A Tribute to Nurses 9 9 unread replies. 9 9 replies.

Select one of the nurses in the video (Joanne, Bridgett, Jason, Brian, or Sister Stephen) and describe how they exemplify one of the NLN competencies (human flourishing, professional identity, nursing judgment, or spirit of inquiry) along with the associated QSEN competencies.

In your post, also discuss the knowledge, skills, and attitudes of the selected QSEN competency or competencies. Refer to the QSEN website and the activities from the interactive tutorial on Professional Nursing Practice.

Initial Discussion Post 

Carolyn Jones is a sociologist who has researched the work and lives of nurses as part of The American Nurse Project. (Links to an external site.) For this discussion post, you need to watch her video: A Tribute to Nurses.

Jones, C. A tribute to nurses. (Links to an external site.) (10:48 minutes). This video is closed-captioned and has a transcript.

As you are watching this video, think about the QSEN and NLN competencies you have learned about in this module.

Select one of the nurses in the video (Joanne, Bridgett, Jason, Brian, or Sister Stephen) and describe how they exemplify one of the NLN competencies (human flourishing, professional identity, nursing judgment, or spirit of inquiry) along with the associated QSEN competencies.

In your post, also discuss the knowledge, skills, and attitudes of the selected QSEN competency or competencies. Refer to the QSEN website, and the activities from the interactive tutorial on Professional Nursing Practice.

Your discussion postings must conform to the AD Nursing Discussion Posting Requirements; review the requirements prior to submitting your discussion posts.

Nursing Core Values and Competencies

To deliver safe, quality patient care, the RN must demonstrate knowledge, skills, and attitudes that demonstrate competence in nursing care delivery. Standards for nursing care are nationally accepted statements defining the entry-level competencies of registered nurses. Nursing standards that guide nursing practice are periodically and systematically reviewed and revised based on current research.

The National League for Nursing (NLN) defines the core values of nursing as:

  • Caring: Promoting health, healing and hope in response to the human condition.
  • Diversity: Affirming the uniqueness of and differences among persons, ideas, values, and ethnicities.
  • Excellence: Co-creating and implementing transformative strategies with daring ingenuity.
  • Integrity: Respecting the dignity and moral wholeness of every person without conditions or limitations.

National League for Nursing (2019). Core values. (Links to an external site.)

The American Nurses Association (ANA) identified these basic principles of nursing practice:

  • Nursing practice is individualized.
  • Nurses coordinate care by establishing partnerships.
  • Caring is central to the RN’s practice.
  • RNs use the nursing process to plan and provide individualized care.
  • RNs have an ethical obligation to promote and maintain healthy work environments that are conducive to quality health care.

American Nurses Association (2015). Nursing: Scope and Standards of Practice (3rd ed.)

Competency is defined by the profession of nursing. Regulatory agencies establish minimal standards of competency. An individual demonstrates competency by performing at a level that integrates the expected knowledge, skills, abilities, and judgments of a registered professional nurse. Competency also may vary based on changing circumstances. For example, if a nurse has been working with pediatric patients for 10 years and then takes a position working with critical care patients, they must develop a new set of competencies to deliver safe, effective care. Competency is evaluated by the individual (self), peers, faculty, supervisors, and patients.

Nursing educational programs also have competencies that are expected of their students when they finished the nursing program. The four (4) broad competencies for the graduates of the associated degree program outlined by NLN (2010) are summarized here.

  • Human flourishing: Advocate for patients and families that promote the patient’s self-determination, integrity, and growth.
  • Nursing judgment: Make nursing judgments based on evidence to provide safe, quality care.
  • Professional Identity: Implement the role of RN with integrity, responsibility, and ethical practices.
  • Spirit of inquiry: Examine the evidence that underlies clinical nursing practice to challenge the status quo.

The Institute of Medicine (IOM) Report on the Future of Nursing outlined methods to provide seamless, affordable, quality care that is accessible to all, leading to improving health outcomes. An outcome of the report identified the five (5) key areas of nursing competencies that students achieve upon graduation. The areas are client-centered care, interdisciplinary teamwork, evidence-based practice, quality improvement, and informatics.

Quality and Safety Education for Nurses (QSEN) began an ongoing national project in 2005 to provide the foundation in preparing future nurses with the knowledge and skills to improve patient care and the health care environment. The outcome from the research identified six (6) competencies nursing students should demonstrate upon graduation.

