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z FALL06 CONCEPTS Nursing Dee

Terms

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The British Government denied this Nurse the right to join nursing efforts during the Crimean War.
SEACOLE, Mary
Where was the first hospital in North America founded?
First hospital in the colonies was built in Philadelphia in 1751
Three African American Nurses that made important contributions to nursing efforts during the Civil War
Tubman, Truth, Taylor
Best known for the development & establishment of a viable practice for public health nurses in the 20th century.
Lillian WALD
Founded the American Red Cross
CLARA BARTON
The first to attribute disease to natural causes rather than to supernatural causes?
Hippocrates
Responsible for writing a pharmacopia to assist in the care & management of disease?
Egyptians
Taught a moral philosophy that adressed one's obligation to society?
Confucius
For what was the purpose of the "Vedus"
a guide to health care practices
A period in time when women of nobility devoted themselves to caring for the sick & the injured?
MIDDLE AGES
One of the first organized methods of disease control & prevention, written by the Hebrews in Palestine is called the?
The MOSAIC CODE
The Father of Medicine?
Hippocrates
Responsible for designing a written patient record & physicians order system?
Richards
The "Dark Ages of Nursing" was during what period of time?
The REFORMATION PERIOD
Established the first Nursing School in England
Nightengale
One who identifies a patients problems & communicates them in writing to other members of the health team is called a?
communicator
A medicare payments system to hospitals & physicians that establishes fees according to diagnosis?
DRG

Diagnostic Related Groups
One who pleads the cause of another or argues or pleads for a cause or proposal is an?
ADVOCATE
Establishes minimal levels of practice which is granted & governed by legislation & administered through the State Board of Nursing?
Licensure
The unlawful restraint or detention of another person against his/her wishes?

a) Assult

b) Battery

c) False Imprisonment

d) Breach of Duty
False Imprisonment
A civil case of which the burden of proof is on the plantif/accusor & the penalty is money?
Torte
Established to protect health care providers who provide assistance at the scene of an emergency against claims of malpractice?
Good Samaritan Act
Laws written by the state to ensure that all RN's, LPN's & UAP's are licensed & have the proper credentials?
Nurse Practice Acts
A legal wrong committed against society?
Crime
Established for implementation of the statute by carrying on the licensing & educational functions for practical, registered & advanced practical nursing?
OBN

Oklahoma Board of Nursing
Requires any person who practices or offers to practice practical or registered nursing to be licensed?
Oklahoma Nursing Practice Act
A term used to describe criminal offenses such as drug trafficking, fraudulent billing for medicare patients, and theft, rape, and murder?
felony
The attainment of board certification in a specialty?
Certification
The attributes, characteristics, & actions of the nurse providing care on behalf of or in conjunction with the client?
The definition of nursing
The performance of services provided for purposes of nursing diagnosis & treatment of human responses to actual or potential health problems that are consistant with educational preparation?
Scope of Nursing Practice
Causing a person to fear he/she will be touched without consent is?
ASSAULT
If the nurse does not get a patient's permission before initiating a procedure or treatment, the patient can declare what type of offense against her?
BATTERY
Defamation by means of print, writing or pictures is referred to as?
libel
The discussion of unprivilaged information, or to talk about someone that damages a reputation is referred to as?
slander
An agreement accepted by a client to accept a course of treatment or procedure is called?
Informed Consent
The information a patient must be given to satisfy the requirements of informed consent are?
1) Benifits

2) Risks

3) Alternatives

4) Prognosis without treatment or procedure
An oral or written agreement is?
Expressed Consent
Implied consent is?
When non verbal behavior indicates agreement
The duty to disclose information so the patient can make intellegent choices is mandated by?
Federal Statute & State Law
Three main types of social support?
1) Emotional

2) Practice help

3) Sharing points of view
A moderating factor in the developement of psychological &/or physical disease as a result of stressful events is?
Social Support
The physical & emotional comfort given to us by family, friends, co-workers & others is referred to as?
Social Support
The common denominators of time management strategies are:
1) a to-do-list

