1. Roles of the nurse (advocate, collaborator, educator, etc)
		1. Provider of Care: role typically seen in the hospital setting. 
•	Traditional role or nursing
•	Knowledge is critical  to providing safe, quality care. 
•	Caring most emphasized. 
•	Expertise is require and more emphasis on the emotional side of caring. 
•	Care is provided in clinics, schools, the community homes, industry etc. 
•	2. Educator: teaching patients, families, communities, and populations. 
o	Focus on health promotion and prevention, and helping patients cope with illness and injury. 
o	Planned based on needs and mustknow about teaching princibles and methods. 
o	Some teach other nurses and healthcare providers in healthcare settings which is called staff development  or staff education. 
o	Nursing school educators. 
•	3. counselor- providing advice and counseling to patients, families, communities and populations. Done in conjunction with other roles. 
•	4. manager- act as manager daily in their positions even if they do not have a formal management position. 
o	Process of getting something done efficiently and effectively though and with other people
o	Involves critical thinking, planning, decision making, delegating, collaborating, coordinating, communicating, and working with interdisciplinary teams. 
•	5. researcher- small percent of nursing do this. 
o	Most critical done by EBP
o	Hold positions in research studies that may or may not be nursing research studies. 
o	Assist in data collection and manage data collection projects. 
•	6. collaborator- cooperative effort that focuses on a win-win strategy. 
o	Depends on each individual recognizing  the prespective of others who are involved and eventually reach a consensus of common goals. 
•	7.Change agent- initiate change for improvement 
o	an intrapreneur-requires risk  and the ability to see change in a positive light. 
•	8. Entrepeneur- works to make changes in a broader sense 
o	ex. Healthcare consultants   and legal nurse consultants, and nurses who establish business related to health care. Eg staffing agency, healthcare products, healthcare media business. 
•	9. Patient Advocate-advocate on behalf of an individual, a family, a community, or a population. 
o	A change agent  and a risk taker. 
o	Speaks for the patient but does not take away the patient’s independence. 
o	Advocate for better healthcare coverage by writing congressmen. 
	2.  What is critical thinking and how does that intertwine clinical judgement?
•	Critical thinking, and clinical reasoning and judgment should be used throughout the nursing procces
•	Critical thinking  requires nurses to generate and examine questions and problems, use intuition, examine feelings and clarify and evaluate evidence. 
o	Aware of change and willing to  take some risks. 
o	Avoids seeing things as good or bad/ black/white
•	Critical judgement-requires more recall and understanding of content or selection of the correct answer. 
•	Requires the ability to apply, analyze, and synthesize knowledge. 
•	Process or the ways in which nurses come to understand the problems, issues or concerns of client/patients. 
•	Process includes both deliberate, conscious decsionmaking and intuition. 
	
	3.  What is nursing research and how is it used?
•	A methodological examination that uses regimented techniques to resolve questions or decipher dilemmas. 
•	Major purpose to expand nursing knowledge to improve patient care and outcomes. 
•	Helps to explain and predict care that nurses provide
•	2 types of research: basic and applied
o	basic- done to gain knowledge for knowledge sake. Can be used in applied or clinical research
•	research process similar to the nursing process in that there is a need to identify a problem using data, determine goals, describe  what will be done and then assess results
•	researchers take time to develop  research proposals 
o	describe in detail  what they plan to do in a study. 
o	Used to request funding-grants
•	National institute of Nursing Research
•	Evidence-based Practice- EBP- 
•	Professional Literature-provides repository of nursing knowledge that is accessible to nusing students and nurses. 
	
	4.  Look at page 7--ANA definition of nursing and understand the meaning of the definition
	ANA definition of nursing- Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis  and treatment of human response, and advocates in care of individuals, families, communities, and populations.
	5.  How does caring impact a nurse/client relationship? Pg 61
•	Characteristics of relationship
o	Being physically present ith the patient
o	Having a dialogues with the patient
o	Showing a willingness to share and hear to use active listening
o	Avoiding assumptions
o	Maintaining confidentiality
o	Showing intuition and flexibility 
o	Believing in hope. 
•	Caring often involves competent assessment of the patient to determine what needs to be done, and the ability to provide care.
	6.  Image of nursing/Media image of nursing.
•	Image is part of and impacts many facets of a profession
•	How nurses view themselves impacts professional self-esteem
•	Visibility- publics view of nursing based on personal experience 
o	May not reflect all of nursing capabilities
o	Impacted by patients emotions
o	 
o	
•	important for nurses to be visible External factors;
•	Historical role of nurses as handmaiden
•	Hierarchial structure of healthcare organizations-limited the role of the nurse in decision making
•	Perceived authority and directives of physicians- limited independent role of nuses
•	Hospital policy-limited nursing action
•	Threat of disciplinary or legal action or loss of job-might limit a nurse when she needs to speak out-advocate. 
•	Media reflects public image of nursing (nursing is not directing the image)
•	How do nurses view themselves- cohen survey- nurses don’t have consensus about how to improve image
•	Advertising 
o	Advertising to prospective nurses and public at the same time
o	Johnson & Johnson campaign. 
o	
•	role of media- nurses must inform the media- professions needs information about current media image to advocate for change if required. Nursing shortage. 
•	Deficit in nurses presence in media. 
•	Media training- nurses are experts, must demonstrate proffesionalism and expertise. 
	
