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by: Miracle Borer
Miracle Borer

GPA 3.52

P. Hickey

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P. Hickey
Class Notes
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This 109 page Class Notes was uploaded by Miracle Borer on Monday October 26, 2015. The Class Notes belongs to NURS 212 at University of South Carolina - Columbia taught by P. Hickey in Fall. Since its upload, it has received 10 views. For similar materials see /class/229560/nurs-212-university-of-south-carolina-columbia in Nursing and Health Sciences at University of South Carolina - Columbia.

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Date Created: 10/26/15
Chapter 3 The Professionalization of Nursing Patrick Hickey RNB SNMSMSNDrPHCNOR lProfession Professional Professionalism I Professional I I Athletes to Pharmacists I Q Value of term quot h I LicenseProfessional E 8 Profession Doctors wirlzout boundaries Occupational group with a set of attitudes or behaviors or both I Professionalism a focused accountable con dent competent motivation toward a particular goal with respect for hierarchy and humanity less the emotionquot Interpretations of Profession I Various Criteria 1 Flexner a Hall a BiXler and BiXler 1 Kelly I Evolution from occupation emphasizing tasks to specialized educational and skill development Flexnor Report 1910 I Criteria for a profession 1 Intellectual Body of knowledge evidenced based practice Practical as well as theoretical CI CI 1 Taught through highly specialized professional education a Strong internal organization of members CI Practitioners motivated by desire to help others Hall 1968 I Five indicators of attitudes towards professionalism 1 Use of a professional organization as a primary point of reference Itx Belief in the value of public service 3 Belief in selfregulation 4 Commitment to a profession that goes beyond economic incentives 5 A sense of autonomy in practice BiXler amp BiXler 1959 I Seven criteria of nursing as a profession 1 Utilizes a wellde ned and wellorganized body of specialized knowledge which is on the intellectual level of higher learning 2 Constantly enlarges body of knowledge and improves techniques of education and service 3 Members educated in institute of higher education 4 Knowledge applied in practical services for human and social welfare 5 Functions autonomously to formulate professional policy and control professional activity BiXler amp BiXler 1959 I Seven criteria of nursing as a profession 6 Attracts individuals With intellectual and personal qualities that put service over personal gain and recognize their chosen occupation as life s work 7 Provides freedom of action professional growth and economic security Now if wu have any problem day w nlubt rm mm here can answer your text messages z mail fan and call all quot Kelly 1981 I Eight characteristics of a profession 1 Services vital to humanity and welfare of society 2 Special body of knowledge continually updated through research 3 Services include intellectual activities individual responsibility and accountability 4 Practitioners are educated in institutions of higher learning 5 Practitioners are relatively independent and control own policies and activities autonomy Kelly 1981 I Eight characteristics of a profession 6 Practitioners are motivated by service and consider their work an important component in their lives 7 There is a code of ethics to guide the decisions and conduct of practitioners 8 There is an organization association to support and encourage high standards of practice Miller s Wheel of Professionalism in Nursing 1984 Center is foundation of nursing education in an institution of higher learning Competence and continuing education Adherence to code of ethics Participation in professional organization Publication and communication Orientation toward community services Theory developmentuseevaluation Research developmentuseevaluation Self regulation and autonomy Nursing s Social Policy Statement De nition of Nursing Nursing is the protection promotion and optimization of health and abilities prevention of illness and injury the alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals families communities and populations Nursing s Social Policy Statement Essential Features of Nursing Provision of a caring relationship that facilitates health and healing Attention to the range of human experiences and responses to health and illness within the physical and social environments Integration of objective data with knowledge gained from an appreciation of the patient or group s subjective experience Application of scienti c knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking Advancement of professional nursing knowledge through scholarly inquiry In uence on social and public policy to promote social justice Code of Ethics 1 The nurse in