Liberal Education and Nursing Practice Discussion

Liberal Education and Nursing Practice Discussion

Liberal Education and Nursing Practice Discussion

Read and Review Nursing Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice.

  1. Post one paragraph addressing the following: How does a solid base in liberal education provide the cornerstone for the practice and education of nurses?
  2. Write a second paragraph describing how you met Essential I during the BSN program. Provide specific examples.

Be sure to use in-text citations and cite scholarly reference(s) in APA format.

Liberal Education and Nursing Practice Discussion

The Essentials of Baccalaureate Education for Professional Nursing Practice

Introduction

The Essentials of Baccalaureate Education for Professional Nursing Practice provides the educational framework for the preparation of professional nurses. This document describes the outcomes expected of graduates of baccalaureate nursing programs. Liberal Education and Nursing Practice Discussion

The Essentials apply to all pre­licensure and RN completion programs, whether the degree is baccalaureate or graduate entry. Program curricula are designed to prepare students to meet the end­of­program outcomes delineated under each Essential.

Background

The healthcare delivery system has changed dramatically since The Essentials of Baccalaureate Education for Professional Nursing Practice was endorsed by the American Association of Colleges of Nursing (AACN, 1998). Building a safer healthcare system has become the focus of all health professions following numerous reports from the Institute of Medicine (IOM, 2000, 2001, 2004), American Hospital Association (2002), Robert Wood Johnson Foundation (Kimball & O’Neill, 2002), the Joint Commission (2002) and other authorities. Liberal Education and Nursing Practice Discussion

Nursing has been identified as having the potential for making the biggest impact on a transformation of healthcare delivery to a safer, higher quality, and more cost­effective system. With the increasing awareness of the need for change in the healthcare system, the clinical microsystems (small, functional units where care is provided within the larger system) have become an important focus for improving healthcare outcomes (Nelson, Batalden, & Godfrey, 2007). Liberal Education and Nursing Practice Discussion

In addition to the concern over healthcare outcomes, the United States and the global market are experiencing a nursing shortage that is expected to intensify as the demand for more and different nursing services grows. Buerhaus, Staiger, and Auerbach (2008) reported that the U.S. may experience a shortage of more than 500,000 registered nurses by the year 2025. Liberal Education and Nursing Practice Discussion

Despite annual increases in enrollments in entry­level baccalaureate nursing programs since 2001 (Fang, Htut, & Bednash, 2008), these increases are not sufficient to meet the projected demand for nurses. According to Buerhaus et al. (Liberal Education and Nursing Practice Discussion 2008), enrollment in nursing programs would have to increase at least 40% annually to replace the nurses expected to leave the workforce through retirement alone. Addressing the need for an increased number of baccalaureate­prepared nurses is critical but not sufficient.

Nursing must educate future professionals to deliver patient­centered care as members of an interprofessional team, emphasizing evidence­based practice, quality improvement approaches, and informatics (IOM, Liberal Education and Nursing Practice Discussion 2003b). Nursing education and practice must work together to better align education with practice environments (Joint Commission, 2002, Kimball & O’Neill, 2002;).

The environments in which professional nurses practice have become more diverse and more global in nature. Scientific advances, particularly in the areas of genetics and genomics, have had and will continue to have a growing and significant impact on prevention, diagnosis, and treatment of diseases, illnesses, and conditions. The increased prevalence of chronic illness is a result of an increasingly older adult population, environmental threats, lifestyles that increase risk of disease, and enhanced technological and therapeutic interventions that prolong life. Liberal Education and Nursing Practice Discussion

Increases in longevity of life have made the older adult the fastest growing segment of the population. In 2003, 12 % of the population was older than 65 years of age. By 2030, this population will increase to 20%, with a large majority older than 80 years of age (He, Sengupta, Velkoff, & DeBarros, 2005). Those older than 65 years of age had almost four times the number of hospitalization days than those younger than 65 years of age (Centers for Disease Control, Liberal Education and Nursing Practice Discussion 2007)

Education for the baccalaureate generalist must include content and experiences across the lifespan, including the very young who are especially vulnerable. The percentage of the population under 18 years of age is 24.6% (U.S. Census Bureau, 2008). U.S. infant mortality in 2006 ranked 38th in the world (World Health Organization, 2008).

