From Novice to Expert: Excellence and Power in Clinical Nursing Practice, Volume 100

Front Cover
Addison-Wesley Publishing Company, Nursing Division, 1984 - Medical - 307 pages
Preface 1 Uncovering the Knowledge Embedded in Clinical Nursing Practice Differences between Practical and Theoretical Knowledge Knowledge Embedded in Expertise Extending Practical Knowledge Common Meanings Assumptions, Expectations, and Sets Paradigm Cases and Personal Knowledge Maxims Unplanned Practices Summary and Conclusions 2 The Dreyfus Model of Skill Acquisition Applied to Nursing Methods Interpretation of Data Stage 1: Novice Stage 2: Advanced Beginner Stage 3: Competent Stage 4: Proficient Stage5: Expert The Meaning of Experience 3 An Interpretive Approach to Identifying and Describing Clinical Knowledge Performance Measurements Identifying Domains and Competencies Summary Domains of Nursing Practice 4 The Helping Role The Healing Relationship: Creating a Climate for and Establishing a Commitment to Healing Providing Comfort Measures and Preserving Personhood in the Face of Pain and Extreme Breakdown Presencing: Being with a Patient Maximizing the Patient's Participation and Control in His or Her Own Recovery Interpreting Kinds of Pain and Selecting Appropriate Strategies for Pain Management and Control Providing Comfort and Communication Through Touch Providing Emotional and Informationa[ Support to Patients' Families Guiding Patients Through Emotional and Developmental Change Summary and Conclusions 5 The TeachingCoaching Function Timing: Capturing a Patient's Readiness to Learn Assisting Patients to Integrate the Implications of Illness and Recovery into Their Lifestyles Eliciting and Understanding the Patient's Interpretation of His Illness Providing an Interpretation of the Patient's Condition and Giving a Rationale for Procedures The Coaching Function: Making Culturally Avoided Aspects of an Illness Approachable and Understandable Summary and Conclusions 6 The Diagnostic and Monitoring Function Detection and Documentation of Significant Changes in a Patient's Condition Providing an Early Warning Signal: Anticipating Breakdown and Deterioration Prior to Explicit Confirming Diagnostic Signs Anticipating Problems: Future Think Understanding the Particular Demands and Experiences of an Illness: Anticipating Patient Care Needs Assessing the Patient's Potential for Wellness and for Responding to Various Treatment Strategies Summary and Conclusions 7 Effective Management of Rapidly Changing Situations Skilled Perforrnace in Extreme Life-Threatening Emergencies: Rapid Grasp of a Problem Contingency Management: Rapid Matching of Demands and Resources in Emergency Situations Identifying and Managing a Patient Crisis Until Physician Assistance Is Available Summary and Conclusions 8 Administering and Monitoring Therapeutic Interventions and Regimens Starting and Maintaining Intravenous Therapy with Minimal Risk and Complications Administering Medications Accurately and Safely Combating the Hazards of Immobility Creating a Wound-Management Strategy that Fosters Healing, Comfort, and Appropriate Drainage Summary and Conclusions 9 Monitoring and Ensuring The Quality of Health Care Practices Providing a Backup System to Ensure Safe Medical and Nursing Care Assessing What Can Be Safely Ommitted From or Added to Medical Orders Getting Appropriate and Timely Responses from Physicians Summary and Conclusions 10 Organizational and Work-Role Competencies Coordinating, Ordering, and Meeting Multiple Patient Needs and Requests: Setting Priorities Building and Maintaining a Therapeutic Team to Provide Optimum Therapy Coping with Staff Shortages and High Turnover Summary and Conclusions 11 Implications for Research and Clinical Practice Involvement versus Distance NursePatient Relationships Early Warning Signals Outside the Boundaries of Nursing Monitoring and Organizational Skills The Phenomenon of Caring 12 Implications for Career Development and Education Career Development Nursing Education 13 The Quest for a New Identity and New Entitlement in Nursing Meaningful Incentives and Reward Systems A Clinical Promotion System Increased Collaborative Relationships Increased Recognition 14 Excellence and Power in Clinical Nursing Practice Transformative Power Integrative Caring Advocacy Healing Power Participative/Affirmtive Power Problem Solving Epilogue Practical Applications Research Application: Identifying the Use and Misuse of Formal Models in Nursing Practice Implementation of Staff Nurse III at El Canmino Hospital Focus on excellence Identification of the Skilled Performance of Masters Prepared Nurses as a Method of Curriculum Planning and Evaluation Building Bridges Between Education and Practice References Glossary Appendix Index.

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Contents

Uncovering the Knowledge
1
The Dreyfus Model of Skill
13
An Interpretive Approach
38
Copyright

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