Educational Pathways and Expanded Roles

Educational Pathways and Expanded Roles

Educational preparationDiploma in NursingAssociate’s Degree in NursingBaccalaureate Degree in NursingMaster’s Degree in NursingDoctoral Degrees in Nursing

Educational Pathways and Expanded RolesAccreditation of programs of

nursingNational League for Nursing Accrediting

Commission (NLNAC) Commission on Collegiate Nursing

Education (CCNE) Specialty nursing certification

American Nurses Credentialing Center (ANCC), subunit of the American Nurses Association (ANA)

ANA offers 39 different certification programs for RNs

Licensure NCLEX-RN®

National Council of State Boards of Nursing (NCSBN) Four main categories of testing

Safe effective care environment Management of care 13%-

19% Safety and infection control 8%-

14% Health promotion and maintenance 6%-

12% Psychosocial integrity 6%-12% Physiological integrity

Basic care and comfort 6%-12%

Pharmacological and parenteral therapies 13%-19%

Reduction of risk potential 13%-19%

Physiological adaptation11%-17%

(NCSBN, 2007)

Educational Pathways and Expanded Roles

Licensed Practical NursingConsidered “directed” in that an

LPN/LVN functions under the direction of an RN, physician, or other health care provider

Provide care in settings where patients are experiencing common health problems and focuses on meeting basic needs

Considered the technical nurse

Educational Pathways and Expanded Roles

Registered NursingIn 1955, Virginia Henderson stated that:The unique function of the nurse is 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

Educational Pathways and Expanded Roles

Registered NursingIn 2004, the ANA defined nursing as: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

Three Primary Roles

Provider of careManager of careMember of the profession

American Nursing Association:Nursing’s Agenda for the Future

Leadership and planningDelivery systemsLegislation/regulation/policyProfessional/nursing cultureRecruitment/retentionEconomic valueWork environmentPublic relations/communicationEducationDiversity

Professional Nursing Organizations

American Nurses Association (ANA) represents the nation’s 2.9 million registered nurses

Advances the profession of nursing byFostering high standards of nursing

practicePromoting the rights of nurses in the

workplaceProjecting a positive and realistic view of

nursingParticipating in lobbying efforts on health

care issues that affect nurses and the public

Professional Nursing Organizations

There are many organizations dedicated to specialty practice

Belonging to one or many professional organizations provides education and socialization in nursing

Scope of PracticeIdentify the responsibilities of nurses,

depending on their educational preparation and licensure

Defined by individual state nurse practice acts

Individual state boards of nursing, which are located within varying government organizations at the state level, commonly exist to protect the consumers of nursing care by regulating the profession

Scope of PracticeThe NCSBN is the unifying body for

the state boards of nursingANA’s publication Nursing: Scope

and Standards of Practice (2004) Addresses the scope of practice and

delineates the practice and professional performance standards and measurement criteria for RNs

Six standards of practice Nine standards of professional

performance

Six Standards of Practice (ANA)

AssessmentDiagnosisOutcomes identificationPlanningImplementationEvaluation

Nine Standards of Professional Performance (ANA)

Quality of practiceEducationProfessional practice evaluationCollegialityCollaborationEthicsResearchResource utilizationLeadership

Multistate Licensure The Nurse Licensure Compact,

developed by the National Council of State Boards (NCSBN) and adopted in 1998

Allows nurses in compact states to work in other compact states without obtaining a license in that state

The nurse licensed in one compact state and practicing in another must adhere to the laws of that compact state, and this requires that the nurse stay abreast of any changes to multistate licensure

DelegationBasic principles of delegation

Delegating the right task, under the right circumstances, to the right person, with right direction and communication, and with the right supervision

DelegationAccording to the ANA (1995), the three

elements of nursing that may not be delegatedThe initial and subsequent nursing

assessments that require professional judgment

The determination of nursing diagnoses, goals, plans of care, and progress

Interventions that require the application of professional knowledge and skills

Decision Making and Problem SolvingClosely related and use a similar process to

arrive at a decision Problem solving involves making a decision

that is focused on trying to solve an immediate problem

Decision making is a purposeful and goal-directed process aimed at identifying and selecting options as part of problem solving, planned change, or improvement

Decision Making and Problem Solving

Steps for effective decision making and problem solving (Yoder-Wise, 2003) Gather data from many sourcesLearn different approaches to problem

situationsObserve positive role models in actionTalk to a colleague or superior who is an

effective problem solver and decision maker

Perform research to increase your knowledge base

Take risks using new approaches to problem solving

Ethics and Leadership Leadership has a moral or ethical

dimension Five principles of ethical leadership

Serving othersShowing justiceRespecting othersHonestyBuilding community

Ethics and LeadershipLeaders have the ethical responsibility to

treat followers with dignity and respect and be sensitive to their interests, needs, and concerns

Professional AdvocacyAn advocate

Defends or promotes the rights of othersChanges systems to meet the needs of othersEmpowers and promotes self-determination in

othersPromotes autonomy of diverse cultures and

social groupsEnsures respect, equality, and dignity for

othersCares for the humanness of all