NUR3805
Dimensions of Professional Practice
Chapter 1
Discussion
Discussion Topic:
First of all ~ What area do you work in
now, and where do you see yourself in 5 years. (This is not to imply you are
unhappy, only to challenge you to examine your position and your options~ which
I expect you have already done, as here you are!)
After reading through the learning plan and
completing your reading/PPT, choose one of the identified challenges the future
of nursing is faced with. Find a peer reviewed journal article that addresses
this problem to summarize and give your perspective on where we, as nursing
professionals, should go from here ~ what is our role, as nurses, in looking
forward on the issue. Please attach the article as a PDF for your peers if
possible, but certainly include the reference.
NUR3805
Dimensions of Professional Practice
Chapter 2
Discussion
The history and social context of nursing
As we attempt to synthesize the historic,
contemporary and emerging theories & principles affecting the practice of
nursing, we are going to explore some of of the organizations that are helping
define the future of professional nursing practice. As nurses, we have a great
history ~ but you all are the future of nursing!
And I take my cap off to you!
You have stepped out of your comfort zone
and here you are! Now, where to from here on a personal level.
Please take some time to read about one of
nursing’s biggest advocates and what’s happening on a national level regarding
the social context of nursing:
1. Johnson & Johnson:
Link to Champion of Nursing: Johnson &
Johnson (Links to an external site.)Links to an external site.
Link to Johnson & Johnson Website
(Links to an external site.)Links to an external site.
2. Robert Wood Johnson Foundation:
Link to Robert Wood Johnson Foundation
(Links to an external site.)Links to an external site.
3. Nurses are taking Washington,D.C. by
Laura Stokowski, (Links to an external site.)Links to an external site. MSN,
RN. Do you see yourself as a policy game changer? How can we support these
efforts without going to Washington?
4. Feel free to explore what is happening
in the health care policy-making in Tallahassee (state level) or in Washington
(national level) if this is an area of interest to you.
DISCUSSION
View TED talk by Roselinde Torres (Links to
an external site.)Links to an external site.
Based on your own self-reflection, having
exploring the sites above, consider what your professional role as a nurse
looks like or could look like. No citations needed. These responses are of a
personal nature.
1. Where are you anticipating change in
your professional life? (take a look at your calendar: Who are you spending
time with? On what topics? What are you reading? Does what you are doing match
your goals)
2. What is the diversity measure of your
professional stake network? (Your capacity to develop relationships with people
very different from yourself)
3. Are you courageous enough to abandon a
practice that has made you successful in the past? Do you have a dream
(actually, many have already answered that this past week) My goal is to help
you develop a plan for here you see your career as a professional nurse taking
you. I don’t have a dream for you ~ and there are no dreams too small or too
big. But finding your interest, learning to dream, and forming a plan is where
it all starts.
NUR3805
Dimensions of Professional Practice
Chapter 4
Discussion
“So… you’re a nurse?”
The general public often puts all nurses
into the same category, however we who are in the profession, know that there
are many different kinds of nurses. This can be defined by nursing specialties,
levels of education, areas of passion (ICU, peds, ED, home health, etc.), where
one works,… ~ and I’m probably missing something!
Discussion Prompts: This week’s discussion will focus on our
choices ~ “If we knew then what we know now..” choices. This is not
just a conversation, though it certainly could be! I would like to hear from
you researched facts based on what you answer ~ I want more than just your gut
feeling on the topic. There are 4 discussion points ~ Answer ONE of the
following questions. Between all of you, I would like all of the discussion points
to be covered so please try to avoid too much duplication, but feel free to add
your perspective through responses.
1. If a friend who wants to become a nurse
asked your advice about the type of program he or she should enroll in, what
would your answer be (LPN, ADN, BSN, Diploma, etc.)? What would you cite as the
advantages and disadvantages for your recommended program? What are the
differences in scope of practice, responsibility, job opportunities, and
salary?
2. The Brown Report, ANA, the National Commission
for the Study of Nursing and Nursing Education (Lysaught Report), National
Commission on Nursing, NLN, and AACN all recommend the BSN degree as entry into
practice; however, this has not happened to date in the United States. In what
way would the unification of nursing education strengthen the profession in the
US? What are the drawbacks to this approach?
