This chapter opens with the challenge Nightingale and her close colleagues faced in establishing nursing as a profession when the ethical standards of the existing (secular) nurses were (generally) so low. The ethical issues she had to deal with in her own school, soon after it opened, are discussed three thorny problems with appointments. Anyone reading Nightingale’s writing on nursing will be struck by how often and how forcefully she insisted on high ethical standards. The reason for the emphasis on ethical standards is obvious enough in the task Nightingale faced in raising the new profession from its disreputable past. The International Council on Nursing (ICN) established its Code of Ethics in 1953, again based on Nightingale principles. It identified four responsibilities: to promote health, to prevent illness, to restore health, and to alleviate suffering. The code asks nurses not only to act ethically themselves, but to challenge unethical practices.

This chapter describes the various roles and functions of the treatment program or clinical management staff in the residential facility. It characterizes the roles of support staff and agency personnel. Teachers, physicians, nurses, psychologists, social workers, lawyers, and accountants in the TC ply their professions in the usual way. The relationship between staff and peer roles is rooted in the evolution of the Therapeutic Community (TC). In the TC approach, the role of staff is complex and can be contrasted with that of mental health and human service providers in other settings. An array of staff activities underscores the distinctively humanistic focus of the TC. The chapter describes how primary clinical staff in the treatment program supervise the daily activities of the peer community through their interrelated roles of facilitator, counselor, community manager, and rational authority. Other staff provide educational, vocational, legal, medical, and facility support services.

This chapter focuses on a disaster that resulted in international cooperation at a time of political conflict. The vastness of the destruction and the number of persons who remained under the rubble shook the world’s public opinion; for the first time, a natural disaster emergency became an event of political significance in the field of international relations. Local responses to the earthquake augmented external assistance. Because the tsunami rendered the Messina harbor unusable, Italian Royal Navy torpedo boats could not immediately be used for helping the population. After the initial rescue work, the priority became disease control and vaccination of the entire population of southern Italy. Many nurses volunteered to help the survivors. Despite the difficulties of transferring people to the disaster area, volunteer teams consisting of nurses, doctors, engineers, technicians, workers, priests, and teachers provided their assistance to survivors in the earthquake zone.

This chapter reviews patient and nursing care models, patient classification systems (PCSs), staffing and scheduling models, leader and manager staffing and scheduling responsibilities, and ways to make self-scheduling a positive experience for nurses. The primary/total patient care delivery model is the oldest model with its origins coming from the work of Florence Nightingale, and echoed in patient care provided by nursing students. PCSs are used to provide a quantitative measure of workload for the determination of staffing needs by measuring the amount of care a patient requires using objective measures such as vital signs, treatments, and number of medications. According to the American Organization of Nurse Executives competencies for nurse managers, the responsibilities of the manager include the following: staff selection, evaluation of staffing patterns, matching staff competencies to assignments, defining the role of the staff members within their scope of practice, and completing and evaluating the orientation process.

Providing the highest quality of care to clients, and keeping them safe, is a priority for all nurses. This chapter presents an evolving case scenario that will follow a nurse's exploration of quality and safety on her patient care unit. It helps the reader to define quality improvement and safety in healthcare. The chapter describes approaches that nurses can take to evaluate the quality of care through measurement and benchmarking. It helps the reader to explain the influence of variation on the quality of care and apply a framework to improve reliability. The chapter differentiates prepatient events, safety events, and serious safety events and describes how human factors contribute to events of harm. It defines the culture of safety and its elements, including event reporting, event disclosure, and accountability in a just culture. The chapter finally explains the process for determining actual and potential failures in processes.

This chapter presents a framework for the establishment of goals and priorities as well as numerous time management techniques to improve the efficiency of nurses. It helps the reader to identify ways to manage time efficiently and reduce time wasters and to analyze various time management techniques to determine their usefulness in one's specific situation. Although life is filled with many competing priorities, the good news is that there are techniques to manage time. The chapter tabulates five principles for goal setting such as clarity, challenge, commitment, feedback, and task complexity. It provides a list of self-assessment questions to assess the time management skills. Effective time management skills require planning and practice. Commitment to enhancing and using time management strategies will increase the chances of successfully achieving ones goals.

Older adult abuse is a multifactorial problem that includes problematic relationships among the older adult and spouse/partner, cohabitating with adult children, and caregivers left unsupervised with an older adult. Researchers focusing on the etiology of abuse of older adults need to place a greater emphasis on the characteristics of the abuser as a predicting variable rather than the characteristics and stereotypes of the victim as the responsible predictor of the abuse. The perpetrators of abuse against older adults, in most cases, are those who have an interpersonal relationship with the older adult. Nurses are in an ideal position to be vigilant about the status of older adults under their care, evaluating risk factors for abuse on assessment of the older adult, as well as looking for signs of abuse during their care. Older adults are usually viewed as victims of crime, rather than perpetrators of crime.

This chapter describes the characteristics of adult learners and explains how nurses can assess their personal learning style. It focuses on the academic skills many faculty and nurses consider essential for success, notably, writing, reading for meaning, note-taking, and study skills. The chapter also reviews test taking, information literacy, referencing, presentation and project completion, along with statistical and mathematical skills. It provides helpful tips from faculty and students, checklists on how to evaluate papers, as well as several printed and online resources to help nurses achieve academic success. Adult learners, like nurses, enter the academic environment with a range of abilities and skills. As they reenter the academic world, they may find themselves on some steep learning curves with all the new material required for each course. So nurses give themselves an advantage and get a head start by learning from their peers’ experiences.

The world needs visionary, effective, and wise leaders. Never has this statement been truer than it is in the world of healthcare today. Leadership matters. It matters in every organization, not only for nurses to thrive in their careers but to advance effective healthcare for society. This chapter considers the challenges facing today’s leaders in healthcare systems and the need for leaders who can transform these challenges into opportunities. It reviews foundational historical and theoretical contexts for leadership, and discusses the evolution and envisioned role of doctorally prepared nurses in healthcare systems and how they can exert positive influence as leaders within these systems. The chapter then explores theoretical contexts in the discipline of leadership to guide transformational leadership. It helps reader to develop leadership skills to shape the future of nursing and healthcare.

This chapter focuses on nurse entrepreneurs who strike out on their own and make their own path in the world of business. The time for nurse entrepreneurship has arrived—it is the here and now. It is an opportunity for nurses to embrace their history while moving forward toward greater independence and self-determination. Nurse entrepreneurship allows nurses to shine on their own, both inside and outside the medical model. A DNP degree can add value to the credentials of a nurse embarking on a journey of independent entrepreneurism. It says to the world that this nurse has achieved the highest level of education as a clinician. This should add to the success of DNP-prepared nurse entrepreneurs on their journey toward greater practice and financial independence with the ultimate goal of improved health for individuals and populations by closing the gaps, streamlining the systems, and providing expert care.