Term
| How many questions should you have for each interview at a minimum? |
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Definition
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Term
| What are appropriate questions to ask? |
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Definition
May I see the job description?
How many pt's on unit?
How many patients will I be responsible for ?
What will my scheduled shift be ? |
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Term
| Name the four phases of 'Reality Shock' |
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Definition
Honeymoon phase
Shock or rejection phase
Recovery phase
Resolution phase |
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Term
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Definition
| The merging of school values with those of the workplace. |
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Term
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Definition
| The gradual decline of compassion over time as a result of caregivers being exposed to events that have traumatized their patients. |
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Term
| Horizontal hostility (also known as lateral hostility) |
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Definition
| “A consistent (hidden) pattern of behavior designed to control, diminish, or devalue another peer [or group] that creates a risk to health and/or safety” |
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Term
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Definition
| A mutual interactive method of learning in which a knowledgeable nurse inspires and encourages a novice nurse. |
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Term
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Definition
| A nurse who is entering the professional workplace for the first time; usually occurs from the point of graduation until competencies required by the profession are achieved. |
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Term
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Definition
| An experienced professional nurse who serves as a mentor and assists with socialization of the novice nurse. |
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Term
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Definition
| Occurs when a person prepares for a profession, enters the profession, and then finds that he or she is not prepared. |
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Term
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Definition
| A person who serves as an example of what constitutes a competent professional nurse. |
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Term
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Definition
| The nurturing, acceptance, and integration of a person into the profession of nursing; the identification of a person with the profession of nursing. |
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Term
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Definition
| Moving from one role, setting, or level of competency in nursing to another; change. |
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Term
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Definition
| Sexual harassment and abusive acts from patients that can be physical, verbal, and emotional and lead to a hostile work environment. It has been suggested that identifying workplace violence is difficult due to its subjectivity by the recipient. |
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Term
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Definition
| Reality shock occurs in novice nurses when they become aware of the inconsistency between the actual world of nursing and that of nursing school. As the novice nurse enters the new profession, reality shock begins. |
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Term
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Definition
| leads to stress (Bowles and Candela, 2005), which can threaten the well-being of new nurses resulting in physical illness and mental exhaustion, leading to disillusionment with their career (Hertel, 2009) and ultimately absenteeism and turnover (Jennings, 2008). There are four phases of reality shock: honeymoon, shock or rejection, recovery, and resolution. |
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Term
| Name the four phases of reality shock: |
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Definition
| honeymoon, shock or rejection, recovery, and resolution. |
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Term
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Definition
| During the honeymoon phase everything is just as the new graduate imagined. The new nurse is in orientation with former school friends or other new graduates who often share similarities. Many novice nurses in this phase are heard making the following comments: “Just think, now I'll get paid for making all those beds” and “I'm so glad I chose nursing; I will be a part of changing the future of health care.” |
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Term
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Definition
| Then orientation is over, and the novice nurse begins work on his or her assigned unit. This nurse receives daily assignments and begins the tasks. “But wait. I've only observed other nurses hanging blood. Where is my instructor?” Now the shock or rejection phase comes into play. The nurse comes into contact with conflicting viewpoints and different ways of performing skills, but lacks the security of having an expert available to explain uncertain or gray areas. The security of saying, “I am just the student nurse,” is no longer valid. During this phase, the novice nurse may be frightened or react by forming a hard, cold shell around him or herself. Vague feelings of discomfort are experienced, and the inexperienced nurse often wonders whether the other nurses care about the patients. After going home from a shift, the new nurse may experience feelings of rejection and a sense of lack of accomplishment. The novice nurse may reject the new environment and have a preoccupation with the past when he or she was in school. A need to contact former instructors, call schoolmates, or visit the nursing school may occur. Others may reject their school values and adopt the values of the organization. In this way, they may experience less conflict (Kramer, 1974); however, there are drawbacks to this approach as well. |
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Term
| Name eight of the negative responses to the 'Shock' or 'Rejection' phase: |
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Definition
| Natives, Runaways, Rutters, Burned Out, Compassion Fatigue, Loners,New Nurse on the Block, Change Agents |
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Term
| What is usually the first sign of the 'Recovery Phase' ? |
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Definition
| The return of humor usually is the first sign of the recovery phase. The novice nurse begins to understand the new culture to a certain degree. There is less tension and anxiety, and healing begins. The nurse in this phase may comment, “I'll hang that blood, and I'll bet I can infuse it before 8 hours this time.” |
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Term
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Definition
| Many nurses choose to go “native” (Kramer, 1974, p. 161). That is, they decide they cannot fight the experienced nurses or the administration, thus they adopt the ways of least resistance. These nurses may mimic other nurses on the unit and take shortcuts, such as administering medications without knowing their action and side effects and the associated nursing responsibilities. |
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Term
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Definition
| Others choose to “run away.” They find the real world too difficult. These new nurses may choose another occupation or return to graduate school to prepare for a career in nursing education to teach others their “values in nursing.” |
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Term
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Definition
| Some adopt the attitude that “I'll just do what I have to do to get by,” or “I'm just working until I can buy some new furniture.” These nurses are called “rutters.” They consider nursing just a job. |
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Term
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Definition
| These nurses bottle up conflict until they become burned out. Kramer (1974) describes the appearance of these nurses as having the look of being chronically constipated. In this situation, patients may feel compelled to nurse their nurse. Inexperienced nurses may become burned out because they assume too many responsibilities in a short period of time (Domrose, 2000). Some common symptoms of burnout include extreme fatigue, headaches, difficulty sleeping, mood swings, anxiety, poor work quality, depression, and anger (Larsen, 2000). The more intelligent, hard-working nurses are the most prone for burnout, but if you exhibit these symptoms; remember that they can be reduced. |
