Transcript Personal & Vocational Concepts

Personal & Vocational
Concepts
PN 101
Learning Styles
 Visual Learners: Learn
best by watching.
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Sit in the front of the
class
Stay focused on the
instructors facial
expression & body
language
Make notes & highlight
important points
“Picture” a procedure
rather than memorizing
steps
Learning Styles
 Auditory Learners:
Learn best by hearing.
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Read aloud,
concentrate on hearing
the words
Listen to the
instructors words
instead of taking notes.
Ask permission to tape
the lectures.
Find a “study buddy” to
discuss the course
content
Learning Styles
 Kinesthetic Learners:
Learn best by doing.
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Handle the equipment
before practicing the
procedure
Move while reading or
studying (rocking,
Stairmaster)
Draw boxes & circles
around key concepts,
make diagrams
What Type of Learning Style Do You
Have?
What Type of Learner are You?
 Traditional Adult Learner—learners coming
directly from high school or other program of
study
 Returning Adult Learner—learners who have
been out of school for several years
 Recycled Adult Learner—learners with prior
education beyond high school in disciplines
other than nursing
Geared for Success
 Each type of adult learner has qualities that
help ensure success
 Traditional adult learners—are experienced in
educational environment and learning
procedures and skills
 Returning adult learners—are serious,
motivated, self-directed learners
 Recycled adult learners—are self-directed
learners who are also experienced in
educational learning procedures and skills
Liabilities, Pitfalls, and Hidden
Dangers
 Dangers shared by all
adult learners:
 Fear of failure
 Negative mental
attitude
 Dwelling on lack of
success in the past
(Cont'd…)
Liabilities, Pitfalls, and Hidden
Dangers
(…Cont’d)
 Dangers for the traditional adult learner:
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Increased difficulty in new educational setting
Social activities
Employment
(Cont'd…)
Liabilities, Pitfalls, and Hidden
Dangers
(…Cont’d)
 Dangers for the returning adult learner:
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Physical changes with age
Rusty educational skills
Social responsibilities
(Cont'd…)
Liabilities, Pitfalls, and Hidden
Dangers
(…Cont’d)
 Dangers for the recycled adult learner:
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Personal responsibilities
Overconfident attitude
Poor study habits
Responsibilities of a Learner
 The first responsibility of the learner is to
learn.
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Instructors alone are not responsible for
successful learning or failure
Instructors alone are not responsible for failure
to learn
Instructors help students learn how to learn
Other Responsibilities of the Learner
 Abide by rules and policies.
 Follow recognized channels of
communications.
 Be prepared for classes and clinical
experiences.
 Think ahead about future assignments.
 Set your goals higher than minimum
standards.
 Seek out resources beyond required
readings, if a topic needs clarification
Other Responsibilities of the Learner
(…Cont’d)
 Be responsible for your own thoughts and behavior.
 Be present and on time for classes and clinical
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experiences.
Enter into class discussions when asked.
Treat with respect everyone with whom you come
into daily contact.
Seek out instructors when you are having difficulties.
Keep a record of your grades as each course
proceeds. (DISCUSSION POINT- CONCORDE)
Getting Organized
 Calendar
 Index cards
 Post-It notes
 Time line
 Computer, tablet
 Smart phone
(DISCUSSION POINTCONCORDE)
Other Planning Activities
 Setting priorities
Which activities are most important?
 Difference between important activities and
urgent activities
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 Delegating tasks
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Significant other
Children
Friends
Relatives
Study Skills
 Lack of study skills is a
primary reason for lack
of success in school.
 High school/college
learning skills do not
always translate to the
practical/vocational
nursing program.
