Professional Nursing Concepts & Challenges - 10th
Edition
Visit the link below to download the full version of this book:
https://medipdf.com/product/professional-nursing-concepts-amp-challenges-10th-ed
ition/
Click Download Now
TENTH EDITION
PROFESSIONAL NURSING
CONCEPTS & CHALLENGES
Beth Perry Black, PhD, RN, FAAN
Associate Professor Emeritus
University of North Carolina at Chapel Hill
School of Nursing
Chapel Hill, North Carolina
Elsevier
3251 Riverport Lane
St. Louis, Missouri 63043
PROFESSIONAL NURSING: CONCEPTS & CHALLENGES, TENTH EDITION ISBN: 978-0-323-77665-3
Copyright © 2024 by Elsevier Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center
and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notice
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds or experiments described herein. Because of rapid advances in
the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made.
To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors, or contributors for
any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or
from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Previous editions copyrighted 2020, 2017, 2014, 2011, 2007, 2005, 2001, 1997, and 1993.
Senior Content Strategist: Sandra Clark
Content Development Manager: Danielle Frazier
Senior Content Development Specialist: Maria Broeker
Publishing Services Manager: Julie Eddy
Senior Project Manager: Rachel E. McMullen
Design Direction: Ryan Cook
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Photo courtesy Grant and Rebeckah Berry.
I dedicate this edition to the life and memory of Diane Berry, who graced our lives
with her rare ability to make everyone in her sphere feel like her best friend; in her
presence, you were the only person who mattered in the moment. An expert nurse
and accomplished researcher, Diane was a gift—a kind, loving, loyal, courageous
human unafraid to be herself. And she made us all kinder, more loving, more
loyal, more courageous, and more human. That was her enduring gift to those
of us—all her best friends—who miss “Mama Bear.”
—BPB
P R E FA C E
As the largest group of health care providers in the U.S., and content that was successful in the ninth edition:
nurses are well-positioned to be leaders in re-envision- more narrative and fewer statistics. I have rarely met
ing and reforming health care access and delivery. To be an engaged nurse who didn't start a story with, “I had
effective leaders, nurses must master knowledge about a patient once who…” These narratives teach us about
health and illness and human responses to each, think what is important in nursing.
critically and creatively, participate in robust interprofes- Words matter. Throughout the book, I have been
sional education and collaborations, be both caring and very careful to use inclusive language, to avoid heter-
professional, and grapple with complex ethical dilem- onormative and ethnocentric words, to use examples
mas that challenge providers in a time when health care that avoid stereotypes of all types, and to include pho-
resources are strained. As leaders, nurses should under- tographs that capture the diversity of American nursing.
stand their history because the past informs the present; You will notice that I use the gender-neutral “they” as a
vision for the future builds on the lessons of today. now-accepted singular pronoun, and its related posses-
The tenth edition of Professional Nursing: Concepts & sive form “theirs,” both avoiding the awkward “he and/
Challenges reflects my commitment to present current or she” term and assigning a specific gender to a situa-
and relevant information. This edition is written while tion or person.
the COVID-19 global pandemic still rages. The stresses A note about references: older references refer to
on the health care system are enormous, and the effects classic papers or texts. There are a few references that
of the COVID-19 pandemic on the most vulnerable do not reach the level of “classic” texts, but the author
citizens in the U.S. provide irrefutable evidence of the turned a phrase in a clever or elegant way that needed
consequences of severe, prevalent disparities related to to be cited. No manner of updated paper could replace
access to both health and illness care. Ongoing legislative these interesting comments or points of view. Research
reluctance to address injustices related to climate change and clinical works are relevant and contemporary.