2) setting priorities

3) goal management
One of the major criticisms of time management is?
Taking the time to do it!
The use of tools or techniques for planning & scheduling time to increase effectiveness &/or efficiency of personal & corporate time use is called?
Time Management
A formal statement of a groups ideals & values is called?
A Code of Ethics
A set of ethical principles shared by members of a group that reflects their moral judgments & serves as a standard for professional actions is called?
A Code of Ethics
A role that includes activities to assist the patient physically & psychologically is?
Caregiver
The role of a caregiver assists the patient in what ways?
physically & psychologically
An occupation or a calling that requires extensive education, special knowledge, skill & preparation?
Profession
A profession is an occupation that requires?
1) extensive education

2) special knowledge

3) special skill

4) special preparation
The administrative process for validating qualifications of licensed professionals & assessing their background?
Credentialing
An objective evaluation of a persons current licensure, training or experience, competence & ability to provide particular services or perform particular procedures is a process known as?
Credentialing
A period in time when the Roman Catholic Church became a central figure in the organization & management of health care?
The Middle Ages
A period in nursing history when women used herbs & new methods of healing & men continued using the methods of purging, leeching, & mercury?
The Middle Ages
A period in time when Nurses were used by kings & other aristocrats to deliver babies & care for the young, the elderly, and the sick?
The Early Christian Era
The period in time when a religious movement led to the establishment of Protestant churches?
The Reformation
A religious movement in the 16th century that led to the reform of the Roman Catholic Church and the establishment of Protestant Churches?
The Reformation
The rebirth of Europe took place in an era referred to as the?
Renaissance
A period in time when new emphasis was given to medical education but of which nursing education was practically nonexistant?
Renaissance
A period in time when health practices were strongly guided by beliefs of magic, religion & superstition?
Ancient Times
Certification is defined as?
The attainment of board certification in a specialty
To be trusted by the patient to provide aid, advice, or protection because of the RN's knowledge & skills & accepts the duty to act in anothers interest is known as?
Fiduciary Responsibility
Overt or covert expression of erotic or romantic thoughts/feelings &/or gestures by an RN toward a patient is?
Sexual Misconduct
An intentional decision to deviate from established conduct & behaviors is known as?
Boundary Crossing
The failure to engage in the therapeutic relationship is called?
Under Involvement
The definition of Nursing is?
The attributes, characteristics, & the actions of the Nurse providing care on behalf of or in conjucntion with the client.
The Scope of Nursing Practice is the performance of services provided for purposes of?
Nursing Diagnosis & treatment of human responses to actual or potential health problems consistant with educational preparation.
A situation where there is a discrepancy between the RN's management & the patient vulnerability?
Power Differential
A breach of trust to meet the RN's needs before the patients is?
Over Involvement
A therapeutic Relationship is also referred to as?
A Helping Relationship
Keys to a therapeutic relationship?
1) The developement of trust & acceptance between the nurse & the client

2) An underlying belief that the nurse cares about & wants to help the patient
A Nurse Client relationship wherein trust & acceptance between the nurse & the client developes with an underlying belief that the nurse cares about & wants to help the patient?
Therapeutic Relationship
A set of priciples shared by members of a group that reflect their moral judgments & serve as a standard for professonal actions?
Code of Ethics
An occupation that requires extensive education or a calling that requires special knowledge, skill & preparation is?
A Profession
Laws written by the state to protect the public from unsafe healthcare practices by nurses?
Nurse Practice Acts
Nursing practice acts are written & passed by?
LEGISLATORS !!!
What is the purpose of Certification?
recognition of excellence
in nursing practice
Who grants nursing certification?
Non-governmental agencies which are usually nursing organizations & of which requirements & practice opportunities vary
Duties of the Board of Nursing are?
1) responsible for administering the states nursing practice act

