NURSING AS A PROFESSION SCIENCE AND ART OF NURSING PRACTICE BENNER: FROM NOVICE TO EXPERT SCOPE AND STANDARDS OF PRACTICE ANA STANDARDS OF NURSING PRACTICE STANDARDS OF PROFESSIONAL NURSING PRACTICE STANDARDS OF PROFESSIONAL PERFORMANCE ANA STANDARDS OF PROFESSIONAL PERFORMANCE CODE OF ETHICS PROFESSIONAL RESPONSIBILITIES AND ROLES

1. REFERENCE: Fundamentals of Nursing 10TH EDITION, 2021
(Hall, Amy M. Perry, Anne Griffin Potter etc.)
UNIT 1. NURSING AND THE HEALTH CARE ENVIRONMENT
A. NURSING TODAY
NURSING AS A PROFESSION
Nursing is a career. There is no single factor that distinguishes a job from a profession, but
the distinction is significant in terms of how you practice. Use your critical thinking skills to
provide quality evidence-based, patient-centered care in a safe, prudent, and
knowledgeable manner to act professionally. You are accountable to yourself, your
patients, and your colleagues.
Nursing offers a wide range of career options, including clinical practice, education,
research, management, administration, and even entrepreneurship are all examples of
occupations.
SCIENCE AND ART OF NURSING PRACTICE
Because nursing is both an art and a science, Nursing practice necessitates a combination
of current knowledge and practice standards, as well as an in-depth and compassionate
approach to your patients' health care needs. To provide the highest level of care, your
care must reflect societal needs and values as well as professional standards of care and
performance, meet the needs of each patient, and integrate evidence-based findings.
BENNER: FROM NOVICE TO EXPERT
NOVICE Beginning nursing student or any nurse entering a situation in which
there is no previous level of experience (e.g., an experienced
operating room nurse chooses to now practice in home health). The
learner learns via a specific set of rules or procedures, which are usually
stepwise and linear.
ADVANCED BEGINNER A nurse who has had some level of experience with the situation. This
experience may be only observational in nature, but the nurse is able
to identify meaningful aspects or principles of nursing care.
COMPETENT A nurse who has been in the same clinical position for 2 to 3 years. This
nurse understands the organization and specific care
required by the type of patients (e.g., surgical, oncology, or orthopedic
patients). He or she is a competent practitioner who is able to
anticipate nursing care and establish long range goals. In this phase
the nurse has usually had experience with all types of psychomotor skills
required by this specific group of patients.
PROFICIENT A nurse with more than 2 to 3 years of experience in the same clinical
position. This nurse perceives a patient’s clinical situation as a whole, is
able to assess an entire situation, and can readily transfer knowledge
gained from multiple previous experiences to a situation. This nurse
focuses on managing care as opposed to managing and performing
skills.

2. Use critical thinking skills to help you acquire and interpret scientific knowledge, integrate clinical
experience knowledge, and become a lifelong learner.
Integrate critical thinking skills into your practice. This includes incorporating knowledge from the
basic sciences and nursing, applying knowledge from previous and current experiences,
implementing critical thinking attitudes in a clinical setting, and implementing intellectual and
professional standards. When you provide well-thought-out care with compassion and care, you
are providing each patient with the best of nursing science and art.
SCOPE AND STANDARDS OF PRACTICE
When giving care, it is essential to provide a specified service according to standards of practice
and to follow a code of ethics. Professional practice includes knowledge from social and
behavioral sciences, biological and physiological sciences, and nursing theories. In addition,
nursing practice incorporates ethical and social values, professional autonomy, and a sense of
commitment and community.
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 response; and
advocacy in the care of individuals, families, communities, and populations. American Nurses
Association (ANA, 2015)
Nursing encompasses autonomous and collaborative care of individuals of all ages, families,
groups, and communities, sick or well, and in all seings. 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
(ICN, 2018)
ANA STANDARDS OF NURSING PRACTICE
ASSESSMENT The registered nurse collects pertinent data and information relative to the
healthcare consumer’s health or the situation.
DIAGNOSIS The registered nurse analyzes the assessment data to determine the actual
or potential diagnoses, problems, and issues.
OUTCOMES
IDENTIFICATION
The registered nurse identifies expected outcomes for a plan individualized
to the health care consumer or the situation.
PLANNING The registered nurse develops a plan that prescribes strategies to attain
expected, measurable outcomes.
IMPLEMENTATION The registered nurse implements the identified plan.
a. Coordination of Care: The registered nurse coordinates care
delivery.
EXPERT A nurse with diverse experience who has an intuitive grasp of an existing
or potential clinical problem. This nurse is able to zero in on the problem
and focus on multiple dimensions of the situation. He or she is skilled at
identifying both patient-centered problems and problems related to
the health care system or perhaps the needs of the novice nurse.

