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Nursing In the past, nursing was viewed primarily in terms of direct patient care roles, mainly in hospitals Now - nearly 50% of nurses work in settings outside of ... – PowerPoint PPT presentation

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Title: Nursing

  • In the past, nursing was viewed primarily in
    terms of direct patient care roles, mainly in
  • Now - nearly 50 of nurses work in settings
    outside of hospitals (hospice care, home care,
    and nursing home care)
  • Nurses develop their own group practices
  • Nurses can build careers in the "business" side
    of nursing

  • In the first edition of the Random House
    Dictionary (1966) the verb "to nurse" means to
    foster or cherish (?????????, ??????), to treat
    or handle with adroit care to bring up, train,
    or nurture to handle carefully or fondly to
    preserve. "Nurse" suggests attendance and
    service its antonym is neglect (???????).

  • In Random House Collegiate Dictionary (1995),
    the first meaning of "nurse" is "a person
    formally educated in the care of the sick or
    infirm, especially a registered nurse"

  • Legal definitions in nurse practice acts exist to
    protect the public and to protect the title.
  • North Carolina was the first state to pass a
    licensing law (1903), and it was intended to
    protect the title, not to define the practice.
    The early statutes were certification laws,
    permissive rather than mandatory, and in general
    permitted anyone to perform legally the functions
    of a nurse, even for compensation, but only those
    who were licensed could use the RN title (Hadley,

  • Inclusion ... of the diagnostic function would
    authorize the nursing practitioner to make
    nursing diagnoses, not medical diagnoses. Whereas
    the diagnostic function as an intellectual
    process is central to the practice of any number
    of professions, including medicine and nursing,
    the focus of this function varies among these
    professions. For example, the focus in medicine
    is the nature and degree of pathology or deviaion
    from normality within nursing the focus is the
    individal's response to an actual or potential
    health problem and the nursing needs arising from
    such responses. Driscoll, 1976, p. 61 italics
    in original

  • "Nursing is the diagnosis and treatment of human
    responses to actual or potential health problems"
    (ANA, 1980)

Staff Nurses Working in Hospitals
  • At present, 59.6 of all employed nurses work in
    hospitals, and this number is projected to
    decrease to 52.8 by 2008
  • In 1992, 84 of all registered nurses 30 years
    old or younger worked in hospitals, whereas only
    50 of nurses over 50 worked in hospitals.
  • Most hospital nurses work in general medical and
    surgical units (40), but many work in acute care
    units such as critical care (18), operating
    rooms (7), and emergency rooms (8).

The current demographics of RNs in the United
States in 1996.
  • 2,558,874 people were licensed as RNs
  • 82.7 were currently employed as RNs, and 60
    were working in hospitals
  • The number of male RNs in 1996 was 5.4, which is
    a substantial increase from the 3 in 1980.
    Moreover, in 1996 nearly 12 of newly licensed
    RNs were men

  • About 10 of RNs come from racial or ethnic
  • 4.2 were African American
  • 3.4 were Asian or Pacific Islander
  • 1.6 were Hispanic
  • and 0.5 were Native American.
  • Again, when we look at the numbers of newly
    licensed RNs, we see steady change 5.5 were
    African American 6 were Asian or Pacific
    Islander 3 were Hispanic and 0.8 were Native
    American (NCSBN, 2000).

  • The average salary of a full-time RN in 1996 was
    42,000, which was an 11 increase over RN
    salaries in 1992
  • Most employed RNs (58.4) had less than a
    baccalaureate degree 31.8 had a baccalaureate
    as their highest degree 9.1 had a masters as
    their highest degree and 0.6 were doctorally

  • For nurses working in large hospital centers,
    increased specialization is common.
  • In small rural hospitals, however, nurses are
    often called upon to be generalists, to be
    competent in caring for an older person with a
    cardiac condition as well as in emergency room
    treatment of an injured child.

Within hospitals, nurses are caring for sicker
patients for shorter periods of time with ever
more sophisticated technology. Hospital staff
nurses require expert clinical and communication
skills to
  • 1. Monitor and care for their patients
  • 2. Counsel their patients' families
  • 3. Interface and collaborate with other health
    care providers as part of a health care team
  • 4. Keep up with rapid technological advances
  • 5. Effectively use information systems to manage
    patient care
  • 6. Participate in clinical research.

Today's hospital nurses have to supervise and
delegate nursing duties to unlicensed assistive
  • 1. Staff nurses need to know exactly what is
    allowed under their state practice acts for
    example, they should not delegate nursing
    assessments and judgment.
  • 2. Staff nurses need to be the ones who train the
    unlicensed assistive personnel to perform the
    tasks or to monitor the patients so that they
    know exactly what the assistant can do.
  • 3. Staff nurses need to develop protocols for the
    unlicensed assistive personnel to work under.
  • 4. Staff nurses need to supervise the care given
    (King, 1999).

Causes of staff shortage
  • overwork
  • work-related stress
  • mandatory overtime
  • drops in student enrollment
  • cost cutting by hospitals
  • increased job opportunities for women
  • health risks at the workplace (risk of infection,
    sensitivity to latex)
  • workplace violence

  • Hospitals and nursing homes account for 64 of
    workplace violence, and health care workers have
    a 16 times greater risk of sustaining a fatal
    injury on the job than the general population has
    (ANA, 2000c Smith-Pittman McKoy, 1999).
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