2) responsible for granting & renewing licenses

3) Impose disciplinary action when provisions of the act are violated
The administering of the states nursing prasctice act, granting & renewing licenses & taking disciplinary action when provisions of the nursing practice act are violated is the reponsibility of?
The Board of Nursing
The description of requirements & procedures necessary for the initial entry into practice is found in?
Practice Acts
Laws written & enacted by legislative bodies are known as?
Statutory Laws
A level of law in which violations are criminal offenses & punishable by fines or imprisonment?
Statutory Law
EMTALA, ADA, Patient Self Determination Act & HIPAA are regulated under what type of Law?
FEDERAL STATUTORY LAW
A law that prohibits the transfer of unstable patients including women in active labor from one facility to another is?
EMTALA

Emergency Medical
Treatment & Active Labor Law
Enacted to prohibit the refusal of care for indigent & uninsured patients seeking medical assistance in emergency departments?
EMTALA


Emergency Medical Treatment & Active Labor Law
The Americans with Disabilities Act of 1990 is a?

1) State Statutory Law

or

2) Federal Statutory Law

or

3) Local Statutory Law
FEDERAL Statutory Law
A law requiring hospitals to inform adult patients in writing about their right to make treatment choices & ask patients if they have a living will or durable power of attorney for health care?
Patient Self Determination Act of 1990
Federal Statutory Law intended to ensure confidentiality of patient medical records & sets guidelines for maintaining the privacy of health data?
HIPAA

Health Insurance Portability * accountability Act of 1996

FEDERAL Statutory Law
The Nursing Practice Act is regulated under what type of law?
STATE STATUTORY LAW
Health professionals must report any of these 3 findings under penalty of fine or imprisonment for failure to do so?
1) infant or child abuse

2) dependent elder abuse

3) specified communicable diseases
A type of law created through cases heard & decided in federal & state appellate courts?
Common Law
Another term used for "Common Law" is?
Decisional or Judge Made Law
The duty that nurses will exercise independent judgment to prevent harm to patients is called?
Affirmative Duty
The failure to act in a reasonable & prudent manner is the definition for?
Negligence
A special type of neglegence wherein a professional fails to acts in a reasonable & prudent manner?
Malpractice
To prove neglegence or malpractice is one must prove?
1) the nurse owed the patient/client a special duty of care based on the establishment of a nurse patient relationship

2) nurse breached duty to the patient/client

3) patient suffered actual harm or damage

4) there is proximate cause or causal connection between the standard of care by the nurse & the patients injury
The failure of a professional to act in a reasonable and prudent manner?
Malpractice
Under what governmental body of law hears cases involving negligence or malpractice?
Civil Law
The most frequent allegations of nursing negligence are?

(name 5)
1) failure to ensure patient safety

2) improper treatment or negligent performance of treatment

3) Failure to monitor the patient & report significant findings

4) medication errors

5) Failure to follow the agency's policies & procedures
What is "res ipsa loquitur"?
It is the doctrine that applies when the negligent act clearly lies within the range of a jury's common knowledge & experience to determine the standard of care.

"the thing thast speaks for itself"
Damages awarded by a court that are meant to punish the nurse for outrageous conduct?
PUNITIVE DAMAGES
A reckless act that reflects a concious disregard for the patients welfare?
GROSS Negligence
An act deemed so reckless that the action also results in serious injury or death to the patient?
Criminal Negligence
Conservative estimates suggest as many as how many patients die each year from negligence & malpractice of health care providers?
98,000
A negligent act also constitutes?
A crime
Defenses against claims of negligence?
1) Emergency situations

2) Governmental immunity

3) Good Samaritan immunity
Governmental immunity is?
Individual health care workers employed in federal or state facilities are shielded from personal responsibility for damages in malpractice cases is Governmental Immunity.
Individual health care workers employed in federal or state facilities are shielded from personal responsibility for damages in malpractice cases are protected under?
Civil Law -Governmental Immunity
Intentional Torts on Nursing practice are?
1) Defamation of character (libel/slander)

2) False Imprisonment

3) Invasion of privacy

4)Intentional infliction of emotional distress
An offense against society defined through written criminal statutes or codes?
Crime
When a patient/client leaves against medical advice the nurse must?
1) act promptly to notify the provider