all professional relationships practices with compassion and respect for the inherent dignity worth and uniqueness of every individual unrestricted by considerations of social or economic status personal attributes or the nature of health problems 2 The nurse39s primary commitment is to the patient Whether an individual family group or community 3 The nurse promotes advocates for and strives to protect the health safety and rights of the patient Code of Ethics 4 The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse39s obligation to provide optimum patient care 5 The nurse owes the same duties to self as to others including the responsibility to preserve integrity and safety to maintain competence and to continue personal and professional growth 6 The nurse participates in establishing maintaining and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action Code of Ethics 7 The nurse participates in the advancement of the profession through contributions to practice education administration and knowledge development 8 The nurse collaborates with other health professionals and the public in promoting community national and international efforts to meet health needs 9 The profession of nursing as represented by associations and their members is responsible for articulating nursing values for maintaining the integrity of the profession and its practice and for shaping social policy ANA 2004 Social Policy Statement Standard 10 Collegiality The registered nurse interacts with and contributes to the professional development of peers and colleagues Collaboration cooperation and recognition of interdependence Sharing supporting assisting and counseling Mentors ReturnReminisceReconnecl 39 1 i J r 39 Role models Chapter 4 Legal Aspects of Nursing Patrick Hickey RNB SNMSMSNDrPHCNOR Nurses Nurse Managers and health care facilities are all subject to being found legally liable that is legally responsible for harm caused to others by civil wrongs Common Legal Terms NF ACCIDENT Unforeseen and unintended event or occurrence ALLEGATION An unproved charge or assertion ASSAULT A threat to harm another person physically or an unsuccessful attempt to do so BATTERY An offensive intentional unconsentedtotouching of a person COMPETENCY Determination of the ability to give a level of care according to a predetermined set of standards or law COMPLAINT A document that sets forth the act or reason for a lawsuit identifies the plaintiffs and defendants in the suit CONSENT A voluntary act by which one person agrees to allow someone else to do something CONTRIBUTORY NEGLIGENCE The act or failure to act by a person that contributes to the injury of another CORPORATE NEGLIGENCE The failure of a hospital or other health care facility to fulfill its responsibilities to exercise safeguards that would protect against injuries to patients or staff Common Legal Terms DEFENDANT The person or entity being sue DEPOSITION Pretrial statements of a witness under oath taken in questionandanswer format as if it were in court ETHICS Standards on conduct or moral views about what is right or wrong good or bad LIABILITY The obligation of one party to another LICENSURE Permission given by a state government to practice an activity such as nursing PLAINTIFF The person who brings a lawsuit against another who is called the defendant SCOPE OF PRACTICE A range of activities actions or requirements set by law or recognized by a profession as the domain of practice STANDARD OF CARE The quotnormquot for practice Laws Law is de ned as rules of conduct that are authored and enforced by t i iiiiiEEgii iii W UNAU DlSPLAViNG DiSTlNGUlSHING formal authorities and people 6 DSORHLylEIECrfLELYFLATEs PERSONS WILL as D AWAY AT OWNER S EXPENSE I igVViiEEDVEHICLES MAV BE RECLAIMED BY TELEPHONING SPD 7307100 CVC SECHON NO 22652 Common law is decisional or Nomemums PAR39KING judgemade law AT WW ATVEHIUI OWNEil39S waist UK 10207 VC 12658 51125003 Statutory laws are established through formal legislative process iriiii alzfoiri xii im WED WAY OWNER S EXPENSE AEA TOWING 7513000 SPD 7307100 CVC SECTlON N0 ZZGSBA Administrative laws relate to authority of governmental agencies to create laws that meet the intent of a statute iaw affects every aspect of American life Including parking lots Note the citations to statutes on the sign Laws I Civil Law recognizes and enforces the rights of individuals such as disputes over legal rights or duties of individuals in relation to one another ie child custody dispute I Criminal Law involves public concerns regarding an individual s unlawful behavior that threatens society ie murder or possession of illegal substances Court Actions Criminal Civil z Area of the law dealing zo Concerned with the legal with criminal statues rights and duties of z Murder private person z Theft oz Malpractice a Drug Violations 339 Negligence z Feonies oz Informed