Personal/Professional

A. Positive image of a Professional Nurse

-Self Assessment
In social psychology, self-assessment is the process of looking at oneself in order to assess aspects that are important to one's identity. It is one of the motives that drive self-evaluation, along with self-verification and self-enhancement. Sedikides (1993) suggests that the selfassessment motive will prompt people to seek information to confirm their uncertain self-concept rather than their certain self-concept and at the same time people use self-assessment to enhance their certainty of their own self-knowledge.[1][2] However, the self-assessment motive could be seen as quite different to the other two self-evaluation motives. Unlike the other two motives through self-assessment people are interested in the accuracy of their current self view, rather than improving their self-view. This makes self-assessment the only self-evaluative motive that may cause a person's self-esteem to be damaged.

Functions
So if through self-assessing there is a possibility that a person's self-concept, or self-esteem is going to be damaged why would this be a motive of self-evaluation, surely it would be better to only self-verify and self-enhance and not to risk damaging self-esteem? Trope suggests in his chapter "Self-Enhancement and Self Assessment in Achievement Behaviour"[3] that selfassessment is a way in which self-esteem can be enhanced in the future. For example selfassessment may mean that in the short-term self-assessment may cause harm to a person's selfconcept through realising that they may not have achieved as highly as they may like; however in the long term this may mean that they work harder in order to achieve greater things in the future, and as a result their self-esteem would be enhanced further than where it had been before self-assessment. Within the self-evaluation motives however there are some interesting interactions. Selfassessment is found a lot of the time to be associated with self-enhancement as the two motives seem to contradict each other with opposing aims; whereas the motive to self-assess sees it as important to ensure that the self-concept is accurate the motive to self-enhance sees it as important to boost the self-concept in order to protect it from any negative feedback.

[edit Research
In 1993, Constantine Sedikides performed an experiment investigating the roles of each of the self-evaluation motives, investigated if one was stronger and held more weight than others and tried to draw out specifically the self-assessment and self-verification motives.[1] The first experiment conducted the results showed that when choosing what questions they wanted to be

asked they were more likely to request those that would verify their self-concept rather than assess it. This finding supports the idea that certain traits are more central to a person's selfconcept, however shows little support for the self-assessment motive. When considering the interaction between how strong and how central certain traits are to a person's self-concept Sedikides again found evidence in support of the self-verification and self-enhancement motives, though again none for the self-assessment motive.[1] The second experiment conducted by Sedikides (1993)< investigated the possibility that the ability for greater reflection than experiment one may show greater levels of self-assessment in the participants. However the results of this experiment showed that though through some analysis there was evidence of some self-verification there was no real evidence pointing towards self-assessment and all the results supported self-enhancement. The third experiment again tried to draw out evidence for self-verification and self-assessment and though, as with experiment two, there was some evidence to support the self-verification motive most of he results pointed towards the self-enhancement method and not self-assessment.ref name=Sedikides1993 /> In experiment four Sedikides suggests that the reason past experiments have not supported selfassessment is because participants reflect more on the central traits than peripheral traits, which are generally ones that are assessed so as to be able to improve at the same time as not harming the self-concept too much. This experiment therefore looked at whether this was true and whether it was the central traits that were being looked at in this study rather than peripheral. The results showed exactly what Sedikides expected, though because of this the results of the other parts of the experiment gave support to the self-enhancement motive rather than self-assessment of self-verification.[1] The fifth experiment carried out by Sedikides suggests that in the past experiments the possibility of self-assessing was less likely than self-verification or self-enhancement as the participants would not have been objective in their self-evaluation. For this experiment therefore the experimental group were asked to approach their reflections in an objective way, as if they were approaching their self-concept as a scientist, bringing each of their traits under scrutiny. Results of this study showed that those subjects who were asked to be objective in their assessment strove more for accuracy than those not asked to be specifically objective. The authors then conducted one final experiment looking at the validation of self-enhancement when reflecting on the self.[1] Sedikides and Strube (1997)[2] reviewed past research into the self-assessment motive and looked at whether participants would be more attracted to tasks that were high or low in accuracy about their characteristics, whether they would choose to take part in tasks that were more or less accurate and if they would prefer to create highly or less accurate tasks. This review showed that people are more attracted to taking part in tasks that are more accurate about them than those that are less accurate[4] and would prefer to take part in higher accuracy tests.[5] However, when only being asked if they would like to take part in high or low accuracy tasks does not give a complete accurate view of self-assessment; if there is no threat of actually taking part in the tasks the participants may not be as honest as if they actually had to take part. Brown[5] therefore showed that self-assessment is can be seen when participants are asked to actually take part in tasks that

will be high in their accuracy or low in their accuracy of a person's characteristics. This research found that participants were more likely to choose to take part in tasks that were higher in accuracy about their characteristics. The last area of self-assessment Sedikides and Strube[2] reviewed was whether participants would want to construct highly or less accurate tasks and if participants would be more persistent or more likely to succeed if they were taking part in highly or less accurate tasks. The review showed that participants would prefer to make highly accurate tasks which measured their abilities; however they will be more persistent in tasks which are lower in accuracy.[6] The review also showed though that participants were more likely to succeed on tasks that they were told were high in accuracy.[7] It is suggested that this is because when completing tasks that are highly accurate about a person's characteristics there is more to gain from succeeding in a task as it will therefore give more information about the person's characteristics than if it was low in accuracy.

Conclusion
Though self-assessment is one of the self-evaluation motives it could be suggested that it may not be the most popular one. Self-enhancement was displayed in each of the experiments conducted by Sedikides[1] and self-assessment, and even self-verification to an extent was only displayed when it was teased out. This is not to say that self-assessment is not a self-evaluation motive, however most of the experiments conducted by Sedikides[1] ended up with the participants reflecting on central traits rather than peripheral traits. This is unsurprising as they are the most important traits to a person's self-concept, however it is not therefore surprising that these are the traits that are enhanced rather than assessed as if someone assessed their central traits and found fault it would be more of an issue than finding a fault with a peripheral tr

-Self Awareness

Self-awareness describes the condition of being aware of one's awareness. It is the awareness that one exists as an individual being. Without self-awareness the self perceives and accepts the thoughts that are occurring to be who the self is. Self-awareness gives one the option or choice to choose thoughts being thought rather than simply thinking the thoughts that are stimulated from the accumulative events leading up to the circumstances of the moment.

The basis of personal identity

[edit] A philosophical view "I think, therefore I exist, as a thing that thinks." "...And as I observed that this truth 'I think, therefore I am' (Cogito ergo sum) was so certain and of such evidence ...I concluded that I might, without scruple, accept it as the first principle of the Philosophy I was in search."

"...In the statement 'I think, therefore I am' ... I see very clearly that to think it is necessary to be, I concluded that I might take, as a general rule, the principle, that all the things which we very clearly and distinctly conceive are true..."[1][2]

While reading Descartes, Locke began to relish the great ideas of philosophy and the scientific method. On one occasion, while in a meeting with friends, the question of the "limits of human understanding" arose. He spent almost twenty years of his life on the subject until the publication of An Essay Concerning Human Understanding, a great chapter in the History of Philosophy.[3] John Locke's chapter XXVII "On Identity and Diversity" in An Essay Concerning Human Understanding (1689) has been said to be one of the first modern conceptualizations of consciousness as the repeated self-identification of oneself, through which moral responsibility could be attributed to the subjectand therefore punishment and guiltiness justified, as critics such as Nietzsche would point out, affirming "...the psychology of conscience is not 'the voice of God in man'; it is the instinct of cruelty ... expressed, for the first time, as one of the oldest and most indispensable elements in the foundation of culture."[4][5][6] John Locke does not use the terms self-awareness or self-consciousness though.[7] According to Locke, personal identity (the self) "depends on consciousness, not on substance" nor on the soul. We are the same person to the extent that we are conscious of our past and future thoughts and actions in the same way as we are conscious of our present thoughts and actions. If consciousness is this "thought" which doubles all thoughts, then personal identity is only founded on the repeated act of consciousness: "This may show us wherein personal identity consists: not in the identity of substance, but ... in the identity of consciousness". For example, one may claim to be a reincarnation of Plato, therefore having the same soul. However, one would be the same person as Plato only if one had the same consciousness of Plato's thoughts and actions that he himself did. Therefore, self-identity is not based on the soul. One soul may have various personalities. Self-identity is not founded either on the body or the substance, argues Locke, as the substance may change while the person remains the same: "animal identity is preserved in identity of life, and not of substance", as the body of the animal grows and changes during its life. Take for example a prince's soul which enters the body of a cobbler: to all exterior eyes, the cobbler would remain a cobbler. But to the prince himself, the cobbler would be himself, as he would be conscious of the prince's thoughts and acts, and not of the cobbler's life. A prince's consciousness in a cobbler body: thus the cobbler is, in fact, a prince. But this interesting border-case leads to this problematic thought that since personal identity is based on consciousness, and that only oneself can be aware of his consciousness, exterior human judges may never know if they really are judgingand punishingthe same person, or simply the same body. In other words, Locke argues that you may be judged only for the acts of your body, as this is what is apparent to all but God; however, you are in truth only responsible for the acts for which you are conscious. This forms the basis of the insanity defense: one can't be held accountable for acts in which one was unconsciously irrational, mentally ill[8]and therefore leads to interesting philosophical questions:

"personal identity consists [not in the identity of substance] but in the identity of consciousness, wherein if Socrates and the present mayor of Queenborough agree, they are the same person: if the same Socrates waking and sleeping do not partake of the same consciousness, Socrates waking and sleeping is not the same person. And to punish Socrates waking for what sleeping Socrates thought, and waking Socrates was never conscious of, would be no more right, than to punish one twin for what his brother-twin did, whereof he knew nothing, because their outsides were so like, that they could not be distinguished; for such twins have been seen."[3]

Or again:
"PERSON, as I take it, is the name for this self. Wherever a man finds what he calls himself, there, I think, another may say is the same person. It is a forensic term, appropriating actions and their merit; and so belong only to intelligent agents, capable of a law, and happiness, and misery. This personality extends itself beyond present existence to what is past, only by consciousness, --whereby it becomes concerned and accountable; owns and imputes to itself past actions, just upon the same ground and for the same reason as it does the present. All which is founded in a concern for happiness, the unavoidable concomitant of consciousness; that which is conscious of pleasure and pain, desiring that that self that is conscious should be happy. And therefore whatever past actions it cannot reconcile or APPROPRIATE to that present self by consciousness, it can be no more concerned in it than if they had never been done: and to receive pleasure or pain, i.e. reward or punishment, on the account of any such action, is all one as to be made happy or miserable in its first being, without any demerit at all. For, supposing a MAN punished now for what he had done in another life, whereof he could be made to have no consciousness at all, what difference is there between that punishment and being CREATED miserable? And therefore, conformable to this, the apostle tells us, that, at the great day, when every one shall 'receive according to his doings, the secrets of all hearts shall be laid open.' The sentence shall be justified by the consciousness all person shall have, that THEY THEMSELVES, in what bodies soever they appear, or what substances soever that consciousness adheres to, are the SAME that committed those actions, and deserve that punishment for them."[4]

Henceforth, Locke's conception of personal identity founds it not on the substance or the body, but in the "same continued consciousness", which is also distinct from the soul since the soul may have no consciousness of itself (as in reincarnation). He creates a third term between the soul and the bodyand Locke's thought may certainly be meditated by those who, following a scientist ideology, would identify too quickly the brain to consciousness. For the brain, as the body and as any substance, may change, while consciousness remains the same. Therefore personal identity is not in the brain, but in consciousness. However, Locke's theory also reveals his debt to theology and to Apocalyptic "great day", which by advance excuse any failings of human justice and therefore humanity's miserable state.
[edit] A modern scientific view See also: Secondary consciousness

[edit] Self-Awareness Theory

Self-Awareness Theory states that when we focus our attention on ourselves, we evaluate and compare our current behavior to our internal standards and values. We become self-conscious as objective evaluators of ourselves. However self-awareness is not to be confused with selfconsciousness.[9] Various emotional states are intensified by self-awareness, and people sometimes try to reduce or escape it through things like television, video games, drugs, etc. However, some people may seek to increase their self-awareness through these outlets. People are more likely to align their behavior with their standards when made self-aware. People will be negatively affected if they don't live up to their personal standards. Various environmental cues and situations induce awareness of the self, such as mirrors, an audience, or being videotaped or recorded. These cues also increase accuracy of personal memory.[10] In Demetriou's theory, one of the neo-Piagetian theories of cognitive development, self-awareness develops systematically from birth through the life span and it is a major factor for the development of general inferential processes.[11] Moreover, a series of recent studies showed that self-awareness about cognitive processes participates in general intelligence on a par with processing efficiency functions, such as working memory, processing speed, and reasoning.[12]

[edit] In theater
Theater also concerns itself with other awareness besides self-awareness. There is a possible correlation between the experience of the theater audience and individual self-awareness. As actors and audiences must not "break" the fourth wall in order to maintain context, so individuals must not be aware of the artificial, or the constructed perception of his or her reality. This suggests that self-awareness is an artificial continuum just as theater is. Theatrical efforts such as Six Characters in Search of an Author, or The Wonderful Wizard of Oz, construct yet another layer of the fourth wall, but they do not destroy the primary illusion. Refer to Erving Goffman's Frame Analysis: An Essay on the Organization of Experience.

[edit] In animals
See also: Mirror test

Thus far, there is evidence that bottlenose dolphins, some apes,[13] and elephants may have the capacity to be self-aware.[14] Recent studies from the Goethe University Frankfurt show that magpies may also possess self-awareness.[13] Common speculation suggests that some other animals may be self-aware.[15]

[edit] In science fiction

In science fiction, self-awareness describes an essential human property that bestows "personhood" onto a non-human. If a computer, alien or other object is described as "self-aware", the reader may assume that it will be treated as a completely human character, with similar rights, capabilities and desires to a normal human being.[16] A computer that is self-aware has the

ability to think for itself, rather than thinking what is predetermined by its code. The words sentience, sapience and consciousness are used in similar ways in science fiction.

[edit] In psychology
In psychology, the concept of "self-awareness" is used in different ways:
y

y y

As a form of intelligence, self-awareness can be an understanding of one's own knowledge, attitudes, and opinions. Alfred Binet's first attempts to create an intelligence test included items for "auto-critique" a critical understanding of oneself.[17] Surprisingly we do not have a privileged access to our own opinions and knowledge directly. For instance, if we try to enumerate all the members of any conceptual category we know, our production falls much short of our recognition of members of that category. Albert Bandura[18] has created a category called self-efficacy that builds on our varying degrees of self-awareness. Our general inaccuracy about our own abilities, knowledge, and opinions has created many popular phenomena for research such as the better than average effect. For instance, 90% of drivers may believe that they are "better than average" (Swenson, 1981)[19] Their inaccuracy comes from the absence of a clear definable measure of driving ability and their own limited self-awareness; and this of course underlines the importance of objective standards to inform our subjective self-awareness in all domains. Inaccuracy in our opinion seems particularly disturbing, for what is more personal than opinions. Yet, inconsistency in our opinion is as strong as in our knowledge of facts. For instance, people who call themselves opposite extremes in political views often hold not just overlapping political views, but views that are central to the opposite extreme. Reconciling such differences proves difficult and gave rise to Leon Festinger's theory of Cognitive Dissonance.[20

B. Roles and responsibilities of beginning nurse practitioner

-Benner's theory

BENNERS THEORY
Dr. Benner categorized nursing into 5 levels of capabilities: novice, advanced beginner, competent, proficient, and expert. She believed experience in the clinical setting is key to nursing because it allows a nurse to continuously expand their knowledge base and to provide holistic, competent care to the patient. Her research was aimed at discovering if there were distinguishable, characteristic differences in the novices and experts descriptions of the same clinical incident.

NOVICE:
The person has no background experience of the situation in which he or she is involved. There is difficulty discerning between relevant and irrelevant aspects of the situation. Generally this level applies to nursing students.

ADVANCED BEGINNER :

The advance beginner stage develops when the person can demonstrate marginally acceptable performance having coped with enough real situations to note, or to have pointed out by mentor, the recurring meaningful components of the situation.

Nurses functioning at this level are guided by rules and oriented by task completion.

COMPETE

The co pe en s age is he os pivo al in clinical learning because he learner us begin o recogni e pa erns and de er ine which ele en s of he si ua ion warran a en ion and which can be ignored. The co p e en nurse devises new rules and reasoning procedures for a plan while applying learned rules for ac ion on he basis of he relevan fac s of ha si ua ion.

T:

PROFICIENT:
The performer perceives the information as a whole (total picture) rather than in terms of aspects and performance. Proficient level is a qualitative leap beyond the competent. Nurses at this level demonstrate a new ability to see changing relevance in a situation including the recognition and the implementation of skilled responses to the situation as is it evolves.

EXPERT:

Fif h s age is achieved when he e per perfor er no longer relies on analy ical principals o connec her or his unders anding of he si ua ion o an appropria e ac ion

-Nurse practitioner

A Nurse Practitioner (NP) is an advanced practice nurse who has completed graduate-level education (either a Master's or a Doctorate degree) and training in the diagnosis and management of common as well as complex medical conditions. To become licensed to practice, Nurse Practitioners hold national certification in an area of specialty (family practice, pediatrics, adult care, acute care, etc), and are licensed through nursing boards.