2) clearly articulate the danger inherent in leaving
The value of an AMA (leaving against medical advice)document depends a great deal on the nurses charting which should note the following:
That leaving the facility could result in:

1) Aggravate the current condition & complicate future care

2) result in permanent physical or mental impairment or disability

3) result in complications leading to death
The goal when clinical restraints are indicated is to:
Use the least restrictive restraint & only when all other strategies to ensure patient safety have been exhausted
The use of physical and chemical restraints & seclusion are governed by?
Federal & State Statutes & Accrediting Bodies
The purpose of licensure is?
The protection of the public
Skills required of nurses?
1) problem solving

2) Communication

3) Teaching

4) Caring

5) Management
Nursing skills are most effectively learned through activities such as:
1) Problem based learnng

2) Case studies

3) Diverse projects in many community agencies
The evaluation of nursing skills is based on documenting competence by?
1) performance based examinations

2) developing a structured portfolio
Which of the following best describes the Scope of Nursing Practice?

1) Providing care to clients, preventing illness & counceling

2) Promoting health & wellness, preventing illness, restoring health & care of the dying
Promoting health & wellness, preventing illness, restoring health & care of the dying
Which of the following recipients of nursing seek assistance because of illness or the need for surgery?

1) consumer

2) client

3) patient

4) customer
patient
According to the ANA Standards of Clinical Nursing Practice the nurse who follows the standard of professional performance would?
Aquire & maintain current knowledge in nursing practice
The components of a professional are?
1) specialized education

2) A service orientation

3) ongoing research

4) autonomy

5) code of ethics

6) a professinal organization
Recognized as the founder of professional nursing?
Nightengale
A governmental level of law (tort law) that deals w/conduct considered uncceptable. Based on societal expectations regarding interpersonal conduct?
Civil Law
Common cases of litigation that include professional malpractice, negligence, and assault and battery is heard on what level of governmental law?
Civil Law
Laws created through cases heard and decided in federal and state appellate courts are also known as?
Decisional or Judge-Made Law
A program administered by an employer; it is designed to upgrade the knowledge or skills of employees.
In-Service Education
The progressive movement from one type or level of education to another, often based on flexible advanced placement options, is referred to as?
Educational Mobility
In civil cases the legal criteria against which the nurse’s (and physician’s) conduct is compared to determine whether a negligent act or malpractice occurred?
Standard of Care
A list of nursing graduates is called?
Nursing registry
Statutes that provide for revocation of laws if not received and renewed within a specified time period is called?
Sunset legislation
Process by which nurses licensed in one state may seek licensure in another w/out repeating exams is?
Licensure by endorsement
Identifies graduates of a particular school of nursing. Symbolizes the philosophy, beliefs, and aspirations of the nursing program?
Nursing pin
The organization whose membership consists of the board of nursing of each state or territory is?
National Council of State Boards of Nursing inc.
The program developed by the state board of nursing proposes interstate compact so that nurses licensed in one state may practice in another with out holding multiple licensure is called?
Mutual recognition
(a Law term, also called Mutual Recognition Model)

A state that has established an agreement with other states allowing nurses to practice within the state with out an additional license is called a?
Compact State
Process where nursing schools are approved to teach nursing.
Accreditation
Role of the State Board of Nursing
To Protect the Public from Unsafe Nursing Practice

Determines boundaries

Takes disciplinary actions against nurses who violate grounds

Determines if to separate the nurse from the profession or rehabilitation the offender
Golden Rule of Boundaries
Do or say nothing in private or public which cannot be documented in the patient’s record
Limitations of a nurse patient relationship are?
Therapeutic Physical Contact

Social Contact only when "on-duty"

Avoid Financial Dealings

Limit Self-Disclosure to superficial information

Avoid making patient’s problems your own
Sexual gratification from illicit tactile stimulation
Usually acted out in public?
Frotteurism
Sexual gratification from observing other sexual acts?
Voyeurism
Sexual gratification disguised as a treatment is characterized by?
Unnecessary breast exams, pelvic exams, touching genitals

