Preceptor Selection, Orientation, and Evaluation in Baccalaureate Nursing Education

The benefits obtained from properly managed clinical preceptorships cannot be underestimated. Nursing students benefit from clinical preceptors who exemplify the application of theoretical knowledge in actual clinical settings. Preceptorships, and the use of preceptors, remain a viable and important adjunct for faculty in US schools of nursing. This article reports on a portion of a study of undergraduate baccalaureate nursing programs and the use, selection, and evaluation of clinical preceptors. The results suggest that the design of most preceptorship programs does not consistently secure the use of qualified clinical preceptors. Today's clinical preceptors need to be more carefully selected, oriented, and evaluated to ensure quality education of nursing students. Benefits can be realized not only in nursing education, but also in nursing practice, patient care, and nursing administration. More research needs to be done in the area of clinical preceptorships and more specifically, selection and evaluation methods.

Teaching Through Storytelling: An Exemplar

Many new faculty are being hired to fill the ever-increasing vacancies created by the attrition of current faculty members. To meet the diverse demands of today's educational climate, new faculty must develop an understanding of a variety of learning environments and skill in traditional and contemporary teaching strategies. This article presents storytelling as one strategy for educating potential new faculty in online instruction in an undergraduate nursing research course.

Influence of Nurse Characteristics on the Acquisition of Cultural Competence

This study examined how nurses' personal and professional characteristics influenced their response to an educational intervention to improve their cultural knowledge and cultural competence. A one-group repeated measures design was used to evaluate the effectiveness of the intervention, which 76 public health nurses (PHNs) attended. Regression analysis showed that nurses with fewer years of nursing experience and higher level of education had a weak association with increased cultural knowledge and cultural competence but learning style and age were not associated with the outcomes.

Using Imaginative Literature to Foster Cultural Sensitivity

Readings from two novels, Sandra Cisneros' The House on Mango Street and Toni Morrison's The Bluest Eye, were included in maternal-child clinical courses as part of a pilot project to identify potentially effective strategies for increasing student cultural sensitivity and reflective thinking skills. The authors analyzed student journals to determine student values and beliefs during maternal-child clinical experiences. The study sample consisted of 40 young women enrolled in a baccalaureate nursing program in a private, liberal arts university. These young women consistently interpreted `the other' in their own image. They responded most strongly to themes of belonging, including the struggles of immigrants to `fit in,' the ways of being acceptable and valued in U.S. society, and the process through which students as nurses learn to accept and care for others who are different.

Solution Focused Teaching: A Transformative Approach to Teaching Nursing

Nurses work in complex health care systems, which today are based not only on medical treatment and cure, but also on enabling individuals and strengthening communities. This paper describes a curriculum approach to teaching nursing in an Australian university which seeks to prepare students for this environment. Underpinned by transformative education principles, and termed Solution Focused Nursing, specific teaching and learning strategies are discussed. A goal is to cultivate critical thinkers and knowledge workers, that is, nurses who are not only able to work skillfully, strategically, and respectfully with clients, but who also demonstrate discernment, optimism, and vision about nursing and health care.

Conflict in the Preceptorship or Field Experience: A Rippling Tide of Silence

A major component of the educative process in the professional disciplines is the field education/preceptorship experience in which students are afforded opportunities to develop professional competence under the tutelage of a practising professional and/or a university instructor. During this time students are exposed to competing discourses about what it means to think and act as nurses, teachers, doctors and social workers. Frequently, field teaching is characterized by conflictual situations involving students, field instructors and university faculty. Such conflict is poorly understood as indicated by the lack of literature available in the professional disciplines. The purpose of this study was to explore the phenomenon of conflict within the context of field teaching in professional education. Pivotal to this study was the issue of making sense of the conflict that prospective nurses, teachers, social workers and doctors experience in professional education within the practice realm and how such discourses shape their professional identities, practices and ultimate social values. At issue is the social construction of meaning that takes place within professional education. This study was conducted from the perspective of four professional programs including education, medicine, nursing and social work. The researchers focused on the final year of each program at a time when students were engaged in a major field / preceptorship experience in hospitals, schools, communities and social agencies. The experiences derived from the nursing data are presented in this paper.

Connecting: Perceptions of Becoming a Faculty Mentor

The school of nursing faculty at a liberal arts university created an innovative group-mentoring course to support students' progression through the undergraduate nursing program. The foundation of the mentoring program is the dynamic relationship between novice and expert. Students are enrolled in this one-hour course for each of their four semesters in the upper division nursing curriculum. Group membership (faculty and students) is consistent throughout this time. The mentoring course requires faculty to lead a process-oriented group. Faculty are confident in teaching courses that are content-driven but have struggled with the unstructured nature of facilitating a process-oriented group. Therefore, the role of group mentor has been identified by faculty as very challenging.The purpose of this study was to explore faculty members' perceptions of assuming the role of a group mentor. Eight subjects participated in audio-taped interviews guided by open-ended questions. Four themes emerged including uncertainty, evolution, mutuality, and milieu.

