The Image of Nursing (1600-1700) and the Impact of Florence Nightingale, Exams of Nursing

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Nurs1131 Exam 1 Questions With Complete Solutions

the 7 trends in nursing (LAW-WIRE) hhCorrect Answers hh1) Image

2. Education

3. Advancement in practice

4. War

5. Workforce issues

6. Licensure/regulation

7. Research

8. The Image of Nursing hhCorrect Answers hh-Mass communication and entertainment.

-Popular public perception of nurses' influences: *How nurses are treated by patients, other healthcare professionals, and the public. *How nurses perceive themselves and the profession. *How they treat each other in the workplace.

2. The Education of Nurses hhCorrect Answers hhEarly nursing education: -Apprenticeship and observation. -Educated by physicians and nurse supervisors. -It was very unorganized at first

... Progression of nursing education and additional degrees Became much more organized

3. Advances in Practice hhCorrect Answers hh-Advances in healthcare technology. (Heart transplants, Ventilators, 3D printing, Etc)

-Development of new practice approaches/disciplines to effectively treat healthcare concerns. Ex - School nursing was an advance in practice (for children in poverty)

• Technological advancements: Influence and improve outcomes. Fast-paced changes to nursing practice.

-Sociopolitical (factors that influence environment: war, poverty, etc) and healthcare environments: Influence practice trends. Necessity of practice advancement.

-New practice approaches/disciplines developed over time to address specific client concerns.

4. War and Its Effect on Nursing hhCorrect Answers hh-Evolution of nursing in U.S. intricately tied to war. -Posed unique challenges and opportunities. -Much of technology is direct result of wartime.

5. Nursing Workforce Issues hhCorrect Answers hh-supply and demand: Supply and demand is a huge issue as far as nursing shortages (not enough of them)

-Shortage of workers in certain speciality occupations (psychiatric care)

-Other issues: men, ethnic minorities, and racial minorities in nursing. (Started off as mainly white caucasion females)

6. Licensure and Regulation hhCorrect Answers hh-All practicing nurses are required to obtain and maintain licenses. (NClex license -- needs to be renewed every year)

-Certifications and specialty endorsements are essential component of nursing practice. (Ensure competency as they delineate role, responsibility, and obligation)

-Nurse Practice Acts (NPA) define legal boundaries of nursing practice based on licensure, regulation, and certification.

-Licensure/regulation laws: Set tone for entry into different levels of nursing practice. Ensure accountability of all professional nurses.

7. Nursing Research hhCorrect Answers hh-Nursing education university settings = nursing research activities.

-Once nursing got it's own education, more opportunities for research

"Evidence-based practice" = the most recent and peer reviewed research in conjunction with clinical experience and patient preference

-Continued advancement and refinement of nursing knowledge = obligation of all nurses.

BS MS Doctorally-prepared RN

(Roles in Research...) hhCorrect Answers hhBS in Nursing: provide questions/topic for inquiry and implement research findings at clinical level.

MS in Nursing: do all that BSNs do, plus assist in creation and execution of research studies.

Doctorally-prepared RNs: create, manage, and disseminate all aspects of research studies to improve practice through evidence; usually by leading interprofessional research teams.

Origin of the term "nurse" hhCorrect Answers hhWord "nurse" derived from Latin "nutrire" (to nourish)

Originates from Latin noun "nutrix" (nursing mother): Early eras women were wet nurses (called nutrix's) -- they would breastfeed newborn babies in hospital (little about sanitation was known)

Term nurse eventually evolved (mid-1500's) to mean "caretaker of the sick"

people classified as "nurses" hhCorrect Answers hh1) Registered nurses (RNs) -Has additional educational expertise in assessment, critical thinking, pharmacology, and infusion therapy -Highest of these three listed

2. Practical nurses (LPNs)
3. Vocational nurses (LVNs) -LPN's and LVN's are more task oriented, require less school, more responsible for the comfort of patient

"Nightingale Pledge" hhCorrect Answers hh**scripted by Lystra Gretter

-Was based on what she knew about nursing from Florence Nightingale and other nurse leaders of the period -Pledge was based on prevailing christian beliefs (religious) and suggested the nursing obligation to self, the profession, and society while describing the devotion nurses should have to the physician and his work

Jean Watson hhCorrect Answers hhdefined a nurse's work as "transpersonal caring":

"the nurse is able to form a union with the other person on a level that transcends the physical... [ensuring] there is a freeing of both persons from their separation and isolation" during a health event.

