Nurs310 Final Exam

  1. Why is is important to define nursing?
    • To I.D. the purposes and functions of nursing
    • To differentiate nursing from other health occupations (this is important because health care facilities are concerned with cost. They try to replace nurses with unqualified people-unlicensed)
    • Needed in legislation (our government writes laws. The law that governs the practice of nursing-Nurse Practice Act)
  2. observable circumstance or event
  3. What is a concept?
    • the building blocks of theory
    • abstract ideas or mental images of phenomena
    • expressed in words or phrases
  4. Concepts can be...?
    • 1. readily observed or concrete (thermometer, rash, lesion)
    • 2. indirectly observable (pain, anxiety)
    • 3. nonoservable (powerless, stress, adaptation)
  5. What is a metaparadigm?
    • often used to describe the interrelationship between concepts that represent and are common to a profession
    • a phenomenon of interest
    • really BIG concepts, or words, with many different meanings or ways in which to use the word
  6. What are the 4 concepts of nursing theory (metaparadigm)?
    • 1. person or client-recipient of care (ind., families, groups, or communities)
    • 2. environment (both external and internal that affects the client)
    • 3. health (degree of wellness or well-being)
    • 4. nursing (attributes, ch., and actions of the nurse providing care on behalf or in conjunction with the client)
  7. What is a philosophy?
    • study of truths and priniciples of being, knowledge, or conduct
    • this looks at the nature of things and beings when someone starts to wonder about something
  8. What is a conceptual framework?
    • a group of related concepts
    • abstract in nature
    • often the foundation from which theories are derived
    • provide guidelines for data collection but cannot be used to predict events or outcomes
  9. What is a conceptual framework?
    a picture or diagram of a conceptial framework
  10. What is a theory?
    • a statement or set of statements that aims to describe, explain, predict, or control a phenomenon
    • defines concepts and specifically outlines relationships between those concepts
    • less abstract than conceptual frameworks and are more prescriptive-they propose an explicit outcome that is testable in practice and research
  11. What are the 3 elements of a theory?
    • 1. construct
    • 2. proposition statement
    • 3. hypothesis
  12. a concept invented for a special purpose
  13. specifies the relationship between the constructs (concepts)
    proposition statement
  14. a statement that tries to predict whether there is or is not a relationship between the constructs and the proposition statement
  15. What is role socialization?
    the process by which people learn to become members of groups and society, learn the social rules and define relationships into which they will enter
  16. Socialization involves...?
    • behavior
    • feeling
    • seeing the world
    • it is a lifelong process
  17. Professional Socialization
    • is a learned process
    • social control is intrinsic-capacity of a social group to regulate itself through conformity and adherence to group norms, norms become internalized standards
  18. Formal vs. Informal Professional Socilization
    • formal-taught in school
    • informal-observed
  19. behaviors oriented to the expectations of others
    • roles
    • we all have numerous roles
  20. Ideal role
    socially prescribed and agreed upon rights and responsibilities associated with the role
