Contemporary Nursing - E-Book

Barbara Cherry; Susan R. Jacob

BOOK

Contemporary Nursing - E-Book

Barbara Cherry | Susan R. Jacob

(2015)

Additional Information

Book Details

ISBN: 978-0-323-39037-8
Edition: 7
Language: English
Pages: 536
Subjects: General practice
Nursing
Nursing sociology

Abstract

Thoroughly prepare for the rapidly evolving world of nursing with Contemporary Nursing: Issues, Trends, & Management, 7^th Edition. Expert authors Barbara Cherry and Susan Jacob combine their own expertise from both academics and practice as they cover the relevant issues affecting today’s nurses. In 28 chapters, including a new chapter on palliative care, this comprehensive new edition takes readers through the evolution of nursing, the role of the nurse today, safe and effective decision-making, collaboration and communication, leadership, job opportunities, and a number of timely issues affecting healthcare and nursing practice today.

Full-color design enhances the narrative with a clear, visually appealing explanation of concepts.
Humorous cartoons open each chapter to illustrate the chapter themes.
Vignettes at the beginning of each chapter personalize nursing history and practice and help readers understand their place in the profession. Questions to Consider While Reading This Chapter follow the vignettes and prepare the reader for the topic to be discussed.
Key terms, learning outcomes, chapter overviews, and chapter summaries help readers focus their learning experience.
Unit on Leadership and Management in Nursing includes content to prepare nurses to effectively function in the management roles expected of the professional nurse.
Unit on Career Management provides strategies on how to make the transition from student to practitioner and tips on how to pass the NCLEX-RN Examination.
Case studies help readers apply theory to clinical practice.

NEW! Chapter on palliative care focuses on how to best provide patients with relief from the symptoms and stress of a serious illness, and how to improve the quality of life for both the patient and family.
NEW! Combined chapter on quality improvement and QSEN keeps readers up to date on the latest competencies from the Institute of Medicine.
NEW! Professional/Ethical Issue boxes provide a short scenario about an ethical issue related to the chapter content.
NEW! Updated coverage reflects the latest NCLEX test plan.
NEW! Incorporation of Triple Aim in healthcare discusses ways to improve the health of the population, enhance the experience and outcomes of the patient, and reduce per capita cost of care for the benefit of communities.
NEW! Expanded coverage of working in an interdisciplinary team reflects the changing healthcare landscape and need to work in collaboration with a variety of healthcare specialists.

Section Title	Page	Action	Price
Front cover	Cover
Contents	IFC
Unit 1 \tthe development of nursing	IFC
Unit 2\tcurrent issues in health care	IFC
Unit 3\tleadership and management in nursing	IFC
Unit 4\tcareer management	IFC
Front matter	i
Contemporary nursing	i
Copyright	iv
Dedication	v
How to use	iv
Being a nurse means . . .	iv
Contributors	vii
Reviewers	ix
Preface	xi
Who will benefit from this book?	xi
Organization	xi
Unit 1: The development of nursing	xi
Unit 2: Current issues in health care	xi
Unit 3: Leadership and management in nursing	xi
Unit 4: Career management	xi
Learning AIDS	xi
New to this edition	xii
Teaching and learning resources	xii
For instructors	xii
For students	xii
About the authors	xiii
Acknowledgments	xv
Table of contents	xvii
1 The Development of Nursing	1
1 The evolution of professional nursing	1
Learning outcomes	2
Key terms	2
Professional/ethical issue	2
Vignette	2
Questions to consider while reading this chapter:	2
Chapter overview	2
Prehistoric period	3
Early civilization	3
Egypt	3
Palestine	3
Greece	3
India	6
China	6
Rome	6
The middle ages	6
The renaissance and the reformation period	7
The colonial american period	7
Florence nightingale	7
Mary seacole	8
Nursing in the united states	9
The civil war period	9
1900 to world war I	10
World war I and the 1920s	11
The great depression (1930 to 1940)	12
World war II (1940 to 1945)	13
Post–world war II period (1945 to 1950)	13
Nursing in the 1960s	14
Nursing in the 1970s	15
Nursing in the 1980s	15
Nursing in the 1990s	16
Nursing in the twenty-first century	18
Summary	19
References	19
Additional resources	19
2 The contemporary image of professional nursing	21
Learning outcomes	22
Key terms	22
Professional/ethical issue	22
Response 1	22
Response 2	22
Vignette	22
Questions to consider while reading this chapter:	22
Chapter overview	22
Images of nursing	22
Why image is important	23
Registered nurse supply	23
Nursing in art and literature	24
Antiquity image of nursing	24
Victorian image of nursing	25
