Monday, August 29, 2016

The 2016 NPD Scope and Standards: Began with Florence


Patsy Maloney, EdD, MSN, RN-BC, CEN, NEA-BC is a Senior Lecturer of Nursing and Healthcare Leadership at University of Washington Tacoma.

"Let us never consider ourselves finished nurses...we must be learning all our lives."
                                                                                                  -Florence Nightingale

There has been much excitement about the release of the 2016 Nursing Professional Development (NPD) Scope and Standards. The workgroup of NPD experts did a great job. The workgroup stood on the shoulders of the nursing and NPD leaders that went before us. This blog entry will briefly describe what a scope and standards document is, the history of our current scope and standards, a brief overview of the major changes in our current scope and standards, and a call to implement the standards by advancing the NPD specialty.

What is a Scope and Standards document? A nursing specialty scope of practice describes the specialty practice, its boundaries, and its practitioners (Anderson, 2011).  The American Nurses Association (ANA) (2015) publishes a Nursing Scope and Standards that applies to all nurses, including all specialty nurses. The scope is an overview of nursing and answers the who, what, when, where, how, and why questions of nursing practice. The standards of professional practice have two parts, a description of each standard followed by a list of competencies (Strong, 2016). The second edition of Nursing Scope and Standards (ANA, 2010) is available online. The third edition (2015) can be purchased online.

History of the NPD Scope and Standards. The history of our scope and standards begins with the history of our specialty. The roots of our specialty go back to the founder of modern nursing, Florence Nightingale. Ms. Nightingale’s belief that life-long learning was crucial influenced her opposition to registration (licensure) of nurses. She believed that if nurses were licensed after completing their training program, they would consider themselves “finished nurses” and would not continue learning (http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm).
Pfefferkorn
stated “The improvement of the nurse in service, in its broadest implications is as old as nursing…but the improvement of the graduate nurse for professional or cultural growth, is yet in its infancy”  (1928, p.700). So the improvement of nursing practice “in service” of the patient is as old as nursing, but including the professional development of the nurse beyond the immediacy of care of the patient was in its infancy in 1928 (88 years ago). The word in-service and in-service education took hold and articles about in-service education started to appear in the nursing literature. As more nurses moved from independent practice to hospital employees and the need for nurses increased, in-service education to orient and refresh nurses became even more important. By 1953 the in-service education role began to separate from that of nursing administrator, and divisions of in-service education were established within departments of nursing service (Abruzzese & Yoder-Wise, 1996).

Concurrent with the development of divisions of in-service education within hospitals, ANA started to develop the forerunners to scope and standards. These documents were called statements of functions. One of the earliest mentions of these was in the American Journal of Nursing in 1954. These statements of functions were developed by ANA committees. The 1954 statements included education, but not in-service education. By 1956 the statements of functions had evolved to statements of functions, standards, and qualifications for practice. Over the next few years American Journal of Nursing published these statements for a variety of nursing areas. They did not use the term specialties. Although in-service education was not included in the first statements of functions, standards, and qualifications, the specialty was included in The Yearbook of Modern Nursing 1956. It was not until 1966 that the Nursing Service Administrators section of ANA developed a “statement of functions and qualifications for in-service educators (Abruzzese & Yoder-Wise, 1996). This document was the precursor of our scope and standards.

By 1970 in-service education was subsumed under continuing education, which had come to include all education that took place outside degree granting nursing school programs. The Journal of Continuing Education published the ANA’s landmark statement on in-service education in 1970 and in 1972 published ANA’s landmark statement on continuing education. The Council on Continuing Education was organized with members from both in-service education and college continuing education programs in 1973. In 1974 ANA published the first standards for continuing education and in 1976 published guidelines, not standards for staff development. (Abruzzese & Yoder-Wise, 1996). With the publication of these guidelines the term in-service education was replaced with the term nursing staff development. Instead of referring to an area of practice, in-service education came to mean education and training delivered in the practice setting to facilitate an individual’s ability to function within a given agency (ANA, 2000). 

