This book offers leadership lessons for aspiring nurse leaders from luminaries in business, medicine, philanthropy, government, academia, research, and health care. It offers practical advice, lessons learned, and testimonials as to how nurses can prepare themselves for leadership, which in turn, will help them to provide exceptional patient care. As per the report of the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF), the heightened roles of the professional nurse allow nurses of all practices to more fully develop their leadership skills. Nurse leaders are moving the interprofessional collaboration agenda forward by serving in key leadership positions. A nurse leader who led public research in the Kent State University and Bowling Green State University challenged the common perception that successful leaders are born, complete with the requisite temperament and talents. Nurses who play leadership roles can fill in research on health care policy formulation and implementation that will change the course of health care payment, delivery, and quality. The book discusses nurse research leadership from an economist’s perspective, hiring leaders to understand leadership, and nursing leadership lessons from an association executive’s perspective, from a physician’s chief executive officer’s perspective, from a nursing friend’s perspective and from a collaborative team’s perspective. The book also highlights nursing leadership’s contributions to safety and quality, how leadership can usher in health reforms and achieve better health for all people, and advancing the cause of transformational nurse leadership.
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Nurse leaders should be poised for change. One of the common themes across entries was that nurses are central to the changes occurring in health care and that they should seize the opportunities to be in charge of the redesign of the U.S. health care system. There was another strong theme that permeated the entries: that of the knowledge necessary for nurse leaders in health care delivery. To assume leadership roles in a new delivery system, nurse leaders are advised to understand policy and finance and the roles of all team members. Furthermore, leadership must be about the organizational goals, not one’s individual goals. Self-knowledge is essential, including the understanding of how you are reflected in the eyes of others. A high level of self-confidence is essential for leadership. Other important developmental needs for nurse leaders include quantitative skills and technological expertise, including electronic and digital forms of communication.
In the case of anxiety in the concept analysis, the defined cases serve to embed the concept within the nursing discipline through the relationship to the metaparadigm concepts. A number of different concept analysis methodologies are described in the scientific literature. The methodology for concept analysis can be traced to the work of Wilson, who delineated the methodology as an important step to gain scientific and conceptual clarity to guide research. The last step in the process of concept analysis is the identification of empirical referents, or ways to measure the concept. This chapter describes the concept analyses that are embedded in nursing science development or professional nursing practice. The concept analysis process is an important stage in theory development. It helps the scientist refine the concepts under study and thus further refine the disciplinary content.
This book delivers analyses of 30 core concepts that define nursing theory, research, education, and professional practice. Grounded in the concept analysis framework developed by Walker and Avant, the book clearly demonstrates how concepts are used to build theory, support research, and improve education and professional practice. Expert authors from clinical and research disciplines focus on the core of nursing-- the nurse-patient relationship--grouping concepts into the categories of patient/client-focused concepts, career-focused concepts, and organizational/systems-focused concepts. The concept analyses follow a specific method, with defining attributes, antecedents, and consequences given. It talks about the personal characteristics of patients/clients experiencing health/illness. These concepts include hardiness, hope, motivation and self-motivation. The book then explains the caregiver-focused concepts such as anxiety, caregiver burden, clinical autonomy, compassion fatigue, cultural competence, decision making, emotional intelligence, empathy and so on. It also presents analysis of concepts pertinent to nurse workaround, commitment, teamwork, transformational leadership, work engagement, and nurse manager accountability. Nurse workarounds are described as nurses devising an alternative work procedure to address a block in the workforce, even though these alternatives are deviations from policies, procedures, and work processes. The book also includes diagrams of characteristics across concepts for comparison. It helps nurse scholars to develop a sophisticated analytic ability and provide graduate nursing students with a foundation for developing a DNP capstone or PhD research project.
This chapter helps students to identify the changes in the field of mental health that correlate with the evolution of psychiatric-mental health nursing. It provides an overview of the key historical events associated with the evolution of mental health care and their influence on psychiatric-mental health nursing. The chapter describes the current status of psychiatric-mental health nursing and focuses on the scope of practice for the two levels of psychiatric-mental health nursing practice: basic and advanced. It emphasizes the interpersonal models of practice as the standard of care across the full range of settings and client groups. Relationships, interactions, and environment are important components of these models. This focus was selected to enhance this crucial element of nursing practice, the nurse-patient relationship, and, in particular, to establish interpersonal relations as the cornerstone of psychiatric-mental health nursing practice to assist patients in meeting their needs.
