Nursing practice is a symbiotic relationship between the art and science of professional care. One cannot exist in isolation from the other. Nurses are inclined to connect the art of nursing with terms such as compassion, caring attitudes, the therapeutic relationship, presence, professionalism, advocacy, and competence, otherwise known as the “soft or caring side of nursing”. The greatest threat to the disappearance of the art of nursing lies with the perceived “big three”: time, fiscal restraint, and failure of the system to support a full staff of nurses, so those employed are working at full capacity. It is important to recognize that different practice settings have varying needs. One size does not fit all. Yet the requirements for nursing assessments, developing a plan of care, coordinating care with other health care providers, implementing interventions, and evaluating care outcomes are a requirement of all.
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The author, Martin Alpert, presents a method by which individual nurses can be independent, improve patient care, have fun, and earn more money. He proposes that the nursing profession become the leader in a shift to sustainable, least invasive therapies and evaluations (LITE). LITE represents a major profit opportunity for nurses. Many of these new therapies require medical professionals, but not necessarily doctors. They can be administered by dedicated and trained nurses. The impact of LITE on the global society of nursing leading this area of medicine could be transformational for nursing, medicine, and society. Nursing could lead in diagnosis and treatment under the LITE paradigm. Acupuncture is becoming part of conventional therapy. It can be a part of nursing practice. Recently, the World Health Organization estimated that 80” of people worldwide rely on herbal medicines for some part of their primary health care.
Queen behavior in the workplace is not unique to nursing. This chapter describes one of the most toxic workplace behaviors and its serious impact on patient care, staff relationships, and quality of work life. Queens are tough to manage. Many nurse managers can become victims of a queen when engaged in a power struggle. Workplace queens are the embodiment of unprofessional behavior that is nothing short of bullying. The impact of the queen’s toxicity is not limited to the practice setting and can leech into other areas of the organization, community, and beyond. Managing queen behavior is never optional. How it is managed depends on the type of behavior, circumstances, experience of the manager, and resources available to support the process. To tackle queen behavior in the workplace, the nurse managers use both short-term and long-term strategies.
The intent of this book is to provide useful knowledge and practical applications to ease the work of leading or working in a hospital-based nursing research program. It contains principles that apply to all sizes of hospitals, as well as hospital systems that may be spread out over multiple states or be contained in one area. The book describes how nursing research provides new evidence for nursing practice that improves clinical outcomes, changes the culture of the organization, creates new leadership roles for nurses, offers opportunities for interdisciplinary collaboration, enhances patient safety, improves nurse and patient satisfaction, and leads to positive branding of the hospital and the nursing department. Nursing leadership can create (or support) a vision for nursing research based on the benefits that are central to the hospital’s strategic mission and goals. An essential element of setting the foundation and planning, growing, and nurturing a nursing research program is to demonstrate how the program aligns with the strategic plan (vision, mission, and goals) of nursing. The three foundational elements of strong nursing research programs personnel, intranet resources, and a nursing research department database are interconnected and should be available to the entire nursing department, including non-nurse providers and administrators, because important research questions can come from anyone on the team. The nursing research department database is an electronic system of input and storage of direct and indirect data important to the development, conduct, translation, and dissemination of nursing research.
With an eye to creative evolution in nursing education, research and clinical settings, Veda L. Andrus and Marie M. Shanahan discuss how emerging nurse leaders can be agents of change beyond the confines of traditional practice and curricula through innovation and collaboration. Andrus’s focus in nursing care revolves around the importance of making connections and building relationships. She have never lost her passion or commitment to her work in nursing and see it as an avenue to influence the healing and transformation of the nursing profession, the health care system, and our world. Shanahan’s move to hemodialysis, with its life-extending focus, seemed like a way to build the types of relationships she was missing in the fast-paced, often tragic environment of critical care. One of her ongoing professional passions is promoting self-care and renewal in nursing practice.