consent 9 Misdemeanors 4 Plaintiff oz Defendant Civil Law I Concerns nurses more than Criminal Law I Involves El Torts u Negligence u Malpractice Torts A civil wrong in contrast to a criminal act involving injury or damage to another party for which the victim can sue The most common source of legal liability for nurses and nurse managers W V w I aa SuaFEuiiita O 0 PM 012m mes CREQNLM J hzFJ Torts Intentional I Done deliberately by a defendant 1 Assault 2 Battery 3 False Imprisonment 4 Intentional ln iction of emotional distress Unintentional Inadvertent unreasonable act that causes harm 1 Negligence 2 Malpractice Neg gence I Failure to act as a reasonable prudent person in the protection care of another I Failure to meet the standard of care I Example Not turning a patient every 2 hours and consequently the patient develops a Stage IV pressure ulcer Negligence amp Malpractice I Most common legal cases involve El DUDE Failure to seek expert help or supervision with a patient when necessary Issue of treatment standards Issues of foreseeability Issues of Breach of Con dentiality Sentinel events Malpractice 1 Greatest legal concern of health care practitioners a Torts are civil wrongs issue between individuals ie the nurse and the patient resulting in physical emotional or economic harm and may be intentional or unintentional Negligence is the failure to act as a reasonably prudent person would have acted in speci c circumstances Malpractice is negligence applied to the acts of a professional I Unintentional tort I Commission Doing what should NOT be done I Omission NOT doing what SHOULD be done I Standard of care Malpractice Professional Neqliqence Duty exists whenever a hospital or health care provider undertakes care or treatment of a patient Breach of duty the provider failed to it i f conform to the relevant standard of care Damages A sum of money awarded by a court for an injury caused by the act of another Proximate cause The act or happeningthatIsdirect39 39 lyresponsrb39 le for an injury Breach of Confidentiality Overheard conversations Poorly trained support staff Breach in mail FAX Maintaining space privacy Phone breach Poor guardianship of records Research publications Issues of Negligence Failure to follow standards of care Failure to perform a complete admission assessment or design a plan of care Failure to adhere to standardized protocols or institutional policies and procedures for example using an improper injection site Failure to follow a physician s verbal or written order Who can be held accountable Medical Doctors Independent Practitioners NURSES Supervisors Institutions Students What type of nurses get sued Most common I Acute Care Nurses I MedicalSurgical Nurses Labor and Delivery Nurses Emergency Room Nurses Student Nurses I Student nurses can be held liable for their actions and can be sued I A student nurse is held to the same standard of care as a registered nurse when performing RN duties Delegation a Instructing another person to act for you a The Professional Nurse remains legally liable I Must determine that person is competent I Always guided by the patient s right to safe effective care CI ANA Code of Ethics states The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse s obligation to provide optimum patient care Assault and Battery 1 Assault is a threat or attempt of bodily contact With another Without their consent 1 Battery is the assault carried out a Harm does not necessarily have to occur Informed Consent a Authorization for any care treatment or procedure done for that person I Given voluntarily I Must be competent and have understanding necessary to make choice I Adequate information and facts must be given including risks a Role of nurse is to collaborate with primary provider by Witnessing a patient s signing of informed consent DUDE Con dentiality Con dentiality is the protection of private information gathered about a patient during the provision of health care services ANA Code of Ethics states the nurse has a duty to maintain con dentiality of all patient information Legal and ethical consideration Right to privacy May be ordered by court to breach code Duty to report ie child abuse communicable diseases etc Health Insurance Portability and Accountability Act of 1996 HIPAA Federal privacy standard governing protection of patients medical records Access to Medical Records Patients generally should be able to see and obtain copies of their medical records within 30 days and request corrections if they identify errors and mistakes Providers can charge for this service Notice of Privacy Practices Covered health plans doctors and other health care providers must provide a notice to their patients how they may use personal medical information and their rights under the new privacy regulation Patients generally will be asked to sign initial or otherwise acknowledge that