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Term
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Definition
| Not to be confused with burnout or transference, compassion fatigue is the gradual decline of compassion over time as a result of caregivers being exposed to events that have traumatized their patients (Figley, 2001). Even experienced nurses, who commonly have a great deal of empathy, working in environments in which patients have suffered trauma, may develop a reaction in which they have a decrease in compassion. Exposure to traumatic events experienced by their patients may result in compassion fatigue. Nurses who work in emotionally charged environments, such as hospice, emergency departments, and mental health settings, are likely to experience this reaction. The compassion fatigue process is depicted in Figure 24-1. |
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Term
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Definition
| These nurses create their own reality. They adopt the attitude of “just do the job and keep quiet.” These nurses may prefer night shifts, during which they often are “left alone.” |
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Term
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Definition
| These nurses change jobs frequently. They go from the hospital setting to community health to the physician's office. They are always new in their setting and therefore adopt the attitude of “teach me what you want; I'm new here.” |
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Term
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Definition
| These are the nurses who care enough to work within the system to elicit change. They frequently visit the nurse manager or head nurse to suggest change or a better way. They keep the welfare of the patient at the forefront. Unfortunately, Kramer refers to these nurses as “bicultural troublemakers” (1974, pp. 91–93). |
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Term
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Definition
| The resolution phase is the result of the shock phase combined with the novice nurse's ability to adjust to the new environment. If the nurse is able to positively work through the rejection phase, he or she grows more fully as a person and a professional nurse during the resolution phase. Work expectations are more easily met, and the nurse will have developed the ability to elicit change. |
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Term
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Definition
| However, nursing is four times more dangerous than most other occupations (Gallant-Roman, 2008), second only to law enforcement in violence at work. |
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Term
| Nurse Recruiting and interviewing |
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Definition
| Appropriate job choice is critically important and can be costly to the new graduate. Accordingly, an ineffective hiring decision can also be expensive for the employer. Some estimate the cost of recruiting, placing, and orienting a new nurse to be from two to two and one half times the average RN salary—but the costs are more than financial (Donna Herrin, personal communication, 2009). Critical to effective selection is high-level nurse leader competency in resource management processes and attention to creation of an effective healthful practice environment. A great decision on the part of the new graduate and the nurse leader will have better outcomes for the individual nurse in areas of job satisfaction and retention and overall organizational outcomes, employee engagement and retention, and patient outcomes. |
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Term
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Definition
| When interviewing for their first positions, novice nurses should determine philosophies of the agencies and how orientation programs assist new nurses to enter the profession. There are many opinions on the best way to accomplish a smooth transition, and each nurse should evaluate orientation options available. |
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Term
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Definition
| Biculturalism is the joining of two contradictory value systems, in this context, those of school values with those of the workplace. Biculturalism is designed to enhance a positive self-image and help novice nurses set realistic goals for practice. This strategy, if accepted in the workplace, allows the new nurse to introduce ideas or values brought from nursing school and integrate them into the work environment. Kramer (1974) suggests that the novice nurse apprise both sides of an issue, determine how his or her behavior will have an effect on other members of the interprofessional health care team, and single out accessible objectives. |
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Term
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Definition
| The merging of school values with those of the workplace. |
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Term
|
Definition
| Occurs when a person prepares for a profession, enters the profession, and then finds that he or she is not prepared. |
|
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Term
|
Definition
| Then orientation is over, and the novice nurse begins work on his or her assigned unit. This nurse receives daily assignments and begins the tasks. “But wait. I've only observed other nurses hanging blood. Where is my instructor?” Now the shock or rejection phase comes into play. The nurse comes into contact with conflicting viewpoints and different ways of performing skills, but lacks the security of having an expert available to explain uncertain or gray areas. The security of saying, “I am just the student nurse,” is no longer valid. During this phase, the novice nurse may be frightened or react by forming a hard, cold shell around him or herself. Vague feelings of discomfort are experienced, and the inexperienced nurse often wonders whether the other nurses care about the patients. After going home from a shift, the new nurse may experience feelings of rejection and a sense of lack of accomplishment. The novice nurse may reject the new environment and have a preoccupation with the past when he or she was in school. A need to contact former instructors, call schoolmates, or visit the nursing school may occur. Others may reject their school values and adopt the values of the organization. In this way, they may experience less conflict (Kramer, 1974); however, there are drawbacks to this approach as well. |
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Term
|
Definition
| The return of humor usually is the first sign of the recovery phase. The novice nurse begins to understand the new culture to a certain degree. There is less tension and anxiety, and healing begins. The nurse in this phase may comment, “I'll hang that blood, and I'll bet I can infuse it before 8 hours this time.” |
|
|
Term
|
Definition
| These are the nurses who care enough to work within the system to elicit change. They frequently visit the nurse manager or head nurse to suggest change or a better way. They keep the welfare of the patient at the forefront. Unfortunately, Kramer refers to these nurses as “bicultural troublemakers” (1974, pp. 91–93). |
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Term
|
Definition
| The resolution phase is the result of the shock phase combined with the novice nurse's ability to adjust to the new environment. If the nurse is able to positively work through the rejection phase, he or she grows more fully as a person and a professional nurse during the resolution phase. Work expectations are more easily met, and the nurse will have developed the ability to elicit change. |
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Term
| Personal protective equipment (PPE) |
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Definition
| Equipment designed to shield or isolate individuals from chemical, physical, and biologic hazards. |
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Term
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Definition
| Activities that build capability and capacity to address potential needs identified by the threat and vulnerability study. |
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Term
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Definition