3. Why might a BSN program choose one
accrediting agency over the other (ACEN vs. CCNE)? Make a persuasive argument
for one of these two choices.
4. Jan Gonzalez has been an RN for 7 years.
She has become increasingly interested in research, serving on her unit?s
evidence-based practice committee and then on her hospital?s nursing research
council. She is very interested in the effects of sleep deprivation on milk
production in breastfeeding mothers. She is trying to decide between a
doctorate of philosophy (PhD) program and a doctorate of nursing practice (DNP)
program for her doctoral studies.
Address these questions Jan Gonzalez:
What are the differences and similarities
between these two types of programs?
What should Jan consider as she determines
which of these doctorates to pursue?
What are the differences between approaches
to research that Jan will find between these two programs?
NUR3805
Dimensions of Professional Practice
Chapter 5
Discussion
This is a reflective posting so no
citations are required
There’s an old saying: If you don’t know
where you’re going, how do you know when you’ve gotten there? This applies to
professional nursing.
This discussion focuses on the evolution of
the professional nurse and the introduction of a theory that helps us identify
where we are, so we know where we are going professionally not just as
individuals, but as a profession ~ but the journey starts with us, as
individuals …
Discussion:
ANSWER the following 2 prompts:
1. Examine Benner?s model from your
reading. Then, determine at which stage you are in your development as a
student and as a nurse. Give your rationale for that placement. If none of the
models or stages fits your experience, create your own model (or stage). Don’t
be shy, embarrased or humble ~ be honest.
2. Write your own mission statement:
a. After reviewing the definitions of
nursing identified in your book and discussed in the learning plan, write your
own professional mission statement.
b. Identify the vision, values, mission,
and philosophy statement of your place of employment (or another healthcare
organization) and expand on how your mission statement lines up. (Just one or
two paragraphs) *Please include the website/URL or name of the company as a
reference.
c. Evaluate the effects of the above
organization’s mission, values, and philosophy on nursing leadership, quality
of patient care, patient safety and patient outcomes based on your experience
and your readings this week.
NUR3805
Dimensions of Professional Practice
Chapter 7
Discussion
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
Ladies and Gentlemen ~This topic of nursing
ethics is HARD & complex ~ it requires thinking! … and we MUST think! In
addition to thinking, we MUST speak ~ We are the advocates, the ethical voice,
of our patients. We want easy answers but there are no easy answers when it
comes to ethics.
Discussion:
Choose ONE of the following prompts to address:
1. Based on one the two situations below,
discuss the different outcomes that would result if the decision were made
based on these three ethical theories: (1) deontology, (2) utilitarianism, and
(3) principalism. Identify your personal favorite of these three theories.
You need to discharge patients from a full
ICU to make room for a critically ill admission
OR
You are currently working short-staffed on
your unit and you are being forced to take a patient load that will prevent you
from giving good care
2. Read the ICN Code of Ethics for Nurses
online at www.icn.ch/ethics.htm (Links to an external site.)Links to an
external site. or download the PDF: icncode_english.pdfPreview the document and
write your post comparing it to the American Nurses Association?s Code of
Ethics for Nurses. What elements do they have in common? In what ways are they
different?
3. Conduct a literature search for ethical
decision-making models. Choose one that interests you and prepare a summary. In
your summary, discuss whether the model you found includes all six steps
identified in the text.
4. Amelia is a new nurse on a 35-bed
medical unit and is enjoying her first few months there. She particularly
enjoys her new patient, Katy, a 32-year-old mother of two little girls who has
been admitted for fatigue and low blood counts. Katy had a bone marrow biopsy
soon after admission, and she and her husband are anxiously waiting for the
results. Late in the afternoon, Amelia notices that the preliminary report
indicates that Katy has acute myelogenous leukemia (AML).
When Amelia goes to check Katy?s vital
signs at 4 p.m., Katy asks her if the results are back yet. Amelia responds
truthfully that she does not know if Katy?s doctor has seen the results yet.
Katy persists, ??but you have. What is my diagnosis?? Amelia acts as if she had
not heard the question. Katy then said, ?It is bad, then.?