they received this notice Limits on Use of Personal Medical Information The Privacy Rule sets limits on how health plans and covered providers may use individually identi able health information State Licensure confers autonomy on nurses to the limit of legal standards of practice Autonomy involves accountability as well as authority for one s decisions and actions As professional autonomy and responsibility increase so does the level of accountability and liability To the extent that nurses are subject to malpractice lawsuits and this is why we carry malpractice insurance Nurse Practice Act f u The legal status of nursing derives from the Nurse Practice Act of each state administered by state boards of nursing The Practice Act defines the practice of nursing and the standards to which nurses will be held accountable and along with accompanying administrative rules and regulations become principal sources of law that govern a nurse39s practice UUUUU State Nurse Practice Acts Established through legislative process Statutory Law De nes practice Sets educational quali cations and other requirements Determines legal titles and abbreviations Provides for disciplinary action ANA Model Practice Act guides state nurses association seeking revisions in nurse practice acts and includes Differentiation between advanced generalist nursing practice Clari cation of nurses responsibility for delegation Recognition of BSN as minimum education for the professional nurse Evolving Legal Issues Role changes in advanced practice expanding scope of practice Prescriptive authority State Board of Nurses as regulatory authority Physician collaboration Parameters for controlled substances Supervision of unlicensed assistive personnel UAP Payment mechanisms reimbursement from managed care plans Patient SelfDetermination Act 1991 I Advanced directives preferences regarding medical intervention should the patient become incapacitated I Acute carelongterm facilities comply with PSDA by Providing written information to patients about their rights Ensure institutional compliance Provide education for staff Document in medical record evidence of advanced directive An Epidemic of Medical Errors To Err is Human 4400098000 people die each year in hospitals as a result of medical errors Untold thousands suffer pain and disability as a result of medical errors Cost 17 to 29 Billion lost wages productivity disability expenses additional healthcare costs Loss of trust in the healthcare delivery system Health care professionals experience a loss of morale and frustration at not providing best care possible Risk Management Program I An organizationWide program to identify risks control occurrences prevent damage and control legal liability it is a process whereby risks to the institution are evaluated and controlled Required by J CAHO General Roles of Risk Managers I Coordinates administration of insurance coverage including managing claims I Analyzing risk management database including looking for trends in incident reports I Conducting ongoing inservice education for V monitoring ongoing compliance with local state and federal regulations Solutions Maintain open honest respectful relationships and communication with patients family members and colleagues Document document document If it was not documented it was not done Meet the standard of care be a knowledgeable and safe practitioner policiesprocedures equipment use current practice Liability insurance protect assets and income as mistakes do occur Solutions Maintain competence in your specialty area of practice Know legal principles and incorporate them into everyday practice Practice within the bounds of professional licensure licensure is a privilege not a right Know your strengths and weaknesses Know the J CAHO Patient Safety Goals Know who your risk manager is and how to contact him or her Chapter 1 Nursing Today Patrick Hickey RNB SNMSMSNDrPHCNOR Nursing in Today s Health Care Delivery System I Average Registered Nurse 2004 survey a Largest number of health care professionals a 832 actively working in nursing 583 working full time a More than 29 million hold licenses as RN s NURS 212 7 Evolution of Nursing Science quotWalk a Day in My Shoesquot NURS 212 7 Evolution of Nursing Science Number of Basic RN Programs by Program Type 1989 to 1995 and 2003 to 2009 1200 1000 800 600 400 200 1939 1990 1991 1992 1993 1994 1995 2003 2004 2005 2006 2007 2003 2009 n llBaccalaureate QDiploma lAssociate Degree 100 80 60 40 20 Percentage of Basic RN Programs by Program Type 1989 to 1995 and 2003 to 2009 lBaccalaureate QDiploma lAssociate Degree Gender Most RN s are women Males comprise 57 19962000 54 Males are growing at a faster rate than total RN population Between 20002004 there was an increase of 18398 males Currently there are larger groups of men in educational programs NURS 212 7 Evolution of Nursing