Finally, in 1990 ANA published Standards for Nursing Staff Development (ANA, 1990). This was followed in 1994 by Standards for Nursing Professional Development: Continuing Education and Staff Development. Nursing professional development had become the umbrella term to encompass both continuing education and staff development. Embracing this new term, the Scope and Standards of Practice for Nursing Professional Development was published by ANA in 2000. The 2010 Nursing Professional Development: Scope and Standards of Practice was published jointly by ANA and National Nursing Staff Development Organization (NNSDO) (ANA & NNSDO, 2010). Our scope and standards led the way for the re-naming and re-branding of our specialty from NNSDO to the Association for Nursing Professional Development (ANPD) in 2012.

The nursing and NPD leaders on whose work the 2016 NPD Scope and Standards of Practice is built are too numerous to name. But I think it is really important to acknowledge Ms. Barb Brunt, who served with the 1994, 2000, and the 2016 standards work groups. Her contributions to our current scope and standards are immeasurable. Another NPD giant is Dr. Dora Bradley, who led the work group for the 2010 NPD Scope and Standards of Practice. This work group created the NPD Practice Model as a systems model that maintained much of its relevance and only required the 2016 workgroup. The 2010 Scope and Standards was an outstanding foundational document for the 2016 scope and standards work group.

Overview of the revisions in the 2016 NPD Scope and Standards. The significant revisions in the NPD Scope and Standards of Practice (ANPD, 2016) include expanding the settings in which the NPD specialty is practiced beyond acute care and even including virtual environments, replacement of the intertwined elements with seven NPD roles, identification of general (NPD Generalist) and advanced levels (NPD Specialist) of NPD practice. NPD practitioner became the umbrella term that incorporates both the NPD generalist and the NPD specialist (Harper & Shinners, 2016). Two standards of performance (Collegiality and Advocacy) were removed and integrated throughout the other standards. Change Management and Mentorship/Advancing the Profession were added in response to the NPD Role Delineation Study (Warren & Harper, 2015).

Conclusion. The seeds of the 2016 NPD Scope and Standards of Practice were planted by Florence Nightingale when she emphasized the need for life-long learning.  These seeds started to take root when Blanche Pfefferkorn addressed the National League for Nursing Education’s convention and discussed the deliberate pursuit of professional growth post-graduation from nursing school (Pfefferkorn, 1928). After the publication of Pfefferkorn’s address articles on in-service education started to appear in the nursing literature. In the 1950’s in-service education divisions started to appear in hospitals and by the 1960’s the predecessor of the current scope and standards was developed. Our current 2016 Scope and Standards is the result of the work of well over 100 years of thought leaders. The last, but not least standard of performance, Standard 16: Mentoring and Advancing the Profession, calls us to advance our specialty. Our specialty is one of the oldest of nursing specialties. Be proud. Call your specialty by name, Nursing Professional Development. 




References

Abruzzese, R. S., & Yoder-Wise, P. S. (1996).  Staff development: Our visions.  In R. S. Abruzzese (Ed.).  Nursing staff development: Strategies for success (pp. 3-14). St. Louis, MO: Mosby Yearbook.
American Nurses Association. (2000). Scope and standards of practice for nursing professional development. Washington DC: Author.
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.
American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
American Nurses Association and National Nursing Staff Development Organization. (2010). Nursing professional development: Scope and standards of practice. Silver Spring, MD: ANA.
ANA Statements of functions. (1954). The American Journal of Nursing, 56(10), 1305-1309.
ANA Statements of functions, standards, and qualifications. (1956). The American Journal of Nursing, 56(8), 1027-1030.
Anderson, T. (2011). Nursing professional development: Scope and standards of practice (2010). Nebraska Nurse, 44(3), 8-9.
Harper, M. G.  & Maloney, P. (2016).  Nursing professional development:  Scope and standards of practice (3rd ed.).  Chicago, IL:  ANPD.
Harper, M.G. & Shinners, J. (2016). Overview of nursing professional development. Journal for Nurses in Professional Development, 32(4), 228-229.
History Notes. (n.d.). Nursing as a profession. Retrieved from http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm
Pfefferkorn, B. (1928). Improvement of the nurse in service: An historical review. The American Journal of Nursing, 28(7), 700-710.
Strong, M. (2016). Maintaining clinical competency is your responsibility. American Nurse Today, 11(7), 46-47.
Warren, J. I., & Harper, M. G. (2015, July). Nursing professional development role delineation study. Presentation at the annual meeting of the Association for Nursing Professional Development, Las Vegas, NV

