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Current Trends & Issue
in Nursing
From-
Mr.R.RAMACHANDRAN,
Student Tutor,
RNPC.
Professional Nursing Today
Legal Implications for Nursing Practice
Healthcare Delivery System
Entry into Professional Nursing
NRS 101
What is a Nurse?
Definition of Nursing :
 Nursing is a unique function of
nurse, that is to assist the individual
sick or well in the performance of those
activities contributing to health on its
recovery or peaceful death, that he
would perform unaided if he had the
necessary strength, will or knowledge.
- ICN
How are nurse’s portrayed in the
media?
What makes a nurse a professional?
http://www.youtube.com/watch?v=z1-uMKg86Ck
 Extended education
 Theoretical body of knowledge
 Provides a specific service
 Autonomy in decision making and
practice
 Code of ethics
Nursing as a Profession
Scope & Standards of Practice
 Standards of Practice
 Standards of Professional Performance
 Code of Ethics
ANA
Standards of Professional Performance
 Quality of practice
 Professional Practice Evaluation
 Education
 Collegiality
 Ethics
 Collaboration
 Research
 Resource Utilization
 Leadership
Professional Nursing Practice
 Nurse Practice Acts
 Licensure and Certification
 Science and Art of Nursing practice
Historical Perspective
 Florence Nightingale
 Dorothea Dix
 Clara Barton
 Isabel Hampton Robb
 Dr Mildred Montag
Nursing Today
 Registered Nurse
 Licensed Practical Nurse
 Nurse Practitioner
 Clinical Nurse Specialist
 Nurse Midwife
 CRNA
Introduction:-
 Trends:-It denote general direction & tendencies specially of
events, of opinion.
 Nursing trends:-refers to direction towards which the different
nursing events have moved or are moving as well as the opinion
in & around nursing that are found in & about nursing profession.
 Trends in nursing that is changes currently taking place in any
area of nursing which the profession as a whole.
 These do not occur independently but each one has a basis of
related changes in other fields.
These are:-
 Social change
 Change in other profession
 Change in nursing profession itself in
the country
 Change taking place in other countries
in nursing world.
Social change:-
 Nursing profession serves to meet the need of the society
particularly the needs related to health & well being.
 The changes in society will influence to bring about
changes in nursing profession.
1. At present, efforts are made by government of India to
deliver the health care to the community especially in rural
area.
2. Overall improvement in the education of people with ever
growing awareness about health & health need.
Cont…
 Now women are more educated & take up
jobs out of home to serve & earn.
 Advancement of technology
eg. Automatization, Industrialization,
Urbanization
 After independence, government began to
make serious efforts to meet health need of
nation by implementing recommendation of
bhore committee.
Change in other profession:-
Trends in nursing profession are closely related to those in
medical profession.
 Medical profession is fastly changing profession & The era
of specialization & super specialization has come.
 Morden health care facility like ICU, ICCU, Renal unit,
Organ transplant unit etc
 Biomedical science have far advanced resulting in newer
diagnostic equipment such as scanner, New drugs,
monitoring system in field of health care all over the world.
Change in nursing profession itself
in the country:-
There is trends in nursing profession towards meeting the criteria
of profession. It is fast moving in some areas & slower in other
areas.
– Trends to take up education leading to bachelor’s degree in
nursing ,master degree as well as doctoral degree.
– Trends related to tuition fee eg. Paid stipends, free hiring,
accommodation , food & uniform but service is expected
from the nurse.
– Trends related to changes in working condition for nurses.
Change taking place in other
countries in nursing world:-
International influence is brought about by many ways-
– Fast growing trends to post basic dgree
programmes.
– INC promote sharing of ideas & common interest
between member of national organization.
– Exchange of professional literature like
international review, Professional journals, articles
etc
Issue related to nursing
profession:-
 Various issue in nursing profession may be related to the
profession , education ,Practice,& nurses themselves.
 Status in nursing in society in Health care delivery system.
 Value reflect in our nursing profession
 Quality in nursing hand in hand education & practiced in hand
b/w nursing
 Unique function of nursing
Cont….
 Different level of nursing required in country
 Evidenced base nursing research.
 Expanded & extended role of nurse
 Globalisation in the profession
 Nursing leadership bringing change in health
scenario according to community demand.