Prevention is critical in addressing both acute and chronic conditions across the lifespan. The role of the nurse in prevention continues to be of utmost importance. Increasing globalization of healthcare and the diversity of this nation’s population mandates an attention to diversity in order to provide safe, high quality care. The professional nurse practices in a multicultural environment and must possess the skills to provide culturally appropriate care.

According to the U.S. Census Bureau (2008), the nation’s minority population totaled 102 million or 34% of the U.S. population in 2006. With projections pointing to even greater levels of diversity in the coming years, professional nurses need to demonstrate a sensitivity to and understanding of a variety of cultures to provide high quality care across settings. Liberal education, including the study of a second language, facilitates the development of an appreciation for diversity Liberal Education and Nursing Practice Discussion

Strong forces influencing the role of nurses include:

  • scientific advances, particularly in the area of genetics and genomics,
  • changing demographics of patient populations,
  • new care technologies, and
  • patient access to healthcare

These forces call for new ways of thinking and providing health care. Nursing is uniquely positioned to respond to these major forces, requiring an increased emphasis on designing and implementing patient­centered care, developing partnerships with the patient, and a focus on customer service. Liberal Education and Nursing Practice Discussion

Nursing Education

In response to calls for transforming the healthcare system and how healthcare professionals are educated, AACN has maintained an ongoing dialogue with a broad representation of stakeholders internal and external to nursing. The dialogue has focused on the knowledge, skills, and attitudes needed by nurses to practice effectively within this complex and changing environment. New innovative models of nursing education have emerged, and AACN has taken a leadership role in crafting a preferred vision for nursing education.

In 2004, the AACN Board of Directors reaffirmed its position that baccalaureate education is the minimum level required for entry into professional nursing practice in today’s complex healthcare environment. Baccalaureate generalist education, as defined in this document, is the foundation upon which all graduate nursing education builds. Liberal Education and Nursing Practice Discussion

The preferred vision for nursing education includes generalist, advanced generalist, and advanced specialty nursing education. Generalist nurse education occurs at a minimum in baccalaureate­degree nursing programs. Advanced generalist education occurs in master’s degree nursing programs, including the Clinical Nurse Leader (CNL®), which is an advanced generalist nursing role. Advanced specialty education occurs at the doctoral level in Doctor of Nursing Practice (DNP) or research­focused degree programs (PhD, DNS, or DNSc). End­of­program outcomes for the baccalaureate, master’s, and doctoral nursing programs build on each other.

The Discipline of Nursing

Roles for the baccalaureate generalist nurse are derived from the discipline of nursing. The roles of the baccalaureate generalist include: Liberal Education and Nursing Practice Discussion

  • provider of care,
  • designer/manager/coordinator of care, and
  • member of a

Nursing generalist practice includes both direct and indirect care for patients, which includes individuals, families, groups, communities, and populations. Nursing practice is built on nursing knowledge, theory, and research. In addition, nursing practice derives knowledge from a wide array of other fields and professions, adapting and applying this knowledge as appropriate to professional practice. Liberal Education and Nursing Practice Discussion

In the senior college and university setting, every academic discipline is grounded in discrete inquiry­based applications that are distinctive to that discipline. Scientific advances, (particularly in the area of genetics and genomics), changing demographics of patient populations, new care technologies, and patient access to health care information call for new ways of thinking and doing in the provision of health care. Liberal Education and Nursing Practice Discussion

The academic setting provides a forum for contemplating physical, psychological, social, cultural, behavioral, ethical, and spiritual problems within and across disciplines. Faculty have a responsibility to facilitate the translation of knowledge from a liberal education base into the practice of nursing. Nursing faculty introduce nursing science and theories, and guide the student in developing an understanding of the discipline of nursing’s distinctive perspective. Liberal Education and Nursing Practice Discussion

Baccalaureate­prepared nurses provide patient­centered care that identifies, respects, and addresses patients’ differences, values, preferences, and expressed needs (IOM, 2003a). Patient­centered care also involves the coordination of continuous care, listening to, communicating with, and educating patients and caregivers regarding health, wellness, and disease management and prevention. The generalist nurse provides the human link between the healthcare system and the patient by translating the plan of care to the patient. A broad­based skill set is required to fill this human interface role.