History of Nurse Practitioner Program

In 1965: The first Nurse Practitioner program was created by a nurse educator, Loretta Ford, EdD, RN, PNP and a physician, Henry Silver, MD, at the University of Colorado as a non-degree certificate program. This program trained experienced Registered Nurses for their new advanced nursing roles as Pediatric Nurse Practitioners. In the late 1960s into the 1970s: Continued predictions of a primary-care physician shortage increased funding and attendance in various certificate-based nurse practitioner programs. In 1980s: Nurse Practitioner educational requirements were transitioned into graduate-level master's degree programs. Subsequently the national certifying organizations and state licencing boards began to require a master's degree for NP practice. By 2015 all new NPs will need to be trained at the doctorate level as a Doctor of Nursing Practice.

Scope of practice
In some states, nurse practitioners work independently and autonomously of physicians while, in other states, a collaborative agreement with a physician is required for practice. A nurse practitioner's job may include the following:


Diagnosing, treating, evaluating and managing acute and chronic illness and disease (e.g. diabetes, high blood pressure) Obtaining medical histories and conducting physical examinations Ordering, performing, and interpreting diagnostic studies (e.g., routine lab tests, bone xrays, EKGs) Prescribing physical therapy and other rehabilitation treatments Prescribing drugs for acute and chronic illness (extent of prescriptive authority varies by state regulations)

 

 

  

Providing prenatal care and family planning services Providing well-child care, including screening and immunizations Providing primary and specialty care services, health-maintenance care for adults, including annual physicals Providing care for patients in acute and critical care settings Assisting in minor surgeries and procedures (with additional training and usually under supervision) (e.g., dermatological biopsies, suturing, casting) Counseling and educating patients on health behaviors, self-care skills, and treatment options.

 

Practice Settings
The institutions in which they work may include:
         

Community clinics, health centers, urgent care centers Health departments Health maintenance organizations (HMOs) Home health care agencies Hospitals Hospice care Nurse practitioner practices/offices Nursing homes Private & public schools, universities and colleges Physician/private medical practices

Education
The candidate must first complete a Bachelor of Science in Nursing (BSN) and then go on to complete a master's degree, post-master's certificate or a doctoral degree of nurse practitioner programs. The current plan is that all advanced practice nurse programs will require a Doctor of Nursing Practice (DNP) degree by 2015 thus effectively eliminating the MN or the MSN as an entry to practice degree.

Board Certification
The candidate must pass a national board certification in their area of specialty. All states require national board certification for nurse practitioners before they are permitted to practice and the two biggest certifying bodies, the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP). NPs can pursue additional specialty certification through several organizations, including the following:
    

American Association of Critical-Care Nurses American Psychiatric Nursing Association Board of Certification for Emergency Nursing Pediatric Nursing Certification Board National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialties Oncology Nursing Certification Corporation

Licensing
After completing the education program, the candidate must be licensed by the state in which he or she plans to practice. The state boards of nursing regulate nurse practitioners and each state has its own licensing and certification criteria. In general, the criteria include completion of a graduate degree in nursing and board certification by an accrediting body (ANCC, AANP). The license period varies by state; some require biennial relicensing, others require triennial.

Role in Medicine
The role of Nurse Practitioners is very diverse. Nurse Practitioners are educated under the nursing model which seeks to provide holistic and preventative care engaging the individual as the primary leader in their own care and well-being.

Nurse Practitioners often view the health and wellness of individuals within the family or community system and attempt to incorporate cultural relativism within their treatments and recommendations. Nurse practitioners often work very independently in rural areas and nurse-managed health centers as primary care providers to provide critical health care to vulnerable communities in both rural and underserved urban environments. Conversely, in more affluent and urban settings, Nurse Practitioners may either set up an independent practice, or may work collaboratively within a health care team as a critical health care provider in a wide variety of clinical specialties.

1. Acute care Nurse Practitioner

They provide care toadults who are acutely and chronically ill. Emphasis is on stabilizing the individuals condition, minimizing acute complications and on restoring the individual to maximum health. Care is given within acute care hospitals, ambulatory follow up and therapy settings. Graduate has to be recognized as advanced practice nurses by the board of nurse examiners and to take ACNP national certificate exam through the American nurses credentialing centres. ACNP degree plan or post master s certificate degree plan has the following objectives: y y y y To provide healthcare to adults and their families. To become clinical expertises in providing care to acutely ill like complex monitoring and therapies. Enables to use research and theoretical principles in implementing therapies. Integrate the patients care across the continuum of care services in collaboration with other health care proffessional s families and patient.

2. Paediatric nurse practitioner

This program prepares the advanced nurse practitioner to manage the care of the patient from birth to 21 years of age and their family in a changing health care system. Emphasis is on health promotion and management of acute and chronically ill paediatric patients. PNP provides leadership and promote research in development of health care services for children in the community.

Graduates will be recognized as advanced practice nurse by the Board of Nurses Examiners and to take PNP national certification exam offered by National Certification Board of Paediatric Nurse Practitioners and Nurses. PNP program objectives are as follows: y y To provide health care to paediatric patients and families in a variety of settings. Develop collaborative relationship with community agencies concerned with health problems related to economic, psychological, cultural and environmental in the quality improvement of health care delivery to paediatric population. Provide paediatric care and case management in ambulatory setting, acute and chronically ill community setting, acute care facilities and extended care facilities. Use research and theoretical principles in the management and quality improvement of health care delivery and clinical outcomes.

y y

3. Adult nurse practitioner

The ANP program prepare the nurses as primary care providers to manage the health of adult and old age individuals and their families. Emphasis is given to health promotion, illness prevention and management of acute and chronic illness. The ANP provide leadership and promotes research in the delivery of quality health care. Graduates are to be recognized as advanced practice nurses by board of nurse examiners and should be certified by ANP certification exam by American nurses credentialing centres. The objective of the ANP degree plan or ANP post masters certificate degree plan are: y y y y To make the nurses assume responsibility as an ANP to provide health care to adult and their families. Use research and theoretical principles to manage and improve the health care delivery and clinical outcome as an ANP. Collaborate with health professionals and use essential resourses to implement quality, continuous care to adults and their families. To demonstrate confidence in assessment, diagnosis and management of health needs of adult and their families.

4. Emergency nurse practitioner

A specialist nurse who will independently assess, diagnose, investigate and treat a wide range of common accidents and injuries working autonomously without reference to medical staff and determining appropriate referral and follow up care. The program prepares advanced nurses with knowledge and skills needed to provide emergency and urgent health care services to individuals of all ages. They provide care in ambulatory, urgent care and emergency department settings. Recognition as Advance practice nurse by board of nurse examiners and certification from nurse practitioner national certification examination through academy of nurse practitioners is necessary. The objectives of this degree program involves y y To implement the role of an ENP and provide urgent and emergency care to individuals across the life span. Demonstrate clinical expertise in assessment, diagnostic reasoning and therapeutic management of acutely ill individuals of all ages. Providing care to acutely ill complex monitoring and therapies. Use research and theoretical principles in implementing therapies. Integrate the patients care across the continuum of care in collaboration with other health care professionals, families and patients. Implement the role of ENP.(They are trained in advanced nursing skills which though medical in nature- such as taking a full medical history and examination, x-ray interpretation, prescribing, suturing and plastering, also encompass a holistic assessment of the patients needs, taking into account the need for health teaching and education, continuing care within the family and ongoing health support in the community.)

y y y

5. Family nurse practitioner

This program prepares advance practice nurses to manage the health care of individuals and their family across the life span in a changing health care system. Emphasis is on the health promotion and primary care management of acute and chronically ill patient. Graduates of this program will be recognized as advance practice nurse by the board of nurse examiners and certified through the FNP certified exam by American Academy of Nurse Practitioners. The program prepares the nurse to:

Assume the responsibility as a FNP to provide health care in the areas of health promotion, disease prevention and clinical management to patients and families in a variety of settings. Develop collaborative relationships with other health care providers to focus on economic, psychosocial, cultural and environmental factors in the quality improvement of health care delivery for varied population. Use research and theoretical princilple in the management and quality improvement of health care delivery and clinical outcome in FNP practice.

6. Gerontological nurse practitioner

GNP program prepares the practice nurse as primary care providers to manage the health of elders and their families in a changing health care system. Emphasis to be given on the health promotion and management of minor acute illness and complex health needs of older adult to maximize their functional level and independence.Graduates will be recognized by the Board of Nurse Examiners and certified through national certification exam on a gerontological nurse practitioner by American Nurses Credentialing Centre. GNP degree program prepares a nurse practitioner to: y y y y Assume the responsibility as a GNP to provide health care in the areas of health care to elders, their family and the community. Develop collaborative relationship with multidisciplinary teams for coordination and delivery of quality care across the continuum of services. To maximize the quality of life of elders and promote a peaceful death when needed. Uses research to examine the outcome of GNP practice.

7. Psychiatric/mental health nurse practitioner

This program prepares advance practice nurse as primary mental health care provider for individuals and families. Focus is on mental health care through life span of the individual. There are sub-specialities like child/adolescent psychiatry, adult /gerontological psychiatry.

