What nursing is
Nursing combines science, skill, and care. Nurses are the largest group of health professionals and the ones patients see most. For study only, not clinical guidance: always follow your programme, current local protocols, and supervising clinicians.
Defining nursing
Nursing protects, promotes, and optimises health; prevents illness and injury; helps people cope with illness; and advocates for patients, families, and communities. Nurses care for the whole person (physical, emotional, social, and spiritual needs), not just the disease.
Florence Nightingale and nursing history
Florence Nightingale is often called the founder of modern nursing. During the Crimean War in the 1850s, she improved sanitation in military hospitals and used statistics, including her famous polar-area diagrams, to show that most soldiers died of preventable disease. She founded a nursing school at St Thomas' Hospital in London in 1860.
Educational pathways
In the United States, registered nurses (RNs) qualify through an associate degree (ADN) or a bachelor's degree (BSN) and must pass the NCLEX-RN licensing exam. Licensed practical or vocational nurses (LPN/LVN) complete shorter programmes and pass the NCLEX-PN. Advanced practice registered nurses (APRNs), such as nurse practitioners, hold graduate degrees.
Scope of practice
Scope of practice defines what a nurse is legally allowed to do, set by each state's nurse practice act and board of nursing. Nurses must work within their scope, their institution's policies, and their own competence. Delegating tasks to assistive personnel requires judging whether the task, situation, and person are appropriate.
Professional ethics
Nursing ethics rests on principles such as autonomy (respecting patients' right to decide), beneficence (doing good), non-maleficence (avoiding harm), justice (fairness), fidelity (keeping promises), and veracity (truthfulness). The American Nurses Association Code of Ethics guides professional conduct.
Legal responsibilities
Nurses are accountable for their actions. Negligence is failing to provide the standard of care a reasonable nurse would; malpractice is professional negligence causing harm. Key protections include informed consent (obtained by the provider, often witnessed by the nurse), patient confidentiality under laws such as HIPAA, and accurate documentation.
Nursing theories
Nursing theories describe what nursing is and how it should be practised. Examples include Nightingale's environmental theory, Virginia Henderson's 14 basic needs, Dorothea Orem's self-care deficit theory, and Jean Watson's theory of human caring. They shape how nurses think about patients and care.
Worked example
A nursing assistant asks a nurse whether she can assess a new patient's breathing difficulties. Assessment of an unstable patient requires nursing judgement and is within the RN's scope, not the assistant's. The nurse assesses the patient herself and may delegate stable tasks, such as measuring routine vital signs on stable patients, to the assistant.
Key takeaways
Nursing promotes health, prevents illness, relieves suffering, and advocates for patients, caring for the whole person. Nightingale pioneered sanitation and statistics. RNs qualify through ADN or BSN and the NCLEX. Scope of practice is set by state law. Ethics include autonomy, beneficence, non-maleficence, justice, fidelity, and veracity. Nurses must protect consent, confidentiality, and documentation.
Flashcard
Protects health, prevents illness, advocates
Check your understanding
A patient refuses a recommended procedure after being fully informed. Respecting this decision reflects which principle?