NR 393 Week 4 Course Project Milestone 2: Guidelines
NR 393 Week 4 Course Project Milestone 2: Guidelines
Purpose
To apply lessons in nursing history to living nurses contributing to nursing history through an interview and recording of historical information
In the history of nursing, nurses were forced to care for others in turn of a prison sentence or prostitution charges (Judd, 2018). Due to this, nursing was far from a respectable profession. According to Judd, women in the early 1800’s weren’t as prominent in the workforce as they are today. They were meant to be homemakers, moms, or “wet-nurses” to those moms who were unable to breastfeed or care for their own children. Women were seen as inferior, compared to men, when it came to strength and intellect. Through the industrial revolution, more work became available for women. However, many women stayed in roles in hospitals and private duty nursing settings. Nightingale completely revolutionized the medical field, bringing in her truly advanced ideas into the nursing world. Early nursing wasn’t like it is today – it often focused on keeping clean water and fresh air available, cleaning the patients and keeping them presentable, and keeping the general environment clean, for prevention of disease. Today, nursing still has these same basics. However, one thing we are so heavily taught in nursing school is – “if it isn’t charted, it wasn’t done”. So, when did this start? When did documentation become, and maintain, such an important part of what we do? (Judd, 2018).
According to the American Association for the History of Nursing, Linda Richards was born on July 27, 1841. She entered a formal nursing education in 9/1872 and graduated a year later. She worked as an assistant nurse before her formal training. She was well known for her works in education. In 1874, she was the “superintendent of the Boston Training School.” (American Association for the History of Nursing, n.d.) In 1892, she established a school at the Philadelphia’s Methodist Episcopal Hospital, and in 1893-94, she reorganized nursing programs and was maintaining superintendent of at least 2 other training schools. (American Association for the History of Nursing, n.d.) During all this, she also was “recognized as a pioneer in developing nursing documentation, training for nurses, and clarification of professional duties while working at New York’s Bellevue Hospital Training School, focused much of her attention on nursing in mental health care facilities” (Office of Mental Health. 5/2017). While working in multiple hospitals, Linda started to notice that aside from doctors keeping some personal notes, there wasn’t a formal record-keeping system and that patients with more chronic conditions would get treated as a brand-new patient, every visit. (Concordia, 2020). Richards then went to evaluate information in patient charts that should be shared – such as allergies, past diagnosed diseases, and their history (Concordia, 2020). Due to this revelational new system, many patients were better treated, treating diseases more effectively, and decreasing unnecessary pain. Due to this, mortality rates decreased as there was more efficient treatment in long term illness. (Concordia, 2020). At 70 years old, Richards retired and passed away 5/16/1930. (American Association for the History of Nursing, n.d.)
It is amazing to know that nursing started out as a “get out of jail card”. Women forced to care for others, really serve others, and this led to a negative view of nurses. Florence Nightingale really changed the view of nurses, and the more that nurses were required to have formal training, the respect only grew through the years. Today, nursing still has those basic principles – keeping our patients clean, fed, and their environment with clean air, food, and water. However, our roles go so much further. Much of what we do is chart, chart, and chart some more! It can cause so much anxiety thinking about if our documentation systems go down, or we have to paper chart! Before Linda Richards, there was no formal documentation. Could you imagine going to work treating the same patients but having no clue what was done by the previous nurse, or the previous day? Thanks to Linda Richards, we have a very strict protocol to ensure that every action that is done for our patients is recorded. While this is great for collaboration between the team, it’s also important for details that may have been missed in the report between shift to shift and nurse to nurse, as well as legally. Like we all had drilled in our heads in nursing school – “If it wasn’t charted, it wasn’t done!”
References:
American Association for the History of Nursing. (n.d.). Linda A Richards. Retrieved 11/16/20 from https://www.aahn.org/richardsLinks to an external site.
Concordia ASBN. (4/1/2020). National Nurses Week: Four Nursing Role Models who Changed Nursing Forever. Retrieved 11/16/20 from https://absn.csp.edu/blog/national-nurses-week-four-nursing-role-models-changed-nursing-forever/Links to an external site.
Judd, D. (2013). A History of American Nursing. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781284044324/Links to an external site.
Office of Mental Health. (5/2017). OHM’s Psychiatric Nurses: Caring for Both Mind and Body. Retrieved 11/16/20 from https://omh.ny.gov/omhweb/resources/newsltr/docs/may-2017.pdf#:~:text=Linda%20Richards%2C%20recognized%20as%20a%20pioneer%20in%20developing,attention%20on%20nursing%20in%20mental%20health%20care%20facilitiesLinks to an external site..
It amazes me how much, in terms of medicine and technology, that we have advanced over just the last 100 years! From 1MB computers being over the size of a house to us carrying devices in our pockets that seem to just have endless memory. In my current practice, I actually use both EMR and paper charting and have experienced the EMR going down and needing to transition to paper.