| Activities designed to return responders and the facility to full normal operational status and to restore fully the capability to respond to future emergencies and disasters; activities traditionally associated with providing federal supplemental disaster relief assistance under a presidential major disaster declaration. These activities usually begin within days after the event and continue after response activity ceases. Recovery includes individual and public assistance programs that provide temporary housing assistance, in addition to grants and loans to eligible individuals and government entities to recover from the effects of a disaster. |
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Term
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Definition
| Level A provides a totally encapsulated chemical resistant suit, including supplied air. As a result, maximum respiratory and skin protection is provided. In addition, this level of equipment is used to provide protection against liquid splashes or in situations in which agents are still unidentified. |
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Term
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Definition
| Level B provides a chemical splash–resistant suit with hood and self-contained breathing apparatus (SCBA). It provides maximum respiratory protection but less skin protection than level A equipment. |
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Term
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Definition
| Level C equipment is chemical-resistant clothing with a hood and an air-purifying respirator. The respirator can remove all anticipated contaminants and concentrations of chemical materials, thus providing adequate protection against airborne biologic agents and radiologic materials. |
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Term
|
Definition
| Level D protection may consist of a uniform or scrubs and is appropriate when it has been determined that no respiratory or skin hazard is present. |
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Term
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Definition
Use: Increases circulation to brain, which may improve cognitive performance in persons with dementia
Cautions: Close monitoring necessary if taken by person using anticoagulant because it can prolong bleeding time; can reduce effectiveness of anticonvulsants. Should not be used by people who have fragile blood vessels and a tendency to easily bleed. |
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Term
| Complementary and alternative medicine (CAM) |
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Definition
| Healing philosophies, practices, and products that are outside of what Western society considers mainstream medicine and are not typically taught in the educational programs of physicians, nurses, and other health professionals. |
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Term
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Definition
| Western style of medicine practiced in the United States; also called allopathic. |
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Term
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Definition
| Qi gong, Reiki, therapeutic touch, healing touch, bioelectromagnetic-based therapies. |
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Term
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Definition
| Limitation of an emergency situation within a well-defined area. |
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Term
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Definition
| The physical process of removing harmful substances from personnel, equipment, and supplies. |
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Term
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Definition
| The act of reviewing the location of an event to look for information that might help to determine treatment options. |
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Term
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Definition
| Process of prioritizing which patients are to be treated first; first action in any disaster response (Veenema, 2007). |
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Term
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Definition
| Another career option is that of telephone triage nurse. In this practice, nurses interact with clients on the telephone to assess needs, intervene, and evaluate. This position requires excellent communication and assessment skills, in addition to problem-solving skills. Telephone triage is used in a variety of settings, including emergency departments and physician practices. |
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Term
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Definition
| The development of processes and tools that increase efficiency and productivity within the set standard of time. |
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Term
| External Time and Energy Distractions |
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Definition
| Interruptions, Socializing or Visitors, Meetings, excessive paperwork, understaffing, lack of information, inneffective communication, lack of feedback, travel, inadequate policies and procedures, incompetent or uncooperative coworkers, poor filing system, looking for misplaced files etc., personnel or coworkers with problems, lack of teamwork, duplicating efforts, (confusing lines of authority, responsibility, and communication), bureaucratic red tape, Junk Mail, waiting, meeting delays. |
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Term
| Internal Time and Energy Distractions |
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Definition
| Procrastination, inadequate planning, ineffective delegation, failure to set goals and priorities, a cluttered desk or mind, personal disorganization, inability to say no, lack of self discipline, responding to crises, haste, indecisiveness, an 'open door' policy, shifting priorities without sound rationale, leaving tasks unfinished, not setting time limits, daydreaming, attempting too much at once, overinvolvement in routine details, making numerous errors, surfing the internet, not listening. |
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Term
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Definition
| The development of processes and tools that increase efficiency and productivity within the set standard of time. |
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Term
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Definition
| This scenario is not uncommon as novice professionals begin the rigors of full-time work after spending time in college and working part time. Key components of successful transition to a productive, highly energizing experience include paying attention to physical energy through a routine of proper eating, adequate sleep and exercise, frequent breaks during long shifts (about every 90 minutes), drinking plenty of water, and focusing on one activity while collecting thoughts about what to prioritize next. Once the physical capacity of your holistic self is working well, then attention can be paid to your mental, spiritual, and emotional capacities. |
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Term
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Definition
| The mental energy that is most potent in ensuring full engagement and high performance is that of realistic optimism. Realistic optimism is seeing the world as it is, but always working toward an optimal solution or goal. Mental energy is the ability to maintain sustained concentration on a task, move flexibly between broad and narrow issues, and be internally and externally focused as needed by the situation. It includes mental preparation, visualization, positive self-talk, effective time management, and creativity. Susan has begun to identify this mental energy in her desire to get back on track. She realizes that change is necessary. To move in this direction Susan needs to spend some time to reflect on the following: (1) What are my major goals in life, and (2) what is my purpose? |
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Term
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Definition
Often we do not take the time to reflect about what is important to us. Being in a quiet place helps us identify our vision of life—our purpose and direction in life. Susan has yet to determine her life vision given her frequent job changes and her lack of clarity about how she wants to spend her personal time. Having direction and purpose is the key factor in one's spiritual capacity.
Peter Senge (1999) has identified “personal mastery” as the discipline of continually clarifying and deepening one's personal vision, focusing one's energies, developing patience, and seeing reality objectively. People with a high level of personal mastery live in a continual learning mode, uncovering their personal growth areas. |
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Term
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Definition
♦“Nothing changes if nothing changes.”
♦“We train people how to treat us.”