Graduates will get recognized as Advance practice nurses by the Texas board of nurse practitioner and should take the family Psychiatric nurse practitioner exam offered by American nurses credentialing centre. PMHNP program provide the objectives of : y y y y Assuming responsibility as a psychiatric/mental health nurse practitioner to provide compassionate and collaborative mental health care for clients and families. Apply neurobiological and psychosocial theories and use pharmacological and nonpharmacological therapies in the provision of mental health care. Demonstrate clinical expertise in health promotion, illness prevention and treatment of mental health and addictive disorders. Use research methodologies to explore the outcomes of PMHNP.

8. Neonatal nurse practitioner

This program of advanced practice neonatal nursing is a 2 year program leading to the master of science degree. Advance practice neonatal nurse provide expert clinical care to the acutely ill and convalescing neonates and their families. Graduates are prepared to become culturally sensitive leaders in care of neonates and practice in various clinical settings. NNP graduates will have the license as California Board of Registered Nurse or clinical nurse specialist or both and those who complete NNP program are eligible to set for NNP certification exam.

Conclusion
The role of Nurse Practitioners is very diverse. Nurse Practitioners are educated under the nursing model which seeks to provide holistic and preventative care engaging the individual as the primary leader in their own care and well-being. Nurse Practitioners often view the health and wellness of individuals within the family or community system and attempt to incorporate cultural relativism within their treatments and recommendations.

D. Emerging opportunities

-Field of Specialization
1. HOSPITAL OR INSTITUTIONAL NURSING

Nurses work with a health team and the setting is most likely hospitals, hospices, clinics and nursing homes.

2. PUBLIC HEALTH NURSING OR COMMUNITY HEALTH NURSING

Nurses are exposed to the community set-up wherein their clients are individuals, families or groups.

3. PRIV T DUTY OR SPECI L DUTY NURSING

Nurs s ar c nsid r d as indi idual c ntract rs wh r in th ha s l r sp nsibilit f r th cli nt.

4. INDUSTRIAL OR OCCUPATIONAL HEALTH NURSING

Nurses here work with companies and clients here are workers in a certain company. It is required to have previous exposure to hospitals since emerging situations may arise.

 

         

  

5. NURSING EDUCATION

6. MILITARY NURSING

Nurses here are specially trained for medical services during war or peace. They are responsible on both health of civilians and military men as well as people considered as enemies. This kind of field demands endurance of the rapid activity and action on the unpredictable field of work.

Nurs s h r ar als t ach rs and mold rs of th futur of nursin . Th equip youn minds in order to be competent nurses later on.

       

7. SCHOOL NURSING

Nurses are responsible primarily in the welfare of students as well as the faculty. They responsible in health care acti ities and ser ices by the school.

8. CLINIC NURSING

Nurses works with a doctor and serves as the receptionist, data gatherer and organizer. Scheduling of appointments and organizing the patients files are the major activities in this field. Simple procedures such as immunizations or suturing of wounds are assisted by clinic nurses.

-Expanded roles of Nurses

1 Clinical Specialists- is a nurse who has completed a master s degree in specialty and has considerable clinical expertise in that specialty. She provides expert care to individuals, participates in educating

health care professionals and ancillary, acts as a clinical consultant and participates in research. 2. Nurse Practitioner- is a nurse who has completed either as certificate program or a master s degree in a specialty and is also certified by the appropriate specialty organization. She is skilled at making nursing assessments, performing P. E., counseling, teaching and treating minor and self- limiting illness. 3. Nurse-midwife- a nurse who has completed a program in midwifery; provides prenatal and postnatal care and delivers babies to woman with uncomplicated pregnancies. 4. Nurse anesthetist- a nurse who completed the course of study in an anesthesia school and carries out pre-operative status of clients. 5. Nurse Educator- A nurse usually with advanced degree, who beaches in clinical or educational settings, teaches theoretical knowledge, clinical skills and conduct research. 6. Nurse Entrepreneur- a nurse who has an advanced degree, and manages health-related business. 7. Nurse administrator- a nurse who functions at various levels of management in health settings; responsible for the management and administration of resources and personnel involved in giving patient care.

-Balancing personal and professional needs E. Issues and trends is nursing practice/education [migration,aging population, complementary therapy,medical tourism,evidence-base practice,etc.]

F. Nursing Associations

-Accredited professional organization -Interest groups

Advocacy groups (also pressure groups, lobby groups and some interest groups and special interest groups) use various forms of advocacy to influence public opinion and/or policy; they have played and continue to play an important part in the development of political and social

systems. Groups vary considerably in size, influence and motive; some have wide ranging long term social purposes, others are focused and are a response to an immediate issue or concern. Motives for action may be based on a shared political, faith, moral or commercial position. Groups use varied methods to try to achieve their aims including lobbying, media campaigns, publicity stunts, polls, research and policy briefings. Some groups are supported by powerful business or political interests and exert considerable influence on the political process, others have few such resources. Some have developed into important social, political institutions or social movements. Some powerful Lobby groups have been accused of manipulating the democratic system for narrow commercial gain[1] and in some instances have been found guilty of corruption, fraud, bribery and other serious crimes;[2] lobbying has become increasingly regulated as a result. Some groups, generally ones with less financial resources, may use direct action and civil disobedience and in some cases are accused of being a threat to the social order or 'domestic extremists'.[3]

Overview
An advocacy group is a group or an organization which tries to influence the government but does not hold power in the government. A single-issue group may form in response to a particular issue area sometimes in response to a single event or threat. In some cases initiatives initially championed by advocacy groups later become institutionalized as important elements of civic life (for example universal education or regulation of doctors see below for details). Groups representing broad interests of a group may be formed with the purpose of benefiting the group over an expended period of time and in many ways, for example as Consumer organizations, Professional associations, Trade associations and Trade unions.
[edit] Activities

Advocacy groups exist in a wide variety of genres based upon their most pronounced activities.
y

Anti-defamation organizations issue responses or criticisms to real or supposed slights of any sort (including speech or violence) by an individual or group against a specific segment of the population which the organization exists to represent. Watchdog groups exist to provide oversight and rating of actions or media by various outlets, both government and corporate. They may also index personalities, organizations, products and activities in databases to provide coverage and rating of the value or viability of such entities to target demographics. Lobby groups Lobby for a change to the law or the maintenance of a particular law and big businesses fund very considerable lobbying influence on legislators, for example in the USA and in the UK where lobbying first developed. Some Lobby groups have considerable financial resources at their disposal. Lobbying is regulated to stop the worst abuses which can develop into corruption. In the United States the Internal Revenue Service makes a clear distinction between lobbying and advocacy.[4] Legal defense funds provide funding for the legal defense for, or legal action against, individuals or groups related to their specific interests or target demographic. This is often accompanied by

one of the above types of advocacy groups filing an Amicus curiae if the cause at stake serves the interests of both the legal defense fund and the other advocacy groups. [edit] Types

Organizations can be categorized along the lines of the three elements of commerce: business owners, workers, and consumers.
y y

Employers' organizations represent the interests of a group of businesses in the same industry. Occupational, or labour organizations promote the professional and economic interests of workers in a particular occupation, industry, or trade, through interaction with the government, and by preparing advertising and other promotional campaigns to the public. Such groups will also provide member services such as career support, training, and organized social activities.[5] These goals are distinct from those of the regulatory body of a self-governing profession, which licenses and supervises its practitioners with the mission of serving the public interest. [6] The advocacy organization does not interact directly with employers in the way a trade union does. The Consumer organization exists to protect people from corporate abuse, promote fair business practices, and enforce consumer rights.

