美國護士角色和職業(yè)發(fā)展解析

1、安琪國際集團護士培訓(xùn),,American Nursing Roles and Career Development,美國護士角色和職業(yè)發(fā)展,connection.lww.com,Nursing Process,Nursing Process and Skills,nursingservice-lb.aub.edu.lb,Nursing Roles 美國護士角色,The ANA (American Nurse Association)

2、 Standards of Practice and Professional Performance (Dr. Long, O. Carol, 2006).,角色I： 護理評估 Assessment,Collects comprehensive data that pertains to the client’s health or situation.收集病人資料, 貫穿于護理工作的全過程。 從病人入院時的綜合問卷, 到系統(tǒng)查體；

3、從觀測生命體佂，到與病人及家屬的交談；從衣食住行，到心理，精神的觀察和綜合判斷；從閱讀病歷，到與相關(guān)人員的交流；從追蹤病人各項檢查報告， 到有目的的問診及查體。,角色II: 診斷Diagnosis,Analyzes the data collected during the assessment to determine nursing diagnosis or other matters requiring nursing atten

4、tion.整個護理過程是一個循環(huán)，每一步是獨立的又是不可分割的。如在搜集材料的同時，護理診斷的初步形成就已經(jīng)開始了。在實際臨床工作中，護理計劃已格式化，您只需選擇符合該病人的選項。 接班時，“REVIEW”護理計劃，下班前，“UPDATE”護理計劃。,角色III：鑒別護理效果 Outcomes Identification,lists expected outcomes to derive an individualized pla

5、n of care for the client. JACHO（Joint Commission on Accreditation of Healthcare Organizations） 特別強調(diào)護理計劃的個體化。即不同的病人制定不同的護理計劃。 雖然護理計劃有現(xiàn)成的范本，但一定要根據(jù)病人的實際情況補充特別適用于該病人的計劃。,角色IV---計劃Planning,Develops a plan of care that lists

6、strategies to attain expected outcomes.,角色V:實施 Implementing,Facilitates and mobilizes the identified plan of care to provide:依據(jù)所制定的護理計劃， 為病人提供以下服務(wù)：a. coordination of care ：各部門的協(xié)調(diào)b. health teaching and promotion健康教育與 提高

7、c. Consultation 咨詢d. Prescriptive authority and treatment ：處方和治療權(quán),各部門的協(xié)調(diào)Coordination of Care,The registered nurse coordinates care delivery護士要協(xié)調(diào)各部門的工作，保證病人得到最優(yōu)質(zhì)的服務(wù)。在臨床工作中，護士每時每刻都在進行協(xié)調(diào)工作。,健康教育與提高Health Teaching and

8、Promotion,The registered nurse employs strategies to promote health and a safe environment.病人的教育貫穿在你一天的護理活動中。 JACHO 要求每個班次都有正式的有關(guān)病人教育的病案記錄。另外，戒煙，心力衰竭，心冠狀動脈搭橋手術(shù)等必需有規(guī)范化的統(tǒng)一標準的教育。,咨詢： Consultation,The advanced practice regi

9、stered nurse and the nursing role specialist provide consultation to influence the identified plan, enhance the ability to others and to effect change.高級踐習(xí)護士，護理專家為病人提供教育，咨詢。這些人可以在門診，醫(yī)院，科研機構(gòu)，咨詢機構(gòu)等工作。,處方和治療權(quán)Prescriptive

10、Authority and Treatment,The advanced practice nurse used prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations. 高級踐習(xí)護士擁有處方權(quán)，可以做規(guī)定內(nèi)的治療，手術(shù)操作， 推薦

11、醫(yī)生 及相關(guān)治療等。,Career Development護士職業(yè)發(fā)展,職業(yè)發(fā)展Career Development,Career pathways are advanced by means of education preparation and specialty certification. 職業(yè)發(fā)展的軌道是根據(jù)您的教育水平和專業(yè)證書的獲得一步步前進的。,職業(yè)類型,Advanced Practice：高級踐習(xí)護士Edu

12、cator in Practice Settings ：臨床教育專家Educator in Academic Settings 院校教育者Specialty Nursing: ：護理專家：如糖尿病， 創(chuàng)傷Staff RN ：臨床護士Nursing Management ：護理管理,高級踐習(xí)護士Advanced Practice,Educational preparation requires a master’s degree

13、 of higher degree; 護理碩士以上文憑Certification may be required in some states：有些州需要證書Advanced nursing roles include ：包括以下幾類nurse practitioner (NP or APN-advanced practice nurse); （開業(yè)護士)certified nurse midwife (CNM);助產(chǎn)士cli

14、nical nurse specialist (CNS); 臨床護理專家certified registered nurse anesthetist (CRNA). 注冊麻醉師,臨床教育專家Educator in Practice Settings,Bachelor’s degree and generally certification required. 本科學(xué)歷， 需要證書Roles may include diabetes

15、 educator; patient/health/wellness educator; preceptor; staff development; continuing education.如糖尿病，健康專家，教學(xué)老師， 護理人員發(fā)展， 繼續(xù)教育專家,院校教育者Educator in Academic Settings,In associate and diploma programs, a MSN is preferred and

16、 often required. ?？茖W(xué)校， 要求護理碩士In universities and institutions of higher learning, a doctorate or a MSN transitioning to doctorate is required---especially for a professorship（BSN: bachelor of science in nursing, 護理本科; M

17、SN: maser of science in nursing，護理碩士）. 本科或更高的研究院，要求博士， 或碩轉(zhuǎn)博,護理專家Specialty Nursing,BSN or higher degree with role-specific continuing education preferred.本科學(xué)歷， 該領(lǐng)域的繼續(xù)教育Nurse role examples are school-employee-occupationa

18、l health, infection control, public health, and research. 在美國的校醫(yī)室，單位的醫(yī)務(wù)室，護士取代了醫(yī)生的職位。在衛(wèi)生局之類的政府部門，有護士獨立的部門）。,臨床護士Staff RN,Associate degree, diploma, bachelor’s degree, or master’s degree with in-services and /or continuing

19、 education appropriate to a specialtyCertification is a possibility of some rolesEducational requirement is frequently dependent on an employer’ policies?？埔陨蠈W(xué)歷，相關(guān)科室的內(nèi)部培訓(xùn)，繼續(xù)教育， 某些角色需要相關(guān)證書。 如心血管科，ACLS， Sheath pulling.

20、學(xué)歷要求根據(jù)不同工作單位而有不同的政策。,護理管理Nursing Management,Master’s degree or higher generally required：碩士以上文憑Roles would include chief nursing officer, chief operating officer, chief executive officer, and clinical services or office

21、 manager.在美國醫(yī)院，從院長到科室主任，都是護士在管理。醫(yī)生與護士是合作關(guān)系。,其他角色和職位Other Roles & Positions,This category includes roles for which a nursing background can be helpful; but which may require additional education or preparation outsid

22、e of nursing. Role examples include nurse attorney, consult, pharmaceutical/medical supply sales, policy makers, and professional nursing/health organization staff.,其他職業(yè)角色,這些職業(yè)是除護士以外， 需要護理學(xué)歷的職業(yè)。 這些職業(yè)一般還需第二學(xué)歷或?qū)I(yè)證書。護士律師