♦“Everything you own owns you.” |
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Term
| What is the most important step in time management ? |
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Definition
| Planning is the most important step in time management. |
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Term
| Unclear Goals and Priorities. |
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Definition
| Within a particular work shift or within your life as a whole, if you lack clarity about purpose and expected outcomes, the ability to manage time to meet your desires becomes a futile task. |
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Term
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Definition
| If you are constantly overburdened with tasks, events, urgent requests, and last-minute cancellations, you are a better crisis manager than manager of time. |
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Term
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Definition
| Some individuals fear the possibility of standing still too long. They feel guilty with timeouts or time off. Often this is a result of not wanting to address the larger issues in life. Staying too busy to think keeps long-term planning and personal introspection at bay. |
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Term
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Definition
| Need to be a Caretaker. In professions such as nursing the need to be a caretaker is a common devotion and can be very gratifying. However, when this need becomes unbalanced, it can cause you to feel resentful, unappreciated, and overwhelmed. |
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Term
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Definition
| When you are unable to get to the things that are important to you and are unable to meet your personal goals, it may mean you are afraid of failure. It can be very upsetting to go after your dreams and find out you cannot reach them. Sometimes it is easier to avoid making the effort. Take time to understand what your fears are and to openly address them. |
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Term
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Definition
| You may have been given a message somewhere in your life that you do not deserve to be a success. Therefore, it can be anxiety provoking to garner success and stand apart from others who may distance themselves from you. Take time to think through whether or not this is playing out in your life. |
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Term
| Fear of Disrupting the Status Quo. |
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Definition
| Not pursuing your goals for fear of the reactions of those around you is very common. Your family, coworkers, or supervisors may be critical of what you want to pursue. Gradually approaching changes gives you and those around you time to acclimate. |
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Term
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Definition
| If you are afraid of completing a project that is creative and fun because you are fearful that another similar project will not find its way to you or the project may no longer be important to you, take the time to understand why you are not completing a routine task or a major project that has been with you for some time. |
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Term
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Definition
| If you are a perfectionist and feel that everything should be completed with the same level of excellence, you are not keeping things in perspective. If you demand extremely high standards for every single task you undertake, you simply will not get everything done. |
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Term
| Fear of Losing Creativity. |
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Definition
| Many creative people think that by creating an organized time management structure or approach to life their creative natures or tendencies will be squelched. However, creating a framework to manage priorities will allow more freedom and time to enhance one's creative juices. |
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Term
| What is the fundamental currency of high performance ? |
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Definition
| “Energy, not time, is the fundamental currency of high performance” |
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Term
|
Definition
| The mental energy that is most potent in ensuring full engagement and high performance is that of realistic optimism. Realistic optimism is seeing the world as it is, but always working toward an optimal solution or goal. Mental energy is the ability to maintain sustained concentration on a task, move flexibly between broad and narrow issues, and be internally and externally focused as needed by the situation. It includes mental preparation, visualization, positive self-talk, effective time management, and creativity. |
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Term
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Definition
| Peter Senge (1999) has identified “personal mastery” as the discipline of continually clarifying and deepening one's personal vision, focusing one's energies, developing patience, and seeing reality objectively. People with a high level of personal mastery live in a continual learning mode, uncovering their personal growth areas. |
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Term
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Definition
| Physical, mental, and spiritual energy provide fuel for building our emotional capacity. Managing emotions skillfully in the service of high positive energy and full engagement is called emotional intelligence. Goleman (1999) suggests that self-confidence, self-control, and interpersonal effectiveness are all key to emotional intelligence. Striving to increase one's emotional capacity—which includes improving one's self-confidence, self-control, self-regulation, social skills, interpersonal effectiveness, empathy, patience, openness, trust, and enjoyment—will result in a more positive, invigorating work experience and personal life. |
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Term
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Definition
| Health care team composed of professionals from different disciplines including chaplains, nurses, dietitians, pharmacists, physical therapists, physicians, respiratory therapists, social workers, and speech language pathologists who cooperate, collaborate, communicate, and integrate care to ensure that care is continuous and reliable. |
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Term
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Definition
| (1) Traditional duties and responsibilities of the professional nurse, regardless of practice area or setting, such as the roles of care provider, educator, counselor, client advocate, change agent, leader and manager, researcher, and coordinator of the interprofessional health care team. (2) Duties and responsibilities of the professional nurse that are guided by specific professional standards of practice and usually are carried out in a distinct practice area (e.g., flight nurse, forensic nurse, and occupational nurse). |
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Term
| Name 7 Professional Nursing Roles |
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Definition
Care provider
Educator and counselor
Client advocate
Change agent
Leader and manager
Researcher
Coordinator of the interprofessional health care team |
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Term
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Definition
| The role of care provider is basic to the nursing profession. As the provider of care the nurse assesses client resources, strengths and weaknesses, coping behaviors, and the environment to optimize the problem-solving and self-care abilities of the client and family. The nurse plans therapeutic interventions in collaboration with the client, physician, and other health care providers. In addition, the nurse takes responsibility for coordination of care that involves other health professionals or resources, providing continuity and helping the client deal effectively with the health care system. As part of this role, caring is always central to nursing interventions and is an essential attribute of the expert nurse. |
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Term
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Definition
| When nurses first adopted the role of “change agent,” few individuals anticipated to what extent nurses would fulfill this role. However, nurses have expanded their role as change agents in many ways. The profession continues to identify client, patient safety, and health care delivery problems; to assess individual and organizational motivation and capacity for change; to determine alternatives; to explore possible outcomes of the alternatives; and to assess cost-effective resources in infinite health-related situations. |
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Term
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Definition
The leadership role of the professional nurse is paramount to the health care system. Nursing leadership varies according to the level of application and includes:
♦Improving the health status and potential of individuals or families
♦Ensuring that safe, high-quality care is provided across all health care settings
♦Increasing the effectiveness and level of satisfaction among professional colleagues providing care
♦Managing multiple resources in a health care facility
♦Raising citizens’ and legislators’ attitudes toward and expectations of the nursing profession and the health care system
There is little doubt that the management role of the nurse has become more important. Nursing management includes planning, giving direction, and monitoring and evaluating nursing care of individuals, groups, families, and communities. |
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Term
| Coordinator of the Interprofessional Health Care Team |
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Definition
| Interprofessional teams consist of collaborative practice relationships among several disciplines of health care professionals. These disciplines may include nursing, medicine, pharmacy, nutrition, social work, case management, and other allied health professionals, such as physical therapists, respiratory therapists, occupational therapists, and speech therapists. Chaplains or pastoral care representatives also serve a valuable role on the interprofessional health care team. These teams are found in all health care delivery settings and function most effectively when their focus revolves around the needs of the client. |
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Term
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Definition
| The infection control nurse assesses the total incidence of infections within the hospital. Clients who suffer an infection while in the hospital are comprehensively reviewed to ensure prompt and accurate treatment and timely containment of the client's infection so that it is not passed to other clients or staff. The infection control nurse must also conduct a thorough analysis to determine the source of the infection and its onset. If the infection is determined to have been contracted during hospitalization, an investigation is initiated to assess the sequence of events leading up to the infection, and an action plan is developed to prevent future occurrences. A position such as this enables the nurse to have hospital-wide interactions and functioning. Knowledge of epidemiology and outstanding interpersonal skills foster full participation in the infection assessment process. Infection control nurses may work in community settings and hospitals. |
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Term
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Definition
| Although the parameters of a position in quality management may vary from setting to setting, the basic premise is to ensure that outcomes in client care services are consistent with established standards. Benchmarking activities to establish such standards have been under way on a national level for the past few decades. Quality management nurses assess the compliance of the agency or institution with established standards and explore variations from these established standards. Chart reviews and ongoing interaction with the staff of the agency are integral components of a quality management position. Chapter 20 provides a more in-depth overview of the quality management process. |
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Term
|
Definition
| Some hospitals have various coordinator positions, such as trauma nurse coordinator. The nurse in this position is responsible for the coordination and integration of the clinical and administrative requirements of the trauma victim. Consisting of equal parts of program and case management, the trauma nurse coordinator role involves overseeing the care of the client from the point of injury through acute care to rehabilitation and back to society. Maintenance of a comprehensive database on the management of trauma victims is an important part of this position. Another example of a coordinator position for a highly specialized area is the organ donor coordinator, who procures organs and oversees the transplantation program. Coordinators require considerable experience in the specialty in which they practice. |
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Term
| Occupational Health Opportunities |
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Definition
Nursing within the framework of specific occupational groups (e.g., automobile manufacturing, textile plants, etc.) has long been a career option for nurses. Within these settings the nurse designs and implements a program of health promotion and disease prevention for employees and assists with immediate health needs as necessary. In this primary care milieu, the nurse assesses the need for programs about specific topics of importance to the health of the employees. Some examples of these might be breast-screening programs for female employees and information on early identification of prostate cancer for male employees. Other programs might revolve around the management of developmental events, such as empty nest syndrome, menopause, care for aging parents, or retirement.
