From Wikipedia, the free encyclopedia
This article is about the practice in general. For the occupation, see
Nurse. For the physical act in humans, see
Breastfeeding. For the physical act in animals, see
Lactation.
Nursing is a profession focused on assisting individuals, families, and communities in attaining, maintaining, and recovering optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life.
[edit] History of nursing
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- See also: Category:Nurses and Category:Nursing museums
Nursing comes in various forms in every culture, although the definition of the term and the practice of nursing has changed greatly over time. The oldest sense of the word in the English language a woman employed to suckle and/or generally care for a younger child. The former being known as a wet nurse and the latter being known as a dry nurse.[1] In the 15th century, this developed into the idea of looking after or advising another, not necessarily meaning a woman looking after a child.[1] Nursing has continued to develop in this latter sense, although the idea of nourishing in the broadest sense refers in modern nursing to promoting quality of life.
Prior to the foundation of modern nursing, nuns and the military often provided nursing-like services.[2] The religious and military roots of modern nursing remain in evidence today in many countries. For example: in Britain, senior female nurses are known as ‘‘sisters’’. It was during time of war that a significant development in nursing history arose when Florence Nightingale, working to improve conditions of soldiers in the Crimean War, laid the foundation stone of professional nursing with the principles summarised in the book Notes on Nursing. Other important nurses in the development of the profession include: Mary Seacole, who also worked as a nurse in the Crimea; Agnes Elizabeth Jones and Linda Richards, who established quality nursing schools in the USA and Japan, and Linda Richards who was officially America's first trained nurse, graduating in 1873 from the New England Hospital for Women and Children in Boston.
New Zealand was the first country to regulate nurses nationally, with adoption of the Nurses Registration Act on the 12th of September, 1901. Ellen Dougherty was the first registered nurse. North Carolina was the first state in the United States to pass a nursing licensure law in 1903.
Nurses have experienced difficulty with the hierarchy in medicine that has resulted in an impression that nurses primary purpose is to follow the direction of medics.[3] This tendency is certainly not observed in Nightingale's Notes on Nursing, where the doctors are mentioned relatively infrequently and often in critical tones, particularly relating to bedside manner.[4]
The modern era has seen the development of nursing degrees and nursing has numerous journals to broaden the knowledge base of the profession. Nurses are often in key management roles within health services and hold research posts at universities.
[edit] Nursing as a profession
The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at national or state level.
The aim of the nursing community worldwide is for its professionals to ensure quality care for all, while maintaining their credentials, code of ethics, standards, and competencies, and continuing their education. [5] There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and practice and training in clinical skills.
Nurses care for individuals who are healthy and ill, of all ages and cultural backgrounds, and who have physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for those individuals.
In order to work in the nursing profession, all nurses hold one or more credentials depending on their scope of practice and education. A Licensed practical nurse(LPN) (also referred to as a Licensed vocational nurse, Registered practical nurse, Enrolled nurse, and State enrolled nurse) works under a Registered nurse. A Registered nurse (RN) provides scientific, psychological, and technological knowledge in the care of patients and families in many health care settings. ($30,000-$50,000/yr base). Registered nurses may also earn additional credentials or degrees enabling them to work under different titles such as:
- Advanced Practice Registered Nurse (APRN)- Provides primary care and specialized advanced nursing services to patients and families. Principle types of APRNs include: Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse Midwife (CNM) ($40,000-$65,000/yr+)
- Nurse Educator - Utilizes educational methodologies to present current information in patient care settings, universities, and communities. Types of nurse educators include: Clinical Instructor, College/University Professor, Staff Development Specialist, and Patient Education Specialist($30,000-$75,000/yr+)
- Nurse Administrator - Coordinates the use of human, financial, and technological resources to provide patient care. ($40,000-$90,000/yr+)
- Nurse Researcher - Utilizes statistical methodologies to discover or establish facts, principles or relationships. ($40,000-$75,000/yr+)
