QUESTION 81. b. The percentage of false positive ?Outside hospitals, trained nurses quickly beca

QUESTION 81. b. The percentage of false positive ?Outside hospitals, trained nurses quickly became critical in the fight against infectious diseases. In the early 20th century, the newly discovered “germ theory” of disease (the knowledge that many illnesses were caused by bacteria) caused considerable alarm in countries around the world. Teaching methods of preventing the spread of diseases, such as tuberculosis, pneumonia, and influenza, became the domain of the visiting nurses in the United States and the district nurses in the United Kingdom and Europe. These nurses cared for infected patients in the patients’ homes and taught families and communities the measures necessary to prevent spreading the infection. They were particularly committed to working with poor and immigrant communities, which often had little access to other health care services. The work of these nurses contributed to a dramatic decline in the mortality and morbidity rates from infectious diseases for children and adults.At the same time, independent contractors called private-duty nurses cared for sick individuals in their homes. These nurses performed important clinical work and supported families who had the financial resources to afford care, but the unregulated health care labour market left them vulnerable to competition from both untrained nurses and each year’s class of newly graduated trained nurses. Very soon, the supply of private-duty nurses was greater than the demand from families. At the turn of the 20th century, nurses in industrialized countries began to establish professional associations to set standards that differentiated the work of trained nurses from both assistive-nursing personnel and untrained nurses. More important, they successfully sought licensing protection for the practice of registered nursing. Later on, nurses in some countries turned to collective bargaining and labour organizations to assist them in asserting their and their patients’ rights to improve conditions and make quality nursing care possible.By the mid-1930s the increasing technological and clinical demands of patient care, the escalating needs of patients for intensive nursing, and the resulting movement of such care out of homes and into hospitals demanded hospital staffs of trained rather than student nurses. By the mid-1950s hospitals were the largest single employer of registered nurses. This trend continues, although as changes in health care systems have reemphasized care at home, a proportionately greater number of nurses work in outpatient clinics, home care, public health, and other community-based health care organizations.Other important changes in nursing occurred during the latter half of the 20th century. The profession grew more diverse. For example, in the United States, the National Organization of Coloured Graduate Nurses (NOCGN) capitalized on the acute shortage of nurses during World War II and successfully pushed for the desegregation of both the military nursing corps and the nursing associations. The American Nurses Association (ANA) desegregated in 1949, one of the first national professional associations to do so. As a result, in 1951, feeling its goals fulfilled, the NOCGN dissolved. But by the late 1960s some African American nurses felt that the ANA had neither the time nor the resources to adequately address all their concerns. The National Black Nurses Association (NBNA) formed in 1971 as a parallel organization to the ANA.Nursing’s educational structure also changed. Dependence on hospital-based training schools declined, and those schools were replaced with collegiate programs either in community or technical colleges or in universities. In addition, more systematic and widespread programs of graduate education began to emerge. These programs prepare nurses not only for roles in management and education but also for roles as clinical specialists and nurse practitioners. Nurses no longer had to seek doctoral degrees in fields other than nursing. By the 1970s nurses were establishing their own doctoral programs, emphasizing the nursing knowledge and science and research needed to address pressing nursing care and care-delivery issues.During the second half of the 20th century, nurses responded to rising numbers of sick patients with innovative reorganizations of their patterns of care. For example, critical care units in hospitals began when nurses started grouping their most critically ill patients together to provide more effective use of modern technology. In addition, experiments with models of progressive patient care and primary nursing reemphasized the responsibility of one nurse for one patient in spite of the often-overwhelming bureaucratic demands by hospitals on nurses’ time.The nursing profession also has been strengthened by its increasing emphasis on national and international work in developing countries and by its advocacy of healthy and safe environments. The international scope of nursing is supported by the World Health Organization (WHO), which recognizes nursing as the backbone of most health care systems around the world.The practice of nursingAccording to the International Council of Nurses (ICN), the scope of nursing practice “encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings.” National nursing associations further clarify the scope of nursing practice by establishing particular practice standards and codes of ethics. National and state agencies also regulate the scope of nursing practice. Together, these bodies set forth legal parameters and guidelines for the practice of nurses as clinicians, educators, administrators, or researchersNurses enter practice as generalists. They care for individuals and families of all ages in homes, hospitals, schools, long-term-care