creates another barrier to optimal health and wellbeing As with the last five editions, the tenth edition is
among economically disadvantaged U.S. citizens, who written at a level appropriate for use in early courses in
tend to live in areas most affected by flooding and other baccalaureate curricula, in RN-to-BSN and RN-to-MSN
sequelae of a changing climate. Nurses are learning that courses, and as a resource for practicing nurses and grad-
health care is not just what happens in hospitals and uate students. An increasing number of students in nurs-
clinics but that it plays out in every aspect of daily life. ing programs are seeking second undergraduate degrees,
In this edition, the order of the chapters has remained such as midlife adults seeking a career change and oth-
the same as in the ninth edition, based on generous ers who bring considerable experience to the learning
feedback from faculty that this order provides a cohe- situation. Accordingly, every effort has been made to
sive view of nursing; its history, education, and con- present material that is comprehensive enough to chal-
ceptual and theoretical bases; and the place of nursing lenge users at all levels without overwhelming beginning
in the U.S. health care system. Faculty are encouraged, students. The text has been written to be engaging and
however, to use the chapters in any order that reflects interesting, and care has been taken to minimize jargon
their own pedagogic and theoretical approaches. This so prevalent in health care. A comprehensive glossary is
edition continues to address the effects of social media provided to assist in developing and refining a profes-
on nursing, especially with regard to the legal and ethi- sional vocabulary. As in previous editions, key terms are
cal implications of their use by nurses and their role in highlighted in the text itself. All terms in color print are
professional socialization and communication. With the in the Glossary. The Glossary also contains basic terms
easy and free availability of health-related statistics from that are not necessarily used in the text but may be unfa-
.gov and other websites, I am continuing with the format miliar to students new to nursing.
ix
x PREFACE
I hope that the tenth edition continues to meet the Tenth Edition, will contribute to the continuing evo-
high standards set forth by Kay Chitty, who edited the lution of the profession of nursing and, ultimately, to
first four editions of this book. I hope that students the excellent care of patients, their families, and their
and faculty will find this edition readable, informa- communities.
tive, and thought provoking. More than anything, I
hope that Professional Nursing: Concepts & Challenges, Beth Perry Black
ACKNOWLED GMENTS
With each new edition of Professional Nursing: Concepts and diversity. Her incisive, exacting critique of the
& Challenges, I find myself increasingly in awe of the manuscript and her tireless work in searching out
intelligence, creativity, humility, and work ethic of the original sources and better references are an editor's
nurses who continue to inspire me. dream! This text is better because of her work on it,
I am grateful to the many people whose support and and I am truly grateful.
assistance have made this book possible, each in differ- • To Tarteel Suliman, who, as my mentee in her
ent ways: undergraduate honors course, demonstrated envi-
• To nursing faculty who used earlier editions and able wisdom and courage, and taught me much
shared their helpful suggestions to make this book about what I do not know. I was privileged to be her
better. teacher, and grateful for the opportunity. Remem-
• To nursing students who sent e-mails, expressing ber her name.
their gratitude for an interesting and readable text- • To Grant and Rebeckah Berry, who shared their
book while offering ideas for improvement. photo of their beloved wife and mother Diane, and
• To the contributors from the ninth edition whose for sharing her with us in her all-too-short time on
efforts on their chapters provided a solid foundation this earth.
for my work on this edition. • To my erstwhile pandemic companion, Abbey, my
• To my former colleagues in the School of Nursing at big goofy furball because, well, everyone who owns a
the University of North Carolina at Chapel Hill, and dog knows why. She isn't much for conversation, but
to our extraordinary nursing students and alumni, she looks at me with great interest while I talk, and
who make us proud. her needs are pretty simple.
