Nursing's Social Policy Statement (Summary Outline)
American Nurse's Association ~ 1995
The Social Context of Nursing:
The authority for the practice of nursing is based on a social contract
that acknowledges professional rights and responsibilities as well as mechanisms
for public accountability.
Values and Assumptions:
Humans manifest an essential unity of mind/body/spirit. Human experience
is contextually and culturally defined. Health and illness are human experiences.
The presence of illness does not preclude health nor does optimal health
preclude illness.
Definitions of Nursing:
Attention to the full range of human experiences and responses to health
and illness without restriction to a problem-focused orientation.
Integration of objective data with knowledge gained from an understanding
of the patient or group's subjective experience.
Application of scientific knowledge to the processes of diagnosis and
treatment.
Provision of a caring relationship that facilitates health and healing.
Knowledge base for Nursing Practice:
Phenomena of Concern: human experiences and responses to birth, health,
illness, and death. Nurses focus on these phenomena within the context
of individuals, families, groups, and communities.
Diagnosis: facilitate communication among health care providers and
the recipients of care and provide for initial direction in choice of treatments
and subsequent evaluation of the outcomes of care.
Interventions: direct or indirect, involve both physical and emotional
intimacy. Giving physical care, emotional support, health teaching or counseling.
Assisting recovery or a peaceful death
Outcomes: evaluate the effectiveness of their interventions in relation
to identified outcomes. Revise diagnosis, outcomes and plans of care.
Scope of Nursing Practice:
Basic Nursing Practice:
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Graduates of approved school of nursing
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qualified by national exam to be registered nurse
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Baccalaureate degree
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Care for patients and families
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Interventions based on desired outcomes
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Caregivers
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Coordinators of care
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Integrate patient service delivery
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Prep for tests/procedures
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Monitoring of responses to interventions
Advanced Practice Nursing:
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Knowledge base:concentrating or delimiting one's focus to part of the
whole field of nursing
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Practice experiences: expansion refers to the acquisition of new practice
knowledge and skills, including these legitimizing the role autonomy within
areas of practice that overlap traditional boundaries of medical practice.
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Specialization advancement integration of theoretical, research-based,
and practical knowledge that occurs as a part of graduate education in
nursing.
Nurses in Advanced Practice:
Acquire specialized skills and knowledge through study and supervised
practice at the master's or doctoral level in nursing. The term advanced
practice is used exclusively to refer to advanced clinical practice.
APN Scope of Practice:
Distinguished by autonomy to practice at the edges of the expanding
boundaries of nursing's scope of practice, preponderence of self-inititated
treatment regimens, as opposed to dependent functions and complexity of
clinical decision making and a skill managing organizations and environments
Functions of Advanced Practice Nurses:
Assess health needs, develop diagnosis plan, implement and manage
care, evaluate outcomes of care plan, advocate care, promote health, prevent
diseases and disability, direct care or manage systems of care for complex
populations, manage acute and chronic illness, childbirth, etc. Prescribe,
administer and evaluate pharmacological treatment regimens, mentor in basic,
consultant in practice, educate, conduct research to expand the knowledge
base, provide leadership for practical changes, contribute to the advancement
of the profession.
Regulation of Nursing Practice:
Defining its practice base
Providing for research and the development of that practice base
Establishing a system for nursing education
Establishing the structures through which nursing services will be delivered
Providing quality review mechanisms:
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Code of Ethics:
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Standards of practice
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Structures for peer review
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System of credentialing
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Certification:
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Judgement of competence made by nurses who are themselves practicing
within the area of specialization
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Successful completion of an examination
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Content of coursework
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Amount of supervised practice
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Legal Regulation:
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All nurses are legally accountable for actions taken in the course of
nursing practice as well as actions delegated by nurses to others assisting
in the delivery of nursing care
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Accountability arised from licensure criminal and civil statutes
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Statutory Definitions:
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Should be compatible with the profession's definition of its practice
base but general enough to provide for the dynamic nature of an evolving
scope of nursing practice
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Goal:
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For both professional and legal regulatory mechanisms consistent definitions
and criteria for recognition of advanced practice
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Self Regualtion
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Accountability for the knowledge base of practice; formal and continuing
education
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Certification peer review; mechanism by which nurses are held accountable
for practice based on the profession's code of ethics
Conclusion:
Nursing's Social Policy Statement includes a description of nursing
in the United States the values and social responsibility of the profession,
nursing's definition and scope of practice, nursing's knowledge base, and
the methods by which nursing is regulated. The statement is both an accounting
of nursing's professional stewardship and an expression of nursing's continuing
committment to the society it serves. |
