The Nursing Profession: Development, Challenges, and Opportunities
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The Nursing Profession: Development, Challenges, and Opportunities is designed to be a resource for those who are interested in or touched by nursing. This book is designed in part to complement the report by the Institute of Medicine on the future of nursing. Readers—whether researchers or practitioners, foundation or government officials, students, or simply lay people interested in nursing—should use this volume to gain a better understanding of the nursing profession and the issues with which those in the field and related fields are grappling.
Annað
- Höfundar: Diana J. Mason, Stephen L. Isaacs, David C. Colby
- Útgáfa:1
- Útgáfudagur: 8/22/11
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- Format:ePub
- ISBN 13: 9781118686393
- Print ISBN: 9781118028810
- ISBN 10: 111868639X
Efnisyfirlit
- Front Matter
- DEDICATION
- FOREWORD
- Notes
- PREFACE
- NOTE
- EDITORS' INTRODUCTION
- ACKNOWLEDGMENTS
- REVIEW OF THE NURSING FIELD
- REVIEW OF THE NURSING FIELD
- THE NURSING PROFESSION: DEVELOPMENT, CHALLENGES, AND OPPORTUNITIES
- A BRIEF HISTORY OF NURSING
- The Beginnings of Modern Nursing
- The Professionalization of Nursing
- War and the Development of Nursing
- Modern Nursing: Education, Specialization, and Certification
- THE NURSING PROFESSION
- Defining Nursing
- The Nursing Workforce
- Direct Care Workers
- Licensed Practical or Vocational Nurses (LPNs)
- Registered Nurses
- FIGURE 1. The Nursing Workforce of the United States, 1980–2008
- Advanced Practice Registered Nurses
- FIGURE 2. Highest Nursing or Nursing-Related Educational Preparation, 1980–2008
- Others Providing Nursing Care
- Nurses' Employment: Where Nurses Work (and What They Do)
- Hospital Nursing
- Primary and Ambulatory Care
- Home Care
- Public Health and Community Nursing
- School Health
- Long-Term Care
- Other Settings
- Organized Nursing
- Nursing Research
- CURRENT ISSUES AND CHALLENGES
- The Nursing Shortage
- Factors Contributing to the Shortage
- FIGURE 3. Age Distribution of the Registered Nurse Population, 1980–2008
- Potential Solutions to the Nursing Shortage
- TABLE 1. Title VIII Nursing Programs—Funding from FY 2005–2010
- Factors Contributing to the Shortage
- The Nursing Shortage
- Building an Educated Workforce to Meet Contemporary and Future Needs
- FIGURE 4. Graduations from Registered Nurse Programs, 1964–2005
- Educational Requirements for Entry into Practice
- Advanced Practice Registered Nursing Education
- Funding Support for a Better-Educated Nursing Workforce
- Full Utilization of Advanced Practice Registered Nurses
- Clinical Outcomes and Advanced Practice Nursing
- Barriers to Full Utilization of APRNs
- FIGURE 5. Summary of APRN Legislation: Legal Authority for Scope of Practice
- FIGURE 6. Summary of APRN Legislation: Prescriptive Authority
- Removing Barriers
- Quality and Costs in Acute Care
- Nurse Staffing and Clinical Outcomes
- Nurse Staffing and Financial Outcomes
- Improving and Using Data on Nursing and Quality
- Long-Term Care
- FIGURE 7. Outcomes Associated with Average RN Time per Resident per Day
- Community-Based Care
- Neighborhood Nursing
- Nurse-Managed Health Centers
- The Nurse-Family Partnership
- School Health Nursing
- Gender and Power
- A BRIEF HISTORY OF NURSING
- OPPORTUNITIES: A VISION FOR THE FUTURE
- Innovative Models of Care
- Childbirthing Centers
- Transitional Care
- Nurse-Managed Centers
- Convenient Care Clinics
- Promoting Health and Wellness
- Ensuring that the Nation Fully Utilizes Its Nursing Workforce
