one’s own and others’ nursing practice.

10. Resource Stewardship: The registered nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and fiscally responsible and avoid waste.

11. Environmental Health: The registered nurse practices in a manner that advances environmental safety and health.

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Roles And Functions Of The Nurse

Nurses assume a number of roles when they provide care to clients. Nurses often carry out these roles concurrently, not exclusively with one another.

Core Nursing Roles:

Caregiver: Provides physical, psychological, developmental, cultural, and spiritual care. Varies from total to supportive-educative care.
Communicator: Communicates with clients, families, and health teams. Ensures accurate documentation and clear information exchange.
Teacher: Educates clients and caregivers on health procedures. Assesses learning needs, sets goals, and evaluates outcomes.
Client Advocate: Protects client rights and represents client needs to the healthcare team.
Counselor: Provides emotional and psychological support. Helps clients cope, develop self-awareness, and explore choices.
Change Agent: Helps clients and systems adapt to or initiate change (e.g., new behaviors or care processes).
Leader: Motivates and guides individuals or teams to achieve health goals. Requires interpersonal and leadership skills.
Manager: Manages client care, delegates tasks, supervises staff, and evaluates outcomes. Requires knowledge of organizational and management principles.
Case Manager: Coordinates care across disciplines to improve outcomes and control costs.
Research Consumer: Applies research findings to improve care. Understands research principles and ethical considerations.

Expanded Nursing career roles:

Nurse Practitioner (NP): Provides advanced care in specialties like family, pediatrics, psychiatric, or women’s health. Works in primary or acute care settings.
Clinical Nurse Specialist (CNS): Expert in a specialty (e.g., oncology, geriatrics). Provides care, consults, educates, and leads research.
Nurse Anesthetist: Specializes in anesthesia administration and perioperative assessments.
Nurse Midwife: Manages normal pregnancies, deliveries, and women’s health care.
Nurse Researcher: Conducts studies to improve nursing practice. Often works in academia or research institutions.
Nurse Administrator: Manages nursing services, including budgeting, staffing, and program planning.
Nurse Educator: Teaches in academic or clinical settings. Requires expertise in a clinical specialty and teaching strategies.
Nurse Entrepreneur: Runs health-related businesses, often in education, consultation, or research.
Forensic Nurse: Provides care to trauma victims/perpetrators. Collects evidence, works with legal systems, and testifies in court.

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Criteria Of A Profession

A profession has been defined as an occupation that requires extensive education or a calling that requires special knowledge, skill, and preparation.

A profession is generally distinguished from other kinds of occupations by:

its requirement of prolonged, specialized training to acquire a body of knowledge pertinent to the role to be performed
an orientation of the individual toward service, either to a community or to an organization.
ongoing research
a code of ethics
autonomy
a professional organization.

Professionalism refers to professional character, spirit, or methods. It is a set of attributes, a way of life that implies responsibility and commitment. Nursing professionalism owes much to the influence of Florence Nightingale.

Professionalization is the process of becoming professional, that is, of acquiring characteristics considered to be professional.

Nursing is gaining recognition as a profession.

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Socialization To Nursing

The standards of education and practice for the profession are determined by the members of the profession, rather than by outsiders.

Socialization can be defined simply as the process by which people

learn to become members of groups and society.
learn the social rules defining relationships into which they will enter.

The goal of professional socialization is to instill in individuals the norms, values, attitudes, and behaviors deemed essential for survival of the profession.

Various models of the socialization process have been developed.

9.1 Benner’s Stages of Nursing Expertise

Benner’s model (2001) describes five levels of proficiency in nursing based on the Dreyfus general model of skill acquisition.

STAGE I: NOVICE

No experience (e.g., nursing student). Performance is limited, inflexible, and governed by context-free rules and regulations rather than experience.

STAGE II: ADVANCED BEGINNER

Demonstrates marginally acceptable performance. Recognizes the meaningful “aspects” of a real situation. Has experienced enough real situations to make judgments about them.

STAGE III: COMPETENT

Has 2 or 3 years of experience. Demonstrates organizational and planning abilities. Differentiates important factors from less important aspects of care. Coordinates multiple complex care demands.

STAGE IV: PROFICIENT

Has 3 to 5 years of experience. Perceives situations as wholes rather than in terms of parts, as in Stage II. Uses maxims as guides for what to consider in a situation. Has holistic understanding of the client, which improves decision making. Focuses on long-term goals.

STAGE V: EXPERT

Performance is fluid, flexible, and highly proficient; no longer requires rules, guidelines, or maxims to connect an understanding of the situation to appropriate action. Demonstrates highly skilled intuitive and analytic ability in new situations. Is inclined to take a certain action because “it felt right.”

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