NURSING PRELIMS

REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

IS NURSING A PROFESSION? • Its journal, the “Filipino Nurse”, now is

called “The Philippine Journal of Nursing”.
PROFESSION
SCIENCE AND ART OF NURSING PRACTICE
• is defined “as an occupation that
requires extensive education or a calling that • Nursing practice requires a blend of the
requires special knowledge, skill, and preparation most current knowledge and practice standards
which provides service to society”. with an insightful and compassionate approach
to patient care.
CRITERIA OF A PROFESSION
A profession is generally distinguished from other Ability to interpret clinical situations & make
kinds of occupations by: complex situations.
1. Requirement of specialized training to • Foundation of nursing care & the basis for
acquire a body of knowledge. the advancement of nursing practice &
2. An orientation of the individual toward development of nursing science.
service, either to a community or to an
organization. COMPETENCIES OF CRITICAL THINKING
3. ONGOING RESEARCH • Integrating knowledge from basic science
• The ultimate goal is to improve client and nursing.
care. • Applying knowledge from past and
4. CODE OF ETHICS present experiences.
• Philosophical ideals of right and wrong • Applying critical thinking attitudes to a
that define the principles you will use to clinical situation.
provide care to your patients. • Implementing intellectual and professional
5. AUTONOMY standards.
• Independence at work, responsibility,
and accountability for one’s actions. LEVEL OF PROFICIENCY OF DR. PATRICIA BENNER
6. PROFESSIONAL ORGANIZATION 1. NOVICE
• presence of governance in which there • Beginner with no previous level of
is the establishment and maintenance experience (Student nurses & new
of social, political, and economic professional registered nurse).
arrangements by which practitioners 2. ADVANCE BEGINNER
control their practice, their self- • Principles, based on experiences,
discipline, their working conditions, and begin to be formulated to guide
their professional affairs. actions.
EXAMPLE OF PROFESSIONAL ORGANIZATION 3. COMPETENT
• With 2-3 years’ experience on the job
Philippine Nurse Association (PNA) in the same area or in similar day-to-
• The nationally recognized and day situations.
accredited professional organization of nurses in 4. PROFICIENT
the Philippines. • With more than 2 to 3 years of
• It was organized on October 22, 1922, experience in the same clinical
upon the initiation of Mrs. Anastacia Giron-Tupas position.
• The first president was Mrs. Rosario • More holistic understanding improves
Delgado. decision-making.
• Before, it was called “Filipino Nurses
Association”.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

5. EXPERT 4. Nursing is client-centered

• No longer relies on principles, rules, or 5. Nursing is holistic
guidelines to connect situations and 6. Nursing is adaptive
determine act. 7. Nursing is concerned with health
promotion, health maintenance, and
DEFINITIONS OF NURSING health restoration.
“Nursing is the act of utilizing the environment 8. Nursing is a helping profession
of the patient to assist him in his recovery.” STANDARDS OF PRACTICE
“Nursing is to assist the individual, sick or well, in
• describes competent level of nursing care
the performance of those activities which are demonstrated by a critical thinking
contributing to health or its recovery (or to model known as the Nursing Process (ADOPIE)
peaceful death) that he would perform
unaided if he had the necessary strength, will, NURSING PROCESS
or knowledge, and to do this in such a way to
help him gain independence as rapidly as • foundation of clinical decision making &
possible”. includes all significant actions taken by nurses in
providing care to patients.
“Nursing is the protection, promotion, and
optimization of health and abilities, preventions ANA STANDARDS OF NURSING PRACTICE
of illness and injury, alleviation of suffering 1. ASSESSMENT
through the diagnosis and treatment of human 2. DIAGNOSIS
response, and advocacy in the care of 3. OUTCOMES IDENTIFICATION
individuals, families, communities, and 4. PLANNING
populations”. 5. IMPLEMENTATION/INTERVENTION
“Nursing encompasses autonomous and 6. EVALUATION
collaborative care of individuals of all ages, STANDARDS OF PROFESSIONAL PERFORMANCE
families, groups, and communities, sick or well,
and in all settings. Nursing includes the • describe a competent level of behavior in
promotion of health; prevention of illness; and the professional role.
the care of ill, disabled, and dying people. • this provide a method to assure patients
Advocacy, promotion of safe environment, that they are receiving a high-quality care, that
research, participation in shaping health policy the nurses must know exactly what is necessary to
and in patient and health systems provide nursing care, & that measures are in
management, and education are also key place to determine whether nursing care meets
nursing roles”. the standards.

