Professional Issues in Nursing: Challenges and Opportunities

by Huston, Carol Jorgensen

• ISBN13: 9780781748759
• ISBN10: 0781748755
• Format: Paperback
• Copyright: 2005-08-26
• Publisher: LWW

Summary

Nursing students and practicing professionals alike will benefit from this valuable and timely text. In point-counterpoint fashion, the author explores a full range of the most contemporary issues facing nursing. The result is an in-depth, up-to-date insight into the profession and the workplace. Book jacket.

Table of Contents

Furthering the Profession	p. 1
Entry Into Practice: An Elusive Dream or a Critical Professional Need?	p. 3
Proliferation of ADN Education	p. 5
Licensure and Entry Into Practice	p. 6
Educational Levels and Patient Outcomes	p. 7
Employers' Views and Preferences	p. 9
Shifting Health Care Delivery Sites and Required Competencies	p. 9
Entry Level and Professional Status	p. 10
The Two-Year AND Program?	p. 12
Shortages and Entry-Level Requirements	p. 13
Professional Organizations and Advisory Bodies Speak Out	p. 14
Collaboration and Consensus Building: Is it Possible?	p. 15
Grandfathering Entry Levels	p. 15
Linking ADN and BSN Programs	p. 16
An International Issue	p. 17
Conclusions	p. 17
For Additional Discussion	p. 18
Differentiated Nursing Practice: Maximizing Resources or Dividing an Already Divided Profession?	p. 21
Origins of Differentiated Nursing Practice	p. 23
Differentiated Practice in the 21st Century	p. 34
Conclusions	p. 41
For Additional Discussion	p. 42
Defining Evidence-Based Best Practices	p. 46
What Is Best Practice?	p. 47
What Is Evidence-Based Practice?	p. 48
Why, When, and Where Best Practices Are Used	p. 49
Finding Evidence to Answer Nursing Questions	p. 53
Supporting Best Practices	p. 54
Challenges and Opportunities: Strategies for Changing Practice	p. 59
Conclusions	p. 61
For Additional Discussion	p. 61
Socialization and Mentoring	p. 65
Socialization: Roles, Skills, Values, and Change	p. 66
The Health Care Workplace in the 21st Century	p. 67
Socialization and Mentoring: Empowerment	p. 70
Creating a Supportive Environment for Socialization and Resocialization	p. 77
Conclusions	p. 79
For Additional Discussion	p. 79
Workforce Issues	p. 83
The Current Nursing Shortage: Causes, Consequences, and Solutions	p. 85
The Supply	p. 86
The Demand	p. 90
Roots of the Shortage	p. 91
The Consequences of the Shortage	p. 97
Solving the Shortage	p. 98
Conclusions	p. 101
For Additional Discussion	p. 103
Importing Foreign Nurses	p. 108
Global Migration of Nurses: "Push" and "Pull" Factors	p. 109
The Impact of Global Migration on Developing Countries	p. 111
Global Nurse Recruitment and Migration as an Ethical Issue	p. 114
The International Community Addresses the Problem	p. 117
Ensuring Competency of Foreign Nurses: Commission on Graduates of Foreign Nursing Schools	p. 122
Assimilating the Foreign Nurse Through Socialization	p. 123
Conclusions	p. 124
For Additional Discussion	p. 124
Distance Learning: One Strategy for Furthering Nursing Education and Easing the Nursing Shortage	p. 127
Distance Learning: Historical Perspectives	p. 128
Access to Contemporary Forms of Distance Learning	p. 130
Why Distance Education in Nursing?	p. 131
Financial Aid for Distance Education	p. 131
Scope of Distance Education in Nursing	p. 132
Student Needs in Distance Learning	p. 133
Controversies Regarding Distance Education in Nursing	p. 134
Distance Learning and Specific Student Populations	p. 141
Conclusions	p. 143
For Additional Discussion	p. 144
Unlicensed Assistive Personnel and the Registered Nurse	p. 147
Motivation to Use Unlicensed Assistive Personnel	p. 149
Educational Requirements for Unlicensed Assistive Personnel	p. 150
Unlicensed Assistive Personnel Scope of Practice	p. 152
Unlicensed Assistive Personnel and Patient Outcomes	p. 155
Registered Nurses and Unlicensed Assistive Personnel: Their Working Relationship	p. 156
Registered Nurse Liability for Supervision and Delegation of Unlicensed Assistive Personnel	p. 156
Creating a Safe Work Environment	p. 158
The Unlicensed Assistive Personnel Shortage	p. 159
Conclusions	p. 161
For Additional Discussion	p. 162
Diversity in the Nursing Workforce	p. 166
Ethnic Diversity	p. 168
Gender Diversity	p. 174
Generational Diversity in Nursing	p. 178
Professional Organizations Speak Out	p. 180
Conclusions	p. 180
For Additional Discussion	p. 181
Workplace Issues	p. 187
Mandatory Staffing Ratios: Are They Working?	p. 189
Staffing Ratios and Patient Outcomes	p. 190
Are Mandatory Staffing Ratios Really Needed?	p. 192
California as the Prototype for Mandatory Staffing Ratios	p. 194
Similar Initiatives in Other States	p. 201
Other Alternatives	p. 202
Conclusions	p. 203
For Additional Discussion	p. 203
Mandatory Overtime in Nursing: How Much? How Often?	p. 207
Legislating Mandatory Overtime	p. 208
