Politics & Professional Nursing Flashcards

1
Q

Concern for welfare and well-being of others commitment to service

A

Altruism

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2
Q

Right to self-determination

A

Autonomy

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3
Q

Respect for the inherent worth and uniqueness of individuals and populations

A

Human Dignity

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4
Q

Upholding moral, legal, and human rights/principles

A

Social Justice

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5
Q

The allocation of resources and how to work within an organization with people to have your needs met.

A

Politics

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6
Q

Politics relation to operations of a system of government and publically defined institutions & procedures

A

Formal Politics

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7
Q

Politics related to operations within associations

A

Semi-formal politics

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8
Q

Forming alliances, exercising power, and protecting or advancing certain ideas or goals

A

Informal Politics

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9
Q

How limited amounts of resources available are used and what entitlements are available to healthcare consumers.
- healthcare is ultimately defined by and controlled by political forces competing for available resources

A

Allocation

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10
Q

Anyone who has a rested interest in controlling healthcare resources

A

Stakeholders

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11
Q

Stakeholders that exert political pressure on health policy makers in an effort to make the healthcare system work to their economic advantage

A

Lobbyists

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12
Q

The authority/power given to someone to do something or the process of becoming stronger and more confident, especially in controlling one’s life and claiming one’s rights

A

Empowerment

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13
Q

How can nurses develop political skills?

A
  • Build working relationships with legislators
  • Be active in state NA
  • Join organizations r/t your specialty
  • Vote in every election
  • Participate in nurse lobby day
  • Work on federal/state legislative campaigns
  • Develop expertise in shaping policy
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14
Q

Identifying, valuing, and maintaining relationships with a system of individuals who are sources for information, advice, and support.

A

Networking

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15
Q

How can nurses network?

A
  • Participate in organization to network OUTSIDE of department
  • Utilize state NA
  • Use of social media
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16
Q

Competent experienced professionals who develop relationships with less experienced nurses to provide advice, support, information, and feedback

A

Mentor

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17
Q

How can nurses be highly visible?

A
  • Volunteer to serve as member/chairperson of a committee
  • Attend open meetings
  • Share expertise and provide valuable info in meetings
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18
Q

Why are we considered nurse leaders?

A

RNs must continually work to shape/direct future of nursing through political involvement and using power politically to accomplish goals.

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19
Q

One or more rude, discourteous, or disrespectful action that may or may not have negative intent behind them.

A

Incivility

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20
Q

Repeated, unwanted, harmful actions intended to humiliate, offend, or cause distress in the recipient

A

Bullying

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21
Q

What may create threats to patient and/or nurse safety?

A

Destructive behaviors

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22
Q

What is the ANA’s position on workplace violence and bullying?

A

Charges all nurses to create a culture of respect that is free from incivility, bullying, and workplace violence.
- Workplace violence threatens nursing contact with society
- Nurses who choose to ignore or fail to report are perpetuating the violence

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23
Q

What are JCAHO’s 5 Categories of Workplace Violence?

A
  1. Threat to professional status (public humiliation)
  2. Threat to personal standing (name calling, insults)
  3. Isolation (withholding information)
  4. Overwork (impossible deadlines)
  5. Destabilization (failing to give credit)
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24
Q

What are JCAHO’s recommendations for reducing workplace violence?

A
  • Establish a culture the does not tolerate bullying
  • Make zero-tolerance policy the core value of all leaders
  • Confront bullies and support their targets
  • Hold staff accountable for modeling desired behaviors
  • Incentive for institutions to implement strategies to prevent bullying (measurement of nurse bullying factored into HVBP)
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25
Q

Types of Violence:
perpetrator typically has no relationship with the victim and violence carried out in conjunction with a crime.

A

Criminal Intent Violence

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26
Q

Types of Violence:
most common in healthcare settings; environment-based assault - perpetrator is member of public with whom the nurse interacts with during the course of their regular duties.

A

Customer/Client Violence

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27
Q

Types of Violence:
perpetrator and victim work together ~ commonly perceived as bullying.

A

Worker-on-worker Violence

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28
Q

Types of Violence:
Victim targeted as a result of an existing exterior relationship with the perpetrator with the violence taking place in the workplace.

