Array ( [0] => {{Short description|Health care profession}} [1] => {{Other uses}} [2] => {{Redirect2|Nurse|Nurses}} [3] => {{Copy edit|date=April 2024}} [4] => {{pp|small=yes}} [5] => [6] => {{Use dmy dates|date=July 2021}} [7] => {{Infobox Occupation [8] => | name= Nursing [9] => |image = File:Nurse checks blood pressure.jpg [10] => | imagesize = 250px [11] => |caption = A nurse checks a patient's blood pressure. [12] => | official_names= [13] => | Occupation = [14] => | activity_sector= Nursing [15] => | competencies= [16] => Caring for general and specialized well-being of patients [17] => | formation= [18] => Qualifications in terms of statutory regulations according to national, state, or provincial legislation in each country [19] => | employment_field= [20] => *[[Hospital]] [21] => *[[Clinic]] [22] => *[[Laboratory]] [23] => *[[Research]] [24] => *[[Education]] [25] => *[[Home care]] [26] => [27] => | related_occupation= [28] => *[[Medicine]] [29] => *[[Glossary of medicine]] [30] => }} [31] => [32] => '''Nursing''' is a profession within the [[health care|healthcare]] sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and [[quality of life (healthcare)|quality of life]].{{Cite web |title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society - Credo Reference |url=https://search.credoreference.com/content/entry/sageeas/nursing/0 |access-date=2022-03-31 |website=search.credoreference.com |language=en}} Nurses can be differentiated from other [[health care providers|healthcare providers]] by their [[nursing theory|approach to patient care]], [[nurse education|training]], and [[scope of practice]]. Nurses practice in many [[List of nursing specialties|specialties]] with differing levels of [[medical prescription|prescription authority]]. Nurses comprise the largest component of most healthcare environments;{{Cite journal |doi=10.1097/01.NEP.0000000000000659|title=Who Wants to be a Nurse? Understanding Emirati Female Students' Knowledge and Attitudes About Nursing as a Career |year=2020 |last1=Maymoun |first1=Nazneen |last2=Sohail |first2=M. Sadiq |journal=Nursing Education Perspectives |volume=41 |issue=3 |pages=E14–E19 |pmid=32310910 |s2cid=216046198 }}{{Cite journal |doi=10.1186/s12960-017-0223-2 |doi-access=free|title=The Human Resources for Health Effort Index: A tool to assess and inform Strategic Health Workforce Investments |year=2017 |last1=Fort |first1=Alfredo L. |last2=Deussom |first2=Rachel |last3=Burlew |first3=Randi |last4=Gilroy |first4=Kate |last5=Nelson |first5=David |journal=Human Resources for Health |volume=15 |issue=1 |page=47 |pmid=28724381 |pmc=5518138 }} but there is evidence of international shortages of qualified nurses.{{Cite journal |doi=10.1515/emj-2017-0019 |doi-access=free|title=Nurses in Poland — Immediate Action Needed |year=2017 |last1=Haczyński |first1=Józef |last2=Skrzypczak |first2=Zofia |last3=Winter |first3=Małgorzata |journal=Engineering Management in Production and Services |volume=9 |issue=2 |pages=97–104 }} Nurses collaborate with other healthcare providers such as [[physician]]s, [[nurse practitioner]]s, [[physical therapist]]s, and [[psychologist]]s. There is a distinction between nurses and nurse practitioners; in the U.S., the latter are nurses with a graduate degree in advanced practice nursing, and are permitted to prescribe medications unlike the former. They practice independently in a variety of settings in more than half of the United States. Since the [[Post-war|postwar]] period, nurse education has undergone a process of diversification towards [[Nursing credentials and certifications|advanced and specialized credentials]], and many of the traditional regulations and provider roles are changing.Coulehan J. L., Block M. R. (2005): The Medical Interview: Mastering skills for clinical practice, 5th Ed. F. A. Davis. {{ISBN|0-8036-1246-X}}. {{OCLC|232304023}}.Dunphy L. M., Winland-Brown J. E. (2011): Primary care: The art and science of advanced practice nursing. F.A. Davis. {{ISBN|9780803626478}}. [33] => [34] => Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family, and other team members that focuses on treating illness to improve quality of life. In the United Kingdom and the United States, clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe the correct medications and other therapies, depending on particular state regulations.{{Cite web|title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society - Credo Reference|url=https://search.credoreference.com/content/entry/sageeas/nursing/0|access-date=2022-02-18|website=search.credoreference.com|language=en}} Nurses may help coordinate the patient care performed by other members of a multidisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals. In addition to providing care and support, nurses educate the public and promote health and wellness.{{Cite web |last=Freeman |first=Veronica |title=The role of nurses in our society today |url=https://www.cerner.com/ae/en/blog/the-role-of-nurses-in-our-society-today |access-date=2023-03-31 |website=www.cerner.com |language=en}} [35] => {{TOC limit|3}} [36] => [37] => ==History== [38] => {{Main article|History of nursing|Timeline of nursing history}} [39] => [40] => ===Premodern=== [41] => Nursing historians face challenges of determining whether care provided to the sick or injured in antiquity is called nursing care.{{cite book|last1=O'Lynn|first1=CE|editor1-last=O'Lynn|editor1-first=CE|editor2-last=Tranbarger|editor2-first=RE|title=Men in Nursing: History, Challenges, and Opportunities|date=2007|publisher=Springer Pub.|location=New York|isbn=9780826103499|pages=6–8|chapter=History of men in nursing: a review}} In the fifth century BC, for example, the [[Hippocratic Collection]] in places described skilled care and observation of patients by male "attendants," who may have been early nurses.{{cite journal|last1=Levine|first1=EB|last2=Levine|first2=ME|title=Hippocrates, father of nursing, too?|journal=The American Journal of Nursing|year=1965|volume=65|issue=12|pages=86–8|pmid=5319739|doi=10.1097/00000446-196512000-00022|s2cid=38921319}} Around 600 BC in India, it is recorded in [[Sushruta Samhita]], Book 3, Chapter V about the role of the nurse as "the different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, anyone desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully, observe, by dissecting it, and examining its different parts." [42] => [43] => Before the foundation of modern nursing, members of religious orders such as [[nuns]] and [[monks]] often provided nursing-like care.{{cite web|last=Bloy|first=M|url=http://www.victorianweb.org/history/crimea/florrie.html|title=Florence Nightingale (1820–1910)|website=The Victorian Web|access-date=24 November 2014}} Examples exist in [[Christianity|Christian]],{{cite book|last1=Ferngren|first1=GB|title=Medicine & health care in early Christianity|date=2009|publisher=Johns Hopkins University Press|location=Baltimore|isbn=9780801895227|page=121}} [[Islamic]],{{cite book|last1=Sachedina|first1=Abdulaziz|title=Islamic biomedical ethics: principles and application|url=https://archive.org/details/islamicbiomedica00sach_109|url-access=limited|date=2009|publisher=Oxford University Press|location=Oxford|isbn=9780195378504|pages=[https://archive.org/details/islamicbiomedica00sach_109/page/n103 93]–94}} and [[Buddhist]]{{cite book|editor1-last=de Bary|editor1-first=WT|title=The Buddhist tradition in India, China & Japan|date=2011|publisher=Vintage eBooks|location=New York|isbn=9780307778796|pages=35–36|edition=Unabridged.}} traditions amongst others. [[Phoebe (biblical figure)|Phoebe]], mentioned in [[Epistle to the Romans|Romans]] 16 has been described in many sources as "the first visiting nurse".{{cite book|last1=Egenes|first1=KJ|editor1-last=Halstead|editor1-first=J|editor2-last=Roux|editor2-first=G|title=Issues and Trends in Nursing: Essential Knowledge for Today and Tomorrow|date=2009|publisher=Jones and Bartlett|location=Sudbury, MA|isbn=9780763752255|page=[https://archive.org/details/issuestrendsinnu0000unse/page/2 2]|chapter=History of nursing|chapter-url=https://archive.org/details/issuestrendsinnu0000unse/page/2}}{{cite journal|last1=Striepe|first1=JM|title=Reclaiming the church's healing role|journal=Journal of Christian Nursing|year=1992|volume=10|issue=1|pages=4–7|doi=10.1097/00005217-199310010-00002|pmid=8418284}} These traditions were influential in the development of the [[ethos]] of modern nursing. The religious roots of modern nursing remain in evidence today in many countries. One example in the [[United Kingdom]] is the use of the historical title "sister" to refer to a senior nurse in the past.{{cite journal|last1=Wand|first1=T|title=The 'Sister' title: past the use by date?|journal=Collegian|date=January 2004|volume=11|issue=1|pages=35–39|doi=10.1016/S1322-7696(08)60442-4}} [44] => [45] => During the [[Reformation]] of the 16th century, [[Protestant]] reformers shut down the monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe. Those nuns who had been serving as nurses were given pensions or told to get married and stay home.{{cite book|last1=Leonard|first1=AE|chapter=Female religious orders|page=244|editor1-last=Hsia|editor1-first=RP|title=A Companion to the Reformation World|date=2008|publisher=Blackwell Publishers|location=Oxford|isbn=978-1405149624|edition=1st paperback}} Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church, were removed from their positions. The nursing profession suffered a major setback for approximately 200 years.{{cite book|last1=Lundy|first1=KS|editor1-last=Masters|editor1-first=K|title=Role Development in Professional Nursing Practice|date=2014|publisher=Jones & Bartlett Learning|location=Burlington, MA|isbn=9781449681982|pages=11–12|edition=3rd|chapter=A history of health care and nursing}} [46] => [47] => ===19th century=== [48] => [[File:Сестры Крестовоздвиженской общины, Севастополь, 1855.jpg|upright|thumb|Russian Sisters of Mercy in the Crimea, 1854–1855]] [49] => During the [[Crimean War]] the [[Princess Charlotte of Württemberg|Grand Duchess Elena Pavlovna]] issued the call for women to join the Order of Exaltation of the Cross (Krestodvizhenskaya obshchina) for the year of service in the military hospitals. The first section of twenty-eight "sisters", headed by Aleksandra Petrovna Stakhovich, the Directress of the Order, went off to the Crimea early in November 1854.{{Cite journal |jstor=2492652|last1=Curtiss |first1=John Shelton |title=Russian Sisters of Mercy in the Crimea, 1854-1855 |journal=Slavic Review |year=1966 |volume=25 |issue=1 |pages=84–100 |doi=10.2307/2492652 |pmid=11633166 |s2cid=43448185 }} [50] => [51] => [[File:Florence Nightingale (H Hering NPG x82368).jpg|upright|thumb|[[Florence Nightingale]] was an influential figure in the development of modern nursing. No uniform had been created when Nightingale was employed during the [[Crimean War]]. Often considered the first nurse theorist, Nightingale linked health with five environmental factors: (1) pure or fresh air, (2) pure water, (3) efficient drainage, (4) cleanliness, and (5) light, especially direct sunlight. Deficiencies in these five factors resulted in a lack of health or illness.Professional Nursing Practice: Concepts and perspective, Koernig & Hayes, sixth edition, 2011, p.100, {{ISBN|978-0-13-508090-0}} Both the role of nursing and education were first defined by Nightingale.]] [52] => [53] => [[Florence Nightingale]] laid the foundations of professional nursing after the [[Crimean War]].{{cite journal|last1=Winkel|first1=W|title=Florence Nightingale|journal=Epidemiology|year=2009|volume=20|issue=2|pages=311|doi=10.1097/EDE.0b013e3181935ad6 |doi-access=free|pmid=19234417}} Nightingale believed that nursing was a social freedom and mission for women. She believed that any educated woman can help improve the care of the medically sick.{{Cite web |title=nursing {{!}} History, Education, & Practices {{!}} Britannica |url=https://www.britannica.com/science/nursing |access-date=2022-03-31 |website=www.britannica.com |language=en}} Her ''[[Notes on Nursing]]'' (1859) became popular. The Nightingale model of professional education, having set up one of the [[Florence Nightingale Faculty of Nursing and Midwifery|first schools of nursing]] that is connected to a continuously operating hospital and medical school, spread widely in Europe and North America after 1870.{{cite book|last=Quinn|first=Shawna M.|title=Agnes Warner and the Nursing Sisters of the Great War|url=http://www.gooselane.com/media/741.pdf|publisher=Goose Lane editions and the New Brunswick Military Heritage Project |date=2010|isbn=978-0-86492-633-3|access-date=29 November 2014|archive-url=https://web.archive.org/web/20150924023052/http://www.gooselane.com/media/741.pdf|archive-date=24 September 2015}} Nightingale was also a pioneer of the graphical presentation of [[statistics|statistical]] [[data]].{{cite news|last1=Bostridge|first1=Mark|title=Florence Nightingale: the Lady with the Lamp|url=https://www.bbc.co.uk/history/british/victorians/nightingale_01.shtml|publisher=BBC|date=26 October 2017}} [54] => [55] => Florence Nightingale worked by sub concepts of the environmental theory. She included five factors that helped nurses in her time of working in poor sanitation and with uneducated nurses. These factors included (1) fresh air, (2) clean water, (3) a working drainage system, (4) cleanliness, and (5) good light or sunlight. Nightingale believed that a clean, working environment were important in caring for patients. In the 19th century, this theory was ideal for helping patients, providing a guide for nurses to alter the environment around the patient for the betterment of their health.{{Cite web |first=Angelo |last=Gonzalo |date=August 4, 2014 |title=Florence Nightingale: Environmental Theory |url=https://nurseslabs.com/florence-nightingales-environmental-theory/ |access-date=2022-09-02 |website=Nurseslabs |language=en-US}} [56] => [57] => Nightingale's recommendations built upon the successes of Jamaican "doctresses" such as [[Mary Seacole]], who like Nightingale, served in the Crimean War. Seacole practised hygiene and the use of herbs in healing wounded soldiers and those suffering from diseases in the 19th century in the Crimea, Central America, and Jamaica. Her predecessors had great success as healers in the [[Colony of Jamaica]] in the 18th century, and they included Seacole's mother (Mrs. Grant), Sarah Adams, [[Cubah Cornwallis]], and Grace Donne, the mistress and doctress to Jamaica's wealthiest planter, [[Simon Taylor (sugar planter)|Simon Taylor]].Moira Ferguson, ''Nine Black Women'' (London: Routledge, 1998), p. 68. [58] => [59] => Other important nurses in the development of the profession include: [60] => *[[Agnes Hunt]] from [[Shropshire]] who was the first orthopedic nurse and was pivotal in the emergence of the orthopedic hospital The Robert Jones & Agnes Hunt Hospital in Oswestry, Shropshire. [61] => *[[Valérie de Gasparin]] who opened, with her husband [[Agénor de Gasparin]], the first nursing school in the world : [[:fr:Institut et haute école de la santé La Source|La Source]], in [[Lausanne]], [[Switzerland]]. [62] => *[[Agnes Jones]], who established a nurse training regime at the [[Brownlow Hill infirmary]], [[Liverpool]], in 1865. [63] => *[[Linda Richards]], who established quality [[nursing schools]] in the United States and Japan, and was officially the first professionally trained nurse in the US, graduating in 1873 from the ''[[New England Hospital for Women and Children]]'' in Boston. [64] => *[[Clara Barton|Clarissa Harlowe "Clara" Barton]], a pioneer American teacher, patent clerk, nurse, and humanitarian, and the founder of the [[American Red Cross]]. [65] => * Saint [[Marianne Cope]], a Sister of St. Francis who opened and operated some of the first general hospitals in the United States, instituting cleanliness standards which influenced the development of America's modern hospital system.