3. b. Health Teaching and Health Promotion: The registered nurse
employs strategies to promote health and a safe environment.
EVALUATION The registered nurse evaluates progress toward attainment of outcomes.
STANDARDS OF PROFESSIONAL NURSING PRACTICE
The Standards of Professional Nursing Practice contain authoritative statements of the duties that
all registered nurses are expected to perform competently, regardless of role, population, or
specialty. The responsibilities are backed up by a critical thinking model known as the assessment,
diagnosis, outcome identification and planning, implementation, and evaluation are all part of
the nursing process. The nursing process serves as a model for clinical decision making and
encompasses all significant actions taken by nurses in providing patient care.
STANDARDS OF PROFESSIONAL PERFORMANCE
The ANA Standards of Professional Performance define a competent level of professional
behavior. The standards provide a method to ensure that patients receive high-quality care and
that nurses understand exactly what is required to provide nursing care. The standards are also in
place to determine whether nursing care meets the requirements.
ANA STANDARDS OF PROFESSIONAL PERFORMANCE
1. Ethics The registered nurse practices ethically.
2. Culturally
Congruent Care
The registered nurse practices in a manner that is congruent with
cultural diversity and inclusion principles.
3. Communication The registered nurse communicates effectively in all areas of
practice.
4. Collaboration The registered nurse collaborates with health care consumer and
other key stakeholders in the conduct of nursing practice.
5. Leadership The registered nurse demonstrates leadership in the professional
practice seing and the profession.
6. Education The registered nurse seeks knowledge and competency that reflects
current nursing practice and promotes futuristic thinking.
7. Evidence-Based
Practice and
Research
The registered nurse integrates evidence and research findings into
practice.
8. Quality of Practice The registered nurse contributes to quality
nursing practice.
9. Professional
Practice Evaluation
The registered nurse evaluates one’s own and others’ nursing
practice.
10. Resources Utilization The registered nurse uses appropriate resources to plan and provide
and sustain evidence-based nursing services that are safe, effective,
and fiscally responsible.
11. Environmental
Health
The registered nurse practices in an environmentally safe and healthy
manner.
Copyright© American Nurses Association: Nursing scope and standards of practice, ed 3, Silver Springs, MD, 2015, The
Association.

4. CODE OF ETHICS
The nursing code of ethics is a statement of philosophical ideals of right and wrong that define the
principles you will use to care for your patients. It is critical that you incorporate your personal
values and ethics into your practice. As you incorporate these values, consider what kind of nurse
you will be and how you will function within the discipline.
PROFESSIONAL RESPONSIBILITIES AND ROLES
AUTONOMY AND
ACCOUNTABILITY
Autonomy is a critical component of professional nursing that entails
initiating independent nursing interventions without the need for medical
orders.
For example, for a patient who has recently undergone major surgery, you
independently administer coughing and deep-breathing exercises to clear
the lungs and enhance oxygenation. A complication occurs as you
continue to care for this patient. You see the patient has a fever and a
yellow-green discharge from the surgical site. You work with other medical
specialists to come up with the best treatment plan for this patient's surgical
wound infection.
Accountability refers to your professional and legal responsibility for the sort
and quality of nursing care you offer. You must keep up to date on nursing
and scientific knowledge, as well as technical abilities.
CAREGIVER As a caregiver, you assist patients in maintaining and regaining health,
managing sickness and symptoms, and achieving a maximum degree of
function and independence as they rehabilitate. You use both physical
and interpersonal abilities to deliver evidence-based nursing care to
facilitate healing. Healing entails more than just improving one's physical
health. You must aid patients by taking steps to restore their emotional,
spiritual, and social well-being. As a caregiver, you assist the patient and
family in setting goals and achieving them with minimal financial, time, and
energy expenditure.
ADVOCATE As a patient advocate, you safeguard your patient's human and legal
rights and aid them in asserting them if necessary. As an advocate, you
represent your patient and protect their health-care rights.
For instance, you might provide further information to assist a patient in
deciding whether or not to accept a treatment, or you might locate an
interpreter to assist family members in communicating their concerns. You
may need to speak out against policies or actions that put patients in
danger or clash with their rights to make health-care decisions on a more
general level.
EDUCATOR As an educator, you will teach health concepts and facts, clarify the
purpose of routine care activities, demonstrate procedures such as self-
care activities, reward learning or patient behavior, and evaluate the
patient's learning progress.