Current Trends & Issues in Healthcare
 Nursing Shortage
 Patient Satisfaction
 Managed Care
 Transcultural Nursing
 National Patient Safety Initiatives
 Evidence-Based Practice
 Information Age
 Genetics
 Globalization of Health
 Aging Population
 Legal & Ethical Issues
 Terrorism/Bioterrorism/Disaster Nursing
Nursing Shortage
 National problem
which is growing
 Critical shortage in
specialty areas
 Avg age of nurse is
45
 Resurgence of
enticements for
recruitment
Reasons for Shortage
 Work environment
 Recruitment
 Retention
 Aging workforce
 Compensation
 Aging Baby Boomers
 Shortage of nursing faculty
Patient Satisfaction
 Press ganey
surveys
 Good customer
service
 Patient Bill of Rights
 Treat patients like
family
 Healthcare is a
business
Managed Care
 Goal is to keep length of stay (LOS)
down
 Capitation
 Patients are discharged sooner
 Patient acuity higher
 Health Care Plans
 Case manager work closely with
physicians and insurance companies
Transcultural nursing
 Nursing has become
a melting pot
 Nurses are
challenged to be
more culturally
aware
 Cultural sensitivity
National Patient Safety Initiatives
 Joint Commission National Patient
Safety Goals
 Institute for Healthcare Improvement
“5 Million Lives”
Campaign
 The Leapfrog Group
Joint Commission National Patient
Safety Goals
 Improve the accuracy of patient identification
 Improve the effectiveness of communication among
caregivers
 Improve the safety of using medications
 Reduce the risk of health care-associated infections
 Accurately and completely reconcile medications
 Reduce the risk of patient harm from falls
 Encourage patients’ active involvement in their own
care as a patient safety strategy
 The organization identifies safety risks inherent in its
population
 Improve recognition and responses to changes in a
patient’s condition
The Leapfrog Group
 Reduce preventable medical mistakes
and improve the quality and affordability
of health care
 Encourage health providers to publicly
report their quality outcomes so
consumers can make informed choices
IHI “5 Million” Lives Campaign”
 Deploy rapid response teams
 Deliver reliable evidence-based care for
acute MI
 Prevent adverse drug events
 Prevent central line infections
 Prevent surgical-site infections
 Prevent ventilator-associated
pneumonia
Evidence Based Practice
 Goal is to achieve cost-effective, high quality
patient care based on scientific inquiry
 Nurses need to understand research process
involved
 Nursing care should not be based on
opinions, past practices, but on the results of
scientific research
 Clinical journals
 Practice guidelines
 Nursing research
Information Age
 Consumers today are
more computer savvy
regarding healthcare
 More info on internet
 Consumers could
possibly be more
informed than health
care worker
 Joint Commission 2014
all medical records
have to be EMR
Genetics
 Many major
developments in the
field of genetic
research
 Stem Cell
 Human Genome
Project
 Cloning
 Legal & Ethical
issues
Globalization of Health
 Healthcare has
become a global
issue
 People are mobile,
diseases can travel
 Nurses need to
have an
understanding of the
issues pertaining to
global health
Legal Limits of Nursing
Sources of Law
 Statutory law: Nurse Practice Acts
 Regulatory law/Administrative law
 Common law
 Criminal law: felony & misdemeanor
 Civil law: negligence & malpractice
:
Legal Issues in Nursing
 Nurse Practice Act
 Standards of
Professional Practice
 EMTALA
 Advanced Directives
 HIPAA
 Licensure
 Good Samaritan Laws
 Public Health Laws
 Physician-Assisted
Suicide
 Americans With
Disabilities Act
Civil & Common Law Issues in Nursing
Practice
 Intentional Tort
 Unintentional Tort
 Negligence
 Malpractice
 Consent
 Informed Consent
 Malpractice Insurance
 Abandonment & Assignment Issues
Aging Population
 Population is aging
 Growing concerns
regarding the unique
needs of the elderly
 Gerontological
nursing
Terrorism/Bioterrorism/Disaster
Nursing
 The 9-11 terrorist
attacks have
heightened attention
to the growing
threats of terrorism
 Nurses need to be
aware to the health
consequences of
terrorism and use of
biological agents
Common problems of nursing
administration are:
 Poor involvement of nursing administrators in planning and
decision making
 No specific power has been assigned to nursing In charges but
she has been made In charges of all inventories and linen of
hospital
 Lack of knowledge of management of nursing administration
 No clear cut written nursing policies and manuals
 Poor job description for various nursing cadres
Common problems of nursing
administration are:
 Poor organized staff development programmed
Inefficiency of nursing councils to maintain standards, and
inadequate efforts at higher level for implementation of separate
directorate of nursing
 Less educational preparation
 Refuse to accept new role
 Adhere to tradition
 Failure to unity among nurses
Practice Settings for Nurses
 Hospital
 Community Based Practice Settings
Hospital Based Nursing
 Acute care is where largest group of
nurses practice
 Different Staffing Patterns
 Skill Mix Changing
 Increase in skilled nursing facilities due
to aging population and increase in
chronic disease
Community Based Nursing
 Focus on health promotion,
maintenance, education
 Community Health Centers, Clinics
 School Nursing
 Occupational Health
 Home Health
 Physicians Office
 Managed Care Organizations
 Forensics Nursing
Nursing Education
 Diploma
 ADN
 BSN
 Master’s
 Doctorate
 Continuing education
 In-service education
Nursing Roles
 Caregiver
 Clinical Decision Maker
 Client Advocate
 Rehabilitator
 Comforter
 Communicator
 Collaborator
 Teacher
Professional Roles & Responsibilities
 Autonomy & Accountability
 Caregiver
 Client Advocate
 Educator
 Manager/Clinical Decision Maker
 Communicator
 Collaborator
 Career Development
Autonomy & Accountability
 Autonomy is the essential element of
professional nursing
 Person is reasonably independent and self-
governing in decision making & practice
 Increased autonomy=Increased responsibility
 Accountability- nurse is responsible
professionally & legally for type & quality of
care provided
 Regulated through Standards of Practice and
Nurse Practice Act
Clinical Decision Maker
 Utilizes critical
thinking skills and
the nursing process
 Nursing Process:
Assessment,
Diagnosis, Planning,
Implementation,
Evaluation
Client Advocate
 Nurse protects the clients human and
legal rights
 Providing information to assist in
decision making
 Patient Bill of Rights
Rehabilitator Role
 Assist client to
return to optimal
level of functioning
 Nurse helps client to
adapt physically and
emotionally to
changes in lifestyle,
body image
Comforter Role
 Caring for client as a
human being
 Role is traditional to
nursing
 Care is directed to
whole person, not
just a body part
 Demonstration of
care and concern
Communicator Role
 Role is central to all other roles
 Involves communication with client,
family, healthcare team members,
resource people, and the community
 Without clear, concise communication it
will be difficult to give effective care
Teacher/Educator Role
 Explains concepts and facts about
health, demonstrates procedures,
reinforces learning, determines
understanding, and evaluates progress
of learning
 Unplanned or informal education
 Planned or formal education
Nursing Career Roles
 Clinician
 Nurse Educator
 Advanced Practice Nurse
 Nurse Administrator
 Nurse Researcher
 Military Nurse
 Forensic Nursing
Healthcare Team Members
 Nurses
 Physicians
 Physician Assistant
 Therapists and Technicians
 Pharmacist
 Nutritionist/Dietitian
 Case Manager/Social Worker
 Pastoral Care
 Nursing Assistant
 Unit Secretary
 Ancillary Staff
Professional Nursing Organizations
 Created to deal with issues of concern
within profession
 American Nurses Association
 National League of Nursing
 State Nurses Association
 National Student Nurse Association
 Organizations specific to specialty
Health Care Delivery System
 Prospective Payment System
 Diagnosis-related Groups
 Capitation
 Utilization Review
Health Care Plans
 Managed care organization (MCO)
 Medicare
 Preferred provider organization (PPO)
 Medicaid
 Private insurance
 Long term care insurance
Health Care Services
 Primary Care
 Preventive Care
 Secondary Acute Care
 Tertiary Care
 Restorative care
 Continuing Care
Transitions taking place:
in health care
 • Curative Preventive approach
 • Specialized care Primary health care
 • Medical diagnosis Patient emphasis
 • Professional identity Team identity
 • Trial and error Evidence based practice
 • Self – regulation Questioning of professions
 • Focus on quality Focus on costs
Transitions taking place:
In the workplace
 • High tech Humanistic
 • Competition Cooperation
 • Need to supervise Coaching, mentoring
 • Hierarchies Decentralized approach
Transitions taking place:
In nursing
 • Continued competencies Competencies a condition
 • Hospital environment Community environment
 • Quality as excellence Quality as safe
 • Clear role Blurring roles

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Trend and issues of nursing and role of nurse

  • 1. Current Trends & Issue in Nursing From- Mr.R.RAMACHANDRAN, Student Tutor, RNPC.