[http://edition.cnn.com/2012/10/20/health/saint-marianne-cope/index.html?hpt=hp_t3 Mother Marianne becomes an American saint]. CNN. Retrieved 28 July 2013. [66] => [67] => [[Red Cross]] chapters, which began appearing after the establishment of the [[International Committee of the Red Cross]] in 1863, offered employment and professionalization opportunities for nurses (despite initial objections from [[Florence Nightingale]]).{{cite book |last1=Dromi |first1=Shai M. |title=Above the fray: the Red Cross and the making of the humanitarian NGO sector |date=2020 |publisher=University of Chicago Press |location=Chicago |isbn=9780226680248 |pages=93–101 |url=https://press.uchicago.edu/ucp/books/book/chicago/A/bo46479924.html |access-date=27 June 2021}} Catholic orders such as [[Little Sisters of the Poor]], [[Sisters of Mercy]], [[Sisters of St. Mary]], [[Franciscan Alliance, Inc.|St. Francis Health Services, Inc.]] and [[Sisters of Charity]] built hospitals and provided nursing services during this period.{{citation needed|date=November 2014}}{{Cite journal|last=Paradis, Raphael|first=Mary|date=10 March 2017|title=The Sisters of Mercy in the Crimean War: Lessons for Catholic health care|journal=The Linacre Quarterly|volume=84|issue=1|pages=29–43|doi=10.1080/00243639.2016.1277877|pmid=28392597|pmc=5375655|via=NCBI}} In turn, the modern deaconess movement began in Germany in 1836.{{cite book|last1=Naumann|first1=CD|title=In the footsteps of Phoebe: a Complete History of the Deaconess Movement in the Lutheran Church—Missouri Synod|date=2008|publisher=Concordia Pub. House|location=St. Louis, MO|isbn=9780758608314|page=4}} Within a half century, there were over 5,000 deaconesses in Europe.{{cite book|editor1-last=Blackmore|editor1-first=H|title=The Beginning of Women's Ministry: the Revival of the Deaconess in the Nineteenth-century Church of England|date=2007|url=https://books.google.com/books?id=8LQxO03zXygC&pg=PA131|publisher=Boydell Press|location=Woodbridge|isbn=978-1-84383-308-6}} [68] => [69] => Formal use of nurses in the modern military began in the latter half of the nineteenth century. Nurses saw active duty in the [[First Boer War]], the Egyptian Campaign (1882),{{cite web|title=Our History|url=http://www.army.mod.uk/army-medical-services/qaranc/9910.aspx|publisher=British Army Website|access-date=31 October 2011|archive-url=https://web.archive.org/web/20111028190846/http://www.army.mod.uk/army-medical-services/qaranc/9910.aspx|archive-date=28 October 2011}} and the [[Mahdist War|Sudan Campaign]] (1883).{{Cite web|title = History of the School of Nursing|publisher = University of Maryland School of Nursing|url = https://www.nursing.umaryland.edu/about/community/museum/virtual-tour/foundation/|access-date = 19 January 2016|archive-date = 24 January 2016|archive-url = https://web.archive.org/web/20160124130200/https://www.nursing.umaryland.edu/about/community/museum/virtual-tour/foundation/|url-status = dead}} [70] => [71] => ===20th century=== [72] => {{Further|Women in nursing}} [73] => [[File:RedCrossNursen.jpg|thumb|left|A recruiting poster for Australian nurses from [[World War I]]]] [74] => [75] => Hospital-based training came to the fore in the early 1900s, with an emphasis on practical experience. The Nightingale-style school began to disappear. Hospitals and physicians saw women in nursing as a source of free or inexpensive labor. Exploitation of nurses was not uncommon by employers, physicians, and educational providers.{{cite book|last1=Chin|first1=PL|last2=Kramer|first2=MK|title=Integrated Theory and Knowledge Development in Nursing|date=2008|publisher=Mosby Elsevier|location=St. Louis|isbn=9780323052702|pages=[https://archive.org/details/integratedtheory0000chin/page/33 33–34]|edition=7th|url=https://archive.org/details/integratedtheory0000chin/page/33}} [76] => [77] => Many nurses saw active duty in [[World War I]], but the profession was transformed during the [[World War II|Second World War]]. British nurses of the Army Nursing Service were part of every overseas campaign.{{cite web|title=QA World War Two Nursing|url=http://www.qaranc.co.uk/qa_world_war_two_nursing.php|publisher=qaranc.co.uk|access-date=31 October 2011}} More nurses volunteered for service in the US [[United States Army|Army]] and [[United States Navy|Navy]] than any other occupation.D'Ann Campbell, ''Women at War with America: Private Lives in a Patriotic Era'' (1984) ch 2 [https://archive.org/details/womenatwarwitham0000camp/mode/1up online]Philip A. Kalisch and Beatrice J. Kalisch, ''American Nursing: A History'' (4th ed. 2003) The Nazis had their own Brown Nurses, 40,000 strong.Bronny Rebekah McFarland-Icky, ''Nurses in Nazi Germany'' (Princeton University Press, 1999) Two dozen German Red Cross nurses were awarded the [[Iron Cross]] for heroism under fire.Gordon Williamson, ''World War II German Women's Auxiliary Services'' (2003) pp 34–36 [78] => [79] => The modern era saw the development of undergraduate and post-graduate [[Nurse education|nursing degrees]]. Advancement of nursing research and a desire for association and organization led to the formation of a wide variety of [[professional organizations]] and [[nursing journal|academic journals]]. Growing recognition of nursing as a distinct academic discipline was accompanied by an awareness of the need to define the [[Nursing theory|theoretical basis]] for practice.{{cite book|last1=Alligood|first1=MR|editor1-last=Alligood|editor1-first=MR|editor2-last=Tomey|editor2-first=AM|title=Nursing Theorists and their Work|date=2013|publisher=Mosby/Elsevier|location=Maryland Heights, MO|isbn=9780323056410|pages=5–6|edition=7th|chapter=Introduction to nursing theory}} [80] => [81] => In the 19th and early 20th century, nursing was considered a woman's profession, just as doctoring was a man's profession. With increasing expectations of workplace equality during the late 20th century, nursing became an officially [[Gender marking in job titles|gender-neutral]] profession, though in practice the percentage of male nurses remains well below that of female [[physician]]s in the early 21st century.{{Cite web|title = Total Number of Professionally Active Nurses, by Gender|url = http://kff.org/other/state-indicator/total-number-of-professionally-active-nurses-by-gender/#table|website = kff.org|access-date = 19 January 2016|language = en-US}}{{Cite web|title = Distribution of Physicians by Gender|url = http://kff.org/other/state-indicator/physicians-by-gender/|website = kff.org|access-date = 19 January 2016|language = en-US}} [82] => [83] => ====Shortages==== [84] => The biggest shortages of nurses and midwives are in South East Asia and Africa.{{cite news |title=Nursing and midwifery |url=https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery |access-date=30 June 2022 |publisher=WHO |date=18 March 2022}} A global survey by [[McKinsey & Company]] in 2022 found that between 28% and 38% of nurse respondents in the United States, the United Kingdom, Singapore, Japan, and France said they were likely to leave their current role in direct patient care in the next year. Nursing shortages are a rising risk in many countries. The top five factors which they said would make them stay were [85] => *A safe working environment [86] => *Work-life balance [87] => *Caring and trusting team-mates [88] => *Doing meaningful work [89] => *Flexible work schedule [90] => Pay was eighth on the list.{{cite news |title=Around the world, nurses say meaningful work keeps them going |url=https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/around-the-world-nurses-say-meaningful-work-keeps-them-going |access-date=30 June 2022 |publisher=McKinsey |date=12 May 2022}} An American survey in 2023 found about 30% the respondents were considering leaving.{{cite news|title= 2023 AMN Healthcare Survey of Registered Nurses | url= https://www.amnhealthcare.com/amn-insights/nursing/surveys/2023 | access-date=2 May 2023 | date=May 2023}} [91] => [92] => ==Definition== [93] => [94] => Although nursing practice varies both through its various specialties and countries, these nursing organizations offer the following definitions: [95] => [96] => {{Blockquote | Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well, and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. | [[International Council of Nurses]]}} [97] => [98] => {{Blockquote|The use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death.|[[Royal College of Nursing]] (2003) {{cite web |url=https://www.rcn.org.uk/professional-development/publications/pub-004768 |title=Defining nursing 2014 |publisher=[[Royal College of Nursing]] (RCN) |date=22 December 2014 |access-date=2016-10-08 |archive-date=10 October 2016 |archive-url=https://web.archive.org/web/20161010184708/https://www.rcn.org.uk/professional-development/publications/pub-004768 |url-status=dead }}}} [99] => [100] => {{Blockquote|Nursing is the protection, promotion, and optimization of health and abilities; prevention of illness and injury; alleviation of suffering through the diagnosis and treatment of human responses; and advocacy in health care for individuals, families, communities, and populations.|[[American Nurses Association]][https://www.nursingworld.org/practice-policy/scope-of-practice/ ANA Considering Nursing] Retrieved Dec 2018|source=}} [101] => [102] => {{Blockquote|The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge.|[[Virginia Avenel Henderson]][http://www.contemporarynurse.com/archives/vol/5/issue/3/article/3027/virginia-henderson-a-contemporary-nurse-18971996 Contemporary Nurse Virginia Henderson] {{webarchive|url=https://web.archive.org/web/20090914053915/http://www.contemporarynurse.com/archives/vol/5/issue/3/article/3027/virginia-henderson-a-contemporary-nurse-18971996 |date=14 September 2009 }} Retrieved July 2009}} [103] => [104] => ==As a profession== [105] => [[File:Indonesian nurse examines patient.JPG|thumb|A nurse in Indonesia examining a patient]] [106] => [[File:ASC Leiden - Coutinho Collection - 10 04 - Nurses in Ziguinchor hospital, Senegal - 1973.tif|thumb|A nurse treating a patient with burns, [[Ziguinchor]] [[PAIGC]] hospital, 1973]] [107] => The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at the national or state level. [108] => [109] => The aim of the nursing community worldwide is for professional nurses to ensure quality care for all, while maintaining their credentials, code of [[Nursing ethics|ethics]], standards, and competencies, and continuing their education.[http://www.icn.ch/abouticn.htm International Council of Nurses] {{Webarchive|url=https://web.archive.org/web/20100429141916/http://www.icn.ch/abouticn.htm |date=29 April 2010 }} Retrieved August 2007 There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide; all involve extensive study of [[nursing theory]] and practice as well as training in clinical skills. [110] => [111] => Nurses care for individuals of all ages and backgrounds along the wellness continuum in a [[Holistic health|holistic]] manner based on the individual's physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for individuals and communities. [112] => [113] => To work in the nursing profession, all nurses hold one or more credentials depending on their [[scope of practice]] and [[nurse education|education]]. In the United States, a [[Licensed Practical Nurse]] (LPN) works independently or with a [[Registered Nurse]] (RN). The most significant difference between an LPN and RN is found in the requirements for entry to practice, which determines entitlement for their scope of practice. RNs provide scientific, psychological, and technological knowledge in the care of patients and families in many health care settings. RNs may earn additional [[Nursing credentials and certifications|credentials]] or [[academic degree|degrees]]. [114] => [115] => In the United States, multiple educational paths will qualify a candidate to sit for the licensure examination as an RN. An [[Associate of Science in Nursing|Associate Degree in Nursing]] (ADN) is awarded to those who have completed a two-year undergraduate academic degree awarded by community colleges, junior colleges, technical colleges, and bachelor's degree-granting colleges and universities upon completion of a course of study usually lasting two years. It is also referred to as an Associate in Nursing (AN), Associate of Applied Science in Nursing (AAS), or Associate of Science in Nursing (ASN).{{Cite web|title = Associate Degree in Nursing (ADN/ASN)|url = http://www.collegeatlas.org/associate-degree-in-nursing.html|website = collegeatlas.org|access-date = 29 October 2015}} A [[#Bachelor of Science in Nursing|Bachelor of Science in Nursing]] (BSN) is awarded to those who have earned an American four-year academic degree in the science and principles of nursing, granted by a tertiary education university or similarly accredited school. After completing the LPN or either of the RN education programs in the United States, graduates are eligible to sit for a licensing examination to become a nurse, the passing of which is required for the nursing license. The [[National Council Licensure Examination|National Licensure Examination]] (NCLEX) test is a standardized exam (including multiple choice, select all that apply, fill in the blank and "hot spot" questions) that nurses take to become licensed. It costs two-hundred dollars to take and examines a nurse's ability to properly care for a client.{{Cite web|title = NCLEX Exam {{!}} National Council Licensure Examination|url = http://www.allnursingschools.com/nursing-careers/article/nclex-exam/|website = allnursingschools.com|access-date = 29 October 2015}} [116] => [117] => Some nurses follow the traditional role of working in a hospital setting. Options there include: pediatrics, neonatal, maternity, OBGYN, geriatrics, orthopedics, medical-surgical, operating room, ambulatory, and nurse anesthetists and informatics ([[eHealth]]). There are many other options nurses can explore depending on the type of degree and education acquired. These options can also include, community health, mental health, clinical nursing specialists, and nurse midwives.{{Cite web |title=nursing - Advanced nursing practice {{!}} Britannica |url=https://www.britannica.com/science/nursing/Advanced-nursing-practice |access-date=2022-03-10 |website=www.britannica.com |language=en}} RNs may also pursue different roles as [[advanced practice nurse]]s. [118] => [119] => Nurses are not doctors' assistants. This is possible in certain situations, but nurses more often are independently caring for their patients or assisting other nurses.