  • Patient-centered care: Recognize the patient as a full partner when providing compassionate, respectful, and coordinated care based on patient preferences, values, and needs.
  • Teamwork and collaboration: Function effectively within nursing and the inter-professional team while fostering open communication, mutual respect, and shared decision making to achieve quality patient care.
  • Evidence-based practice: Integrate best current evidence with clinical expertise and patient/family preferences for delivery of optimal health care.
  • Quality improvement: Use data to monitor the outcomes of care and use improvement methods to continuously improve the quality and safety of health care systems.
  • Safety: Minimizes risk of harm to patients and providers through both system and individual performance.
  • Informatics: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019She met Sidney Herbert and his wife, who were interested in hospital reform. gathering information about public health and hospital conditions in England, where reforms were much needed and were being intensely debated. Gradually, she began to be considered an expert in these areas and was often consulted by reformers and physicians.Also during this time, she learned about Kaiserwerth, a hospital that trained nurses, run by Pastor Fliedner. She studied at the institute for three months in 1851. CAREER The turning point in her career came in 1854 with the Crimean War. When she learned about the terrible conditions under which care was provided to the wounded British Army soldiers, she consulted Sir Sidney Herbert, Secretary of War and her old friend. Florence Nightingale led a team of nurses to Crimea. It was due to her hard work and efforts that the wartime mortality rates for ill and injured soldiers were significantly reduced. Florence Nightingale’s efforts in the war won her acclaim nationally, and after the war ended, she began instituting public health reforms for British soldiers. These included simple measures like ensuring hygiene, as well as activities such as constructing hospitals. She continued to work tirelessly on public health, hospitals, and nursing reform. Throughout her lifetime she wrote on these subjects as well. Her most famous work is Notes on Nursing(1859). CONTRIBUTIONFlorence Nightingale defined nursing as an art and as a science and created nursing practice as a separate discipline from medicine practice. Her many contributions included identifying that nursing had two components -health and illness; recognizing the importance of cleanliness and nutrition to good health; establishing standards for hospital management; and reforming nursing education. In 1860, she established the school of nursing at St. Thomas’ Hospital, London. Her beliefs about nursing education were the forerunner to modern nursing education
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019and were based on seven principles. These principles were: •The training of nurses would be in schools associated with teaching hospitals.•The curriculum would include both theoretical and clinical components.•Students’ instruction would include attending lectures, taking quizzes, writing assignments, and keeping diaries. •There would be selective admission criteria. •The school matron would have authority over living arrangements, curriculum, and all other facets of the school. •Teachers would be paid for instructing nursing students. •Accurate records would be kept on all students. By example, Florence Nightingale showed what professional nursing care should be. Her vision was largely responsible for the evolution and growth of nursing. MILDRED MONTAG (1908-2004)The evolution of nursing education from hospital programs to community colleges is credited to Mildred Montag. The proposal she made in her now-famous doctoral dissertation, “The Education of Nursing Technicians” (1951) was to provide an alternative method of educating nurses by having programs offered in two-yearcommunity colleges.BEGINNINGSMildred Montag obtained a bachelor’s degree in nursing from the University of Minnesota School of Nursing in 1933. She then received a master’s degree in nursing education from Columbia University Teachers College in 1938.She also did her doctoral studies at Teachers College. CAREERIn 1942, Mildred Montag established a nursing education program at Adelphi University on Long Island, New York. As the founder and director of the program from 1942-48, Montag initiated manychanges in the traditional format of nursing education. She limited the number of clinical hours that students spend in the hospital; she ensured that the
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019program had a strong theoretical component with most classes being conducted on campus; and she encouraged nursing students to participate in college activities much like students in other programs. Dr. Montag was associated with nursing education at Adelphi University, until her death in 2004. Funded by the W.K. Kellogg Foundation, Dr. Montag directed the five-year research project, the Cooperative Research Project in Junior and Community College Education for Nursing at Teachers College, Columbia University, which included seven junior and community colleges and one hospital school, located in six regions of the United States. This research project was later published in 1959 as a significant nursing report titled, Community College Education for Nursing. This report was significant to the development of more associate degree nursing programs. ISABEL HAMPTON ROBB (1860-1910)Isabel Hampton Robb’s major contributions were in the areas of nursing education and nursing organizations. BEGINNINGSIsabel Hampton Robb trained as a nurse at the Bellevue Hospital Training School for Nurses, graduating in 1883. CAREERIsabel Hampton Robb began her career in nursing education when she became the Superintendent of Nurses at Illinois Training School in Chicago. This school was the trailblazer foruniversity based nursing education thatemphasized academic learning.Several years later she was appointed as the Principal of the John Hopkins Hospital Training School for Nurses.