Monday, August 15, 2016

What can I do now? (Cogent Career Planning)

Charlene M. Smith, DNS, MSEd, WHNP, RN-BC, CNE, ANEF is a professor at Wegmans School of Nursing, St. John Fisher College.

In April 2016 a LinkedIn study suggested the millennial generation tended to job-hop in the five years after they graduated college. College graduates between 1986 and 1990 averaged more than 1.6 jobs, and those graduating between 2006 and 2010 averaged nearly 2.85 jobs (Berger, 2016). Although a baby boomer, I too held many jobs over my career that included various positions in nursing, education, and leadership. Similar to many of my colleagues, my career path has taken many twists and turns based on family responsibilities, economics, life events, opportunities, deliberate decisions, and focused goals. My passion for teaching was a major influence in how my career plan was formulated over my career as an educator in both academic and practice settings.

Career planning is “a structured process for analyzing your skills and interests, formulating long-term goals and devising strategies to achieve them” (ConcordiaOnline.net, 2013, para. 7). In fulfilling the functions in a mentor role, NPD practitioners are often called on to counsel and advise others regarding professional growth and career development. Helping others in their career planning is a basic tenet of NPD practice, but career planning is also necessary for one’s own professional growth and career advancement. Although sometimes doors open and opportunities appear with little effort, typically career planning is a cogent and deliberative practice. I have been approached many times by colleagues seeking advice on how to become an educator as they explore possible positions in either an academic or practice setting. Although academic faculty and NPD practitioners have many similar competencies focused on education, there are some fundamental differences in the roles and responsibilities. A framework that can help sort out what direction to go and apply to career planning follows:

Who am I? Self-awareness – An important starting point is to develop a perceptive sense of self-awareness. This requires recognizing one’s values that inform what is important for the individual’s career and associated work. Being able to articulate one’s interests, competencies/skills, and associated gaps in knowledge, skills, and attitudes, is necessary to begin developing the strategies needed to direct and manage a career plan. 
  • Values
  • Interests
  • Competencies/Skills
  • Gaps

What do I want? Goals – The major driving forces in establishing goals for a career plan are based on fiscal, education, and personal influences. Thus, conveying fiscal, education, and personal goals assists in structuring the career plan. A periodic review (e.g., annually) of the goals established for a career plan can ascertain accomplishments, or the need to reassess and change the goals and associated actions of the career plan based on these influences.
  • Fiscal
  • Education
  • Personal

What is out there? Exploration - An essential practice is to continually scan the horizon to align a career plan with changes that may impact nursing, education, health care, and society in the future. A flexible career plan is necessary based on inevitable change and the associated adjustments needed to make a career plan relevant today and in to the future. Individual effort is needed to actively research what options are available to lend validity to a career plan.
  • Scan the horizon
  • Research available options

What do I need to do? Decisions and Actions – Reflecting on the information gathered, weighing the alternatives, and applying a logical decision-making process helps to devise a realistic career plan. Outlining the short- and long-term goals, connected actions, and related outcomes provides the structure needed to begin the operational phase of the career plan. Other important strategies require the individual to at times take risks and purposefully network and market themselves to showcase their knowledge, skills, attitudes, motivation, and talent.
  • Plan – short (< 5 years) and long-term (5 years and beyond)
  • Take risks
  • Network
  • Market

Career development is not an event that just happens, it requires reflective self-awareness, thoughtful career planning, strategic networking and marketing, and persistent monitoring to ensure the career plan is relevant and is able to accommodate fiscal, education, and personal influences and overarching changes in society that impact future career planning. Mentoring others in professional growth and career development is essential for NPD practitioners, yet attending to one’s own professional growth and career development is just as critical as the NPD practitioner is a role model for life-long learning. I challenge my NPD colleagues to strategize your own personal career plan and make it actionable and relevant for you!   