There is no profession which offers as many opportunities for diversified roles as does nursing. Nurses may follow their personal and professional interests by working with any group of people, in any setting, at any time. Some nurses follow the traditional role of working in a hospital setting. Within the hospital setting, nurses may work in areas including:
- Critical Care; Emergency; Maternal/Child Care; Medical: Cardiology, Diabetes, Gastroenterology, Gerontology, Nephrology, Neurology, Oncology, Pulmonary, Rehabilitation, Renal, Rheumatology, Urology; Operating Room/Recovery Room; Pediatrics; Psychiatric/Mental Health; Surgical: Burn, Cardiovascular, Ear/Nose/Throat, Gastroenterology, Orthopedics, Plastic Reconstructive, Transplant
Others may work in non-hospital settings including:
- Public/Community Health; Mental Health Agencies; Home Health Care; Physician's Office; Health Maintenance Organizations and Managed Care Companies; Insurance; Occupational Health; Research Centers; Extended Care Facilities; Clinics; Outpatient Surgery Centers; Hospices; Community Schools, Day Care Centers; Military Branches; Independent Practice; Schools of Nursing; Senior Centers, Shelters, Churches
[edit] The high demand for nurses
The demand for nurses has been on the rise for several years, spurred by various economic and demographic factors. And demand for nurses is likely to continue to increase. Candidates for nursing jobs that are in highest demand include registered nurses, licensed practical nurses, certified nurse assistants, and certified medical assistants.
According to the US Department of Labor Bureau of Labor Statistics, employment for registered nurses is expected to increase 23% between 2006 and 2016. Here is a breakdown of The Bureau's estimated increase percentage per nurse employer type:
39% - Offices of physicians
39% - Home health care services
34% - Outpatient care centers, except mental health and substance abuse
27% - Employment services
22% - General medical and surgical hospitals, public and private
20% - Nursing care facilities
The nurse demand has intersected with job recruitment and job search improvements, now available through internet employment tools, such as nursing job boards. These web sites help to automate the job search and job posting capabilities for industry candidates and employers. Some job boards, like www.NursingJobBank.com www.NursingPost.net and www.nursing-jobs.usspecialize in nursing jobs. Other, such as www.indeed.com, are general job sites that cover jobs for multiple industries.
Most of the available web sites function under a model that offers free use for nursing position job seekers. Also, most provide the ability to filter searches geographically and by job type.
[edit] Nursing practice
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Nursing practice is primarily the caring relationship between the nurse and the person in their care. In providing nursing care, nurses are implementing the nursing care plan, which is based on a nursing assessment.
[edit] Definition
Although nursing practice varies both through its various specialities and countries, the International Council of Nurses offers the following definition:
Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
The use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.[Royal College of Nursing]
Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations.
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.
[edit] Nursing theory and process
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In general terms, the nursing process is the method used to assess and diagnose needs, plan and implement interventions, and evaluate the outcomes of the care provided. Like other disciplines, the profession has developed different theories derived from sometimes diverse philosophical beliefs and paradigms or worldviews to help nurses direct their activities to accomplish specific goals. Currently, two paradigms exist in nursing, the totality paradigm and the simultaneity paradigm.
[edit] Practice settings
Nurses practice in a wide range of settings, from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies. Nurses work in occupational health settings (also called industrial health settings), free-standing clinics and physician offices, nurse-run clinics, long-term care facilities and camps. They also work on cruise ships and in military service. Nurses act as advisers and consultants to the healthcare and insurance industries. Some are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contact in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing.
[edit] Regulation of practice
The practice of nursing is governed by laws that define a scope of practice, generally mandated by the legislature of the political division within which the nurse practices. Nurses are held legally responsible and accountable for their practice. The standard of care is that of the "prudent nurse."
[edit] Nursing specialties
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Nursing is the most diverse of all healthcare professions. Nurses practice in a wide range of settings but generally nursing is divided depending on the needs of the person being nursed.
The major divisions are:-
There are also specialist areas such as cardiac nursing, orthopedic nursing, palliative care, perioperative nursing and oncology nursing or the specialization to cancer.