General Hints
 Concentration: ability to
focus on task at hand
 Concentration hindered
by distractions
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External
Internal
External Distractions
 Come from outside yourself
 Examples:
Hunger
 Personal study area
 Lighting
 Background noise
 Internet
 Peers/Family
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Internal Distractions
 Come from inside
yourself
 Examples:
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Mental fatigue
Boredom
Daydreaming
Note Taking VS. Note Making
 Note taking: trying to capture all the
speaker’s words
 Note making: condensing main ideas
 Understand the information; don’t memorize it
 Two methods of note making:
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Outlining: hierarchy of information
Mapping: graphic organization of information
Comprehension
 Reading with understanding and
comprehension is necessary to:
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Store information in long-term memory
Enable recall of information
 PQRST method
 Preview – overview of material
 Question – develop questions to be answered
 Read – read the material
 State – repeat material in your own words
 Test – test yourself on what you remember
Visual Strategies
 Draw idea sketches
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Process of drawing will facilitate
understanding
 Use color
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Highlighters, crayons, felt-tip pens used to
categorize information according to color
Preparing for a Test
 Preparation begins the
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first day of class
Clarify content to be
covered in test
Clarify test format
Periodically review
material
Organize your time
before the test
Taking a Test
 Arrive with time to spare
 Ignore peer chatter that may increase
anxiety just before the test
 Keep a positive mental attitude
 Silently rehearse facts
 Take slow, deep breaths to reduce tension
 Follow the directions on the test
 Scantrons: Attention to detail
Hints for Multiple-Choice Questions
 Read all options before selecting an answer
 Eliminate obviously wrong options
 Remember the course subject matter and
eliminate unrelated options
Hints for Short Answer Questions
 Think before writing
 Give the information that is requested
 Look for verbs in questions (“list,” “compare,”
“contrast”) and provide answers accordingly
 Give objective, concrete answers
 Write complete sentences when the
directions require it
Classroom Learning Strategies
 Never skip class unless faced with an emergency
 (SEE CONCORDE POLICY !! DISCUSS !!)
 Come to class prepared
 Listen to verbal cues that will inform you of key
points during lectures
 The instructor speaks at a much slower rate than
you are capable of thinking, grab key points
 Look over your notes as soon after class as
possible
 Be mentally present in class
(Cont'd…)
Classroom Learning Strategies
(…Cont’d)
Lectures
 Brief lectures (minilectures) enhance reading assignments and
clarify information
 Lectures are passive learning that don’t actively involve the
student, unless instructor stops for student input
 Active learning helps students make the most of lectures/topics
 Discussion buddies/small group activities help students stay
actively involved
 “You can repeat a reading assignment, but you can never repeat
a missed class.”
(Cont'd…)
Classroom Learning Strategies
Lecture-discussion
 The instructor shares several ideas with the class, then
stops to let the class discuss the ideas
 The instructor acts as the discussion leader
Cooperative learning
 A technique that emphasizes individual accountability for
learning while working in small groups
 Helps students:
 be actively involved in learning
 develop critical-thinking skills
 develop positive relationship with peers
Other Learning Resources
(…Cont’d)
Nursing skills lab
 Allows students to practice and
develop the physical aspects of
nursing skills
 Skills must be practiced
 “You recall 10% of what you
hear, 20% of what you see,
50% of what you read, and
90% of what you do”
(Cont'd…)
Other learning Resources
(…Cont’d)
LRC: Learning Resource Center (computer lab, library)
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Audio-visual materials, texts for checkout
Includes DVDs, Gale Learning Resources for research
“A picture is worth a thousand words”
Provides an additional sensory channel for learning
(Cont'd…)
Other Learning Resources
(…Cont’d)
Internet
 Offers unlimited resources
on many subjects
 Search engines, such as
Google help students zero in
on exact information; are
most effective when the
subject is narrow
 We will discuss research
sources that are allowed,
such as Gale and Mayo
Clinic, CDC, NIH, etc
(Cont'd…)
Critical Thinking
 Critical thinking:
 Entails purposeful, informed, outcome-focused
thinking
 Driven by patient, family, and community needs
 Based on the principles of the nursing process
 Uses logic and intuition
 Calls for strategies that make the most of human
potential
 Constantly reevaluating, self-correcting, and
striving to improve
(Cont'd…)
Critical Thinking
 Critical thinking:
Used to resolve problems
 Used to find ways to improve a situation even
when no problem exists
 Answers the question “How can we do this
better?”