Consider these questions:
What is the ethical dilemma for Amelia?
What actions should she take?
What is the ethical basis for the actions
that you believe she should take?
What principles from the ANA Code of Ethics
can guide Amelia?s responses?
NUR3805
Dimensions of Professional Practice
Chapter 8
Discussion
Time to take care of ourselves!
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
Ladies and gentlemen~
Did you know that “for nearly every
indicator, the health of America?s nurses is worse than that of the average
American. Nurses are more likely to be overweight, have higher levels of stress
and get less than the recommended hours of sleep. Because health care delivery
requires 24/7 support, the demands of shift work exacerbate the health of
nurses. In addition, hazards such as workplace violence and musculoskeletal
injuries are contributing factors to poorer health. According to the Bureau of
Labor Statistics, registered nurses have the fourth highest rate of injuries
and illnesses that result in days away from work when compared to all other
occupations.” (ANA, 2018, Link (Links to an external site.)Links to an
external site.)
Please read through the executive summary
from ANA’s health risk assessment.
Healthy nurse, healthy nation (Links to an
external site.)Links to an external site.
Additional Optional Resources:
Hoffman, A. (2013) Enhancing Self-Efficacy
for Optimizing Patient Outcomes through the Theory of Symptom Self-Management.
Cancer Nurs. 2013 Jan; 36(1): E16?E26.
doi: 10.1097/NCC.0b013e31824a730a
Link to Enhancing Self-Efficacy for Optimizing
Patient Outcomes through the Theory of Symptom Self-Management (Links to an
external site.)Links to an external site.
Discussion: There are 2 parts to this
week’s original posting: Everyone should answer #1 AND either #2, #3, #4, OR #5
1. Some people, once they recognize they
need to change unhealthy behaviors do, and some do not. Review Rosenstock
health belief model OR Albert Bandura’s theory of perceived self-efficacy and
write a short summary of this model/theory, with an application to ONE healthy
behavior (such as use of tobacco, alcohol, adequacy of rest and sleep, etc.).
2. Some theorize that often nurses don’t
take care of themselves due to experienced distress and grief associated with
their patients’ suffering that lead to burnout, moral distress and compassion
fatigue. Do a literature search to explore this further.
3. Select a chronic or acute illness or
health condition and do an online search. Examine websites generated by your
search, assessing them for accuracy and safety. What items on the site do you
consider safe and why? Why do you consider others not as safe? (be sure to look
at who is funding the page~ it’s very small print!)
4. Review the Link to Healthy People 2020
initiative (Links to an external site.)Links to an external site.
Select ONE of the 2020 topic and objectives
to explore & write a summary on why it was chosen for a 2020 initiative,
the objectives, what the interventions that are being implemented are and your
perception of the effectiveness based on the nation’s response.
5. Create a self-care training and
educational plan (based on validated methods) for medical learners (such as
yourself!) supporting personal, professional, and team self-care. Keeping in
mind Bandura’s theory of perceived self-efficacy.
NUR3805
Dimensions of Professional Practice
Chapter 9
Discussion
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
Ladies and gentlemen ~
I believe that the grand theorists were
important to getting nursing where it is today ~ I believe that as nurses, we
need to understand their contribution and give them a nod of thanks. This
module is focused on the utilization and application of nursing theory as a
guide for excellence in nursing practice. As a BSN student, it is important
that you learn to critique nursing research and become an informed consumer of
research relevant to evidence based practice.
That’s where the middle range theories come in… Middle range theories
provide the theoretical framework that link grand nursing theories with nursing
practice.
Discussion topic: Middle Range Theories
1. Identify ONE middle-range nursing theory
from your text, from the list in the Learning Plan, or one you identify on your
own that applies to your area of practice or simply peaks your interest. (I am
hopeful that you will all have different ones)
2. Summarize your chosen middle-range
theory, including the development of it as a middle-range theory, how to
utilize it and the theoretical framework for it. Most middle-range theories
have a theoretical framework. For example, the framework for the middle range
theory of Unpleasant Symptoms:
Framework for Unpleasant Symptoms MRT
Of course, many have their own designed
model for how they perceive the framework should be ~ that’s okay. Which one
makes the most sense to YOU? And if you
don’t like theirs, design your own framework for the theory!