Early twentieth-century nursing	25
The 1930s nurse as angel of mercy	25
The 1940s nurse as heroine	25
Nursing in the antiestablishment era of the 1960s	26
Nursing in the sexual revolution of the 1970s	26
Millennial media	27
Social media	27
Nursing’s response	28
Media campaigns for nursing	28
The enduring public concern with nursing	28
The institute of medicine’s future of nursing	28
What the public believes about nursing	29
The reality of the contemporary staff nurse	29
Facts about today’s registered nurse	29
Creating the image of twenty-first century nursing	30
The basics	31
Changing nurse-physician interactions	31
The look of nursing	32
Creating a new image	33
Summary	34
References	34
3 The influence of contemporary trends and issues on nursing education	37
Learning outcomes	39
Key terms	39
Professional/ethical issue	39
Vignette	39
Questions to consider while reading this chapter:	39
Chapter overview	39
Introduction	40
Trends and issues in contemporary nursing education	40
Knowledge expansion and use of technology and the internet	40
Practice-based competency outcomes	43
Performance-based learning and assessment	44
Sociodemographics, cultural diversity, and economic and political changes	45
Community-focused interprofessional approaches	47
Global health	47
Patient-centered care: Engagement, safety, and privacy	48
Ethics and bioethical concerns	49
Shortage of nurses and faculty	49
Disasters, violence, and terrorism	50
Increasing professional and personal responsibilities	51
Diversity in nursing education programs	51
Licensed practical or vocational nurse programs	51
Hospital diploma programs	52
Associate degree programs	53
Baccalaureate degree nursing programs	53
Master’s degree nursing programs	54
Clinical nurse leader	55
Doctoral programs	55
Flexible education, mobility, and distance-learning programs	56
Summary	58
References	58
4 Nursing licensure and certification	62
Learning outcomes	64
Key terms	64
Professional/ethical issue	64
Vignette	64
Questions to consider while reading this chapter:	64
Chapter overview	64
The history of nursing licensure	64
Recognition: Pins and registries	64
Purpose of licensure	65
Early licensure activities	65
Mandatory licensure	66
Components of nurse practice acts	66
Purpose of act	66
Definition of nursing and scope of practice	67
Licensure requirements	67
Entry into practice licensure	67
Advanced practice nursing licensure	68
Renewal of licensure	68
Mandatory continuing education	68
Role of regulatory boards to ensure safe practice	68
Membership of the board of nursing	68
Duties of the board of nursing	68
Special cases of licensure	69
Military and government nurses	69
Internationally educated nurses	69
International practice	69
Revision of nurse practice acts	69
Sunset legislation	70
Delegation of authority to others	70
Current licensure activities	70
Mutual recognition model	70
Continued competency	71
Certification	71
History of certification	71
Purpose of certification	72
Steps to certification	73
Current issues in certification	73
The consensus model for aprn regulation, licensure, accreditation, certification, and education	74
Summary	74
References	74
5 Theories of nursing practice	75
Learning outcomes	76
Key terms	76
Professional/ethical issue	76
Vignette	76
Questions to consider while reading this chapter:	76
Chapter overview	76
Science and theory	77
Nursing science	78
Theories, models, and frameworks	78
Theory	78
Conceptual model	78
Nursing theory	78
Schematic models	78
Levels of theory	79
Florence nightingale: The first nursing theorist	81
Nightingale’s theory of practice	81
Ventilation and warming	82
Noise	82
Variety	82
Diet	82
Light	82
Chattering hopes and advices	82
Cleanliness (health of houses)	82
Survey of selected nursing theories	82
Betty neuman (1970)—the system model	84
Hildegard E. peplau (1952)—interpersonal relations as a nursing process: man as an organism that exists in an unstable e ...	84
Martha E. rogers (1970)—science of unitary human beings: Humans as energy fields that interact constantly with the envir ...	84
Dorothea orem (1971)—self-care deficit model: self-care, self-care deficits, and nursing systems	85
Sister callista roy (1974)—adaptation model: Assistance with the adaptation to stressors to facilitate the integration p ...	85
Madeline leninger (1977)—theory of cultural care diversity and universality	85
Jean watson (1978)—theory of human caring: Transpersonal caring as the fulcrum; philosophy and science as the core of nursing	85
Margaret newman (1979, revised 1986)—health as expanding consciousness	86
Merle mishel (1981, revised 1990)—uncertainty of illness	86
Future of nursing theories and theorists	86
Summary	86
References	87
Additional resources	87
6 Nursing research and evidence-based practice	88
Learning outcomes	90