Identity confusion (?) hhCorrect Answers hh...Our image and identity suffer immensely because we have not fully understood or studied the history of our profession and the effect the past has on our future

our challenge is to establish an identity that eliminates aspects of inferiority associated with gendered care and elevates the profession based on the moral nature of caring and the attentiveness nurses provide through evidence-based practice

Koloroutis (2004) hhCorrect Answers hhdeveloped a model of caring for nurses and organizations; caring relationships significantly impact nurse-patient outcomes.

nurses practice in three realms: hhCorrect Answers hhDelegated practice

Independent practice

Interdependent

1. Delegated practice hhCorrect Answers hhWhen the nurse carries out entrusted function using his/her knowledge, experience, and judgement to confirm the order is appropriate and safe

(does a task that they have been asked to do that they do not typically do, and they do it to their best extent using their own knowledge, experience, and judgement)

2. Independent practice hhCorrect Answers hhWhen the nurses assess and intervene for the purpose of promoting health and

healing. Focus is on the patient's response to actual or potential problems

(nurse makes the decision themselves for the better of the patient)

3. Interdependent practice hhCorrect Answers hhNurse initiated communication with other members of the healthcare team to assure that the dull scope of interdisciplinary expertise and services coordinate and integrate with the plan of care

(rely on others for help - work together as team)

Future of nursing depends upon the belief that "no nurse walks alone" hhCorrect Answers hhthere is always a nurse who has walked before and subsequently there will continually be a nurse that follows

Surge of academic research in the 1940's - it was determined that advancements and developments in medicine and health care might be diminishing professional aspects of nursing: hhCorrect Answers hhNeed for research was determined as an essential solution to generate new knowledge and substantiate the work of nurses.

Nursing is now considered a "complex process" : hhCorrect Answers hhtechnical and cognitive skills with art of compassion and science of evidence-based practice.

Florence Nightingale: hhCorrect Answers hh"pioneer of modern nursing"

-She used observation to identify problems with patient care and recognize possible solutions -- (today, RN's use this nursing practice in clinical) -innovator and nurse researcher

the "nursing process" that we use today (originated from FN) is actually a method of deduction and reasoning which can lead to improved practice through observation, intervention, and witnessed outcome(s).

Early civilizations and peoples have little or no documentation about actual work of medical workers... Much of what we now understand as their work^^ is the result of historical research and the study in the fields of sociology, anthropology, archeology. hhCorrect Answers hhMuch of what we now understand as their work is the result of historical research and the study in. the fields of: -sociology -anthropology -archeology

1900: American Journal of Nursing (AJN). hhCorrect Answers hhA book that nurses wrote their ideas/interventions in (in the 1900's) -- these historical ideas affect nursing to the present day

1950s: first scholarly journal hhCorrect Answers hhNursing Research

why is historical research important in nursing? hhCorrect Answers hh-adds significance to nursing knowledge as we better

define, distinguish, identify nursing's relationships concerning research, knowledge, theory, and practice -complements quantitative research by making the values, beliefs and attentive premise of the profession explicit

Ancient Civilizations and Their Contributions to Nursing... hhCorrect Answers hh-Ancient Egyptian Healers -Greek Medicine -Islamic Medicine

Ancient Egyptian Healers hhCorrect Answers hh-Healing was based on myths, legends, and the power of the pharoah in conjunction with the magicians or medicines of the time -Scholars (dr's) practiced medicine in collaboration with religion (spells) & healers promoted a healthy diet (especially to ensure fertility) -they understood the circulatory system; they used medical instruments (splints, sutures, surgical instruments, tweezers, etc) -Recognized importance of DENTAL HEALTH

Greek Medicine hhCorrect Answers hh-Asclepius ("to cut open") was the Greek god of medicine/healing -Rod/staff and snake/worm are symbols of healing with Greek origins -The medical "caduceus" (an ancient Greek or Roman herald's wand) was similar to the rod of Asclepius -Medical science of the time identified signs and symptoms of disease: Common diseases and infectious processes were identified in skeletal remains, as were various genetic conditions Evidence of bubonic and other pandemics

