© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 1

2 1 S E C T I O N PAST TO PRESENT IN THE PROFESSION

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 3 1 C H A P T E R THE CURRENT STATE OF THE NURSING DISCIPLINE

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 4 Nursing: Discipline and Profession  Discipline—body of knowledge  Profession—group with standardized knowledge, goals, ethics

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 5 Problems Defining Nursing Practice  Holistic practice is all-encompassing.  Nursing practice overlaps with other providers (Figure 1-1).  Nurses provide care planned by others.

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 6 The role of the nurse frequently overlaps with other members of the health care team.

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 7 Nursing Practice Changes  Influenced by the setting  Affected by technology, social values, science, and economics  Adaptable to patient needs

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 8  Explains, guides, and directs nursing care  Includes multiple perspectives/frameworks  Contains abstract terminology Nursing Theory

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 9 Nursing Theory  Should drive practice and research (Figure 1-3)  Few practice from a well-defined theoretical base.  Frequently research has a weak link to theory.

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 10 Entry Into Practice  Multiple educational routes to becoming an RN (Figure 1-5)  AACN supports BSN as entry point  NLN supports multiple levels of entry and focus on career progression

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 11 There are many pathways to becoming a registered nurse

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 12 Diploma and AD Programs  Shorter program length  Narrow educational focus

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 13 BSN Programs  Provide holistic, broad educational background  Graduates linked to better patient outcomes  Graduates more likely to pursue graduate degrees

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 14 AACN: Changing Advanced Clinical Practice  Advanced generalist degree— master’s degree with CNL designation  DNP—degree needed for advanced clinical nursing practice  Nurse educator—PhD

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 15 Content of Educational Programs  Core competencies identify critical behaviors.  Clinical simulations provide realistic, safe practice.  Online learning offers convenience, increased access.  Globalization incorporates diversity in learning (Figure 1-6).

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 16 Technology in Nursing  Innovative procedures and treatments  Computerized charting systems  Electronic databases and resources  Hand-held electronic devices

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 17 Nursing Shortage  90% more graduates needed to meet demand (Figure 1-7)  Nursing faculty shortage limits numbers of students enrolled

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 18  FTE Supply Implications of Changes in Projected Number of New Graduates from U.S. Nursing Programs. Figure courtesy of Health Resources and Services Administration (HRSA), Bureau of Health Professions (2002, July).  National Center for Health Workforce Analysis. Projected supply, demand, and shortages of registered nurses: Washington DC: Author. Retrieved from _demand.pdf _demand.pdf Nursing Shortage (cont.)

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 19 Increasing Demand for Nurses  Population growth  Aging population  Medical advances

© 2010 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 20 Contributing to Shortage  Decline in number of nursing graduates  Aging nurse workforce  Limited earning potential later in career  More career alternatives