Key terms	94
Ethical/professional issue	94
Vignette	94
Questions to consider while reading this chapter:	94
Chapter overview	94
Definition of nursing research	94
Evolution of nursing research	94
Research priorities	94
National institute of nursing research	94
Agency for healthcare research and quality	94
Private foundations	94
Nursing organizations	94
Components of the research process	94
Study designs	94
Quantitative designs	94
Qualitative designs	95
Triangulation	95
Pilot studies	95
Evidence-based practice and research utilization	95
Advancing evidence-based practice	96
Nurse researcher and evidence-based practice roles	97
Clinical nurse specialist	97
Clinical nurse researcher	97
Emerging roles	97
About the evidence	98
Locating published research and evidence summaries for evidence-based practice	98
Types and levels of evidence	99
Clinical practice guidelines	100
Critical appraisal	101
Evolution of evidence-based practice: Some examples	101
Ethical issues related to research	102
Institutional review	102
Historical examples of unethical research	102
Summary	103
References	103
2 Current Issues in Health Care	105
7 Paying for health care in america: Rising costs and challenges	105
Learning outcomes	107
Key terms	107
Professional/ethical issue	107
Vignette	107
Questions to consider while reading this chapter:	107
Chapter overview	107
History of health care financing	108
Health care financing revolution of the 1980s	108
The development of managed care	110
Access to health care—the problem of the uninsured and underinsured	111
The patient protection and affordable care act	112
How health care is paid	113
Private insurance	113
Public insurance: Medicare and medicaid	113
Effect of payment modes	113
Pay-for-performance	114
Never events	114
Value-based purchasing	114
Reducing readmissions	114
Implications for nurses: managing cost-effective, high-quality care	115
Care coordination	115
Expansion of technology	115
Consumer empowerment	116
Summary	116
References	117
8 Legal issues in nursing and health care	118
Learning outcomes	121
Key terms	121
Professional/ethical issue	121
Vignette	121
Questions to consider while reading this chapter:	121
Chapter overview	121
Sources of law and nursing practice	121
Statutory law	122
Federal statutes	122
Conditions of participation for hospitals in medicare (42 cfr part 482)	122
Emergency medical treatment and active labor law (cobra, 42 u.s.c. 1395dd)	123
Americans with disabilities act of 1990 (public law no. 101-336, 42 u.s.c. section 12101)	124
Patient self-determination act of 1990; omnibus budget reconciliation act of 1990 (public law no. 101-508, sections 4206 a ...	124
Health insurance portability and accountability act of 1996 (public law no. 104-191)	125
State statutes	125
State nurse practice act and board of nursing rules and regulations	125
Violations of an npa	126
Nurse-patient ratios and mandatory overtime statutes	128
Reporting statutes	129
Child abuse reporting statutes	130
Institutional licensing laws	130
Common law	131
Civil law	132
Negligence and malpractice	132
Elements essential to prove negligence or malpractice	133
Negligence and the doctrine of res ipsa loquitur	134
Gross negligence	135
Claims of negligence and student nurses	135
Criminal negligence	136
Defenses against claims of negligence	137
Emergency situations	138
Governmental immunity	138
Good samaritan immunity	138
Statutes of limitation in malpractice cases	139
Transparency and disclosure of error	139
Nursing malpractice insurance	140
Liability	140
Personal liability	140
Personal liability with floating and cross-training	141
Personal liability for team leaders and managers	143
Personal liability in delegation and supervision of team members	144
Employer liability	144
Corporate liability	145
Reducing legal liability	146
Risk management systems	146
Incident reports or unusual occurrence reports	146
Intentional torts in nursing practice	148
Assault and battery	148
Defamation of character	149
False imprisonment	149
Intentional infliction of emotional distress	149
Invasion of privacy	150
The nurse and criminal law	150
The law and patient rights	151
Advance directives	151
Living wills	151
Medical or physician directives and dnr orders	151
Durable power of attorney for health care	152
Informed consent	152
Communication barriers and informed consent	153
The right to refuse diagnostic testing, treatment, and care	154
Leaving against medical advice	154
Use of physical restraints	155
Summary	156
References	156
9 Ethical and bioethical issues in nursing and health care	161
Learning outcomes	162
Key terms	162
Professional/ethical issue	162
Vignette	162
Questions to consider while reading this chapter:	162
Chapter overview	163
Nursing ethics	163
Bioethics	164
Dilemmas for health professionals	164
Dilemmas created by technology	165