In addition to services related to maintaining the health of employees, the occupational nurse is responsible for the assessment of the work environment to ensure the safety of the employees. Examples of significant environmental improvements in the health of U.S. workers are clean air programs, antismoking-on-the-job campaigns, and eliminating the use of asbestos in heating or insulation of buildings. All these activities pose special challenges to the occupational health nurse. The nurse in this setting develops procedures to be followed in the event of illness at work, including the management of health care emergencies.
Opportunities also exist in specific industries. For example, within the airline industry the nurse is responsible for airline safety through maintaining the health of employees. Protection of the employee's health is a component of the role, as is the effect of the health of the employee on the safety of the airline and its passengers. The nurse must be vigilant in the assessment of employee health problems that could affect overall airline safety. An obvious function is alcohol and drug screening. Protocols for the maintenance of employee health programs in the airline industry must be strictly followed and enforced, as required by government regulation.
Nonetheless, the heart of this nursing position still lies with providing care to people, which sometimes can place the nurse in a difficult position. In the ongoing monitoring of the health of the employees, the nurse often is the first to spot a deviation from health that could affect the career and livelihood of an employee. Such an example is hypertension. If an employee is developing high blood pressure, which will affect his or her employment status, that employee may encourage the nurse to “hear” the blood pressure in the qualifying range.
Occupational health and employment screening activities are entwined with urgent care and travel assistance for passengers. Although occasionally an emergency situation develops with a passenger or an employee, most of the client problems are travel related. For example, international travel to some countries requires comprehensive precautions regarding immunizations and inoculations. Airport nurses were critical in screening passengers on international flights during such times as with the severe acute respiratory syndrome (SARS) crisis in 2003. Also passengers may forget prescribed medications, or medications may be lost in baggage. Short-term problems, such as fear of flying, are also managed.
Another form of transportation provides a career opportunity: cruise ship nurse. Generally when people think of taking a cruise, they do not plan on getting sick—nor do nurses usually consider career possibilities in the industry. However, many cruise ships are as large as small cities. The role of the nurse in this setting is similar to that of the airline nurse with respect to the health of the employees and the safety of the passengers. The unique elements of the ship relate to special sanitation requirements, such as testing and culturing the water supply, and managing the total health needs of the passengers. The nurse is responsible for instructing the staff on the basic elements of emergency care and transport. Primary patient care needs are similar to those found in an emergency department. |
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Definition
| Another role that is attractive to nurses is that of quality manager. This reflects the need for health care providers to assess opportunities for process improvement, implement changes, measure outcomes, and then start the improvement process over again. Quality management nurses research and describe findings and look for opportunities to improve care. The result of quality assessment studies may produce critical pathways or algorithms defining care and expected client outcomes. Basic and advanced knowledge of quality management tools is essential, although practice may vary from setting to setting. For instance in the inpatient setting, the quality management nurse needs strong clinical skills, such as those that might be acquired in medical-surgical practice, intensive care units, or the operating room. Experience in home care would be an advantage for a quality management nurse if employed in that setting. Interpersonal skills are important because to be successful in this role, the nurse must build relationships and rapport with people and groups across the organization. The role of quality manager is one that promotes improved care for health care recipients in a variety of settings. |
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Definition
| This role has had a rich tradition in community and public health nursing and now has gained more prominence in acute care. Case managers coordinate resources to achieve health care outcomes based on quality, access, and cost. The complexity of case management practice is obvious in the era of chaotic systems caused by recent changes in the health care market, in which providers, services, and coverage details are constantly changing. Case managers identify the best resources at the lowest cost to achieve the optimal health outcome for the client. Case managers are often nurses, but can also be other professionals, such as medical social workers. |
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Definition
| Activities designed to return responders and the facility to full normal operational status and to restore fully the capability to respond to future emergencies and disasters; activities traditionally associated with providing federal supplemental disaster relief assistance under a presidential major disaster declaration. These activities usually begin within days after the event and continue after response activity ceases. Recovery includes individual and public assistance programs that provide temporary housing assistance, in addition to grants and loans to eligible individuals and government entities to recover from the effects of a disaster. |
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Definition
| stands for chemical, biologic, radiologic, nuclear, and explosive. |
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Definition
| three phases of the disaster continuum: preimpact, impact, and postimpact. In the preimpact phase, activities are focused on planning, preparedness, prevention, and warning. In the impact phase, all efforts are directed to responding to the disaster, initiating the emergency management system, and mitigating the effects of the hazard. During the postimpact phase, which usually begins 72 hours after the disaster and may continue for 2 to 3 years, a network of activities is designed to enhance recovery, rehabilitation, and reconstruction. Evaluation of the disaster preparedness and response plan is a major activity that needs to be included in the postimpact phase. |
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Definition
| Response activities are first initiated during the impact phase of disasters. These activities begin at the time of the event and are focused on providing the first emergency response to victims of the disaster, stabilizing the situation, and providing adequate treatment for the victims. This phase requires the interaction of emergency responders from fire and police departments, emergency medical services, hazardous materials teams, health care agencies, health departments, and other agencies to be able to triage and provide assistance to the victims and stabilize the scene. Usually the first unit responding establishes an incident command post from which to coordinate the activities. However, as other units arrive and as the cause of the incident becomes known, one of the law enforcement agencies may assume control if there is suspicion of a crime before the establishment of a community-based emergency operations center (EOC). |
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Definition
Metropolitan Medical Response System
The MMRS builds a cadre of specialty trained responders and equipment. The system is coordinated with area and statewide planning systems and integrates the efforts of all of the emergency response teams. The MMRS includes plans for expanding hospital-based care, enhancing emergency medical transport and emergency department capabilities, locating specialized pharmaceuticals to respond to a mass casualty event, managing mass fatalities, and providing mental health care for the community, victims, and health care providers. Scenarios designed to test the effectiveness of the MMRS in the community in providing an integrated response to an MCI are conducted on a regular basis. |
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Definition
| The merging of school values with those of the workplace. |