Levels and Predictors of Knowledge and Attitudes Regarding Pain Among Israeli Baccalaureate Nursing Students and Nurses Pursuing Specialty Certificati

This paper presents the research conducted in 2003 by the Nursing Division of the Israeli Ministry of Health regarding the level of and predictors of pain knowledge and attitudes of Israeli nursing students and certifying nurses, in the context of the Division's educational policy. Cross-sectional descriptive in design, the research included first and fourth year baccalaureate students and nurses beginning and completing certification programs (N= 1149). Knowledge and attitudes, educational level, experience and success in pain care were examined via a questionnaire based on the McCaffery and Ferrell and Riddell and Fitche tools. Student's t-test, Pearson correlations and ANOVA were used for data analysis. Educational level was the strongest predictor of knowledge and attitudes among nursing students and certifying nurses, contributing most of the 42.8% explained variance. Small significant contributions were made by other variables. This indicates that formal education is a good vehicle for enhancing knowledge and attitudes.

Development and Psychometric Evaluation of the Eldercare Cultural Self-Efficacy Scale

The purpose of this study was to describe the development and psychometric evaluation of the Eldercare Cultural Self-Efficacy Scale (ECSES). Bandura's Theory of Self-Efficacy provided the theoretical framework. The sample consisted of students (N=248) from seven schools of nursing in a northeast state. The psychometric evaluation included: item analysis, principal factor analysis (PFA) with orthogonal rotation, and internal consistency reliability using Cronbach's alpha. Descriptive statistics were used to determine levels of eldercare cultural self-efficacy among the sample. The PFA revealed a four factor structure (Assessing for Lifestyle and Social Patterns, Determining Cultural Health Practices, Determining Cultural Beliefs, and Dealing with Grief and the Losses Associated with Aging) that accounted for 61% of explained variance. The subscales alpha coefficients ranged from .82 to .95. Findings demonstrate the 28 item scale to be a reliable and valid instrument for use in nursing education to examine students' confidence in caring for ethnically diverse elders.

Selecting and Applying Taxonomies for Learning Outcomes: A Nursing Example

In this manuscript procedures for selecting and applying taxonomies using nursing-related examples are described. Bloom's taxonomy and Gagne's instructional theory are compared. The author concludes that both taxonomies have much in common and are appropriate for use in nursing education.

Action Methods in the Classroom: Creative Strategies for Nursing Education

Nursing education recognizes the need for a framework of experiential learning that supports the development of professional roles. Action methods, originated by Jacob L. Moreno (1953), can be readily adapted to any nursing classroom to create the conditions under which students learn and practice professional nursing roles. While nurse faculty can learn to use action methods, they may not fully comprehend their theoretical underpinnings or may believe they are only used in therapy. This article explores Moreno's ideas related to psychodrama and sociodrama applied in classroom settings, and presents many examples and tips for classroom teachers who wish to incorporate action methods into their classes.

Integrating Clinical Guidelines into Nursing Education

A project planning group consisting of college and university representatives from a collaborative undergraduate nursing program developed an inclusive, process-oriented faculty development initiative to enhance the integration of clinical guidelines in clinical courses. In the first phase, results of a needs assessment were used to inform the development of a six-hour workshop for the third year clinical faculty in acute care, mental health, and community health. Pre-post surveys were conducted with students and clinical faculty during the first phase. Results from the workshop and surveys were used to develop a four-hour workshop for clinical faculty in all years of the program. The relatively short workshop process shows promise for initiating integration of clinical guidelines in undergraduate nursing education.

Educating the Future eHealth Professional Nurse

Nursing is at the cusp of a truly revolutionary time in its history with the emergence of electronic health (eHealth) technologies to support client care. However, technology itself will not transform healthcare without skilled practitioners who have the informatics background to practice in this new paradigm of client care. Nurse educators have been slow to react to the matter of the necessary knowledge, skills, and practice competencies required for nurses to function as eHealth practitioners. Specifically, undergraduate nursing education must take a proactive stance towards curriculum development in the areas of eHealth and informatics. The purpose of this paper, therefore, is to propose recommendations about the review and redesign of nursing curricula in relation to nursing informatics. Recommendations include increased information literacy education, interdisciplinary collaboration, and client-centred technologies. Recommendations for faculty development in nursing informatics are also provided.