References

Berger, G. (2016, April 12). Will this year’s college grads job-hop more than previous grads? Retrieved from https://blog.linkedin.com/2016/04/12/will-this-year_s-college-grads-job-hop-more-than-previous-grads

ConcordiaOnline.net. (2013, November 14). What is career planning and who needs it? Retrieved from http://www.concordiaonline.net/what-is-career-planning-and-who-needs-it/

Monday, August 1, 2016

Zika Virus Awareness and Prevention Crucial in U.S.

News about the Zika virus continues to come out regularly. The U.S. Department of Health and Human Services has made more than $85 million available to fight the Zika virus infection in the U.S., the Center for Disease Control and Prevention (CDC) announced in May. Many hospitals throughout the country are now preparing to care for pregnant women and their babies, as more than 500 people in the U.S. have been diagnosed with the Zika virus, including 279 pregnant women. Most of these patients were infected while traveling outside the U. S.; however, 10 were infected through sexual intercourse with someone who traveled to an area where the Zika virus is spreading. Since only about 20 percent of the people infected by the Zika virus develop symptoms, the number of cases could be much higher.

NPD practitioners need to keep up-to-date with current information about this problem and help educate patients and families about what signs and symptoms to look for, or how to determine whether or not they should take a Zika virus test. For hospitals gearing up to care to patients with this virus, our educational planning skills can be invaluable in preparing staff members to care for these patients. For those who will be traveling this summer, protection while enjoying the outdoors in an area where mosquitos could be prevalent is prudent.


The American Nurses Association website has a wealth of information on what nurses need to know and what resources are available. Read more.

Monday, July 18, 2016

Future of Nursing Report Calls for Nurses to Join Healthcare Boards

Do you or any of your colleagues serve on a board? One of the key messages in the Institute of Medicine (IOM) Future of Nursing report is, "Nurses should be full partners with physicians and other health professionals in redesigning healthcare in the U.S." Being a full partner translates to the health policy arena, where the report suggests, "Nurses should also actively serve on advisory committees, as commissioners and on boards where policy decisions are made to advance health systems to improve patient care." Nurses need to exercise leadership competencies in a collaborative environment in all settings, including hospitals, communities, schools, boards, and policy and business arenas both within nursing and across the health professions. The Nurses on Board Coalition (NOBC), created by the collaborative efforts of 21 nursing organizations, has a goal of placing 10,000 nurses on governing boards by 2020.

Let your voice be heard! If you are serving on a board now or would like to serve, go to www.nursesonboardscoalition.org and register by clicking on the "Be Counted" link at the top of the page.



References
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, D.C.: The National Academies Press.


Nurses on Boards Coalition. (2016, May 10). Re: NOBC Nurse Leader Letter. Retrieved from: https://mail.goggle.com/mail/u/0/?ui=2&ik=8f28728c50&view=pt&search=inbox&th=1549c290 71fd8b08&siml=1549c29071fd8b0&siml=154a65c5e5050950&siml 

Tuesday, July 5, 2016

How to Edit Your Abstract: 3 Essential Tips

Allie Mandel is the Education Associate for ANPD and graduated from OSU with a degree in English.

The opportunity to present an abstract allows nurses to showcase their projects and portray how the strides they have made can improve the role of the NPD nurse. The ability to write an abstract is an important skill for NPD practitioners to possess, but the aptitude to edit your own abstracts will elevate your writing to the next level so that your research truly stands out. While editing your own work may seem daunting, these tips will help you to present a clear, concise, and, consequently, more effective report.

Take Some Space
You’ve worked long and hard to produce an abstract that showcases the effectiveness of your report, and editing that abstract after all the effort you have put in probably sounds less than ideal. Before you dive in to the editing process, take a break to distance yourself from your abstract—go for a walk, read a book, eat a snack, do whatever you need to do to refresh your mind before undertaking the next step in the abstract submission process. If editing your abstract still seems overwhelming, break your writing down into chunks and tackle it piece by piece.