The human response to health and illness meant nurses would promote health, intervene in the presence of disease, and champion disease abatement efforts while coordinating care to enrich human functioning. The author’s first role as an licensed practical nurse (LPN) was in a state facility, caring for men who were profoundly developmentally disabled. Patient advocacy involves risk-taking and remembering that not all health providers are patient advocates. Social determinants and public and environmental health issues shape the nature and type of acute care services that are delivered. Teaching about and modeling the design of systems was an important contribution to quality and implementation science, preparing a workforce to enable systems leadership. Work-arounds add complexity to routine practices, which could include bypassing safeguards that ensure the quality and safety linked to patient care. Holistic care that aligns with human responses to life challenges are fitting dimensions of nursing practice.
Nursing has been the cornerstone of the author’s, Mary Jo Kreitzer, work and the lens through which she have provided leadership. She has a great love of nursing history, and early in her career, she was frustrated by what she saw as a lack of bold leadership and innovation in contemporary nursing. Nursing is exquisitely well positioned to provide leadership as the health care system disintegrates and as new forms and possibilities emerge. The issues of rising costs, shortages of nurses and other health care providers, patients who are dissatisfied, poor outcomes, and disengaged care providers are global in nature. Integrative nursing provides a whole person/whole systems approach that addresses the needs of patients and their families who are demanding care that is comprehensive, coordinated, and attentive to the whole person body, mind, and spirit.
Every nurse has the capacity to embody her or his gifts and offer them to life, to those they serve: patients, families, and communities. In this way, every nurse is a leader, offering a life teaching through her or his embodied study and practice of nursing. In the 1970s, it was not widely accepted that the psychophysiology of mind and body were interconnected and influenced each other. In the mid-1990s, a small grassroots movement in the Northeast arose to address a nationwide challenge to the profession of nursing. Begun as a reorganization of health care, it included downsizing and reengineering of hospitals, massive nursing layoffs, and a campaign to replace licensed RNs with less-costly hospital-trained technicians. These grassroots nurses, who did not see themselves as leaders, facilitated sharing circles, which included national/international nurse leaders, thereby offering real-life leadership experience and building their self-confidence.
The author, A. Lynne Wagner, has always envisioned nurses needing an expansive knowledge of body and disease, of clinical skills and machinery, and perhaps team skills of working together in a crisis. Wagner began her journey in exploring the power of reflective inquiry via story and aesthetic expression to inform self and others through three avenues that fostered deeper meaning of nursing: Nurse-Self as Artist; Practicing Nurse as Artist; and Nurse-Researcher as Artist. A typology of three modes of reflection-cognitive, affective, and collective- used to explore caring-self in nursing practice emerged from the data, describing different activities, processes, and outcomes of reflective storytelling that lead to a fuller understanding of experiences. Wagner came to nursing with a strong moral, ethical foundation of caring for others, with a sense of respect and compassion that was fostered by her caregivers, role models, mentors, and growing spirituality throughout her life.
The original inspiration for this book grew out of the authors' experience while co-teaching an epidemiology course for students enrolled in a doctorate in nursing practice (
DNP) program. They found it difficult to find a textbook that addressed the course objectives and was relevant to nursing practice. They decided a population-based nursing textbook, targeted for use as a primary course textbook in a DNPprogram or as a supplement to other course materials in a graduate community health nursing program, would be of great benefit and value to students enrolled in these programs. This book is the result of that vision. The chapters address the essential areas of content for a DNPprogram as recommended by the American Association of Colleges of Nursing ( AACN), with a focus on the AACNcore competencies for population-based nursing. The primary audience is nursing students enrolled in either a DNPprogram or a graduate community health nursing program. Each chapter includes discussion questions to help students use and apply their newly acquired skills. The third edition adds a chapter on accreditation of population-based programs and provides a list of Internet resources to each chapter. It addresses the increasing interest in the use of social media to address population health as well as other current issues in population-based nursing. As in the earlier editions, this textbook includes successful strategies that nurses have used to improve population outcomes and reinforces high-level application of activities that require the synthesis and integration of information learned.