Improper examinations

Clitoral reflexes

"You need to learn to love"
Varieties of sexual misconduct
Rape without consent

Statutory rape ( under age)
Overt or covert expression of erotic or romantic thoughts/feelings/gestures by a professional toward a patient, that are sexual or may be reasonably construed as sexual is called?
Professional Sexual Misconduct
Boundary Violation is characterized by?
Role reversal and secrecy

Indulgency of personal privilege by the professional

Personal rather than professional relationship
Relationships that allow health professionals to apply their professional knowledge, skills, abilities, and experience toward meeting the health needs of the patient
Professional Therapeutic Relationships
Laws that are written by the state to ensure that all RN’s, LPN’s, and UAP’s are licensed and have the proper educational credentials.
Nurse Practice Acts
Common offenses nurses are charged with?
Illegal practice of medicine

Failure to report child abuse

Falsification of medical records

Assault & battery & physical abuse of patients
Supreme written law of the land?
Constitutional Law
Informed consent s mndated by?
Mandated by federal statute & state law
Establishes minimal levels of practice of which is granted & governed by legislation & administers licenses?
State Board of Nursing
Established by the Oklahoma Nursing Practice Act for the implementation of the statute by carrying on the licensing & educational functions for practical nursing, registered nursing, and advanced practice nursing
Oklahoma Board of Nursing
The Purpose of the Nursing Practice Act?
Declares Nursing to affect Public health, Safety, Welfare

Declares Nurses are subject to Regulation & Control by the OBN

Declares only qualified persons are authorized to Practice

Declares OBN promulgates Rules to identify essential elements of Education & Practice necessary to PROTECT the PUBLIC
The practice of nursing MEANS?
The performance of services provided for purposes of nursing diagnosis & treatment of human responses to actual or potential health problems consistant with educational preparation.
The BASIS of Assessment, according to the Nursing Practice Act, is?
Analysis, planning, intervention & evaluation used in the promotion & maintenance of health & nursing management of illness, injury infirmity, restoration or optimal function or death with dignity IS...KNOWLEDGE & SKILL !
Nursing practice, according to the Nursing Practice Act, is BASED on?
Understanding the human condition across the lifespan & understanding the relationship of the individual within the environment.
Nursing practice, according to the Nursing Practice Act, INCLUDES?
The execution of the medical regime includes the administration of medications & treatments prescribed by any person authorized by state law to prescribe.
The practice of an RN includes but is not limited to?
RN's ASSESS the status of:

INDIVIDUALS-FAMILIES-GROUPS


ASSESSMENT-ANALYIZE-ESTABLISH
GOALS
to meet identified needs!


PLAN-PRIORITIZE-IMPLEMENT


DELEGATE-EVALUATE-TEACH


MANAGE-SUPERVISE-COLLABORATE
How many members are on the OKALHOMA BOARD of NURSING?
11
How many menmbers on the OBN Board are RN's?
6
How many members on the OBN are LPN's?
3
How many members on the OBN are Public Members?
2
What areas of service must the 6 RN's who serve on the OBN represent?
2 RN's - Nursing Education

2-RN's - Nursing Service

2-RN's - Advanced Practice
What areas of service must the 3 LPN's who serve on the OBN represent?
1-LPN for Long Term Care

&

1-LPN for Acute Care
Members of the OBN are selected/appointed by whom?
The GOVERNOR
What are the conditions that must be met by the 2 Public Members of the OBN?
eligeable voters

knowledgeable in consumer
public health concerns

NEVER had an association with Health Care

NEVER enrolled in any health related issue
Those who serve obn the OBN continue to serve until?
Death

Resignation

Removal
Name 3 primary conditions that must be satisfied for RN's & LPN's to become a member on the OBN?
1) Be in good standing

2) Have a minimum of 5 years experience in practice

3) Be IN Practice
Conditions that one must meet in order to become licensed as an RN?
1) Diploma/GED