{{Cite web|title = 5 Myths about Registered Nurses – Ameritech College of Healthcare|url = http://ameritech.edu/blog/5-myths-registered-nurses-busted/|website = Ameritech College of Healthcare|date = 6 November 2014|access-date = 15 October 2015|archive-date = 30 November 2015|archive-url = https://web.archive.org/web/20151130014128/http://ameritech.edu/blog/5-myths-registered-nurses-busted/|url-status = dead}} RNs treat patients, record their medical history, provide emotional support, and provide follow-up care. Nurses also help doctors perform diagnostic tests. Nurses are almost always working on their own or with other nurses. However, they also assist doctors in the emergency room or in trauma care when help is needed.{{Cite web|title = Registered Nurse (RN) Career and Job Information|url = http://www.careerprofiles.info/nurse-career.html|website = careerprofiles.info|access-date = 15 October 2015}} [120] => [121] => ===Gender issues=== [122] => {{Main article|Men in nursing}} [123] => [[File:Male Nurses- Life at Runwell Hospital, Wickford, Essex, 1943 D14313.jpg|thumb|right|upright=0.9|A male nurse at Runwell Hospital, Wickford, Essex, in 1943]] [124] => [125] => Despite equal opportunity legislation, nursing has continued to be a female-dominated profession in many countries; according to the [[World Health Organization|WHO's]] 2020 ''State of the World's Nursing,'' approximately 90% of the nursing workforce is female.{{cite web|url=https://apps.who.int/iris/bitstream/handle/10665/331673/9789240003293-eng.pdf|publisher=World Health Organization|title=State of the World's Nursing 2020|access-date=16 March 2021}} For instance, the male-to-female ratio of nurses is approximately 1:19 in Canada and the United States.{{cite journal|author=Patrick Sullivan |url=http://www.cmaj.ca/cgi/content/full/164/12/1738-b?ck=nck |title=Canada Medical Association Journal 12 June 2001; 164 (12) |journal = CMAJ|publisher=Cmaj.ca |date=12 June 2001 |volume = 164|issue = 12|pages = 1738–1738–b|access-date=4 September 2013}}[http://bhpr.hrsa.gov/healthworkforce/reports/nursing/samplesurvey00/chapter3.htm 2000 National Sample Survey of Registered Nurses] {{webarchive |url=https://web.archive.org/web/20110422161539/http://bhpr.hrsa.gov/healthworkforce/reports/nursing/samplesurvey00/chapter3.htm |date=22 April 2011 }} This ratio is represented around the world. Notable exceptions include [[Francophone Africa]], which includes the countries of Benin, Burkina Faso, Cameroon, Chad, Congo, [[Côte d'Ivoire]], the [[Democratic Republic of Congo]], [[Djibouti]], [[Guinea]], [[Gabon]], [[Mali]], [[Mauritania]], [[Niger]], [[Rwanda]], [[Senegal]], and [[Togo]], which all have more male than female nurses.{{cite book|first1=Chad E. |last1=O'Lynn |first2=Russell E. |last2=Tranbarger |title=Men in Nursing: History, Challenges, and Opportunities|url=https://books.google.com/books?id=-Ag7TqTyIC0C&pg=PA225|year=2006|publisher=Springer Publishing Company|isbn=978-0-8261-0349-9|page=225}} In Europe, in countries such as [[Spain]], [[Portugal]], [[Czech Republic]] and [[Italy]], over 20% of nurses are male. In the United Kingdom, 11% of nurses and midwives registered with the Nursing and Midwifery Council (NMC) are male.{{cite web|url=https://www.nmc.org.uk/globalassets/sitedocuments/annual_reports_and_accounts/equality-and-diversity-report-2015-16.pdf |title=Annual Equality and Diversity Profile, NMC 2015–2016}} The number of male nurses in the United States doubled between 1980 and 2000, although female nurses are still more common.{{cite news|last1=Weintraub|first1=Arlene|title=Nursing: On the Critical List|work=Business Week|date=3 June 2002}} On average, male nurses in the US receive more pay than female nurses.{{Cite web|url = https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf|title = Men in Nursing Occupations|date = February 2013|access-date = 6 October 2015|website = Census.gov|publisher = American Community Survey|archive-url = https://web.archive.org/web/20170713210226/https://www.census.gov/people/io/files/Men_in_Nursing_Occupations.pdf|archive-date = 13 July 2017}} [126] => [127] => === Minorities in U.S. nursing === [128] => As of 2020, in the United States 19.4% of nursing positions are held by people of minority backgrounds. The remaining 80.6% of positions are held by Caucasian individuals, particularly women.{{Cite web|title=AACN Fact Sheet - Enhancing Diversity in the Nursing Workforce|url=https://www.aacnnursing.org/news-information/fact-sheets/enhancing-diversity|access-date=2021-09-24|website=www.aacnnursing.org}} [129] => [130] => == Theory and process == [131] => [132] => {{Main article|Nursing theory|Nursing process}} [133] => Nursing practice is the actual provision of nursing care. In providing care, nurses implement the [[nursing care plan]] using the [[nursing process]]. This is based around a specific [[nursing theory]] which is selected in consideration with the care setting and the population served. In providing nursing care, the nurse uses both nursing theory and best practice derived from [[nursing research]].{{cite book | last = Weber | first = Janet | title = Nurses' handbook of health assessment | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2014 | isbn = 9781451142822 }} The nursing process is made up of five steps: 1.evaluate, 2. implement, 3. plan, 4. diagnose, and 5. assess. Nurses are able to use this process from the American Nurses Association to determine the best care they can provide for the patient. There are many other diverse nursing theories as well.{{Cite web |title=Nursing {{!}} The SAGE Encyclopedia of Economics and Society - Credo Reference |url=https://search.credoreference.com/content/entry/sageeas/nursing/0 |access-date=2022-02-18 |website=search.credoreference.com |language=en}} [134] => [135] => In general terms, the nursing process is the method used to [[Nursing assessment|assess]] and [[Nursing diagnosis|diagnose]] needs, plan outcomes and interventions, implement interventions, and evaluate the outcomes of the care provided. Like other disciplines, the profession has developed different theories derived from sometimes diverse philosophical beliefs and [[paradigm]]s or [[worldview]]s to help nurses direct their activities to accomplish specific goals. [136] => [137] => ==Scope of activities== [138] => [139] => ===Activities of daily living assistance=== [140] => {{main article|Activities of daily living}} Nurses manage and coordinate care to support activities of daily living (ADL). Often the provision of such care is delegated to [[nursing assistant]]s. This includes assisting in patient mobility, such as moving an activity intolerant patient within bed. [141] => [142] => ===Medication=== [143] => Medication management and administration are a part of most hospital nursing roles, however, prescribing authority varies between jurisdictions. In many areas, registered nurses administer and manage medications prescribed by a professional with full prescribing authority such as a [[nurse practitioner]] or a [[physician]]. As nurses are responsible for evaluating patients throughout their care - including before and after medication administration - adjustments to medications are often made through a collaborative effort between the prescriber and the nurse. Regardless of the prescriber, nurses are legally responsible for the drugs they administer. There may be legal implications when there is an error in a prescription, and the nurse could be expected to have noted and reported the error. In the United States, nurses have the right to refuse any medication administration that they deem to be potentially harmful to the patient.Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 735-736. [144] => In the United Kingdom there are some nurses who have taken additional specialist training that allows them to prescribe any medications from their scope of practice.{{cite web|url=https://www.rcn.org.uk/about-us/policy-briefings/pol-1512#tab1|title=RCN factsheet on nurse prescribing in the UK|website=rcn.org.uk|access-date=20 July 2019|archive-date=4 May 2020|archive-url=https://web.archive.org/web/20200504140113/https://www.rcn.org.uk/about-us/policy-briefings/pol-1512#tab1}} [145] => [146] => ===Patient education=== [147] => {{See also|Patient education}} [148] => The patient's family is often involved in the education. Effective patient education leads to fewer complications and hospital visits.Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 468. Many times, nurses are very busy and have a hard time giving information to the patient because they have so many other things going on. Educating the patient and their family increases the chance for a better patient experience.{{Cite journal |last1=Smith |first1=Jackie A. |last2=Zsohar |first2=Helen |date=October 2013 |title=Patient-education tips for new nurses |url=https://journals.lww.com/nursing/fulltext/2013/10000/patient_education_tips_for_new_nurses.24.aspx |journal=Nursing2022 |language=en-US |volume=43 |issue=10 |pages=1–3 |doi=10.1097/01.NURSE.0000434224.51627.8a |pmid=24045809 |issn=0360-4039|doi-access=free }} Giving the best care requires informing the patient of what is going on and support. While explaining procedure, recovery, and taking care of the patient, nurses also have to help patients and their families cope with different medical situations.{{Cite news |title=nursing {{!}} History, Education, & Practices {{!}} Britannica |url=https://www.britannica.com/science/nursing |access-date=2022-03-07 |newspaper=Encyclopedia Britannica |language=en}} [149] => [150] => When speaking with the patient, nurses have to be able to communicate in a way that can be understood by the patient. Informing the patient may involve speaking in broad, general terms, using visuals or different reading materials, and even including demonstrations if necessary. The more the patient and their family understand what the nurse is saying, the better healthcare the patient can receive without the assistance of a nurse. [151] => [152] => ==Specialties and practice settings== [153] => {{Main article|List of nursing specialties}} [154] => Nursing is the most diverse of all [[:category:health care occupations|health care professions]]. Nurses practice in a wide range of settings but generally nursing is divided depending on the needs of the person being nursed. [155] => [156] => The major populations are: [157] => *communities/public [158] => *family/individual across the lifespan [159] => *adult-gerontology [160] => *pediatrics [161] => *neonatal [162] => *women's health/gender-related [163] => *mental health [164] => *informatics ([[eHealth]]) [165] => *acute care hospitals [166] => *ambulatory settings (physician offices, urgent care settings, camps, etc.) [167] => *school/college infirmaries [168] => [169] => Nurses with higher degrees allow for specialization within the medical field. There are many specific nursing professions that can be separated into categories of care type, age, gender, certain age group, practice setting, etc. Nurses are able to specialize with a combination of these categories as well. There are also specialist areas such as [[cardiac nursing]], [[orthopedic nursing]], [[palliative care]], [[perioperative nursing]], [[obstetrical nursing]], [[oncology nursing]], [[nursing informatics]], [[telenursing]], radiology, and [[emergency nursing]]. [170] => [171] => Nurses practice in a wide range of settings, including hospitals, private [[home care|homes]], [[school nursing|schools]], and [[pharmaceutical companies]]. Nurses work in [[Occupational health nursing|occupational health]] settings{{cite journal |author1=Draper Elaine |author2=LaDou Joseph |author3=Tennenhouse Dan J | year = 2011 | title = Occupational Health Nursing and the Quest for Professional Authority | journal = New Solutions | volume = 21 | issue = 1| pages = 57–88 | doi=10.2190/ns.21.1.i|pmid=21411426 |bibcode=2011NewSo..21...57D |s2cid=207317324 }} (also called industrial health settings), free-standing clinics and physician offices, [[nurse-led clinics]], [[long-term care]] facilities and camps. They also work on [[cruise ships]] and in the [[Armed Forces|military service]]. Nurses act as advisers and consultants to the health care and insurance industries. Many nurses also work in the [[health advocacy]] and [[patient advocacy]] fields at companies such as [[Health Advocate]], Inc. helping in a variety of clinical and administrative issues.Schneider, John. "Healthcare advocacy experts aid workers." Miami Herald 31 August 2010 Some are [[lawyer|attorneys]] and others work with attorneys as [[legal nurse consultant]]s, reviewing patient records to assure that adequate care was provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contract in a variety of settings, sometimes known as ''per diem nursing'', ''agency nursing'' or ''travel nursing''. Nurses work as researchers in laboratories, universities, and [[research institutions]]. Nurses have also been delving into the world of informatics, acting as consultants to the creation of computerized charting programs and other software. Nurse authors publish articles and books to provide essential reference materials. [172] => [173] => ==Occupational hazards== [174] => [[File:Sleep Deprivation – Shift Work & Long Work Hours Put Nurses at Risk.webm|thumb|A video describing occupational hazards that exist among nurses]] [175] => Internationally, there is a serious shortage of nurses.{{cite journal |last1=Buchanan |first1=J. |title=Global nursing shortages |journal= BMJ|volume=324 |issue=7340 |pages=751–2 |year=2002 |pmid=11923146 |pmc=1122695 |doi=10.1136/bmj.324.7340.751}} One reason for this shortage is due to the work environment in which nurses practice. In a recent review of the empirical human factors and ergonomic literature specific to nursing performance, nurses were found to work in generally poor environmental conditions. Some countries and states have passed legislation regarding acceptable nurse-to-patient ratios. [176] => [177] => The fast-paced and unpredictable nature of health care places nurses at risk for injuries and illnesses, including high [[occupational stress]]. Nursing is a particularly stressful profession, and nurses consistently identify stress as a major work-related concern and have among the highest levels of occupational stress when compared to other professions. This stress is caused by the environment, psychosocial stressors, and the demands of nursing, including new technology that must be mastered, the emotional labor involved in nursing, physical labor, [[shift work]], and high workload. This stress puts nurses at risk for short-term and long-term health problems, including [[sleep disorders]], [[major depressive disorder|depression]], [[Death|mortality]], psychiatric disorders, stress-related illnesses, and illness in general. Nurses are at risk of developing [[compassion fatigue]] and moral [[distress (medicine)|distress]], which can worsen mental health. They also have very high rates of [[occupational burnout]] (40%) and [[emotional exhaustion]] (43.2%). Burnout and exhaustion increase the risk for illness, medical error, and suboptimal care provision.