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019CONTRIBUTIONIsabel Hampton Robb brought about many innovations in nursing education. Some of her initiatives were the implementation of a grading system, terminating the practice of students doing private duty nursing, using clinical affiliations when a learning experience wasnot available in the parent hospital, reducing the length of the workday for students, and organizing the curriculum into specialty areas. She was instrumental in organizing the American Society of Superintendents of Training Schools for Nurses in 1893.Their responsibilities were education reform. She was also the founder and first president of the Nurses’ Associated Alumnae of the United States and Canada in 1896. Isabel Robb helped develop theAmerican Journal of Nursing, the first professional journal dedicated to enhancing the quality of nursing practice. The American Journal of Nursingis still the official journal of the ANA.LILLIAN WALD (1867-1940)Lillian Wald’s major contributions are in the areas of public health and wellness education.BEGINNINGSLillian Wald was raised in Ohio and graduated from the New York Hospital Training School for Nurses in 1901.Before entering medical school, she worked as a hospital nurse. However, while in medical school, she became involved in working with the poor and sick in the communities of New York City.This motivated her to change her direction back to nursing and open the Henry Street Settlement, which was a storefront health clinic in a very poor section of the city.This clinic was structured for nurses to make home visits focusing on sanitary conditions and children’s health.CAREER
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019Wald advocated for wellness education as a means to provide these nurses with the knowledge to better serve this community.She was instrumental in helping Columbia University to develop courses to prepare nurses to work in public health.Even though this type of education was not embraced by medicine at the time, Metropolitan Life Insurance Company saw its value and she was asked to organize its nursing branch.In 1912, Wald founded and became the first president of the National Organization for Public Health Nursing.In addition, she is credited with the concept of school nursing and was the first to place nurses in public schools.Her efforts have had a direct influence on current ideas in public health nursing and wellness clinics today.ORGANIZATIONSTHE AMERICAN NURSES ASSOCIATION (ANA)•The American Nurses Association (ANA) is the professional organization for registered nurses in the United States. •The forerunner of the ANA was the Nurses’ Associated Alumnae of the United States and Canada, an organization founded by Isabel Hampton Robbin 1896. •Membership in the ANA consists of state nurses’ associations and three territorial constituent units. Individual nurses can belong to the ANA as members of their state organization or by joining ANA directly. •Since its inception in 1911, ANA has worked to promote the nursing profession and the welfare of nurses. This includes being responsible for nursing scope of practice, public policy, ethics, and elevating nursing education. ANA also works with state and federal lawmakers for these purposes.•ANA produces several publications for nurses, including Code of Ethics for Nurses, American Nurse Today(ANA’s official publication), and The Online Journal of Issues in Nursing (OJIN). It also organizes conferences and eventsand provides credentialing and continuing professional development for nurses.
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019NATIONAL LEAGUE FOR NURSING (NLN)•The National League for Nursing promotes excellence in nursing education. •The American Society of Superintendents of Training Schools for Nurses became the National League for Nursing Education, and today is the National League for Nursing. •Membership in the NLN is open to nurses, nursing faculty, the public and nursing serviceand nursing education agencies. •The NLN’s focus is the development and advancement of nursing education. It offers faculty development programs, networking opportunities, testing and assessment, nursing research grants, and public policy initiatives to its membership. •Its testing services include pre-entrance testing for students as well as achievement testing to measure student progress. •The NLN also conducts annual surveys of schools and new RNs, in order to gather and provide research data about nursing education. •Nursing education programs can be accredited by the Accreditation Commission for Education in Nursing (ACEN), an autonomous arm of NLN.NATIONAL COUNCIL OF STATE BOARDS OF NURSING (NCSBN)•The NCSBN is a not-for-profit organization founded in 1978 to replace the Council of State Boards of Nursing. •NCSBN has legal authority over nursing practice and nursing education. Each state, the District of Columbia,and our US territories has a regulatory body that oversees legal activities within that state, district,or territory. NCSBN provides a platform for various boards of nursing to interact and collaborate on issues that affect nursing and public health. •A major responsibility of the NCSBN is the management and development of the licensureexaminations, the National Council for Licensure Examination for Registered Nurses (NCLEX-RN),and the National Council for Licensure Examination for Practical Nurses (NCLEX-PN). •The organization also conducts research, monitors trends, and disseminates data regarding public policy, nursing practice and education, and licensure of nurses.
  • NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019ORGANIZATION FOR ASSOCIATION DEGREE NURSING (OADN)FORMERLY KNOWN AS THE (NATIONAL ORGANIZATION FOR ASSOCIATE DEGREE NURSING (N-OADN)•OADN works toward the enhancement and development of associate degree nursing education. It focuses on the professional role of the associate degree nurse and aims to strengthen and adapt this role in the changing environment of health care. •Founded in 1986, OADN provides a forum for interaction and collaboration among associate degree nurses and individuals interested in associate degree nursing. Individuals (nurses and non-nurses), organizations, states, and institutions of higher education and health care agencies can become members of OADN. •The organization also disseminates research data and other information regarding associate degree nursing. Its official journal is the peer-reviewed, quarterly, Teaching and Learning in Nursing. STUDIES AND REPORTSAPOSITION PAPER ON EDUCATIONAL PREPARATION FOR NURSE PRACTITIONERS AND ASSISTANTS TO NURSES (1965;REAFFIRMED 2000)The American Nurses Association (ANA) Position Paper is among one of the most controversial influences on the advancement of nursing education. When the Position Paper was published in 1965, it raised issues that are still strongly debated within the nursing community. ANA’s Position The ANA put forth the view that the way nurses were educated was the single most important influence on the advancement of the nursing profession. Thus, the paper stated that nursing education should take place in institutions of higher education. It also stated that the baccalaureate degree should be the minimum educational preparation for professional nursing; while the associate degree should be the minimum educational preparation for technical nursing. The paper also recommended that

NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019assistants in health care settings should be educated through intensive, pre-service programs in vocational educational institutions, and not through on-the-job training programs. Entry into Practice Debate There are three routes that prospective graduates can take to becoming a registered nurse: the baccalaureate degree nursing program, associate degree nursing program, and hospital-based diploma program. However, the distinct benefits of choosing one of these routes over the other was not clear at the time the Position Paper was published, since all graduates took the same NCLEX examination and hospitals had very similar expectations of all new graduates. Educational preparation for entry into professional nursing practice is still an issue of debatetoday. Various nursing groups, especially hospital-based diploma programs and associate degree nursing programs were and are strongly opposed to the ANA Position Paper, since it establishes the baccalaureate degree as the minimum preparation for beginning professional nursing practice. These groups cite the fact that irrespective of the route students take to registered nursing, they take the same licensure examination and are given the same responsibilities when they begin work. Thus, there is no basis for preferring the baccalaureate degree over diploma or associate degree programs. These groups are not willing to work toward changing titling or licensure requirements for professional nursing. The issues raised by the Position Paper can be summarized as those related to titling, scope of practice, grandfather clause, and interstate endorsementof the RN license. The ANA reaffirmed its position about the education for nurses in 2000. Today, most hospital-based diploma programs have closed and the number of graduates from associate degree nursing programs has considerably increased. The concern still remains that the associate degree graduate is not continuing on to obtain the baccalaureate degree. In 2011 the IOM published a report entitled The Future of Nursing.This paper outlined the challenges with the increasing complexity of health care and the need to increase baccalaureate prepared nurse from 50% to 80% of the nursing workforce by 2020. The report also recommended increasing the number of nurses with NUR108: Transition to the Professional Nurse RoleModule 2© Excelsior College 2019a doctoral degree. New York State has taken these recommendations to the legislature and after 14 years of lobbying theBSN in 10 lawtook effect December 18, 2017 when it was signed intolawby Governor Cuomo. The newlawaffects anyone who starts a New York State Associate Degree (AD) program to become a Registered Professional Nurse (pre-licensure program) after the bill becamelaw. These nurses must obtain their baccalaureate degree within 10 years of receiving their initial RN license. It is anticipated that many other states will follow New York’s lead in advancing the BSN in 10 initiative. As a result, many associate degree programs are advocating for students to plan on continued education upon graduation and have partnered with university nursingprogramsto create seamless transitions into baccalaureate education.There now is an estimated 55-60 percent of nursing workforcewho have abaccalaureate degree. Research has shown a higher percentage of baccalaureate nurses on a unit reduces patient morbidity and mortality.COMMUNITY COLLEGE EDUCATION FOR NURSING (1959)This landmark study by Mildred Montag paved the way for the creation of associate degree nursing programs in community colleges. The report was based on a five-year study of eight nursing programs, seven community colleges, and one hospital-based programfrom across the United States. Dr. Montag used the findings to establish the need for two-year nursing education programs for technical nurses offered in community colleges. Dr. Montag’s vision was that the associate degree would be a final degree, and not a stepping stone to the baccalaureate degree. Today, the associate degree in nursing is not a final degree. However, it is the most common basic nursing program in the United Statesand can be a solid foundation to your journey in nursing education

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