- Innovative Models of Care
- NOTES
- THE HISTORY OF NURSING AND THE ROLE OF NURSES
- 1 NOTES ON NURSING: WHAT IT IS, AND WHAT IT IS NOT
- EDITORS' NOTE
- 2 THE NATURE OF NURSING
- EDITORS' NOTE
- DEVELOPMENT OF A CONCEPT
- UNIQUE FUNCTION
- NURSING PRACTICE
- NURSING RESEARCH
- NURSING EDUCATION
- SUMMARY
- NOTES
- 3 A CARING DILEMMA: WOMANHOOD AND NURSING IN HISTORICAL PERSPECTIVE
- EDITORS' NOTE
- THE MEANING OF CARING
- CARING AS DUTY
- THE PROFESSED NURSE
- THE HOSPITAL NURSE
- THE INFLUENCE OF NIGHTINGALE
- THE CONTRADICTIONS OF REFORM
- A DIFFERENT VISION
- BEYOND THE OBLIGATION TO CARE
- ALTRUISM WITH AUTONOMY
- NOTES
- 4 NURSING AS METAPHOR
- EDITORS' NOTE
- 5 STAGES OF NURSING'S POLITICAL DEVELOPMENT: WHERE WE'VE BEEN AND WHERE WE OUGHT TO GO
- EDITORS' NOTE
- TABLE 5.1. The Progress of Nursing Through Four Stages of Political Development
- STAGE 1
- STAGE 2
- STAGE 3
- STAGE 4
- IN PURSUIT OF STAGE 4
- CONCLUSION
- REFERENCES
- ACKNOWLEDGMENTS
- 6 KNOWLEDGE DEVELOPMENT IN NURSING: OUR HISTORICAL ROOTS AND FUTURE OPPORTUNITIES
- EDITORS' NOTE
- THE EARLY YEARS
- THE TRANSITION YEARS
- NURSING RESEARCH BECOMES NURSING SCIENCE
- Nursing Science Comes of Age
- FUTURE OPPORTUNITIES
- REFERENCES
- ACKNOWLEDGMENTS
- NURSING EDUCATION AND TRAINING
- 7 THE GOLDMARK REPORT
- EDITORS' NOTE
- THE NURSE IN PUBLIC HEALTH
- Nurse Best Health Educator
- Essential Qualifications
- Nursing the Sick
- Subsidiary Nursing Service
- HOSPITAL TRAINING SCHOOL
- Training Schools Studied
- Recommendations Made
- Post-Graduate Education
- University School of Nursing
- Training of Subsidiary Workers
- The Financial Problem
- EDITORS' NOTE
- TRADITIONAL ENTRY POINTS INTO NURSING
- Diploma Programs
- Associate Degree Programs
- Baccalaureate Programs
- Considerations in Selecting a Nursing Entry Route
- EMERGING ENTRY POINTS
- Entry-Level Master's Programs
- Accelerated Programs for Graduates of Non-Nursing Disciplines
- Community College-Based Baccalaureate Programs
- RN Completion Programs for Licensed Practical Nurses and Other Allied Health Providers
- MOVING ALONG THE EDUCATION CONTINUUM
- RN to BSN Programs
- Baccalaureate to Doctoral Programs
- CONCLUSION
- REFERENCES
- EDITORS' NOTE
- INFLUENCES INSIDE NURSING
- INFLUENCES OUTSIDE NURSING
- PUBLIC AND PRIVATE ACTIVISM
- HOW A PRIVATE AGENDA BECAME PUBLIC POLICY
- THE POLITICAL CLIMATE CHILLS
- GROWTH ON TWO LEVELS
- Expanding the Scope of Practice in Nursing
- Investigating Nursing Problems and Creating an Infrastructure for Research
- NURSING'S ASPIRATIONS
- AFTERWORD
- ACKNOWLEDGMENTS
- NOTES
- ADVANCED PRACTICE NURSING
- 10 ROLE AND QUALITY OF NURSE PRACTITIONER PRACTICE: A POLICY ISSUE
- EDITORS' NOTE
- REFERENCES
- 11 PRIMARY CARE OUTCOMES IN PATIENTS TREATED BY NURSE PRACTITIONERS OR PHYSICIANS: A RANDOMIZED TRIAL
- EDITORS' NOTE
- METHODS
- Participants and Randomization
- Data Collection
- Main Outcome Measures
- Sample Size
- Analysis
- RESULTS
- Recruitment, Enrollment, and Loss to Follow-up
- TABLE 11.1. Randomized and Enrolled Patient Characteristics at Baseline*
- Satisfaction
- FIGURE 11.1. Study Profile
- Self-reported Health Status
- Physiologic Measures
- TABLE 11.2. Patient Satisfaction: Initial Visit and 6-Month Follow- up Interviews
- TABLE 11.3. Health Status Based on MOS SF-36 Results*
- Physiologic Measures
- Recruitment, Enrollment, and Loss to Follow-up
- Utilization
- COMMENT
- TABLE 11.4. Health Services Utilization*
- TABLE 11.5. Subgroup Analyses*
- NOTES
- ACKNOWLEDGMENT
- EDITORS' NOTE
- BRIEF HISTORY
- NURSES OR SOMETHING ELSE
- COMPLEMENT OR SUBSTITUTE?
