School of Nursing Mission, Vision and Values

Mission

To educate nursing students at beginning and advanced levels through excellence and innovation in teaching, scholarship and service.

Vision

To be a center for excellence in nursing education; recognized for innovation, scholarship, and service in the preparation of professional nurses who advocate for health and who collaboratively care for individuals, families, communities and populations throughout the life cycle in a variety of settings.

Values

The School fosters a commitment to values, attitudes and ethical dimensions, including integrity, respect, collaboration, cooperation and social justice that are hallmarks of professional nursing. The School is committed to upholding and maintaining both professional nursing standards and a code of ethics for nursing.

School of Nursing Philosophy

The mission of the School of Nursing is further explicated through the School's philosophical beliefs about the person, the environment, health, nursing, the educational preparation of nurses, and evidence-based nursing practice.

Person

A person may be an individual, a family, a community or a population. The person is defined according to the focus of care.

Environment

The environment is a complex web of internal and external conditions that influence the health of individuals, families, and communities.

Health

Health is the optimal fit between the person and the environment and is ultimately defined by the person. Health is a dynamic experience, influenced by internal and external environments, including interactions with the nurse.

Nursing

Nurses are healthcare providers who work collaboratively with persons and other individual healthcare providers as well as with agencies and institutions to protect, promote and optimize health. This work takes place within an environment of care that is influenced by biological, personal, social, physical and global forces that are more or less supportive of health.

The process of nursing is collaborative in nature, with the nurse entering into partnership with persons to facilitate the accomplishment of mutually determined goals. The partners share not only in determining goals, but also in joint assessment of progress toward goal achievement and in the responsibility for the outcomes. The person is an active participant in the process, possessing varying levels of knowledge and capability to understand and/or manage health and illness and to actively engage in the process

In the nurse-person partnership, the nurse integrates knowledge, skills, experience, values, beliefs and attitudes to facilitate mutual decision-making. The partnership is shaped by characteristics of the nurse, the person and the environment. The nurse assists persons to identify and use their strengths and resources, using problem-solving skills and caring behaviors to facilitate and/or restore an optimal state of health.

Nursing Education

Students and faculty cooperate in assuming a shared responsibility for planning and implementing learning activities within the context of the curriculum. Faculty members are in partnership with students and sensitive to the individual needs of students. Learning readiness, self-directed learning, recognition of the value of past experience and education, and the development of a problem-solving orientation to learning are important aspects of the learning process. Learning is facilitated when the educational environment provides an open, accepting atmosphere in which the faculty and students work together to achieve mutual goals.

Professional nursing practice is based on concepts and theories from the discipline of nursing and from other fields. A strong foundation from the natural sciences and the humanities assists nurses in developing the critical thinking skills essential to scientific nursing practice. Professional nurses use the nursing process to assess, analyze, plan, implement and evaluate nursing care. The scientific basis for practice continues to be developed throughout the nursing curriculum and provides the graduate with the knowledge and skills to practice nursing in a responsible manner.

Nursing education, at the baccalaureate level, provides graduates with the first professional degree in nursing. This education prepares the student for professional practice and beginning leadership roles within an ever-changing healthcare industry. It also serves as a foundation for graduate education in nursing.

Graduate nursing education, at the master's level, prepares nurses with knowledge and skills for advanced nursing practice. Graduates provide expert nursing care to persons; contribute to nursing science; serve as mentors and teachers of nurse colleagues; and participate actively in planning and policy decision-making.

Graduate nursing education, at the doctoral level, prepares advanced practice nurses at the highest professional level of nursing practice. Graduates will advance the application of nursing knowledge through evidence-based practice including practice improvement, innovation and testing of care delivery models, evaluation of health outcomes, health policy, leadership in healthcare delivery and quality improvement, and clinical expertise for advanced nursing education.

Evidence-Based Nursing Practice

Nursing is a discipline that uses research as a process to develop a distinct body of knowledge as a basis for evidence-based practice. Research serves as the basis for changes that influence and improve nursing practice and outcomes of care.

The professional nurse prepared at the baccalaureate level:

1. collaborates with others to identify and answer questions that arise from the practice of nursing and related issues; and
2. is an informed consumer of research, able to appraise original research reports, evidence summaries, and clinical practice guidelines for specific practice implications.

The professional nurse prepared at the master's level:

1. functions as a collaborative member of research teams;
2. evaluates the clinical usefulness of research findings; and
3. assumes a leadership role in promoting evidence-based practice.

The professional nurse prepared at the doctoral level leads practice change by the ability to:

1. develop and test methods to quantify outcomes of care;
2. develop clinical applications of primary research; and
3. design evidence-based practice programs for populations.

School of Nursing Conceptual Framework

The philosophy of the School of Nursing is further explicated through a conceptual framework. The School of Nursing faculty have identified six core concepts for the nursing curriculum:

1. collaborative partnership,
2. professional values,
3. nursing process,
4. environment,
5. cultural competence, and
6. 6) evidence-based practice.

Collaborative Partnerships

Collaborative partnership is a philosophical stance encompassing the values, beliefs and attitudes of the nurse that influence shared power and decision-making in all nurse-person encounters (Gottlieb & Feeley, 2006). The nurse enters into an active, caring relationship with the person to identify and pursue mutually agree-upon goals. This relationship requires active participation by both the nurse and the person to the extent possible given the capabilities of the person. Person participation may range from inactive person and fully active nurse to fully active person and inactive nurse. The optimum balance depends on the health problem or issue, the preference and/or capability of the person at that moment in time, and the situation.