“Nursing is the initiation and/or performance of ANA STANDARDS OF PROFESSIONAL

nursing services, singly or in collaboration with PERFORMANCE
another, to individuals, families, and
communities and in any healthcare setting”. 1. ETHICS 6. LEADERSHIP
2. EDUCATION 7. COLLABORATION
OTHER DEFINITIONS OF NURSING (COMMON 3. EVIDENCED-BASED 8. PROFESSIONAL
THEMES) PRACTICE AND PRACTICE
1. Nursing is caring RESEARCH EVALUATION
2. Nursing is an art 4. QUALITY OF 9. RESOURCES
3. Nursing is a science PRACTICE 10. ENVIRONMENTAL
5. COMMUNICATION HEALTH

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

CODE OF ETHICS • this involves achieving improved physical,

emotional, spiritual, and social well-being.
• a philosophical ideal of right and wrong
that define the principles you will use to provide ADVOCATE
care to your patients.
• you protect your patient’s human and
THE CODE OF ETHICS FOR NURSES WITH legal rights & provide assistance in asserting
INTERPRETIVE STATEMENTS these rights if the need arises.
• you act on behalf of your patient & secure
• a guide for carrying out nursing your patient’s health care right.
responsibilities that provide quality nursing care;
also outlines the ethical obligations of profession. EDUCATOR
PROFESSIONAL PREPARATION • explaining the concepts & facts about
health, describe the reason for routine care
✓ have a license to practice nursing in the
activities, demonstrate procedures, reinforce
country learning or patient behavior, & evaluate the
✓ have a Bachelor of Science degree in patient’s progress in learning.
nursing • always use teaching methods that match
✓ be physically and mentally fit your patient’s capabilities & needs.
✓ be a part of professional organization
COMMUNICATOR
PROFESSIONAL RESPONSIBILITIES & ROLES
• effective communication is central to the
1. AUTONOMY AND ACCOUNTABILITY
nurse-patient relationship.
2. CAREGIVER
• quality communication is a critical factor in
3. ADVOCATE meeting the needs of individuals, families, &
4. EDUCATOR
communities.
5. COMMUNICATOR
6. MANAGER MANAGER
AUTONOMY AND ACCOUNTABILITY • coordinates the activities of members of
the nursing staff in delivering nursing care and
AUTONOMY
has personnel, policy, & budgetary
• an essential element of responsibility for a specific nursing unit or
professional nursing that involves the agency.
initiation of independent nursing CARRER DEVELOPMENT
interventions without medical orders.
I. PROVIDER OF CARE (CLINICIAN)
ACCOUNTABILITY
• Hospital Setting
• you are responsible professionally • Community-Based Care
& legally for the type & quality nursing care • Ambulatory Care
provided. • Nursing Homes/Extended Care Setting
CAREGIVER
• helping patients maintain & regain
health, manage disease & symptoms, & attain
a maximal level of function & independence
through the healing process.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