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Critical Thinking & Practical Nursing
 The principles of critical thinking:
Collecting data in an organized way
 Verifying the data in an organized way
 Arranging the data in an organized way
 Looking for gaps in information
 Analyzing the data
 Testing it out
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(Cont'd…)
Critical Thinking & Practical Nursing
(…Cont’d)
 For the practical/vocational nurse to think critically, it
is necessary to:
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Access information.
Comprehend information.
Store comprehended information in long-term memory.
Recall the comprehended information when needed.
Know what to do when information is not in long-term
memory.
Define Nursing
 Definition by Virginia Henderson:
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“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 if he had the necessary strength, will,
or knowledge.”
Major Events that Shape Nursing
Historical Overview
Historical Overview
 Nursing evolves as society and
health care needs and policies
change.
 Nursing responds and adapts to
these changes, meeting new
challenges.
Nursing Pioneers
 Florence Nightingale
joined the first ever
school of nursing at age
31 in 1851 in
Kaiserswerth, Germany.
 In 1853 she became the
superintendent of a
charity hospital where
quality of patient care
improved.
Florence Nightingale
“The Lady with the Lamp”
 During the Crimean
War in Turkey (1855),
the soldiers wounded
were recovering in
atrocious conditions.
 The Secretary of War
requested that Florence
and 38 nurses leave
England for Turkey to
assist.
 She assisted in bringing
the infection rate down
from approx. 90% to 3%
Nursing; From Occupation to
Profession
 In 1860 Florence Nightingale established the
nursing school at St. Thomas Hospital in London.
 A nurses residence was provided
 Strict admission procedures
 1 year training, including instruction & practical
experience
 Complete records where kept on the students as well
as where they employed after graduation. This
became known as a “registry”.
Nursing Education
What is an
LPN?
Role of the LPN
Practical/vocational nurses
 Provide patient care under general
supervision of an RN, physician, podiatrist, or
dentist
 Function interdependently
 Work in various sites of employment

Majority work in long-term care settings, such
as extended-care units and nursing homes
Nursing Education
What is an
RN?
The Role of the RN
Role of registered nurses:
 Function independently in nursing
 Plan care
 Coordinate all the activities of care
 Provide care that requires more specialized
knowledge and judgment
 Teach patients, families, and other members of the
health care team
 Act as patient advocate
(Cont'd…)
Nursing Education
 ADN
 Baccalaureate
 Master’s
 PhD
Nursing Education- broad
perspective, many types
Registered nurses
 Associate degree (ADN) program
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2-year educational program
 Baccalaureate nursing program
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4-year educational program, and if more is
sought:
(Master’s add approx. 2 years)
(PhD-approx. 2 years more)
Role of the RN
RN postgraduate educational opportunities
 Advanced practice registered nurse (clinical
nurse specialist, nurse practitioner, etc.)
 Master of Nursing programs
 Doctoral degree programs
The Nursing Personnel Part of the
Health Care Team
Student nurses
 Have a responsibility to give safe care and act under
instructor supervision
Nursing assistants
 Training includes minimum 75 hours of instruction
with clinical practice
(Cont'd…)
The Nursing Personnel Part of the
Health Care Team
Clerk receptionists/Med. Office Mgmt.
 Job responsibility is mainly secretarial
 Unit secretary
 Supervise and coordinate management
functions for patient units
Members of the Health Care Team
Emergency care
 Emergency medical technicians (EMTs)
 Registered nurse (RN)
 Emergency room doctor
 X-ray technician
 Radiologist
 Family physician
 Orthopedic surgeon
 Lab personnel
Members of the Health Care Team
(…Cont’d)
Surgery
 Anesthetist
 Surgical technician
 Anesthesiologist
 R.N.