2) Approved Nursing Education

3) No convictions within 5 years
(or has recieved presidential or guberatorial pardon)
(dates effective from date of conviction or satisfaction of terms required by court to include probation)

Criminal History from OSBI

Examination
Renewals of licensing for nursing occur when?
every 2 years
Who has the power to deny, revoke or suspend licenses to practice nursing?
OBN

Oklahoma Board of Nursing
The Oklahoma Nursing Practice Act is not construed to affect or apply to?
1 - gratuitous nursing of the sick by friends or members of the family

2- RN's or LPN's from any state called into temporary attendance to a patient in any county of this state

3- the practice of nursing associated with the program of study by students enrolled in nursing education programs approved by the board

4- persons trained & competency certified to provide care pursuant to state or federal law, rules or regs

5 - the practice of any legally qualified nurse of another state employed by the US Government or any bureau, division or agency thereof, while in the discharge of his or her official duties

6 - the rendering of service by a physician's trained assistant under the direct supervision & control of a licensed physician

7 - the practice of nursing in connection with healing by prayer or sprititual means alone in accordance with the tenets & practice of any well-recognized church or denomination so long as that individual not make false claims to be a graduate of or as an RN or LPN
What is a PEER assistance program?
Rehabilitation for nurses whose competency may be compromised because of alcohol or drug abuse so they can be treated & return to or continue the practice of nursing
The PEER assistance program is under whose supervision and control?
OBN
The election of the Board officers of the OBN occurs when?
Every January
Rehabilitation for nurses whose competency may be compromised because of alcohol or drug abuse is called?
PEER Assistance
When a RN or LPN petitions the OBN to request promulgation, amendment, or a repeal what measures should she take?
Submit petition accompanied by explanation:

1) co-signed by at least 10 RN's or LPN's;

2) submitted to the OBN at least 30 days prior to a regular meeting;

3) be referred to the OBN's attorney for legal consideration;

4) be considered by the Board at a regular meeting; and

5) be scheduled for a Public Hearing within 90 days after being considered by the Board in a regular meeting
A petition requesting promulgation, amendment orr repeal of a rule shall not be considered by the Board if the subject of the Petition is the same or similar to a previous petition that was considered by the Board within what period of time?
12 months
The central office of the OBN is located in?
Oklahoma City
The Oklahoma Nursing Practice Act requires any person who practices as a RN or LPN to be?
1 - licensed

2- submitt sufficient evidence of qualification to practice
The OBN is established by?
Oklahoma Nursing Practice Act
The reason the OBN is established by the Oklahoma Nursing Practice Act is?
For the implementation of the statute by carrying on the licensing & educational functions for practical nursing, registered nursing & advanced practice nursing
Assuming responsibility to the client, the public, or other health-care practitioners & one's self for one's actions &/or decisions and outcomes is called?
Accountable
An individual other than a licensed nurse who performs an assistive role & has been certified to perform core skills as delegated by a licensed nurse & as authorized by the rules & reg's of the OBN is an?
advanced unlicensed assistive person
Entrusting the performance of selected nursing duties to individuals who are qualified, competent & legally able to perform such duties is?
delegation
All "conduct hearings" are conducted and governed in accordance with the provisions of ?
The Oklahoma Administrative Procedures Act
Conditions for employment are?
1) Drivers License

2) Oklahoma License & Certificate of Recognition issued by the OBN

3) A valid temporary license shall be required in lieu of a full certificate of licensure

4) Any person DIRECTING or SUPERVISING nursing services must have a license issued by the OBN
To be eligible to participate in a PEER Assistance Program, applicants must?
1- have a current unrestricted license

2- have no pending felony or conviction that would prevent the practice of nursing

3- voluntarily submitt an application for participation

4 - reside in this state
Who defines the Scope of practice for nurses in this state?
The Oklahoma Nursing Practice Act
A medically controlled state of depressed consciousness in which the patient has the ability to retain protective airway reflexes, independently & continuously maintain a patent airway, & to respond to age-appropriate physical & verbal stimul
Conscious Sedation
What 3 conditions must be present for Conscious Sedation?
1- Patient has the ability to retain protective airway reflexes