A

Personal Relationship violence

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29
Q

Group of individuals or organizations with common interest who agree to work together toward a common goal.
- Collective action to create changes
- Effective political strategy for collective action
- Focused on effort to effect change
- Network between groups
- Identifying shared interests
- Collaborate among groups for greater success in change

A

Coalition

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30
Q

When are coalitions built and how are they built?

A

Coalitions often built when dealing with state legislature and congress to show nursing consistency and presence.
- Organize get together with people w/ common goals
- Meet informally and attend meetings of those who share same interests
- Share ideas on how to create desired change while developing coalition

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31
Q

A critically important skill of making trade-offs
- AKA bargaining
- Useful for organizational and political power

A

Negotiaing

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32
Q

What are the components of negotiation?

A
  • Asking for more than reasonable and negotiating down to what you want
  • Both sides may enter asking for radically different things and settle that’s different from original position
  • Bargaining process goes on until reach mutually agreeable result or one/both walk away from failed negotiation
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33
Q

Negotiating that is regulated by the state and federal labor laws and usually involves representation by a state ANA or nursing union.
- Staffing levels
- Wages
- Proposed HC bills

A

Collective Bargaining

34
Q

What are the key components of a successful negotiator?

A
  • Well-informed on both sides
  • Know pros and cons of both sides
  • Assist other party in seeing cost v. benefit
  • Knowing opposition to respond to their questions
35
Q

Those with advanced formal education who are able to apply theoretical and analytical knowledge.
- As knowledge content of nursing work increases, practice is guided by science and NOT procedure

A

Knowledge Workers
- IOM called for 80% of RN populations to be BSN by 2020

36
Q

Reflects a framework of mutuality, facilitation, protection, and coordination in which nurses control their own practice and is consistent with the goals of nursing profession.

  • Umbrella term for activites and strategies undertaken to address the challenges faced by nurses in their setting.
A

Workplace Advocacy
*must be adopted by both leaders and staff

37
Q

What does workplace advocacy focus on?

A

Career Development, Employment Opportunities, Employment Rights & Protection, Control of Practice, Labor-Mgmt Relationships, OSHA, & Employee Assistance

38
Q

Employees commitment to organization’s mission, vision, and values that results in success for the organization and personal & professional satisfaction.

A

Engagement

39
Q

What are some characteristics of engaged nurses?

A
  • Go above and beyond
  • Tie success to their organization
  • Trust is core of work
  • Autonomy in nurses (encourages innovation)
  • Measured by better patient outcomes and job satisfaction
  • Requires individual and group action
40
Q

What are the methods/models of engagement?

A
  • Shared Governance
  • Collective Bargaining
  • Magnet Status
  • Collective Action
  • Unionization
41
Q

An organizational strategy that supports nurses to have ownership, autonomy, and input in their practice.
- professional practice model based on partnership, equity, accountability, and ownership

A

Shared Governance

42
Q

What are the benefits of shared governance?

A
  • empowers nurses to manage their professional practice
  • improved job satisfaction & nurse retention
  • primary professional group (RNS) linking all aspects of pt care to mission/values
  • improved flow of information stimulated innovation and reinforces team mentality
  • staff nurses share responsibility and control
  • unlikely to desire unionization
  • decentralized decision making in flat structure
  • councils represent various services / depths
43
Q

ANA & ANCC endorsed program for hospitals that provide evidence of excellence in nursing:
- organization has characteristics that produce increased patient outcomes, attract & retain nurses, demonstrate exemplary practice, and has transformational leadership & EBP.

A

Magnet Recognition Program
- Improves nurse work environment

44
Q

Magnet Status is a ______ commitment and requires _______.

A

Multiyear commitment that requires nursing advocacy in all organizational elements.
- Longterm framework for QI & engaging/motivating staff
- Must meet standards for ideal nursing practice environments
- Nurses must validate the date
- Unit-based and organization-wide councils meet to discuss

45
Q

What are the benefits of being magnet status?

A
  • pt assured hospital holds top credential
  • associated with decreased fall rates and improved skin integrity
  • increased pt satisfaction with nurse communication, availability, and discharge information
  • decreased risk for 30d readmissions
46
Q

Activities undertaken by a group of people with common interest to create a “single voice” & often used to address problems in the workplace.

A

Collective Action
- Magnet status is the work of collective action

47
Q

What are the 4 main purposes of collective action?

A
  1. promote professional nursing practice
  2. Establish & maintain standards of care
  3. Allocate resources
  4. Create satisfaction in the workplace
48
Q

What are the characteristics of collective action?