[edit] Influential advocacy groups

There are many significant advocacy groups through history, some of which could be considered to operate with different dynamics and could better be described as social movements. Here are some notable groups operating in different parts of the world:y y

y y y y y y y y y y y

The American Israel Lobby (AIPAC) described by the New York Times as the 'Most influential Lobby impacting US relations with Israel'.[7] British Medical Association formed at a meeting of 50 doctors in 1832 for the sharing of knowledge; lobbying led to the Medical Act 1858 and the formation of the General Medical Council which has registered and regulated doctors in the UK to this date.[8] Campaign for Nuclear Disarmament non-proliferation of nuclear weapons and unilateral nuclear disarmament in the UK since 1957 whose logo is now an international peace symbol.[9] Center for Auto Safety Formed in 1970 to give consumers a voice for auto safety and quality in the United States.[10] Drug Policy Alliance (Drug law: USA)[11] Energy Lobby An umbrella term term for the representatives of large oil, gas, coal, and electric utilities corporations that attempt to influence governmental policy in the United States Greenpeace Formed in 1970 as the Don't Make a Wave Committee to stop Nuclear weapons testing in the United States.[12] National Rifle Association Formed in New York in 1871 to protect the rights of gun-owners[13] Oxfam Formed in 1942 in the UK as the 'Oxford Committee for Famine Relief'.[14] Pennsylvania Abolition Society Formed in Philadelphia in 1775 with a view to abolish slavery in the United States.[15] People for the Ethical Treatment of Animals Animal rights[16] Royal Society for the Protection of Birds Founded in Manchester in 1889 to campaign against the 'barbarous trade in plumes for women's hats'.[17] Sierra Club Formed in 1892 to help protect the Sierra Nevada.[18]

y y y y

Stop the War Coalition against the War on Terrorism which included a march of between 750,000 and 2,000,000 people in London in 2003.[19] Suffragettes Voting rights for women after direct action and hunger strikes from 1865-1928 in the United Kingdom[20] Sunday School movement Formed in about 1751 to promoting universal schooling in the UK[21] Tories Formed in 1678 to fight the British Exclusion Bill; it developed into one of the first political parties, now known as the Conservative Party.[22]

Corruption and illegal activity

In some instances Advocacy groups are convicted of illegal activity. Major examples include:
y y

Jack Abramoff Indian lobbying scandal Corrupt and fraudulent lobbying in relation to Native American gambling enterprises[23] Tobacco Master Settlement Agreement between the Attorneys General of 46 states and the four largest US tobacco companies who agreed to pay $206 billion over the first twenty-five years of the agreement.[24]:25

[edit] Adversarial groupings

On some controversial issues there are a number of competing advocacy groups, sometimes with very different resources available to them:
y y y y y

Pro-choice movement vs Pro-life movement (abortion policy in the United States) SPEAK campaign vs Pro-Test (animal testing in United Kingdom) The Automobile Association vs Pedestrians' Association (now 'Living Streets') (road safety in the United Kingdom since 1929) Tobacco Institute vs Action on Smoking and Health (tobacco legislation) Flying Matters vs Plane Stupid (aviation policy in the United Kingdom since 2007)

[edit] Benefits and incentives

The general theory is that individuals must be enticed with some type of benefit to join an interest group.[25] Known as the Free Rider Problem, it refers to the difficulty of obtaining members of a particular interest group when the benefits are already reaped without membership. For instance, an interest group dedicated to improving farming standards will fight for the general goal of improving farming for every farmer, even those who are not members of that particular interest group. So there is no real incentive to join an interest group and pay dues if they will receive that benefit anyway.[26] Interest groups must receive dues and contributions from its members in order to accomplish its agenda. While every individual in the world would benefit from a cleaner environment, that Environmental protection interest group does not, in turn, receive monetary help from every individual in the world.[27] Selective material benefits are benefits that are usually given in monetary benefits. For instance, if an interest group gives a material benefit to their member, they could give them travel

discounts, free meals at certain restaurants, or free subscriptions to magazines, newspapers, or journals.[26] Many trade and professional interest groups tend to give these types of benefits to their members. A selective solidary benefit is another type of benefit offered to members or prospective members of an interest group. These incentives involve benefits like "socializing congeniality, the sense of group membership and identification, the status resulting from membership, fun and conviviality, the maintenance of social distinctions, and so on.[28] A solidary incentive is when the rewards for participation are socially derived and created out of the act of association. An expressive incentive is another basic type of incentive or benefit offered to being a member of an interest group. People who join an interest group because of expressive benefits likely joined to express an ideological or moral value that they believe in. Some include free speech, civil rights, economic justice, or political equality. To obtain these types of benefits, members would simply pay dues, donate their time or money to get a feeling of satisfaction from expressing a political value. Also, it would not matter if the interest group achieved their goal, but these members would be able to say they helped out in the process of trying to obtain these goals, which is the expressive incentive that they got in the first place.[29] The types of interest groups that rely on expressive benefits or incentives would be environmental groups and groups who claim to be lobbying for the public interest.[27] Some public policy interests are not recognized or addressed by a group at all, and these interests are labeled latent interest.

[edit] Theoretical perspectives

Much work has been undertaken by academics in trying to categorise how pressures groups operate, particularly in relation to governmental policy creation. The field is dominated by numerous differing schools of thought: 1. Pluralism: this is based upon the understanding that pressure groups operate in competition with one another and play a key role in the political system through acting as a counterweight to undue concentrations of power
However this pluralist theory (formed primarily by American academics) reflects a more open and fragmented political system similar to that in countries such as America. Therefore under neo-pluralism the concept of political communities developed that is more similar to the British form of government

2. Neo-Pluralism: this is based on the concept of political communities in that pressure groups and other such bodies are organised around a government department and its network of client groups that then co-operate together to during the policy making process 3. Corporatism

-Specialty Organizations
Academy of Medical- Surgical Nurses East Holly Ave., Box 56 Pitman, NJ 08071-0056 (866) 877-2676 Fax: (856) 589-7463 amsn@ajj.com www.medsurgnurse.org The Academy of Neonatal Nursing 2220 Northpoint Parkway Santa Rosa, CA 95407-7398 (707) 568-2168 Fax: (707) 569-0786 memberinfo@academyonline.org www.academyonline.org Air & Surface Transport Nurses Association 7995 East Prentice Ave., Suite 100 Greenwood Village, CO 80111 (800) 897-6362 Fax: (303) 770-1614 astna@gwami.com www.astna.org

American Academy of Ambulatory Care Nursing East Holly Ave., Box 56 Pitman, NJ 08071-0056 (800) AMB-NURS (262-6877) Fax: (856) 589-7463 aaacn@ajj.com http://aaacn.org American Academy of Nurse Practitioners P.O. Box 12846 Austin, TX 78711 (512) 442-4262 Fax: (512) 442-6469 admin@aanp.org www.aanp.org American Academy of Nursing 888 17th St., NW Suite 800 Washington, DC 20006 (202) 777-1170 Fax: (202) 777-0107 info@aannet.org www.aannet.org American Assembly for Men in Nursing

P.O. Box 130220 Birmingham, AL 35213 (205) 956-0146 Fax: (205) 956-0149; Attn.: Byron McCain aamn@aamn.org www.aamn.org American Assisted Living Nurses Association P.O. Box 10469 Napa, CA 94581 (707) 253-7299 Fax: (707) 253-8228 www.alnursing.org American Association of Colleges of Nursing One Dupont Circle, NW, Suite 530 Washington, DC 20036 (202) 463-6930 Fax: (202) 785-8320 www.aacn.nche.edu American Association of Critical-Care Nurses 101 Columbia Aliso Viejo, CA 92656-4109 (800) 899-AACN (-2226); (949) 362-2000 Fax: (949) 362-2020

info@aacn.org, certcorp@aacn.org www.aacn.org American Association of Diabetes Educators 200 W. Madison St. Suite 800 Chicago, IL 60606 (800) 338-3633 aade@aadenet.org www.diabeteseducator.org American Association for the History of Nursing, Inc. 10200 W. 44th Ave., Suite 304 Wheat Ridge, CO 80033 (303) 422-2685 Fax: (303) 422-8894 aahn@aahn.org www.aahn.org American Association of Heart Failure Nurses 15000 Commerce Parkway, Suite C Mount Laurel, NJ 08054 (888) 452-2436 Fax: (856) 439-0525; Attn.: Heather Petet, executive director information@aahfn.org www.aahfn.org

American Association of Legal Nurse Consultants 401 N. Michigan Ave. Chicago, IL 60611 (877) 402-2562 Fax: (312) 673-6655 info@aalnc.org www.aalnc.org American Association of Managed Care Nurses 4435 Waterfront Dr., Suite 101 Glen Allen, VA 23060 (804) 747-9698 Fax: (804) 747-5316 www.aamcn.org American Association of Neuroscience Nurses 4700 W. Lake Ave. Glenview, IL 60025 (888) 557-2266; (847) 375-4733 Fax: (847) 375-6430 info@aann.org www.aann.org American Association of Nurse Anesthetists 222 S. Prospect Ave. Park Ridge, IL 60068-4001

(847) 692-7050 Fax: (847) 692-6968 info@aana.com www.aana.com American Association of Nurse Assessment Coordinators 400 South Colorado Blvd., Suite 600 Denver, CO 80246 (800) 768-1880 Fax: (303) 758-3588 info@aanac.org www.aanac.org The American Association of Nurse Attorneys, Inc. Executive Office P.O. Box 515 Columbus, OH 43216-0515 (877) 538-2262 Fax: (614) 221-2335 taana@taana.org www.taana.org American Association of Nurse Life Care Planners 3267 East 3300 South #309 Salt Lake City, UT 84109 (888) 575-4047; (801) 274-1184 Fax: (801) 274-1535 www.aanlcp.org

