Mission, Values, Goals and Conceptual Framework
Continuing Nursing Studies offers post-basic specialty programs, professional development courses, re-entry programs, and other courses and programs based on assessed needs. The goals of Continuing Nursing Studies are to:
- Facilitate ongoing professional development for RNs and LPNs practicing in a rapidly changing clinical environment
- Support and assist nurses in rural areas through distance education
- Make learning opportunities accessible and affordable for all nurses
The vision of Continuing Nursing Studies is to be a leader in professional development by empowering students to access timely outcome-based, user-friendly learning resources that stimulate the desire for continuous learning and continuous quality improvement.
Continuing Nursing Studies is committed to developing and maintaining competency of nurses by providing post-basic specialty and professional development courses that are based on needs of key stakeholders and that are accessible to all students.
Values and Beliefs
Continuing Nursing Studies, in pursuit of leadership in professional development, believes in developing the strengths of its students by promoting respect, competence, self-direction, individuality, trust, collaboration, and critical thinking. The department is committed to providing planned learning experiences beyond basic nursing education programs. These educational programs are designed to promote evidence-based practice and personal development by expanding the nurse’s knowledge, skills, and attitudes. Content included in these programs arises from evolving scientific knowledge and changing professional standards. The planned learning experiences are built upon adult learning principles, are specific to the student’s needs, and are applicable to the student’s goal. Values identified by Continuing Nursing Studies are:
- The student as an individual in the identification of his/her learning needs and potential
- Collaboration and partnerships both within and outside CNS in order to realize the vision and mission
- Lifelong learning principles in order to stimulate continuous learning and continuous quality improvement
- Continuing education as an integral part of the change process which allows the student to actively prepare for and respond to change
- A non-threatening learning environment conducive to the student’s self-direction, self-inquiry, and self-actualization
- Methods of delivery of educational programs that promote self-paced learning and accessibility to students
- Ongoing continuing evaluation to ensure programs being offered are relevant, current, and meet quality improvement principles
The Conceptual Framework is developed from key concepts identified in the vision, mission, and values and beliefs statements. The following is an explanation of the Conceptual Framework (see Model of Framework following explanation).
The student - The inner circle, which represents the student (RN or LPN), is the focal point of the conceptual framework.
Programs - The middle circle represents the programs. Programs that are offered by Continuing Nursing Studies are based on continuous needs assessment of key stakeholders (Registered Nurses, Licensed Practical Nurses, employers, community at large, and others), evolving scientific knowledge, health care delivery system, professional nursing organizations, and any other groups that have relevant input to selection of programs.
Key Concepts to Program Development- The outer circle represents key concepts surrounding programs. Key concepts that have been identified as being essential to the development of programs are:
- Individuality - Each student has a different level of education, value system, and set of experiences. These differences are recognized in program development.
- Adult Learning Principles - Programs will be developed using adult learning principles as the “philosophy” of education.
- Continuum of Learning - Courses will be developed to allow for a continuum of learning to motivate and facilitate students to develop an attitude of lifelong learning.
- Evidence-Based Practice - Current nursing research and methods will be incorporated into programs to facilitate evidence-based practice.
- Prior Learning Assessment - Continuing Nursing Studies is committed to recognizing prior learning.
- Partnerships - Continuing Nursing Studies will develop partnerships with key stakeholders.
- Distance Education Methods - Distance education methods will meet the educational needs of the students by providing accessibility to programs.
- Technology - Technology will be utilized where possible in the provision of programs to facilitate interactive learning.
- National and Provincial Standards - National and provincial standards from professional and educational organizations will be incorporated into programs.
- National/Provincial Approval - All programs will be approved by relevant professional bodies.
- Continuous Program Evaluation - Programs and courses will undergo continuous evaluation to ensure relevance, currency of content, quality, latest technology available used, and satisfaction from students and employers. This will be done through Quality Initiatives.
Conceptual Framework for Continuing Nursing Studies
Continuing Nursing Studies Conceptual Framework for Nursing
The Conceptual Framework, which serves as a blueprint for the development of nursing courses in Continuing Nursing Studies, is an eclectic one. Concepts central to the framework include holism, systems theory, sequential pattern of growth and development, beliefs and values, continuum, wellness, health, illness, stressors, coping, adaptation, maladaptation, collaborative relationships, and advocacy. A detailed explanation of the four main concepts (person, health, environment, nursing) in our paradigm of nursing follows.
Each person is viewed as a unique individual composed of biological, psychological, sociological, and spiritual dimensions. Though these dimensions are identified as separate entities, in actuality, they are not; they constantly interact with one another, are dependent on one another and are coordinated in a systematic way. This balance or exchange between systems maintains a person's holism; the idea that the person is considered to be greater than the sum of her/his parts.
The person is an open system that interacts internally as well as externally with other components such as social, physical, cultural, political and economical systems. Stressors from within the internal and external components of the environment continuously confront the person. Successful adaptation by the person to these stressors results in health or wellness while unsuccessful adaptation results in illness or death.
Growth and development of a person occurs in a logical sequential pattern from conception through death. Beliefs and values developed during the lifespan help a person formulate perceptions about self, health and the world.
Perceptions, particularly about health, determine whether or when the person will seek health care. The nurse, when working with the person, develops a helping relationship. During this relationship the nurse facilitates the person to become an active participant and to assume responsibility for personal health.