A
  • Level of independence during shift and interdependence among shifts/setting
  • RNS learn quick to rely on colleagues
  • Forming a committee to address practice concerns and joining together to cause change
  • Empowered and engaged workforce
  • Dividing alternatives to achieve optimal care
  • through both committee work and patient advocacy
49
Q

Process of negotiations between employers and group of employees aimed at reaching agreements to regulate working conditions.
- ex: salaries, staffing, safety, training, etc.

A

Collective Bargaining

50
Q

What are the characteristics/benefits of collective bargaining?

A
  • Typically results in the formation of a union when bargaining fails
  • Provides opportunity to use voice through collective action
  • Goal is to prevent conflict & reach mutual benefits
  • Seeks to keep interests of RN and pts in balance
  • Mechanisms for setting labor disputes by negotiation between employer and representative of workers
51
Q

Informal and formal legal group that works through collective bargaining agents to present desires formally; organization of workers who come together to achieve common goals.
- ex: protecting integrity of the trade, increased safety standards, increased wages/benefits, increased staffing, and better working conditions

A

Unions / Unionization

52
Q

Why does the ANA support unionization?

A

ANA supports the RN’s right to bargain through the balanced support for collective bargaining and workplace advocacy.

53
Q

What are the PROS of unions?

A
  • May improve job security, and working conditions, and achieve goals
  • earn 200-400$ more per week than at-will employees
  • assistance with grievance processes
  • managers may decrease flexibility in discipline
54
Q

What are the CONS of unions?

A
  • Changes in labor law have direct effect on level of union activity
  • Difficulty in removing incompetent RNs
  • Mandatory strikes with NO PAY
  • Seniority to take precedence over performance
  • Many not led by actual RNs
55
Q

Who decides when a union strikes?

A

The decision has to be made by a majority or all of the union members, and a collective bargaining agent CAN NOT make that decision.

56
Q

What is a “no-strike” clause?

A

A clause placed in the contract by a collective bargaining agent that states union members must give an organization a TEN DAY notice of strike, and is prohibited without notice.

THERE MUST BE A CONTINUATION OF PATIENT CARE IN STRIKE SITUATIONS.

57
Q

An act in which an individual discloses information regarding a violation of law, rule, or regulation OR a substantial & specific danger to public health/safety.

A

Whistleblowing

58
Q

What is important to know about whistleblowing?

A

RNs must report problems to a higher authority
- supervisor, state/federal agency, or law enforcement

a HC provider may not be disciplined in retaliation for reporting ILLEGAL conduct or medical malpractice that poses a risk to safety under state & federal law.

59
Q

When should you “blow the whistle”?

A

REPORTING:
violation of any law, rule, regulation
abuse of authority
gross mismanagement
danger to public health or safety
gross waste of funds

60
Q

Allows persons/entities with evidence of fraud against federal contracts/programs to due wrongdoer on behalf of the government and gives the government right to intervene/take action.
- Typically in insurance fraud

A

QUI FAM lawsuit / False Claims Act

61
Q

What is the “process” of whistleblowing?

A
  1. Report to the supervisor & follow chain of command
    - if ignored continue to SBON
  2. File qui fam lawsuit
    - ONLY if SURE of fraud
62
Q

What are ANA recommendations for whistleblowing?

A
  • Reserve judgment until you have adequate documentation of wrongdoings
  • Seek counsel of someone you trust outside of the situation
  • Consult with state NA before taking action
  • you are not protected from retaliation by the employer until you BLOW THE WHISTLE (report claim to federal or state agency)
  • Private groups do not confer protection (TJC, NCQA)
  • Be sure you WANT TO BLOW THE WHISTLE
63
Q

What are the proper steps for whistle-blowing?

A
  1. File qui fam secretly within the court
  2. Do not let agency know you filed…serve copy to dept of justice with written disclosure of concern
  3. if govt goes forward, they’re responsible for litigating lawsuits and covering costs
64
Q

Produces several reports reflective of the efforts to refocus healthcare to quality and form the basis HC professionals must address to promote safe care.

