Nursing as a profession.pptx

Nursing as a profession
Philosophy, nursing practice
Aims and objectives
Characteristics of a professional nurse
Current trends and issues in Nursing.
Regulatory bodies; INC,SNC acts: constitution, functions

1. D r R.Rajalakshmi , M.Sc ( Psy . Nursing)., MBA-(HR)., MA-Sociology, P h .d College of Nursing, National Institute of Mental Health & Neuro Sciences, Bangalore-560 029 Nursing as a profession

2. Objective of the session To learn about Nursing as a profession Philosophy, nursing practice Aims and objectives Characteristics of a professional nurse Current trends and issues in Nursing. Regulatory bodies; INC,SNC acts: constitution, functions

3. Introduction Nursing, besides being a honorable profession, is one of the oldest arts and an essential modern occupation. Nursing is one of the greatest of humanitarian services and all people whether ill or well, rich or poor, literate or illiterate, young or old are in some way or other, directly or indirectly closely associated with it.

4. Nursing has its own body of knowledge scientifically based and humanitarianism that promises expanded benefits to people and society. It assists the individual or family to achieve their potential for self-direction for health.  

5. Nursing is not only an applied science, it is also an art, which provides skillful care for the sick in appropriate relationship with the patient, family, physician and with others who have related responsibilities. It is concerned equally with the prevention of illness and the conservation of health. Skillful nursing care embraces the whole person, body, mind and soul, his physical, mental, social and spiritual well-being ( holistic approach) .

6. NURSING is a discipline involved in the delivery of health care to the society. is a helping profession is service-oriented to maintain health and well-being of people. is an art and a science.

7. Nursing is caring. Nursing involves close personal contact with the recipient of care. Nursing is concerned with services that take humans into account as physiological, psychological, and sociological organisms. Nursing is committed to promoting individual, family, community, and national health goals in its best manner possible.

8. Characteristics of Nursing Nursing is committed to personalized services for all persons without regard to color, creed, social or economic status. Nursing is committed to involvement in ethical, legal, and political issues in the delivery of health care.

9. NURSE - originated from a Latin word NUTRIX, means to nourish, to cherish, to protect, to sustain. N= nobility U= usefulness R=responsibility S= simplicity E=efficiency Florence nightingale defined nursing 100 yrs ago as “the act of utilizing the environment of the patient to assist him in his recovery” (Nightingale 1860).

10. Nursing Virginia Henderson was one of the first modern nurses to define nursing. According to her “the unique function of the nurse to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible” Henderson 1966.

11. Nursing Nursing is the protection, promotion and optimization of health and abilities prevention of illness and injury alleviation of suffering through the diagnosis and treatment of human response and advocacy in the care of individuals, families, communities and populations (ANA, 2003). This definition asserts the prominence and importance nursing holds in providing health care to people of our global community.

12. NURSING DEFINED “ Nursing is the unique function of the nurse, that is to assist the individual (sick or well) in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.” - ICN

13. Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. Last Updated on 23 June 2014 Definition of Nursing

14. Person Environment Health nursing Concept of nursing

15. Philosophy of Nursing Nursing philosophy is described as a statement of fundamental and universal assumptions, beliefs and principles about the nature of knowledge and thought(epistemology) and about the nature of the entities represented in the meta paradigm( ie , nursing practice and human health processes (ontology)

16. Leddy and Pepper (2003) defined philosophy of nursing is the intellectual and effective outcomes of the professional nurses' efforts to understand the ultimate relationship among humans, environment, and health; to approach nursing as a scientific discipline; to integrate a sense of values into practice; to appreciate esthetic (study of sensory or emotional values), elements that contribute to health and well-being; and to articulate a personal belief system about human beings, environment, health and nursing.

17. Philosophy Nursing philosophy refers to the belief system of the profession and provides perspectives for practice, scholarship, and research. Intellectual Moral Spiritual Emotional Physical social

18. Current perspectives in philosophy Integrative philosophy of nursing is the current movement. This perspective links the art and science of nursing and closes gap between practice and science. It is a philosophy that recognizes nursing as a basic discipline with a unique focus.

19. Philosophy of nursing Principle of excellence in service Principle of excellence in Practice Principle of excellence in Leadership Principle of excellence in administration Interrelatedness Factual evidence Delegation of responsibility Individual and organizational goal Effective communication Flexibility

20. To prepare nurses who will give expert bedside nursing care in the hospital and home. To provide integration of health and social aspects theory and practice in generalized public health nursing To provide an adequate, sound scientific foundation to understand the functioning of the body and mind in health and disease. Aims and Objectives of Nursing

21. Aims and Objectives of Nursing To prepare nurses who will be able to work co-operatively with team members. To provide opportunities through curricular and extra-curricular activities for full development of personality of each individual student To ensure opportunities for initiative and resourcefulness, sense of responsibility for one self.