The ethics of care	166
Answering difficult questions	166
Balancing science and morality	166
Values formation and moral development	167
Examining value systems	167
Learning right and wrong	167
Understanding moral development theory	168
Moving toward moral maturity	168
Ethical theory	169
Utilitarianism	170
Deontology	170
Ethical principles	170
Autonomy	170
Beneficence and nonmaleficence	170
Veracity	171
Ethical decision-making model	171
Situation assessment procedure	172
Identify and analyze available alternatives for action	172
Select one alternative	172
Justify the selection	172
Usefulness and application of the situation assessment procedure	172
Bioethical dilemmas: Life, death, and dilemmas in between	173
Life	173
The end of life	174
Dilemmas in between	174
The right to health care	174
Allocation of scarce resources	174
Ethical challenges	175
The challenge of veracity	175
The challenge of paternalism	175
The challenge of autonomy	176
The challenge of accountability	176
Summary	177
References	178
10 Cultural competency and social issues in nursing and health care	179
Learning outcomes	180
Key terms	180
Professional/ethical issue	180
Vignette	180
Questions to consider while reading this chapter:	180
Chapter overview	180
Population trends	181
Federally defined minority groups are:	181
Marginalized populations	182
Economic and social changes	182
Poverty	182
Violence	183
Attitudes toward culturally diverse groups	183
Diversity in the health care workforce	184
Need for diversity in the health care workforce	184
Current status of diversity in the health care workforce	184
Recruitment and retention of minorities in nursing	186
Strategies for recruitment and retention of minorities in the health care workforce	187
Cultural competence	188
Cultural competence in nursing education	188
Cultural belief systems	190
Cultural phenomena	190
Environmental control	190
Biologic variations	191
Social organization	191
Communication	191
Space	192
Time	192
Practice issues related to cultural competence	194
Health information and education	194
Education and certification	194
International marketplace	194
Nursing literature	194
Responsibility of health care facilities for cultural care	195
Recommended standards for culturally and linguistically appropriate services (clas)	196
Cultural assessment	196
Cultural self-assessment	196
Cultural client assessment	196
Cultural client nutrition assessment	197
Cultural beliefs about sickness and cures	198
Summary	200
References	200
Additional resources	201
11 Complementary and alternative healing	202
Learning outcomes	203
Key terms	203
Professional/ethical issue	203
Vignette	203
Questions to consider while reading this chapter:	203
Chapter overview	203
Use of complementary and alternative healing methods	204
Principles underlying alternative healing	204
Overview of popular cam healing therapies	205
Acupuncture	205
Ayurveda	206
Biofeedback	207
Chiropractic medicine	207
Dietary supplements	207
Herbs	207
Homeopathy	208
Hypnotherapy	210
Imagery	210
Magnet therapy	211
Massage, bodywork, and energy therapies	211
Meditation and progressive relaxation	212
Naturopathy	212
Prayer and faith	213
Tai chi	213
Yoga	213
Nursing and complementary and alternative medicine therapies	213
A holistic approach	213
Facilitating use of complementary and alternative medicine	214
Integrating complementary and alternative medicine into conventional settings	214
Using complementary and alternative medicine competently	216
Legal considerations	216
Summary	216
References	216
Additional resources	218
12 Palliative care	219
Learning outcomes	220
Key terms	220
Professional/ethical issue	220
Vignette	220
Questions to consider while reading this chapter	220
Chapter overview	220
Introduction	222
The natural course of serious illness	222
Prognostication	223
Two roads to death	224
Criteria for palliative care	226
Key elements of palliative care	226
Eight elements of end-of-life nursing education consortium	226
Eight domains of national consensus project	227
Benefits of palliative care	227
Pain and symptom management	228
Suffering	228
Family caregiving	229
Barriers to palliative care	229
Common challenges	230
Professional issues in palliative care	231
Certification	231
Quality assessment and improvement	231
Research	231
Ethical concerns	231
Advance care planning	231
Double effect	232
Palliative sedation	232
Medically futile care	232
Legal concerns	232
Right to refuse treatment	232
Summary	232
References	232
13 Workforce advocacy for a professional nursing practice environment	236
Learning outcomes	237
Key terms	237
Professional/ethical issue	237
Vignette	237
Questions to consider while reading this chapter:	237
Chapter overview	237
Promoting workforce advocacy and a professional practice environment	238