As far as paper charting, I think that some of the pros are that it’s just easier – there is no searching for a certain box to click or where to input this piece of data. The paper charting systems I have worked with are pretty straight forward and organized for a body-wide assessment. Writing in a quick nursing note can cover everything you need without needing to check off what seems like hundreds of little boxes. However, there are some cons as well. Legibility is probably the biggest one for me. Not everyone has perfect penmanship, and if you can’t read the notes, they might as well be useless. There is also the concern about paper orders getting confused, again due to bad penmanship or inaccurate use of abbreviations. If that piece of paper gets misplaced, thrown away, or soiled with food and/or water/liquid, it is also destroyed. With paper charting, there isn’t a backup save feature so you can get that information back – so you have to be careful and aware when dealing with paper charting. Another con would be room to chart – I tend to write comprehensive, complete notes, and they can often take up more space on the paper charting than I may be able to afford. With EMR, that isn’t a concern. While the EMR may be a little more time consuming, at least until you get used to the program you are using, there are some definite positives. It is nice when doing an assessment that there are drop-down boxes that can prompt or remind you to ask certain questions, for a more complete exam. Having things all in one place, such as medication list or past medical history. There isn’t a need to go searching through a paper chart when it is under its own little tab on the computer. Of course, there is always the nursing notes tabs that allow you to chart whatever you need in, for me, what is like a word document. There is also not a concern for running out of space, like with paper. However, when the EMR or computer systems go down, we always need to make sure that we have a back-up paper system! I know at the SNF/s I work at, the MAR’s automatically print if the system crashes for any reason, and they print the most recent one saved into the system, and the charting systems are pretty good about updating quickly when orders are input.
Today, nurses are so heavily trained on the EMR that they forget that we always have to know how to paper chart as well, and I fully believe that our new nurses, whether in school or at their first jobs, need to be fully educated on the do’s and don’t’s of paper charting. There is nothing worse than doing a night shift and the scheduled computer updates shut your entire floor or facility down – and you don’t know where the paper charting forms are, or how to fill them out! I feel like with the EMR, it’s kinda self-explanatory, as everyone is so adapted to the use of computers and cell phones in our everyday lives. However, I have seen many newer nurses have complete panic attacks because they are unaware of knowing how to use the fallback of paper charting.
Thanks to Richards, we are able to communicate with our team members, as well as the patient’s family and friends, through a charting system, which has become a crucial area to a nurse’s success in the field. When I think about what she would think today – I fully believe the technology would be kind of a shock – but for her to see what her works 150 years ago have allowed for today, she would be proud.
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Course Outcomes
The Course Project enables the student to meet the following Course Outcomes.
Incorporate appropriate historical perspectives into current professional nursing practice (PO 2).
Compare current professional nursing practice roles with historical roles of the nurse (PO 7).
Points
The entire project is worth 600 points. Milestone 2 is worth 200 points of this total.
Due Date
Submit your completed NR393 Milestone 2 by the end of Week 4 at 11:59 p.m. MT.
Requirements and Guidelines
Carefully review this Milestone 2 Guidelines document rubric and the Milestone 2 Template.
Review the Differences Between Closed and Open-Ended Questions (Links to an external site.)Links to an external site. document. Use the suggestions to formulate your initial and follow-up questions.
Download the Milestone 2 Template (Links to an external site.)Links to an external site.. Save it to your computer in Microsoft Word 2010 (or later) as a .docx file with the file name as Your Last Name NR393 Milestone 2.docx.
Carefully review the rubric criteria for Milestone 2 and type directly on your saved Milestone 2 Template. Note that some of the questions have been provided for you on the template.
Submit your completed Milestone 2 as instructed by Sunday of Week 4.
After return of the graded Milestone 2, use faculty feedback to revise areas and questions for a superior interview. Revisions do not need to be submitted to faculty for approval.
Note: The date of the interview must be after Friday of Week 5 to allow your instructor time to grade your Milestone 2 and provide you with feedback (unless you have received prior permission from your instructor). If the interviewee’s schedule requires that you do the interview before that date, consult your instructor regarding early submission of Milestone 2 to ensure that you receive comments in time to incorporate revisions before the interview. Thank you.
Important: Remember that the interview must be a face-to-face or phone interview where you can ask questions of the nurse, the nurse can respond, and you can provide your response. It is not acceptable to use e-mail, text messages, or any other method to have the nurse write or type the answers. Contact your instructor if you have questions. Thank you.
Course Project Milestone 2Template
Prior to completing this template, carefully review Course Project Milestone 2 Guidelines, paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly in this template, and save again. This assignment is due by the end of Week 4at 11:59 p.m.MT.
Your Name:_________
| Assignment Criteria | Answers
Note:See Milestone 2 Rubric for details required in each area. |
| Scheduled Date and Location of Interview
30 points |
Datefor interview (must be after Friday of Week 5):
Location: |
| Interview Recording Method
20 points |
Select one:Written notes,audio, or audio/visual
Hardware and/or software used: |
| Milestone 3 Submission Method
20 points |
Select one: Typed on Milestone 3 Template, audio, or audio/visual |
| Questions to Be Asked
Remember that all questions must be open ended and clearly related to this nurse. Follow-up questions must be clearly related to the associated primary question. |
|
| Primary Questions
30 points (Type Question #3 below.) |
Follow-Up Questions for Each Primary Question
80 points (Type questions below; see guidelines and announcements for details.) |
| 1:What are some of your favorite memories of nursing school? | a. |
| b. How did classmates or instructors impact your development as a nurse? | |
| 2:How have you improved the quality of nursing practice during your career? | a. |
| b. | |
| 3: | a. |
| b. | |
| 4:How have you contributed to the profession of nursing and to nursing history? | a.Why has work in that area become your passion? |
| b. | |
| 5:Who is your favorite nurse from nursing history? | a. |
| b. How has that nurse influenced your own nursing practice? |
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