22. To provide a needed service to the society. To advance knowledge in its field. To protect its members and make it possible to practice effectively. Conti…….

23. Profession Meaning Profession has been defined as an occupation that requires extensive education, that requires special knowledge, skill and preparation Professionalism Professionalization

24. A basic profession requires an extended education of its members, as well as a basic liberal foundation. A profession has a theoretical body of knowledge leading to defined skills, abilities and norms. A profession provides a specific service . Members of a profession have autonomy in decision-making and practice. It utilizes in its practice of well defined & well organized body of specialized knowledge which is on the intellectual level of higher learning Characteristics of a profession

25. It constantly enlarges the body of knowledge It applies its body of knowledge in practical services which are vital to human and social welfare. It entrusts the education of its practitioners, to institutes of higher education. It attracts individuals of intellectual & personal qualities

26. Conti…… Members of profession adhere to a code of ethics Members of profession participate in professional organization Members of the profession are autonomous and self regulatory, operation under the professional organization Profession develops, evaluates and uses theory as a basis for practice Members of profession involved in research.

27. Differences Occupation Profession Training may occur in the job and length of training varies Values ethics belief are not important Commitment and personal identification vary or poor Workers are supervised People often change the job Accountability rest with employer Education take place at college or university, based on the curriculum Values ethics belief are integral part Commitments and personal identification is strong and necessary Workers are autonomous People unlikely to change the job Accountability rest with individual

28. Nursing As A Profession

29. Genevieve and Roy Bixler first wrote about the status of nursing as a profession in 1945. These criteria include the following. The services provided are vital to humanity and the welfare of the society . Nursing is the service that is essential to the wellbeing of the people and to the society. Nursing promotes, maintains and restores the health of individuals, groups and communities. Assisting others to attain the highest level of wellness is the goal of nursing. Caring, meaning nurturing and helping others are the basic components of professional nursing.

30. 3.There is a special body of knowledge that is continually enlarged through research . In the past, nursing was based on principles borrowed from the physical and social sciences and other disciplines. Today there is a unique body of knowledge to nursing. 4. The services involve intellectual activities. Individual responsibilities (accountability) are a strong feature . Nursing has developed and refined its own unique approach to practice. Nursing process is a cognitive activity that requires both critical and creative thinking and serves as the basis of providing nursing care.  

31. 5. Individual accountability in nursing has become the hallmark of practice. Accountability is ‘ is being answerable to some one for something one has done’ Through legal opinion and court cases, society has demonstrated that nurses are individually responsible for their actions as well as for those of personnel under their supervision. 6. Practitioners are educated in institution of higher learning. There are basic nursing program, baccalaureate program, masters and Doctoral program in nursing.  

32. 7. Practitioners are relatively independent and control their own policies and activities. (Autonomy). Autonomy or control over one’s practice is another controversial area for nursing. Although many nursing actions are independent, most nurses are employed in hospitals where authority resides in one’s position. 8. Practitioners are motivated by service (altruism) and considered their work an important component of their lives. Nurses are dedicated to the ideal of service to others, which is known as altruism.( Selflessness)

33. 9. There is a Code of Ethics to guide the decisions and conduct of practitioners. The International Council of Nurses (ICN) has established Code of Nursing Ethics through which standards of practice are established, promoted and refined. 10. There is an organization (Association) that encourages and supports high standards of practice. Nursing has a number of professional associations that were formed to promote the improvement of the profession. Foremost among these, is the TNAI (The Trained Nurses Association of India). The purposes of TNAI are to foster high standards of nursing practice, promote professional and educational advancement of nurses and promote the welfare of the nurses.

34. Characteristics of a Professional Nurse For an efficient discharging of her/his duties and for a satisfactory fulfillment of all the aims and aspirations that her/his profession stands for, the following qualities in a nurse are inevitable. 1. Love : with all its other attendant qualities like mercy, kindness, gentleness, patience and understanding are a must in a successful nurse. All her service for the sick and disabled are sponsored by these qualities. Without these essential characteristics the nurse becomes only a mechanical aid.

35. Willingness and self-sacrifice : These two qualities are complimentary to each another. Because she is willing to serve under any trying situation, a nurse sacrifices her time, comfort and even material benefits. Eg . Florence Nightingale at Scutari. Reliability : A nurse is one who can be depended upon for a faithful discharging of her duties, the patients under her care, their families, doctors and members of the "health team" depend on her, for she is trust worthy and competent.