Islamic Medicine hhCorrect Answers hh-Religion and medicine closely linked in Muslim world (spiritual rituals connected to healing) -Public health was important. -Believed in a delicate balance between mind and body. -One of the first medical scholars to understand the "pathology of contagion" (as a result, they CREATED HOSPITALS with separate wards so the contagious disease would not be spread) -Jewelry was often worn to "ward off disease and influence of the evil eye"

-Evidence of: Inhaled anesthesia, Distilled alcohol used for before and after surgery, Sutures made from animal gut

Meridian of Time hhCorrect Answers hhMany believed that "An anointed one" performed healings based on faith, hope, and belief.

Medieval Europe hhCorrect Answers hh-Living conditions sucked (cause lots of illness & death) -many fire incidents: houses catching on fire all the time because the houses were shit and they needed to have fire for literally everything -Outhouses for taking poops in -- no proper place for human waste -People didn't bathe enough -Clothes were often very dirty -Illness considered to be from God. -people relied on herbal medicine, charms, religious symbols, faith pilgrimages for healing

-Hippocratic principles and strategies (such as urine samples) were utilized to assess overall health -four humors or temperaments (black bile, yellow bile, phlegm, blood) believed to have influenced the health of individuals

Research: Seeking Historical Information hhCorrect Answers hh1) The Procedure

2. Primary sources (original evidence)

3. Appraisal of the information found

4. Important for researcher/historian to understand his/her/their current perspectives

5. Historical research requires:

6. Historical research (purpose):

7. Critical to historical research is:

8. Sources

9. It is important to have a well-defined topic to not get off track with research

10. The Procedure: hhCorrect Answers hhAcquisition, analysis, interpretation and verification

11. Primary sources (original evidence) hhCorrect Answers hh-It is important that other documents (in addition to the specific doc) from the same era are attained to verify or substantiate consistencies or inconsistencies in the material

12. Appraisal of the information found hhCorrect Answers hhrelevancy to the historical question/narrative, validity, reliability

4. Important for researcher/historian to understand his/her/their current perspectives hhCorrect Answers hhhow these viewpoints may influence the interpretation of the historical material (try to keep your own personal bias out of your research)

5. Historical research requires: hhCorrect Answers hh-Other documents (secondary sources) from same era/context attained to verify or substantiate consistencies or inconsistencies. -Familiarity with journals, documents, books, relics, artifacts of the past. -Attention to facts and details. -Consideration of original context of material and reliability of source.

6. Historical research (purpose): hhCorrect Answers hh-Validates nursing work. -Supports evidence-based practice as it becomes history tomorrow.

7. Critical to historical research is: -Appraisal of information found -- how relevant is it to historical question or narrative? -Validity/reliability of document established hhCorrect Answers hh

8. Sources hhCorrect Answers hh(secondary sources provide an outside perspective on events and individuals while often identifying primary historical or nonfiction works) -Bibliographies -Historical or nonfiction works -Periodical articles -Digitized copies of journals, books, images

-Artifacts available via Internet or curators ^^lots of secondary sources have been digitized and are easily accessible for us to use for research

9. It is important to have a... hhCorrect Answers hhwell-defined topic to not get off track with research

Acquiring Information: Where Can It Be Found? hhCorrect Answers hhWhere to search for historical material:

1. Organizational, academic, & public libraries -- to find articles, archives, special collections: -Librarians and curators -Library catalogs -Academic search premier, article databases, electronic journals databases

2. Databases Medline PubMed EBSCO CINAHL HealthSource: Nursing/Academic Edition JSTOR Nursing Journals@Ovid

Investigative Searches -- how you should research... hhCorrect Answers hh1) Selections of specific keywords

2. Designation of a time frame
3. MeSH terminology (used for titling medical articles -- MeSH terms are official words or phrases selected to represent particular biomedical concepts. When labelling an article,

indexers select terms only from the official MeSH list - never other spellings or variations)

4. Boolean operators (what to keep in mind when looking up articles) -AND (Discuss or compare the two) -OR (About one or the other) -NOT (about 1 thing, not the other)

Chapter 4: Nursing in the American Colonies from the 1600s to the 1700s hhCorrect Answers hh...