Engaging Baccalaureate Clinical Faculty

Role theory was utilized in this descriptive study to investigate clinical faculty in baccalaureate nursing programs. The Clinical Faculty Role Questionnaire was developed and employed to study 134 full-time and part-time clinical faculty members. Theory derivation was used and the concept of role engagement was empirically supported. Pearson's correlation analysis was used to investigate the relationships among the variables. T-test results identified differences between full-time and part-time faculty members on role variables of status, role conception, and role engagement. The relationships between study concepts and areas of educational content related to the teaching role were explored and identified as supportive of the clinical educator role. Ancillary qualitative investigation resulted in the identification of several themes: the need for clinical competence; for part-time faculty, a desire to be included in program planning

Nursing EDGE: Evaluating Delegation Guidelines in Education

Delegation, an important concept for nursing students to learn and practice, is central to registered nurse (RN) performance, and important on the NCLEX-RN examination. Nursing faculty members from an ADN program designed a descriptive study to evaluate planned versus actual delegation in the curriculum, and a second study to evaluate an intervention on delegation. Study One assessed the presence of delegation in each nursing course. Statistical analysis compared the planned implementation with the results for student definitions of delegation, and identification of the five rights of delegation based on the National Council of State Boards of Nursing (NCSBN) definition and five rights. Study one results are shared. Study Two utilized a comparison of pre-to-post intervention measures. Students were asked to complete eight steps of a delegation exercise and determine what could be delegated to an unlicensed assistant, and what should be completed by the RN. Answers were coded and entered into SPSS. Statistical analysis compared each student's ability to correctly identify the five rights of delegation prior to the exercise, against the ability to correctly answer five questions two weeks post exercise. Significant improvement (p< 0.05) occurred on each measure. Recommendations are discussed.

Malaysian Registered Nurses' Professional Learning

Findings of a study of the impact of professional learning on Malaysian registered nurses are reported. The offshore delivery post-registration nursing degree programme is a formal aspect of professional learning, which enables Malaysian registered nurses to upgrade their hospital-based training or diploma of nursing qualification to a degree. Using a qualitative case study approach, data were collected from twelve programme graduates, through individual and focus group interviews. The programme promoted their personal professional growth and enhanced their professional development. It increased self-confidence, knowledge, self-fulfillment, critical thinking ability, interpersonal skills, interest in research and research utilisation, and life-long learning. There was...

Contextual Learning: A Reflective Learning Intervention for Nursing Education

Nursing educators need to continue to explore ways that new pedagogies such as narrative pedagogy and reflective practice inform and extend students' thinking in classroom and clinical situations. The goal of instruction becomes creating an opportunity for learning that integrates content knowledge with knowledge of the context. Educational methodologies that incorporate the use of context in a reflective, dialogical approach over time hold much promise in developing a dynamic process of thinking in practice. Contextual learning is a reflective learning intervention that offers new possibilities for nurse educators to prepare nurses to think critically in practice. In this expository paper the design and instructional methodology of contextual learning is discussed, beginning with a brief overview of the nature of critical thinking and the use of narrative as major underpinnings in the development of this intervention. Examples of how the intervention was implemented with novice nurses in practice is provided. Finally, reflections on how the intervention could be refined for nursing students is offered.

End of Life Issues Action: Impact of Education Kurz, Jane M.

There is an increased momentum to improve nurses' expertise in dealing with end of life issues via a standardized education program, ELNEC. This program has not been evaluated systematically. This quasi-experimental, longitudinal study's goal was to measure ELNEC Program's impact on registered nurses' death anxiety, death attitudes, and knowledge over time. General Systems Theory provided the foundation. Nurses completed surveys prior to and 3 times after the program. Research and control groups were similar. Research group's death anxiety scores increased immediately post- program, decreased 6 months later (t=-2.65, p=.02) and returned to pre-program levels at 12 months. Death attitudes varied. Knowledge levels improved significantly. The control group had steady increases in death anxiety scores. The program was associated with decreased death anxiety. Recommendations include timing evaluations after participants have time for reflection and planning "booster programs" to sustain effects. Future studies should include larger samples, incentives, and research method triangulation.

Fostering Academic Success of Mexican Americans in a BSN Program: An Educational Imperative

Hispanic/Latinos are the fastest growing minority group in the U.S. and the most underrepresented in the U.S. nursing workforce. Although a body of knowledge is growing regarding factors that foster academic success of undergraduate nursing students of color, there is limited information about Hispanic students in general, and Mexican American students in particular in BSN programs. Explored in this qualitative study, were perceived influences of institutional and interpersonal factors on retention and graduation of nine Mexican American students from a predominantly White BSN program. The key findings include adequate financial assistance, maintaining bicultural relations, and experiencing authentic caring relationships from institutional agents, family, and peers as crucial factors in academic success. Recommendations for nursing faculty and administrators are offered.