36. Resourcefulness: In critical circumstances she uses her wisdom and knowledge and performs her duties to the best of her ability with whatever means that are at her disposal. She tackles situations with clarity. Courage : In times of confusion, calamity or catastrophe, the nurse manages her work with compassion and is ready to meet any problem with courage. She is cool and levelheaded and does not get agitated easily.

37. Loyalty and honesty : Her relationship with the patient, the doctor and her associates are marked by utmost loyalty and honesty. Observant : A good nurse is always vigilant. She keeps a close and constant watch on the patients, their progress, their changes and reactions to treatment etc. and gives the doctor timely reports, A nurse should anticipate and meet the patients' needs.

38. Willingness to learn: A nurse must keep in touch with the latest discoveries and developments in medicine and treatment and must "maintain her knowledge and skill at a consistently high level". Co-operative and considerate : A nurse learns to live in harmony with patients, doctors and other members of the health team and tries to help them in times of need.

39. Cleanliness: A nurse is always clean and neat personally and in her work. She must be tidy and demand high standards of cleanliness from those whom she is associated within her profession. Spirituality: A nurse must learn to create a spiritual atmosphere for the patient and must try and help the patients to put their confidence and trust in a "Power" that is higher than any other power in the world.

40. QUALITIES OF A NURSE Love for fellow beings, honest, courteous, dignified & loyal Disciplined, obedient, alert & intelligent Technically competent, resourceful & economic Dependable & adjustable Able to inspire confidence Sympathetic, empathetic, tactful & poised Patient & with a sense of humour Physically and mentally healthy Generous Gentle & quiet

41. Conti…. Self confident Loyal Cooperative Good listener Observer Administrator Impartial Capable Responsible Competent Decision making

42. FUNCTIONS OF A PROFESSIONAL NURSE Provide basic care to clients Administer treatments as advised Observe patients response and adaptation to illness Observe patients response and adaptation to treatments Teach self care and counsel on health matters

43. Conti…. Supervise/ guide in rehabilitative activities related to daily living Participate in research work related to health care Plan care with the patient (trust & self worth) Coordinate all services for client care Teach & supervise nursing students, auxiliary personnel and clients Maintain own physical and mental health

44. Roles of a Professional nurse Caregiver/ Care provider The traditional and most essential role Functions as nurturer, comforter, provider “mothering actions” of the nurse Provides direct care and promotes comfort of client Activities involves knowledge and sensitivity to what matters and what is important to clients Show concern for client welfare and acceptance of the client as a person

45. Teacher Provides information and helps the client to learn or acquire new knowledge and technical skills Encourages compliance with prescribed therapy. Promotes healthy lifestyles Interprets information to the client

46. Counselor Helps client to recognize and cope with stressful psychological or social problems; to develop an improve interpersonal relationships and to promote personal growth. Provides emotional, intellectual to and psychological support. Focuses on helping a client to develop new attitudes, feelings and behaviors rather than promoting intellectual growth. Encourages the client to look at alternative behaviors recognize the choices and develop a sense of control.

47. Change agent Initiate changes or assist clients to make modifications in themselves or in the system of care. Client advocate Involves concern for and actions in behalf of the client to bring about a change. Promotes what is best for the client, ensuring that the client’s needs are met and protecting the client’s right. Provides explanation in clients language and support clients decisions.

48. Manager Makes decisions, coordinates activities of others, allocate resource Evaluate care and personnel Plans, give direction, develop staff, monitors operations, give the rewards fairly and represents both staff and administrations as needed.

49. Researcher participates in identifying significant researchable problems participates in scientific investigation and must be a consumer of research findings must be aware of the research process, language of research, a sensitive to issues related to protecting the rights of human subjects.

50. Extended roles of nurse Communicator Teacher Client Advocate Counselor Change agent Leader Manager Decision maker Rehabilitator Comforter Nurse practitioner Nurse clinician Nurse midwives Nurse anesthetist Nurse researcher Nurse entrepreneur Nurse advisors

51. Expanded roles of nurse Flight Nurse Aerospace Nurse Industrial Nurse School Nurse Hotel Nurse Nurse informaticist

52. Trends and issues in nursing  Trends denote general direction and tendencies especially of events. so the nursing trends refer to the general direction towards which the different nursing events have moved and are moving as well as opinions in and around nursing and tendencies that we find in and about our profession.