Nursing shortages and workforce challenges	239
Future rn employment opportunities	240
Health care as a challenging work environment	240
Nursing school enrollments and recruitment	240
Educational preparation	241
Faculty shortages	241
Nurse retention	241
Aging workforce and retention	241
Emerging workforce recruitment and retention	242
Nursing salaries	242
Work environment	242
Safe staffing	243
Floating and mandatory overtime	246
Patient advocacy and safety	246
Patient safety	247
Whistle-blower protection	247
Nurse and workplace safety	248
Exposure to bloodborne pathogens	248
Ergonomic injuries	249
Workplace violence and incivility in the workplace	249
Fatigue	250
Advocating for a safer workplace	250
Magnet recognition program®	250
Pathway to excellence® recognition program	251
Shared governance	251
Summary	252
References	252
14 Collective bargaining and unions in todays workplace	256
Learning outcomes	258
Key terms	258
Professional/ethical issue	258
Vignette	258
Questions to consider while reading this chapter:	258
Chapter overview	258
Development of collective bargaining in america	258
Early activities	258
Federal legislation	258
Development of collective bargaining in nursing	259
The collective bargaining process	259
The preformal period in union organizing	259
Right-to-work laws	260
Allowable actions during the union organizing effort	260
The election process	261
Post election	261
Principles to guide fairness during union organizing	262
Unions and professional nursing	262
Professionalism versus unionization	262
Questions to answer	262
Gains for the nursing profession and patient care?	262
Promoting a positive work environment	263
Management or staff?	263
To strike or not?	264
Nursing unions and interprofessional teamwork?	265
Summary	265
References	265
15 Information technology in the clinical setting	266
Learning outcomes	267
Key terms	267
Professional/ethical issue	267
Vignette	267
Questions to consider while reading this chapter:	267
Chapter overview	267
Health information technology across the globe	268
Health information technology in the united states	268
Electronic health records	268
Key functions of the ehr	269
Ehr data management	269
Data capture	270
Storage	270
Information processing	271
Information communication	271
Security	271
Information presentation	271
Ehrs and “meaningful use”	272
Opportunities and barriers to adoption of ehrs in the united states	272
Ehrs and the health insurance portability and accountability act	273
Point-of-care technology	273
Telehealth	273
Information literacy for nurses	274
Consumer health information technology	274
Finding information on the internet	275
Evaluating information found on the internet	276
Future health information technology trends	277
Summary	277
References	277
16 Emergency preparedness and response for todays world	279
Learning outcomes	281
Key terms	281
Professional/ethical issue	281
Vignette	281
Questions to consider while reading this chapter:	281
Chapter overview	281
The national imperative for emergency preparedness	282
The basics of emergency preparedness and response	283
Phases of disaster	285
Preparedness phase	285
Metropolitan medical response system	286
National disaster medical system	287
Disaster medical assistance teams	287
Commissioned corps	287
Strategic national stockpile	287
Relief response phase	288
Response activities	288
National incident management system	288
Personal protection and safety	288
Communication within the health care facility	289
Lessons learned from mass casualty incidents	289
Biologic causes of mass casualty	290
Pandemic influenza	290
Ebola	291
Manmade causes of mass casualty: Active shooter events	291
Summary	292
References	293
3 Leadership and Management in Nursing	294
17 Nursing leadership and management	294
Learning outcomes	295
Key terms	295
Professional/ethical issue	295
Vignette	295
Questions to consider while reading this chapter:	295
Chapter overview	296
Leadership and management defined and distinguished	296
Leadership defined	296
Management defined	297
Leadership versus management	297
Power and authority	297
Formal and informal leadership	297
Leadership theory	298
Leadership trait theory	298
Transformational leadership	298
Leadership skills	298
Management theory	299
Organizational theory	300
Systems theory	300
Chaos theory	301
Management functions	301
Planning	301
Mission and philosophy	301
Strategic planning	302
Goals and objectives	303
Operational planning	304
Organizing	304
Staffing	304
Directing	305
Communicating performance expectations	305
Creating a motivating climate	306
Role modeling	306
Controlling	307
Establishing performance standards	307
Evaluating employee performance	307
Roles of the nurse leader and manager	308
Patient satisfaction and customer service provider	308
Team builder	308
Resource manager	309