American Association of Occupational Health Nurses 2920 Brandywine Rd., Suite 100 Atlanta, GA 30341 (770) 455-7757 Fax: (770) 455-7271 aaohn@aaohn.org www.aaohn.org American Board of Neuroscience Nursing 4700 W. Lake Ave. Glenview, IL 60025-1485 (888) 557-2266; (847) 375-4733 Fax: (877) 734-8677 info@cnrn.org www.aann.org /credential American College of Nurse-Midwives 8403 Colesville Rd., Suite 1550 Silver Spring, MD 20910 (240) 485-1800 Fax: (240) 485-1818 www.midwife.org American College of Nurse Practitioners 1501 Wilson Boulevard, Suite 509 Arlington, VA 22209

(703) 740-2529 Fax: (703) 740-2533 acnp@acnpweb.org www.acnpweb.org American Forensic Nurses 255 North El Cielo Rd., Suite 195 Palm Springs, CA 92262 (760) 322-9925 Fax: (760) 322-9914 info@amrn.com www.amrn.com American Holistic Nurses Association 323 N. San Francisco St., Suite 201 Flagstaff, AZ 86001 (800) 278-AHNA (-2462) Fax: (928) 526-2752 info@ahna.org www.ahna.org American Medical Informatics Association 4915 St. Elmo Ave., Suite 401 Bethesda, MD 20814 (301) 657-1291 Fax: (301) 657-1296

mail@amia.org www.amia.org American Nursing Informatics Association 1908 S El Camino Real, Suite H San Clemente, CA 92672 mbrs@ania.org www.ania.org American Nephrology Nurses' Association East Holly Ave., Box 56 Pitman, NJ 08071-0056 (888) 600-ANNA (-2662); (856) 256-2320 Fax: (856) 589-7463 anna@ajj.com www.annanurse.org American Nurses Foundation 8515 Georgia Ave., Suite 400 West Silver Spring, MD 20910 (301) 628-5227 anf@ana.org www.anfonline.org American Organization of Nurse Executives Liberty Place 325 Seventh St., NW

Washington, DC 20004 (202) 626-2240 Fax: (202) 638-5499 aone@aha.org www.aone.org AONE Chicago Office (operations & membership) One North Franklin St., 32nd Floor Chicago, IL 60606 (312) 422-2800 Fax: (312) 422-4503 American Pediatric Surgical Nurses Association P.O. Box 1605 Lansdale, PA 19446 (614) 722-3926 webadmin@apsna.org www.apsna.org American Psychiatric Nurses Association 1555 Wilson Blvd., Suite 530 Arlington, VA 22209 (866) 243-2443 Fax: (703) 243-3390 inform@apna.org www.apna.org American Public Health Association

800 I St., NW Washington, DC 20001-3710 (202) 777-APHA (-2742) Fax: (202) 777-2534 comments@apha.org www.apha.org American Radiological Nurses Association 7794 Grow Dr. Pensacola, FL 32514 (866) 486-2762; (850) 474-7292 Fax: (850) 484-8762 ARNA@dancyamc.com www.arna.net American Society of Ophthalmic Registered Nurses P.O. Box 193030 San Francisco, CA 94119-3030 (415) 561-8513 Fax: (415) 561-8531 asorn@aao.org www.asorn.org American Society for Pain Management Nursing P.O. Box 15473 Lenexa, KS 66285-5473 (888) 34ASPMN; (913) 895-4606 Fax: (913) 895-4652 aspmn@goamp.com

www.aspmn.org American Society for Parenteral and Enteral Nutrition 8630 Fenton St., Suite 412 Silver Spring, MD 20910 (800) 727-4567; (301) 587-6315 Fax: (301) 587-2365 aspen@nutr.org www.nutritioncare.org American Society of PeriAnesthesia Nurses 10 Melrose Ave., Suite 110 Cherry Hill, NJ 08003-3696 (877) 737-9696; (856) 616-9600 Fax: (856) 616-9601 aspan@aspan.org www.aspan.org American Society of Plastic Surgical Nurses 7794 Grow Drive Pensacola, FL 32514 (800) 272-0136; (850) 473-2443 Fax: (850) 484-8762 aspsn@dancyamc.com www.aspsn.org Association of Camp Nurses 8630 Thorsonveien, NE

Bemidji, MN 56601 (218) 586-2633 acn@campnurse.org www.campnurse.org Association of Community Health Nursing Educators 10200 West 44th Avenue, Suite 304 Wheat Ridge, CO 80033 (303) 422-0769 Fax: (303) 422-8894 achne@resourcenter.com www.achne.org Association of Nurses in AIDS Care 3538 Ridgewood Rd. Akron, OH 44333 (800) 260-6780; (330) 670-0101 Fax: (330) 670-0109 anac@anacnet.org www.anacnet.org Association of Pediatric Hematology/Oncology Nurses 4700 W. Lake Ave. Glenview, IL 60025-1485 (847) 375-4724 Fax: (877) 375-6475 info@aphon.org

www.aphon.org Association of Operating Room Nurses (same as Association of periOperative Registered Nurses, see below) Association of periOperative Registered Nurses 2170 S. Parker Rd., Suite 300 Denver, CO 80231 (800) 755-2676; (303) 755-6304 Fax: (303) 750-3212 custsvc@aorn.org www.aorn.org Association for Professionals in Infection Control and Epidemiology 1275 K St., NW, Suite 1000 Washington, DC 20005-4006 (202) 789-1890 Fax: (202) 789-1899 APICinfo@apic.org www.apic.org Association of Rehabilitation Nurses 4700 W. Lake Ave. Glenview, IL 60025 (800) 229-7530; (847) 375-4710 Fax: (847) 375-6481 info@rehabnurse.org

www.rehabnurse.org Association of State and Territorial Directors of Nursing 2231 Crystal Drive, Suite 450 Arlington, VA 22202 askastdn@astdn.org www.astdn.org Association of Women's Health, Obstetric and Neonatal Nurses 2000 L St., NW, Suite 740 Washington, DC 20036 (800) 673-8499; (202) 261-2400 (800) 245-0231 (Canada) Fax: (202) 728-0575 www.awhonn.org Baromedical Nurses Association P.O. Box 531190 San Diego, CA 92153 (303) 918-9686 Fax: (619) 651-7543 www.hyperbaricnurses.org Caribbean Nurses Organization Antigua & Barbuda Nurses Association Headquarters Queen Elizabeth Highway St. Johns, Antigua, W. I.

Dr. Marion Howard, President 2B Kennedy Close, Green Hill St. Michael, Barbados (246) 424-0819 Fax: (246) 436-6279 mefolh@sunbeach.net http://caribbeanurses.org Commission on Graduates of Foreign Nursing Schools 3600 Market St., Suite 400 Philadelphia, PA 19104-2651 (215) 222-8454 www.cgfns.org Council on Cardiovascular Nursing American Heart Association National Center 7272 Greenville Ave. Dallas, TX 75231 (800) 242-8721 www.americanheart.org Dermatology Nurses' Association 15000 Commerce Parkway, Suite C Mt. Laurel, NJ 08054 (800) 454-4362 DNA@dnanurse.org www.dnanurse.org Developmental Disabilities Nurses Association

P.O. Box 536489 Orlando, FL 32853-6489 (800) 888-6733; (407) 835-0642 Fax: (407) 426-7440 www.ddna.org Emergency Nurses Association 915 Lee St. Des Plaines, IL 60016-6569 (800) 900-9659 (800) 243-8362 (membership) enainfo@ena.org www.ena.org Endocrine Nurses Society P.O. Box 211068 Milwaukee, WI 53221 Phone and Fax: (414) 421-3679 ens@endo-nurses.org www.endo-nurses.org Family Medicine Residency Nurses Association 11400 Tomahawk Creek Parkway Leawood, KS 66211-2672 krose@mc.utmck.edu www.fmrna.com Home Healthcare Nurses Association 228 7th St., SE Washington, DC 20003

(202) 546-4754 hhna_info@nahc.org www.hhna.org Hospice and Palliative Nurses Association One Penn Center West, Suite 229 Pittsburgh, PA 15276-0100 (412) 787-9301 Fax: (412) 787-9305 hpna@hpna.org www.hpna.org Infusion Nurses Society 315 Norwood Park South Norwood, MA 02062 (781) 440-9408 Fax: (781) 440-9409 www.ins1.org International Association of Forensic Nurses 1517 Ritchie Highway, Suite 208 Arnold, MD 21012-2323 (410) 626-7805 Fax: (410) 626-7804 info@iafn.org www.iafn.org International Council of Nurses 3, Place Jean Marteau 1201 - Geneva, Switzerland +41-22-908-01-00 Fax: +41-22-908-01-01 icn@icn.ch www.icn.ch

International Nurses Society on Addictions P.O. Box 163635 Columbus, OH 43216 (614) 221-9989 Fax: (614) 221-2335 intnsa@intnsa.org www.intnsa.org International Organization of Multiple Sclerosis Nurses P.O. Box 450 Teaneck, NJ 07666 or 359 Main Street, Suite A Hackensack, NJ 07601 (201) 487-1050 Fax: (201) 678-2291 info@iomsn.org www.iomsn.org International Society of Nurses in Cancer Care 375 West 5th Avenue, Suite 201 Vancouver, British Columbia V5Y 1J6 Canada (604) 630-5516 Fax: (604) 874-4378 info@isncc.org www.isncc.org

