Fundamentals of Nursing: The Art and Science of Person-Centered Care

Book Preface

Today’s competitive, market-driven health care environment is challenging the very nature of professional nursing practice. Fundamentals of Nurs ing : The Art and Science of Pers on-Centered Care, Tenth Edition, promotes nursing as an evolving art and science, directed to human health and well-being. It challenges students to cultivate the Quality and Safety Education for Nurses (QSEN) and blended competencies they will need to serve patients and the public well. Our aim is to prepare nurses who combine the highest level of scientific knowledge and technical skill with responsible, caring practice. We want to challenge students to identify and master the cognitive and technical skills required of a nurse. But we also intentionally integrate other core content including interprofessional/intraprofessional/interpersonal communication, ethical comportment, legal regulations and standards, population health principles, and a systems-based perspective to facilitate the development of the student nurse as a member of the profession. We refuse to allow love of humanity, accountability, caring relationships, compassionate presence, and advocacy to become relics of a bygone era.

Those new to nursing can quickly become overwhelmed by the demands placed on the nurse’s knowledge, technical competence, interpersonal skills, and commitment. Therefore, much care has gone into the selection of both the content in this edition and the manner of its presentation. We strive to capture the unique essence of both the art and science of nursing, distilling what the person beginning the study and practice of nursing needs to know. We invite students to identify with the profession, to share in its pride, and to respond to today’s challenges competently, enthusiastically, and accountably. The Gallop Poll for 2021 noted that nurses earned the most trusted professional distinction for the 20th year. We hope to provide an opportunity for students to appreciate how their individual, unique talents contribute to and strengthen the profession of nursing.

LEARNING EXPERIENCE

This text and the entire Taylor Suite have been created with the student’s experience in mind. Care has been taken to appeal to all learning styles. The student-friendly writing style ensures that students will comprehend and retain information. The updated art program and strong features enhance understanding of important concepts. The textbook features, interrelated Fundamentals products, and associated CoursePoint resources have been intentionally developed and integrated to provide a consistent, cohesive learning experience.

ORGANIZATION

Fundamentals of Nurs ing : The Art and Science of Pers on-Centered Care, Tenth Edition, is organized into seven units. Ideally, the text is followed sequentially, but every effort has been made to respect the differing needs of diverse curricula and students. Thus, each chapter stands on its own merit and may be read independently of others. Nursing Concepts lists in each chapter opener highlight connections to fundamental nursing concepts and support ease of identification, especially for concept-based nursing programs.
Unit I, Foundations of Thoughtful, Person-Centered Nursing Practice
Unit I opens with a description of contemporary nursing. Successive chapters introduce content foundational to nursing practice: theory, research, and evidence-based practice; health, illness, and disparities; health of the individual, family, community and environment; cultural diversity; values, ethics, and advocacy; legal dimensions of nursing practice; communication; teaching and counseling; and leadership, managing, and delegating.
Unit II, Health Care Delivery
Unit II is completely revised in light of the continuing changes in health care delivery. The new content highlights nurses’ expanding roles in care coordination as partnerships are forged with patients, families, local and global communities, and the populations we serve. Chapters address the variety of community-based health care settings; continuity of care as the patient enters a health care facility, is transferred within the facility, and is discharged into another setting within the community; and care provided within the home. This unit highlights ANA’s Principles for Health System Transformation, IHI’s quadruple aim, new information on Reliability Care Accountability Matrix, and updated health care reform information that emphasizes nurses’ contributions.
Unit III, Processes of Thoughtful, Person-Centered Practice
Unit III offers a thoroughly revised and detailed, step-by-step guide to each component of the nursing process with practical guidelines and examples included in each chapter. Each chapter concludes with a section on “Reflective Practice Leading to Personal Learning” that invites readers to look at their experience with each step of the nursing process, understand it, and learn from it. The goal is always to invite reflection on how we can improve our thoughtful, person-centered practice.
Chapter 13 offers a careful introduction to thoughtful, person-centered practice with expanded content on theories of caring, clinical reasoning, clinical judgment, decision making, and reflective practice. Separate chapters address the nursing process as a whole: Quality and Safety Education for Nurses (QSEN) and blended competencies, clinical reasoning, clinical judgment, assessing, diagnosing/problem identification, outcome identification and planning, implementing, and evaluating. Chapter 14 is a new chapter dedicated exclusively to clinical judgment that describes new features in the text. Chapter 16, previously focused on nursing diagnoses, now has a new focus on analyzing and hypothesizing to identify patient problems and needs. Chapter 20 includes expanded content on privacy guidelines and standards for social media, electronic health records (EHRs), reporting, and conferring. Chapter 21, Informatics and Health Care Technologies is responsive to what today’s nurses need to know about how best to use new technologies and information to coordinate care and achieve desired outcomes. There is recognition that more health care facilities and organizations are combining virtual services with in-person care to ease hospital burden and provide better patient experiences and satisfaction. Central to this transition is telehealth, remote monitoring, and mobile care teams.
Unit IV, Developmentally Appropriate Care
Unit IV provides the basis for understanding growth and development across the lifespan and acknowledges nursing’s differing requirements arising from the various developmental stages and abilities to meet developmental tasks. This content is framed to recognize the historical context and core tenets of developmental theories, while reinforcing that inclusivity and acceptance without bias are essential to good nursing care.
Unit V, Actions Basic to Nursing Care
Unit V introduces the foundational skills used by nurses: maintaining asepsis, measuring vital signs, assessing health, promoting safety, incorporating complementary and alternative therapies, administering medication, and caring for surgical patients. Chapter 29 was reorganized around the person-centered, systems-based, and population-based aspects of safety and security to intentionally integrate the spheres of practice and highlight three new domains in AACN’s Es s entials : person-centered care (domain 2), systems-based practice (domain 7), and population health (domain 3). Chapter 31 relies on guidance from professional nursing organizations with expertise in perioperative nursing.
Unit VI, Promoting Healthy Physiologic Responses
Unit VI explores the nurse’s role in helping patients meet basic physiologic needs: hygiene; skin integrity and wound care; activity; rest and sleep; comfort and pain management; nutrition; urinary elimination; bowel elimination; oxygenation and perfusion; and fluid, electrolyte, and acid–base balance. Chapter 33 contains the latest guidance on pressure injury prevention, staging, and management. Chapter 36 addresses the opioid crisis and challenges students to consider different perspectives regarding legal ramifications and related structural disparities. Chapter 40 includes cardiovascular content as it pertains to its role in oxygenation. In each chapter, guidelines are included for assessing and diagnosing unhealthy responses and for planning, implementing, and evaluating appropriate care strategies.
Unit VII, Promoting Healthy Psychosocial Responses
Unit VII uses the same format as Unit VI to focus on the psychosocial needs of patients: self-concept; stress and adaptation; loss, grief, and dying; sensory functioning; sexuality; and spirituality.