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| Biculturalism is the joining of two contradictory value systems, in this context, those of school values with those of the workplace. Biculturalism is designed to enhance a positive self-image and help novice nurses set realistic goals for practice. This strategy, if accepted in the workplace, allows the new nurse to introduce ideas or values brought from nursing school and integrate them into the work environment. Kramer (1974) suggests that the novice nurse apprise both sides of an issue, determine how his or her behavior will have an effect on other members of the interprofessional health care team, and single out accessible objectives. |
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| Mentoring and role modeling are often considered to be the same, but in fact they are different. Mentoring is an interactive, mutual, and personal experience (Sullivan and Decker, 2009), whereas role modeling is usually not an interactive process (Stone, 2000). Sullivan and Decker (2009) suggest that choosing the correct mentor is one of the most important tasks for the novice nurse. |
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Definition
| Mentors are experienced nurses who must be willing to commit to a relationship with novice nurses to help them recognize their weaknesses and strengths. Mentors help novice nurses set and reach realistic goals by reinforcing and recommending appropriate courses of action. Mentors help novice nurses build self-confidence and gain professional satisfaction while helping novice nurses develop as nurses and individuals (Blakeney, 2005). The benefactor of mentoring is termed a protégé. A skilled mentor can be a role model, but also serves as the student advocate (Blakeney, 2005) opening not only the novice's eyes to the profession but also hopefully a few professional doors and career opportunities. |
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Definition
| Networking with other male nurses helps with the socialization and integration of men into the profession. |
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Definition
| Because new graduates are frequently victims of horizontal violence in their first year of practice, preceptors with zero tolerance for such activities are invaluable. It is also suggested that having nurses on the unit describe their first year may deflect the desire to continue the violence cycle with the new hires (Baltimore, 2006; Longo and Sherman, 2007). Novices who practiced responses to horizontal violence during orientation were better equipped to successfully defend against horizontal violence (Longo and Sherman, 2007). Baltimore (2006) also suggests that nurses should devise a plan to increase socialization of novice nurses with staff; make assignments realistic, role modeling professional behavior, check egos, evaluate attitudes of staff, resist gossiping, and should conflict arise address it directly with the individual. Should incompetence of the novice be apparent, leave this to management to resolve. Perhaps most important is making horizontal violence transparent. DeRung (2004), herself a novice nurse, suggested finding intra and interprofessional coworkers who exhibit healthy working relationships and not dwell on the negative but refuse to accept abusive behaviors. Novice nurses entering the workforce will find the Occupational Safety and Health Administration (OSHA) book Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers helpful (www.osha.gov/SLTC/etools/hospital/hazards/workplaceviolence/viol.html) along with the Framework Guidelines for Addressing Workplace Violence in the Health Sector (www.osha.gov/SLTC/etools/hospital/hazards/workplaceviolence/viol.html#violenceprevention). In fact, OSHA has called for zero tolerance of workplace violence. “The incidence of lateral violence and bullying in the workplace is on the rise” |
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Term
| key to stopping the cycle of horizontal violence |
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Definition
| Novice nurses are key to stopping the cycle of horizontal violence by being aware of its existence and refusing to accept it as part of the hazing of new nurses. Novice nurses must report any behavior that undermines them on their job; this may be horizontal violence |
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Definition
| Another important skill that novice nurses need to learn is delegating. First, nurses should consider how others have delegated to them. Body language is important when delegating. Look at the person, be pleasant, and leave room for suggestions from the delegatee; however, do not allow the delegatee to resist or intimidate you so that you end up completing the task yourself. After communicating face to face, give a list of tasks in writing or post it at the nurses’ station. This leaves little room for misunderstanding. Be willing to change the assignment if there are changes in a patient's condition, new patients are admitted, or you realize that the time needed to perform a task was underestimated. If time allows, it is always good to help those to whom you have delegated tasks. For example, if a nurse passes by a door and the attendant is trying to turn a very large patient, she should enter the room and ask, “How can I best help you turn the patient?” Always take time to give sincere positive reinforcement and say thank you. |
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Term
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Definition
| Now consider the best way to prioritize. How did you prioritize in nursing school? What worked then will probably work now with a few modifications. Remember: if it is not written down, it probably will be forgotten. Keep a notepad and pen in your pocket. Jot down reminders of things to be done and place a number indicating their importance. |
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Definition
| Now consider the best way to prioritize. How did you prioritize in nursing school? What worked then will probably work now with a few modifications. Remember: if it is not written down, it probably will be forgotten. Keep a notepad and pen in your pocket. Jot down reminders of things to be done and place a number indicating their importance. |
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Term
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Definition
| Now consider the best way to prioritize. How did you prioritize in nursing school? What worked then will probably work now with a few modifications. Remember: if it is not written down, it probably will be forgotten. Keep a notepad and pen in your pocket. Jot down reminders of things to be done and place a number indicating their importance. |
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Definition
| Experienced RNs should consider the following to help ease the transition of the novice nurse to the profession of nursing: The novice nurse should not be expected to enter the work environment and be as productive as experienced staff members. It is important for experienced nurses serving on agency committees to serve as advocates for novice nurses by reminding nurse managers and administrators that it is not possible for nursing students to learn everything necessary for professional practice during school. Also remind other members of the nursing unit about this fact. If a novice nurse develops initiative, autonomy, and a desire to become a team member, he or she will succeed. |
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Definition
| role modeling is usually not an interactive process |
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Term
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Definition
| The process whereby workers organize under the representation of a union in order to share a degree of power with management to determine selected aspects of the conditions of employment. |
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Definition
| Occurs when there is a single union for all workers in a corporation. For example, all people who work in an automobile manufacturing company may be grouped together under the United Auto Workers (UAW). It is possible that the industrial union, with its massive numbers of union members, is the strongest possible collective group. |
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| A term associated with a negative workplace event that results in an allegation by an employee that he or she has not been treated fairly and equitably. Grievances can occur in union and nonunion settings. In a union setting, a grievance generally arises when two parties, such as an employee and a manager, interpret contract provisions differently. Grievances often involve job security or safety, which is a union priority, or job performance or discipline, which is a management priority. |
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Definition
| A form of settling disputes that involves a trained person who listens to all parties and makes recommendations. Such mediation is generally not legally binding. |
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Definition