{{Cite news|url = http://www.medscape.com/viewarticle/765974|title = Alleviating Job Stress in Nurses|date = 25 June 2012|newspaper = Medscape|publisher = Medscape and NIOSH|last1 = Roberts|first1 = Rashaun|last2 = Grubb|first2 = Paula L.|last3 = Grosch|first3 = James W.}} [178] => [179] => === Patient Handling === [180] => Healthcare has consistently ranked among the industries with the highest rates of musculoskeletal injuries largely related to patient handling. Anywhere from 30-70% of reported musculoskeletal injuries are related to patient handling.Nurses and other healthcare staff are tasked with routinely lifting, repositioning and mobilizing patients. These tasks present unique ergonomic hazards that results in a high rate of acute and cumulative musculoskeletal injuries.{{Cite journal |last1=Morse |first1=Tim |last2=Fekieta |first2=Renee |last3=Rubenstein |first3=Harriet |last4=Warren |first4=Nick |last5=Alexander |first5=Darryl |last6=Wawzyniecki |first6=Patricia |date=2008-05-29 |title="Doing the Heavy Lifting: Health Care Workers Take Back Their Backs" |url=https://doi.org/10.2190/NS.18.2.j |journal=NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy |language=en |volume=18 |issue=2 |pages=207–219 |doi=10.2190/ns.18.2.j |pmid=18511397 |bibcode=2008NewSo..18..207M |issn=1048-2911}}{{Cite journal |last1=Aslam |first1=Imran |last2=Davis |first2=Scott A. |last3=Feldman |first3=Steven R. |last4=Martin |first4=Willis E. |date=June 2015 |title=A Review of Patient Lifting Interventions to Reduce Health Care Worker Injuries |url=https://doi.org/10.1177/2165079915580038 |journal=Workplace Health & Safety |language=en |volume=63 |issue=6 |pages=267–275 |doi=10.1177/2165079915580038 |pmid=26135600 |issn=2165-0799}} The most frequently injured body part is the back, with up to 72% of nurses reporting non-specific low back pain.{{Cite web |title=Unsafe patient handling |url=https://www.who.int/tools/occupational-hazards-in-health-sector/unsafe-patient-handling |access-date=2024-02-22 |website=www.who.int |language=en}} According to the [[National Institute for Occupational Safety and Health|National Institute for Occupational Safety and Health (NIOSH)]] the single greatest factor in overexertion injuries in healthcare workers is the manual lifting, moving and repositioning of patients.{{Cite web |date=2023-04-17 |title=Safe Patient Handling and Mobility (SPHM) {{!}} NIOSH {{!}} CDC |url=https://www.cdc.gov/niosh/topics/safepatient/default.html |access-date=2024-04-16 |website=www.cdc.gov |language=en-us}} The US Bureau of Labor Statistics reported that for 2021-2022 the rate of overexertion injuries leading to days away from work for nurses was 45.4, for nursing aids it was 145.5 compared to the average for all industries over that time period of 26.1 per 10,000 full time employees.{{Cite web |title=Survey of Occupational Injuries and Illnesses Data : U.S. Bureau of Labor Statistics |url=https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables.htm |access-date=2024-03-26 |website=www.bls.gov |language=en-us}} Traditionally, nurses have been trained in a variety of manual patient handling techniques seeking to reduce the risk of musculoskeletal injury.{{Cite journal |last=Waters |first=Thomas R. |date=2007 |title=For CE Credit: When Is It Safe to Manually Lift a Patient? |url=https://www.jstor.org/stable/29746479 |journal=The American Journal of Nursing |volume=107 |issue=8 |pages=53–59 |doi=10.1097/01.NAJ.0000282296.18688.b1 |jstor=29746479 |pmid=17667392 |issn=0002-936X}} The body of evidence has demonstrated, however, that such interventions are ineffective. [181] => [182] => === Workplace Violence === [183] => Nurses are also at risk for violence and abuse in the workplace.{{cite web |url = http://blogs.cdc.gov/niosh-science-blog/2013/08/12/hcwviolence-prevention/ |title = Free On-line Violence Prevention Training for Nurses |date = 12 August 2013 |first1 = Dan |last1 = Hartley |first2 = Marilyn |last2 = Ridenour |access-date = 15 January 2015 |publisher = National Institute for Occupational Safety and Health}} Violence is typically perpetrated by non-staff (e.g. patients or family), whereas abuse is typically perpetrated by other hospital personnel. Of American nurses, 57% reported in 2011 that they had been threatened at work; 17% were physically assaulted. [184] => [185] => There are 3 different types of workplace violence that nurses can experience. First, physical violence, which can be hitting, kicking, beating, punching, biting, and using objects to inflict force upon someone.{{Citation|title=Gender Matters: Discourses of Violence in Early Modern Literature and the Arts|date=2014-01-01|work=Gender Matters|pages=5–15|publisher=BRILL|doi=10.1163/9789401210232_002|isbn=9789401210232 |last1=Wade |first1=Mara R. }} Second, psychological violence is when something is done to impair another person through threats and/or coercion. Third, sexual violence which can include any completed or attempted non-consensual sexual act.{{Cite web|date=September 2021|title=Sexual Harassment in the Workplace|url=https://www.workplacesrespond.org/harassment-facts/ |website=Work Places Respond}} [186] => [187] => Workplace violence can also be categorized into two different levels, interpersonal violence and organizational coercion. Interpersonal violence could be committed by co-workers and/or patients by others in the hospital. The main form of this level is verbal abuse. Organizational coercion may include an irrationally high workload, forced shifts, forced placement in different wards of the hospital, low salaries, denial of benefits for overwork, poor working environment, and other workplace stressors.{{Cite journal|last1=Faghihi|first1=Mitra|last2=Farshad|first2=Aliasghar|last3=Abhari|first3=Maryam Biglari|last4=Azadi|first4=Nammamali|last5=Mansourian|first5=Morteza|date=2021-05-19|title=The components of workplace violence against nurses from the perspective of women working in a hospital in Tehran: a qualitative study|journal=BMC Women's Health|volume=21|issue=1|page=209|doi=10.1186/s12905-021-01342-0|pmid=34011330|issn=1472-6874|pmc=8136170 |doi-access=free }} These problems can affect the quality of life for these nurses who may experience them. It can be extremely detrimental to nurses if their managers lack understanding of the severity of these problems and do not support the nurses through them. [188] => [189] => There are many contributing factors to workplace violence. These factors can be divided into environmental, organizational, and individual psychosocial. The environmental factors can include the specific setting (for example the emergency department), long patient wait times, frequent interruptions, uncertainty regarding the patients' treatment, and heavy workloads.{{Cite journal|last1=Zhang|first1=Liuyi|last2=Wang|first2=Anni|last3=Xie|first3=Xia|last4=Zhou|first4=Yanhong|last5=Li|first5=Jing|last6=Yang|first6=Lijun|last7=Zhang|first7=Jingping|date=July 2017|title=Workplace violence against nurses: A cross-sectional study|journal=International Journal of Nursing Studies|volume=72|pages=8–14|doi=10.1016/j.ijnurstu.2017.04.002|pmid=28412581|issn=0020-7489}} Organizational factors can include inefficient teamwork, organizational injustice, lack of aggression and/or stress management programs, and distrust between colleagues. Individual psychosocial factors may include nurses being young and inexperienced, previous experiences with violence, and a lack of communication skills. Misunderstandings may also occur due to the communication barrier between nurses and patients.{{Cite journal|last1=Alkorashy|first1=Hanan A. Ezzat|last2=Al Moalad|first2=Fawziah Bakheet|date=June 2016|title=Workplace violence against nursing staff in a Saudi university hospital|url=https://onlinelibrary.wiley.com/doi/10.1111/inr.12242|journal=International Nursing Review|language=en|volume=63|issue=2|pages=226–232|doi=10.1111/inr.12242|pmid=26830364}} An example of this could be the patient's condition being affected by medication, pain, and/or anxiety. [190] => [191] => There are many causes of workplace violence. The most common perpetrators for harassment and/or bullying against nursing students were registered nurses including preceptors, mentors, and clinical facilitators. However, the main cause of workplace violence against nurses were patients. 80% of serious violence incidents in health care centers were due to the nurses' interactions with patients. [192] => [193] => There are many different effects of workplace violence in the field of Nursing. Workplace violence can have a negative impact on nurses both emotionally and physically. They feel depersonalized, dehumanized, fatigued, worn out, stressed out, and tired.{{Cite journal|last1=Vrablik|first1=Marie C|last2=Chipman|first2=Anne K|last3=Rosenman|first3=Elizabeth D|last4=Simcox|first4=Nancy J|last5=Huynh|first5=Ly|last6=Moore|first6=Megan|last7=Fernandez|first7=Rosemarie|date=August 2019|title=Identification of processes that mediate the impact of workplace violence on emergency department healthcare workers in the USA: results from a qualitative study|journal=BMJ Open|volume=9|issue=8|pages=e031781|doi=10.1136/bmjopen-2019-031781|pmid=31462490|issn=2044-6055|pmc=6720251}} Because of the severity of some incidents of violence, nurses have reported manifestations of burn-out due to the frequent exposure. This can heavily impact of a nurses' mental health and cause nurses to feel unsatisfied with their profession and unsafe in their work environment. [194] => [195] => ===Prevention=== [196] => There are a number of interventions that can mitigate the occupational hazards of nursing. They can be individual-focused or organization-focused. Individual-focused interventions include [[stress management]] programs, which can be customized to individuals. Stress management programs can reduce anxiety, sleep disorders, and other symptoms of stress. Organizational interventions focus on reducing stressful aspects of the work environment by defining stressful characteristics and developing solutions to them. Using organizational and individual interventions together is most effective at reducing stress on nurses. In some Japanese hospitals, [[Powered exoskeleton#Medical|powered exoskeletons]] are used.{{cite news|last1=Gilhooly|first1=Rob|title=Exoskeletons await in work/care closet|url=http://www.japantimes.co.jp/life/2012/06/17/general/exoskeletons-await-in-workcare-closet/|access-date=21 August 2013|work=The Japan Times|date=17 June 2012}} Lumbar supports (i.e. [[back belt]]s) have also been trialed.{{cite journal | pmc=2078392 | year=2007 | last1=Dawson | first1=A. P. | last2=McLennan | first2=S. N. | last3=Schiller | first3=S. D. | last4=Jull | first4=G. A. | last5=Hodges | first5=P. W. | last6=Stewart | first6=S. | title=Interventions to prevent back pain and back injury in nurses: A systematic review | journal=Occupational and Environmental Medicine | volume=64 | issue=10 | pages=642–650 | doi=10.1136/oem.2006.030643 | pmid=17522134 }} [197] => [198] => ==Worldwide== [199] => ===Americas=== [200] => ====United States==== [201] => [[File:Poston, Arizona. Registered nurse, Mrs. Edythe Sasser, is assisited by Yoshiko Konatsu, nurse's aid . . . - NARA - 537104.jpg|thumb|Two nurses in Arizona, 1943]] [202] => {{Main article|Nursing in the United States|History of nursing in the United States}} [203] => In the US, scope of practice is determined by the state or territory in which a nurse is licensed. Each state has its own laws, rules, and regulations governing nursing care. Usually the making of such rules and regulations is delegated to a state [[board of nursing]], which performs day-to-day administration of these rules, licenses for nurses and nursing assistants, and makes decisions on nursing issues. In some states, the terms "nurse" or "nursing" may only be used in conjunction with the practice of a [[registered nurse]] (RN) or [[Licensed Practical Nurse|licensed practical or vocational nurse]] (LPN/LVN). [204] => [205] => In the hospital setting, registered nurses often delegate tasks to LPNs and [[unlicensed assistive personnel]]. [206] => [207] => RNs are not limited to employment as bedside nurses. They are employed by physicians, attorneys, insurance companies, governmental agencies, community/public health agencies, private industry, school districts, ambulatory surgery centers, among others. Some registered nurses are independent consultants who [[self-employed|work for themselves]], while others work for large manufacturers or chemical companies. Research nurses conduct or assist in the conduct of research or evaluation (outcome and process) in many areas such as biology, psychology, human development, and health care systems. [208] => [209] => Many employers offer flexible work schedules, child care, educational benefits, and bonuses. About 21 percent of registered nurses are union members or covered by union contract.United States Department of Labor Bureau of Labor Statistics [210] => [211] => Nursing is the nation's largest health care profession. In 2017, there were more than 4,015,250 registered nurses and 922,196 licensed practical nurses nationwide.{{cite journal|title=The U.S. Nursing Workforce in 2018 and Beyond |journal=Journal of Nursing Regulation |volume=8 |number=4 |year=2018 |pages=S3–S6 |url=https://wyoleg.gov/InterimCommittee/2019/10-20190613EnvironmentalScan2018.pdf}} Of all licensed RNs, 2.6 million or 84.8% are employed in nursing. Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation's long-term care. The primary pathway to professional nursing, as compared to technical-level practice, is the four-year Bachelor of Science in nursing (BSN) degree. Registered nurses are prepared either through a BSN program; a three-year associate degree in nursing; or a three-year hospital training program, receiving a hospital diploma. All take the same state licensing exam. (The number of diploma programs has declined steadily—to less than 10 percent of all basic RN education programs—as nursing education has shifted from hospital-operated instruction into the college and university system.) [212] => [213] => =====Educational and licensure requirements===== [214] => [215] => ======Diploma in Nursing====== [216] => {{main article|Diploma in Nursing}} [217] => The oldest method of nursing education is the hospital-based diploma program, which lasts approximately three years. Students take between 30 and 60 credit hours in [[anatomy]], [[physiology]], [[microbiology]], [[nutrition]], [[chemistry]], and other subjects at a college or university, then move on to intensive nursing classes. Until 1996, most RNs in the US were initially educated in nursing by diploma programs.American Nurses Association. [http://www.ana.org/readroom/fsdemogr2.htm#education "Nursing Facts: Today's Registered Nurse – Numbers and Demographics"] {{Webarchive|url=https://web.archive.org/web/20070809113102/http://www.ana.org/readroom/fsdemogr2.htm#education |date=9 August 2007 }} Washington, D.C., American Nurses Association, 2006. According to the Health Services Resources Administration's 2000 Survey of Nurses only six percent of nurses who graduated from nursing programs in the United States received their education at a Diploma School of Nursing.Health Resources and Service Administration. "Findings from the National Sample Survey Of Registered Nurses" Washington, D.C., U.S. Department of Health and Human Services Health Resources and Service Administration Bureau of Health Professions Division of Nursing, 2000. [218] => [219] => ======Associate Degree in Nursing====== [220] => {{main article|Associate of Science in Nursing}} [221] => The most common initial nursing education is a two-year [[Associate Degree in Nursing]] (Associate of Applied Science in Nursing, Associate of Science in nursing, Associate Degree in Nursing), a [[community college|two-year college]] degree referred to as an ADN. Some four-year colleges and universities also offer the ADN. Associate degree nursing programs have prerequisite and corequisite courses (which may include English, Math and Human Anatomy and Physiology) and ultimately stretch out the degree-acquiring process to about three years or greater. [222] => [223] => ======Bachelor of Science in Nursing====== [224] => {{main article|Bachelor of Science in Nursing}} [225] => Another pathway into the profession, or a higher level of education for other nurses, is obtaining a [[Bachelor of Science in Nursing]] (BSN), a four-year degree that also prepares nurses for graduate-level education. For the first two years in a BSN program, students usually obtain general education requirements and spend the remaining time in nursing courses. In some new programs the first two years can be substituted for an active LPN license along with the required general studies. Advocates for the ADN and diploma programs state that such programs have an on the job training approach to educating students, while the BSN is an [[academic degree]] that emphasizes research and [[nursing theory]]. Some states require a specific amount of clinical experience that is the same for both BSN and ADN students. A BSN degree qualifies its holder for administrative, research, consulting and teaching positions that would not usually be available to those with an ADN, but is not necessary for most patient care functions. Nursing schools may be accredited by either the [[Accreditation Commission for Education in Nursing]] (ACEN) or the [[Commission on Collegiate Nursing Education]] (CCNE). [226] => [227] => ======Graduate education====== [228] => {{Further|Master of Science in Nursing|Doctor of Nursing Practice}} [229] => [230] => Advanced education in nursing is done at the master's and doctoral levels. It prepares the graduate for specialization as an [[advanced practice registered nurse]] (APRN) or for advanced roles in leadership, management, or education. The [[clinical nurse leader]] (CNL) is an advanced generalist who focuses on the improvement of quality and safety outcomes for patients or patient populations from an administrative and staff management focus. Doctoral programs in nursing prepare the student for work in nursing education, health care administration, clinical research, public policy, or advanced clinical practice. Most programs confer the PhD in nursing or [[Doctor of Nursing Practice]] (DNP). [231] => [232] => [[Advanced practice registered nurse]] (APRN) [233] => [234] => Areas of advanced nursing practice include that of a [[nurse practitioner]] (NP), a certified [[nurse midwife]] (CNM), a [[nurse anesthetist|certified registered nurse anesthetist]] (CRNA), or a [[clinical nurse specialist]] (CNS). Nurse practitioners and CNSs work assessing, diagnosing and treating patients in fields as diverse as [[family practice]], women's health care, [[emergency nursing]], acute/critical care, [[psychiatry]], [[geriatrics]], or [[pediatrics]], additionally, a CNS usually works for a facility to improve patient care, do research, or as a staff educator. [235] => [236] => =====Licensure examination===== [237] => [238] => Completion of any one of these three educational routes allows a graduate nurse to take the [[NCLEX-RN]], the test for [[nurse licensure|licensure]] as a registered nurse, and is accepted by every state as an adequate indicator of minimum competency for a new graduate. However, controversy exists over the appropriate entry-level preparation of RNs. Some professional organizations believe the BSN should be the sole method of RN preparation and ADN graduates should be licensed as "technical nurses" to work under the supervision of BSN graduates. Others feel the on-the-job experiences of diploma and ADN graduates makes up for any deficiency in theoretical preparation.{{Citation needed|date=December 2022}} [239] => [240] => =====Shortage in the United States===== [241] => {{Main article|Nursing shortage}} [242] => RNs are the largest group of health care workers in the United States, with about 2.7 million employed in 2011.{{Cite web|url=https://www.bls.gov/oes/tables.htm|archiveurl=https://web.archive.org/web/20120811044058/http://www.bls.gov/oes/current/oes291111.htm|url-status=dead|title=Tables Created by BLS : U.S. Bureau of Labor Statistics|archivedate=11 August 2012|website=Bureau of Labor Statistics}} It has been reported{{By whom|date=July 2012}} that the number of new graduates and foreign-trained nurses is insufficient to meet the [[demand]] for registered nurses; this is often referred to as the [[nursing shortage]] and is expected{{By whom|date=July 2012}} to increase for the foreseeable future. There are data to support the idea that the nursing shortage is a voluntary shortage.{{cite book | vauthors = Haddad LM, Annamaraju P, Toney-Butler TJ | title = Nursing Shortage [243] => | publisher = Stat Pearls | date=January 2020 | url = https://www.ncbi.nlm.nih.gov/books/NBK493175/ | access-date = 10 May 2020 | pmid = 29630227}} {{Citation needed|date=July 2012}} In other words, nurses are leaving nursing of their own volition. In 2006 it was estimated that approximately 1.8 million nurses chose not to work as a nurse. The Bureau of Labor Statistics (BLS) reported that 296,900 healthcare jobs were created in 2011. RNs make up the majority of the healthcare work force, therefore these positions will be filled primarily by nurses. The BLS also stated that by 2020, there would be 1.2 million nursing job openings due to an increase in the workforce, and replacements.{{cite web |author=Rosseter, R. |date=6 August 2012 |title=Media Relations/ Nursing Shortage |publisher=American Association of Colleges of Nursing |url=http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage |access-date=4 June 2013 |archive-date=9 August 2017 |archive-url=https://web.archive.org/web/20170809162859/http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage }} [244] => [245] => ======Causes====== [246] => {{Speculation|section|date=July 2012}} [247] => The International Council of Nursing (ICN), the largest international health professional organization in the world, recognizes the shortage of nurses as a growing crisis in the world. This shortage impacts the healthcare of everyone worldwide. One of the many reasons is that nurses who pursue to become nurses do so very late in their lives. This leads to a non-lengthy employment time. A national survey prepared by the Federation of Nurses and Health Professionals in 2001 found that one in five nurses plans to leave the profession within five years because of unsatisfactory working conditions, including low pay, severe under staffing, high stress, physical demands, mandatory overtime, and irregular hours. Approximately 29.8 percent of all nursing jobs are found in hospitals. However, due to administrative cost cutting, increased nurse's workload, and rapid growth of outpatient services, hospital nursing jobs will experience slower than average growth. Employment in home care and nursing homes is expected{{By whom|date=July 2012}} to grow rapidly. Though more people are living well into their 80s and 90s, many need the kind of long-term care available at a nursing home. Many nurses will also be needed to help staff the growing number of out-patient facilities, such as HMOs (Health Maintenance Organizations), group medical practices, and ambulatory surgery centers. Nursing specialties will be in great demand. There are, in addition, many part-time employment possibilities.{{cite book |title=Nursing (Ferguson's Careers in Focus) |publisher=Ferguson |location=New York, N.Y. |year=2006 |page=[https://archive.org/details/careersinfocusnu0000unse_l8r2/page/188 188] |isbn=978-0-8160-6587-5 |url=https://archive.org/details/careersinfocusnu0000unse_l8r2/page/188 }}Nardi, Deena A., and Charlene C. Gyurko. "The Global Nursing Faculty Shortage: Status and Solutions for Change." (2013): 1–11. Web. 28 January 2015. [248] => [249] => Levsey, Campbell, and Green voiced their concern about the shortage of nurses, citing Fang, Wilsey-Wisniewski, & Bednash, 2006, who state that over 40,000 qualified nursing applicants were turned away in the 2005–2006 academic year from baccalaureate nursing programs due to a lack of masters and doctoral qualified faculty, and that this number was increased over 9,000 from 32,000 qualified but rejected students from just two years earlier. Several strategies have been offered to mitigate this shortage including; Federal and private support for experienced nurses to enhance their education, incorporating more hybrid/blended nursing courses, and using simulation in lieu of clinical (hospital) training experiences.{{cite journal | last1=Fang | first1=D. | last2=Wilsey-Wisniewski | first2=S.J. | last3=Bednash | first3=G.D. | year = 2006 | title = 2005–2006 enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: American Association of Colleges of Nursing. Levsey, K.R., Campbell, D., & Green, A. (2007). Yesterday, Today, and Tomorrow; Challenges in Securing Federal Support for Graduate Nurses | journal = Journal of Nursing Education | volume = 46 | issue = 4| pages = 176–183 }} [250] => [251] => Furthermore, there is a shortage of academically qualified instructors to teach at schools of nursing worldwide. The serious need for educational capacity is not being met, which is the underlying most important preparation resource for the nurses of tomorrow. The decrease in faculty everywhere is due to many factors including decrease in satisfaction with the workforce, poor salaries, and reduction in full-time equivalent. Throughout the span of 6 years the nursing faculty shortage has been written about an increasing amount. There is no clear consensus or an organized plan on how to fix the ongoing issue.Nardi, Deena A., and Charlene C. Gyurko. "The Global Nursing Faculty Shortage: Status and Solutions for Change." (2013): 1–11. Web. 28 January 2015 [252] => [253] => =====Continuing education===== [254] => With health care knowledge growing steadily, nurses can stay ahead of the curve through continuing education. Continuing education classes and programs enable nurses to provide the best possible care to patients, advance nursing careers, and keep up with Board of Nursing requirements. The American Nurses Association and the American Nursing Credentialing Center are devoted to ensuring nurses have access to quality continuing education offerings. Continuing education classes are calibrated to provide enhanced learning for all levels of nurses. Many States also regulate Continuing Nursing Education. Nursing licensing boards requiring Continuing Nursing Education (CNE) as a condition for licensure, either initial or renewal, accept courses provided by organizations that are accredited by other state licensing boards, by the American Nursing Credentialing Center (ANCC), or by organizations that have been designated as an approver of continuing nursing education by ANCC.{{cite web|url=http://www.nursecredentialing.org/AccredContactHoursFAQ|title=FAQs: Contact Hours (CNE Credit)|access-date=10 February 2015|archive-url=https://web.archive.org/web/20150211024758/http://www.nursecredentialing.org/AccredContactHoursFAQ|archive-date=11 February 2015}} There are some exceptions to this rule including the state of California, Florida and Kentucky. National Healthcare Institute{{cite web|url=http://www.nhinstitute.com|title=Continuing Education for Nurses and Medics|website=NHI|access-date=10 December 2017}} has created a list to assist nurses in determining their CNE credit hours requirements. While this list is not all inclusive, it offers details on how to contact nursing licensing boards directly.{{cite web|url=http://www.nursingworld.org/ |title=American Nurses Association |publisher=Nursingworld.org |access-date=21 August 2011}}{{cite web|url=http://www.nhinstitute.com/item/education-requirements-by-board-of-nursing.html|title=National Healthcare Institute Continuing Education Requirements by Board of Nursing |publisher=NHInstitute.com |access-date=14 February 2012}} [255] => [256] => =====Board certification===== [257] => {{main article|Nursing credentials and certifications}} [258] => [259] => Professional nursing organizations, through their certification boards, have voluntary certification exams to demonstrate clinical competency in their particular specialty. Completion of the prerequisite work experience allows an RN to register for an examination, and passage gives an RN permission to use a professional designation after their name. For example, passage of the American Association of Critical-care Nurses specialty exam allows a nurse to use the initials 'CCRN' after his or her name. Other organizations and societies have similar procedures. [260] => [261] => The [[American Nurses Credentialing Center]], the credentialing arm of the [[American Nurses Association]], is the largest nursing credentialing organization and administers more than 30 specialty examinations.American Nurses Credentialing Center. [http://www.ana.org/ancc/cert/index.html "ANCC Certification"] {{Webarchive|url=https://web.archive.org/web/20070607205339/http://www.ana.org/ancc/cert/index.html |date=7 June 2007 }} Washington, D.C., American Nurses Association, '''2006'''. [262] => [263] => =====Correctional nursing===== [264] => {{main article|Correctional nursing}} [265] => [266] => Due to its large [[Incarceration in the United States|prison population]], the United States needs many [[Correctional nursing|correctional nurses]] to help inmates receive proper health-care, including [[Mentally ill people in United States jails and prisons|mental health treatments for prisoners with psychological issues.]] The demand for nurse is high everywhere. Nurses working in correctional care have to focus on the care of the patient, not what they did. They are to provide the best possible care because is a compassionate field and all nurses want is to better the patient. [267] => [268] => Nurses are not the only health care workers in correctional facilities. Some examples of people who work in correctional facilities are LPNS, RNs, nurse practitioners, doctors, pharmacists, therapists, and specialists.