Sociopolitical Climate (1600-1700's) hhCorrect Answers hh-In 1600-1700's, Colonial America was considered an outpost of Great Britain -We were "unrested" -- related to desire for autonomy (we desired to be free and independent) and what was perceived as unfair taxation by Great Britain -This^^ led to... American Revolutionary War in 1775

The Image of Nursing (during 1600-1700) hhCorrect Answers hh- The image of nursing in America during the 1600's and 1700's was "Synonymous with popular perceptions of nursing held in Great Britain and Europe" -Most Nursing care in Great Britain and Europe (that was not provided by family members in the home) was provided by monks and nuns in "monastery wards" as charity work -The Destruction and closures of "monastery sick wards" during the Reformation resulted in the creation of public hospitals

-Public hospitals were filthy, chaotic, poorly appointed, disorganized, stench-filled buildings where went to die when they had no other alternatives -Difficult to secure laywomen staffing: nurses were not trained, qualified, or motivated -Judges in the legal system began giving women who broke the law (prostitutes, public intoxication) the choice of going to jail or working in a hospital :/

The Education of Nurses (1600-1700's) hhCorrect Answers hh-No formal education for nurses in the american colonies during 1600/1700's -Knowledge gained from personal experiences -Nurses were often functionally illiterate

Advances in Practice (1600-1700's) hhCorrect Answers hh-Until mid-1700's, there were no hospitals in what is now called the US -Instead, the colonies had "Almshouses" for the poor& "Pesthouses" for contagious disease isolation -Crude forms of treatment (such as bleeding or purgatives) often worsened illnesses and conditions -First Hospital in America (Pennsylvania) -Second Hospital in America (New York)

Europe-- -1619: William Harvey explained "how blood circulated throughout the human body" -Anton van Leeuwenhoek discovered protozoa, bacteria, human spermatozoa after Improving an existing microscope to magnify objects up to 270 times its size

War and Its Effects on Nursing (1600-1700's) hhCorrect Answers hh-The revolutionary army was Ill-prepared for the realities of combat (no medical corps, no red cross, no trained nurses) -In 1777, George Washington ordered that untrained "nurses" were brought in to provide nursing care to the soldiers -These hired nurses ended up doing more cooking and cleaning then they did nursing -"Camp followers": many women who accompanied their relatives to the front lines and, in addition to cooking, cleaning, and mending... they assumed unpaid, unofficial nursing roles for ill and injured -No advances in nursing immediately following Revolutionary war -- due to the nurses who were brought in were not actually nurses

Nursing Workforce Issues (1600-1700's) hhCorrect Answers hh-idea of men in nursing became socially unacceptable (idea started in Great Britain and continued in the colonies) -The Reformation and the Thirty Years' War resulted in the destruction, closure, or disbanding of all-male monasteries that provided care for sick -Catholic Church shifted responsibility for this activity to nuns (women)

Licensure and Regulation (1600-1700's) hhCorrect Answers hhNurses not licensed or formally regulated in any way during 1600s and 1700s in American colonies

Chapter 5: The Work of Florence Nightingale hhCorrect Answers hh...

Sociopolitical Climate (during Nightingale's time) hhCorrect Answers hh-Women expected to be homemakers

-Nightingale born into privilege: *She chose to pursue a life in nursing despite resistance from those closest to her *Her revolutionary approaches to nursing, military healthcare reform, sanitation, nursing education, and organization of hospitals transformed health care

Did you know about Nightingale? hhCorrect Answers hh-Founder of modern nursing -Established 1st school that provided theory-based learning and clinical skill-building -Believed that there is a body of nursing knowledge that is different and separate from medical knowledge

The Image of Nursing (during Nightingale's time) hhCorrect Answers hh1840s -1860s: dark period in nursing -Unfavorable public perception -Nightingale changed image of nursing by: *Lobbying to improve overall conditions *Publishing her work and data/charts/tables she collected

The Education of Nurses (during Nightingale's time) hhCorrect Answers hh**1860: Nightingale Training School opened at St. Thomas's Hospital in London -First school of its kind -Nursing students (probationers) -Served as model for other training schools