CAN-Care: An Innovative Model of Practice-Based Learning

The "Collaborative Approach to Nursing Care" (CAN-Care) Model of practice-based education is designed to meet the unique learning needs of the accelerated nursing program student. The model is based on a synergistic partnership between the academic and service settings, the vision of which is to create an innovative practice-based learning model, resulting in a positive experience for both the student and unit-based nurse. Thus, the objectives of quality outcomes for both the college and Health Care Organization are fulfilled. Specifically, the goal is the education of nurses ready to meet the challenges of caring for persons in the complex health care environment of the 21st century.

Nursing school

A Nursing school is a type of educational institution, or part thereof, providing education and training to become a fully-qualified nurse. The nature of nursing education and nursing qualifications varies considerably across the world.

History of nursing schools

United Kingdom

Florence Nightingale was one of the pioneers in establishing the idea of nursing schools from her base at St Thomas' Hospital, London in 1860 when she opened the 'Nightingale Training School for Nurses'. Her intention was to train nurses to a qualified level, with the key aim of learning to develop observation skills and sensitivity to patient needs, then allow them to work in hospital posts across the United Kingdom and abroad. Her influence flourished and nursing is now a course taught at a number of British universities. The University of Manchester was one of the first English institutions to offer the course at degree level.

Entry level courses, sought by most universities, are often five Standard Grades/GCSEs, including English, maths and a science (preferably biology), and two Highers/A-Levels. Mature students, over the age of twenty-one, have the option of entering upon completion of a college access course, and experience in jobs such as being a health/nursing assistant are also worthy for consideration into the course.

Currently, nursing is a three-year course in the UK with a balance between course work in classes and practical placements in a health care setting. The first year is foundation, where students learn anatomy and physiology and basic health care. In Second Year, students then split into one of four chosen branches adult nursing, paediatric nursing, mental health or learning disability nursing that they wish to specialise in and nursing placements usually involve working within the chosen branch area (for example, paediatric student nurses would only be sent to paediatric units) learning skills essential to that setting. Students complete their course after their Third Year, with the choice of undertaking degree essays during that final year or graduating with only a diploma. Those studying midwifery follow a different pathway, specialising in this area from the first day of First Year. Newly qualified nurses then have to register with the Nursing and Midwifery Council in order to apply for jobs and legally practice.

United States

In 1909 The University of Minnesota was the first university based nursing program. Yale School of Nursing became the first autonomous school of nursing in the United States in 1923. It had its own dean, faculty, budget, and degree meeting the standards of the University. The curriculum was based on an educational plan rather than on hospital service needs. In 1956, the Columbia University School of Nursing became the first in the United States to grant a master's degree in a clinical nursing specialty.

Pre-requisites often include math, English, and other basic level courses. Basic courses in biology, anatomy and physiology are required. Core coursework includes anatomy, physiology, pathology, and pharmacology. Additionally, a strong emphasis is placed on procedural education such as insertion of intravenous and urinary catheters, sterile dressing changes, proper administration of medications, physical examinations, caring bedside manner, and other vital skills. After the first semester basic skills are obtained, students rotate through Obstetrics, Mental Health, Medical, Surgical, Oncology, Critical Care and Pediatric Units to get a holistic view of nursing and what it encompasses. Many nursing students and nursing schools use medical and healthcare educational software as a study or training aid.

In the United States, students graduate from nursing education programs qualified to take the national licensing exam for Licensed Practical Nurses (LPNs) or Registered Nurses (RNs).

Nurse educator

A nurse educator is a nurse who teaches and prepares licensed practical nurses (LPN) and registered nurses (RN) for entry into practice positions. Nurse Educators also teach in graduate programs at Master’s and doctoral level which prepare advanced practice nurses, nurse educators, nurse administrators, nurse researchers, and leaders in complex healthcare and educational organizations.
this is Faculty who teach in LPN, associate degree and baccalaureate programs are required to hold a Master’s degree in nursing. Most baccalaureate and higher degree programs require a minimum of a Master’s degree and prefer the doctorate for full-time teaching positions. Many nurse educators have a clinical specialty background that is often blended with coursework in education. Individuals may complete a post-Master’s certificate in education to complement their clinical expertise if they choose to enter a faculty role.

Nurse Education

Nurse education consists in the theorical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to nursing students by experienced nurses and other medical professionals who have qualified or experienced for educational tasks. Most countries offer nurse education courses that can be relevant to general nursing or to specialized areas including mental health nursing, pediatric nursing and post-operatory nursing. Courses leading to autonomous registration as a nurse typically last four years. Nurse education also provides post-qualification courses in specialist subjects within nursing.