Decision maker and problem solver	309
Nursing process as a guide for decision making and problem solving	309
Assessment.	309
Analysis and diagnosis.	309
Planning.	310
Implementation.	310
Evaluation.	310
Change agent	310
Stages of change	311
Involvement	311
Education and training	311
Clinical consultant	311
Staff developer	311
Mentor	311
Corporate supporter	311
Creating a caring and respectful environment	312
Addressing and preventing bullying	312
Special leadership challenges in the twenty-first century	313
Summary	313
References	314
18 Budgeting basics for nurses	315
Learning outcomes	317
Key terms	317
Professional/ethical issue	317
Vignette	317
Questions to consider while reading this chapter:	317
Chapter overview	317
What is budgeting?	317
Planning	318
Coordinating and communicating	318
Monitoring progress	319
Evaluating performance	319
Types of budgets	319
Operational budget	319
Labor budget	320
Capital budget	320
Budget methods	321
Incremental budgeting	321
Zero-based budgeting	321
Developing a budget	321
Variance analysis	323
Cost concepts related to budgeting	323
Improving the cost and quality of clinical care	326
Summary	327
References	327
19 Effective communication and conflict resolution	328
Learning outcomes	329
Key terms	329
Professional/ethical issue	329
Vignette	329
Questions to consider while reading this chapter:	329
Chapter overview	329
Our profession speaks	329
The communication process	329
Interpretation	330
Context and environment	330
Precipitating event	331
Preconceived ideas	331
Style of transmission	331
Past experiences	331
Personal perceptions	331
Filtration	331
Feedback	331
Verbal versus nonverbal communication	331
Verbal communication	332
Nonverbal communication	332
Positive communication techniques	333
Developing trust	333
Using “I” messages	333
Establishing eye contact	333
Keeping promises	334
Expressing empathy	334
Using open communication	334
Clarifying information	334
Being aware of body language	334
Using touch	334
Negative communication techniques	335
Blocking	335
False assurances	335
Conflicting messages	336
Logical fallacies	336
AD hominem abusive	336
Appeal to emotion	336
Red herring	336
Listening	336
Written and electronic communication	336
Accuracy	338
Attention to detail	338
Thoroughness	339
Conciseness	339
Electronic communication	339
Communication styles	340
Assertive communication	340
Aggressive communication	341
Passive communication	341
Passive-aggressive communication	341
Special influences on communication	341
Communication and gender differences	341
Communication and generational differences	342
Traditionalists	342
Baby boomers	343
Generation X	343
Millennials	343
Homelanders	343
Communication and cultural diversity	343
Interprofessional team communication	344
Confidentiality and privacy	344
Social media—warning! warning! warning!	344
Social media: Good and bad	344
Online etiquette	345
Understanding and managing conflict	346
The nature of conflict	346
Conflict resolution	346
Summary	349
References	349
20 Effective delegation and supervision	351
Learning outcomes	353
Key terms	353
Professional/ethical issue	353
Vignette	353
Questions to consider while reading this chapter:	353
Chapter overview	353
Delegation and supervision in the health care system	353
What is delegation?	353
What should and should not be delegated?	354
State nurse practice acts	354
Patient needs	355
Job descriptions and competencies	355
Organizational policies and procedures	357
Clinical situation	357
Professional standards of nursing practice	357
Developing safe delegation practices	358
Know the patient	358
Know the staff member	359
Know the task(s) to be delegated	359
Explain the task and expected outcomes	359
Expect responsible action from the delegatee	359
Assess and supervise job performance	359
Evaluate and follow up	359
Understand high-risk delegation	359
Supervision	361
Assigning versus delegating	362
Assignment considerations	362
Working with interprofessional health care team members	362
Building delegation and supervision skills	363
Communicate effectively	363
Create an environment of trust and cooperation	363
Provide feedback and follow-up evaluation	363
Summary	364
References	364
21 Staffing and nursing care delivery models	365
Learning outcomes	366
Key terms	366
Professional/ethical issue	366
Vignette	366
Questions to consider while reading this chapter:	366
Chapter overview	367
Staffing	367
Staffing and patient needs	367
Patient classification systems	367
Level of staff preparation and experience	368
Staffing and staff satisfaction	368
Staffing and organizational needs	368
Financial resources	369
Licensing regulations and accreditation	369
Customer satisfaction	369
Nursing care delivery models	369
Total patient care	370
Functional nursing	370
Team nursing	371
Primary nursing	372
Partnership model	372