A

Institute of Medicine Reports on Quality (IOM)

65
Q
  • Integrated safety reports for the organization
  • System errors more common than individual
  • Hospitals must report on quality of care
A

To Err is Human (IOM 2000)

66
Q
  • Care moved from discipline-foci to pt-centered
  • Reinforced best practices
  • Holistic environments based on EBP
  • Impetus on pay for quality
  • 6 AIMS: safe, effective, pt-centered, timely, efficient, equitable
A

Crossing Quality Chasm (IOM 2001)

67
Q
  • Collaborative teams
  • Exposed silo of education; reality requires collaboration
  • Expectation of lifelong learning
  • COMPETENCIES: pt-centered care, interdisciplinarity teams, EBP, QI, informatics
A

Bridge to Quality (IOM 2003)

68
Q

What were the components of the IOM 2010 Future of Nursing: Leading Change, Advancing Health?

A
  1. Increase RNs with BSN to 80% by 2020
  2. Double # of RNs with doctorate by 2020
  3. Increase Access to care by APRN & NPs
  4. Interprofessional collaboration; expand opportunities to RNs to lead
  5. Ensure leadership positions available and filed by RNs
  6. Interprofessional workforce data (education, supply of RNs, demands)
  7. Make diversity a priority in nursing workforce
  8. Implement nurse residency programs
69
Q

What were the components of the IOM 2020 Future of Nursing: Charting a Path to Health Equity?

A

Achievement of health equity built on strengthened nursing capacity & expertise.
1. Remover barriers to scope of nursing practice that restricts them from fully practicing to improve types and amt of HC services
2. Public/private payers establish sustainable payment models to support nurses; eliminate scope barriers on RNs and NPs; adequate funding.
3. Nursing school curriculum rich in health equity promotion
4. Employers must fully support nurses well-being by 2021
5. Prioritize the elimination of health inequities

70
Q

The act or process of pleading for, supporting, or recommending a cause or course of action for individuals, groups, organizations, communities, society, or policy issues.
- Complex interactions between nurses, patients, public, and professional colleagues.
- This is what gives power to the caring RN

A

Advocacy

71
Q

The RN educates the hc consumer so they can make decisions related to their own values to achieve desired outcomes; the consumer learns self- management and decision-making.

A

Individual Advocacy

72
Q

The RN empowers consumers by providing emotional support, assistance in obtaining resources, and necessary help through interactions.

A

Interpersonal Advocacy

73
Q

RN supports cultural and social transformation of organizations, communities, or populations.
- understands obligations to improve environmental and societal conditions related to health, wellness, and care of hc consumers.

A

Community Advocacy

74
Q

Conditions in the environments where people live, learn, work and play that affect a wide range of outcomes.
- HC access and quality, environment, social/community context, economic stability, education access and quality

A

SDOH (social determinants of health)

75
Q

What are examples of organizational advocacy?

A
  • Workplace Advocacy (shared governance, magnet)
  • Unions & Collective Bargaining
  • Organizations (r/t specific issues, national nursing issues w/ ANA, CEUs)
76
Q

RN promotes the inclusion of hc consumer’s voice into policy, legislation, and regulation about issues.
- ex: hc access, reduction of cost and financial burden, protection of the consumer, enviro health
- must clearly articulate what nursing is and how we impact society in order to exercise power

A

Policy Advocacy

77
Q

External rules and regulations formulated, enacted, and enforced through political process at local, state, or federal level that protect clients and nurses by defining safe practice, quality standards, and requirements for HCO and insurance.

FEDERAL - pt bill of rights, HIPPA, whistleblower
STATE - right to die, nurse-to-pt ratios, medical marijuana use

A

Healthcare Legislative Policy

78
Q

The nurse ________ sets goals to strengthen the profession.
The nurse ________ votes and writes congress & state legislators.
The nurse __________ is an active member of a professional organization.
The nurse ________ runs for political office.

A

Individual
Citizen
Activist
Politician

RN POLITICAL ROLES

79
Q

Groups of people who share a set of professional values and who decide to join their colleagues to effect change through setting standards of practice and maintaining code of ethics.
- Promote nursing to public
- Educate members through CEUs and publications
- Advocate for members on federal and state level

A

Associations

80
Q

Only full-service professional organization representing the 3.6 million RNs in the US through it’s 54 constituent associations.
- Umbrella Organization

A

ANA (American Nurses Association)

81
Q

How does the ANA advance the nursing profession?

A
  • Fostering high standards of practice
  • Promoting nurse rights
  • Projecting positive and realistic view of nursing
  • Lobbying congress and legislation on issues affecting RNs & public