2- Patient independently & continuously maintains a patent airway

3- Patient responds to age-appropriate physical & verbal stimuli
A medically controlled state of depressed consciousness fron which a patient is not easily aroused is called?
DEEP Sedation
The doctor writes an order that reads as follows: “give .1 mg drug X bid IV” The nurse administers 1mg drug X by IV. The patient dies from receiving 10 times the prescribed dose. What type negligence would this be?
Criminal Negligence


(death by decimal- page 3 Nursing Negligence class notes).
. The doctor writes an order as follows: give 2 mg drug Z. The nurse believes this to be an excessive dose and checks the drug reference. The reference list the maximum dose as 4 mcg. The nurse consults with the doctor, advising him of what the drug refe
Notify the charge nurse of the discrepancy.

The charge nurse can deal w/ situation from that point.
Define Malpractice?
Failure to act as a reasonably prudent RN would do in a similar situation
List 4 elements that must be proved to establish malpractice?
Nurse owed patient special care based on establishment of nurse-patient relationship
(nurse accepted the assignment)

Nurse breached duty to the patient

Actual harm or damage was suffered by the patient

Proximate cause or causal connection between breach in standard of care by nurse and the patient was injured
The RN is supposed to give a medication at 2000 but gets busy and doesn’t administer it until 2130 & then charts it as having given it at 2000.

This is an example of?
a) Fraud

b) Malpractice

c) Neglect

d) Gross neglect
list 6 factors that contribute to malpractice
Delegation

Nursing Shortage

Early discharge

Advances in technology

Increased autonomy & responsibility

Better informed consumers
What religion organized and managed health care during the middle ages?
The Roman Catholic Church
What symbol from that period is still used today?
MALTESE CROSS

(symbolized on nursing pins)

identified monks and Christian knights
During the middle ages, who became nurses?
Noble women
4. What women were nurses during the reformation, leading to the “The dark ages of nursing”?
Female prisoners

Prostitutes

Women of undesirable character
Who established the 1st nursing school?
Florence Nightengale
During the period form 1945-1953, what milestone was reached with regard to nursing education?
Minimal nursing education standards were established
What occurred in the 1970’s regarding nursing education and degrees?
Masters degree for nurse practitioner
What are 4 areas in which the public seeks advice from nurses?
Self-care

Immediate post op care

OTC health care products

Administration of drugs

Interpreting physician info
What must the RN do if he wants to be treated as a professional?
Speak, write, dress, & conduct themselves like professionals !!!
List 5 skills required of nurses?
Problem solving

Communication

Teaching

Caring management
Why have competency based performance examinations become necessary in nursing schools?
Increased medical errors leading to lawsuits
List 4 factors that have lead to the current shortage of nurses?
Current workforce is older with fewer nurses available

Fewer qualified preceptors for students

Fewer students choosing nursing as a career

Shortage of qualified teachers
. What is one consequence of the shortage of nurses?
Medication Errors
What are the degree options open to nurses now?
Associates (ASN)

Bachelors (BSN)

Masters (MSN)

Doctoral (PhD, DNS, ND, DNP)
Who approves nursing programs?
State Boards of Nursing
What must the RN do after graduation to keep their license current?
Continuing education

and

In-Service Education
What are 3 major roles of the RN?
Providing Care

Leadership

Member of Profession
What are barriers nursing students faced with regarding their education?
Balancing work and school

Concerns about Academic skills

Blending student role with work and family
managing time
meeting work commitments
meeting family commitments
meeting school commitments
Paying for school
getting & keeping an effective support system
Name the 7 stages to the Spencer & Adams transition model . . .
Stage 1
losing focus

Stage 2
minimizing the impact

Stage 3
The Pit

Stage 4
letting go of the past

Stage 5
Testing the limits

Stage 6
Searching for meaning

Stage 7
integration
What role must the student assume with regard to learning?
Be responsible for own learning

Do not rely on faculty to provide ALL the knowledge needed
What should the student do to be prepared for their classes?
Read