Keep it Simple
An effective abstract summarizes the report without unnecessary elaboration or “fluff,” so it is important to stick to the facts and keep your abstract brief. If your abstract is peppered with long sentences containing several ideas, break those sentences down into 2-3 succinct ones—shorter sentences add an element of conciseness, allowing each sentence to pack a greater punch. When in doubt, remember that less is always more; rather than adding to your abstract, trim down the paragraphs that include excess or redundant information. Additionally, steer clear of big, fancy words—keep the language as simple as possible so that anyone who reads your abstract understands the main takeaways.

Use Your Resources
Even the strongest writers and editors find themselves stumped from time to time, and there are plenty of online resources you can utilize to make the editing process seem less intimidating. Whether you need assistance with grammar and punctuation, formatting, or even proofreading strategies, websites like the
Purdue Online Writing Lab (OWL) or Guide to Grammar and Writing are excellent tools to keep in mind. You can also find abstract-specific resources by researching other organizations; for example, the International Association of Clinical Research Nurses’ (IACRN) site includes a PowerPoint presentation, “Writing a Conference Abstract: Tips for Success,” that you may find helpful when editing your abstract. A peer review is another great way to edit your abstract—a second pair of eyes is always helpful!

Monday, June 20, 2016

Presenter Do's and Don'ts

As NPD Practitioners, giving presentations using slides is nothing new. Most of us can whip up a PowerPoint in a few minutes if needed. But have you ever thought about the kind of presentation you want to give and the type of presenter you want to be? Below, find some “do’s and don’ts” for presenters.

Do’s
  • When listening a great presentation, make notes as to what the presenter is doing to keep you interested and engaged.
  • When listening to a not-so-great presentation, make note of what the presenter does that turns you off.
  • Make sure you use powerful images that are relevant to the content, otherwise they only distract and confuse the learner.
  • Connect with your audience – use emotion in your voice, personal stories, and examples to get your point across.
  • Provide takeaways during your presentation that the audience can implement.
  • Limit your number of slides and make every word and image count.
  • Practice, practice, practice! A well-prepared and polished presentation is effective (and noticeable).  

Don’ts
  • Your slides should not be filled with words – this is boring and learners tend to tune out.
  • Don’t use a monotone voice when speaking and make sure you’re not just reading your slides or directly from your notes. This doesn’t allow you to connect with your audience.
  • Don’t try to be funny if you’re not. Instead of trying to “dress up” your presentation with humor, simply focus on delivering an engaging message.
  • Avoid color combinations on slides that are difficult to read.
  • Don’t wing it – you’ll be doing a disservice to your audience and wasting their time. They are there to learn.
  • Don’t forget to prepare for questions – try to anticipate the kinds of questions that might be asked and have an answer ready.

Monday, June 6, 2016

Developing Leadership Skills

Barbara Brunt, MA, MN, RN-BC, NE-BC is an Education Consultant and past ANPD President.


 Leadership is not a title - anyone can be a leader.  All NPD specialists, regardless of our role, can continue to develop leadership skills.  I have used the letters of the word leadership to outline some of the characteristics of a leader.

          Learning is critical to leadership – learning and competence matter.  We need to be lifelong learners and constantly seek out new knowledge.  We learn by making mistakes – they help us grow and are NOT failures.  Thomas Edison said “I have not failed, I just found 10,000 ways that will not work”, and “our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.”  There are multiple resources for your professional development, such as webinars, books, online courses, etc, available through ANPD.

          Empowering others is important.   Webster defines empowerment as “giving power or authority to or give ability to”.  We need to help our coworkers and others feel significant, showing concern and caring.  Pierre de Chardin said, “The most empowering relationships are those in which each partner lifts the other to a higher possession of their own being.”  We need to lift others up to fully develop our own leadership skills.