  21. Role expectations
    norms specific to the position
  22. Perceived role
    how a person believes they should behave in a role
  23. Performed role
    what the person actually does
  24. What are boundaries for nursing roles?
    • concepts: person, environment, health, nursing
    • nursing process
    • standards of nursing practice
    • nurse practice act & licensure laws
    • national and international code of ethics
  25. Caregiver Role
    • direct hands-on care in a variety of settings
    • assist clients-preserve client dignity
    • physical, psychological, developmental and spiritual realms
    • influenced by holistic approach
    • essential attribute of the expert nurse
  26. Teacher/Educator Role
    • teaches patients, families, the community, other health care members, students
    • determine learning needs, motivation and readiness of learner
  27. Counselor role
    • help client recognize and cope with stressful situations
    • one on one
    • groups (self-help)
  28. Manager/Leader role
    management of resources
  29. Characteristics of a Manager
    • officially appointed, offical power
    • carry out predetermines policies, procedures, and rules
    • attempt to maintain an orderly environment
    • relate to people according to rules
    • perform role as long as the appointment is held
    • rewarded by achieving the organizations mission and goals
    • may or may not be good leaders
  30. Characteristics of a Leader
    • may or may not have an official position
    • have power if followers allow it
    • influence followers to set goals
    • risktakers
    • intuitively and empathetically relate to people
    • feel rewarded by personal accomplishments
    • may or may not be successful managers
  31. Management Styles
    • traditional: focus on hierarchy and division of roles
    • behavorist: interested in group dynamics
    • systems: focuses on the organization as a series of units or departments
    • continguency: blends all 3 styles
  32. Leadership Styles
    • charismatic: "people person"
    • autocratic: authoritarian
    • democratic: involves followers in decision making
    • laissez-faire: passive and uninvolved
  33. Advocate role
    • promotes what is best for the client
    • sees that the clients needs are met
    • protects client's rights
  34. Change agent role
    • works to initiate and facilitate change
    • requisite skills: tact, energy, creativity, interpersonal skills
  35. entrepreneur/consultant role
    • gives advice and expertise to others
    • may own business
  36. researcher role
    • investigates whether current nursing actions achieve their expected outcomes
    • investigates what options of care are available and how to best provide nursing care
  37. collaborator role
    • works with other health care professional to ensure that everyone agrres on the same patient outcome
    • collaborates with patients and their families
  38. case manager role
    • critical pathways and variance analysis
    • came about d/t: change in reimbursement programs, the need to manage clinical outcomes to limit costs
  39. What is the difference between role stress and strain?
    • stress-occurs when obligations are unrealistic or conflicting
    • strain-emotional reaction
  40. Role ambiguity
    unclear role expectations
  41. Role conflict
    competing role expectations
  42. role incongruity
    values incompatible with role expectations
  43. Overload vs. Underload
    • overload-too much expected
    • underload-minimal expectations
  44. Professional Accountabilities include...?
    • quality improvement
    • research
    • education
    • management
  45. ANA standards of professional performance
    • quality of care
    • performance appraisal
    • education
    • collegiality
    • ethics
    • collaboration
    • research
    • resource utilization
  46. Role Socialization
    • learn necessary cognitive and motor skills
    • adopt values of the profession
    • gain identity with the profession
    • balance the professional role with other roles
  47. Models that define the process of role socialization
    • Davis Model: student socialization
    • Hinshaw's Model: 3-phrase general model of socialization
    • Benner's stage of proficiency: novices, advanced beginner, competent practitioner, proficient practitioner, expert practitioner
  48. Dalton, Thompson & Price Career Stages
    • stage I: apprentice, subordinate
    • stage II: colleague
    • stage III: informal mentor, role model
    • stage IV: sponser
  49. Kramer Resocilization Model
    • stage 1: skill and routine mastery
    • stage 2: social integration
    • stage 3: moral outrage
    • stage 4: conflict resolution
  50. Critical values of professional nursing
    • strong commitment to the service that nursing provides for the public
    • belief in dignity & worth of each person
    • a commitment to education
    • autonomy
  51. Cohen Model
    4 stages: unilateral dependence, negativity/independence, dependence/mutuality, interdependece
  52. Davis Model
    6 stages: innocence, recognition of incongruity, "psyching out", increasing role stimulation, provisional internalization, stable internalization
  53. Benner's Stage of Nursing Proficiency
    • novice: little background, relies on rules
    • advanced beginner: marginally competent skills, difficulty establishing priorities
