1. The Culture of Healthcare Nursing Care Processes Lecture a This material (Comp2_Unit6a) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

2. Nursing Care Processes Learning Objectives Learn what nurses do and how they are trained (Lecture a) Learn how nurses make clinical decisions and assess patients (Lecture b) Learn about the settings where nurses work (Lectures a, c) Learn about the procedures that nurses perform (Lecture c) 2 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a

3. What Do Nurses Do? Provide direct care: Provide hands-on care (such as bathing and wound care) Screen patients for diseases Help doctors with procedures Give medications and write prescriptions 3 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a

4. What Do Nurses Do? (continued) Educate others: –Teach patients and their families about health issues –Teach the public about health issues –Advise organizations Coordinate care for patients Manage other nurses or nurse aides Conduct research 4 Health IT Workforce Curriculum Version 3.0/Spring 2012 4 The Culture of Healthcare Nursing Care Processes Lecture a

5. Nursing Specialties There are several ways to specialize in nursing: –By body system (for example, circulatory system) –By health problem (for example, cancer) –By patient population (for example, older people) –By location (for example, schools) Some specialties do not involve direct patient care (for example, nursing informatics) 5 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a 5

6. Types of Nurses There are three general categories of nurses, based on their education levels: Licensed practical nurses (LPNs) Registered nurses (RNs) (most common) Advanced practice nurses (APNs) (most responsibility) 6 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 6

7. What LPNs Do Licensed practical nurses (LPNs): –Provide medical care and help with self-care –Keep patient records –Teach family members how to care for the patient –Perform other tasks, such as preparing meals Some states call them licensed vocational nurses 7 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 7

8. Education and Licensing of LPNs Becoming an LPN is a 3-step process: Complete a state-approved training program that lasts about 1 year Pass a national licensing exam for LPNs Meet all state requirements to work, such as passing a background check 8 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 8

9. What Registered Nurses Do Registered nurses (RNs) are a large part of the healthcare workforce. They might: Plan patient care Give medications Keep patient records Teach patients, their families, and the public Consult with doctors Manage LPNs 9 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 9

10. Where Registered Nurses Work Many registered nurses work in hospitals Increased demand for RNs is predicted in: –Doctor’s offices –Home healthcare services –Nursing care facilities –Employment services 10 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 10

11. Education and Licensing of Registered Nurses There are 3 steps to becoming an RN: Earn a nursing diploma, associate degree in nursing, or a bachelor’s of science in nursing over 2 to 4 years Pass a national licensing exam for RNs Meet all state requirements 11 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 11

12. What Advanced Practice Nurses Do RNs with extra training can become advanced practice nurses (APNs) Depending on their training, APNs can: –Give patients anesthesia (certified registered nurse anesthetist) –Provide gynecological and obstetrical care (certified nurse-midwife) –Provide primary care (nurse practitioner, NP) –Treat patients and conduct research (clinical nurse specialist, CNS) 12 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 12

13. Education and Licensing of Advanced Practice Nurses There are 3 steps to becoming an APN: –Earn an RN license and work as an RN –Earn a master’s degree or higher in nursing –Meet state requirements to work as an APN APNs are also called advanced practice registered nurses 13 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 13

14. Continuing Education and Credentialing All nurses pursue continuing education to meet various requirements All nurses can become certified in a specialty by taking an exam from an approved organization 14 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 14

15. Common NP Specialties Acute care Adult care Adult psychiatric & mental health Diabetes management  advanced Family care Family psychiatric & mental health Gerontology (older people) Pediatrics (children and adolescents) School nursing 15 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 15

16. Common CNS Specialties Adult health Adult psychiatric & mental health Child & adolescent psychiatric & mental health Diabetes management  advanced Home health Gerontology (older people) Pediatrics (children and adolescents) Public\community health 16 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 16

17. Examples of Other Nursing Specialties Cardiac rehabilitation Case management College health Informatics Medical-surgical Nurse executive Pain management Perinatal (newborns) 17 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 17

18. Advanced Degrees for Nurses Nurses can pursue advanced degrees for career growth: A master’s degree lets an RN become an APN, if he or she meets the other requirements Doctoral degrees –PhD: prepares nurses for research and teaching –DNP: degree names and programs vary, but they always emphasize advanced nursing practice, and usually also leadership and management 18 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a Health IT Workforce Curriculum Version 3.0/Spring 2012 18

19. Nursing Care Processes Summary – Lecture a Nursing roles include patient care, teaching, research, and administration Specialization lets nurses gain expertise in certain areas of medicine All nurses must have formal training, pass a national exam, and meet state requirements Nurses stay licensed and build their careers by pursuing continuing medical education, certification, and advanced degrees 19 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a

20. Nursing Care Processes References – Lecture a References American Academy of Nurse Practitioners [Internet]. 2007 [cited 2011 Dec 1]. Frequently Asked Questions: Why Choose a Nurse Practitioner as your Healthcare Provider? [3 pages]. Available from: http://www.npfinder.com/faq.pdf. http://www.npfinder.com/faq.pdf American Medical Informatics Association [Internet]. Undated [cited 2011 Dec 5]: Nursing Informatics [1 page]. Available from: http://www.amia.org/programs/working-groups/nursing-informatics.http://www.amia.org/programs/working-groups/nursing-informatics American Nurses Association [Internet]. 2011 [cited 2011 Dec 5]. How to Become a Nurse [1 page]. Available from: http://nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/RegisteredNurseLicensing.html. http://nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/RegisteredNurseLicensing.html American Nurses Association [Internet]. 2011 [cited 2011 Dec 1]. What Nurses Do [1 page]. Available from: http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/RNsAPNs.html. http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/RNsAPNs.html American Nurses Association, Center for Continuing Education and Professional Development [Internet]. 2011 [cited 2011 Dec 6]: Browse CE: Subject [2 pages]. Available from: http://ananursece.healthstream.com/Pages/Category.aspx?category=Subject&cat=ANA&orderby=DisplayName&dir =ASC. http://ananursece.healthstream.com/Pages/Category.aspx?category=Subject&cat=ANA&orderby=DisplayName&dir =ASC American Nurses Credentialing Center [Internet]. 2011 [cited 2011 Dec 6]: ANCC Certification Center [2 pages]. Available from: http://www.nursecredentialing.org/Certification.aspx#specialty.http://www.nursecredentialing.org/Certification.aspx#specialty Bureau of Labor Statistics, U.S. Department of Labor [Internet]. Updated 2009 Dec 17 [cited 2011 Dec 1]. Occupational Outlook Handbook, 2010-11 Edition: Licensed Practical and Licensed Vocational Nurses [3 pages]. Available from: http://www.bls.gov/oco/ocos102.htm.http://www.bls.gov/oco/ocos102.htm Bureau of Labor Statistics, U.S. Department of Labor [Internet]. Updated 2009 Dec 17 [cited 2011 Dec 1]. Occupational Outlook Handbook, 2010-11: Registered Nurses [6 pages]. Available from: http://www.bls.gov/oco/ocos083.htm. http://www.bls.gov/oco/ocos083.htm 20 Health IT Workforce Curriculum Version 3.0/Spring 2012 The Culture of Healthcare Nursing Care Processes Lecture a