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SOCIAL CONTEXT OF NURSING
- Many historical and social factors influence the current social context of the
- nursing profession
These factors were likely influential when you chose to enter the nursing profession
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SOCIAL FACTORS INFLUENTIAL TO NURSING
Gender
The image of nursing
National population trends
Technology
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Gender vs. Sex
Sex = Biological
Gender = Social
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Historical Influence on Gender
Early nursing schools only accepted females
Expected to be respectable women with lady-like qualities
Submissive
Sensitive
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1960’s: Women’s movement
Societal changes for women
Women now entered professions other than nursing and education
Nursing profession now had more competition for recruiting intelligent men and women
Improved salaries and working conditions for nurses
Nurses and nursing students became more politically involved
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GENDER – MEN IN NURSING
Traditionally men in health care were physicians and women were nurses
After women’s movement, women increasingly entered medicine and other health care professions
Men were still slow to enter nursing
Men in nursing sometimes experience role strain
Even today some patients mistakenly assume all men delivering care are physicians
Imbalance between genders in nursing is seen as a barrier to nursing’s recognition as a profession
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American Assembly for Men in Nursing (AAMN)
Founded in 1974
Membership open to men and women
- “The purpose of AAMN is to provide a framework for nurses as a group to meet,
- discuss, and influence factors which affect men as nurses.” (AAMN, 2010)
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GENDER – POPULAR CULTURE EXAMPLES
Meet the Parents
Gaylord “Greg” Focker (Ben Stiller)
Character works as an emergency department nurse
The “Male Nurse Action Figure”
“Physicians prescribe. Nurses Provide.”
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IMAGE OF NURSING
Ever hear someone say “Image is everything”?
Society’s understanding of the nursing profession is molded by images
Images of nursing are often portrayed in the media
These images often do not represent the complexity and range of modern nursing
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The "Older" Image of Nursing
The nursing cap and white uniform were formerly identifying symbols of the nurse
The traditional nurse uniform and cap began its demise in the 1970’s and today is mostly extinct
After the demise of the cap and white uniform some expressed concerns that the RN is often not distinguishable from other members of the health care team
- Many facilities now require a special uniform or identifier so patients can identify
- the RN
e.g at HUP all nurses wear navy blue
e.g. at Magee RN’s have a very large “RN” label above their name badge
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ADDRESSING THE NURSE
Physicians usually introduce themselves to clients and team members as doctor and their last name
Nurses usually introduce themselves to clients and team members as their first name only
- Some nurses fear using formal titles with patients will be harmful to establishing
- relationships
Using formal titles would show more respect for the nursing profession
“Nurse Ratched” from One Flew Over the Cuckoo’s Nest was a harmful image to nursing
Some nurses may not want to use this formal title with their clients because of the “Nurse Ratched” image
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PUBLIC OPINION OF NURSING
Despite the public’s poor understanding of what nurses actually do, nurses usually score favorably in public opinion surveys
Nurses repeatedly score amongst the highest of all professions in areas such as trust, respect, and prestige.
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WOODHULL STUDY OF NURSING AND THE MEDIA
- Purpose:
- *Survey and analyze the portrayal of health care and nursing in U.S. newspapers, magazines, and industry trade publications
- Key Findings:
- *Nurses are often invisible in the media
- *Nurses were rarely cited in the media
- *Often times a nursing source would have been more appropriate to use than the source that was used
Recommendations:
*Nursing and the media need to be more proactive in establishing dialogue
*The media should change “ask your doctor” to “ask your health care provider”
*The media should better distinguish research “doctors” from medical “doctors”
*The media should include more information by and about nurses
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JOHNSON AND JOHNSON CAMPAIGN
- *A multimillion dollar campaign by the J&J corporation to enhance the image of
- nursing
*The campaign included
Television advertisements
Written media
Scholarships
Fund raising
Research
www. Discovernursing.com
Early information indicates that this campaign is positively influencing the image of nursing
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IMAGE OF NURSING
Taking responsibility….
Nurses must reinforce positive images
Nurse must speak out against negative images
Nurses (and nursing students) must always present themselves in a professional manner to reinforce the positive image of nursing
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NATIONAL POPULATION TRENDS
Nurses have historically responded to poverty, wars, epidemics, and social movements
Nurses must be proactive in adapting to meet the needs of a changing nation and world
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AGING OF AMERICA
Because of improvements in health care, people are living longer
In 2006 there were 37.3 million people over the age of 65 in the U.S. (CDC, 2006)
People over age 75 are more likely to be widowed, female, living alone, poor, and suffering from a chronic health condition
This population thus uses a disproportionate share of health services compared to other age groups
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Nursing Profession Responds
Gerontological nursing courses incorporated into pre-licensure nursing curriculum
Gerontological specialty nursing certifications available as generalist, clinical nurse specialist, and nurse practitioner
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CULTURAL DIVERSITY
America has always been a “melting pot” of cultures, ethnicities, and races
- Vital for members of the health care systems to be familiar with demographic
- characteristics of the population served
The U.S. continues experience immigration
- Many cultural and ethnic groups now prefer to preserve their heritage rather than
- becoming “Americanized”
Projections indicate that the Anglo-American (white) culture will become a minority in the U.S. by the middle of the 21st century
Nurses must also recognize that disease prevalence varies among certain ethnic and racial groups
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Nursing Profession Responds on Cultural Diversity
Cultural education incorporated into education programs
The American Association of College of Nurses recommends that baccalaureate nursing education programs be grounded in liberal education to prepare graduates to work with culturally diverse populations (2008)
Minority groups only represent about 10.6% of the RN workforce in the U.S. (U.S. DHHS, 2005)
- The nursing profession is making efforts to recruit more minorities into the
- profession
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TECHNOLOGIC DEVELOPMENTS
*Genetics:
Drexel one of the first programs to require nursing genetics course
*Biomedical:
Increased use of high-tech equipment by nurses
This equipment is great, but always remember the client is a human and not a machine!
