Clinical Nursing Skills: Basic to Advanced Skills, 9th Edition

Chapter 1 Professional Nursing TEACHING/LEARNING STRATEGIES Lecture–Discussion Instructor Planning. Have students access a copy of their state’s Nurse Practice Act. This document may be available online or a copy may be obtained for each student. Draw the students’ attention to the text information regarding the Code of Ethics, ANA’s Nursing’s Social Policy Statement, and the National Student Nurses’ Association Code of Academic and Clinical Conduct. . Interpret and discuss these documents. Also discuss the Standards of Nursing Practice as outlined in the text. Written Assignment Instructor Planning. Obtain a patient chart or computerized record from the hospital where the students will have clinical experience. Suggest they document the skills as they practice them, i.e., chart vital signs, BP, I&O. Resource Suggestions Access the Joint Commission website at _www.jointcommission.org_. for information on National Patient Safety Goals and Core Measures. CRITICAL THINKING Strategies Exercise 1 Discuss the Nurse Practice Act by asking students to read sections of the act and then describe in their own words the meaning of the statement. Ask the students to identify how the practice act will affect their career. Exercise 2 Ask the students to obtain the Standards of Practice for the nursing unit where they are assigned for clinical practice. Compare the standards against the ANA published Standards of Nursing Practice. Discuss the Standards of Nursing Practice with the students. Break students into small groups and assign each group to one standard. As a group, define how the standard is used in the clinical setting and how evaluation of that standard is accomplished. Exercise 3 Ask the students to think back to when they first decided to become a nurse. Ask, “How does the image compare to the actual role you are assuming now? Identify the major differences you are experiencing that you didn’t think or know about earlier.” Have the students share their thoughts in a small group and identify similarities among the group. The similarities can be shared with the entire class if time allows. Exercise 4 Assign each student to research and describe a potential clinical incident that could be defined as gross negligence, criminal negligence, and malpractice. In a small group, ask the students to describe the incident and ask the group to determine which type of negligence has been described. Exercise 5 Provide information about HIPAA (Health Insurance Portability and Accountability Act) and ask the students to discuss the role of the nurse in carrying out the privacy mandate. Scenario 1 As a new student you are going into the hospital to prepare for the clinical experience tomorrow morning. There are two stages of preparation. The first stage is obtaining all the necessary information you will need to provide safe care. The second stage is reviewing your textbooks and lecture notes to gain an understanding of the client’s diagnosis, medications, lab values, and diagnostic tests that will be done during his/her hospitalization. 1. If you have only a limited time to review the client’s chart, what sections of the chart will provide you with sufficient information to render you safe to care for the client? 2. In preparing for clinical practice, what information is essential to review in addition to the data you have obtained from the clinical record? Where is the most appropriate place to find this information? 3. List the priority interventions you will carry out within the first hour of the clinical experience. Explain the rationale for your answers. Scenario 2 As a student nurse, you have been assigned to complete an activity where you compare and contrast legal/ethical issues related to nursing practice. You are assigned to research the ANA standards of clinical nursing practice, the Nurse Practice Act in your state, and the code of academic and clinical conduct from the National Student Nurses’ Association, Inc. 1. Briefly describe the primary purpose/function of each of these nursing regulations or guidelines. 2. Select one of the above nursing regulations/guidelines and describe how the regulation/guideline will impact your role as a professional nurse. 3. The National Student Nurses’ Association developed the code of academic and clinical conduct. How do you plan to incorporate the code into your practice as a student nurse? How will this practice prepare you for the registered nurse profession? Resolution Possibilities for Scenario 1 1. Client’s medical diagnosis; medications to be given during clinical; essential lab values for medications or tests; and whether client has any allergies. 2. Information on medications from PDR and drug reference texts; information on medical diagnosis from textbooks; nursing skills protocols and procedures from skills text; lab information from laboratory diagnostic text. 3. Perform hand hygiene. Receive oral report from nurse; check Kardex or computer generated care plan for new client information; introduce yourself to your client; take vital signs; complete a focus assessment; and check that all medications are available in cart if not using Pyxis machine. Each of these tasks is designed to provide safe client care. Washing your hands prevents the spread of microorganisms to client. Checking medications and new orders are essential to provide accurate care. Focus assessment provides baseline information on client’s condition and promotes individualized client care. Resolution Possibilities for Scenario 2 1. The ANA standards of clinical nursing practice describes the competent level of nursing care. The standards apply to all licensed registered nurses working in clinical practice, regardless of clinical specialty, practice setting, or educational preparation. The standards describe a competent level of professional performance common to all nurses engaged in clinical practice. The Nurse Practice Act defines professional nursing and recommends those actions that the nurse can practice independently and those actions that require a physician’s order before completion. The act is a series of statutes enacted by a state to regulate the practice of nursing in that particular state. Each state has their own individual nursing practice act. A code of academic and clinical conduct outlines the ethical principles that guide the student’s professional development. Included are guides that describe the advocacy role for the rights of clients, providing for client safety, and actively promoting the highest level of moral and ethical behavior. 2. The answer depends on the regulation or guideline selected. For the content that needs to be addressed, refer to the chapter information. 3. Discussion of how ethical practice is critical in developing as a registered nurse is important. These practices include promoting the highest level of moral and ethical conduct, accepting responsibility for one’s actions, using every opportunity to improve faculty and clinical staff, and providing safe, timely, and compassionate care to clients. All of these behaviors are part of assuming the RN role. Clinical Nursing Skills, 9e Smith, Duell, Martin, Aebersold, and Gonzalez © 2017, Education Inc.