Historical background

During recent past decades, the moving on education has replaced the more practically focused, but often ritualistic, training structure of conventional preparation. Nurse education integrates today a broader awareness of other disciplines allied to medicine, often involving inter-professional educationg, and the utilization of research when making clinical and managerial decisions. Orthodox training can be argued to have offered a more intense practical skills base, but emphasized the hand maiden relationship with the physician. This is now outmoded, and the impact of nurse education is to develop a confident, inquiring graduate who contributes to the care team as an equal. In some countries, not all qualification courses have graduate status. Traditionally, from the times prior to Florence Nightingale, nursing was seen as an apprenticeship, often undertaken in religious orders such as convents by young women, although there has always been a proportion of male nurses, especially in mental health services. In 1860 Nightingale set up the first nurse training school at St Thomas' Hospital, London. Nightingale's curriculum was largely base around nursing practice, with instruction focused upon the need for hygiene and task competence. Her methods are reflected in her "Notes on Nursing", (1898).

Some other nurses at that time, notably Ethel Bedford-Fenwick, were in favor of formalized nursing registration and curriculum that were formally based in higher education and not within the confines of hospitals.

Nurse education in the United States has been conducted within university schools, although it is unclear who offered the first degree level program. So far as known Yale School of Nursing became the first autonomous school of nursing in the United States in 1923. In Europe the University of Edinburgh was the first European institution to offer a nursing degree in 1972.

Present aims

Among nurse educators, arguments continue about the ideal balance of practical preparation and the need to educate the future practitioner to manage healthcare and to have a broader view of the practice. To meet both requirements, nurse education aims to develop a lifelong learner who can adapt effectively to changes in both the theory and practice of nursing.

Nursing care to children Rheumatism with heart disease )

1. Defenisi
Heart disease is the symptoms of rheumatism the rest of fever rheumatism (DR) which is also an acute disease acute inflammation that can accompany the faringitis caused by Streptococcus beta-hemolyticus group A. This disease tends to recur and is seen as a cause of acquired heart disease in children and young adults around the world.
2. Etiology
Streptococcus infection of beta-hemolyticus group A in throat always precede the occurrence of fever, rheumatism, both in the first attack and attack back.
Has been known that in cases of fever, rheumatism, there are several predisposisi include:
a. There is a history fever rheumatism in the family
b. Age
DR often occurs between ages 5 - 15 years and rarely at the age of less than 2 years.
c. Social condition
Often occur in families with less social and economic conditions, poor housing with the solid and the air is humid, and nutrition and health that are less good.
d. Season
In countries with 4 seasons, there is a high incidence in late winter and the beginning of the semi (March-May) while the lowest incidence in August - September.
e. Distribusi area
f. Fever rheumatism previous attacks.
DR re-attack after the reinfeksi with beta-Streptococcus group A hemolyticus is often the children who previously never got DR.
3. Patofisiologi
According to the hypothesis Kaplan et al (1960) and Zabriskie (1966), DR occurs because there is a process autoimun or antigenic similarity between the body tissue and somatic antigen streptococcus. When the body infected by Streptococcus beta-hemolyticus group A against the foreign antigen is immediately form imunologik the antibody reaction. Due to the nature of this antigen with the antibody will also attack the body of the network components in this case the sarcolemma due to myocardial there with the antibody against the network in the heart of serum and tissue penderiat DR myocard damaged. One of the toxin that may have a role in the event DR is stretolysin titer 0, a product extraseluler Streptococcus beta-hemolyticus A group that is known to be toxik network myocard.
Several of the various somatic streptococcal antigen settle for a short period of time and the other for a long time. Serum imunologlobulin will be increased in patients after streptococcal sore get especially IG G and A.
4. Clinical manifestations
Associated with the diagnosis, clinical manifestations in the DR on differentiated acute manifestation of major and minor.
a. Major manifestations
• Karditis. Karditis rheumatic inflammation is an active process on the endokardium, miokardium, and pericardium. Early symptoms are feeling tired, pale, and anoreksia. Clinical sign karditis include takikardi, disritmia, noisy patologis, the kardiomegali in radiology that the longer the swell, the heart failed, and alert perikarditis.
• Artritis. Arthritis occurs in approximately 70% of patients with rheumatic fever, in the form of movement is not intentional and does not aim or inkoordinasi muskuler, usually on the face and muscle ektremitas.
• Eritema marginatum. Eritema marginatum found in approximately 5% patients. No itching, macular, eritema edge with a worm that appears to encircle the skin normal.often on the torso and leg proksimal, and does not involve the face.
• Nodulus subkutan. Found in 5-10% of patients. Nodul measuring between 0.5 - 2 cm, no pain, and can be moved freely. Mostly located at the surface ekstendor joints, especially elbow, finger joint, knee, foot and pivot.
b. Minor manifestations
Minor manifestation in acute rheumatic fever include fever can be remiten, antralgia, painful abdomen, anoreksia, Nausea, and vomiting.
5. Inspection Diagnostic
a. Examination of blood
a. LED high
b. Lekositosis
c. Low hemoglobin values may be
b. Bacteriology examination
• clear the throat culture to prove the existence of streptococcus.
• Vetting serologi. Titer measured ASTO, astistreptokinase, anti-hyaluronidase.
c. Radiology examination
Elektrokardoigrafi and ekokardiografi to assess the deviation of the heart.
6. Diagnosis
Acute rheumatic fever diagnosis portrait Jones based on criteria that have been revised. Because patologis depend on the clinical manifestations and diagnosis should be referred to the clinic manifestation, such as fever rheumatism with poliatritis only. The existence of two major criteria or one major and two minor criteria, indicates the possibility of fever, acute rheumatism, if supported by evidence of group A infection sterptokokus before.
7. Complications
a. Dekompensasi Cordis
Current dekompensasi cordis in babies and children there is described the clinical syndrome caused myocardium not able to meet the metabolic needs, including growth. This situation arose because of excessive heart muscle, usually because the structure of the heart rudiment, rudiment, such as heart muscle itself inflamasi process or a combination of both these factors.
In general pains in the heart of the classic children treated with digitalis and drugs diuretika. Treatment goal is to eliminate symptoms (simptomatik) and the most important primary treat disease.
b. Pericarditis
Inflammation in pericard visceralis and parietalis which vary from a mild inflammation reaction buried until the liquid in the cavum pericard.
8. Medicine
Because fever rheumatism closely associated with inflammation-hemolyticus beta Streptococcus group A, the eradication and prevention of inflammation is directed at. This can be:
a. Eradikasi bacteria Streptococcus beta-hemolyticus group A
Adekuat treatment must begin as soon as possible in the DR and proceed with precaution. Erythromycin was given to those who are allergic to penicillin.
b. Anti-rheumatism drug
Cortocisteroid and salisilat well known as a useful drug to reduce / eliminate symptoms of acute inflammation in the DR.
c. Diet
Food enough calories, protein and vitamins.
d. Rest
Rest is recommended until the signs disappear and inflamasi decline in the heart of the cases kardiomegali. Usually 7-14 days in the case of DR minus carditis. In the case of plus carditis, long rest average sunday 3 - 3 months depending on the weight difference ringannya the journey and the progress of disease.
e. Other medicines
Given in accordance with their needs. In the case of the dekompensasi kordis given digitalis, diuretika and sedative. When given largactil have chorea, and others.

