Fundamentals of Nursing

Fundamentals of Nursing Chapter 1 – Nursing and the Health Care Environment 🎨 Nursing: Art + Science

  • Art β†’ compassion, caring, respect for dignity
  • Science β†’ evidence-based practice, updated with new discoveries πŸ‘©β€βš• Benner’s Stages of Nursing Proficiency
  1. 🍼 Novice
  2. 🌱 Advanced Beginner
  3. βš– Competent
  4. 🎯 Proficient
  5. ⭐ Expert 🧠 Critical Thinking
  • Essential skill for safe care
  • Combine scientific knowledge + clinical experience
  • Be a lifelong learner πŸ“ Standards of Practice (ANA)
  • Nursing Process: Assessment β†’ Diagnosis β†’ Outcomes β†’ Planning β†’ Implementation β†’ Evaluation
  • Professional Performance: Ethics, Quality, Communication, Leadership, Collaboration βš– Code of Ethics
  • Guides right vs. wrong in patient care
  • Nurses align personal values with professional standards πŸ›‘ Roles & Responsibilities
  • Autonomy/Accountability – take responsibility for care decisions
  • Caregiver – promote healing & independence
  • Advocate – protect rights
  • Educator – teach & explain health concepts
  • Communicator – build relationships
  • Manager – coordinate team & resources πŸš€ Career Paths
  • Clinician, NP, CNS, Nurse Midwife, CRNA, Educator, Administrator, Researcher 🌟 Historical Figures
  • Florence Nightingale – sanitation, first school of nursing, epidemiologist
  • Clara Barton – founded American Red Cross
  • Mary Mahoney – first African American RN
  • Lillian Wald & Mary Brewster – Henry Street Settlement (community health) 🌍 Trends in Nursing
  • Evidence-Based Practice (EBP)
  • QSEN β†’ safety & quality competencies
  • Technology β†’ EHR, CPOE
  • Genomics & genetics
  • Nursing’s role in politics & health policy πŸ“˜ Chapter 2 – Health & Health Care Delivery ⚠ Challenges in U.S. Health Care
  • Complex & costly system
  • Many uninsured β†’ delay/skipped care
  • Aging population = ↑ demand
  • Shortage of primary care physicians & nurses πŸ₯ Levels of Health Care
  1. Preventive – screenings, immunizations
  2. Primary – health promotion, well-baby, nutrition counseling
  3. Secondary – specialist care (ER, med-surg, cardiologist)
  4. Tertiary – highly specialized (ICU, surgery)
  5. Restorative – rehab, home care, sports med
  6. Continuing – long-term, hospice, assisted living 🏑 Health Care Settings
  • Home Care – individualized, family-centered
  • Rehabilitation – PT/OT/speech, regain independence
  • Extended Care – skilled nursing, IV, wound care
  • Assisted Living – autonomy but some support
  • Respite Care – relief for caregivers
  • Adult Day Care – daytime care, meds, activities
  • Hospice/Palliative – comfort, dignity, not curative πŸ’² Health Care Costs & Quality
  • Medicare/Medicaid use DRGs for payment
  • Affordable Care Act (ACA) ties quality β†’ reimbursement
  • Value-based care: ↓ readmissions, ↑ patient satisfaction πŸ§‘β€πŸ€β€πŸ§‘ Patient-Centered Care
  • Clear communication
  • Respect preferences
  • Family support
  • Emotional + physical needs πŸ… Magnet Recognition Program
  • Recognizes hospitals with nursing excellence
  • Components: leadership, empowerment, evidence-based practice, innovation, outcomes πŸ€– Technology & Future of Care
  • AI, robotics, telemedicine, telehealth
  • Nurses must evaluate & use tech safely
  • Diversity, Equity & Inclusion β†’ reduce disparities
  • Future = consumer-centered + nurse-driven Chapters 5 & 6 - Evidence-Based Practice (EBP) & Performance Improvement (PI) πŸ”Ή Evidence-Based Practice (EBP)
  • Uses the best available evidence (research + clinical expertise + patient preference) to guide care
  • Goal = improve patient outcomes and ensure safe, effective nursing care πŸ”Ή Performance Improvement (PI)
  • A continuous process to make health care safer, more effective, and efficient
  • Looks at local work processes (like how a hospital unit runs)
  • If problems are found (like a sentinel event, active error, or latent error), a PI project is started
  • PI + EBP together = strong foundation for quality patient care πŸ”Ή Research vs EBP vs PI
  • Research = creates new, general knowledge
  • EBP = uses research + evidence for patient care decisions
  • PI = improves local processes (not always generalizable)
  • Sometimes, EBP or PI can uncover problems that need further research πŸ“˜ Chapter 3 – Community Nursing 🏘 Community-Based Nursing Practice
  • Focus: health promotion, disease prevention, restorative care
  • Collaborative & patient-centered