- MONEY
- CONCLUSIONS
- REFERENCES
- ACKNOWLEDGMENTS
- EDITORS' NOTE
- THE QUALITY COST MODEL OF APN TRANSITIONAL CARE
- Components of the Intervention
- Testing the Model
- Findings for Patient Outcomes and Health Care Costs
- TABLE 13.1. Randomized Clinical Trials of APN Transitional Care Model
- EDITORS' NOTE
- HOW DID THIS HISTORIC AGREEMENT COME ABOUT?
- WHAT IS THE NEW APRN REGULATORY MODEL?
- WHAT DOES THIS MEAN TO CURRENTLY LICENSED APRNS?
- HOW WILL THE MODEL IMPACT NP EDUCATION, CERTIFICATION, AND LICENSURE?
- IMPLEMENTATION OF THE MODEL
- HOW WILL A UNIFORM REGULATORY MODEL IMPACT APRNS?
- NOTES
- THE NURSING WORKFORCE/NURSING SHORTAGES
- 15 IMPLICATIONS OF AN AGING REGISTERED NURSE WORKFORCE
- EDITORS' NOTE
- METHODS
- Data
- TABLE 15.1. Comparison of Estimates of Total RN FTEs and Average Age of RNs*
- Statistical Analysis
- Data
- RESULTS
- Estimates of Age and Cohort Effects
- FIGURE 15.1. Estimated Percentages of RN FTEs by Age and Year
- Evaluating the Validity of the Model
- FIGURE 15.2. Predicted and Actual Number of FTE RNs by Age for Selected 5-Year Birth Cohorts
- FIGURE 15.3. Split-Sample Forecast of Total Annual RN FTEs and FTEs for RNs Younger Than 40 Years and Age 40 Years and Older
- Projection to 2020
- FIGURE 15.4. (HRSA) Estimates of Registered Nurse (RN) Requirements Through 2020
- FIGURE 15.5. Actual and Projected Number of RN FTEs by Age Group for Selected Years
- Forecast Assumptions
- Estimates of Age and Cohort Effects
- COMMENT
- NOTES
- ACKNOWLEDGMENTS
- 16 GLOBAL NURSE MIGRATION
- EDITORS' NOTE
- MIGRATION AND THE GLOBAL HEALTHCARE WORKFORCE
- General Trends in Migration
- The Global Nurse Workforce
- TABLE 16.1. Common Push/Pull Factors That Precipitate Global Nurse Migration
- Trends in U.S. Nurse Migration
- Retrogression
- POLICY IMPLICATIONS FOR THE U.S. NURSING WORKFORCE
- Determining the Relative Contribution of Foreign-Educated Nurses
- Keeping Track
- Tracking by Nursing Organizations
- TABLE 16.2. Policy Issues and Strategic Challenges That Must Be Considered When Migration Policies Are Developed
- Monitoring Systems
- Assessing Credentials and Improving Regulatory Mechanisms for Licensure
- U.S. Illegal Immigration Reform and Immigrant Responsibility Act
- VisaScreen®: Visa Credentials Assessment
- Educational Credentials
- Providing Supervised Practice, Language Training, Health System Orientation, Cultural Orientation, and Social Support
- Language
- Acculturation
- Developing Ethical Policies Regarding Recruitment
- Determining the Relative Contribution of Foreign-Educated Nurses
- SUMMARY
- REFERENCES
- QUALITY, SAFETY, AND COST
- 17 NURSE-STAFFING LEVELS AND THE QUALITY OF CARE IN HOSPITALS
- EDITORS' NOTE
- METHODS
- Measures of Adverse Outcomes
- Study Population
- Measures of Staffing
- RISK ADJUSTMENT AND CHARACTERISTICS OF THE HOSPITALS
- Statistical Analysis
- RESULTS
- Rates of Adverse Patient Outcomes and Length of Stay
- TABLE 17.1. Patient Outcomes and Characteristics of the 799 Hospitals*
- Variations in Staffing Levels and Mix of Skills
- Association Between Adverse Outcomes and Staffing by Nurses
- TABLE 17.2. Hours of Nursing Care*
- Registered Nurses and Adverse Outcomes
- TABLE 17.3. Relation Between Adverse Outcomes Among Medical Patients and the Levels of Staffing by Registered Nurses (RNs)*