    • competent practitioner: feels competent, organized, sets goals, several tasks
    • proficient practitioner: holistics, sets priorities, long term goals
    • expert practitioner: autonomatic
  54. What is a role?
    a set of expectations associated with a position in society
  55. Role transition
    • the process by which a person assumes or develops a new role
    • move to a new set of: responsibilites, norms, values
  56. Nurses' 4 responsibilities
    • 1. help the ill regain health
    • 2. help the healthy maintain their health
    • 3. help those who cannot be cured to realize their potential
    • 4. help the dying live as fully as possible until their deaths
  57. Stratgies for relieving role stress
    • priority setting and time management
    • rewriting job descriptions for clarity
  58. Advanced practice nursing
    • health care reform
    • societal changes
    • managed care
    • demongraphical population changes
  59. What did early advanced practice nursing degrees focus on?
    the functional roles of nurse administrators and educators
  60. Hildegard Peplau
    1954-Rutgers University developed to prepare APN in psyc/mental health
  61. When was the master's degree level proiferated?
    in the 1940s and 50s
  62. When was the master's degree to prepare nurse specialists established?
    1952-NLN agreed baccalaureate education program to prepare nurse generalists
  63. Clinical Nurse Specialist (CNS)
    • improve client care
    • function as expert in practice setting
    • specalized area of nursing
    • resource to novice nurses
    • education and development
    • consultant for physicians
    • active participant in research
  64. First NP Program
    • health care personnel shortage as a result of Vietnam War
    • developed in 1965 by Dr. Loretta Fod and Dr. Henry Silver
    • University of Colorado
    • focused on the care of children
    • w/in 9 years-65 NP programs in pediatrics, additional developed in women health and family health
  65. Master's Degree in Nursing
    • according to AACN-requires preparation at graduate level
    • CNS
    • nurse-anestetist
    • nurse-midewife
    • NP
    • specialized roles: management, education, administration and informatics
  66. Doctoral Programs
    • research
    • education
    • practice
    • PhD
    • DNS
    • ND
    • emergining DNP program
  67. Nurse Practitioner
    • wide scope of practice
    • more autonomous role
    • acute-care NP, adult NP, family NP, gerontoloical NP, pediatric NP
  68. CRNA
    • one of the earliest APN roles in the US
    • American Association of Nurse Anesthetics
  69. The health care system is in the midst of what kind of change?
    • economically-driven change
    • health care organizations must change to survive
  70. Skills needed by a nurse to initiate change?
    • integrative thinking
    • skill in applying change theory
    • problem-solving aptitude
  71. the process of making something different from what it was, leads to alteration in individual or institutional patterns of behavior
  72. Spontaneous change
    reactive or unplanned change because it is not fully anticipated, it cannot be avoided, and there is little or no time to plan response stratgies
  73. Developmental Change
    physio-psychologic changes that occur during an individual's life cycle or to the growth of an organization as it become more complex
  74. Planned change
    an intended, purposeful attempt by an individual, group, organization, or larger social system to influence the status quo of itself, another organism, or a situation
  75. What are the 3 change approaches?
    • power-coercive
    • empirical-rational
    • normative-reductive
  76. Power-coercive change approach
    • power is with 1 or more persons of influence
    • command and control approach in which positions of authority enforce the change
    • can cause resistance
  77. Empirical-rational Change approach
    • people are rational and they will change if it is in their self-interest
    • most effective when there is little resistance to the change and is perceived as reasonable
  78. Normative-reductive change approach
    • human motivations depends on the sociocultural norms and individuals commitment to these norms
    • change occurs if the people invovled develop new attitudes and values by acquiring new information
  79. Change Agent
    one who works to bring about change
  80. Responsibilities of change agents
    • develop a rational for change
    • write objectives in measurable terms that xan be accurately evaluated
    • develop a projected timetable for each stage-remember to be flexible
    • develop a system of information flow
    • monitor progress
    • plan for long-range evaluation
  81. Resistance to change
    behavior intended to maintain the status quo; prevent change
  82. Restraining forces to change
    • fear something of personal value will be lost
    • misunderstanding of change and implications
    • low tolerance for change r/t intellectual or emotional insecurity
    • perception that change will not achieve goals
    • failure to see big picture
    • lack of time/energy
  83. motivating forces to change
    • perception that change is challenging
    • economic gain
    • perception that change will improve the situation
    • visualization of the future impact of change
    • potential for self-growth, recognition, acheivement, improved relationships
  84. Kurt Lewin's Change Theory
    • 1948
    • believed in I.D. driving forced which faclitate change and restraining forces with impede change
    • 3 step process: unfreezing, moving, refreezing stages
Card Set
Nurs310 Final Exam
Nurs310 Final Exam