  • Nurses: assess β†’ plan β†’ implement β†’ evaluate community services 🌍 Community-Based Health Care
  • Reaches everyone, including poor & uninsured
  • Deals with chronic illness, STDs, substance abuse, low immunization rates
  • Challenges: politics, social determinants, disparities, economics πŸ“Š Population Health
  • Covers public health prevention β†’ disease management
  • Goal: health equity & better health for all 🎯 Healthy People 2030 Goals
  • ↑ Life expectancy & quality of life
  • ↑ Health literacy
  • Eliminate disparities
  • Better access & delivery of care πŸ— Social Determinants of Health (SDOH)
  • Factors shaping health:
    • πŸ’° Economic stability
    • πŸ“š Education
    • πŸ₯ Health care access
    • 🏘 Neighborhood/built environment
    • 🀝 Social/community context βš– Health Equity & Disparities
  • Equity = everyone can achieve best health
  • Disparities = preventable differences (poverty, lack of care, unsafe environment) πŸ§‘β€βš• Roles in Community Health Nursing
  • Caregiver
  • Case Manager
  • Change Agent
  • Advocate
  • Collaborator
  • Counselor
  • Educator
  • Epidemiologist 🌎 Global Health Impact
  • ↑ Travel, climate change, urbanization β†’ new infections (COVID-19, Ebola, Dengue)
  • Nurses = frontline in prevention & education πŸ‘₯ Vulnerable Populations
  • Poverty, homeless, older adults, disabled, immigrants, abuse victims, mentally ill, substance users 🧾 Community Assessment
  • Look at: structure (services, meeting places), population (demographics), and social systems (schools, agencies) πŸ“˜ Chapter 4 – Theoretical Foundations of Nursing Practice πŸ“š What is Theory?
  • Explains events by defining concepts & predicting outcomes
  • Links theory β†’ research β†’ practice
  • Nursing theory = explains/describes/predicts/prescribes nursing care 🌐 Domain & Paradigm of Nursing
  • Domain = nursing’s perspective/territory
  • Paradigm = pattern of beliefs guiding practice
  • Metaparadigm Concepts:
    • πŸ‘© Person – patient, family, community
    • ❀ Health – individual meaning & needs
    • 🌎 Environment – all factors affecting care
    • πŸ‘©β€βš• Nursing – diagnosis & treatment of human responses 🌟 Notable Theorists
  • 🌸 Nightingale – environment affects health
  • πŸ—£ Peplau – nurse-patient relationships
  • 🌍 Leininger – transcultural caring
  • πŸ™Œ Orem – self-care deficit
  • πŸ’– Watson – human caring
  • 🧩 Henderson – assist with activities for health/recovery
  • πŸ”„ Roy – adaptation model
  • 🌱 Benner – caring = foundation for connection & coping πŸ”— Theory, Research, Practice
  • Theory builds nursing knowledge base
  • Research tests & improves theories
  • Practice applies theory in real care
  • Together β†’ strengthen nursing as both art & science πŸ“˜ Chapter 6: Health & Wellness πŸ”Ή Maslow’s Hierarchy of Needs
  • Human needs are connected (not always step-by-step)
  • Nurses prioritize based on what the patient needs most at the moment (ex: airway > emotional support) πŸ”Ή Health Promotion & Prevention
  • Health Promotion = keeping or improving health (exercise, good nutrition)
  • Health Education = teaching people how to care for themselves
  • Illness Prevention = stopping disease before it gets worse πŸ”Ή Three Levels of Prevention βΏ‘ Primary – prevent disease before it starts (e.g., flu shot, exercise) βΏ’ Secondary – catch disease early & prevent complications (e.g., screenings, BP checks) βΏ£ Tertiary – rehab & manage permanent conditions (e.g., stroke rehab, diabetes management) πŸ”Ή Risk Factors
  • Nonmodifiable = age, genetics, sex, family history
  • Modifiable = lifestyle (diet, smoking, exercise)
  • Environmental = where you live, pollution, water quality πŸ”Ή Stages of Behavior Change (Transtheoretical Model)
  1. πŸ’€ Precontemplation – not thinking of change
  2. πŸ€” Contemplation – thinking about change
  3. πŸ“ Preparation – small steps before change
  4. πŸš€ Action – making the change
  5. πŸ”’ Maintenance – keeping the change long-term πŸ”Ή Illness
  • Disease = medical condition
  • Illness = how the person feels/experiences it (physical, emotional, spiritual impact)
  • Acute = short & severe
  • Chronic = lasts > 6 months πŸ”Ή Impact of Illness
  • Changes emotions
  • Changes self-image
  • Affects family roles
  • Affects relationships πŸ”Ή Caring for Yourself (as a nurse)
  • Eat well
  • Sleep enough
  • Exercise & relax
  • Balance work & life
  • Care for spiritual health
  • Build coping skills
  • Allow time to grieve *Β FindΒ aΒ mentor