Conceptual Framework

CONCEPTUAL FRAMEWORK

The conceptual framework utilizes two central themes as the basis for developing the nursing educational program: (1) health care consumer, and (2) the practice of nursing. In addition, there are several concepts which are unifying threads throughout the curriculum.

HEALTH CARE CONSUMER

· BASIC NEEDS

An individual's behavior is a result of striving toward meeting needs, beginning with those essential to life and progressing toward creative self-realization. Needs are communicated through a wide variety of behaviors. Nursing needs to be knowledgeable about various behavior patterns in society to develop an understanding of individuals and assist them in maintaining health and coping with illness and other crises.

· DEVELOPMENT ACROSS THE LIFE SPAN

The developmental process is a continuous, lifelong progression through definable stages that begin with conception and end with death. Human development is the outcome of the individual's response to a variety of intrinsic and extrinsic forces: biological, psychological, social and environmental. Nursing practice as it relates to the developmental process focuses upon an identification of the stages of the human life cycle to promote the factors that permit attainment of the individual's optimal potential.

· SOCIAL ORGANIZATION

The individual, the family, and the community are interacting with components of the social structure. Nursing practice utilizes a broad biological and behavioral science background, as well as an awareness of diverse cultural influences, as a prerequisite for the nursing focus on the individual, the family, and the community.

· HEALTH

As the individual interacts and responds to the internal and external environment, varying degrees of health are experienced. The wellness continuum is a symbolic representation of the varying degrees of health experienced by the individual, the family and the community through time and space. The changing status of health, on a continuum, is influenced by both the maintenance and promotion of wellness and the alleviation of illness. The nurse relates the totality of a person's life to those factors affecting health maintenance. A broad range of biological, psychological and social factors are considered in helping a person formulate programs for health maintenance.

PRACTICE OF NURSING

NURSING ROLE DEVELOPMENT
A role can be defined as a cluster of those functions a person performs when occupying a specific position within a particular social context. In response to a dynamic society, nursing is continually redefining nursing roles to provide more individual and comprehensive health care. Nursing roles identified by the State Board’s Differentiated Entry Level Competencies are Provider of Care, Coordinator of Care, and Member of the Profession. Standards of care for each level of nursing as well as competency statements guide the nurse in fulfilling the roles of Provider of Care, Coordinator of Care, and Member of the Profession.

The graduate nurse demonstrates competencies in these roles, depending on the educational level completed, for example:

Ø The Certified Nursing Assistant practices in structured settings and provides basic nursing care under the direct supervision of a licensed nurse.

Ø The Licensed Vocational Nurse is an accountable member of the health care team and collaborates in providing basic preventative, therapeutic, and rehabilitative measures for clients of all ages and cultural backgrounds in a variety of structured settings.

Ø The Associate Degree Nurse is an accountable member of the health care team, providing preventative, therapeutic, and rehabilitative measures for clients and families of all ages and cultural backgrounds, coordinating care for a group of clients and families through use of the problem solving process, and supervising other health care providers in a variety of community based settings.

Ø The Baccalaureate of Science Nurse is an accountable member of the health care team, developing and applying nursing research and theory, implementing comprehensive nursing care for a variety of clients in various settings, coordinating care for individuals, families, aggregates and communities, and supervising other health care workers.

Provider Of Care

o Nurses of all educational backgrounds provide preventative, therapeutic, and rehabilitative measures for clients in a variety of settings.

o Nurses use critical thinking to make appropriate nursing decisions, based on a specific knowledge base, experience, competencies, attitudes, and standards. Nurses incorporate knowledge from nursing literature and advancing technology to provide relevant and safe nursing care.

o The nursing process is an organized, systematic method to assess health needs, plan, administer, and evaluate care given to individuals or groups in various settings.

o Nursing requires effective use of communication skills to function in interviewing, teaching/learning, and counseling situations.

o Communication of empathy, respect and care facilitate effective delivery of nursing care.

Coordinator Of Care

o Nurses organize and facilitate the delivery of comprehensive services to clients.

o Collaboration with the client, significant others, and members of the multidisciplinary health care team is essential to nursing care.

o Nursing services are provided in a variety of health care settings. Because disease is only one aspect of the wellness continuum, problems of health promotion, maintenance, and restoration are encountered in many different settings (home, community, school, work, recreation, and institutions). The nursing education program is designed to provide exposure to a variety of disciplines and clinical experiences in diversified settings to enhance the learner's understanding of man and his environment.

Member Of The Profession

o As increasing scientific and technological progress and social change result in consumer demands for more comprehensive health care, nursing must respond by redefining and expanding nursing roles to meet the needs of a dynamic, diverse, and multicultural society.

o Responsibilities of the nurse should include: commitment to the profession through active participation in those political and professional organizations designed to promote the development and practice of nursing, accountability and responsibility in nursing practice, legal and ethical nursing practice, and assurance of high standards in the practice of nursing.

Other organizing concepts incorporated throughout the nursing curriculum are:

· The Teaching/Learning Process For The Adult Learner

Learning is an active process that utilizes the thinking and perceiving abilities and knowledge previously acquired to gain new knowledge in explaining events, facilitating change, and solving problems. Nursing utilizes learning theories in conjunction with a broad scientific foundation to promote the development of critical thinking and the synthesis of learning. Through partnership in learning, both students and faculty are active participants in the learning process. In addition, the content flows from simple to complex.

· The Development Of The Nursing Role

Through a multiple entry - exit program (MEEP), the nursing program addresses the needs of the adult learner in the community. The nursing programs provide the following: entry through tech-prep with preparatory courses in local high schools, preparation as a certified nurse assistant through the continuing education department, entry into the LVN program at various sites, entry into the ADN program with an elective to take the LVN licensing exam, a transition for currently licensed LVN's and Paramedics into the ADN program, courses to prepare for a higher degree at local universities, a transition for ADN graduates into the baccalaureate program available at the University Center at the Montgomery College site, and continuing education courses at various sites. Each component of the nursing program has been designed to promote a seamless educational journey which encourages and expedites mobility between the levels of nursing.

· The Decision Making Process

Decision making, the end product of the problem solving process, is utilized to fulfill needs and reach goals. The decision making process, in addition to being a part of the nursing process, is an inherent aspect of daily living. Critical thinking is essential to the decision making process in nursing, incorporating information from a specific knowledge base, experience, competencies, attitudes, and standards. Decisions are also based on knowledge from research and advancing technology.

· The Communication Process

Communication is the means through which social interaction and learning take place. It is the process by which ideas, attitudes and knowledge are transmitted and received. Nursing requires effective use of communication skills to function in interviewing, teaching-learning, and counseling situations.

· The Process of Health Promotion

The promotion of health is an integral component of nursing practice. This includes promotion, maintenance and restoration of optimal health.

· The Process of Developing a Caring Relationship

A caring relationship between nurses, clients, and their families begins with self-awareness on the part of the nurse. The nurse must then recognize the other person's worth, dignity, and frame of reference, within the diversity of experience, lifestyle, and culture. The nurse-client relationship progresses to the giving of self while providing competent nursing care to clients and their families. A caring relationship develops as the nurse becomes empathetic and responds to the needs of the individual, family, and group. Interaction with clients in a humanistic, empathetic manner is the artistic activity of caring in nursing.

Multiple Entry-Exit Program (MEEP) Options Flowchart