 L.P.N. “float”
(Cont'd…)
Members of the Health Care Team
(…Cont’d)
Postanesthesia Care Unit (PACU)
 PACU registered nurse
 Transport aide
 Staff nurse
(Cont'd…)
Members of the Health Care Team
(…Cont’d)
Intensive care
 RNs
 Clerk receptionist
 Medical records department
 Pharmacist
 Respiratory therapy department
 Transport aide
(Cont'd…)
Members of the Health Care Team
(…Cont’d)
Surgical floor/discharge team
 Nurse manager
 Team leader
 Practical/vocational nurse (LPN/LVN)
 Physical therapist (PT)
 Physical therapy assistant (PTA)
 Social worker
 Patient care technologist (PCT)
 Dietitian
 Housekeeper
(Cont'd…)
Members of the Health Care Team
Extended-care unit
 Physical therapist (PT)
 Physical therapy assistant (PTA)
 RN/LPN
 Nursing assistant (NA)
 Occupational therapist (OT)
 Day supervisor
The Goal of the Health Care Team
 To restore optimal physical, emotional, and
spiritual health
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Health care includes a large number of
specialized services.
It is impossible for one person to provide all
the necessary knowledge, expertise, and
skills.
Each team member needs to have good
communication skills.
The Nursing Process
 An orderly way
of developing a
plan of care for
the individual
patient.
Five-Step RN Nursing Process
1. Assessment (Data Collection)
2. Diagnosis
3. Planning
4. Intervention
5. Evaluation
Four-Step LPN Nursing Process
1. Assessment (Data Collection)
2. Planning
3. Intervention
4. Evaluation
Role Differences Between RNs and
LPN/LVNs
 RN’s Role
Nursing diagnosis
 Independent role in all process areas
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 LPN/LVN’s Role
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No nursing diagnosis
Dependent role in some process areas
Independent role in some process areas
LPN Nursing Process
Phase 1: Data Collection
 Systematic information gathering
 Information verification
 Information communication
 Continuing data collection
 Measuring and collecting data accurately
LPN Nursing Process
Phase 2: Planning
 Assist RN in developing nursing diagnosis
 Assist RN in developing outcomes
 Assist RN in developing nursing interventions
LPN Nursing Process
Phase 3: Implementation
 Nursing action
 Maintaining patient safety
 Teaching in support of RN’s teaching
 Reporting and documenting
LPN Nursing Process
Phase 4: Evaluation
 Assisting in determining patient progress
toward meeting desired goals and outcomes
 Communicating findings
Healthcare Settings
Proprietary (For-Profit) Hospitals
 General
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serve full range of medical conditions
experienced by patients
more than 6,000 in the U.S.
 Specialized
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deal with a particular disease or condition
limited to one type of patient
more than 1,000 in the U.S.
Teaching and Research Hospitals
(such as O.H.S.U., U. of WA. Med.)
 Emphasis is on serious or unusual conditions
 Training sites for health care professionals
 Conduct research into and development of
treatments
 Almost always affiliated with medical schools
 Access to highly skilled practitioners
Ambulatory Versus
Acute Care Settings
 Ambulatory care
 outpatient; often less expensive
 for people who live independently or are cared
for at home
 provides assessment, treatment, and care
coordination
 Acute care
 inpatient in general and specialized hospitals
 patients acutely ill and require more skilled
nursing care
Free Clinics
 Alternative means of providing primary health
care
 For people who cannot afford traditional
health services
 As free of “red tape” as possible
Rehabilitation Services
 Focus on return of function and prevention of
further disability
 Can take place in:
rehabilitation centers
 long-term care facilities
 outpatient facilities
 group residential homes
 patient’s home base
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 Nurses play an important role.
