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Rock Street 34, San Francisco State

Middle Ages
bubonic plague, poor sanitation, nursing orders founded
Beginning of nursing education, little organization to nursing, low social standing, medicine taught in universitites
Colonists faced same health problems as Europeans, fold remedies
Industrial Revolution (1700-1800)
Urban population growth, poor sanitation, increase in disease
Crimean War (1854-1856)
Florence Nightingale, improved sanitation, round the clock care, Nightingale Training School for Nurses in London (1860)
American Civil War
Improved nutrition and sanitation
World War I
Army School of Nursing, expansion of hospitals, shortage of visiting nurses
World War II
Federal funds to train nurses, baby boom, increase in number of hospitals, shortage of nurses, unfavorable work conditions, ANA
Korean War
MASH, community college nursing programs
Vietnam War
ICU’s and recovery rooms (PACU’s), technical nursing skills, specialization
American Nurses’ Association Definition of Nursing
“The diagnosis and treatment of human responses to health and illness.”
LVN (Licensed Vocational Nurse)
Different states have different names ex. LPNs, 12 month program
2 yr program, usually community colllege setting
4 yr, greater opportunity
hosptial based schools, hosptials trained to care for their patients, 3 yrs long, some college work
Masters Level
APN _ Advanced Practice Nurse
CNS _ Clinical Nurse Specialist
NP _ Nurse Practitioner
CNM _ Certified Nurse Midwife
CRNA _ Certified Registered Nurse Anesthetist
Emphasizes research
Nursing is considered more of a profession because of the research that is done.
Areas of Nursing and Research
Physiologic Processes
Comfort and Pain
behavior that upholds the status, methods, character, and standards of a given profession, a set of attributs, a way of life, that implies responsibilty and commitment
Nurse Practice Acts
Legally define the scope of nursing in any given state- what can nurses do
Purpose is to protect the public:guarantee minimum standards that every nurse must meet.
Each State has a Nurse Practice Act.
Nurses who know and follow NPA are providing safe and competent care to patients.
If you are not suppose to do a certain skill or whatever, don’t do it.
Professional Nursing Organizations
Establish and improve standards for nursing practice and education-learn to learn
Enhances sense of professional commitment-makes you feel good about what you are doing
Educate the public
Protect the public
Protect one another
Nursing Organizations
American Nurses’ Association (ANA)
Internation Council of Nurses (ICN)
National League for Nursing (NLN)
Commission on Collegiate Nursing Education (CCNE)
Nation Student Nurses’ Association
Commission on Collegiate Nursing Education (CCNE)
Voluntary accredidation that we have met certain criteria they have set for that is larger than the minimal expectations
American Nurses Association (ANA)
Nursing Education
High Standards of Nursing
Improved Standards of health
Promotion of professional development
Roles of the Professional Nurse
Caregiver-Direct patient care, clinican
Advocate- Protects patients rights, helps to assert patients rights when necessary
Coordinator and Manager of Care- What is the doctor, pharmacy, PT, OT doing?
Continuing Care Planner- What do they need before they go home?
Change Agent- What can we do to make changes in our system or with the patient?
Educator- You are either the recipient or the educator.
What is the ultimate goal of the Professional Nurse?
To assist patients, families, aggregates (groups of people), and communities to achieve an optimal state of wellness.
Health according to WHO
A state of complete physical, mental, and social well-being, and not merely the absence of disease.
A specific disorder characterized by a certain set of signs and symptoms
Cause of the disease
Personal experiences of feeling unhealthy
Acute Condition
Sudden onset, short duration, less than six months usually
Chronic Condition
Last for extended time, more than six months usually, more vague, ex. CHF, Asthma, never get rid of, it is just managed
A state of optimal health or optimal physical and social functioning
Includes relationships with other, emotional stability, intellectual growth, spiritual growth
Health Illness Continuum
Death on one end and Optimal Wellness on the other end
Health Care Models
Medical model (Scientific model)
Holistic model
Medical Model (Scientific Model)
disease caused by germs, viruses, bacteria, breakdown of body. Tx (treatment) aimed at presenting signs and symptoms
Holistic Model
takes into account all aspects of individual – biological, physchological, sociological, spiritual
Four Types of Healthcare Services
1. Diagnosis and Treatment
2. Rehabilitation
3. Supportive Care
4. Health Promotion and Illness Prevention
Holistic Practices Include:
Self Responsibility
Informed Choices
Self Worth
Community Based Healthcare
Found where the people are
Related to the publics desire to participate more actively in their healthcare
Focus-health of the whole person in relation to the person’s environment
Leading Health Indicators
Physical Activity
Overweight and Obesity
Tobacco Use
Substance Abuse
Responsible Sexual Behavior
Mental Health
Injury and Violence
Environmental Quality
Access to Healthcare
Primary Prevention
Health Education Programs
Health Fairs
Family Planning
Physical and Nutritional Fitness Activities
Secondary Prevention
You’ve got it, what are we going to do about it?
Not going to prevent it, find it early
Screening and diagnostic techniques for early diagnosis and treatment
Breast Self-Exam, Testicular Exam, Assessing children for normal growth and development
Encouraging regular medical and dental screenings and care
Tertiary Prevention
Restore to Optimal Level
Cardia rehabilitation after a heart attack
Teaching a diabetic to recognize and avoid complications of the disease
Refer someone to a support group for that disease process
Complimentary Therapies
Prayer, Relaxation, Biofeedback, Guided Imagery, Music Touch, Humor/Laughter, Nutrition
Complimentary and Alternative Medicine (CAM)
Treatments outside traditional Western medicine
National Center for Complimentary and Alternative Medicine (NCCAM)
5 Major Domains of CAM Practices
Alternatice Medical Systems: Oreintal medicine, Ayurvedic medicine, Homeopathy, Naturopathic medicine

Mind-Body Interventions: Meditation, Hypnosis, Dance, Music, Art THerpay, Prayer

Biologically Based Therapies: Diet Therapies (Dr. Atkins, Ornish, Pritikin, Weil), Shark Cartilage, Bee Pollen

Manipulatice and Body Based Methods: Massage, Chiropractic, Osteopathy

Energy Therapists: Qi Gong, Reiki, Therapeutic Touch, Use of Magnets

Forces Influencing Healthcare
Population Demographics
Patterns of Disease
Manage Health Care
Systems of care that focus on groups or populations of persons who are enrolled in a health benefit plan
Most often through ones employment
PPO, HMO, Integrated Service Network
Features of Managed Care
Pre-negotiated payment rates
Mandatory pre-certification
Utilization Review
Limited Choice of Providers
Fixed-Price Reminbursment
Federally Funded
Citizens over 66 yrs of age
Disabled people
End Stage Renal Disease
Federally and State Funded
People with Low Incomes (Indigent)
Blind, Elderly, and Disabled covered by supplemental security benefits
Beneficiaries of aid to families with dependent kids
Caring Theories
Leininger, Madeline
Watson, Jean
Caring in Nursing Practice
Knowing the Patient
Spiritual Caring
Family Care

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