CONCEPT Nursing
1. Of
Make a routine of physical
Get the history of health, particularly on the evidence of infection streptokokus antesenden.
Observation of manifestation fever rheumatism.
2. Nursing Diagnosis
a. High rainfall decrease in the risk associated with heart disfungsi myocardium
b. Increased body temperature (hipertermia) associated with the infection disease.
c. Nutrition needs of less-related nausea, vomiting, anoreksia.
d. Pain associated with the process inflamasi.

3. Nursing Plan
a. High rainfall decrease in the risk associated with heart disfungsi myocardium
Objectives: Patients can show improvement rainfall heart.
Rational intervention
Digoksin according to its instructions, with the precautions that have been determined to prevent toksisitas.
Knowledge signs toksisitas digoksin (nausea, vomiting, anoreksia, bradikardia, disritmia)
Often taken EKG rhythm strip
Jamin entries that potassium strong

Observation of signs hipokalemia
Give drugs to reduce afterload appropriate instructions rainfall can increase heart


To prevent the occurrence of toksisitas

Assess the status of the heart
Decrease in serum potassium level increases toksisitas digoksin


b. Increased body temperature (hipertermia) associated with the infection disease.
Destination: normal body temperature (36 - 37 'C)
Rational intervention
Knowledge while the incidence of fever
Observation vital signs: temperature, pulse, TD, breathing every 3 hours
Give an explanation of the causes of fever or increased body temperature

Please provide an explanation on the client and family about the things that made
Explain the importance tirah lie for the client and the consequences if it does not do
Encourage clients to drink lots of approximately 2.5 - 3 liters / day and explain the benefits

Give a warm compress and recommend wear thin


Give antipiretik accordance with the instruction pattern can be identified / high fever
Signs is a vital reference for the general client condition
Explanation of the conditions that experienced clients can help reduce the client and family care
To overcome the fever and encourage clients and families to be more cooperative
The involvement of family is very meaningful in the process of healing the client in the hospital

Increased body temperatures cause increased evaporation body fluids so that the need to offset with a lot of liquids Feed
Will compress can help lower body temperature, light clothing will be able to help improve the body's heat evaporation

Antipiretika who have reseptor in the hypothalamus can regulation body temperature so that the temperature near the body temperature normal effort
c. Nutrition needs of less-related nausea, vomiting, anoreksia.
Destination:
Client's nutrition needs met, the client is able to consume food that has been provided.
Rational intervent
knowledge factors that cause