	7.  Generational issues in nursing
•	4 generations
o	traditional- emphasis on bureaucratic structure, and difficult to change in some healthcare organizations. 
o	baby boomers-less experience with technology, materialistic and competitive, appreciates consensus leadership. Person chose a career and stuck to it, even if she was not happy. 
o	generation x- more accomplished in technology. Want to be led  and not managed. Leaders are motivational, positive communication, appreciate team players, good people skills. Have conflicts with baby-boomers. 
o	generation y-multitaskers, high leval of technology skills. Handle change better, take risks, and want to be challenged. Connected to cellsphones and makes it difficult for them to focus on one task
•	
	8.  What is patient advocacy?
•	Advocacy- speaking for something important. 
•	Patient Advocate-advocate on behalf of an individual, a family, a community, or a population. 
o	A change agent  and a risk taker. 
•	Speaks for the patient but does not take away the patient’s independence. 
•	Advocate for better healthcare coverage by writing congressmen. 
	9.  Universal healthcare system.
•	America does not use this system
o	Government does not play an important role in the U.S.  healthcare system. But not the major role as it is the case with a universal system. 
•	Due to Americans  view that the government should be limited 
•	Approach taken to healthcare policy-fragmented and incremental
•	Does not look at the whole system and how things work and do not work. 
•	Role of state-  health policies vary from state to state. 
•	There is a shared role with federal government. Ex. Medicaid
•	Role of president. 
	10.  how is medicaid and medicare funded?
•	Medicaid- matching funds- federal government  pays for half and the states pay for the other half. 
•	Medicare-funded only by the federal government. 
	11.  How can nurses affect health care policy?
•	Nurse citizens
o	Each nurse is a potential voter-potential influence over who will be elected over legislative decisions. 
o	Political competence-ability to use opportunities; networking, highlighting  nursing expertise, using powerful persuasion, demonstrating a commitment to working with others, thinking strategically, and perservering. 
•	Being aware of rules and the game of recognizing that the other side needs something. 
•	Nurse activists
o	Joing PAC, Contribute financially to campaigns, write legislaturors. 
•	Lobbying-critical part of US political process. 
o	Someone who represents a specific inte
o	rest or interest group that tries to influence policy-making. 
o	Contact legislative staff-staff gets data about an issue; formulating solution that may become bills and if passed, laws. 
•	Communicate with elected representatives to accept particular approach and solution. 
o	ANA, NLN and AACN- have lobbyist  
o	Committees-legislative are dependent on committees
•	Committees from both major parties- democrat and republican
•	To effectively influence legislation, it is important to understand which committee will be involved in. 
•	Knowing information can help development of more effective strategy to influence the course of policy or to prevent it from progressing. 
o	Nurse politicians
•	At state and national level
•	1992, first nurse to was elected to house of representatives. 
o	Nurses who knew how to use the political power
•	Diane Carlson Evans- efforts erected the Vietnam Women’s memorial
o	Karen Daley- protect healthcare providers from sustaining similar injuries (HIV and Hep C through needlestick). 
•	Passage of legislature at the state levels, needlestick prevention and safety act  of 2000, needlestick prevention campaign by ANA. 
	12.  The priniciples of ethical behavior (veracity, fidelity, etc)
	13.   What is the purpose of the ANA code of ethics
	14.  What is assault and battery?
	15.  What is negligence?
	16.  What are standards of care? (minimum standard)
	17.  What components must be present for a malpractice suit
	18.  Who obtains informed consent?
	19.  What are advanced directives/POA?
	20. What impacts access to health care?
	21.  What is Healthy People initiative?
	22. Primary/secondary/tertiary prevention
	23.  The difference between health prevention and promotion
	24.  Difference between acute and chronic illness
	25.  what is a vulnerable population, and what does that mean?
	26.  What is the largest department in a hospital (of employees)
	27. What is a deductible
	28.  What is the difference between for profit and non-for profit