International Society of Nurses in Genetics 461 Cochran Road, Box 246 Pittsburgh, PA 15228 (412) 344-1414 Fax: (412) 344-0599 isongHQ@msn.com www.isong.org International Society of Psychiatric-Mental Health Nurses 2810 Crossroads Dr., Suite 3800 Madison, WI 53718 (866) 330-7227; (608) 443-2463 Fax: (608) 443-2474 or -2478 info@ispn-psych.org www.ispn-psych.org National Association of Bariatric Nurses East Carolina University College of Nursing 2111 Health Sciences Building Greenville, NC 27858 (252) 744-6379 nabn@bariatricnurses.org www.bariatricnurses.org National Association of Clinical Nurse Specialists 2090 Linglestown Rd., Suite 107 Harrisburg, PA 17110 (717) 234-6799 Fax: (717) 234-6798 nacnsorg@nacns.org

www.nacns.org National Association of Directors of Nursing Administration in Long-Term Care Reed Hartman Tower 11353 Reed Hartman Highway, Suite 210 Cincinnati, OH 45241 (800) 222-0539; (513) 791-3679 Fax: (513) 791-3699 info@nadona.org www.nadona.org National Association of Hispanic Nurses 1501 16th St., NW Washington, DC 20036 (202) 387-2477 Fax: (202) 483-7183 info@thehispanicnurses.org www.thehispanicnurses.org National Association for Home Care & Hospice 228 Seventh St., SE Washington, DC 20003 (202) 547-7424 Fax: (202) 547-3540 membership@nahc.org www.nahc.org

National Association of Independent Nurses 1125 E. Broadway Road, Suite #116 Tempe, AZ 85282 (800) 338-5105 nurse@Independentrn.com www.independentrn.com National Association of Neonatal Nurses 4700 W. Lake Ave. Glenview, IL 60025-1485 (800) 451-3795; (847) 375-3660 Fax: (888) 477-6266 info@nann.org www.nann.org National Association of Nurse Massage Therapists 28 Lowry Drive P.O. Box 232 West Milton, OH 45383 (800) 262-4017 nanmtadmin@nanmt.org, infor@nanmt.com www.nanmt.org National Association of Nurse Practitioners in Women's Health 505 C St., NE Washington, DC 20002 (202) 543-9693

info@npwh.org www.npwh.org National Association of Occupational Health Professionals 1525 State St., Suite 204 Santa Barbara, CA 93101 (800) 666-7926 Fax: (805) 965-4853 info@naohp.com www.naohp.com National Association of Orthopaedic Nurses 401 North Michigan Ave., Suite 2200 Chicago, IL 60611 (800) 289-NAON (-6266) Fax: (312) 527-6658 naon@smithbucklin.com www.orthonurse.org National Association of Pediatric Nurse Practitioners 20 Brace Rd., Suite 200 Cherry Hill, NJ 08034-2634 (877) 662-7627 (members only); (856) 857-9700 Fax: (856) 857-1600 info@napnap.org www.napnap.org

National Association of School Nurses Eastern Office: P.O. Box 1300 Scarborough, ME 04070-1300 (877) 627-6476; (207) 883-2117 Fax: (207) 883-2683 Western Office: Amy Garcia, Executive Director 8484 Georgia Avenue, Suite 420 Silver Spring, MD 20910 (866) 627-6767; (240) 821-1130 Fax: (301) 585-1791 nasn@nasn.org www.nasn.org National Association of State School Nurse Consultants P.O. Box 708 Kent, OH 44240 www.nassnc.org National Black Nurses Association 8630 Fenton St., Suite 330 Silver Spring, MD 20910-3803 (800) 575-6298; (301) 589-3200 Fax: (301) 589-3223

NBNA@erols.com www.nbna.org National Conference of Gerontological Nurse Practitioners 7794 Grow Drive Pensacola, FL 32514 (866) 355-1392 Fax: (850) 484-8762 ncgnp@dancyamc.com www.ncgnp.org National Council of State Boards of Nursing 111 E. Wacker Dr., Suite 2900 Chicago, IL 60601 (312) 525-3600 Fax: (312) 279-1032 info@ncsbn.org www.ncsbn.org National Gerontological Nursing Association 7794 Grow Dr. Pensacola, FL 32514 (800) 723-0560; (850) 473-1174 Fax: (850) 484-8762 ngna@dancyamc.com www.ngna.org

National League for Nursing 61 Broadway, 33rd Floor New York, NY 10006 (800) 669-1656; (212) 363-5555 Fax: (212) 812-0391 generalinfo@nln.org www.nln.org National Nurses in Business Association P.O. Box 561081 Rockledge, FL 32956-1081 (877) 353-8888; (321) 633-4610 bemis@nnba.net www.nnba.net National Nursing Staff Development Organization 7794 Grow Dr. Pensacola, FL 32514-7072 (800) 489-1995; (850) 474-0995 Fax: (850) 484-8762 nnsdo@dancyamc.com www.nnsdo.org National Organization for Associate Degree Nursing 7794 Grow Dr. Pensacola, FL 32514

(877) 966-6236; (850) 484-6948 Fax: (850) 484-8762 noadn@dancyamc.com www.noadn.org National Organization of Nurse Practitioner Faculties 1522 K St., NW, Suite 702 Washington, DC 20005 (202) 289-8044 Fax: (202) 289-8046 nonpf@nonpf.org www.nonpf.com National Organization of Nurses with Disabilities c/o Beth Marks, PhD, RN 1640 West Roosevelt Road Chicago, IL 60608 (312) 413-4097 www.NOND.org info@nond.org National Private Duty Association 941 East 86th Street, Suite 270 Indianapolis, IN 46240 (317) 663-3637 Fax: (317) 663-3640 info@privatedutyhomecare.org www.privatedutyhomecare.org National Rural Health Association Administrative Office: 521 East 63rd St. Kansas City, MO 64110 (816) 756-3140

Fax: (816) 756-3144 mail@NRHArural.org Government Affairs Office: 1108 K Street, NW; 2nd Floor Washington, D.C. 20005-4094 (202) 639-0550 Fax: (202) 639-0559 dc@NRHArural.org www.nrharural.org National Student Nurses' Association 45 Main St., Suite 606 Brooklyn, NY 11201 (718) 210-0705 Fax: (718) 210-0710 nsna@nsna.org www.nsna.org NANDA International 100 N. 20th St., 4th Floor Philadelphia, PA 19103 (800) 647-9002; (215) 545-8105 Fax: (215) 564-2175 info@nanda.org www.nanda.org

Navy Nurse Corps Association P.O. Box 5983 Virginia Beach, VA 23471 president@nnca.org www.nnca.org Nurse Healers-Professional Associates International P.O. Box 419 Craryville, NY 12521 (877) 32N-HPAI; (518) 325-1185 Fax: (509) 693-3537 nhpai@therapeutic-touch.org www.therapeutic-touch.org Nurses Organization of Veterans Affairs 1726 M St., NW, Suite 1101 Washington, DC 20036 (202) 296-0888 Fax: (202) 833-1577 nova@vanurse.org www.vanurse.org Nursing Network on Violence Against Women, International PMB 165 1801 H Street B5 Modesto, CA 95354-1215 (888) 909-9993 www.nnvawi.org Nursing Organizations Alliance c/o AMR Management Services

201 East Main St., Suite 1405 Lexington, KY 40507 (859) 514-9157 Fax: (859) 514-9166 alliance@AMRms.com www.nursing-alliance.org Oncology Nursing Society 125 Enterprise Dr. Pittsburgh, PA 15275 (866) 257-4ONS (-4667); (412) 859-6100 Fax: (877) 369-5497 customer.service@ons.org www.ons.org Pediatric Endocrinology Nursing Society 7794 Grow Dr. Pensacola, FL 32514 (877) 936-7367; (850) 484-5223 Fax: (850) 484-8762 PENS@dancyamc.com www.pens.org Philippine Nurses Association of America Leo-Felix M. Jurado, president 5113 Longview Drive

Troy, MI 48098-2374 (888) PNAA-ORG; (248) 267-1187 www.philippinenursesaa.org Preventive Cardiovascular Nurses Association 613 Williamson Street, Suite 205 Madison, WI 53703 (608) 250-2440 Fax: (608) 250-2410 info@pcna.net www.pcna.net Respiratory Nursing Society c/o Casey Norris 708 Gladstone CR Maryville, TN 37804 CNorris@etch.com www.respiratorynursingsociety.org Rural Nurse Organization P.O. Box 11025 Tuscaloosa, AL 35486-0007 rno@bama.ua.edu www.rno.org Sigma Theta Tau International 550 West North St. Indianapolis, IN 46202 (888) 634-7575; (317) 634-8171 stti@stti.iupui.edu www.nursingsociety.org Society of Gastroenterology Nurses and Associates, Inc.