| Each occupation within a given company has separate unions; these occupational groups might join others of like work across boundaries and across the country. White-collar workers coming from a background of higher education and some measure of job security tend to prefer occupational unionism and organizing with like-minded professionals. In general, nurses prefer occupational unionism. |
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| In general nurses prefer what type of unionism ? |
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Definition
| In general, nurses prefer occupational unionism. |
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Term
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Definition
| Collective bargaining is a method for achieving power-sharing in the workplace. |
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Definition
| Refers to a worksite that requires all new employees in a specific work group to join the union. Dues will be deducted automatically from employees’ paychecks as defined in the facility's contract. |
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Definition
| As a result of these early efforts at unionization, Congress passed the National Labor Relations Act (NLRA) in 1935. Under the terms of the NLRA, employees were given the right to self-organize, to form labor unions, and to bargain collectively. As part of the 1935 NLRA, the National Labor Relations Board (NLRB) was established to implement provisions of the NLRA. The NLRB continues to play a vital role in labor-management relations and, working through 52 regional and field offices in major U.S. cities, they conduct union elections and prosecute unfair labor practices. |
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Definition
| employees of nonprofit hospitals such as nurses were not protected under the NLRA and therefore were not legally protected for participation in collective bargaining activities. Hospitals’ employees may have been excluded from protection by the NLRA because it was believed that services provided were so essential that organizing activities would be contrary to the public's interest. Eventually in 1974 legislation allowed for the inclusion of nonprofit hospitals in coverage under provisions of the NLRA. Nurses could form collective bargaining units. The 1974 amendments also included the requirement for a 10-day written notice of the intent to picket or to strike. This notice would allow the health care facility time to prepare and would protect the relative health and safety of the public. |
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Definition
| Formal unionization in nursing began in 1946 when the American Nurses Association (ANA) endorsed collective bargaining as a way to gain economic security and influence other employment issues. Its efforts were dealt a serious blow, however, when Congress passed the 1947 Taft-Hartley Act, exempting charitable institutions, including nonprofit hospitals, from the 1935 NLRA Act. The ANA immediately began efforts to get the Taft-Hartley provisions related to charitable institutions repealed. As noted, legislation enacted in 1974 finally allowed for the inclusion of nonprofit hospitals in coverage under the NLRA. |
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Term
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Definition
| in 1999, a national nurses union, the United American Nurses (UAN), was established as an ANA affiliate to create an independent voice for union nurses. UAN is also affiliated with the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO), which is the largest federation of unions in the United States. The mission of UAN is to “shape the future of all staff nurses and the health care system for the better by improving the economic and general welfare of nurses, providing a quality work environment, protecting nurse and patient safety and influencing nursing practice standards” (UAN, 2009, p. 1). Today, UAN represents a significant number of the estimated 200,000 unionized nurses, but virtually all major unions now represent nurses at some level. |
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Term
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Definition
| Collective bargaining is a method of equalizing power. As such, it involves negotiation and administrative agreements between employees and employers. Because the individual employee, or even a small group of employees, has limited power to bargain with the employer, the idea of banding together in a union enhances the position of employees in situations calling for negotiation. The goals of collective bargaining are achieved by imposing rules regarding how employers must treat employees represented by a union. The union movement in the United States is involved with strengthening a worker's position in the relationship between management and labor. |
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Term
| DEVELOPMENT OF COLLECTIVE BARGAINING IN AMERICA |
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Definition
| During the late nineteenth century, when the Industrial Revolution was a force throughout North America, a cadre of thinkers arose who believed that to protect workers from circumstances such as long work hours, child labor, and unhealthy factory conditions, there needed to be collectivization of workers. These early groups sought such basic conditions as safety in work situations, adequate pay for hours worked, and the right not to be arbitrarily dismissed. This banding together of workers to accomplish goals was termed trade unionism. This technique was successful in many instances and remains with us today. |
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Definition
| The process of negotiation sanctioned in the United States by the National Labor Relations Board. It is the method used for formal talks between management and labor within modern business, industry, or service organizations. Binding arbitration means that all parties must obey the arbitrator's recommendations. |
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Definition
| Activities that enhance adaptation to a new environment. |
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Term
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Definition
| Application of pressure to pressure points on the hands and feet that correspond to various parts of the body |
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Term
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Definition
| A therapy that uses techniques to direct universal life energy to specific sites |
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Definition
| Reiki is a practice in which the Reiki practitioner (of which there are several levels) channels energy to others using a series of hand positions. It is believed that healing energy flows through the hands without the need for any special skills. Like other forms of energy work, Reiki is believed to be useful for pain management, wound healing, stroke rehabilitation, and general relaxation |
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Term
| ROLFING (STRUCTURAL INTEGRATION) |
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Definition
| Use of manual manipulation and stretching of body's fascial tissues to establish balance and symmetry |
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Term
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Definition
| Although it recently has gained popularity because of the writings and lectures of Deepak Chopra, Ayurveda has existed in India for more than 5000 years. Ayurveda means “the science of life” and is a system of care that promotes spiritual, mental, and physical balance. Noninvasive approaches are used to achieve balance and include yoga, massage, diet, purification regimens, breathing exercises, meditation, and herbs.Currently there is no process for licensing or certifying Ayurvedic practitioners. Because some of the treatments have the potential to cause complications (e.g., dehydration from cleansing enemas, herb-drug interactions), finding a reputable trained practitioner is important. The Ayurveda websites listed in Box 11-2 can assist in locating qualified practitioners. |
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Definition
| Aromatherapy, art therapy, biofeedback, dance therapy, hypnosis, imagery, meditation, music therapy, prayer, relaxation, self-help support groups, tai chi, yoga. |
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Definition
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Definition
Biofeedback is a technique in which the client is taught to alter specific bodily functions (e.g., heart rate, blood pressure, muscle tension). The client uses various relaxation and imagery exercises to affect desired responses. Machinery, such as electroencephalograms, electromyelograms, and thermistors, are used to measure and offer feedback about the function that the client is trying to alter. As the client becomes familiar with ways to successfully alter bodily responses, the equipment may no longer be necessary.
