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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