Introduction to Nursing (OER): Front Matter

To future nurses everywhere: May you thrive and grow, and learn from your patients every day.

To our students who helped shape this text: Thank you for your insights, wisdom, and future thinking.

Chapter One: Influences on Contemporary Nursing Practice

1. Historical Influences on Nursing Practice
   1. Florence Nightingale
   2. Clara Barton
   3. Lavinia Dock
   4. Lillian Wald
   5. Isabel Hampton
   6. Robb Mary
   7. Mahoney Mary Adelaide Nutting
   8. Mildred Montag
   9. Other pioneers
2. Contemporary Influences on Nursing Practice
   1. Healthcare laws and policies
   2. Health disparity and vulnerable populations
   3. Rising health care costs
   4. Supply and demand of nurses
3. Theoretical Influences on Nursing Practice
   1. How nursing theories guide practice
   2. Historical and modern nursing theorists

Chapter Two: Professional Identity and Nurse Self-Care

1. Professional Identity within the Nursing Profession
   1. Definitions and scope of practice
   2. Characteristics of professional identity
   3. Professional identity development
      1. Benner’s professional development model
   4. Context within healthcare
   5. Exemplars
      1. Integrity
      2. Caring
      3. Advocacy
2. Nurse Self-Care
   1. Importance of
   2. Exemplars
      1. Compassion fatigue
      2. Secondary traumatic stress
      3. Burnout Resilience

Chapter Three: Legal and Ethical Considerations

1. Legal Considerations
   1. Definition and scope
   2. Attributes, criteria, and context in healthcare
      1. Patient rights
      2. Professional nursing responsibilities and patient advocacy
   3. Exemplars
      1. Negligence & malpractice
      2. Standards of care
      3. Breach of duty and abandonment
2. Ethical Considerations
   1. Definitions and scope
   2. Attributes, criteria, and context in healthcare
   3. Ethical principles
   4. Ethical theory
   5. Ethical issues
   6. Exemplars
      1. Confidentiality
      2. Advanced Directives

Chapter Four: Evidence-Based Practice, Safety, and Quality Improvement

1. Evidence-Based Practice
   1. Definitions and scope & levels of research
   2. Attributes, criteria, and context in healthcare
   3. Exemplars
      1. Case study application of evidence
2. Safety
   1. Definitions and scope Levels of errors
      1. Types of errors
      2. Placement of errors
      3. Root cause
   2. Attributes, criteria, and context in healthcare
      1. Culture of safety
   3. Exemplars
      1. Case study application of safety
3. Quality Improvement
   1. Definitions and scope
   2. Attributes, criteria, and context in healthcare
      1. Quality improvement processes
      2. Health information technology support
      3. Regulatory agencies
   3. Exemplars
   4. Centers for Medicare & Medicaid Services
   5. The Joint Commission
   6. The Agency for Healthcare Research & Quality

Chapter Five: Cultural Considerations and the Art and Science of Patient-Centered Caring

1. Cultural Considerations
   1. Definitions and scope
      1. Enculturation
      2. Acculturation
      3. Assimilation
      4. Biculturalism
   2. Attributes, criteria, and context in healthcare
      1. Culture is learned
      2. Culture can change and adapt
      3. Shared beliefs, values, and behaviors
      4. Cultural considerations for nurse-patient encounters
      5. Cultural Competencies
         1. Desire
         2. Self-awareness
         3. Knowledge and encounters
         4. Skill
   3. Exemplars
      1. Nonverbal communication and family roles
      2. Cultural taboos and health beliefs
2. The Art and Science of Patient-Centered Caring
   1. Definitions and scope
      1. Caring theories
      2. Care of the patient
      3. Care of the caregiver
   2. Attributes, criteria, and context in healthcare
      1. Caring Skills (Presence, touch, listening)
      2. Professional boundaries
      3. Environmental factors
   3. Exemplar
      1. Nursing care for the patient and caregiver