{{Cite web |date=2019-08-12 |title=What to Expect as a Correctional Care Nurse and How to Avoid Burnout in Challenging Settings |url=https://nursing.usc.edu/blog/correctional-nurse-career/ |access-date=2022-03-10 |website=USC-MSN |language=en-US}} [269] => [270] => ====== Role of correctional nurse ====== [271] => When the individual arrives, nurses perform an initial exam that is just a basic checkup to determine what needs the patient may have while in prison. Here they can discover existing conditions or even signs of substance abuse. A correctional nurse can face a wide variety of healthcare issues including chronic medical conditions, mental health, infectious disease, and much more. Correctional nurses must follow stricter protocols than in a hospital due to confidentiality. Assessing a patient can be difficult. A deputy or officer may have to be present during exams, which can make the patient feel restricted, and be less open with their medical information. Without the nurse knowing some information from the patient, prevent them from receiving the best care possible. [272] => [273] => ====Canada==== [274] => {{Main article|Nursing in Canada}} [275] => [276] => =====History===== [277] => Canadian nursing dates back to 1639 in [[Quebec]] with the Augustine nuns.[http://www.cna-nurses.ca/CNA/nursing/certification/specialties/default_e.aspx Link text] {{webarchive|url=https://web.archive.org/web/20111229233442/http://www.cna-nurses.ca/cna/nursing/certification/specialties/default_e.aspx|date=29 December 2011}}. These nuns were trying to open a mission that cared for the spiritual and physical needs of patients. The establishment of this mission created the first nursing apprenticeship training in North America. In the nineteenth century, some Catholic orders of nursing were trying to spread their message across Canada. Most nurses were female and only had an occasional consultation with a physician. Towards the end of the nineteenth century, hospital care and medical services had been improved and expanded. Much of this was due to Nightingale's influence. In 1874 the first formal nursing training program was started at the General and Marine Hospital in St. Catharines in Ontario. [278] => [279] => ====Education==== [280] => All Canadian nurses and prospective nurses are heavily encouraged by the [[Canadian Nurses Association]] to continue their education to receive a [[bachelor's degree]]. This degree may result in better patient outcomes.{{citation needed|date=March 2019}} All Canadian provinces and territories, with the exception of the [[Yukon]] and [[Quebec]], require that all nurses have a bachelor's degree. The length of time generally required to obtain this degree is four years. However, some Canadian universities offer a condensed program that is two years in length. [281] => [282] => Nursing specialty certification is available through the [[Canadian Nurses Association]] in 22 practice areas, including: [283] => [284] => * cardiovascular nursing [285] => * community health nursing [286] => * [[critical care nursing]] [287] => * pediatric critical care nursing [288] => * [[emergency nursing]] [289] => * gastroenterology nursing [290] => * [[gerontological nursing]] [291] => * hospice palliative care nursing [292] => * [[medical-surgical nursing]] [293] => * [[neonatal nursing]] [294] => * nephrology nursing [295] => * [[neuroscience nursing]] [296] => * [[occupational health nursing]] [297] => * [[oncology nursing]] [298] => * [[orthopedic nursing]] [299] => * [[pediatric nursing]] [300] => * peri-anesthesia nursing [301] => * [[obstetrical nursing]] [302] => * peri-operative nursing [303] => * [[psychiatric and mental health nursing]] [304] => * rehabilitation nursing [305] => * [[Wound, ostomy, and continence nursing]] [306] => [307] => Nursing specialty certification generally requires practice, experience, and passing a test that is based on competencies for that specific medical or surgical domain in which nursing care is provided. The certification in gerontological nursing, which involves providing care to the elderly, is offered to not only RNs and NPs but also LPNs. [308] => [309] => ====Latin America==== [310] => Latin American nursing is based on three levels of training: (a) professional/registered, (b) technical, and (c) auxiliary.{{cite book|title=Siantz, de Leon, M.L., Malvárez, S., (31 May 2008) "Migration of Nurses: A Latin American Perspective" OJIN: The Online Journal of Issues in Nursing; Vol. 13 No. 2 Manuscript 2.}} The nursing education in Latin America and the Caribbean includes the principles and values of the Universal Health and primary health care. These principles underpin transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning.{{citation|doi=10.1590/1518-8345.2232.2913|title=The situation of nursing education in Latin America and the Caribbean towards universal health|year=2017|last1=Cassiani|first1=Silvia Helena De Bortoli|last2=Wilson|first2=Lynda Law|last3=Mikael|first3=Sabrina de Souza Elias|last4=Peña|first4=Laura Morán|last5=Grajales|first5=Rosa Amarilis Zarate|last6=McCreary|first6=Linda L.|last7=Theus|first7=Lisa|last8=Agudelo|first8=Maria del Carmen Gutierrez|last9=Felix|first9=Adriana da Silva|last10=Uriza|first10=Jacqueline Molina de|last11=Gutierrez|first11=Nathaly Rozo|journal=Revista Latino-Americana de Enfermagem|volume=25|pages=e2913|pmid=28513769|pmc=5466053}} The Pan American Health Organization/World Health Organization (PAHO/WHO) proposes the Strategy for Universal Access to Health and Universal Health Coverage to improve health outcomes and other basic objectives of health systems based on the right of each person to receive the best standard of health, without exposing people to financial difficulties through nursing intervention.Pan American Health Organization. Strategy for universal access to health and universal health coverage. Washington, D.C.: OPS; 2014. http://www.paho.org/uhexchange/index.php/en/uhexchange-documents/technical-information/26-strategy-for-universal-access-to-health-and-universal-health-coverage/file [311] => [312] => === Europe === [313] => [314] => ====Spain==== [315] => See [[Nursing in Spain]] [316] => [317] => ====United Kingdom==== [318] => {{Main article|Nursing in the United Kingdom}} [319] => To practice lawfully as a registered nurse in the United Kingdom, the practitioner must hold a current and valid registration with the [[Nursing and Midwifery Council]]. The title "Registered Nurse" can only be granted to those holding such registration. This protected title is laid down in the Nurses, Midwives and Health Visitors Act, 1997.United Kingdom Government [http://www.opsi.gov.uk/ACTS/acts1997/1997024.htm Nurses, Midwives and Health Visitors Act, 1997.] London: HMSO, 1997. From April 2016, nurses in the United Kingdom are expected to revalidate every three years which involves providing evidence of further development and active practice.{{cite news|last=Jackson|first=Linda|date=24 February 2016|title=How revalidation will work for nurses and midwives|work=The Guardian|url=https://www.theguardian.com/healthcare-network/2016/feb/24/revalidation-nurses-midwives-how-it-works|access-date=8 October 2016}}{{Cite news|date=16 October 2015|title=NMC Revalidation to begin in April 2016|language=en-GB|work=NursingNotes|url=https://nursingnotes.co.uk/news/professional/nmc-revalidation-to-begin-in-april-2016/|access-date=1 June 2017}} [320] => [321] => =====First and second level===== [322] => First-level nurses make up the bulk of the registered nurses in the UK. They were previously known by titles such as Registered General Nurse (RGN), Registered Sick Children's Nurse (RSCN), Registered Mental Nurse (RMN), and Registered Nurse (for the) Mentally Handicapped (RNMH). The titles used now are similar, including Registered Nurse Adult (RNA), Registered Nurse Child (RNC), Registered Nurse Mental Health (RNMH), and Registered Nurse (of) Learning Disabilities (RNLD). Second-level nurse training is no longer provided; however, they are still legally able to practice in the United Kingdom as a registered nurse. Many have now either retired or undertaken conversion courses to become first-level nurses. They are entitled to refer to themselves as registered nurses as their registration is on the Nursing & Midwifery Council register of nurses, although most refer to themselves as Enrolled Nurses (ENs) or State Enrolled Nurses (SENs). [323] => [324] => =====Advanced practice===== [325] => [326] => * ''Nurse practitioners'' – Most of these nurses obtain a minimum of a master's degree and a desired post grad certificate. They often perform roles similar to those of physicians and physician assistants. They can prescribe medications as independent or supplementary prescribers, although they are still legally regulated, unlike physician's assistants. Most Nurse Practitioners (NPs) have referral and admission rights to hospital specialties. They commonly work in [[primary care]] (e.g. General Practitioner (GP) surgeries), [[Emergency department|Accident and Emergency (A&E) departments]], or pediatrics although they are increasingly being seen in other areas of practice. In the UK, the title "nurse practitioner" is legally protected. [327] => * ''Specialist community public health nurses'' – traditionally [[district nurse]]s and [[health visitor]]s, this group oversees research and publication activities. [328] => * ''Lecturer-practitioners (also called practice education facilitators)'' – these nurses work both in the National Health Service (NHS), and in universities. They typically work 2–3 days per week in each setting. In university, they train pre-registration student nurses (see below), and often teach on specialist courses post-registration nurses. [329] => * ''Lecturers'' – these nurses are not employed by the NHS. Instead they work full-time in universities, both teaching and performing research. [330] => [331] => =====Managers===== [332] => Many nurses who have worked in clinical settings for a long time choose to leave clinical nursing and join the ranks of the NHS management. This used to be seen as a natural career progression for those who had reached ward management positions, however with the advent of specialist nursing roles (see above), this has become a less attractive option. [333] => [334] => Nonetheless, many nurses fill positions in the senior management structure of NHS organizations, some even as board members. Others choose to stay a little closer to their clinical roots by becoming clinical nurse managers or ''[[Matron|modern matrons]]''. [335] => [336] => =====Nurse education===== [337] => ======Pre-registration====== [338] => To become a registered nurse, one must complete a program recognised by the [[Nursing and Midwifery Council]] (NMC). Currently, this involves completing a [[Academic degree|degree]], available from a range of [[:Category:Nursing schools in the United Kingdom|universities offering these courses]], in the chosen branch specialty (see below), leading to both an academic award and professional registration as a 1st level registered nurse. Such a course is a 50/50 split of learning in university (i.e. through lectures, assignments and examinations) and in practice (i.e. supervised patient care within a hospital or community setting). [339] => [340] => These courses are three (occasionally four) years' long. The first year is known as the common foundation program (CFP), and teaches the basic knowledge and skills required of all nurses. Skills included in the CFP may include communication, taking observations, administering medication and providing personal care to patients. The remainder of the program consists of training specific to the student's chosen branch of nursing. These are: [341] => [342] => * Child nursing [343] => * Mental health nursing [344] => * Learning disabilities nursing [345] => [346] => {{As of|2013}}, the Nursing and Midwifery Council will require all new nurses qualifying in the UK to hold a degree qualification.{{cite web|title=Changes to pre-registration nursing programmes: FAQs | Nursing and Midwifery Council|url=http://www.nmc-uk.org/Get-involved/Consultations/Past-consultations/By-year/Pre-registration-nursing-education-Phase-2/Changes-to-pre-registration-nursing-programmes-FAQs-/|date=20 April 2010|publisher=Nmc-uk.org|archive-url=https://web.archive.org/web/20110727073118/http://www.nmc-uk.org/Get-involved/Consultations/Past-consultations/By-year/Pre-registration-nursing-education-Phase-2/Changes-to-pre-registration-nursing-programmes-FAQs-/|archive-date=27 July 2011|access-date=21 August 2011}} However, those nurses who hold a diploma, or even a certificate in nursing are still able to legally practice in the UK, although they are able to undertake university modules to obtain enough credits to top up to a degree. [347] => [348] => [[Midwifery]] training is similar in length and structure, but is sufficiently different that it is not considered a branch of nursing. There are shortened (18-month) programs to allow nurses already qualified in the adult branch to hold dual registration as a nurse and a midwife. Shortened courses lasting 2 years also exist for graduates of other disciplines to train as nurses. This is achieved by more intense study and a shortening of the common foundation program.Nursing and Midwifery Council [http://www.nmc.org.uk Pre-registration training.] London: NMC, 2003. [349] => [350] => {{As of|2016}} student nurses in England and Wales can apply for a [[bursary]] from the government to support them during their nurse training, and may also be eligible for a student loan, although there has been speculation that this will not be available in the future.{{cite web|title=Student bursary system 'unsustainable', claims minister in response to editors|url=https://www.nursingtimes.net/news/education/bursary-system-unsustainable-claims-minister-03-10-2016/|website=Nursing Times|date=3 October 2016|access-date=10 December 2017}} Student nurses in Scotland still receive a standard bursary which is not means tested, and their tuition fees continue to be paid – however, they are not eligible for student loans. [351] => [352] => Before Project 2000, nurse education was the responsibility of hospitals and was not based in universities; hence many nurses who qualified prior to these reforms do not hold an academic award. [353] => [354] => ======Post-registration====== [355] => After the point of initial registration, there is an expectation that all qualified nurses will continue to update their skills and knowledge. The Nursing and Midwifery Council insists on a minimum of 35 hours of education every three years, as part of its post registration education and practice (PREP) requirements.