Science Percentage of Students Enrolled in Nursing Programs by Sex and Program Type 200809 100 30 60 40 20 LPNILVN 4M BSN DIP IFemale ADN BSRN IMale Master39s DOC Race and Ethnicity As of 2004 884 White NonHispanic 46 AfricanAmerican 33 AsianPaci c Islander 18 Hispanic 04 Native AmericanAlaskan Native Between 20002004 there was a decrease in the percentage of nurses in the nonwhite categories AACN 2005 2006 24 undergrads were from racialethnic minorities NURS 212 7 Evolution of Nursing Science Age The RN population is getting older graying of the workforce Average Age 1980 403 2000 452 2004 468 The of RN s older than 54 years 1980 172 2000 243 2004 255 The of RN s younger than 30 years x 2000 91 2004 81 NURS 212 7 Evolution of Nursing Science Percentage of Students Enrolled in Nursing Programs by Age and Program Type 200809 30 LPNILVN 70 60 50 40 30 20 10 0 Mml I M I 25 and under DIP ADN 26 to 30 BSRN Q31 to 40 Master s I41 and over DOC 705 married 92 never married Marital Status As of 2004 18 1 widowed divorced separated Nurses with children 52 have children at home 28 have kids less than 6 years of age RN s that were members of two parent family with children younger than 6 years were more likely to work parttime NURS 212 7 Evolution of Nursing Science Foreign Educated Nurses As of 2004 35 of nurses completed their basic nursing education outside the US 502 Philippines 202 Canada 84 United Kingdom Workforce setting 255 California Florida 96 New York 93 Texas 67 NURS 212 7 Evolution of Nursing Science DDDDDDDDD Employment Opportunities Hospitals 1 Research Private practice D company CEOS Public and private clinics D IndUStTy Military service 1 Schools Home Health a Camps UniVefSitieS a Nursing Homes Education a Medical Of ces Entrepreneur D Churches Forensics a Pharmaceutlcal NURS 212 7 Evolution of Nursing Science I I Hospital Based Nursing Historically nursing care originated in homes and the community movement into hospitals Within past 150 years Patient s Children WomenNewborns Adults Elderly Health conditions Medical Surgical Trauma Cancer NURS 212 7 Evolution of Nursing Science I I Hospital Based Nursing Work settings Within the hospital Medical Surgical Operating Room Critical Care ICUCCUMTUSTUNICU Emergency Room 7 LampD g rquot Roles Directors Educators Managers Staff NURS 212 7 Evolution of Nursing Science Hospital Based Nursing Certi cations Pediatric CPN Operating Room CNOR Critical Care CCRN Emergency Room CEN MaternalChild RNC NURS 212 7 Evolution of Nursing Science Hospital Based Nursing Credentials RN Associate RN Diploma BSN MSN Work Experience MedicalSurgical y LampD A 39 Pediatrics Progress to critical care NURS 212 7 Evolution of Nursing Science Hospital Based Nursing Nurse Manager In charge of all activities Hiring and ring BSN degree or higher Business and financial skills budgets Clinical Ladder Various levels Experience Certi cation Education NURS 212 7 Evolution of Nursing Science Hospital Based Nursing I Clinical Specialist Master s degree Direct care to patients with dif cult or complex problems Resource person to other nurses NURS 212 7 Evolution of Nursing Science Hospital Based Nursing Staf ng 73pm 311 117 77pm 7pm7am 7aml 1 30pm Baylor Plans 12 hr shifts X 3 4 days off Flexibility to meet personal needs NURS 212 7 Evolution of Nursing Science x x I Community Health Nursing Lillian Wald established the Henry Street Settlement in New York City Focus of community health is to improve the health of the community through planningimplementation of health programs Settings Ambulatory clinics Health Departments Hospice GovernmentalPrivate agencies Schools Retirement communities Home health care NURS 212 7 Evolution of Nursing Science Nurse Entrepreneurs Autonomy independence Own and operate your own business Selfemployed Consultants Roles Legal Nurse Consultant CRNA Informatics NURS 212 7 Evolution of Nursing Science Nurse Entrepreneur An entrepreneur is someone who establishes and runs his or her own business A nurse entrepreneur starts a business by combining nursing experienceknowledge with business knowledge Traditional roles a Temporary staffing agencies nursing educator or consultant nurse attorney nurse case manager nurse death investigator nurse midwife nurse paralegal psychiatric nurse legal nurse consulting and sexual assault nurse NURS 212 7 Evolution of Nursing Science Nurse Entrepreneur Getting started 1 Assess your own skills 1 Find an area of health care where there is a need a Research the need a Borrow startup money 1 Build client base NURS 212 Evolution of Nursing Science Nurse Entrepreneur I Legal nurse consultant 1 A licensed RN who critically evaluates and analyzes healthcare issues in medically related lawsuits a Work settings attorneys of ces independent practices hospital setting as risk management health insurance companies NURS 212 Evolution of Nursing Science