401 N. Michigan Ave. Chicago, IL 60611-4267 (800) 245-7462; (312) 321-5165 Fax: (312) 673-6694 sgna@smithbucklin.com www.sgna.org Society of Gynecologic Nurse Oncologists Susan D. Coples, BSN, RN, CCN, president 930 Johnson Ferry Road, #900 Atanta, GA 30342 (W) (651) 602-5333 susan.coples@segynonc.com www.sgno.org Society of Otorhinolaryngology and Head-Neck Nurses, Inc. 202 Julia Street New Smyrna Beach, FL 32168 (386) 428-1695 Fax: (386) 423-7566 info@sohnnurse.com www.sohnnurse.com Society of Pediatric Nurses 7794 Grow Dr. Pensacola, FL 32514

(800) 723-2902; (850) 494-9467 Fax: (850) 484-8762 spn@dancyamc.com www.pedsnurses.org Society of Trauma Nurses 1020 Monarch St., Suite 300B Lexington, KY 40513 (859) 977-7456 Fax: (859) 977-7441 sclements@traumanurses.org www.traumanurses.org Society of Urologic Nurses and Associates East Holly Ave., Box 56 Pitman, NJ 08071-0056 (888) 827-7862 suna@ajj.com www.suna.org Society for Vascular Nursing 203 Washington Street PMB 311 Salem, MA 01970 (888) 536-4SVN (-4786); (978) 744-5005 Fax: (978) 744-5029

svn@administrare.com www.svnnet.org Space Nursing Society 3053 Rancho Vista Blvd. #H377 Palmdale, CA 93551 (661) 949-6780 Fax: (661) 949-7292 lplushsn@ix.netcom.com Transcultural Nursing Society Madonna University College of Nursing and Health 36600 Schoolcraft Road Livonia, MI 48150 (888) 432-5470 Fax: (734) 432-5463 www.tcns.org United Spinal Association 75-20 Astoria Boulevard Jackson Heights, NY 11370 (800) 404-2898; (718) 803-3782 Fax: (718) 803-0414 info@unitedspinal.org www.unitedspinal.org Wound, Ostomy and Continence Nurses Society 15000 Commerce Parkway, Suite C Mt. Laurel, NJ 08054 (888) 224-WOCN (-9626) Fax: (856) 439-0525 wocn_info@wocn.org

www.wocn.org Licenses, Scope of Practice, and More: State Boards of Nursing The state boards of nursing set the standards for qualified students and nurses to obtain their licenses to practice and to reestablish licensure (requirements include continuing education and mandatory courses on specific topics such as infection control or child abuse detection and reporting). They also determine participation in the multistate licensure compact, which allows nurses to practice in more than one state with one current license, and provide current information on the scope of nursing practice within the state. For information on a specific state, go to www.ncsbn.org , the Web site of the National Council of State Boards of Nursing, which includes a current list of all state board Web sites and contact information.

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G. Elements and types of career planning H. Dressing for successful interview

Prepare and practice for an job interview . After the appointment and locale has been determined, allow time for adequate preparedness for the big day . Remember that first mental pictures do last, so the way an applicant looks really does matter. Employers could easily make the finding of fact based on the manner of dressing during the initial job interview. Better interrogative sentences and service can be invited if the appearance itself commands respectfulness. It is important to consider the surrounds of the company yielding you an job interview . There is no reason to be over dressed or badly dressed during this really important day . In fact, it is a good rule of thumb to always dress up suitably for any situation . All to frequently appearance is glossed over. Some might say that the inner characteristics of the individual matter more, but in reality, you simply have one chance for a first impression . Make it count! . Although there are specific guidelines that can be pursued, these does not apply to all states like New York for example, where individuals don voguish up to extreme expressive styles that are far away from the common fashion principles common people know. The rule of thumb should be to put on something that could promote more confidence. Below are the top ten do's and do n'ts during an job interview Avoid wild colorized nail polish before the job interview . The same goes with long nails that could easily turn off some conservative employers. These should be neat and very kempt looking . Never wear jewellery that rattles and joggles as you talk and make a motion. Attempt not to wear two or more rings or earrings. Piercing aside from the ears is likewise a no no. Professional persons hairstyle too counts . If you are a adult female, wear closed shoes . Heels are very appropriate as this gives more confidence to an individual and signified of respect is as well provided once they view the individual wearing them. Once again, for the ladies , never bare those new shaven legs . If possible, use stockings regardless of the temperature. But make sure not to use fancy colorized ones. Simply use those made for neutral looking legs . These should too correspond the shoes . Remember that a good lawsuit or dress conveys more confidence as well. This will likewise grant more comfortableness and chance for the applier to answer comfortably or with ease.

Avoid short skirts for fair sexes. Wearing trousers or leggings are a no, no during interviews. Put on the appropriate sport jackets just as long as they do not appear fashion outdated. Do not use any leather coats or jackets. For adult males, the necktie is still appropriate. Avoid using polo necks. If there is no suit and tie available, use a collared shirt or white long sleeves. Men must not use too much aftershave. Women should be using bags that are not overly bright and blazing. These should be conservative and corresponding the apparel. Any briefcase used must be in perfect condition . The way a person appears equal the subject matter he is trying to convey . During the job interview , this can either turn a positive component for the applicant or large loss . Know for a fact that the way an applicant should look must be appealing, stylish but not loud . Regard the latest styles in the area or location where the prospective job is located. One aspect that is a role of how employer picks a new hire is based on the physical attributes of the applicant. From the way the hands were shaken , holding an eye contact, the way the attitude was held, the smile was delivered up to the manner of getting dressed is being rated already. Irrespective of your personal vocation background , accomplishments, and underlying talents , if the first impression was failed to outstanding enough to make an outstanding appeal to the interviewers, nothing else counts. This can be the potential employers initial interpreting of how an applicant will do on the job. Whether that perception is fair is irrelevant. Do you desire the job ? Look the portion and your opportunities for success are much greater! .

I. Milk-code

E.O. 51
National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements, and Other Related Products -Signed into law on 20 October 1986

Aim of the Code (Section 2)

to contribute to the provision of safe and adequate nutrition for infants -by the protection and promotion of breastfeeding; and -by ensuring the proper use of breastmilk substitutes and breastmilk supplements when these are necessary on the basis of adequate information and through appropriate marketing and distribution

S ope of the Code (Se tion 3 of E. . 51)

The Code applies to the marketing, and practices related thereto, of the following products:
-breastmilk substitutes, including infant formula; -other milk products

Scop of th Cod

-foods nd b v g s, including bottl f d compl m nt y foods, h n m k t d o is p s nt d to b suit bl , ith o oth ithout modific tion, fo us s p ti l o tot l pl c m nt of b stmilk

It lso ppli s to th i qu lity nd v il bility, nd to info m tion conc ning th i us .

# %# $$$ $

$#

%# %#

$ #

$ % # $

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-f

ding bottl s nd t

ts

( (

' $#% # # $ #% $ % $ %$ $ # % $ & % # # #% #% # &%# & # $ # # # %$ # %$ # # & ! "! ! $

% !!

Prohibitions / Violations
Sec. 6 (b) Manufacturers and distributors shall not be permitted to give, directly or indirectly,


samples and supplies of products within the scope of this Code, or gifts of any sort

to any member of the general public, including members of their families, to hospitals and other health institutions, as well as to personnel within the health care system, save as otherwise provided in this Code.

Sec.6 (d) nuf ctu ers nd distributors sh ll not distribute to pregn nt omen or mothers of inf nts ny gifts or rticles or utensils hich m y promote the use of breastmilk substitutes or bottle feeding, nor shall any other groups, institutions or individuals distribute such gifts, utensils or products to the general public and mothers.

Sec.7 (b) No facility of the health care system shall be used for the purpose of promoting infant formula or other products within the scope of this Code.

Sec.7 (c) Facilities of the health care system shall not be used for the display of products within the scope of this Code, or for placards or posters concerning such products.

Sec.7 (d) The use by the health care system of professional service representatives, mothercraft nurses or similar personnel, provided or paid for by manufacturers or distributors shall not be permitted.

Sec.7 (e) n health education classes for mothers and the general public, health workers and community workers shall emphasize the hazards and risks of the improper use of breastmilk substitutes particularly infant formula. Feeding with infant formula shall be demonstrated only to mothers who may not be able to breastfeed for medical or other legitimate reasons.

Sec.8 (c) No financial or material inducements to promote products within the scope of this Code shall be offered by manufacturers or distributors to health workers or members of their families, nor shall these be accepted by the health workers or members of their families, xxx.

Sec.8 (d) Samples of infant formula or other products within the scope of this Code, or of equipment or utensils for their preparation or use, shall not be provided to health workers except when necessary for the purpose of professional evaluation or research in accordance with the rules and regulations promulgated by the DOH.