Long-Term Care Facilities
 The purpose of long-term care (LTC) is to
help people who have disabilities or require
chronic care. LTC includes:
postacute care
 residential care
 nursing home
 intermediate care
 skilled care (“SNF”)
 assisted care
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Community Health
Nursing Services
 Improve health through public education
 Screen for early detection of disease, such as
HIV, tuberculosis
 For people who need care outside the acute
care setting who may be at risk
Home Health Agencies
 Public or private agencies that provide home
health services.
 Focus on teaching self-care.
 Services include: RN/LPN skilled nursing;
physical and speech-language, and
occupational therapy; medical-social and
homemaker-health aide services
Other Health Care Settings
 Adult day care: for individuals who are not
yet ready for nursing homes
 Wellness: nutritional counseling, weightreduction, smoking cessation, stress
reduction, etc.
 Hospice: end-of-life services for the
terminally ill delivered at home, at a freestanding center, or in the hospital
Nursing Laws & Ethics
Ethical Issues in 21st Century Health
Care
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in vitro fertilization
artificial insemination
surrogate motherhood
cloning
organ donation
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Including cadaver, child, and aborted fetus
donations
 stem cell research/procedures
(Cont'd…)
Ethical Issues in 21st Century Health
Care
(…Cont’d)
 abortion
 euthanasia
 Death with Dignity Act
 advance directives
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living wills, power of attorney
 right to die
Ethics, Morals, and Values
 Ethics—a system of standards or moral
principles that directs actions as being right or
wrong
 Morals—system dealing with right or wrong
behavior (conduct) and character
 Values—the worth a person assigns to an
idea or action
Nursing Ethical and Legal
Responsibilities
 Nursing ethics: the values and principles
governing nursing practice, conduct, and
relationships
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Responsibilities: focused on ideal behavior,
morality, and higher standards
 Legal aspects: state statutes that apply to
licensed persons and the situations in patient
care that could result in legal action
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Responsibilities: focused on rules, regulations,
and obligations mandated by law
Ethical Codes in Nursing
 NAPNES Codes—National Association of
Practical Nurse Educators and Services
 NFLPN Codes—National Federation
of Licensed Practical Nurses
 Nurse Practice Acts—published by each
state
Principles of Ethics
 Nonmaleficence (Do No Harm): the principle
of doing the least amount of harm possible to
a patient
 Most beneficial treatments involve risk of
harm to the patient to some extent
 Examples:
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skin puncture
drug side effects
physical movement/transfer of patients
Beneficence
 Two major nursing duties associated with
beneficence:
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Put patient interests first
Place the good of patients before one’s own
needs
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includes organizational and other work-related
needs
Autonomy (Free to Choose)
 Four steps of autonomous decisions:
Thinking through all the facts
 Deciding on the basis on an independent
thought process
 Acting based on a personal decision
 Undertaking a decision voluntarily, without
pressure from anyone else

(Cont'd…)
Autonomy (Patient and Staff)
 Patient’s right to privacy
choose care based on personal beliefs
 accept or reject treatment
 avoid needless exposure

 Personal values may be contrary to medical
ethics
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patient can refuse care for religious, cultural,
or personal reasons
Fidelity (Be True)
 Fidelity: Acting in patients’ best interests
when they are unable to make free choices
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does not include paternalistic decisions
must differentiate between your own feelings
and those of the patient
maintain patient confidentiality
Justice (Fair to All)
 Justice: give patients their due and treat
each patient fairly and equally (i.e., with
dignity and respect)
 avoid letting personal ethics and values
interfere with patient justice
Beneficent Paternalism
 a disrespectful attitude toward the patient and his or
her contribution to personal care and recovery