facilities, outpatient clinics, and medical offices. Many countries require three to four years of education at the university level for generalist practice, although variations exist. For example, in the United States, nurses can enter generalist practice through a two-year program in a community college or a four-year program in a college or university.Preparation for specialization in nursing or advanced nursing practice usually occurs at the master’s level. A college or university degree in nursing is required for entrance to most master’s programs. These programs emphasize the assessment and management of illnesses, pharmacology, health education, and supervised practice in specialty fields, such as pediatrics, mental health, women’s health, community health, or geriatrics.Research preparation in nursing takes place at the doctoral level. Coursework emphasizes nursing knowledge and science and research methods. An original and substantive research study is required for completion of the doctoral degree.Hospital nursing is perhaps the most familiar of all forms of nursing practice. Within hospitals, however, there are many different types of practices. Some nurses care for patients with illnesses such as diabetes or heart failure, whereas others care for patients before, during, and after surgery or in pediatric, psychiatric, or childbirth units. Nurses work in technologically sophisticated critical care units, such as intensive care or cardiac care units. They work in emergency departments, operating rooms, and recovery rooms, as well as in outpatient clinics. The skilled care and comfort nurses provide patients and families are only a part of their work. They are also responsible for teaching individuals and families ways to manage illnesses or injuries during recovery at home. When necessary, they teach patients ways to cope with chronic conditions. Most hospital-based nurses are generalists. Those with advanced nursing degrees provide clinical oversight and consultation, work in management, and conduct patient-care research.Community health nursing incorporates varying titles to describe the work of nurses in community settings. Over the past centuries and in different parts of the world, community health nurses were called district nurses, visiting nurses, public health nurses, home-care nurses, and community health nurses. Today community health nursing and public health nursing are the most common titles used by nurses whose practices focus on promoting and protecting the health of populations. Knowledge from nursing, social, and public health sciences informs community health nursing practices. In many countries, ensuring that needed health services are provided to the most vulnerable and disadvantaged groups is central to community health nursing practice. In the United States, community health nurses work in a variety of settings, including state and local health departments, school health programs, migrant health clinics, neighbourhood health centres, senior centres, occupational health programs, nursing centres, and home care programs. Care at home is often seen as a preferred alternative for caring for the sick. Today home-care nurses provide very sophisticated, complex care in patients’ homes. Globally, home care is being examined as a solution to the needs of the growing numbers of elderly requiring care.Mental health (or psychiatric) nursing practice concentrates on the care of those with emotional or stress-related concerns. Nurses practice in inpatient units of hospitals or in outpatient mental health clinics, and they work with individuals, groups, and families. Advanced-practice mental health nurses also provide psychotherapy to individuals, groups, and families in private practice, consult with community organizations to provide mental health support, and work with other nurses in both inpatient and outpatient settings to meet the emotional needs of patients and families struggling with physical illnesses or injuries.on the care of infants, children, and adolescents. The care of families, the most important support in childrens’ lives, is also a critically important component of the care of children. Pediatric nurses work to ensure that the normal developmental needs of children and families are met even as they work to treat the symptoms of serious illnesses or injuries. These nurses also work to promote the health of children through immunization programs, child abuse interventions, nutritional and physical activity education, and health-screening initiatives. Both generalist and specialist pediatric nurses work in hospitals, outpatient clinics, schools, day-care centres, and almost anywhere else children are to be found.The care of women, especially of childbearing and childrearing women (often called maternal-child nursing), has long been a particular nursing concern. As early as the 1920s, nurses worked with national and local governments, private charities, and other concerned professionals to ensure that mothers and children received proper nutrition, social support, and medical care. Later, nurses began working with national and international agencies to guarantee rights to adequate health care, respect for human rights, protection against violence, access to quality reproductive health services, and nutritional and educational support. Generalist and specialist nurses caring for women work on obstetrical and gynecological units in hospitals and in a variety of outpatient clinics, medical offices, and policy boards. Many have particular expertise in such areas as osteoporosis, breast-feeding support, domestic violence, and mental health issues of women.1. d. The predictive value of a positive test. ?1. e. The predictive value of a negative test. ?  Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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