II. ADVANCE PRACTICE REGISTERED NURSES (APRN) HISTORICAL INFLUENCES

• Most independently functioning nurse. WORLD HISTORY OF NURSING
FOUR CORE ROLES: 1. WOMEN’S ROLES
• Traditional female roles of wife,
• Clinical Nurse Specialist mother, daughter, and sister have
• Nurse Practitioner always included the care &
• Certifies Nurse-Midwife nurturing of other family members.
• Certified Registered Nurse Anesthetist • From the beginning of time, women
III. NURSE EDUCATOR have cared for infants and children;
thus, nursing could be said to have
• works primarily in schools of nursing, staff its roots in “the home”.
development, patient education • Women were called on to care for
departments. others in community who were ill.
PRIMARY FOCUS
2. RELIGION
• Teach & coach patients & their families
how to self-manage their illness or SAINT FABIOLA
disability and make positive choices or • a matron of Roman Empire who
change their behaviors to promote converted to Christianity and used
their health. their wealth to provide houses of
IV. NURSE ADMINISTRATOR care and healing for the poor, the
sick, and homeless.
• manages patient care & delivery of
specific nursing services within a health CRUSADES
care agency. formed several orders of knights providing
• often have master’s degree (MHA, MPH, nursing care to the sick and injured
MBA) comrades, like:
• needs to be skilled in business &
management and understand all aspects • Knights of Saint John of Jerusalem
of nursing & patient care (also known as the Knight
Hospitalers)
FUNCTIONS: • Teutonic Knights
• budgeting, staffing, strategic planning • Knights of San Lazarus
of programs & services, employee THEODOR FLIEDNER
evaluation, and employee
development. reinstituted the Order of
Deaconesses & opened a small
V. NURSE RESEARCHER hospital and training school in
• improve nursing care and further define Kaiserswerth, Germany, where
and expand the scope of nursing Florence Nightingale received her
practice through evidenced-based “training” in nursing.
practice and research.
• preferred educational requirement is
doctoral degree, with at least a master’s
degree in nursing.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

3. WAR MOTHER BICKERDYKE

During the Crimean War (1853 – 1856) organized ambulance services and
walked abandoned battlefields at
SIR SIDNEY HERBERT night, looking for wounded soldiers.
of the British War Department asked
Florence Nightingale to recruit a
contingent of female nurses to MARY ELIZA MAHONEY (1845 – 1926)
provide care to the sick and injured
in the Crimean. was the first African American
professionally trained nurse. She
Nightingale is credited in improving the graduated from the New England
sanitation quality; the mortality rate in the hospital for Women and Children in
Barracks Hospital in Scutari, Turkey was reduced 1879.
from 42.7% to 2.2% in 6 months.
LILIAN WALD (1867 – 1940)
During the American Civil War (1860 – 1865)
considered the Founder of Public
Several nurses emerged who were notable for Health Nursing. together with Mary
their contributions to a country torn by internal Brewster, they opened the Henry
strife: Street Settlement and Visiting Nurse
Service, which provided nursing
HARRIET TUBMAN & SOJOURNER TRUTH
and social services and organized educational
provided care and safety to over 300 slaves and cultural activities to the poor in New York
fleeing to the North on the Underground slums.
Railroad movement. WALT WHITMAN & LOUISA MAY ALCOTT
HARRIET TUBMAN
volunteered as nurses to give care to injured
known as “The Moses of Her soldiers in military hospitals.
People” for her work with the
Underground Railroad.

SOJOURNER TRUTH
DOROTHEA DIX
is an abolitionist, Underground
Railroad agent, preacher, and became the Union’s
women’s rights advocate, a nurse Superintendent of Female Nurses
for over 4 years during the Civil War responsible for recruiting nurses &
and worked as a nurse and supervising the nursing care of all
counselor for the Freedmen’s Relief Association women nurses working in the army
after the war. hospital.
CLARA BARTON
founder of the American Red Cross,
searched the battlefields and gave
care to injured and dying soldiers.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

WORLD WAR 1 TWENTIETH CENTURY

“THE SPIRIT OF NURSING” • A movement toward developing scientific,
research-based defined body of nursing
• stands in Arlington National Cemetery knowledge & practice evolved.
that honors the nurses who served in the • Nurses began to assume expanded &
U.S. Armed Services in World War I advanced practice roles.
• many of whom are buried in Section 21 • Army and Navy Nurse Corps were
which is called the “Nurses Section”. established to expand nursing practice.
WORLD WAR 2 • Nursing specialization began on 1920s.
• Graduate nurse-midwifery programs
CADET NURSE CORPS began.
• Casualties created an acute shortage • Specialty-nursing organizations were
of caregivers, and the Cadet Nurse created.
Corps was established in response to a MARY ADELAIDE NUTTING
marked shortage of nurses.
• Practical nurses, aides, and technicians first nursing professor at Columbia
provided much of the actual nursing Teacher’s College in 1906. Was
care under the instruction and instrumental in moving nursing
supervision of better prepared nurses. education into universities.