Nurse Entrepreneur Legal nurse consultant El El UUUUUU Drafts legal documents under the supervision of an attorney Interview Witnesses Provides education to attorneys and other parties involved in healthcare issues and standards Researches nursing literature standards and guidelines Reviews analyzes and summarizes medical records Identi es and confers with expert Witnesses Assesses causation and issues of damages relating to the case Develops case strategy with the legal team Provides support during the legal proceedings NURS 212 7 Evolution of Nursing Science Informatics Nursing Combines nursing science information science and computer science to manage patient information Adapts and modi es usual practices ie nurses spend 50 of time gathering coordinating and documenting information Affects all nurses need to be prepared Issues Lack of consultation with end users System downtime Education of staff Security of systems NURS 212 7 Evolution of Nursing Science Of ce Based Nursing Duties Health assessment Drawing blood Administering medications Health teaching Supervising Scheduling Hospital rounds NURS 212 7 Evolution of Nursing Science Occupational Health Nursing Work Settings Factories Industry Large companies Duties Health assessment Health education Emergency treatment Regulatory Agencies OSHA Education AAOHN recommends BSN NURS 212 7 Evolution of Nursing Science Military Nursing Broader responsibility and scope of practice due to the demands of nursing in the eld BSN is required for active duty nurses Nurses are encouraged to seek higher education Travel and change are constants Military Branches Army Navy Airforce NURS 212 7 Evolution of Nursing Science School Nursing Federally recommended ratio of 1750 Most school districts require BSN Responsibilities Growth and development Counseling Immunizations Hygiene and nutrition Vision and hearing Accidental injuries Medical problems Chronicallv ill NURS 212 7 Evolution of Nursing Science Hospice Nursing Holistic philosophy of care promote quality of life End of life care is largely the responsibility of nurses Historically nursing programs have not adequately prepared students for dealing with death and dying Responsibilities Administration of medications Preparing patient and family for end of life Intervene between MD and family Settings Inpatient hospitals nursing homes Outpatient homes NURS 212 7 Evolution of Nursing Science Case Management a Most recently developed system a Attempts to improve costeffectiveness While providing quality care 1 Manage length of stay a Case manager serves as assessor planner facilitator and patient advocate Do not provide direct care but actively collaborate with primary nurses assigned to patients and MD s NURS 212 7 Evolution of Nursing Science Case Management I A collaborative process of assessment planning facilitation and advocacy of services to meet an individual s health needs through communication and available resources to promote quality costeffective outcomes NURS 212 7 Evolution of Nursing Science Case Management I Nurse case managers act as advocates for clients and their families by coordinating care and linking the client with the physician other members of the healthcare team resources and the payer l The goal of the nurse case manager is to help the client obtain quality costeffective care While decreasing the duplication and fragmentation of care NURS 212 7 Evolution of Nursing Science Case Management I Factors that indicate the need for a nurse case manager include a A complex treatment plan that requires coordination a plan that is unclear a An injury or illness that may permanently prevent the client from returning to a previous level of health a A preeXisting medical condition that may complicate or prolong recovery El A need for assistance in accessing healthcare resources 1 Environmental stressors that may interfere with recovery NURS 212 7 Evolution of Nursing Science Telehealth Utilization of current technology Computers Teleconferences Real time transmission of data Issues Adaptation of usual procedures charting Legal and regulatory HIPPA NURS 212 7 Evolution of Nursing Science Faith Community Nursing Emphasis on spirituality and it s relation to wellness and healing Formerly called Parish Nursing Independent practice BSN preferred Roles Health educator Counselor Intermediary between MD and patient Patient advocate NURS 212 7 Evolution of Nursing Science Forensic Nursing u Forensic nursing is a eld of health care that unites nursing H law enforcement and the forensic sciences u The generic term forensic means anything belonging to or pertaining to the law NURS 212 Evolution of Nursing Science Forensic Nursing l Forensic nurses provide a continuum of care to victims and their families beginning in the emergency room or at the crime scene and when necessary participating in the criminal investigation and