{{cite web|title=Post Registration Education and Practice (Prep) requirements for midwives | Nursing and Midwifery Council|url=http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Post-Registration-Education-and-Practice-Prep-requirements-for-midwives/|publisher=Nmc-uk.org|archive-url=https://web.archive.org/web/20101126092059/http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Post-Registration-Education-and-Practice-Prep-requirements-for-midwives/|archive-date=26 November 2010|access-date=21 August 2011}} [356] => [357] => There are also opportunities for many nurses to gain additional clinical skills after qualification. [[Cannulation]], [[venipuncture]], [[Intravenous therapy|intravenous drug therapy]] and [[Urinary catheterization|male catheterization]] are the most common, although there are many others (such as [[advanced life support]]), which some nurses undertake. [358] => [359] => Many nurses who qualified with a diploma choose to upgrade their qualification to a degree by studying part-time. Many nurses prefer this option to gaining a degree initially, as there is often an opportunity to study in a specialist field as a part of this upgrading. Financially, in England, it was also much more lucrative, as diploma students get the full bursary during their initial training, and employers often pay for the degree course as well as the nurse's salary.Nursing and Midwifery Education, 2007 [360] => [361] => To become specialist nurses (such as nurse consultants, nurse practitioners etc.) or nurse educators, some nurses undertake further training above bachelor's degree level. Master's degrees exist in various healthcare related topics, and some nurses choose to study for PhDs or other higher academic awards. [[District nurse]]s and [[health visitor]]s are also considered specialist nurses, and to become such they must undertake specialist training. This is a one-year full-time degree. [362] => [363] => All newly qualifying [[district nurse]]s and [[health visitor]]s are trained to prescribe from the Nurse Prescribers' Formulary, a list of medications and dressings typically useful to those carrying out these roles. Many of these (and other) nurses will also undertake training in independent and supplementary prescribing, which allows them (as of 1 May 2006) to prescribe almost any drug in the [[British National Formulary]]. This has been the cause of a great deal of debate in both medical and nursing circles.{{cite web|title=BNF Publications|url=http://bnf.org/bnf/index.htm|author=BNF Publications}} [364] => [365] => ====European Union==== [366] => In the European Union, the profession of nurse is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for nurse{{cite web|title=Regulated professions database – European Commission|url=http://ec.europa.eu/internal_market/qualifications/regprof/index.cfm?action=profession&id_profession=12402&tab=countries|publisher=European Commission|access-date=10 December 2017}} in the European Union (EU) member states, European Economic Area (EEA) countries, and Switzerland. This list is covered by the Directive 2005/36/EC. [367] => [368] => === Asia === [369] => [370] => ====India==== [371] => Nursing education is governed in [[India]] by the central body [[Indian Nursing Council]] and its norms are implemented through respective State Nursing councils. The list of state nursing councils are available in the official web page of Indian Nursing Council. First formal education in nursing was offered in Madras Medical college, in Madras presidency. [372] => Indian Nursing Council Act, 1947. Act Year Number: Act No. 19 of December enactment Date of enactment: [31 December 19act] Act Objective: An Act to constitute the Nursing Council of India. To establish uniform standards of training for nurses, midwives, and health visitors. It is implemented with 17 sections and each section indicates the specific legislative role of the council. [373] => [374] => The nursing profession was dominated by females in the British colonial period, but in Madras Presidency, men were actively engaged in the profession.Jayapal SK, Arulappan J. Historical Trajectory of Men in Nursing in India. SAGE Open Nurs. 2020 May 13; 6:1-10. doi: 10.1177/2377960820920128. PMID 33415276; PMCID: PMC7774447 [375] => [376] => ====Iran==== [377] => {{main|Nursing in Iran}} [378] => [379] => ====Israel==== [380] => Nurses in [[Israel]] have a wide variety of responsibilities, including hospital care, patient education, wound care, prenatal and other monitoring, midwifery, and well-baby clinics. [381] => [382] => Nursing in Israeli Jewish culture traces its origins to [[Shiphrah and Puah|Shifra and Puah]], two [[Hebrews|Hebrew]] midwives depicted in the [[Book of Exodus]] helping women in ancient Egypt give birth and keep their infants safe. [383] => [384] => Modern-day nursing was established by nurses sent to [[Mandatory Palestine]] and later Israel by the [[Hadassah Women's Zionist Organization of America|Hadassah]] organization, as well as a nursing school founded by [[Henrietta Szold]] in 1918. During those times, the United Kingdom regulated midwifery in Mandatory Palestine, but the nurses were not mentioned in the regulation decree. [385] => [386] => Today, nurses and midwives are regulated by the [[Israeli Ministry of Health]]. [387] => [388] => ====Japan==== [389] => {{main article|Nursing in Japan}} [390] => [391] => =====History===== [392] => Nursing was not an established part of Japan's healthcare system until 1899 with the Midwives Ordinance.{{cite web|title=Nursing in Japan – Overview of Japanese Nursing System|url=http://www.nurse.or.jp/jna/english/nursing/system.html|website=nurse.or.jp|access-date=25 February 2018|archive-date=11 March 2018|archive-url=https://web.archive.org/web/20180311091329/http://www.nurse.or.jp/jna/english/nursing/system.html|url-status=dead}} From there the Registered Nurse Ordinance came into play in 1915. This established a legal substantiation to registered nurses all over Japan. A new law geared towards nurses was created during [[World War II]]: the ''Public Health Nurse, Midwife and Nurse Law'', established in 1948. It established educational requirements, standards and licensure. There has been a continued effort to improve nursing in Japan. In 1992 the Nursing Human Resource Law was passed. This law created the development of new university programs for nurses. Those programs were designed to raise the education level of the nurses so that they could be better suited for taking care of the public. [393] => [394] => =====Types of nurses===== [395] => Japan only recognizes four types of nursing and they are [[Public Health Nursing]], [[Midwifery]], Registered Nursing and Assistant Nursing. [396] => [397] => ======Public health====== [398] => This type of nursing is designed to help the public and is also driven by the public's needs. The goals of public health nurses are to monitor the spread of disease, keep vigilant watch for environmental hazards, educate the community on how to care for and treat themselves, and train for community disasters. [399] => [400] => ======Midwifery====== [401] => Nurses that are involved with midwifery are independent of any organization. A [[midwife]] takes care of a pregnant woman during labour and postpartum. They assist with things like breastfeeding and caring for the child. [402] => [403] => ======Nursing assistant====== [404] => Nursing assistants, also known as nurse assistants or CNAs (Certified Nursing Assistants), assist patients with basic daily tasks. Individuals who are assistant nurses follow orders from a registered nurse. They report back to the licensed nurse about a patient's condition. Assistant nurses are always supervised by a licensed registered nurse. [405] => [406] => =====Education===== [407] => In 1952 Japan established the first nursing university in the country. An [[Associate of Science in Nursing|associate degree]] was the only level of certification for years. Soon people began to want nursing degrees at a higher level of education. Soon the [[Bachelor of Science in Nursing|Bachelor's Degree in Nursing]] (BSN) was established. Currently, Japan offers [[Doctorate in Nursing|doctorate]]-level degrees of nursing in a good number of its universities. [408] => [409] => There are three ways that an individual could become a registered nurse in Japan. After obtaining a high school degree the person could go to a nursing university for four years and earn a bachelor's degree, go to a junior nursing college for three years or go to a nursing school for three years. Regardless of where the individual attends school they must take the national exam. Those who attended a nursing university have a bit of an advantage over those who went to a nursing school. They can take the national exam to be a registered nurse, public health nurse or midwife. In the cases of becoming a midwife or a public health nurse, the student must take a one-year course in their desired field after attending a nursing university and passing the national exam to become a registered nurse. The nursing universities are the best route for someone who wants to become a nurse in Japan. They offer a wider range of general education classes and they also allow for a more rigid teaching style of nursing. These nursing universities train their students to be able to make critical and educated decisions when they are out in the field. Physicians are the ones who are teaching the potential nurses because there are not enough available nurses to teach students. This increases the dominance that physicians have over nurses. [410] => [411] => Students that attend a nursing college or just a nursing school receive the same degree as one who graduated from a nursing university would, but they do not have the same educational background. The classes offered at nursing colleges and nursing schools are focused on more practical aspects of nursing. These institutions do not offer many general education classes, so students who attend these schools will solely be focusing on their nursing educations while they are in school. Students who attend a nursing college or school do have the opportunity to become a [[midwife]] or a public health nurse. They have to go through a training institute for their desired field after graduating from the nursing school or college. Japanese nurses never have to renew their licenses. Once they have passed their exam, they have their license for life. [412] => [413] => =====Today===== [414] => Like the United States, Japan is in need of more nurses. The driving force behind this need is the fact that country is aging and needs more medical care for its people. However, the number of available nurses does not seem to be increasing. Nurses face poor working conditions and low social status, and there is a cultural idea that married women quit their jobs for family responsibilities.{{cite web|title=Nursing in Japan – Working conditions in Japan|url=http://www.nurse.or.jp/jna/english/nursing/employment.html|website=nurse.or.jp|access-date=25 February 2018|archive-date=25 February 2021|archive-url=https://web.archive.org/web/20210225151221/https://www.nurse.or.jp/jna/english/nursing/employment.html|url-status=dead}} On average, Japanese nurses make around 280,000 yen a month, and it is one of the higher paying jobs. However, physicians make twice as much as nurses.{{cite web|title=Professional Nurse Salaries – International Comparison|url=http://www.worldsalaries.org/professionalnurse.shtml|website=worldsalaries.org|access-date=25 February 2018}} Similar to other cultures, the Japanese people view nurses as subservient to physicians. According to the [[American Nurses Association]] article on Japan, "nursing work has been described using negative terminology such as 'hard, dirty, dangerous, low salary, few holidays, minimal chance of marriage and family, and poor image.'" [415] => [416] => There are organizations that unite Japanese nurses like the [[Japanese Nursing Association]] (JNA); the JNA is a professional organization and not a union. Members of the JNA lobby politicians and produces publications about nursing. According to the American Nurses Association's article on Japan, the JNA "works toward the improvement in nursing practice through many activities including the development of a policy research group to influence policy development, a code of ethics for nurses, and standards of nursing practice." The JNA also provides certification for specialists in mental health, oncology and community health. There are other organizations, including some that categorize nurses by specialty, like emergency nursing or disaster nursing. One of the older unions that relates to nursing is the Japanese Federation of Medical Workers Union, which was created in 1957. It is a union that includes physicians as well as nurses. This organization was involved with the '''Nursing Human Resource Law'''. [417] => [418] => ====Philippines==== [419] => {{main article|Nursing in the Philippines}} [420] => Philippines is well known for migrant nurses working in other countries especially in the west like the United States of America. It accounts a quarter of overseas nurses in the world. Every year, around 20,000 nurses leave the Philippines to work in more developed countries looking for better pay.{{cite news |title=The Worlds Largest Supplier of Nurses: The Philippines |work=Hawk Herald |url=https://www.hawkherald.com/2021/11/the-worlds-largest-supplier-of-nurses-the-philippines/|access-date=6 December 2022|archive-date=20 November 2021|archive-url=https://web.archive.org/web/20211120041136/https://www.hawkherald.com/2021/11/the-worlds-largest-supplier-of-nurses-the-philippines/|url-status=live}} Nurses in the Philippines must be licensed by the [[Professional Regulatory Commission]]. [421] => [422] => ====Taiwan==== [423] => {{main article|Nursing in Taiwan}} [424] => In [[Taiwan]], the [[Ministry of Health and Welfare (Taiwan)|Ministry of Health and Welfare]] is in charge of the regulation of nursing.{{cite web|title=Ministry of Health and Welfare|url=http://www.mohw.gov.tw/EN/Ministry/Index.aspx|access-date=6 May 2016|archive-date=28 April 2017|archive-url=https://web.archive.org/web/20170428230510/http://www.mohw.gov.tw/EN/Ministry/Index.aspx}} The Taiwan Union of Nurses Association (TUNA) is the union unit in Taiwan, fighting for nurses on payment and working time issues.{{Cite web|url=https://www.nurse.org.tw/|title=中華民國護理師護士公會全國聯合會|website=www.nurse.org.tw}} [425] => [426] => ===Australia=== [427] => {{main article|Nursing in Australia}} [428] => Catholic religious institutes were influential in the development of Australian nursing, founding many of Australia's hospitals – the Irish [[Sisters of Charity of Australia|Sisters of Charity]] were first to arrive in 1838 and established [[St Vincent's Hospital, Sydney]] in 1857 as a free hospital for the poor. They and other orders like the [[Sisters of Mercy]], and in aged care the Sisters of the Little Company of Mary and [[Little Sisters of the Poor]] founded hospitals, hospices, research institutes and aged care facilities around Australia.{{cite web|url=http://national.stvincents.com.au/history.php|date=6 July 2011|archive-url=https://web.archive.org/web/20100402062826/http://national.stvincents.com.au/history.php|archive-date=2 April 2010|access-date=31 July 2012|title=Sisters of Charity Health Service }}{{cite web|title=Little Sisters of the Poor Oceania|url=http://www.littlesistersofthepoor.org.au/|publisher=Littlesistersofthepoor.org.au|access-date=31 July 2012}} [429] => [430] => A census in the 1800s found several hundred nurses working in Western Australia during the colonial period of history, this included Aboriginal female servants who cared for the infirm."But Westward Look" by author [431] => [432] => The state nursing licensing bodies amalgamated in Australia in 2011 under the federal body AHPRA (Australian Health Practitioner Registration Authority).