VIETNAM WAR
• Approximately 90% of the 11,000 American TWENTY-FIRST CENTURY
military women stationed in Vietnam were Revision of nursing practice & school
nurses.
curricula to meet the ever-changing needs
• Youngest group of medical personnel ever of society:
to serve in wartime.
✓ Aging population
VIETNAM WOMEN’S MEMORIAL ✓ Bioterrorism
• is a monument established to “honor the ✓ Emerging infections
women who served and also for the ✓ Disaster management
families who lost loved ones during the ✓ Advances in technology &
war… to let them know about the informatics
women who provided comfort, care, ✓ High acuity level of care of
and a human touch for those who were hospitalized patients
suffering and dying”. NURSING LEADERS
SOCIETAL ATTITUDES FLORENCE NIGHTINGALE (1820 – 1910)
• Before the mid-1800s, nursing was without Earned her title as “Lady with the
organization, education, or social status;
Lamp”. She was the first nurse to
the prevailing attitude was that a woman’s exert political pressure on
place is in the home and that no government. She is also
respectable woman should have a career. recognized as nursing’s first
• Nurses in hospitals during this period were scientist-theorist for her work Notes on Nursing:
poorly educated; some were even What It Is and What It Is Not (1860 – 1969).
incarcerated criminals.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

LINDA RICHARDS (1841 – 1930) CONTEMPORARY INFLUENCES

was America’s first trained nurse. MULTIPLE EXTERNAL FORCES AFFECTS NURSING:
She graduated from New England
Hospital for Women and Children • Nurse’s Self Care
in 1873. Was known for introducing • Affordable Care Act (ACA) & rising
nurse’s notes and doctor’s orders. healthcare costs
She initiated the practice of nurses • Demographic Changes of Population
wearing uniform. • Increasing Numbers of Medically
Underserved
LAVINIA L. DOCK (1858 – 1956)
1. IMPORTANCE OF NURSE’S SELF CARE
a feminist, prolific writer, political
activist, suffragette. She COMPASSION FATIGUE
participated in protest movements • a state of burnout & secondary
for women’s rights that resulted in traumatic stress.
the 1920 passage of the 19th • this occurs without warning & often
Amendment to the U.S. Constitution, which results from giving high levels of
granted women the right to vote. energy & compassion over a
DOCK, NUTTING, & ROBB prolonged period to those who are
suffering, often without experiencing
In 1893, Dock, with the assistance improved patient outcomes.
of Mary Adelaide Nutting & Isabel • Frequent, intense, or prolonged
Hampton Robb, founded the exposure to grief & loss.
American Society of
BURNOUT
Superintendents of Training Schools
for Nurses of the United States and Canada, a • condition that occurs when
precursor to the current National League for perceived demands outweigh
Nursing. perceived resources.
MARGARET HIGGINS SANGER (1879 – 1966) • state of physical & mental exhaustion
that often affects health care
A public health nurse in New York, providers because of nature of their
has had a lasting impact on work environment.
women’s health care. She is • lack of social support, organizational
considered the founder of Planned pressures influencing staffing, &
Parenthood, was imprisoned for inability of nurse to practice self-care.
opening the first birth control information clinic in
SECONDARY TRAUMATIC STRESS
Baltimore in 1916.
MARY BRECKINRIDGE (1881 – 1965) • the trauma that health care providers
experience when witnessing and
A nurse who practiced midwifery in caring for others suffering trauma.
England, Australia, and New
REMINDER!!!
Zealand. Founder of the Frontier
Nursing Service (FNS) in Kentucky in Nursing students report feeling initially
1925 to provide family-centered hesitant and uncomfortable with their first
primary health care to rural populations. encounters with a dying patient and identify
feelings of sadness, anxiety, and discomfort.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