  • 2. Professional Nursing Today Legal Implications for Nursing Practice Healthcare Delivery System Entry into Professional Nursing NRS 101
  • 3. What is a Nurse?
  • 4. Definition of Nursing :  Nursing is a unique function of nurse, that is to assist the individual sick or well in the performance of those activities contributing to health on its recovery or peaceful death, that he would perform unaided if he had the necessary strength, will or knowledge. - ICN
  • 5. How are nurse’s portrayed in the media?
  • 6. What makes a nurse a professional? http://www.youtube.com/watch?v=z1-uMKg86Ck
  • 7.  Extended education  Theoretical body of knowledge  Provides a specific service  Autonomy in decision making and practice  Code of ethics Nursing as a Profession
  • 8. Scope & Standards of Practice  Standards of Practice  Standards of Professional Performance  Code of Ethics
  • 9. ANA Standards of Professional Performance  Quality of practice  Professional Practice Evaluation  Education  Collegiality  Ethics  Collaboration  Research  Resource Utilization  Leadership
  • 10. Professional Nursing Practice  Nurse Practice Acts  Licensure and Certification  Science and Art of Nursing practice
  • 11. Historical Perspective  Florence Nightingale  Dorothea Dix  Clara Barton  Isabel Hampton Robb  Dr Mildred Montag
  • 12. Nursing Today  Registered Nurse  Licensed Practical Nurse  Nurse Practitioner  Clinical Nurse Specialist  Nurse Midwife  CRNA
  • 13. Introduction:-  Trends:-It denote general direction & tendencies specially of events, of opinion.  Nursing trends:-refers to direction towards which the different nursing events have moved or are moving as well as the opinion in & around nursing that are found in & about nursing profession.  Trends in nursing that is changes currently taking place in any area of nursing which the profession as a whole.  These do not occur independently but each one has a basis of related changes in other fields.
  • 14. These are:-  Social change  Change in other profession  Change in nursing profession itself in the country  Change taking place in other countries in nursing world.
  • 15. Social change:-  Nursing profession serves to meet the need of the society particularly the needs related to health & well being.  The changes in society will influence to bring about changes in nursing profession. 1. At present, efforts are made by government of India to deliver the health care to the community especially in rural area. 2. Overall improvement in the education of people with ever growing awareness about health & health need.
  • 16. Cont…  Now women are more educated & take up jobs out of home to serve & earn.  Advancement of technology eg. Automatization, Industrialization, Urbanization  After independence, government began to make serious efforts to meet health need of nation by implementing recommendation of bhore committee.
  • 17. Change in other profession:- Trends in nursing profession are closely related to those in medical profession.  Medical profession is fastly changing profession & The era of specialization & super specialization has come.  Morden health care facility like ICU, ICCU, Renal unit, Organ transplant unit etc  Biomedical science have far advanced resulting in newer diagnostic equipment such as scanner, New drugs, monitoring system in field of health care all over the world.
  • 18. Change in nursing profession itself in the country:- There is trends in nursing profession towards meeting the criteria of profession. It is fast moving in some areas & slower in other areas. – Trends to take up education leading to bachelor’s degree in nursing ,master degree as well as doctoral degree. – Trends related to tuition fee eg. Paid stipends, free hiring, accommodation , food & uniform but service is expected from the nurse. – Trends related to changes in working condition for nurses.
  • 19. Change taking place in other countries in nursing world:- International influence is brought about by many ways- – Fast growing trends to post basic dgree programmes. – INC promote sharing of ideas & common interest between member of national organization. – Exchange of professional literature like international review, Professional journals, articles etc
  • 20. Issue related to nursing profession:-  Various issue in nursing profession may be related to the profession , education ,Practice,& nurses themselves.  Status in nursing in society in Health care delivery system.  Value reflect in our nursing profession  Quality in nursing hand in hand education & practiced in hand b/w nursing  Unique function of nursing
  • 21. Cont….  Different level of nursing required in country  Evidenced base nursing research.  Expanded & extended role of nurse  Globalisation in the profession  Nursing leadership bringing change in health scenario according to community demand.