Health is viewed as a dynamic process in the life continuum of a person which encompasses the concepts of wellness, health, and illness. These concepts refer to a person's ability to achieve a level of biological, psychosocial, and spiritual well-being by continually adapting to the internal and external environment. The degree of health attained is determined by a person's ability to successfully respond to stressors in the internal and external environment. The level of functioning which maximizes an individual's potential to function within the environment is wellness. Effective responses implies the use of adaptive mechanisms to successfully achieve or maintain a person's holistic nature or balance, whereas ineffective responses cause a maladaptation/imbalance among the person's systems. This imbalance is referred to a illness, which may lead to death.
Wellness, health, and illness are seen as separate, but parallel, entities on a continuum and their positions are determined by the nature and strength of adaptive responses in relation to the nature and strength of stressors. Since no one attains perfect health and not everyone is defined as ill, there must be a range on the continuum that allows for health and illness to co-exist.
People view health and illness in terms of their own perceptions which stem from their individual value systems. Alterations in their health status usually lead individuals to seek care within the health care delivery system. People have a universal right to health care. The right to seek or not seek health care must be respected, as long as people understand the implications of their actions and this does not pose a threat to others.
The primary goal of nursing is to promote, maintain, or restore a person's adaptation to an optimal state of health. Since the process of health is a unique and individual experience, the person must be regarded as an active participant and the ultimate authority in the plan of care. The goals of nursing care must then be dynamic, individualized, and determined collaboratively by the person and the nurse.
The Health Process 211
Figure 10-3 Health Continuum (Reprinted with permission from Twaddle, AC: A Sociology of Health, p. 13. St. Louis, C.V. Mosby, 1977).
Environment in the broadest sense includes all of the internal and external influences affecting the development of a person or group. These influences are seen as systems that are open and interact with one another. A person is many systems and sub-systems that interrelate in an integrated fashion to maintain one's totality or holism. Both persons and environment are seen as living, dynamic systems with porous boundaries that allow for exchange of matter, energy, and information within and between each other.
The internal environment of a person includes a variety of sub-systems such as biological, psychological, sociological, and spiritual. These components include unique characteristics as well as characteristics that are common with other persons. Each of these sub-systems, the biological for example, can be further divided into components such as gastrointestinal, respiratory, and circulatory systems.
The biological system contains sub-systems that affect a person's normal body functioning. The psychological system contains sub-systems that affect a person's thinking and feeling. A person's ability to develop formal and informal relationships with one person, the family, or other social groups describes the sociological system. The spiritual component may include a person's need to believe in a Supreme Being, a special order of the universe, or that life has meaning. The internal environment therefore includes everything internal to a person's body boundaries.
The external environment includes anything exterior to a person's internal environment. This includes anything that may impact or encroach upon a person's life. Physical environment, cultural environment, social environment, political environment, and economic factors are examples of the sub-systems that may have an impact upon a person's life. The physical environment includes elements like: air, water, soil, and food quality; geography; climate; and building structures. Cultural factors include racial and ethnic identity, values and beliefs, language, and intercultural communications of the person. The social environment consists of the social systems with which a person interacts such as the family, social groups, and the community at large. Job availability, the quality and accessibility of health care services and other resources, and financial stability of the community exemplify components of the economic environment. The political environment represents the governmental power to influence or determine policies relevant to health care, environment, and other issues in society.
The profession of nursing allows the nurse to develop a very special and unique relationship with a patient. During this relationship, the patient places a great deal of trust in the nurse. The nurse frequently deals with a patient who is in a weakened and disruptive state. In this precarious relationship, in which the nurse may become the patient advocate, it is essential that the nurse be a caring individual with strong ethical and moral values.
The nurse begins the process by developing an open, honest, individualized and collaborative relationship with the patient which is reliant upon good communication skills. Although nurses also work with families and groups, the emphasis here is on the individual. This relationship can be established with individuals of any age group, therefore, understanding the concepts of growth and development is an essential part of this process.
Nursing care is provided to patients in acute, long term, ambulatory, rehabilitative, and community settings. These settings provide the nurse with the opportunity to work with individuals at varied positions along the wellness-illness continuum.
Promoting, maintaining and restoring a patient's adaptation to an optimal state of health is the major goal of nursing. The nurse helps facilitate the patient to adapt positively to stressors in the internal and external environment, moving patients toward health and growth. Maladaptation occurs when the stressor or stressors are stronger than the person's adaptive responses.
In order to determine a person’s adaptive ability and level of health the nurse must assess the person’s internal and external environment. Stressors, that have the potential to disrupt a person’s system or holism, are identified by looking at various components of the patients’s internal and external environment. The nurse assesses the patient's level of health by identifying factors such as information about the patient's coping abilities, functional health patterns, past experiences, and ability to change.
The nurse can determine if the patient is adapting effectively or ineffectively to stressors by identifying coping responses. These responses may include the use of psychological and physiological defenses as well as intellectual reasoning. Ineffective coping behaviours on the other hand, will lead to maladaptation, illness or death. It should be noted however, that stress is an essential part of normal life and when it reaches crisis proportions, may result in maladaptation.
The nurse, in collaboration with the patient, utilizes decision making and problem solving to plan and implement strategies to deal with stressors effectively. These nursing strategies include providing information, teaching more effective coping responses and modifying or changing the internal or external environment of the patient. Evaluation of these strategies is ongoing throughout the nurse-patient relationship.
When working with healthy and well individuals, the nurse can provide teaching and information to promote or maintain a high quality of life or level of functioning within the environment. Often the patient will be able to function in everyday life despite being ill. The nurse then focuses on strengthening or maintaining positive adaptive responses.
The nurse, even though independent in her/his role to a large degree, does not care for the patient in isolation. The nurse is a member of the health care team which includes other professionals such as physicians, social workers, physiotherapists and dieticians. Providing holistic nursing care places the nurse in a unique situation not only as the giver of care but also as the coordinator of care.