• To Amanda Black, whose keen eye for detail was • To my grandson, Calvin, who as a two-year-old
invaluable in preparing the final manuscript for sub- shows remarkable willingness to say “yes” instead of
mission. More important, however, was Amanda's “no.” That's a great lesson for all of us who are learn-
sensitivity to the issues and language of gender, race, ing something new.
xi
CONTENTS
1 Nursing in Today’s Evolving Healthcare 10 The Science of Nursing and Evidence-Based
Environment, 1 Practice, 224
2 The History and Social Context of Nursing, 33 11 Developing Nursing Judgment Through Critical
Thinking, 247
3 Nursing’s Pathway to Professionalism, 62
12 Communication and Collaboration in Professional
4 Nursing Education in an Evolving Healthcare
Nursing, 266
Environment, 78
13 Nurses, Patients, and Families: Caring at the
5 Becoming a Professional Nurse: Defining Nursing
Intersection of Health, Illness, and Culture, 292
and Socialization in Practice, 101
14 Health Care in the United States, 318
6 Nursing as a Regulated Practice: Legal Issues, 123
15 Political Activism in Nursing: Communities,
7 Ethics: Basic Concepts for Professional Nursing
Organizations, and Government, 348
Practice, 145
16 Nursing’s Challenge: To Continue to Evolve, 367
8 Conceptual and Philosophic Foundations
of Professional Nursing Practice, 177
Epilogue, 381
9 Nursing Theory: The Basis for Professional Glossary, 382
Nursing, 204
xiii
1
Nursing in Today’s Evolving
Healthcare Environment
To enhance your understanding of this chapter, try the Student Exercises on the Evolve site at
http://evolve.elsevier.com/Black/professional.
LEARNING OUTCOMES
After studying this chapter, students will be able to: • Identify evolving practice opportunities for nurses.
• Describe the demographic profile of registered • Consider nursing roles in various practice settings.
nurses today. • Explain the roles and education of advanced practice
• Recognize the wide range of settings and roles in nurses.
which today’s registered nurses practice.
Nurses comprise the largest segment of the healthcare of new or ongoing symptoms of long COVID contin-
workforce in the United States and have increasing ues to widen. This poses a threat to a healthcare system
opportunities to practice in a wide variety of settings. already burdened by significant changes in care deliv-
More than ever, the profession requires a well-trained, ery required by this infectious, airborne virus, and the
flexible, and knowledgeable workforce of nurses who sometimes overwhelming numbers of patients with
can practice in today’s evolving healthcare environment. COVID infections requiring acute and critical care.
Recent legislation, demands of patients as consumers of Furthermore, how to manage the spread of COVID
health care, and the need to control costs while optimiz- became the source of much political and sociocultural
ing outcomes have had a great influence on the way that debate. Topics of debate included whether and how to
health care is delivered in the United States. Nursing is mandate wearing masks and vaccinations, the effective-
evolving to meet these demands. ness of social distancing, and how to address the spread
As this edition of Professional Nursing: Concepts & of disinformation related to COVID-19 transmission
Challenges is being developed, the United States contin- and the use of untested, unsupported, and even danger-
ues to face the significant challenges of the worldwide ous substances to prevent or cure infection. Importantly,
pandemic caused by SARS-CoV-2, more commonly the long-term effects of the pandemic and its over-
known as COVID-19. The long-term health and socio- whelming strain on the healthcare workforce, including
economic effects of the pandemic are numerous and are registered nurses, continues to evolve, and will likely
not yet fully realized, although researchers, scientists, result in an acute shortage of nurses in the near future.
and healthcare providers are recognizing the presence The issue of access to care and how to pay for it
of a phenomenon known as long COVID or postacute continues to challenge U.S. citizens, which has lagged
COVID, the symptoms of which do not appear to be behind other nations of comparable economic develop-
related to the severity of the initial COVID infection ment in terms of accessibility of adequate health care,
(Centers for Disease Control and Prevention [CDC], mortality rates, disease burden, and other key health
2021). As the numbers of newly diagnosed COVID metrics (Peterson-KFF, 2021). One of the most nota-
infections and deaths related to acute COVID may be ble influences on today’s healthcare environment is
abating in the U.S. at the time of this writing, the array the Affordable Care Act (ACA), passed in 2010 by the
1
2 CHAPTER 1 Nursing in Today’s Evolving Healthcare Environment
111th Congress and signed into law by President Barack Your nursing education will provide you with a flexible
Obama. The ACA is actually two laws: the Patient Pro- set of skills and opens to you a wide variety of experi-
tection and Affordable Care Act (PL 111–148) and the ences that await you as you begin—or continue—your
Health Care and Education Affordability Reconciliation career as a professional registered nurse (RN).