LATERAL VIOLENCE TRENDS IN NURSING

• can result from compassion fatigue EVIDENCE-BASED PRACTICE
occurs in nurse-nurse interactions and • Practice must be based on evidence, not
include behaviors such as: just according to education & experiences
& the policies and procedures of health
✓ withholding information care facilities.
✓ making snide remarks • Reduces health care errors & improve
✓ demonstrating nonverbal patient safety.
expressions of disapproval (raising
eyebrows, making faces) QUALITY & SAFETY EDUCATION FOR NURSES (QSEN)
WHAT TO DO? addresses the challenge to prepare nurses
with competencies needed to continuously
• Nurses need to be self-aware,
improve the quality of care in work
allowing them to identify their own environments.
vulnerability to secondary traumatic
stress & burnout. • Patient-Centered Care
• Participating in health promotion • Teamwork & Collaboration
activities • Evidence-Based Practice
• Quality Improvement
2. ACA & RISING HEALTH CARE COSTS
• Safety
• affects how health care is paid for and • Informatics
delivered.
PATIENT-CENTERED CARE
• have greater emphasis on health
promotion, disease prevention, & illness • Involve family and friends in care.
management. • Elicit patient values and preferences.
• Provide care with respect for diversity of
3. DEMOGRAPHIC CHANGES human experience.
• to effectively meet all health care needs of TEAMWORK & COLLABORATION
expanding & aging population, changes
need to occur as to how care is provided • Recognize the contributions of other
(outpatient-, community-, & home-based health team members & patient’s family
services) members.
• Discuss effective strategies for
4. MEDICALLY UNDERSERVED communicating & resolving conflicts.
• unemployment, underemployment and • Participate in designing methods to
low-paying jobs, mental illness, support effective teamwork.
homelessness, and rising healthcare costs
EVIDENCE-BASED PRACTICE
all contribute to increase the medically
underserved population. Caring for this • Demonstrate knowledge of basic scientific
population is a global challenge; social, methods.
political, economic, and health literacy • Appreciate strengths & weaknesses of
factors affect both access to health care- scientific bases for practice.
related resources. • Appreciate the importance of regularly
reading relevant journals.

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REVIEWER | FIRST SEMESTER FUNDAMENTALS OF NURSING PRACTICE

QUALITY IMPROVEMENT GENOMICS:

• Use tools such as flow charts & diagrams to • PRECONCEPTION AND PRTENATAL TESTING
make process of care explicit. • NEWBORN SCREENING
• Appreciate how unwanted variation in • DISEASE SUSCEPTIBILITY
outcome affects care. • SCREENING AND DIAGNOSIS
• Identify gaps between local & best • PROGNOSIS AND THERAPEUTIC DECISIONS
practices. • MONITORING DISEASE BURDEN AND
RECURRENCE
SAFETY
PROFESSIONAL RN (REGISTERED NURSE)
• Examine human factors& basic safety EDUCATION
design principles and commonly used
unsafe practice. BACCALAUREATE DEGREE PROGRAM
• Value own role in preventing errors.
• Includes 4 years of study in
INFORMATICS college/university.
• Navigate an electronic health record. MASTER’S DEGREE IN NURSING
• Protect confidentiality of protected health
• Provides the advanced clinician with
information in EHR (Electronic Health
strong skills in nursing science & theory.
Record).
• Important for the roles of educators &
IMPACT OF EMERGING TECHNOLOGIES administrators
ELECTRONIC HEALTH RECORD (EHR) PROFESSIONAL DOCTORAL PROGRAMS IN
NURSING
• offers an efficient method to record &
manage patient health care information. • Prepare graduates to apply research
findings to clinical nursing.
COMPUTERIZED PHYSICIAN/PROVIDER ENTRY
ORDER (CPEO)
• a key patient safety initiative. PADAYON NURSING!!!
3 SETS OF SKILLS NEEDED
1. Use technology to facilitate mobility,
communication & relationship (telehealth &
telemedicine)
2. Develop an expertise to acquire & distribute
knowledge (evidence-based practice, case-
based reasoning)
3. Understand & use genomics
GENOMICS
• Newer term that describes the study of all
the genes in a person and interactions of
these genes with one another and with
the person’s environment

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