- TABLE 17.4. Relation Between Adverse Outcomes Among Surgical Patients and the Levels of Staffing by Registered Nurses (RNs)*
- Measures of Staffing by Other Nurses
- Rates of Adverse Patient Outcomes and Length of Stay
- DISCUSSION
- ACKNOWLEDGMENTS
- Appendix C oding Rules for Adverse Outcomes*
- NOTES
- 18 HOSPITAL NURSE STAFFING AND PATIENT MORTALITY, NURSE BURNOUT, AND JOB DISSATISFACTION
- EDITORS' NOTE
- METHODS
- Patients, Data Sources, and Variables
- Box 18.1: Surgical Patient Diagnosis Related Groups Included in the Analyses of Mortality and Failure-to-Rescue
- Data Analysis
- Patients, Data Sources, and Variables
- RESULTS
- Characteristics of Hospitals, Nurses, and Patients
- TABLE 18.1. Study Hospitals, Surgical Patients Studied, and Nurse Respondents in Hospitals*
- TABLE 18.2. Characteristics of Nurses (N = 10 184) in the Study Hospitals*
- TABLE 18.3. Characteristics of the Surgical Patients Included in Analyses of Mortality and Failure-to-Rescue*
- Staffing and Job Satisfaction and Burnout
- TABLE 18.4. Patient-to-Nurse Ratios with High Emotional Exhaustion and Job Dissatisfaction Among Staff Nurses and with Patient Mortality and Failure-to-Rescue*
- Staffing and Patient Mortality and Failure-to-Rescue
- Characteristics of Hospitals, Nurses, and Patients
- COMMENT
- NOTES
- ACKNOWLEDGMENTS
- 19 NURSE STAFFING IN HOSPITALS: IS THERE A BUSINESS CASE FOR QUALITY?
- EDITORS' NOTE
- STUDY DATA AND METHODS
- EXHIBIT 19.1. Mean and Standard Deviation (SD) of Patient Outcomes and Hospital Characteristics, Hospital Sample
- EXHIBIT 19.2. Proportion of Registered Nurses (RNs) and Number of Licensed Nursing Hours at the 25th and 75th Percentiles of Hospitals Studied
- Study Results
- EXHIBIT 19.3. Costs of Hiring Additional Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) to Increase Nurse Staffing to the 75th Percentile of Hospitals Studied, National Estimates Updated to 2002
- Discussion
- EXHIBIT 19.4. Avoided Adverse Outcomes, Hospital Days, Costs, and Deaths If Proportion of Registered Nurses (RNs) or Number of Licensed Nursing Hours Were Increased to the 75th Percentile of Hospitals Studied, National Estimates Updated to 2002
- SPECIALTY PRACTICE IN NURSING
- 20 LONG-TERM CARE POLICY ISSUES
- EDITORS' NOTE
- POOR QUALITY OF CARE AND WEAK REGULATORY ENFORCEMENT
- INADEQUATE NURSING HOME STAFFING LEVELS
- NURSING FACILITY REIMBURSEMENT REFORM
- CORPORATE OWNERSHIP TRANSPARENCY
- HOME AND COMMUNITY-BASED SERVICES
- PUBLIC FINANCING OF LONG-TERM CARE
- SUMMARY
- REFERENCES
- 21 THE FUTURE OF HOME CARE
- EDITORS' NOTE
- THE LEGACY OF HOME CARE
- MEDICARE: HOME CARE'S SECOND COMING
- REINING IN A BENEFIT OUT OF CONTROL
- HOME CARE'S FUTURE
- NOTES
- 22 FOLLOW THE MONEY: FUNDING STREAMS AND PUBLIC HEALTH NURSING
- EDITORS' NOTE
- Public Health in America
- THE PERSPECTIVE OF PUBLIC HEALTH
- CHANGES OVER TIME
- FINANCING PUBLIC HEALTH
- THE IMPACT ON NURSING
- HEALTH REFORM AND MANAGED CARE
- WHAT ABOUT NURSING?
- 23 SWAMP NURSE
- EDITORS' NOTE
- 24 ROLE OF THE SCHOOL NURSE IN PROVIDING SCHOOL HEALTH SERVICES
- EDITORS' NOTE
- SCHOOL NURSE DEFINITION
- BACKGROUND
- SCHOOL NURSE ROLE
- SCHOOL NURSE ACTIVITIES
- SCHOOL HEALTH SERVICES TEAM
- PROFESSIONAL PREPARATION FOR SCHOOL NURSES
- CONCLUSION
- RECOMMENDATIONS
- NOTES
- AFTERWORD
- THE EDITORS
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