Patient-centered care	373
Case management	373
Case management related to other nursing care delivery models	373
Newer models of case management	373
Clinical pathways	374
Components of clinical pathways	375
Choosing a nursing care delivery model	375
Future nursing care delivery models	376
Summary	376
References	377
22 Quality improvement and patient safety	378
Learning outcomes	380
Key terms	380
Professional/ethical issue	380
Vignette	380
Questions to consider while reading this chapter:	380
Chapter overview	381
The urgent case for quality improvement in the u.s. health care system	381
Principles of quality improvement	382
Quality	382
Scientific approach	383
All one team	383
Advancing quality through regulation and accreditation	384
The joint commission	384
Core measures: National hospital quality measures	384
Clinical indicators and process improvement tools and skills	385
Flowcharts	385
Pareto charts	386
Cause-and-effect diagrams	387
Run charts	387
Understanding, improving, and standardizing care processes	388
Clinical pathways or critical pathways	388
Clinical protocols or algorithms	388
Breakthrough thinking to improve quality	390
Patient safety	390
Institute for safe medication practices	390
Role of regulatory and accrediting agencies to promote patient safety	391
Sentinel event standard	391
National patient safety goals	391
Never events	392
The professional nurse and patient safety	392
Nursing quality indicators	392
Interprofessional teamwork	393
QSEN (quality and safety education in nursing) competencies	393
Role of professional nurses in quality improvement	395
Summary	396
References	396
23 Health policy and politics: Get involved!	397
Learning outcomes	399
Key terms	399
Professional/ethical issue	399
Vignette	399
Questions to consider while reading this chapter:	399
Chapter overview	399
Nurses’ involvement in health policy and political action	399
What is health policy?	400
Health policy at the local, state, and federal level	400
Local health policy	400
State health policy	400
Federal health policy	401
How is health policy developed?	402
Legislation and health policy development	402
Health policy through regulation	404
Health policy and politics: A key connection	405
Health policy and the nursing process	405
Grassroots political strategies	405
Register to vote and vote in all elections	406
Join a professional nursing organization	406
Work in political candidates’ campaigns	406
Visit with policymakers and their staff members	406
Participate in “meet the candidates” town hall meetings	407
Communicate with policymakers through e-mail, fax, and telephone	407
The american nurses association	408
Nurses strategic action team	408
Current health policy issues	409
Health care reform	409
The iom future of nursing report	411
Other nursing policy initiatives	411
Summary	412
References	412
4 Career Management	413
24 Making the transition from student to professional nurse	413
Learning outcomes	414
Key terms	414
Professional/ethical issue	414
Vignette	414
Questions to consider while reading this chapter:	414
Chapter overview	415
Real-life scenario	415
Reality shock	415
Honeymoon phase	416
Shock (rejection) phase	416
Natives	417
Runaways	417
Rutters	417
Burned out	417
Compassion fatigue	417
Loners	418
New nurse on the block	418
Change agents	418
Recovery phase	418
Resolution phase	418
Causes of reality shock	419
Partial-task versus whole-task system	420
Evaluation methods	420
From novice to expert	421
Special needs of novice nurses	421
Interpersonal skills	421
Clinical skills	422
Organizational skills	422
Delegation skills	423
Priority-setting skills	423
Assertiveness skills	423
Violence at work	424
Intuition	424
Strategies to ease transition	425
Biculturalism	425
Role models and mentors	425
Preceptorships	425
Self-mentoring	426
Residency programs	426
Preprofessional and professional organizations	426
Self-confidence and self-esteem	426
Violence prevention	427
Keys to survival during transition	428
Meeting special needs of the novice nurse	429
Organizational skills	429
Clinical skills	429
Interpersonal skills	429
Delegation skills	430
Priority-setting skills	431
Summary	431
References	432
25 Managing time: The path to high self-performance	434
Learning outcomes	436
Key terms	436
Professional/ethical issue	436
Vignette	436
Questions to consider while reading this chapter:	436
Chapter overview	436
Health care today	436
Perspectives on time	437
Energy management	438
Physical energy	438
Mental energy	438
Spiritual energy	439
Emotional energy	439
Time distractions and energy distractions	439
Time-management strategies	439
Planning, organizing, and implementing to control the use of time	440
Planning for control	440
Setting priorities	440
Scheduling activities	441
Establishing a to-do list	442
Organizing for control	442
