Nursing Leadership & Measurement of Patient Safety Essay

Chapter 13 Evolution of Nursing as a Profession Copyright © 2015. F.A. Davis Company Early Years • • • • • Nursing occurred in the home Origin of hospitals Physician-directed care Differences in quality care Religious orders vs. city/community based institutions Copyright © 2015. F.A. Davis Company Nursing Defined • Florence Nightingale • Virginia Henderson • Martha Rogers Copyright © 2015. F.A. Davis Company Modern Nursing Role • Nurses are viewed as collaborative members of the health-care team. • Nursing has emerged as a strong profession of its own. • Nurses have a wide range of responsibilities and obligations. • Recent polls demonstrate that nurses are considered the most trusted group of professionals. Copyright © 2015. F.A. Davis Company Early Nurse Leaders • • • • Florence Nightingale Lillian Wald Margaret Sanger Mary Eliza Mahoney Copyright © 2015. F.A. Davis Company Modern Nurse Leaders • Mildred Montag – Associate degree nursing programs – Shift of nursing education from hospital-based environments to institutions of higher learning • Virginia Henderson – “Modern Florence Nightingale” – Advocated for autonomy of nursing practice – Proponent of publicly financed universally accessible health care Copyright © 2015. F.A. Davis Company st 21 Century • Linda Aiken – Research on nurse-patient ratios and patient safety – Development of MAGNET hospitals • Beverly Malone – Deputy Assistant Secretary for Health – Chief Executive Officer of the NLN • Tim Porter-O’Grady – Senior Partner of Tim Porter-O’Grady Associates – Contributed to changes in practice and education – Focus on health systems innovation Copyright © 2015. F.A. Davis Company Political Influences • Nursing advances occurred during the time of social upheaval and change. • Strengthening of public health nursing services • Amendments to the Social Security Act that created Medicare and Medicaid • Development of health insurance companies Copyright © 2015. F.A. Davis Company Political Influences (cont’d) • Civil Rights Act – Guaranteed equal treatment for all individuals – Prohibited gender discrimination in the workplace – Law lacked enforcement • Feminist Movement – National Organization of Women • Development of nursing specialty disciplines Copyright © 2015. F.A. Davis Company Nursing in Times of War • Wars created situations facilitating changes in nursing practice. • Increase in the need for nurses • Enhanced public awareness of nursing’s role within society • Korean War changed nursing practice. – Nurses on the front line – Nurses worked in mobile hospital units. Copyright © 2015. F.A. Davis Company Vietnam War • Nurses were pushed beyond boundaries. • They functioned in mobile hospital units. • They worked without direct supervision of physicians. • They performed emergency procedures. • This created feelings of restriction and unrest when they returned home and had to practice under limitations. Copyright © 2015. F.A. Davis Company Technology • Technology permitted the wide use of life support systems. • Nurses face ethical dilemmas involving the use of technology. • Nurses are active in formulating policies that address ethical issues. • There is renewed interest and support for Hospice nursing. Copyright © 2015. F.A. Davis Company Nursing and the Early 21st Century • Nurses and the World Trade Center disaster – Raised multiple questions regarding nursing’s ability to react and respond to major disasters • Hurricane Katrina – Damages to hospitals – Practicing under unfamiliar and unusual situations • Increased disaster preparedness for nurses Copyright © 2015. F.A. Davis Company Nursing and Health-Care Reform • Nightingale and Wald both demonstrated nursing’s commitment to health-care reform. – Interventions and outcomes research – School nursing – Health promotion/disease prevention • Sanger – Women’s health initiatives Copyright © 2015. F.A. Davis Company 21st Century • The 21st century brings challenges and opportunities. • It is estimated that 434,000 nurses will be needed by the year 2020. • The nursing shortage has increased the demand for nurses. • The Affordable Health Care Act offers opportunities for nurses to take the lead. Copyright © 2015. F.A. Davis Company Nursing and Health Care in the Future • Increased demand for primary health-care providers • Nurses should be permitted to practice to the full extent of their education. • Greater need for advanced practice nurses • Report from the IOM and Future of Nursing – Advocating for BSN education – Promoting educational mobility • Increase in diversity of nursing workforce Copyright © 2015. F.A. Davis Company Conclusion • Higher demand for safe, quality, and effective nursing care • Move toward population/community-based care • Nurses need to become politically active. • Nurses need to join nursing organizations that promote quality care. Copyright © 2015. F.A. Davis Company …