The aim of nursing education is to prepare students in a systematic way for competent, caring practice based both on clinical knowledge and knowledge of the situation. Clinical knowledge is the theoretical and experiential understanding of people, both as individuals and groups, and how they respond and cope during times of health, vulnerability and illness (Gottlieb & Feeley, 2006). This knowledge also includes understanding the complexities of health and illness, the environment in which healthcare is provided, and the factors that influence the processes and outcomes involved in the collaborative partnership. Situational knowledge comes from getting to know the person who is in the current collaborative partnership. Within this relationship, nursing care is provided to facilitate achievement of optimal physical, social, spiritual and psychological well-being.

Professional Values

Professional values are the foundation for nursing practice and provide a framework for working within collaborative partnerships. Core professional values include:

1. altruism: a concern and advocacy for the welfare and well-being of people;
2. autonomy: the right to self-determination;
3. human dignity: respect for the inherent worth and uniqueness of people;
4. integrity: acting in accordance with an appropriate code of ethics and accepted standards of practice; and
5. social justice: fair treatment of people regardless of socioeconomic status, ethnicity, age, citizenship, state of health or illness, disability or sexual orientation (AACN, 2008).

The aim of nursing education is to promote the development and application of professional values and associated caring behaviors within the context of the collaborative partnership.

Nursing Process

The nursing process, a critical thinking framework, is collaborative in nature and involves five essential elements: assessment, diagnosis, planning, implementation and evaluation. Assessment is the systematic gathering of information related to internal and external environments using observation, interview and physical examination as appropriate to the situation. Diagnosis is the identification of the person's responses to health and illness. A plan of care is developed based on mutually-determined goals and objectives. Interventions are designed and implemented based on these goals as well as the knowledge and expertise of the nurse, and the knowledge, capabilities, and preferences of the person. Interventions include ongoing assessment, direct or indirect care, teaching-learning, counseling, referral and advocacy. Evaluation of outcomes is ongoing and may lead to reaffirmation and/or renegotiation of any of the elements of the process.

The aim of nursing education is to offer varied learning opportunities in which students develop and/or enhance their knowledge related to health and illness. Critical knowledge and skills for the nursing process include:

1. communication;
2. critical thinking;
3. diagnostic reasoning;
4. clinical judgment, and
5. psychomotor skills.

Environment

The environment is a complex web of internal and external conditions that influence the health of individuals, families, and communities. Aspects of the internal environment include the physiological, genetic, developmental, psychological and spiritual makeup that are unique to a particular individual. The external environment is the context within which people live (such as family, neighborhood), work, recreate, and receive health and nursing care. External environmental factors, such as social networks, culture, economic conditions, physical environment and politics influence the health and well-being of individuals, families, and communities. Each individual, family, neighborhood and community is situated in a unique set of these conditions that can have negative or positive effects on health and well-being. The role of the nurse is to create, restore, maintain and advocate for caring environments that support health and well-being of individuals, families, communities, and aggregates.

Students work in multiple environments of care to learn about and provide collaborative care including health promotion, disease and illness prevention, and illness care. These environments of care consist of homes, schools, churches, workplaces, neighborhoods, communities, hospitals, rehabilitation centers, mental health centers, long-term care facilities, primary and specialty care clinics, hospice, mobile vans, and any setting where nursing care is provided. Within these settings and agencies, students learn about the importance of partnership and have the opportunity to work collaboratively with individuals, families, communities, and interdisciplinary providers. A home-base is an environment of care that is unique to the UNF SON undergraduate curriculum, providing students the opportunity to work in one place with a cohort of other students across the curriculum. The continuity of the home-base experience is designed to complement the semester rotations across nursing specialty areas.

Cultural Competence

Cultural competence is a lifelong process of learning that focuses on persons becoming increasingly self-aware and responsive to cultural differences within the context of their environments. Cultural competence requires skills beyond a basic understanding of cultural diversity and ethnicity. Appreciating differences in family and roles, communication, healthcare practices, nutrition, spirituality and death rituals among persons is crucial in creating culturally sensitive environments of care (Purnell & Paulanka, 2005). Nurses care for all persons who comprise varying social mores, world views, languages, literacy skills, socio-economic levels and have the potential to help reduce racial and ethnic disparities across all environments of care (Smedley, Stith, & Nelson, 2002).

The aim of nursing education is to instill a commitment to cultural competence and to assist students to develop the requisite skill set. Critical skills for the development of cultural competence include:

1. understanding of self;
2. integration of cultural knowledge and cultural sensitivity into the nursing process; and
3. advocating against ethnocentric practices, cultural biases, stereotypes and health disparities.

Evidence-Based Practice

Evidence-based practice, a rigorous problem-solving approach to care, provides the nurse with the tools to integrate the most current, best evidence into the plan of care. After identifying a clinical problem or question, the nurse first considers the preferences of the person with whom the nurse is partnering. Other forms of evidence, including practice guidelines, systematic reviews, results of well-designed scientific studies, expert opinions and local data, are appraised for usefulness and appropriateness. The resulting best evidence is then integrated, with person preferences, into the plan of care. As the nurse appraises the evidence, outcome measures are also identified for inclusion in the plan. Using the best evidence enhances the quality of care, optimizes outcomes, and increases the satisfaction of the partners.

The aim of nursing education is to assist students in the development of critical appraisal skills for the evaluation of the evidence for clinical usefulness.

References

• American Association of Colleges of Nursing. (2008). Revision of the essentials of baccalaureate education for professional nursing practice - Draft. Washington, DC: Author.
• Gottlieb, L.N., & Feeley, N. (2006). The collaborative partnership approach to care: A delicate balance. St. Louis, MO: Mosby.
• Purnell, L.D., & Paulanka, B.J. (2005). Guide to culturally competent health care. Philadelphia: Davis.
• Smedley, B.D., Stith, A.Y., & Nelson, A.R. (Eds). (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: The National Academies Press.