Teaching nursing is both a science and an art. As a science, the scholarship of teaching is focused on describing, explaining, implementing, evaluating, and disseminating evidence-based teaching-learning strategies to prepare graduates who will contribute to improving patient and healthcare outcomes. As an art, teaching nursing demands creativity and innovation from both the learner and the educator. Learners are expected to demonstrate willingness to participate in the learning activity, be present in the moment, and cultivate an attitude of self-reflection after each learning opportunity. This book showcases exemplars of teaching strategies and innovation from national and international leaders in academia that advance and elevates the science and art of teaching both at the undergraduate and graduate level. It affirms that nursing education is a specialty area of practice and an advanced practice role within the discipline of nursing. This book will support educators in meeting these expectations by providing evidence-based teaching strategies that have influenced both undergraduate and graduate student nursing learning outcomes positively. Further, the book describes teaching that exemplifies nursing education as a dynamic and symbiotic process that draws its energy from the meaningful interactions between the learners and its facilitators. It attempts to capture that energy that educators can use to inspire and motivate learners and further fuel their drive for excellence in teaching. Each book entry is organized in a consistent format to facilitate ease in adopting the teaching strategy. The outcomes-focused teaching strategies also include a discussion of the evidence base that supports the teaching strategy, a description and implementation process of the teaching strategy, the methods or proposed methods to measure its effectiveness, and how they are linked with student-centered competencies and nursing education accreditation standards.
This book deepens our understandings of the importance of theory in developing the science of nursing. The interest in middle range theory continues to grow as demonstrated by the increased number of published theories as well as the desire among nursing faculty and researchers to use theories at the midrange level to guide practice and research. Middle range theory can be defined as a set of related ideas that are focused on a limited dimension of the reality of nursing. Middle range theories are developed and grow at the intersection of practice and research to provide guidance for everyday practice and scholarly research rooted in the discipline of nursing. The book uses the ladder of abstraction to articulate the logic of middle range theory as related to a philosophical perspective and practice/research approaches congruent with theory conceptualization. The book is structured in four sections covering 23 chapters. The first section presents a meta-perspective on middle range theory. The first chapter elaborates on the structure of the discipline of nursing as a present and historical context for the development and use of middle range theories. The second chapter offers a clear and formal way of presenting the theories. The ladders represent the editors’ view of the philosophical grounding of the theory. The third chapter describes evaluation of middle range theories for the discipline of nursing. In the second section of the book, thirteen middle range theories are included: uncertainty, meaning, bureaucratic caring, self-transcendence, symptom management, unpleasant symptoms, self-efficacy, story, transitions, self-reliance, cultural marginality, and moral reckoning, and self-care of chronic illness. The third section contains five chapters that frame a systematic approach for concept building. The fourth section of the book contains two articles from Advances in Nursing Science that document a historical meta-perspective about middle range theory development over decades.
Nursing as basic science would require PhD programs in the discipline, creating disciplinary knowledge that had a distinctive focus. Students in current doctoral-level nursing theory classes often express interest in the term as a way to legitimize the scientific enterprise and distinguish nursing science from other disciplines, particularly health disciplines. Nursing research often was not connected directly to nursing theory, and the value of nursing theory was not always recognized. It can be interpreted that the 1983 Institute of Medicine (IOM) report, in characterizing nursing research as part of biomedical and/or behavioral science, implied that nursing was an applied science. Throughout the nursing knowledge literature there is general agreement that nursing knowledge has developed from the abstract to the specific, from the broad theoretical propositional statements to the specific testable hypotheses. Nurse scholars continue to develop theoretical, empirical, and expert clinical knowledge for the nursing discipline.
This book addresses roles for nurses engaged in doctoral advanced nursing practice, to which similarly but differently describes the role of the clinical executive, faculty member with a clinical focus, quality officer, and the other diverse roles that the Doctor of Nursing Practice (DNP) graduate may assume. It is divided into three sections. The first section provides background information on the evolution of the DNP degree, essential content on role theory, what nursing “roles” are and how they evolved, and a discussion of how master’s- versus doctoral-level advanced nursing practices differ. The second section focuses on the three basic roles of the DNP graduate that currently predominate: practitioner, clinical executive, and faculty member with a clinical focus; as well as the role of the clinical scholar, something each graduate is expected to embrace as stewards of the discipline. One of the assumptions of the book is that there is a domain of practice beyond the master of science in nursing (MSN) degree and that with the doctoral credential the graduate is empowered and obliged to be a greater steward to the discipline. Part of this enhanced stewardship is a commitment to both the conduct and dissemination of clinical scholarship in its multiple forms. The final section covers the diverse skills that comprise the doctoral advanced practice registered nurses (APRN) and doctoral advanced practice nursing (APN) role; including leadership content, negotiation skills, quality improvement, and leveraging technology to support doctoral advanced level practice; and inclusion of doctoral global health competencies with mandatory study abroad; and how the doctoral APRN or the DNP engaged in doctoral APN can use their new competencies to function at a higher level.
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Nurse Caring Behaviors Following Implementation of a Relationship-Centered Care Professional Practice Model
Caring has historically been considered an important part of nursing practice. Theories that contain an explication of the concept of nurse caring have received attention in both the scientific and the professional practice arena within the discipline (Watson, 1988, 2008). While a considerable literature exists comparing nurses’ and patients’ perceptions of caring behaviors, there is no literature that specifically addresses nurses’ perceptions of caring behaviors following implementation of a hospital-wide professional practice model (PPM). This chapter presents a study which describes nurses’ perceptions of caring 6 months after implementation of a new Relationship-Centered Care (RCC) PPM. Nurse leaders were engaged in the implementation of the PPM, and were supportive of the changes that were introduced to enhance care provisions. In addition, nurse leaders consistently tracked the implementation of the PPM and the caring behaviors on each unit.