the courts of law I In 1992 the term forensic nursing was coined to cover many of the activities that ER nurses had done for years NURS 212 7 Evolution of Nursing Science Forensic Nursing I Sexual assault nurse examiner SANE El Most SANEs work in a hospital or emergency room with other members of a sexual assault response team Functions include I Offering compassionate care I Preserving the victim s dignity and reducing psychological trauma I Assessing the victim and collecting evidence I Testifying in court NURS 212 7 Evolution of Nursing Science Forensic Nursing I SANE requirements 1 Must be an RN 1 Must complete an adultadolescent SANE education program 40 hours classroom 3 college credit hours with clinical supervision until shown to be competent 1 Must pass the certi cation examination NURS 212 7 Evolution of Nursing Science Forensic Nursing I Medical examiner nurse death investigator 1 Other titles I Forensic nurse investigator I Death investigator I Deputy coroner a Role is to advocate for the deceased NURS 212 Evolution of Nursing Science Forensic Nursing I Medical examiner nurse death investigator Responds to scene of death or accident Works in collaboration with law enforcement Examines the body Pronounces death Takes tissue blood samples pictures evidence Recognizes and integrate other evidence such as patterns of 1njury I Keeps records I Arranges transport of body to morgue or coroner s office I Works with the forensic pathologist NURS 212 7 Evolution of Nursing Science Forensic Nursing I Medical examiner nurse death investigator education 1 Must be an RN 1 Each region of the country speci es the requirements in its own jurisdictions 1 Currently no required credentialing or education standards for nurse death investigators in the United States NURS 212 7 Evolution of Nursing Science Forensic Nursing I Forensic psychiatric nurse 1 Works with individuals with mental health needs who have entered the legal system 1 Generally practices in state psychiatric institutions jails and prisons NURS 212 Evolution of Nursing Science Forensic Nursing Forensic psychiatric nurse Performs physical and psychiatric assessments Develops plans of care Assists clients with selfcare Administers medical care and treatment Monitors effectiveness of treatment Promotes coping skills Improves mental health in a therapeutic environment NURS 212 7 Evolution of Nursing Science Forensic Nursing I Forensic psychiatric nurse education El Must be an RN El Advanced practice level master s degree in psychiatric mental health nursing clinical nurse specialists or nurse practitioners a Prescriptive authority NURS 212 7 Evolution of Nursing Science Forensic Nursing I Forensic correctional nurse 1 Provides health care for inmates in correctional facilities such as juvenile centers jails and prisons 1 Has high level of autonomy compared to that of other nursing roles NURS 212 Evolution of Nursing Science Forensic Nursing I Forensic correctional nurse Cl UUUUUU Manages acute and chronic illness Develops healthcare plans Dispenses medications Performs health screenings Provides health education Performs psychiatric assessments Responds to emergency situations NURS 212 7 Evolution of Nursing Science Nursing Opportunities Requiring Higher Education I Advanced Practice Nurses 1 Clinical Nurse Specialist CNS 1 Nurse Practitioner NP 1 Certi ed Nurse Midwife CW 1 Certi ed Registered Nurse Anesthetist CRNA NURS 212 7 Evolution of Nursing Science Nurse Practitioner NP a Master s degree a Direct patient care according to specialty Family Adult Pediatric Women Elderly Acute Care Mental Health NURS 212 7 Evolution of Nursing Science Certi ed Nurse Specialist CNS a Master s degree a Experts in speci c eld 1 Mental Health I Gerontology J Cardiac care J Cancer care lt Community health lt Neonatal care NURS 212 7 Evolution of Nursing Science BUDDIES Certi ed Nurse Midwife Majority have a Master s degree Gynecological care Uncomplicated prenatal delivery and postpartum care Have widest prescriptive rights of all APN s Births attended by midwives are among safest Utilization of midwives is increasing NURS 212 7 Evolution of Nursing Science Certi ed Registered Nurse Anesthetist Master s degree I Preoperative assessments I3 1 Administration of anesthesia during surgery 65 RC COVGI39y I39OOITl CEII39C I3 NURS 212 7 Evolution of Nursing Science Issues for APN a Autonomy a Prescriptive authority 1 Challenges from MD associates NURS 212 7 Evolution of Nursing Science Employment Outlook 1 Great job security a One Voice One Plan a Home health care positions are expected to increase the fastest of all NURS 212 7 Evolution of Nursing Science UUUDUUUUU Provider of care Teacher Counselor Manager Researcher Collaborator Change agent Entrepreneur Patient Advocate Nursing Roles NURS 212 7 Evolution of Nursing Science


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