53. Changes in society For the past five decades, five social factors have greatly influenced present trends in nursing. These are, Intensive efforts of government to meet the health needs of people. Gradual improved literacy level of the people with the growing awareness of health needs. Advanced scientific technology The changing role of women and the continuing growth of population.  

54. Changes in other professions Trends in the nursing profession have always been closely related to those in the medical profession. Growing specialization in medical field is resulting in a trend towards increased specialization in nursing. The development of new diagnostic procedure and equipments make specialization even more necessary.  

55. Patients Bill of Rights, patients care and legal responsibilities for the patient.   Developments in other discipline Developments in other discipline other than medicine also influence trends in nursing profession. Nursing is moving towards more specific nursing functions as other members of health team like dieticians, social workers and physiotherapists are more available and more highly specialized.

56. Leadership within the profession Leadership within the profession also influences the trends in nursing. Nursing is moving towards professionalism due to the untiring efforts of nurses who have been dedicated to achieve the aim.

57. Working and studying in abroad Working and studying in abroad is influenced by many factors within India and in other countries. Shortage of nurses in other countries, higher salary paid in abroad is the main causes for the working of Indian nurses in abroad.   Greater specialization in nursing education and practice. Greater specialization in nursing education and practice is a trend related to that in the medical profession and the growing amount of scientific knowledge available.

58. Working conditions Working conditions for nurses are also changing. There is a gradual change towards shorter and more convenient hours of duty, better accommodations and higher salaries.  Trends in other countries Trends in other country also influence the trends in nursing profession in India. The rapid development of the degree programme has promoted the same emphasis and development here for professional nursing.

59. Changing roles and functions of the nurse as perceived in the globe. The nurses in India are also prepared and more privileged to face the changes and ready to accept the challenging roles and functions of the nurse as perceived in the globe because of the development in the education and training system.  

60. The following roles and positions perceived as in the globe are given below. a. Nurse educator works in schools of nursing, staff development departments. They provide the educational programme for student’s nurses and nurses, teach clients about the self-care and home care. b. Clinical nurse specialist specializes in managing specific diseases and they function as clinicians, educators, managers, consultants and researchers. c. Nurse practitioners are certified to provide health care to clients in out-patient or community settings.

61. Certified nurse-midwife are certified by the American College of Nurse-Midwives to provide independent care for women during normal pregnancy, labour and delivery. Nurse anesthetist , having advance training in anesthesiology, provides surgical anesthesia to the client under the supervision of an anesthesiologist during minor surgery with baccalaureate degrees or master’s degree. Nurse administrators manage client care within the healthcare agencies in a middle level or upper level management position. Nurse researcher with Doctoral degree investigate nursing problem to improve care and to define and expand the scope of nursing practice. Advancements in science increase health needs of the society and thereby expect changes in the role of nurses and thus increases the scope for nurses.  

62. Issues in nursing It refers to items for consideration or questions for discussion. Issues grouped in to three broad areas. Issues related to the profession of nursing. Issues related to the areas of nursing education and nursing practice. Issues related to the nurses themselves.

63. Issues related to profession of nursing Status of nursing in society in the health care delivery system. Values reflected in our nursing performances. Attitude, humane approach and concern shown in our behavioral pattern. Quality in nursing education and practice. Is nursing within the mainstream of health? How does nursing relate itself to the country’s health policy programmes and goals.

64. Issues… Has nursing leadership in India formulated its own strategies in the perspective of changing health scenarios and demands. Has nursing leadership disseminated the essential information in this regard to the nurses. Has nursing developed a nursing information network. Has leadership been able to create its rightful place in the health administration.

65. Have today’s nursing educational programmes in the country taken into consideration of national health policy goals and programmes. Have it Shifted the emphasis from traditional to community health oriented approach and reoriented nursing curriculum accordingly. whether sincere efforts are put to prepare nurses for the jobs, where they are expected to perform in their work fields in terms of appropriate skills, knowledge and right attitude and desired behavior pattern. Issues related to nursing education and nursing practice.

66. Related to nursing education… Did country had been preparing nurses by keeping the states and country’s health needs in mind. Did country had Been making efforts for leadership building, management and skill training. Made efforts in organizing higher education in nursing including post diploma etc. Giving the due emphasis on nursing research.

67. Issues related to area of nursing practice The nurses have to work under tremendous constraints and pressure both in community settings and institutional setting. Are nurses as a matter of policy consulted in all matters related to decision areas for nursing practice? Have nursing man hour studies been conducted in relation to various nursing practice areas? Do they have the necessary backup support from the system for performing the way they are required to perform.