{{cite journal|last1=Ralph|first1=Nicholas|last2=Birks|first2=Melanie|last3=Chapman|first3=Ysanne|date=November 2013|title=The accreditation of nursing education in Australia|url=http://eprints.usq.edu.au/25901/14/Ralph_Birks_Coll_SV.pdf|journal=Collegian|volume=22|issue=1|pages=3–7|doi=10.1016/j.colegn.2013.10.002|pmid=26285403}} Several divisions of nursing license is available and recognized around the country. [433] => [434] => * Enrolled nurses may initiate some oral medication orders with a specific competency now included in national curricula but variable in application by agency. [435] => * Registered nurses hold a university degree (enrolled nurses can progress to registered nurse status and do get credit for previous study). [436] => * Nurse practitioners have started emerging from postgraduate programs and work in both private practice and [[Public hospital|public hospitals and clinics]]. [437] => * Mental health nurses must complete further training as advanced mental health practitioners in order to administer client referrals under the ''Mental Health Act''. [438] => [439] => Australia enjoys the luxury of a national curriculum for vocational nurses, trained at Technical and Further Education (TAFE) colleges or private Registered Training Organization (RTO). Enrolled and registered nurses are identified by the department of immigration as an occupational area of need, although registered nurses are always in shorter supply, and this increases in proportion with specialization. [440] => [441] => [http://www.anu.edu.au/polsci/marx/interventions/rebelwomen/nurses.htm Nurses' militancy stemmed from two different kinds of experiences]. Anu.edu.au (19 November 1983). Retrieved 28 July 2013. [442] => [443] => In 1986 there were a number of rolling industrial actions around the country, culminating when five thousand Victorian nurses went on strike for eighteen days. The hospitals were able to function by hiring casual staff from each other's striking members, but the increased cost forced a decision in the nurses' favor. [444] => [445] => == Online Healthcare Staffing Platforms == [446] => The early 2010s saw the emergence of [[digital health]] platforms that connect nurses and nurse assistants with vacant job openings in healthcare facilities like skilled nursing homes, home health agencies, and hospitals. They commonly use an app to facilitate communication and allow nurses to find flexible work opportunities based on their preferences. Healthcare partners and facilities benefit from access to a qualified pool of nurses to fill staff shortages quickly and efficiently.{{Cite journal |last1=Han |first1=Xinxin |last2=Pittman |first2=Patricia |last3=Barnow |first3=Burt |date=2021-09-09 |title=Alternative Approaches to Ensuring Adequate Nurse Staffing |url=http://dx.doi.org/10.1097/mlr.0000000000001614 |journal=Medical Care |volume=59 |issue=Suppl 5 |pages=S463–S470 |doi=10.1097/mlr.0000000000001614 |pmid=34524244 |issn=0025-7079|pmc=8428863 }} They now compete with large, traditional staffing agencies. In 2017, the National Health Service in the United Kingdom had begun trialling an app for nurses, for short-term placements.{{Cite magazine |title=The NHS is going to trial a gig economy app for nurses |url=https://www.wired.co.uk/article/nhs-app-nurses-flexible-working-jeremy-hunt-gig-economy |access-date=2024-01-24 |magazine=Wired UK |language=en-GB |issn=1357-0978}} [447] => [448] => Some online healthcare staffing platforms, such as [[United States]]-based ConnectRN, Nomad Health, Gale Healthcare solutions or Lantum go beyond simply connecting nurses with jobs. They aim to couple staffing applications with fostering a community for nurses, offering resources, career development tools, and networking opportunities.{{Cite web |last1=Mayer |first1=Miguel Angel |last2=Rodríguez Blanco |first2=Octavi |last3=Torrejon |first3=Antonio |date=2019-06-26 |title=Use of Health Apps by Nurses for Professional Purposes: Web-Based Survey Study (Preprint) |doi=10.2196/preprints.15195 |doi-access=free }} [449] => [450] => == Nursing as a Science == [451] => {{Main article|Nursing research}} [452] => Florence Nightingale's [[Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army|seminal epidemiological study]], examining mortality among British soldiers during the [[Crimean War]] had been published in 1858,{{sfn|Boswell|Cannon|2014|p=30–31}} but with the exception of her works, nursing was largely transferred as an oral tradition until the mid 20th century. The inaugural issue of ''[[Nursing Research]]'', the first scientific journal specialized in nursing, was released in 1952. During the 1960s, there was an increased interest in attaining PhDs among nurses in the US, but nursing science was still a fledgling area of research, with only a few journals in print until the 1970s.{{sfn|Watson|2021|loc=From Oral Tradition to Written Scholarship}} It has been increasingly argued that nursing research is a sub-discipline in its own right, although there is no prevailing definition of its distinct nature, and many scholars do not attempt giving one.{{sfn|Manhart Barrett|2017|p=129}} The question is further complicated by the numerous interpretations of what the defining nature of nursing itself is.{{sfn|Manhart Barrett|2002|p=51}}{{sfn|Mulhall|1998|p=4}} [453] => [454] => === Evidence-Based Practice === [455] => {{Main article|Evidence-based nursing|Evidence-based medicine}} [456] => The need to integrate up-to-date scientific evidence into clinical practice, in order to achieve quality care has been increasingly recognized.{{sfn|Boswell|Cannon|2014|p=3–4}} This does not preclude the application of personal expertise, as well as adapting to the wants and needs of the client, especially in cases where scientific evidence is sparse, or not applicable to the specific situation.{{sfn|Boswell|Cannon|2014|p=3–8}} Common barriers to the study and integration of research findings into clinical decision making include: a lack of opportunity due to demanding working conditions, inexperience in assessing scientific material, and the rapid accumulation of new evidence.{{sfn|Mulhall|1998|p=4}} [457] => [458] => == Nursing and Medicine == [459] => According to the traditional interpretation physicians are concerned with curing or treating medical conditions, while nurses focus on care. In healthcare settings this line is often blurred, and a more acute difference would be how nurses work in close proximity to their patients for longer periods of time.{{sfn|Mulhall|1998|p=4–5}} [460] => [461] => ==See also== [462] => {{Portal|Medicine}} [463] => {{col div|colwidth=20em}} [464] => *[[Advanced practice registered nurse]] [465] => *[[Deaconess]] [466] => *[[Emergency nursing]] [467] => *[[History of hospitals]] [468] => *[[History of medicine]] [469] => *[[History of nursing]] [470] => *[[History of Nursing in the United Kingdom]] [471] => *[[History of nursing in the United States]] [472] => *[[History of Philippine nurses in the United States]] [473] => *[[Index of nursing articles]] [474] => *[[Licensed practical nurse]] [475] => *[[List of nurses]] [476] => *[[List of nursing specialties]] [477] => *[[Men in nursing]] [478] => *[[Nightingale Pledge]] [479] => *[[Nurse uniform]] [480] => *[[Nurse–client relationship]] [481] => *[[Nurse scheduling problem]] [482] => *[[Nursing care plan]] [483] => *[[Nursing ethics]] [484] => *[[Nursing in Australia]] [485] => *[[Nursing in Germany]] [486] => *[[Nursing in Hong Kong]] [487] => *[[Nursing in India]] [488] => *[[Nursing in Islam]] [489] => *[[Nursing in Japan]] [490] => *[[Nursing in Kenya]] [491] => *[[Nursing in Pakistan]] [492] => *[[Nursing in Taiwan]] [493] => *[[Nursing in the Philippines]] [494] => *[[Nursing in the United States]] [495] => *[[Nursing school]] [496] => *[[Nurse stereotypes]] [497] => *[[Nursing theory]] [498] => *[[Registered nurse]] [499] => *[[Transcultural nursing]] [500] => *[[Wet nurse]] [501] => {{colend}} [502] => [503] => ==References== [504] => {{Reflist}} [505] => [506] => === Book sources === [507] => * {{Cite book |title=Nursing Theory: Utilization & Application |date=2010 |publisher=Mosby/Elsevier |isbn=978-0-323-05640-3 |editor-last=Alligood |editor-first=Martha Raile |edition=4th |location=St. Louis}} [508] => *{{cite book |date=2012 |edition=7th |first=Julia W. |isbn=9780323083348 |last=Balzer-Riley |location=St. Louis, Mo. |publisher=Mosby/Elsevier |title=Communication in Nursing}} [509] => * {{cite book |date=2014 |edition=3rd |editor=Boswell Carol, Cannon Sharon |isbn=9781449681968 |location=Burlington, MA |publisher=Jones & Bartlett Learning |title=Introduction to Nursing Research: Incorporating Evidence-based Practice}} [510] => * {{Cite book |last=Eliopoulos |first=Charlotte |url=https://www.worldcat.org/title/265657164 |title=Gerontological Nursing |date=2010 |publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins |isbn=978-0-7817-5344-9 |edition=7th|location=Philadelphia |oclc=265657164}} [511] => * {{cite book |date=2017 |edition=7th |editor=Joyce Newman, Giger |isbn=9780323399920 |language=eng |location=St. Louis, Missouri |publisher=Mosby/Elsevier |title=Transcultural Nursing: Assessment & Intervention}} [512] => * {{Cite book |last1=Muñoz |first1=Cora C. |title=Transcultural Communication in Nursing |last2=Luckmann |first2=Joan |date=2005 |publisher=Thomson/Delmar Learning |isbn=978-0-7668-4877-1 |edition=2nd |location=Clifton Park, NY}} [513] => [514] => === Journal articles === [515] => * {{Cite journal |last1=Fawcett |first1=Jacqueline |last2=Watson |first2=Jean |last3=Neuman |first3=Betty |last4=Walker |first4=Patricia Hinton |last5=Fitzpatrick |first5=Joyce J. |date=2001 |title=On Nursing Theories and Evidence |url=http://dx.doi.org/10.1111/j.1547-5069.2001.00115.x |journal=Journal of Nursing Scholarship |volume=33 |issue=2 |pages=115–119 |doi=10.1111/j.1547-5069.2001.00115.x |pmid=11419305 |issn=1527-6546 |ref=CITEREFFawcett et al.2001}} [516] => * {{Cite journal |last1=Hosseinzadeh Siboni |first1=Fatemeh |last2=Behboudi |first2=Faezeh |last3=Mohebbi |first3=Kasra |last4=Majidi |first4=Soheila |last5=Yaghobi |first5=Yasaman |last6=Carroll |first6=Karen |date=2023 |title=Virginia Henderson's Writings on the Nature of Nursing: An Exemplar of Nursing Practice |url=http://dx.doi.org/10.1177/08943184221150255 |journal=Nursing Science Quarterly |volume=36 |issue=2 |pages=134–138 |doi=10.1177/08943184221150255 |pmid=36994952 |issn=0894-3184}} [517] => * {{Cite journal |last1=Manhart Barrett |first1=Elizabeth Ann |date=2002 |title=What is nursing science? |url=https://pubmed.ncbi.nlm.nih.gov/11873474 |journal=Nursing Science Quarterly |volume=15 |issue=1 |pages=51–60 |doi=10.1177/089431840201500109 |issn=0894-3184 |pmid=11873474}} [518] => * {{cite journal|last=Manhart Barrett|first=Elizabeth Ann |year=2017|title=Again, What Is Nursing Science?|journal=Nursing Science Quarterly|volume=30 |issue=2 |pages=129–133|doi=10.1177/0894318417693313|pmid=28899250}} [519] => * {{Cite journal |last=Mulhall |first=Anne |date=1998 |title=Nursing, research, and the evidence |url=https://ebn.bmj.com/content/1/1/4 |journal=Evidence-Based Nursing |language=en |volume=1 |issue=1 |pages=4–6 |doi=10.1136/ebn.1.1.4 |issn=1367-6539}} [520] => * {{Cite journal |last1=Newman |first1=M. A. |last2=Sime |first2=A. M. |last3=Corcoran-Perry |first3=S. A. |date=1991 |title=The focus of the discipline of nursing |url=https://pubmed.ncbi.nlm.nih.gov/1819254 |journal=ANS. Advances in Nursing Science |volume=14 |issue=1 |pages=1–6 |doi=10.1097/00012272-199109000-00002 |issn=0161-9268 |pmid=1819254}} [521] => * {{Cite journal |last=Ross |first=Linda A. |date=1994 |title=Spiritual aspects of nursing |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.1994.tb01105.x |journal=Journal of Advanced Nursing |language=en |volume=19 |issue=3 |pages=439–447 |doi=10.1111/j.1365-2648.1994.tb01105.x |pmid=8014303 |issn=0309-2402}} [522] => * {{Cite journal |last=Steinbrook |first=Robert |date=2002 |title=Nursing in the Crossfire |url=http://www.nejm.org/doi/abs/10.1056/NEJM200205303462225 |journal=New England Journal of Medicine |language=en |volume=346 |issue=22 |pages=1757–1766 |doi=10.1056/NEJM200205303462225 |pmid=12037165 |issn=0028-4793}} [523] => * {{Cite journal |last=Watson |first=Jean |date=2021 |title=Watson's View of Nursing Science Quarterly's 35th Anniversary |url=http://dx.doi.org/10.1177/08943184211051366 |journal=Nursing Science Quarterly |volume=35 |issue=1 |pages=67–69 |doi=10.1177/08943184211051366 |pmid=34939483 |issn=0894-3184}} [524] => [525] => ==External links== [526] => {{Wikiquote|Nursing}} [527] => {{Wikibooks|Careers|Nursing}} [528] => {{Commons category|Nursing}} [529] => * [http://library.uncg.edu/dp/wv/itemSearch.aspx?t=1&k=nurse UNCG Library Betty H. Carter Women Veterans Historical Project: Nurse] [530] => * {{Cite EB1911|wstitle=Nursing |short=x}} [531] => [532] => {{Nursing}} [533] => {{Medicine}} [534] => {{Glossaries of science and engineering}} [535] => {{Authority control}} [536] => [537] => [[Category:Nursing| ]] [538] => [[Category:Military supporting service occupations]] [539] => [[Category:Rehabilitation team]] [540] => [[Category:Health care occupations]] [541] => [[Category:Hospital staff]] [542] => [[Category:Occupational safety and health]] [] => )
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Nursing

Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses are trained to be knowledgeable, compassionate, and skilled in various aspects of healthcare.

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Nurses are trained to be knowledgeable, compassionate, and skilled in various aspects of healthcare. The Wikipedia page on nursing provides a comprehensive overview of the profession, covering its history, education and training, roles and responsibilities, specialties, professional organizations, and regulations. It also delves into the diverse settings in which nurses practice, including hospitals, clinics, schools, and home care. The history section traces the origins of nursing back to ancient civilizations and highlights the contributions of notable figures such as Florence Nightingale who played a crucial role in shaping modern nursing practices. The education and training section outlines the different pathways to becoming a nurse, including diploma programs, associate degree programs, and bachelor's degree programs. Advanced nursing degrees, such as master's and doctoral degrees, are also discussed. The roles and responsibilities of nurses are explored in depth, highlighting their role in patient care, collaboration with other healthcare professionals, patient advocacy, and involvement in research and education. The page also highlights the wide range of specialties within nursing, such as pediatric nursing, geriatric nursing, psychiatric nursing, and critical care nursing, among others. Professional organizations and regulatory bodies, both at national and international levels, are listed to demonstrate the importance of maintaining high standards and ethical practices in nursing. The page also emphasizes the significance of continuing education and professional development for nurses to stay abreast of advances in healthcare and provide the best possible care to patients. Overall, the Wikipedia page on nursing serves as a valuable resource for both aspiring and practicing nurses, as well as anyone seeking to understand the vital role nurses play in the healthcare system.

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