Patient­ centered care also requires the development of a nurse­patient partnership. Patients, as consumers of healthcare services, and as integral members of the healthcare team, have an increasing role and responsibility for the mutual planning of care and healthcare decision making.

The fundamental aspects of generalist nursing practice are: direct care of the sick in and across all environments, health promotion and clinical prevention, and population­based health care. A defining feature of professional nursing practice is the focus on health promotion and risk reduction.

Advances in science and technology will continue to emerge, which will help to predict future health problems. Nurses will design and implement measures to modify risk factors and promote healthy lifestyles. These same advances in science and technology also have allowed individuals to live longer and often with increasing numbers of chronic illnesses and conditions. With an increasing emphasis on cost­savings and cost­benefits, nurses will play a leading role in the provision of care. Liberal Education and Nursing Practice Discussion

Assumptions

The baccalaureate generalist graduate is prepared to:

  • practice from a holistic, caring framework;
  • practice from an evidence base;
  • promote safe, quality patient care;
  • use clinical/critical reasoning to address simple to complex situations;
  • assume accountability for one’s own and delegated nursing care;
  • practice in a variety of healthcare settings;
  • care for patients across the health­illness continuum;
  • care for patients across the lifespan;
  • care for diverse populations;
  • engage in care of self in order to care for others; and
  • engage in continuous professional
Roles For the Baccalaureate Generalist Nurse

Baccalaureate Generalist nurses are providers of direct and indirect care. In this role, nurses are patient advocates and educators. Historically, the nursing role has emphasized partnerships with patients – whether individuals, families, groups, communities, or populations – in order to foster and support the patient’s active participation in determining healthcare decisions. Patient advocacy is a hallmark of the professional nursing role and requires that nurses deliver high quality care, evaluate care outcomes, and provide leadership in improving care. Liberal Education and Nursing Practice Discussion

Changing demographics and ongoing advances in science and technology are a reality of healthcare practice. The generalist nurse provides evidence­based care to patients within this changing environment. This clinician uses research findings and other evidence in designing and implementing care that is multi­dimensional, high quality, and cost­ effective.

The generalist nurse also is prepared for the ethical dilemmas that arise in practice and will be able to make and assist others in making decisions within a professional ethical framework. Understanding advances in science and technology and the influence these advances have on health care and individual well­being is essential. Understanding patients and the values they bring to the healthcare relationship is equally important.

The generalist nurse practices from a holistic, caring framework. Holistic nursing care is comprehensive and focuses on the mind, body, and spirit, as well as emotions. The generalist nurse recognizes the important distinction between disease and the individual’s illness experience. Assisting patients to understand this distinction is an important aspect of nursing. In addition, nurses recognize that determining the health status of the patient within the context of the patient’s values is essential in providing a framework for planning, implementing, and evaluating outcomes of care. Liberal Education and Nursing Practice Discussion

The generalist nurse provides care in and across all environments. Nurses focus on individual, family, community, and population health care, as they monitor and manage aspects of the environment to foster health.

Baccalaureate generalist nurses are designers, coordinators, and managers of care. The generalist nurse, prepared at the baccalaureate­degree level, will have the knowledge and authority to delegate tasks to other healthcare personnel, as well as to supervise and evaluate these personnel. As healthcare providers who function autonomously and interdependently within the healthcare team, nurses are accountable for their professional practice and image, as well as for outcomes of their own and delegated nursing care. Liberal Education and Nursing Practice Discussion

Nurses are members of healthcare teams, composed of professionals and other personnel that deliver treatment and services in complex, evolving healthcare systems. Nurses bring a unique blend of knowledge, judgment, skills, and caring to the healthcare team.

Baccalaureate generalist nurses are members of the profession and in this role are advocates for the patient and the profession. The use of the term “professional” implies the formation of a professional identity and accountability for one’s professional image. As professionals, nurses are knowledge workers who use a well­delineated and broad knowledge base for practice. Professional nursing requires strong critical reasoning, clinical judgment, communication, and assessment skills. Liberal Education and Nursing Practice Discussion

The professional nurse also requires the development and demonstration of an appropriate set of values and ethical framework for practice. As advocates for high quality care for all patients, nurses are knowledgeable and active in the policy processes defining healthcare delivery and systems of care. The generalist nurse also is committed to lifelong learning, including career planning, which increasingly will include graduate level study. Liberal Education and Nursing Practice Discussion

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