**Nightingale's "Notes on Nursing" book (1860) -Nursing text at Nightingale Training School -Written bodies of work laid the foundation of professional nursing

Nightingale's Advances in Practice hhCorrect Answers hh-1860: Beginnings of holistic nursing -Established standards for cleanliness, ventilation, light, noise, & nutrition -Imperative to attend to total environment -Nightingale first nurse to use statistical analysis to justify proposed policy and treatment protocol changes

War and Its Effects on Nursing (Nightingale) hhCorrect Answers hh1853: Crimean War -Military hospitals ill-equipped; poorly managed -Nightingale sent to Scutari to improve conditions, bring & organize medical supplies -Mortality went from 60% to just over 1% due to Nightingale's interventions -Nightingale returned to England a national hero -Nightingale labored ceaselessly to improve military hospital conditions -Philanthropic organization, Nightingale Fund, set up by colleagues and supporters

Nightingale's impact on Nursing Workforce Issues hhCorrect Answers hh-Nightingale's work helped make nursing a respectable occupational for women -Nursing became a workforce of single, middle-class women who chose to be nurses

-She did not support idea of men in nursing

Licensure and Regulation (Nightingale) hhCorrect Answers hh- Nurses during Nightingale's time were not licensed or formally regulated -Graduates of Nightingale Training School were considered "certificated" -There was no coordinated or organized effort between schools, cities, regions, or countries

What Nightingale found out through research: hhCorrect Answers hh-Skin cleanliness is important -Carefully wash hands very frequently

-Nightingale engaged in retrospective study: **Used findings to justify proposed treatment protocol and healthcare policy changes **Recognized (2) components of nursing: HEALTH & ILLNESS

What Is Nursing Theory? hhCorrect Answers hh-Nursing theories are the creative products of nurses who describe the many aspects of nursing in ways that could be studied, evaluated, & used by other nurses -Attempt to explain patterns and relationships found in nursing phenomena -Nursing theories allow nurses to have the opportunity to study, evaluate, participate in, and add to an ongoing dialogue that is based on nursing

"Nursing theorists" hhCorrect Answers hhpeople who have been nurses -- they try from their own perspective to describe the phenomenon of nursing -- record their thoughts and observations based on personal and professional experiences

Nursing theories can be placed into 3 loosely defined categories: hhCorrect Answers hh1) Philosophies

2. Grand Theories

3. Middle-Range Theories

4. Philosophies hhCorrect Answers hhDefinitions of nursing in general

5. Grand Theories hhCorrect Answers hhDiscussions of broad nursing practice areas

6. Middle-Range Theories hhCorrect Answers hhAssertions about specific nursing actions, processes or concepts

Why Are Theories Important in Nursing? hhCorrect Answers hh- Provide structure and order for guiding and improving professional practice, teaching & learning, and research -Once you have mastered the technical skills of nursing, theories take on more meaning

Are theories always right? Is one theory better than others? hhCorrect Answers hhNO

The Development of Nurse Theories hhCorrect Answers hhMost nurse theorists didn't plan to create a theory.

Most began as a way to improve patient care - whether through direct clinical practice or through education of nurse. Early theorists were bold, unafraid to challenge the status quo. Most of early theorists never married or had children -- they had lifelong commitment to nursing theories

Two major universities were responsible for educating most of the early nurse theorists hhCorrect Answers hhColumbia University Yale

Why Theories Were Developed hhCorrect Answers hhNursing theories Started during the 1950s Couldn't always borrow other disciplines' theories (It became apparent that nursing was unique and contained many aspects that were not discussed in theories from other disciplines)

2 primary reasons:

1. To further nursing as a scholarly profession
2. to organize and improve the delivery of nursing care

How Theorists Created Theories hhCorrect Answers hhBegan with Nightingale (Flo) and her astute observations of actual nursing practice environments (fresh air, clean bandages)

-Theory about a practice discipline must come from actual practice experience. -HOW? -- "reflect on personal and professional experiences to make sense of worldviews and then put together the pieces of the puzzle with the goal of coherent description and explanation"

"the theorists observed a phenomenon in practice, reflected on it overtime, compared it to what was known, and determined goodness of fit and usefulness"

Testing of Theory hhCorrect Answers hhQualitative... what is the lived experience of...(quality)

Quantitative... Do axillary temp measures accurately reflect core body temp? (quality)

Chapter 4: Evaluating A Theory hhCorrect Answers hh...