Explain the importance of adequate nutrition


Encourage clients to eat in small portions and often, if vomiting does not continue
Make a good mouth care after vomiting
Measure BB every day

Record the amount of the portion of the client spent
Factor determining the cause, will determine the intervention / follow-up
Enhance client and family so that the client motivated to consume food
Avoid nausea and vomiting and excessive stomach distensi

That does not smell good at the mouth increase the likelihood of vomiting
BB is an indicator not met the needs of nutrition
Knowing the number of Feed / client fulfillment nutrition





d. Pain associated with the process inflamasi.
Destination: pain is reduced or lost
Rational intervention
Knowledge level of pain experienced by clients with a range of pain (1-10), specify the type of pain and patient response to the pain experienced
Knowledge-factor of factors that influence the reaction of the patient's pain

Provide a comfortable position, try to calm the situation room
Give the happy atmosphere for patients, patient divert attention from pain (Involve families)
Give the client the opportunity to communicate with friends / people nearby

Give medicines analgetik appropriate instructions To know how many levels of pain experienced


Patient react to the pain can be affected by various factors like that also individual responses to pain vary different dab
Reduce excitatory painful stimulus due to external
By doing other activities, clients can forget a little attention to the pain experienced
Stay in touch with the nearest / friend to make the patient happy / happy and dapaty divert attention to the painful
Reducing pain with effect farmakologik..

Managing Nurses Education

Interesting scrutinize actionstral Java, on Thursday, June 7 and Saturday, 16 June 2007, in Semarang. "Suara Merdeka" proclaim that the action title "Demo Reject D4 Nursing." Basic nurse education regulation is the order of professionalism and globalization. Professionalism requires a nurse must complete the academic and professional education, as other health professions that have been developed, such as doctor, dentist, pharmacist, and psychologist.

Currently most of the nurse education is vokasional (D3 Nursing), part of a small ners and specialists. Even still have the SPK (at the senior secondary school). The lack of nurse education, a cause of the low quality of nursing and nurse our competitiveness compared to foreign nurses. In fact, the number of health professionals is a nurse.

Low nurse education can not be separated from the history of its development. The development of nursing in nursing services adopted in the Netherlands, the professional nurse of birth because of humanitarian services, such as nuns. Therefore, nursing education less developed compared with the Commonwealth countries.

In the UK, nursing education has grown through the university since 1868. Thus, the framework of professionalism and service is very nursing forward.

In Indonesia, designed to help nurses, doctors, so that the role and functions of the nursing shifts. MOH and the results of research, University of Indonesia (UI) shows more than 90% nurses perform tasks non nursing (set of disease diagnosis, prescription drugs create, take action treatment). Only 50% who do care nursing in accordance with the role and functions.Competency Test

On the other hand, the International Council of Nursing (ICN) requires a nurse to provide services that will have to go through certification and testing competency to obtain a register nurse (RN). RN to test, a person must complete the education ners. Thus, the international standard of basic education must be professional nurse education ners. Nurses who pass the RN have the right to work in all countries. At this time we nurse difficult entry to another country because they do not have the RN.

When we have nurses who work in Middle Eastern countries, they are a nurse vokasional. Development lower than India or the Philippines nurse, who has been certified internationally.

Similarly nurse regulations in the country. Many foreign nurses who will go to Indonesia. They have a high standard of competence and moral responsibility of both. If we do not anticipate, then their presence can be a threat to us, and we will be guests in their own country. In order to anticipate the threat, the regulation required higher education system of good nursing.

Education flows

Basic Indonesian National Nurses Union (PPNI) and managing the type of nursing education is the Law (UU) 20/2003 on National Education System. To become a professional nurse (RN), graduates high school education should be academic and S1 Nursing Profession Ners. But if you want to become a nurse vokasional, (primary nurse) can take the D3 Nursing / Nursing Academy.

SPK graduates who still want to be a nurse should be immediately or directly to the D3 to S1 Nursing. Furthermore, D3 Nursing graduates can continue to S1 and Nursing Ners. Education from S1 and Ners, new to the Masters in Nursing / Doctor and specialist / consultants. Expected in 2015, most of the nursing staff is S1 Nursing and Ners. Therefore, expect very PPNI nurse education vokasional forward to S1 and Nursing Ners.

Professional Education

There are several reasons why there is no level D4 Nursing? First, the demands and needs of professional nurses in the era of globalization. Nurses are professionals, as in the declaration lokarkarya national in 1983. Basic education must be education professionals.

Second, the more types and levels of education vokasional nurse will make the interest. The difference between the competence and authority of D3, D4, and Ners how? Third, if the study will continue, after the pass to which D4? No transfer of education from D4 to S1 Nursing.

Many graduates Undip D4 Nurse Educators (now closed) must continue to S1 with the D3 Nursing.

