Nursing's Social Policy Statement

American Nurse's Association (ANA) 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:
Graduates of approved school of nursing
qualified by national exam to be registered nurse
Baccalaureate degree
Care for patients and families
Interventions based on desired outcomes
Caregivers
Coordinators of care
Integrate patient service delivery
Prep for tests/procedures
Monitoring of responses to interventions

Advanced Practice Nursing:
Knowledge base:concentrating or delimiting one's focus to part of the whole field of nursing. 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. 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:

Code of Ethics:
Standards of practice
Structures for peer review
System of credentialing

Certification:
Judgement of competence made by nurses who are themselves practicing within the area of specialization
Successful completion of an examination
Content of coursework
Amount of supervised practice

Legal Regulation:
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. Accountability arised from licensure criminal and civil statutes

Statutory Definitions:
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

Goal:
For both professional and legal regulatory mechanisms consistent definitions and criteria for recognition of advanced practice

Self Regulation:
Accountability for the knowledge base of practice; formal and continuing education 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 commitment to the society it serves.





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