Take notes

Consider objectives to be covered

Ask questions
Sitting quietly in a room, taking a walk in the woods, not overextending yourself, going to a movie, eating healthy, and staying organized are ?
Stress antidotes

(more in our class notes)
What is the purpose of licensure for nurses?
The need to demonstrate a certain level of skill and knowledge, thereby protecting the public.
What are components of Nursing Practice Acts?
Provides for protection of the health and safety of the populace

protects the title of RN

defines professional nursing and advanced practice

describes requirements for licensure

describes guidelines to enter nursing practice

describes guidelines to renew license

designates regulatory board

gives guidelines for delegation
What are the duties of the board of nursing?
Administer states Nursing Practice Act

Granting and renewing nursing licenses

Taking disciplinary action
A nurse in the U.S. Navy that is licensed in Oklahoma, but works at Portsmouth Naval Hospital in Portsmouth, Va. Is an example of?
Special cases of licensure
Who writes Nursing Practice Acts?
State legislatures.
What is certification?
Certification recognizes excellence, is granted by various non-governmental agencies.
What is licensure?
Licensure can ONLY be done by the state. States the holder has met a minimum qualification criteria to be licensed.
Assertion that every person is responsible for wrong or injury done to another resulting from carelessness defines?
Liability
Can an RN be relieved of liability if they are following the orders of another health care professional?
No !
The nurse must assume responsibility for any harm or injury resulting from her/his actions.


For example:
Dr. orders too high of a dose of medication for a patient. It is the responsibility of the RN to know the maximum safe dose. If the RN exceeds the max dose simply because the Dr. ordered it, he is liable for any injury to the patient.
What factors must the RN consider before delegating tasks to a person of less training than the RN?

(i.e. an LPN, or an aid)
Determine if it’s legal to delegate such task.

Determine if it’s reasonable and prudent to delegate such task based on the level of training of the other health care person as well as the status of the patient.
Why are incident reports necessary?
RNs are legally required to report critical incidents to their manager. A critical incident that results in patient injury or death may result in a malpractice claim.
What are the pros and cons to cross training and floating?
Pro's...
enhances efficiency and reduces staffing cost

Con ...
Increases personal liability of the RN
When should a nurse NOT float to a different department?
When the nurse does not have the needed knowledge or skills to work in that department.
What standards are student nurses held to?
The same standard and scope of practice as an RN to the level which they have been trained.
Failure to act as a reasonably prudent person would in a similar situation is considered to be an act of?
Negligence
What are the major categories of negligence?
FAILURE TO:

Follow standard of care

Use equipment in a reasonable manner

Communicate

Document

Assess and monitor
Reckless act by nurse that reflects conscious disregard for patient’s welfare.
Showing complete indifference to consequences of action to patient defines?
GROSS Negligence
When a negligent act also constitutes a crime it is called?
CRIMINAL NEGLIGENCE
When might it be acceptable to breach the standard of care?
In a life threatening situation where following procedure would likely result in patients death.
Asserts that every person is responsible for the wrong or injury done to another resulting from carelessness defines?
Liability
A nurse assume's responsibility for patient harm or injury as a result of his/her negligent acts & this is called?
Personal liability
Implications of Personal liability?
Nurse assumea responsibility for patient harm or injury as a result of his/her negligent acts

Nurse cannot be relieved of liability by another professional such as a physician or nurse manager

Taking the blame

Damages can be levied against current assets and future earnings
A nurse should consider these factors of Personal liability in delegation and supervision of team members?
Nurses must be absolutely clear about the lawfulness of patient care assignments

Determine if it is reasonable and prudent to delegate a task based on knowledge of the worker

Patient’s status, and current work setting conditions
Employer liability is considered to be?
vicarious liability
Nurses are legally bound to report critical incidents to?
the manager
Critical incidents that result in patient injury or death may lead to what type of claim?
malpractice claim
In an Incident Report it is important to describe events in what way?
Describe events objectively

Avoid subjective comments or personal opinions

Deck Info

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