There are many conditions for which biofeedback can offer benefit, including urinary incontinence, anxiety, stress, irritable bowel syndrome, neck and back pain, and cardiac arrhythmias. |
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Definition
| Individuals are believed to have distinct metabolic body types called doshas, which are vata, pitta, and kapha (Table 11-1). Signs of illness occur when the delicate balance of the doshas is disturbed. |
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Definition
Homeopathy is a branch of medicine developed in the late eighteenth century by Samuel Hahnemann. It was widely practiced in the United States until the early 1900s, when modern (i.e., conventional) medicine discredited it as being unscientific and ineffective. Homeopathy remained popular in other parts of the world, however, and recently has regained popularity in our country.
The origin of the word homeopathy helps in understanding this therapy. In Greek the word homos means “similar,” and pathos means “suffering.” The foundation of homeopathy are the laws of similars, the minimum dose, and cure Box 11-4.
Although the reason for their effectiveness is not fully understood, homeopathic remedies have been shown to be effective for a variety of conditions. People use homeopathy for a range of health concerns, from wellness promotion and disease prevention to the treatment of diseases and conditions such as allergies, asthma, chronic fatigue syndrome, depression, digestive disorders, ear infections, headaches, and skin rashes (NCCAM, 2009b).
The ideal way to use homeopathic remedies is to have a homeopath prescribe a customized remedy based on individual characteristics and symptoms. However, homeopathic practitioners are not plentiful, so the next best thing is to buy over-the-counter preparations that are labeled for their intended purpose (e.g., arthritis, headache, hay fever, cold). |
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Definition
| Some common symptoms of burnout include extreme fatigue, headaches, difficulty sleeping, mood swings, anxiety, poor work quality, depression, and anger (Larsen, 2000). The more intelligent, hard-working nurses are the most prone for burnout, but if you exhibit these symptoms; remember that they can be reduced. |
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Definition
| Dirty bomb causes immediate effects (radiation burns, acute poisoning) and long-term effects (cancer, contamination of drinking water); decontamination must occur before patient care can be safely provided by the health care worker |
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Term
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Definition
Agents injure or kill through variety of means: vesicant, nerve, blood, respiratory
Spread easily through air; cause immediate effects; require decontamination
Less toxic than biologic agents; need to be used in large quantities; subject to dispersion by wind; terrorists need to protect themselves; require trained HAZMAT teams
Dependent on agent used; in some cases have agent-specific medications; require decontamination; require use of personal protective equipment by personnel |
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Definition
Ionizing radiation able to strip electrons from atoms, causing chemical changes in molecules; expression may be delayed; radiation depends on time, distance, shielding, and quantity of radioactive material
Available; psychologic effect likely to be substantial; often used in conjunction with explosive devices (“dirty bomb”)
Delayed effects of radiation materials; difficult to shield against
Dirty bomb causes immediate effects (radiation burns, acute poisoning) and long-term effects (cancer, contamination of drinking water); decontamination must occur before patient care can be safely provided by the health care worker |
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Term
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Definition
Most common method for terrorists; capable of violent decomposition; pressure, temperature changes and propellants cause injury and/or death
Easy to find materials to construct explosive device; large devices can be placed in abandoned vehicles; smaller devices can be placed on bodies of persons willing to commit suicide by igniting the device
Volatile ingredients could cause premature explosion of device, thus creating danger for terrorists; government agencies have improved training and processes for identifying incendiary devices
Symptomatic; often requires treatment for burns |
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Term
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Definition
Depends on yield of nuclear weapon, but consists of blast range effects, thermal radiation, nuclear radiation, and radioactive fallout
Requires decontamination; contamination can remain for many years; psychologic effect likely to be substantial
Large, heavy, and dangerous weapons; hazardous to terrorist; expensive and difficult to make weapons of this type
Symptomatic treatment of thermal burns, shrapnel injuries, and radioactive fallout; depends on distance from source and time of exposure |
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Term
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Definition
Imagery is the process of creating a “picture” (image) in the mind that can cause a specific bodily response. Although hypnosis uses imagery, in hypnosis an image and suggestion are presented to the person, whereas in imagery the person creates an image on his or her own. The process of imagery begins by the client establishing a desired outcome (e.g., to relieve stress, enhance circulation, reduce blood pressure). The nurse or other practitioner assists the client in creating an image that helps to achieve the outcome (e.g., the nurse may describe how the blood circulates through the body, help the client develop an image of how cancer cells can be eliminated, or suggest that the client think of a peaceful place where cares can “melt away”) and guides the client in reaching a relaxed state. As an alternative to having someone guide him or her through an imagery exercise, a client can learn the process from books or use commercially prepared audiotapes.
Imagery is not a difficult mind-body healing therapy to master and can be easily implemented in virtually every practice setting. |
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Definition
Although the use of trance states for healing purposes dates back to primitive cultures, hypnotherapy was not approved as a valid medical treatment until the 1950s. This mind-body therapy is now widely and successfully used for a wide range of conditions, including chronic pain, migraines, asthma, smoking cessation, and irritable bowel syndrome.
The process of hypnosis begins by the therapist guiding the client into a relaxed state and then creating an image that focuses attention to the specific symptom or problem that needs to be improved. The client must be in a state of deep relaxation to be receptive to a posthypnotic suggestion. Most people are capable of being hypnotized if they are willing. |
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