Mandatory Overtime in Nursing	p. 211
Consequences of Enforcing Mandatory Overtime	p. 213
Patient Abandonment	p. 216
Professional Duty and Conscience	p. 218
Unions and Mandatory Overtime	p. 219
Alternatives to Mandatory Overtime	p. 220
Conclusions	p. 222
For Additional Discussion	p. 222
Violence in Nursing: The Expectations and the Reality	p. 226
Perspectives on the Issue	p. 228
Defining Workplace Violence	p. 231
Typology of Workplace Violence	p. 232
The Impact of Workplace Violence on Nurses and Nursing	p. 237
Strategies to Address the Problem	p. 238
Nursing Code of Ethics	p. 241
What Should Be Done?	p. 242
Conclusions	p. 243
For Additional Discussion	p. 244
Technology in the Health Care Workplace: Benefits, Limitations, and Challenges	p. 248
New Technologies in Health Care	p. 249
Telehealth and Telenursing	p. 256
Is Technology Worth the Costs?	p. 260
The Internet and Health Care	p. 260
Conclusions	p. 263
For Additional Discussion	p. 264
Medical Errors: An Ongoing Threat to Quality Health Care	p. 268
Seminal Research on Medical Errors	p. 270
Working to Achieve the Institute of Medicine Goals	p. 275
Creating a Culture of Safety Management	p. 280
Conclusions	p. 286
For Additional Discussion	p. 287
Legal and Ethical Issues	p. 293
Whistle-blowing in Nursing	p. 295
Groupthink and Whistle-blowing	p. 297
Examples of Whistle-blowing in Nursing	p. 299
When Whistle-blowing Is Appropriate	p. 300
The Personal Risks of Whistle-blowing	p. 302
Ethical Dimensions of Whistle-blowing	p. 304
Whistle-blowing as a Failure of Organizational Ethics	p. 306
Legal Protection for Whistle-blowers	p. 307
Whistle-blowing as an International Issue	p. 310
Conclusions	p. 310
For Additional Discussion	p. 311
The Chemically Impaired Nurse: Discipline or Treatment?	p. 314
Prevalence of the Problem	p. 315
Overview of the Literature	p. 316
How Can We Stop Losing Nurses to Substance Abuse?	p. 323
Conclusions	p. 324
For Additional Discussion	p. 325
Collective Bargaining and the Professional Nurse	p. 328
Historical Perspective of Unionization in America	p. 330
Historical Perspective of Unionization in Nursing	p. 332
Unions Representing Nurses	p. 333
Motivation to Join Unions	p. 334
Reasons Not to Join Unions	p. 337
Eligibility for Union Membership	p. 338
Union Organizing Strategies	p. 339
Seeking Union Representation	p. 341
Labor-Management Relations	p. 342
American Nurses Association and Collective Bargaining	p. 343
Nurses and Strikes	p. 343
Conclusions	p. 345
For Additional Discussion	p. 345
Assuring Provider Competence Through Licensure, Continuing Education, and Certification	p. 348
Defining Competence	p. 350
Professional Licensure	p. 353
Continuing Education	p. 355
Certification	p. 357
Reflective Practice	p. 360
Who's Responsible for Competence Assessment in Nursing?	p. 361
Conclusions	p. 363
For Additional Discussion	p. 364
Professional Power	p. 369
The Nursing Profession's Historic Struggle to Increase Its Power Base	p. 371
Factors Contributing to Powerlessness in Nursing	p. 373
Driving Forces to Increase Nursing's Power Base	p. 379
Action Plan for the Future	p. 382
Conclusions	p. 387
For Additional Discussion	p. 388
Professional Identity and Image	p. 391
Nursing Stereotypes	p. 393
How Nurses Feel About Contemporary Depictions	p. 398
How Ingrained are Nursing Stereotypes?	p. 398
Consequences of Inaccurate or Negative Images	p. 401
Changing Nursing's Image in the Public Eye	p. 402
Conclusions	p. 408
For Additional Discussion	p. 409
Advanced Practice Nursing: Challenges of Role Definition, Recognition, and Reimbursement	p. 412
Role Definition: Advanced Practice Nursing and Related Specialty Areas	p. 414
Role Recognition	p. 417
Scope of Practice: Medicine and Advanced Practice Nursing	p. 422
Outcome Studies: Validating the Worth of Advanced Practice Nursing Practice	p. 428
Controlling the Future of Advanced Practice Nursing	p. 430
Conclusions	p. 431
For Additional Discussion	p. 431
Nursing and Public Policy: Getting Involved	p. 435
Defining Politics and Policy	p. 436
Defense, Domestic, and Foreign Policy	p. 437
Policies and Values	p. 438
Conceptualizing Politics and Policy Development	p. 438
Roots of Involvement in Policy and Politics: Early 1900s	p. 443
Nursing, Public Policy, and Politics: Mid- to Late 1900s	p. 447
Nursing in Contemporary Politics and Policy	p. 452
Conclusions	p. 456
For Additional Discussion	p. 457
Nursing's Professional Associations	p. 460
The Growth of Professional Associations	p. 461
The Formation and Work of Nursing's Early Professional Associations	p. 462
Shaping the Nursing Profession	p. 464
Development of Specialty Nursing Professional Associations	p. 465
Challenges for Contemporary Nursing Professional Associations	p. 473
The Association for the Future	p. 478
Conclusions	p. 483
For Additional Discussion	p. 484
Index	p. 489
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