Differences of views between the elite PPNI the right and set the type of education as a nurse with the education provider D4 Nursing, need to be completed. PPNI defend idealism and professionalism that the existence and recognition of the profession is increasing in the eyes and other professional communities.

Meanwhile, the government has Politeknik Health (Poltekes) in many provinces the color quality of our nurses, despite the existence Poltekes which is managed by the Ministry of Health is not education as a service mandated by law.

The real difference, when there is the desire that the recruitment of civil servants in the future prioritize D4 Nursing graduates. Where S1 Nursing students after graduating? Perhaps it is the struggle by S1 Nursing Alliance BEM all Indonesia. Arogansi each will only aggravate a situation that will affect the nursing service.

Many of the profession has grown and developed well. Professional organizations to manage both their profession. Already as a profession is given the opportunity to also develop the framework of norms and professionalism, so that competitiveness Nursing human resources capable to compete with other professions.

Development of Nursing

Development of Nurses in ENGLISH
Available F.N cream war back to the UK
England opened the way for progress & development in nursing I pelopori F.N
Th 1840 English major changes in treatment
- Education Hopital nurses in London
- Th 1820 a modern school nurse
Kontrubusi F.N for the development of nursing:
Nutrition is an important part of askep
Recreation therapy is a patient for
Identify personal needs nursing ps & u / fulfilling
Setting a standard management R.S
Develop standard job bg ps woman
Develop a nursing education
Set 2 components, namely nursing health & diseases
Nursing & stand-alone medical profession berbada dg
Emphasizing kebut. Pddkan continues for nurses
(Play, 1978 quoted in Taylor 1989)

3. Development of Nursing IN INDONESIA
Governmental Netherlands
- Nurse derived from indigenous pddk (Velpleger) in the guard for the sick (Zieken Oppaser)
- Working in hospitals Binnen Hospital in Jakarta (1799) maintain health staff of the Netherlands &
- Form the office of the health & public health agencies
VOC period (gubenur English Rafles 1812-1816)
- Human health is the property to public vaccination.
- help how patient care dg ggn soul.
- Health & care of the prisoners.

4. The development of nursing professional organizations
Some nursing organizations
ICN (International Council of Nurses) professional women's organization in the world in the first established date 1 July 1899 o / Mrs.Bedford Fenwick.
The goal:
- The strengthening of the world at all nursing
- Provide an opportunity to meet in bg prwt world slrh u / discuss problem nursing.
- Uphold the rules in the ICN in order to reach progress in services, nursing education based on the code of ethics profession.
ANA in 1800 I established members of the state-2, play a role:
- Set the standard practice of nursing
- Canadian Nurse Association (CNA) dg ANA same goal to give permission nursing independent practice
NLN (National League for Nursing) in dirikan th 1952, the u / development & improve the quality of lan-kep & pdkkan keprwtan
British Association of Nurse dirikan th 1887, purpose:
strengthen the unity & slrh union nurses in the UK & thp trying to obtain recognition of professional nursing.
PPNI in established 17 March 1974

.

Nursing History

The era of primordial (primitive Culture)
Humans believe that what is in the earth, have the power spritual / mystical do affect human life (animism)
Pain in sebabkan by:
- The strength of natural / supernatural power (large rocks, high mountains & large tree-2) people> believe in the traditional
Time of egypt people believe in god is able to cure disease ibis
Syetan in China as a cause of disease

As a result, the nurse does not expand to treat
2.Pertengahan VI century BC
Nursing in the developing continents asia southwest asia precisely the middle east over the development of Islam dg
VII century Arab peninsula growing knowledge spt mathematics, chemistry, Hygiene and medicine
Nursing experience of some basic principles of self-health importance of hygiene (personal Hygiene), food hygiene, water & environment
Legend of the arab world is Rafidah

3.Permulaan XVI century
Community orientation of the power of religious war.
Byk yg houses of worship close I usually use to treat sick people.
Nurse salary in the low-dg long working hours on working conditions do poorly.
Positive side of war u / keprwtan progress victim byk need volunteers as prwt (2-religious order, the husband and wife do about the war & I-2 as a double prwat) concept P3K

3 Hospital do thp major role in the development of nursing of the present (mid-period), namely at the Lion Hotel Dieu originally nursing former reclaimed, not long after I educated nurses use rs of page
Hotel Dieu in Paris in order, stlh revolution religion in order to change people in the del-2 indeterminate bound-free religion, plpr prwt famous rs this is Genevieve Bouquet
St. Thomas Hospital, in dirikan th M 1123 Florence Nigtingale nursing update

4. Mid-century XVIII - XIX
nursing people start to believe in the Florence Nigthingale
FN 1820 th birth of the family is rich, respected, grow & develop in the UK, received in the course of education nurses aged 31 years..