          Accountability and aspiring for excellence are other characteristics of leadership.  Leaders take accountability for their decisions, and constantly aspire to be the best they can be.  We need to continually strive for excellence, even though we realize we may not get there.

          Driving innovation is another component of leadership.  Webster defines innovation as introducing new methods or devices.  All of us need to question why – because we have always done it that way is not an acceptable answer.  There is an increasing amount of literature providing the best evidence for our care – leaders need to constantly look for better ways of doing things.  Consider applying for a research grant, if you want to validate an innovative approach to teaching or NPD practice.

          Embracing change is a critical skill in today’s ever-changing health care environment.  Change is a constant, and we need to accept that fact.   John F. Kennedy said, “Change is the law of life.  And those who only look to the past or present are sure to miss the future.”  Not only do we need to accept change, but we need to serve as change agents to help others cope with change.  A few of my favorite quotes about change are:
Gandi – Be the change you wish to see in the world
Socrates – The secret of change is to focus all of your energy not into fighting the old but on building the new
Norm Brodsky (Entrepreneur) – Either you are an agent of change or you are destined to become a victim of change.  You simply can’t survive over the long haul by standing still. 
I think these quotes emphasize the importance of your reaction to change.

          Resolving conflicts is essential to success when applying leadership skills.  Conflict is inevitable and we need to deal with it rather than letting it fester.  Resolving conflicts is often not pleasant and we tend to procrastinate when there is something we don’t want to do; however, that will not make the conflicts go away.  The first step to conflict resolution is to recognize what factors contribute to conflict.  Some of these are:  differences in values, fear, miscommunication, treatment of others, honesty, and attitudes.  Four basic strategies for resolving conflicts are accommodation, assertion, avoidance, and negotiation. 

          Serving others and seeking out a mentor are two other leadership characteristics.  Servant leadership can be helpful in getting others to work towards a common goal.  Servant leadership is both a leadership philosophy and set of leadership practices. Traditional leadership generally involves the accumulation and exercise of power by one at the “top of the pyramid.” By comparison, the servant-leader shares power, puts the needs of others first, and helps people develop and perform as highly as possible.  People love to follow servant leaders

          A mentor can open doors and present opportunities for your personal and professional growth.  A mentor is different from a preceptor.  Mentors do not have to work in the same facility or even be in the same state.  Belinda Puetz is one of my mentors.  When I was actively involved in the National Nursing Staff Development Organization, she was the Executive Director of that group.  The American University of Beirut in Lebanon was looking for a staff development consultant to do an on-site visit, and she suggested they contact me.  I went there back in 1999 and helped them further develop their staff development program.  Gladys Mouro, who was the CNO at that time, became a board member of STTI later.  I believe her letter of support helped me receive one of the STTI Founders awards, because of the emphasis on global impact.

          Honing collaboration and teamwork skills are critical skills for leaders.  With the focus on interprofessional education and teamwork, we need to work closely with other members of the healthcare team.  With the complexity of health care today, it takes a village with multiple skill sets to most effectively care for our patients. Research has long suggested that interprofessional collaboration improves coordination, communication and, ultimately, the quality and safety of patient care. It utilizes both the individual and collective skills and experience of team members, allowing them to function more effectively and deliver a higher level of services than each would working alone.

          Inspiring others and getting involved is important.  Providing a clear vision can motivate others to become more involved.  Great leaders inspire others.  John Quincy Adams said, “If your actions inspire others to dream more, learn more, do more, and become more, you are a leader.”  ANPD has a lot of opportunities for you to get involved in whatever activities resonate with you.  You can become involved by being a part of a committee, or volunteering for a task force or specific task, such as reviewing chapters in ANPD publications.

          Providing feedback is the last leadership characteristic.  The important of clear and frequent communication, both written and verbal, can’t be overemphasized.  You need to let your coworkers know what they are doing well, or if there are things they could be doing better.  My background as an English teacher has served me well throughout my career – I love to write, and my initial education provided me with the tools to communicate clearly both verbally and in writing. 

          You never know what difference you will make in someone’s life. I challenge all of you to develop your leadership skills and make a difference.