Chapter Six: Healthcare Systems, Organizations, and Informatics

1. Healthcare Systems and Organizations
   1. Definitions and scope
   2. Attributes, criteria, and context in healthcare
      1. Purpose and service domains
      2. Structure, finance, and work culture
      3. External factors and ongoing change
   3. Exemplars
      1. Hospitals and nursing homes
      2. Homecare and hospice agencies
      3. Global and local faith-based organizations
2. Informatics
   1. Definitions and scope
   2. Attributes, criteria, and context in healthcare
   3. Exemplars
      1. Computerized documentation
      2. Personal health records
      3. Barcode medication administration

Chapter Seven: Collaboration and Teamwork

1. Collaboration
   1. Definitions and scope
      1. Nurse-patient collaboration
      2. Nurse-nurse (intra-professional) collaboration
      3. Nurse-interprofessional team collaboration
      4. Nurse-organizational collaboration
      5. Nurse-community collaboration
   2. Attributes, criteria, and context in healthcare
      1. Values/ethics
      2. Roles/responsibilities
      3. Communication
      4. Teamwork/team-based practice
   3. Exemplars
      1. TeamSTEPPS
      2. PACERS
2. Teamwork
   1. Definition and scope
   2. Attributes, criteria, and context in healthcare
      1. Delegation
      2. Civility in the workplace
   3. Exemplars
      1. Mentoring
      2. Interprofessional education

Chapter Eight: Educational Preparation, Licensure and Certification Requirements, and Professional Organizations

1. Educational Preparation
   1. Definitions and scopes of practice
   2. Attributes, criteria, and context
      1. Becoming a successful student nurse
      2. Becoming a successful registered nurse
      3. Advancing education and career opportunities
   3. Continuing education requirements
   4. Nurse practice acts
   5. Exemplars
      1. Diploma nurses
      2. ASN nurses
      3. BSN nurses
      4. MSN nurse specialists
      5. Doctorally prepared nurses
2. Licensure and Certification Requirements
   1. Licensure for registered nurses
   2. Licensure for advance practice nurses
   3. Certifications for nurse specialists
   4. Exemplars
      1. NCLEX & NCSBN
      2. Specialty Certifications
3. Professional Organizations
   1. Student nurse organizations
   2. American Nurses Association and state associations
   3. Specialty organizations

Nursing is considered both a science and an art.  As a result, it requires a specialized body of knowledge and specific technical skills to provide care for individuals in various states of wellness and illness.  Nursing care takes place in many settings: Hospitals, emergency rooms, urgent care, health departments, community clinics, schools, and corrections facilities – just to name a few. Nurses are constantly on the frontlines of healthcare, caring for people every day.  
Nursing has been voted the most trusted profession for the past 17 years (Brenan, 2018).  The public is most aware of the caring component; however, another side is often overlooked – the science.  Healthcare is based on a strong foundation in the natural and social sciences.  Nurses blend scientific principles from biology, psychology, and sociology with practice standards and “an insightful and compassionate approach to patient care” (Potter, Perry, Stockert, and Hall, p. 1, 2017).  A competent nurse also masters the art of nursing which encompasses emotional intelligence, empathy, and critical thinking.  

This open textbook will help students:

• understand the scope of professional nursing roles 
• introduce them to the vast responsibilities, fund of knowledge, and aptitudes required of modern nurses
• master important information about the nursing profession
• decide whether a nursing career is a good fit
• increase confidence before entering a nursing program.
• Topics progress from the history of nursing to the role of the professional nurse within modern healthcare settings.

Content areas include: 

• historical and contemporary influences on modern nursing practice
• professional identity and nurse self-care
• legal and ethical considerations
• evidenced-base practice, safety, and quality improvement
• cultural considerations and the art and science of patient-centered caring
• healthcare systems, organizations, and informatics
• teamwork and collaboration
• educational preparation and licensure requirements

Subject matter is supported by evidence-based nursing research, professional standards, Quality and Safety Education for Nurses (QSEN, 2019) competencies, online resources, and nursing textbooks. The authors hope this open textbook will help students be more confident in mastery of this introductory material.

Debbie Amason, DNP, MS, RN (Professor)
Paula Stover, DNP, RN, CNS (Associate Professor)