68. Issues related to area of nursing practice… Do the practicing nurses feel confident and secure in independently performing the different nursing tasks required of them at the community and institutional settings? Is there a hospital nursing management information system available where the nursing records play a vital role?

69. Issues related to nurses themselves Long hours of duty with very little time for recreation. Working against the presence of: Overcrowding Shortage of staff Dearth of essential supplies and equipment Attending to many bosses Non availability of guidance and counseling services when ever necessary irregular staff development including in-service education and continuing education.

70. Issues related to nurses themselves Non availability of regular health care programmes for nurses Non availability of crèches for the children of married nurses coming from outside. Non availability of residential accommodation for nurses working in emergency services. Pressure from influential people. Inadequate dietary provisions for on duty nurses. Non- involvement of nurses in nursing matters Poor pay structure.

71. Lack of promotional opportunities leading to job dissatisfaction, stagnation and frustration. Work environment-not always congenial or friendly. Lack of security and safety. Non availability of basic amenities like toilet facilities in the residential accommodation of community nurses. Non availability of transport facilities for community nursing services.  

72. Categories of nursing professional Director / superintendent Deputy superintendent Asst nsg . Superintendent Ward inchrges / Tuter Senior nurse Junior nurse/staff nurses Principal Professor Associate professor Assistant professor Lecturer Asst. Lecturer Tutor

73. Organizations provide a means through which united efforts are made to elevate standards of nursing education and practice. It also offers a means of voicing and opinions, developing our abilities and keeping informed of new trends. a) The Indian Nursing Council (INC) The Indian Nursing Council was authorized by the Indian Nursing Council Act of 1947. It was established in 1949 to provide uniform standards in nursing education and reciprocity in nursing registration throughout the country. Professional Organizations

74. Indian Nursing Council The Indian Nursing Council is an Autonomous Body under the Government of India, Ministry of Health & Family Welfare was constituted by the Central Government under section 3(1) of the Indian Nursing Council Act, 1947 of parliament. The basic Aims, Objectives and functions of Indian Nursing Council are as follows:

75. Indian Nursing Council To establish and monitor a uniform standard of nursing education for nurses midwife, Auxiliary Nurse-Midwives and health visitors by doing inspection of the institutions. To recognize the qualifications under section 10(2)(4) of the Indian Nursing Council Act, 1947 for the purpose of registration and employment in India and abroad.  To give approval for registration of Indian and Foreign Nurses possessing foreign qualification under section 11(2)(a) of the Indian Nursing Council Act, 1947. lieu

76. Indian Nursing Council To prescribe the syllabus & regulations for Nursing programs . Power to withdraw the recognition of qualification under section 14 of the Act in case the institution fails to maintain its standards under Section 14 (1)(b) that an institution recognized by a State Council for the training of nurses, midwives, auxiliary nurse midwives or health visitors does not satisfy the requirements of the Council. To advise the State Nursing Councils, Examining Boards, State Governments and Central Government in various important items regarding Nursing Education in the Country.

77. Functions 1. It provides uniform standards in nursing education and reciprocity in nursing registration. 2. It has authority to prescribe curriculum for nursing education in all states. 3. It has authority to recognize programme of nursing education or to refuse recognition of a programme if it did not meet the standards required by the council. 4. It is registering the foreign nurses. 5. It also maintains the Indian Nurses Register. 6. The INC authorizes State Nurses Registration Council and examining boards to issue qualifying certificates.

78. Organizational Structure of Indian Nursing Council President Vice President Secretary Joint Secretary Deputy Secretary Assistant Secretary Office Staff

79. Committees Executive Committee of the Council to deliberate on the issues related to maintenance of standards of nursing programs   The Nursing Education Committee , The committee is constituted to deliberate on the issues concerned mainly with nursing education and policy matters concerning the nursing education.   Equivalence Committee – to deliberate on the issues of recognition of foreign qualifications which is essential for the purpose of registration under section 11(2)(a) or (b) of the Indian Nursing Council Act, 1947, as amended.

80. Regulation of training programme of the diploma, Graduate and Post Graduate Courses. Supervision of the practice of the profession by its Member. Granting recognition to the training institutions and periodical Inspection there on, as the Council is governing authority of physical and clinical facilities in almost all the nursing courses conducted in the institution. FUNCTION OF STATE NURSING COUNCIL

81. FUNCTION OF STATE NURSING COUNCIL … Proscribing syllabus and curriculum for various nursing courses and conducting qualifying examination there for. Registration and granting certificate to qualified persons to practice their profession and to watch and take action against practice of profession by quacks and check mal-practice as well and to take action.

82. Thankyou