*Information:
Most health care facilities have moved to computerized charting and medical records
Obama administration wants healthcare to go “paperless”, creating records that can be easily transmitted between health care facilities
Creates concerns for confidentiality and privacy
- *Knowledge:
- Use of technology to generate knowledge
iPod touch, SimMan
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EARLY NURSING EDUCATION
1860: Florence Nightingale opened the first organized school of nursing
1879: The first nursing schools opened in the U.S.
These programs were hospital based and awarded graduates a diploma
These programs primarily existed to staff the hospital and not necessarily to educate the students
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EDUCATIONAL PATHWAYS TO NURSING TODAY
Three different pathways to becoming an RN exist in the U.S. today
Diploma programs
Baccalaureate degree programs
Associate degree programs
All graduates take the same NCLEX-RN to earn licensure
Having 3 pathways is confusing to both nurses and the general public
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DIPLOMA PROGRAMS
Earliest form of nursing education in the U.S.
The number of diploma programs has significantly decreased since the 1960’s
- This decrease is a result of a health care system that demands higher academic
- preparation
Modern diploma programs no longer use students as “cheap staff”
Today most diploma programs are 2 years long
- Credits earned at diploma programs often cannot be transferred to a college or
- university because hospital based programs are not part of the U.S. higher
- education system
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BACCALAUREATE DEGREE PROGRAMS (HISTORY)
First bachelors program founded in 1909 at University of Minnesota
Brown report (1948) recommended that nursing education take place in colleges and universities rather than hospitals
1965, the ANA recommended that the baccalaureate degree be the minimum education requirement to enter nursing
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BACCALAUREATE DEGREE PROGRAMS
Today programs combine nursing courses with general education courses
Programs offered by senior colleges and universities
Generally 4 years in length
Higher educational requirements for faculty
BSN graduates prepared for leadership roles and graduate programs
BSN graduates in higher demand than associate and diploma graduates
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ASSOCIATE DEGREE PROGRAMS
Began in the 1950’s post World War II to accommodate a nursing shortage
Popular because of the shorter length and lower tuition of community colleges
Because of the number of credits required, associate degree programs usually take longer than 2 years to complete
Associate degree programs are easily used as a step toward a bachelor’s degree because community colleges are accredited the the higher education system of the U.S.
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ALTERNATE EDUCATION PROGRAMS
Baccalaureate programs for Registered Nurses
RN-BSN programs
Increase the quantity of baccalaureate prepared nurses
- Accelerated
- programs for 2nd degree baccalaureate students
ACE program
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Master’s education
Traditionally require 18-24 months of full time study post BSN
Curriculum includes theory, research, clinical practice/specialty courses
Master’s degree programs require an area of specialization
¢CNS
¢NP
¢Education
¢Informatics
¢Nurse-midwifery
¢Nurse anesthesia
¢Administration
¢Many other areas of specialization…
¢Most programs award of Master of Science or a Master of Science in Nursing
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Doctoral education
Research Degrees in Nursing
¢Doctor of Nursing Science (DNSc)
¢Doctor of Philosophy in Nursing (Ph.D)
¢Doctor of Education in Nursing (Ed.D)
Practice Doctorate in Nursing (DNP)
¢Doctor of Nursing Practice
- ¢AACN recommends that the education for APRN’s
- change from the MSN to the DNP
¢Still controversy about this recommendation
Hybrid Doctorate in Nursing (Part research & part practice)
¢The one and only DrNP @ Drexel
Non-nursing doctorates
- ¢Some nurses with MSN’s choose to earn a doctorate in a
- discipline other than nursing
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CERTIFICATION PROGRAMS
¢Certification validates knowledge and competency beyond licensure
¢Certification awarded by a certifying body
¢Requirements for certification determined by the certifying body
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CONTINUING EDUCATION
¢Continuing Education (CE) is required by most states to renew licensure and required by most certifying bodies to earn recertification
¢The American Nurses Credentialing Center (ANCC) determines the standards for CE.
¢Usually 1 hour of education = 1 CE
¢Be certain to know the CE requirements of your state and/or certifying body
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