Basic Understanding of Theory in 6 steps hhCorrect Answers hh1) What concepts are present that list/classify nursing components of interest?

2. How does the theory define person, health, environment, and nursing?
3. What is the theory trying to describe?
4. What types of definitions are used in the theory? -("Theoretical" definitions explain the nature of something in a broad sense and may not be immediately applicable to everyday activities) -("Operational" definitions are meant to explain exactly how something works)
5. What are the links between terms, concepts, and theoretical assertions?
6. How are the concepts and statements organized? (simple to complex? Linear? Highly structured? unstructured?)

steps to Evaluate the Theory hhCorrect Answers hh1) Does it make sense?

2. Is the theory clear?
3. Is it easily explainable?
4. How general is it?
5. How much research exists in current literature using theory?
6. If you used the theory would it impact your practice?

Answer yes to any of the following questions, then theory matters: hhCorrect Answers hhDoes it resonate with long-held professional insights? Does it Stimulate new ways of thinking? Does it Provide fresh viewpoints?

Theories That Define Nursing or Discuss Nursing in A General Sense: Philosophies hhCorrect Answers hh...

"Philosophy" hhCorrect Answers hhsystem of beliefs regarding morality, ethics, how world should be viewed

Nursing philosophies: hhCorrect Answers hhaddress the question "How does nursing fit into the universe?"

Nursing philosophers: hhCorrect Answers hhNightingale, Henderson, Wiedenbach and Watson

A Sunday on La Grande Jatte - Georges Seurat hhCorrect Answers hhEnvision the painting of Seurat when exploring theories that seek to define nursing in general:

Seurat uses the form of art "pointillism" -- the complex art is composed of little dots (thousands of them): -Most nurses are able to agree on the general concepts presented in theories regarding nursing in general, much like those who agree that a Sunday on La Grande jatte depicts people out for a Sunday stroll at the park -Often, disagreements among nurses regarding the content or applicability of a general theory arise from the "close-up" rather than the "faraway" view

background on Nightingale hhCorrect Answers hh-Nightingale came from wealth (from a Aristocratic English Family) -She was Well-educated -Trained to be a nurse for 3 months (in germany) -She returned to England and began to inspect & write about conditions in hospitals, reformatories, and charitable institutions -1854 - Nightingale went to Crimean War and brought 38 nurses with her to minister to injured and dying British soldiers (when they arrived, conditions were terrible) -After Nightingale and her nurses finished their work there, they significantly Improved hygiene, nutrition and level of care to patients...mortality rate dropped to 1%! -She began to open nursing training schools and worked toward the reform of army hospitals & began writing a lot

Nightingale's 10 bullets to define nursing hhCorrect Answers hh1) Religious beliefs

2. Nursing is a "higher calling"
3. Wholism (nurse should take into account the total environment, client, other persons, the social situation, and any other situationally related factors when providing care)

4. Disease is reparative process (natures (or Gods) effort to remedy poisoning, decay, or a reaction against conditions in which a person was placed)
5. Nature and God are synonymous (nature and god are similar -

• indicating the belief of a spiritual foundation for nursing actions)

6. Nurses role was to Prevent interruption of reparative process (provide optimal conditions for its enhancement through careful observation and committed action to support a cal, and reparative environment)
7. Nurses should be "moral agents" and "Agents of change"
8. Noble, disciplined, hard-working, selfless
9. Independent
10. Nursing could be a Means of serving God through selfless service

Nightingales' definition of nursing hhCorrect Answers hh-Nursing is independent, yet parallel profession to medicine -All factors in patient's environment influence healing -Recognize negative factors & correct them -Nurses must be Highly trained/educated -Nurses must be Dignified & have the highest moral character

Background on Virginia Henderson hhCorrect Answers hh-5th of 8 children born in Kansas City, Missouri -Moved to Washington, DC -Graduated from Army School of Nursing in DC, 1921 -Upon graduation, she became a home visit in community health nurse -Got her MA