  • 22. Current Trends & Issues in Healthcare  Nursing Shortage  Patient Satisfaction  Managed Care  Transcultural Nursing  National Patient Safety Initiatives  Evidence-Based Practice  Information Age  Genetics  Globalization of Health  Aging Population  Legal & Ethical Issues  Terrorism/Bioterrorism/Disaster Nursing
  • 23. Nursing Shortage  National problem which is growing  Critical shortage in specialty areas  Avg age of nurse is 45  Resurgence of enticements for recruitment
  • 24. Reasons for Shortage  Work environment  Recruitment  Retention  Aging workforce  Compensation  Aging Baby Boomers  Shortage of nursing faculty
  • 25. Patient Satisfaction  Press ganey surveys  Good customer service  Patient Bill of Rights  Treat patients like family  Healthcare is a business
  • 26. Managed Care  Goal is to keep length of stay (LOS) down  Capitation  Patients are discharged sooner  Patient acuity higher  Health Care Plans  Case manager work closely with physicians and insurance companies
  • 27. Transcultural nursing  Nursing has become a melting pot  Nurses are challenged to be more culturally aware  Cultural sensitivity
  • 28. National Patient Safety Initiatives  Joint Commission National Patient Safety Goals  Institute for Healthcare Improvement “5 Million Lives” Campaign  The Leapfrog Group
  • 29. Joint Commission National Patient Safety Goals  Improve the accuracy of patient identification  Improve the effectiveness of communication among caregivers  Improve the safety of using medications  Reduce the risk of health care-associated infections  Accurately and completely reconcile medications  Reduce the risk of patient harm from falls  Encourage patients’ active involvement in their own care as a patient safety strategy  The organization identifies safety risks inherent in its population  Improve recognition and responses to changes in a patient’s condition
  • 30. The Leapfrog Group  Reduce preventable medical mistakes and improve the quality and affordability of health care  Encourage health providers to publicly report their quality outcomes so consumers can make informed choices
  • 31. IHI “5 Million” Lives Campaign”  Deploy rapid response teams  Deliver reliable evidence-based care for acute MI  Prevent adverse drug events  Prevent central line infections  Prevent surgical-site infections  Prevent ventilator-associated pneumonia
  • 32. Evidence Based Practice  Goal is to achieve cost-effective, high quality patient care based on scientific inquiry  Nurses need to understand research process involved  Nursing care should not be based on opinions, past practices, but on the results of scientific research  Clinical journals  Practice guidelines  Nursing research
  • 33. Information Age  Consumers today are more computer savvy regarding healthcare  More info on internet  Consumers could possibly be more informed than health care worker  Joint Commission 2014 all medical records have to be EMR
  • 34. Genetics  Many major developments in the field of genetic research  Stem Cell  Human Genome Project  Cloning  Legal & Ethical issues
  • 35. Globalization of Health  Healthcare has become a global issue  People are mobile, diseases can travel  Nurses need to have an understanding of the issues pertaining to global health
  • 36. Legal Limits of Nursing Sources of Law  Statutory law: Nurse Practice Acts  Regulatory law/Administrative law  Common law  Criminal law: felony & misdemeanor  Civil law: negligence & malpractice :
  • 37. Legal Issues in Nursing  Nurse Practice Act  Standards of Professional Practice  EMTALA  Advanced Directives  HIPAA  Licensure  Good Samaritan Laws  Public Health Laws  Physician-Assisted Suicide  Americans With Disabilities Act
  • 38. Civil & Common Law Issues in Nursing Practice  Intentional Tort  Unintentional Tort  Negligence  Malpractice  Consent  Informed Consent  Malpractice Insurance  Abandonment & Assignment Issues
  • 39. Aging Population  Population is aging  Growing concerns regarding the unique needs of the elderly  Gerontological nursing
  • 40. Terrorism/Bioterrorism/Disaster Nursing  The 9-11 terrorist attacks have heightened attention to the growing threats of terrorism  Nurses need to be aware to the health consequences of terrorism and use of biological agents
  • 41. Common problems of nursing administration are:  Poor involvement of nursing administrators in planning and decision making  No specific power has been assigned to nursing In charges but she has been made In charges of all inventories and linen of hospital  Lack of knowledge of management of nursing administration  No clear cut written nursing policies and manuals  Poor job description for various nursing cadres
  • 42. Common problems of nursing administration are:  Poor organized staff development programmed Inefficiency of nursing councils to maintain standards, and inadequate efforts at higher level for implementation of separate directorate of nursing  Less educational preparation  Refuse to accept new role  Adhere to tradition  Failure to unity among nurses
  • 43. Practice Settings for Nurses  Hospital  Community Based Practice Settings