The stacked-desk syndrome	442
The art of “no detourism”	442
The art of “wastebasketry”	443
E-mail and memo mania	443
Implementing for control	443
Attacking the priorities	443
Finding “extra” time	443
Handling e-mail and paperwork appropriately	444
Avoiding procrastination	444
Delegating appropriately	444
Controlling interruptions	445
Learning the art of saying no	445
Rewarding yourself	446
Using technology	446
Continuing to succeed	447
Summary	447
References	448
26 Contemporary nursing roles and career opportunities	449
Learning outcomes	450
Key terms	450
Professional/ethical dilemma	450
Vignette	450
Questions to consider while reading this chapter:	450
Chapter overview	450
Nursing—much the same, but bigger and better	451
Care provider	451
Educator and counselor	451
Client advocate	451
Change agent	451
Leader and manager	451
Researcher	451
Coordinator of the interprofessional health care team	452
Nurses today: Who are they, and what are they doing?	452
Demographics for registered nurses	454
Hospital opportunities	455
Infection control	456
Quality management	456
Specific client services	456
Coordinator positions	456
Variations on traditional roles in nursing	456
Hospice nurse	457
Informatics nurse specialist	457
Occupational health opportunities	457
Quality manager	458
Case manager	459
Flight nurse	459
Telephone triage nurse (telehealth nurse)	459
Forensic nurse	459
School nurse	459
Travel nurse	460
Faith community nurse	460
Nursing educator	460
Other unique roles	461
Advanced practice nursing	461
Nurse practitioner	461
Clinical nurse specialist	462
Certified registered nurse anesthetist	462
Certified nurse-midwife	463
Nurse administrator or nurse executive	464
What about the future?	464
Summary	465
References	465
27 Job search: Finding your match	467
Learning outcomes	468
Key terms	468
Professional/ethical issue	468
Vignette	468
Questions to consider while reading this chapter:	468
Chapter overview	468
Exploring options	468
Knowing oneself	469
Networking	470
Written introductions	471
How to write a cover letter	471
How to prepare a résumé	471
How to prepare a portfolio	474
How to interview effectively	475
How to prepare: Planning ahead	476
How to prepare: Self-talk	476
How to prepare: Rehearse	476
How to prepare: The interview itself	477
Dress appropriately	477
Arrive on time	477
Bring a résumé	477
The telephone interview	477
The face-to-face interview	478
1. What positions interest you?	478
2. Tell me about your work history	478
3. How did you choose to apply for a job here?	478
4. Do you want a full-time or part-time position, and which shift do you prefer?	478
5. What are your strengths and weaknesses?	478
6. It is not advisable to avoid the issue of weaknesses	479
7. What would you do if . . .?	479
8. Why should we hire you?	479
9. What questions do you have?	479
The applicant’s tasks	480
Assess the climate of the work environment	480
Ask for a tour	480
Follow-up	481
Thank-you letter	481
Avoid impulse decisions	481
Weighing options	481
Does the position match the nurse’s qualifications?	481
What are the actual responsibilities of the job?	481
Does this position lead the nurse in the direction of projected career goals?	482
How will the work be compensated?	482
The employer’s tasks	482
Summary	484
References	484
Additional resource	484
28 The NCLEX-RN examination	485
Learning outcomes	486
Key terms	486
Professional/ethical issue	486
Vignette	486
Questions to consider while reading this chapter:	486
Chapter overview	486
Are you prepared for the NCLEX-RN examination?	486
The NCLEX-RN examination	487
Purpose of the NCLEX-RN examination	487
Characteristics of the NCLEX-RN examination	487
Computer adaptive testing	487
Skipping questions and changing answers	488
Question format	488
Traditional format: Multiple-choice, one option	488
Alternate item format	489
Cognitive domains and the NCLEX-RN examination	490
Knowledge questions (remember)	490
Comprehension questions (understand)	490
Application questions (apply)	491
Analysis questions (analyze)	491
Components of the NCLEX-RN® examination test plan	491
Client needs	491
Safe and effective care environment	491
Health promotion and maintenance	492
Psychosocial integrity	492
Physiologic integrity	492
Integrated processes	492
Nursing process	492
Assessment.	492
Analysis.	492
Planning.	492
Implementation.	492
Evaluation.	492
Caring	493
Communication and documentation	493
Teaching and learning	493
Preparing for the NCLEX-RN® examination	493
Build your NCLEX study plan	494
Food for thought when selecting an NCLEX-RN review course	495
Summary	496
References	496
Index	497
A	497
B	498
C	498
D	500
E	501
F	502
G	503
H	503
I	503
J	505
K	505
L	505
M	506
N	507
O	510
P	510
Q	512
R	512
S	512
T	514
U	515
V	515
W	516
Y	516
Z	516

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