3. Identify how this middle range theory
can help you organize your thoughts for critical thinking and decision making
in nursing practice.
NUR3805
Dimensions of Professional Practice
Chapter 10
Discussion
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
So ~ We’re always talking about
evidenced-based practice, but HOW DOES ONE FIND THE EVIDENCE?!?
Let’s talk about scholarly articles for a
moment ~ There are different types of scholarly literature, some of which
require original research (or “primary literature”) and some that are
based on other published work (“secondary literature”). For this
module, though I highly value original work, we are going to look at review
articles (a secondary literature source). Review articles give an overview of
existing literature on a topic, often identifying specific problems or issues
and analyzing information from available published work on the topic with a
balanced perspective.
There are three types of review articles
(broadly speaking!):
1. the literature review: An important part
of the text of a scholarly paper that includes the current knowledge including
substantive findings, as well as theoretical and methodological contributions
on a specific topic.
2. the systematic review: This form of
review collects and summarizes all empirical evidence that fits pre-specified
eligibility criteria (our review of choice this week!).
3. the meta-analysis: This just strengthens
the findings of a systematic review as it statistically combines data from
multiple studies to evaluate a common effect.
Systematic reviews and meta-analysis are
considered to be the highest quality evidence on a research topic because their
study design reduces bias and produces more reliable findings. This week we are
going to look at a topic of your choice. Ideally, there are a least peer
reviewed articles on the topic, however it would be nice to find a systematic
review. How does one find systematic reviews?! (Hint: Look at CINAHL database
through EFSC library and Cochrane Database of Systematic Reviews (CDSR) which
is considered the leading resource for systematic reviews in health care. The
CDSR includes Cochrane Reviews (Links to an external site.)Links to an external
site. (the systematic reviews) and protocols @ Cochrane.org Link (Links to an
external site.)Links to an external site.)
Discussion:
Please answer 2 of the 5 questions below. Choose ONE of questions from
1-4 AND complete question 5.
Part I: Answer question 1, 2,3 or 4:
1. Discuss the difference between inductive
and deductive reasoning. Why is neither adequate to advance knowledge alone?
OR
2. Identify the NIH and NINR definition of
nursing research. Base on this, what is the primary focus of EBP?
OR
3. Is inductive or deductive reasoning most
likely to change practice? Explain.
OR
4. Where does research on improving nursing
education and learning outcomes fit into the definition of nursing research
provided by the NIH and NINR definition?
Part II: Please answer the following
question:
5.
Choose a topic that interests you and examine the SECONDARY research
using the PICO process.
Do a search of the literature in 2 data
bases: CINAHL database (Cumulative Index of Nursing and Allied Health
Literature ~ the largest and most in-depth nursing research database) and
Cochrane (at Chochrane.org~ the ‘gold standard’ for EBP) and, based on your
findings, choose ONE secondary research article (ideally a systematic review or
meta-analysis!) that interests you to summarize. In the summary, please
include:
Can the steps of the research process be
identified ?
Does the article make you consider
practicing in a different way?
How To Resource: How to do a library data
base search: Go to Library Resources on your MyEFSC.edu site. choose Database
Search. Click on the the data bases then put in your search words: CINAHL ~
this process takes practice. Don’t let yourself feel frustrated at the process!
Cochrane Database is not part of the EFSC
database collection but it is accessible to you. In regard to the Cochrane
Database of Systematic Reviews (CDSR) you can use the advanced search (Links to
an external site.)Links to an external site. or you can browse by topic (Links
to an external site.)Links to an external site. or by Cochrane Review Group
(Links to an external site.)Links to an external site. (CRG).
NUR3805
Dimensions of Professional Practice
Chapter 12
Discussion.
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
After you complete the readings, view the
PPT, and viewing the following lectures, please address one of the following discussion
postings.
View:
Lorelei Linguard: (about 20 min.)
Collective Competence ~ (Hear: Collaborative Communication!)
Kathy Torpie’s story: (about 4 min.)