  • 44. Hospital Based Nursing  Acute care is where largest group of nurses practice  Different Staffing Patterns  Skill Mix Changing  Increase in skilled nursing facilities due to aging population and increase in chronic disease
  • 45. Community Based Nursing  Focus on health promotion, maintenance, education  Community Health Centers, Clinics  School Nursing  Occupational Health  Home Health  Physicians Office  Managed Care Organizations  Forensics Nursing
  • 46. Nursing Education  Diploma  ADN  BSN  Master’s  Doctorate  Continuing education  In-service education
  • 47. Nursing Roles  Caregiver  Clinical Decision Maker  Client Advocate  Rehabilitator  Comforter  Communicator  Collaborator  Teacher
  • 48. Professional Roles & Responsibilities  Autonomy & Accountability  Caregiver  Client Advocate  Educator  Manager/Clinical Decision Maker  Communicator  Collaborator  Career Development
  • 49. Autonomy & Accountability  Autonomy is the essential element of professional nursing  Person is reasonably independent and self- governing in decision making & practice  Increased autonomy=Increased responsibility  Accountability- nurse is responsible professionally & legally for type & quality of care provided  Regulated through Standards of Practice and Nurse Practice Act
  • 50. Clinical Decision Maker  Utilizes critical thinking skills and the nursing process  Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation
  • 51. Client Advocate  Nurse protects the clients human and legal rights  Providing information to assist in decision making  Patient Bill of Rights
  • 52. Rehabilitator Role  Assist client to return to optimal level of functioning  Nurse helps client to adapt physically and emotionally to changes in lifestyle, body image
  • 53. Comforter Role  Caring for client as a human being  Role is traditional to nursing  Care is directed to whole person, not just a body part  Demonstration of care and concern
  • 54. Communicator Role  Role is central to all other roles  Involves communication with client, family, healthcare team members, resource people, and the community  Without clear, concise communication it will be difficult to give effective care
  • 55. Teacher/Educator Role  Explains concepts and facts about health, demonstrates procedures, reinforces learning, determines understanding, and evaluates progress of learning  Unplanned or informal education  Planned or formal education
  • 56. Nursing Career Roles  Clinician  Nurse Educator  Advanced Practice Nurse  Nurse Administrator  Nurse Researcher  Military Nurse  Forensic Nursing
  • 57. Healthcare Team Members  Nurses  Physicians  Physician Assistant  Therapists and Technicians  Pharmacist  Nutritionist/Dietitian  Case Manager/Social Worker  Pastoral Care  Nursing Assistant  Unit Secretary  Ancillary Staff
  • 58. Professional Nursing Organizations  Created to deal with issues of concern within profession  American Nurses Association  National League of Nursing  State Nurses Association  National Student Nurse Association  Organizations specific to specialty
  • 59. Health Care Delivery System  Prospective Payment System  Diagnosis-related Groups  Capitation  Utilization Review
  • 60. Health Care Plans  Managed care organization (MCO)  Medicare  Preferred provider organization (PPO)  Medicaid  Private insurance  Long term care insurance
  • 61. Health Care Services  Primary Care  Preventive Care  Secondary Acute Care  Tertiary Care  Restorative care  Continuing Care
  • 62. Transitions taking place: in health care  • Curative Preventive approach  • Specialized care Primary health care  • Medical diagnosis Patient emphasis  • Professional identity Team identity  • Trial and error Evidence based practice  • Self – regulation Questioning of professions  • Focus on quality Focus on costs
  • 63. Transitions taking place: In the workplace  • High tech Humanistic  • Competition Cooperation  • Need to supervise Coaching, mentoring  • Hierarchies Decentralized approach
  • 64. Transitions taking place: In nursing  • Continued competencies Competencies a condition  • Hospital environment Community environment  • Quality as excellence Quality as safe  • Clear role Blurring roles

Editor's Notes

  1. Trends:-It denote general direction & tendencies specially of events, of opinion. Nursing trends:-refers to direction towards which the different nursing events have moved or are moving as well as the opinion in & around nursing that are found in & about nursing profession. Trends in nursing that is changes currently taking place in any area of nursing which the profession as a whole. These do not occur independently but each one has a basis of related changes in other fields.
  2. Trends:-It denote general direction & tendencies specially of events, of opinion. Nursing trends:-refers to direction towards which the different nursing events have moved or are moving as well as the opinion in & around nursing that are found in & about nursing profession. Trends in nursing that is changes currently taking place in any area of nursing which the profession as a whole. These do not occur independently but each one has a basis of related changes in other fields.