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“I know what’s best for you”
discounts the patient’s self-knowledge
often occurs with female patients in response to
female-specific health issues
 Examples:
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deciding in advance that a patient fits into a certain
category
developing a care plan without patient input
influencing a patient’s choice
Nursing Lawsuits
 Assault & Battery
 Defamation
 Fraud
 False Imprisonment
 Invasion of Privacy
 Negligence
 Malpractice
Nurse Practice Act
 Basic terminology
 Content
definition of nursing
 definition of LPN/LVN
 use of title LPN/LVN
 elements of unprofessional conduct
 functions of the state board of nursing

State Board of Nursing
 Functions of the state board of nursing (or
nurse regulatory board)
 Disciplinary responsibility
 Disciplinary process
Nursing Licensure
 NCLEX-PN® Examination
 Working as an LPN/LVN in other states

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interstate endorsements
multistate licensure
 (Nurse Licensure Compact)

border recognition
Criminal Versus Civil Action
 Criminal action—involves people and
society as a whole and relationships between
individuals and government
 Civil action—protects individual rights and
results in payment of money to the injured
person
Intentional and Unintentional Torts
 Intentional tort—
intended to cause harm
to the patient (threat or
actual physical harm)
 Unintentional tort—an
action that is not meant
to cause harm to the
patient, but does
The Four Elements Needed to Prove
Negligence
 Duty—the nurse’s responsibility to provide
care in an acceptable way
 Breach of duty—the fact that the nurse did
not adhere to the nursing standard of care
 Damages—the patient must prove that the
nurse’s negligent act caused injury or harm
 Proximate cause—a reasonable cause-andeffect relationship must be shown between
the omission or commission of the nursing act
and the harm to the patient
Legal Action Process
 Steps for bringing legal
action by a patient
 Depositions
 Giving testimony
Charting (Legal Documentation)
 Focus charting—use of focus to label
nurses’ notes, categories of data, action and
response, and flow sheets
 Charting by exception—nurse and
physician chart only was is the “exceptional”
finding/data. Findings “in the norm” need not
be charted in this system.
Liability
 Personal liability—holds nurses responsible
for their own behavior, including negligence
 Institutional liability—a type of vicarious
liability; assumes the health facility provides
certain safeguards to keep patients from
harm
Patient Rights
 Patient’s Bill of Rights
 Health Insurance Portability and
Accountability Act (HIPAA)
 JCAHO Patient Safety Goals
Patient’s Right to Consent
 General (implied) consent—routinely
obtained on admission in the form of a signed
general admission form
 Informed consent—must be obtained by
physician for invasive procedures after patient
has been told all pertinent information
 Authorized consent—type of consent
obtained from parents for all children younger
than age 18
End-of-Life Issues
Advance Directives
 Living will—a legal document stating a person’s
wishes for end-of-life care when there is no hope of
recovery and the patient can no longer make a
competent decision
 Durable power of attorney—a legal document (valid
throughout the U.S.) that names a health care proxy
to make medical decisions on behalf of the person
executing it, if that person is no longer able to speak
for himself or herself
(Cont'd…)
End-of-Life Issues
(…Cont’d)
 Do-not-resuscitate order (DNR)
 Advance directives
 POLST
 Removal of life support systems
 Death with Dignity Act
 Organ donation
Good Samaritan Acts
 Laws that stipulate that a person who renders
emergency care in good faith at the scene of
an accident is immune from civil liability for
his or her action while providing the care
Practical Application of Ethics and
Law in Difficult Situations
 Late entry
 Verbal orders, misunderstood?
 Questionable order, nurse disagrees
 Understaffed unit
(Cont'd…)
Practical Application of Ethics and
Law in Difficult Situations
(…Cont’d)
 Documenting someone else’s care
 Illegal alteration of a patient’s record
 Personal criticism of nurse in patient’s record
 Illegible physician’s order
 Telephone orders
(Cont'd…)
Practical Application of Ethics and
Law in Difficult Situations
(…Cont’d)
 Signing a will
 Possible negligence
 Standing orders, for how long is it legal?
 Discharge instructions
 Patient education
Questions