Discussion: Choose one of the discussion
prompts below ~ Ideally, as a class, all questions will be answered as each
covers a different aspect of professional communication. Please read through
each other’s work and respond to at least one of your peers with a scholarly
response.
1. You have just transferred to theICU from
a M/S unit. You notice that the unit seems to face several challenges because
of ineffective communication. Unit morale is down. Both nurses and physicians
are under immense stress. You know that high-quality, efficient communication
takes teamwork, dedication, and patience. You set out to make a difference in
your new place of work.
The Johari window is a metaphor often
utilized to help create awareness and address communication issues. Please
expand on what the Johari window is and how it can be utilized in this
situation.
2. Three types of formal organizational
communication exist: upward, downward, and vertical. Describe each of these
types of communication and provide a workplace example.
3. What are ways to complete the
orientation phase of a nurse-patient relationship in one acute-care shift?
(Keep in mind the difference between social and professional relationships)
4. Perform an Internet or library search
using ?communication AND hospital errors? as key words. Create a summary of one
scholarly article that you found interesting.
5. Discuss ways to demonstrate caring with
one?s patients. How can a nurse be sensitive to a patient?s personal needs
while still being professional and efficient? (Keep in mind the priniciples for
determining professional boundaries)
6. Discuss the communication theory~ based
on this, identify the communication style in these examples:
(1) ?That must be horrible.?
(2) ?Could you rephrase your last comment??
(3) ?Dr. Smith does lots of surgeries; I?m
sure you will be OK.?
(4) ?I lost my mother, too; I know how you
feel.?
(5) ?This was not what you expected to
happen and is likely causing you many emotions.?
(6) ?Many people have been through this and
returned to normal.?
(7) ?This must be disappointing.?
(8) ?Oh, you are not hungry.?
(9) ?Things will get better soon.?
(10) “I don’t think that question is
relevant to your care. Let’s focus on you….”
7. In what ways is the collaborative
process similar to the nursing process?
Additional resources:
Kourkouta, L., & Papathanasiou, I. V.
(2014, February 20). Communication in Nursing Practice (Links to an external
site.)Links to an external site..
Vertino, K. A. (2014, September 30).
Effective Interpersonal Communication: A Practical Guide to Improve Your Life
(Links to an external site.)Links to an external site..
NUR3805
Dimensions of Professional Practice
Chapter 13
Discussion
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
Ladies and gentlemen ~ After reviewing the learning plan, completing
the reading, and viewing the PowerPoint, I imagine you are a bit overwhelmed.
Keep focused on the topic: Communication
and the roll of the nurse. Complete ONE
of the three discussion prompts:
1.
Incivility in the workplace:
Kathleen Bartholomew, RN, MN, managed a
57-bed orthopedic and spine unit in a tertiary hospital. Recognizing that the
culture of an institution is critical to patient safety, she speaks about the
image and future of nursing, creating healthy work environments, communication,
nurse-to-nurse hostility, and improving physician-nurse relationships.
Lessons from Nursing to the World |
Kathleen Bartholomew | TEDxSanJuanIsland (Links to an external site.)Links to
an external site.
Lessons from Nursing to the World |
Kathleen Bartholomew | TEDxSanJuanIsland
Based on this video, let’s look at
incivility in the workplace. Workplace
incivility, defined as “characteristically rude and disrespectful, revealing
a lack of respect for others” is a significant problem in healthcare
settings and especially in nursing.
Incivility not only negatively impacts the individual enduring the
negative behaviors but also the care that is delivered under the shadow of incivility.
There is a great deal of research in this area!
How can incivility in the workplace be
addressed?
2.
Self-Care:
Complete the personal stress inventory
found in Table 13-1 of the textbook. Consider your own coping skills. Review one of the articles below (OR do a
library search for an article that discusses “nurse*” and
“self-care”) and see what research-based recommendations are made for
nurses and their health. Summarize your
article and address some of the following questions:
How should one maintain a life?work
balance?
How do you manage school, home, and work
responsibilities?
In what ways are you taking care of your
health? What are the impediments?
Identify one action that you could
implement to enhance your physical or psychological health or both.