5. COMMUNICATOR The nurse-patient connection depends on a good communicator. It
enables you to learn about your patients' preferences, strengths,
limitations, and requirements.
MANAGER To offer safe, high-quality care with favorable patient outcomes, nurse
managers must create a collaborative patient-centered care
environment.
A manager oversees the operations of members of the nursing staff in
providing nursing care and is responsible for the personnel, policies, and
budget of a particular nursing unit or organization. A manager employs the
right leadership styles to create a nursing environment for patients and staff
that matches the health care organization's mission and values.
CAREER
DEVELOPMENT
New nursing jobs have been established as a result of health-care
innovations, expanding health-care systems and practice settings, and
increased patient needs. The nursing profession offers a variety of career
prospects due to increased educational opportunities for nurses, the
growth of nursing as a profession, and a growing focus for job enrichment.
PROVIDER OF
CARE
An increased need for community-based health promotion activities,
restorative care, and end-of-life care, as well as an increase in direct care
activities given in the home care setting Educate your patients and their
families on how to be healthy and practice self-care. Focus your care, in
collaboration with other members of the health-care team, on returning a
patient to his or her home in the best possible condition.
ADVANCED
PRACTICE
REGISTERED
NURSES
The advanced practice registered nurse (APRN) is the most self-sufficient
nurse. An APRN holds a master's or Doctor of Nursing Practice (DNP) degree
in nursing, as well as advanced training in pathophysiology,
pharmacology, and physical assessment, as well as certification and
expertise in a specialized area of practice.
4 roles
− Clinical Nurse Specialist (CNS)
− Nurse Practitioner (NP)
− Certified Nurse Midwife (CNM)
− Certified Registered Nurse Anesthetist (CRNA)
NURSE EDUCATOR
Nurse educators work largely in nursing schools, health-care staff
development departments, and patient education departments. Nurse
educators require clinical experience in order to equip them with practical
skills and theoretical knowledge.
Nurse educators work in health care facilities' staff development divisions
to deliver educational programs for nurses. New employee orientation,
critical care nursing courses, assistance with clinical skill competency,
safety training, and learning about new equipment or procedures are all
part of these programs. Nursing educators are frequently involved in the
creation of nursing policies and procedures.
The major goal of a nurse educator at a patient education department of
an organization like a wound treatment clinic is to teach and coach
patients and their families how to self-manage their sickness or disability
and make positive choices or changes in their behaviors to improve their
health.

6. NURSE
ADMINISTRATOR
Within a health care agency, a nurse administrator oversees patient care
and the delivery of specific nursing services. Clinical care coordinators are
among the first positions in nursing administration. Experience and extra
education can lead to a middle-management job like nurse manager of
a specific patient care area or house supervisor, as well as an upper-
management role like associate director or director of nursing services.
NURSE
RESEARCHER
The nurse researcher engages in evidence-based practice and research
in order to enhance nursing care and to further define and broaden the
scope of nursing practice.
A doctoral degree is recommended, but a master's degree in nursing is
acceptable