Act (PL 111–152). These laws provide for incremental
but progressive change to the way that Americans gain
access to and pay for their health care. The ACA pro-
NURSING IN THE UNITED STATES TODAY
vided increased opportunities for nurses: the Commit- A diverse nursing workforce is fundamental to meet-
tee on the Robert Wood Johnson Foundation (RWJF) ing healthcare needs in the U.S., and to address health
Initiative on the Future of Nursing at the National Acad- inequities, including access to care among historically
emy of Medicine (NAM) noted nursing’s opportunities underserved communities (American Association of
to act in partnership with other health professions in Colleges of Nursing [AACN], 2020). To achieve this
improving and reconfiguring the U.S. healthcare system fundamental goal, schools of nursing must recruit and
and how care is delivered (National Academy of Medi- admit individuals from diverse backgrounds (AACN,
cine [NAM], 2010). The most recent study by NAM on 2020). Understanding the composition of the nursing
the Future of Nursing 2020-2030 built on the findings workforce is necessary to identify underrepresented
from 2010-2020, noting the primacy of the health of its groups and to recognize workforce trends such as the
citizen to ensure that a nation will thrive, and that nurses age of nurses in practice and the percentage of licensed
as “trusted bridge builders” are catalysts for implement- nurses holding jobs in nursing.
ing changes in to the U.S. healthcare system to advance As an initial mechanism to respond to the need for
health equity by building on a stronger and more expert understanding the nursing workforce, the U.S. Depart-
nursing workforce (NAM, 2021). The Future of Nurs- ment of Health and Human Services conducted a com-
ing 2020-2030 document and related resources can be prehensive survey of the nursing workforce every 4
found at https://nam.edu/publications/the-future-of- years, beginning in 1977. Known as the National Sample
nursing-2020-2030/. Survey of Registered Nurses (NSSRN), this effort gave
Writing about “nursing today” poses a challenge policymakers, educators, and other nurse leaders data
because what is current is likely to change by the time you about the workforce, allowing them to make informed
read this. What does not change, however, is the com- decisions about allocation of resources, development of
mitment of nurses to what Rosenberg (1995) referred programs, and recruitment of nurses. This important
to as “the care of strangers”: professional caring, learned survey was discontinued, however, after its final report
through focused education and deliberate socialization issued in 2010.
(Storr, 2010). In other words, you will be taught to think In response and the ongoing need to understand
like a nurse and to do well those things that nurses do. the nursing workforce, in 2013 the National Council
You will become a nurse. Importantly, some of you are of State Boards of Nursing (NCSBN) and the Forum of
already nurses and are returning to school to further State Nursing Workforce Centers (FSNWC) combined
your education. Thank you for your commitment to the efforts to conduct a comprehensive national survey
profession and to your own professional development! of a randomized sample of 157,459 registered nurses
You have experienced firsthand the sometimes quickly and 39,765 licensed practical nurses/licensed voca-
shifting needs of the profession in an evolving health- tional nurses (Smiley et al., 2021). In this chapter, data
care system in a changing world and are poised to move from the 2020 National Nursing Workforce Survey are
nursing forward with your knowledge from both your presented to provide you with a thumbnail sketch of
education and your wide variety of experiences. nursing, specifically focusing on the number of nurses
In this chapter you will learn some basic information in the workforce, and their gender, age, race, ethnic-
about today’s nursing workforce: who nurses are, the ity, and educational levels. Any data retrieved from
settings where they practice, and the patients for whom sources other than the 2020 National Nursing Work-
they are providing care. You will also be introduced to force Survey are cited; otherwise, data are from this
some nurses who have had intriguing experiences and survey. For more comprehensive data, you can down-
opportunities that you may not know are even possible. load the survey as a .pdf in its entirety for free at https://