Choose ONE of the suggested articles
available through EFSC library CINAHL data base (feel free to search for one on
the same subject matter):
Cassie, F. (Feb/Mar 2015) Coping with shift
work: Is there a perfect roster? Nursing Review (1173-8014), 15(1): 4-7. 4p.
(Journal Article – pictorial, tables/charts) ISSN: 1173-8014
Helm, M. (July, 2017) The role of mindfulness in enhancing
self-care for nurses. American Journal of Critical Care, 26(4): 344-348. 5p. (Article – research,
systematic review, tables/charts) ISSN: 1062-3264.
Malloy, P., Thrane, S., Winston, T.,
Virani, R.,Kelly, K. (April, 2013) Journal of Hospice & Palliative Nursing,
Volume 15(2), p 99?106.
Van Wijlen, J. (2017) Healing the Healer: A
Caring Science Approach to Moral Distress in New Graduate Nurses, International Journal for Human Caring, 2017;
21(1): 15-19. 5p. (Article) ISSN: 1091-5710
3.
Cultural Competence:
Different cultures have different
rules. Read or View at least ONE of the
following resources and consider your answer to the following questions:
Summarize ONE of the resources (articles or
the Ted Talk), and answer 2 of the following 7 job interview style questions:
Share any experience you have in working
with individuals from backgrounds different from yours. How would this
experience translate to working within a health care environment and with
patients?
What are some of the challenges you have
encountered in working with patients from diverse populations?
Do you have experience working with
individuals with Limited English Proficiency?
What languages do you speak? If language
other than English is offered, ask about proficiency (conversational, fluent,
read, write, etc.) and if the proficiency has been tested.
Have you worked with interpreters? If yes,
in what capacity and what was your scope of involvement? Are you knowledgeable
about a specific culture such that you could serve a mentor role in teaching
other staff about that culture?
If you suspected a patient was experiencing
challenges (not following treatment plan, missing appointments, etc.) due to
cultural preferences, what steps would you take to understand their
preferences?
How would you go about building rapport
with a patient who is from a background different from yours?
Article 1:
Rahimaghaee, F.,Mozdbar, R. (2017) Cultural intelligence and it’s
relation with professional competency in nurses. Nursing Practice Today 4(3):
115-124. 10p. (Article – research, tables/charts) ISSN: 2383-1162
Article 2: Riley, D., Smyer, T., York, N.
(2017) Cultural Competence of Practicing Nurses Entering an RN-BSN Program.
Ted Talk:
View Fayth Parks: Ms. Parks is a licensed psychologist and associate
professor at Georgia Southern University.
She has over 25 years experience studying disparities in rural
education, rural health care access, and cultural competency training.
NUR3805
Dimensions of Professional Practice
Chapter 14
Discussion
Follow the instructions under Discussion
Board Rubric and Discussion Guidelines and APA Tips to create your post and
respond to at least one other student. Internal citations and references are
required.
Discussion:
Choose one of the following discussion topics to develop ~ be sure to
respond to one of your peers.
Review the healthcare initiative of Healthy
People 2020 and Healthy People 2030 (being developed) In what ways might
nursing address the Healthy People 2020 broad goals? (consider using the 10
health indicators as a guide)
Think about the four major categories of
health care services (health promotion and maintenance, illness prevention,
diagnosis and treatment, and rehabilitation and long-term care). Which have you
or a family member used? Which ones might have been more useful and why?
Identify a local or global health care
agency/system and do the following: determine how the agency is classified
(e.g., public, voluntary, for-profit, not-for-profit), obtain a copy of the
organizational chart, identify to whom the chief nurse executive (CNE) reports
and who reports to the CNE, and describe the types of health services provided.
Discuss the causes of health
disparities. After researching this
topic, did you find that health care disparities have gotten significantly
worse or have remained unchanged?
According to the text, people who support a
free-market economy consider health care a privilege. The United States,
however, has health care payment policies inconsistent with a free-market
economy. Based on basic economic theory, discuss whether health care in the
United States is a right or a privilege. (This topic is a personal favorite 😉
Do a little research on how hospital bills
break down payments. What are the
advantages and disadvantages to including nursing services in hospitals as part
of the ?room rate?? How does this affect the pr