Chapter 1

Professional Nursing

KEY POINTS

PROFESSIONAL Nursing practice

• Nursing focuses on the (1) protection, promotion, and optimization of health and

abilities; (2) prevention of illness and injury; (3) facilitation of healing; and (4)

alleviation of suffering through compassionate presence. Nursing is the diagnosis of and

treatment of human responses and advocacy in the care of individuals, families,

communities, and populations.

• Nurses offer skilled care to those recuperating from illness or injury, advocate for

patients’ rights, teach patients to manage their own health, support patients and

caregivers at critical times, and help them navigate the complex health care system.

• A number of nursing organizations offer certification in nursing specialties, such as

critical care, geriatric, emergency, psychiatric and mental health, and community health

nursing.

• Entry-level nurses with an associate or baccalaureate degree in nursing are prepared to

function as generalists. With additional preparation, nurses can assume roles such as

clinical nurse specialist or nurse practitioner.

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INFLUENCES ON NURSING

• Ever changing technology and rapidly expanding knowledge add to the complexity of

health care. The increasing diversity of the population and the healthcare environment

directly influence nursing practice. Many patients today are engaged in their healthcare.

• Because nurses play such a vital role in providing safe care, major nursing organizations

develop standards of practice, lobby for legislation and regulations, develop strategies to

prevent errors, and address nursing issues that affect patient safety.

PATIENT-CENTERED CARE

• Nurses have long shown that they deliver compassionate and coordinated care based on

each patient’s unique needs and with respect for the patient’s preferences, values, and

needs.

• Nurses use clinical judgment to make decisions that lead to the best patient outcomes.

Clinical judgment is the ability to make decisions and solve problems by making sense of

information in a situation through using your nursing knowledge.

• The nursing process is a problem-solving approach to the identification and treatment of

patient problems that is the foundation of nursing practice. The 5 phases of the nursing

process are assessment, diagnosis, planning, implementation, and evaluation.

• Nursing care is delivered using a variety of models. The nurse’s role in most cases is one

of interdependence and co-participation with the patient and other health care team

members.

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 • Four spheres of care describe the healthcare needs of individuals, families, and

populations and the care and services required to address these needs and promote health.

• Caregivers play a valuable role in the patient’s health and well-being and are members of

the health care team. They often need our guidance and support as well as information

and access.

Interprofessional Partnerships

• To collaborate effectively with members of the interprofessional team, you must be

aware of the knowledge and skills of other team members and be able to communicate

effectively with them.

• Delegation of nursing interventions to licensed practical nurses/licensed vocational

nurses (LPN/VNs) and assistive personnel (AP) is an important function of the

professional nurse.

• Assignment is the distribution of work that each staff member is responsible for during a

given work period. Assignments occur when the nurse directs other nurses, LPN/VNs,

and AP to perform care that is within their routine function.

• Supervision includes guidance and direction, oversight, evaluation, and follow-up by the

RN. When you delegate, you are responsible for supervision of AP or LPN/VNs.

• Effective communication is key to fostering teamwork and coordinating care.

Information must be clearly and accurately exchanged among team members to avoid

breakdowns in communication. A variety of methods, including SBAR, huddles, and

CUS, offer a structured way to discuss patient care among team members.

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 • Using a formal patient handoff can enhance communication during transitions of care. It

should include information about the patient’s condition and any recent or anticipated

changes. There should be an opportunity to ask questions and a way to confirm

information, such as read-back.

Safety and Quality

• Quality and safety are interrelated; the higher the culture of safety, the better the quality

of care.

• By implementing various procedures and systems to improve communication and health

care delivery to meet safety goals, health care systems create a culture of safety that

minimizes the risk of harm to the patient.

• Nurses are a vital part of promoting this culture of safety by providing care in a manner

that reduces errors and actively promotes patient safety.

 The nurse’s role in quality improvement is to coordinate the complex aspects of patient

care, including the care delivered by others, and identify and correct issues associated

with poor quality and unsafe care.

• The National Database of Nursing Quality Indicators provides data on nursing-sensitive

patient outcomes. Patient outcomes are nursing sensitive if they improve with a greater

quantity or quality of nursing care.

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Informatics and Healthcare Technology

• All nurses use informatics every day in practice. Information technology has changed

how you obtain and review diagnostic information, make clinical decisions, communicate

with patients and health care team members, document, and provide care.

• As a nurse, you must be able to help patients access and use appropriate health

information and to evaluate information as it relates to your own practice.

Evidence-Based Practice

• Evidence-based practice (EBP) is a problem-solving approach to clinical decision

making that involves the use of the best available evidence in combination with clinician

expertise and patient preferences and values to achieve desired patient outcomes.

• EBP is a process that involves finding, examining, and using research conducted by

others in efforts to answer a specific clinical question.

Copyright © 2027 by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and
similar technologies.