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Performance Appraisal The nurse evaluates his/her own nursing practice in relation to professional practice standards and relevant statutes and regulations. Standard III: Education The nurse acquires and maintains current knowledge in nursing practice. Standard IV: Collegiality The nurse contributes to the professional development of peers, colleagues, and others. Standard V: Ethics The nurse’s decisions and actions on behalf of patients are determined in an ethical manner. Standard VI: Collaboration The nurse collaborates with the patient, significant others, and health care providers in providing patient care. Standard VII: Research The nurse uses research findings in practice. Standard VIII: Resource Utilization The nurse considers factors related to safety, effectiveness, and cost in planning and delivering patient care. Standard IX: Practice Environment The nurse contributes to the environment of care delivery within the practice settings. Standard X: Accountability The nurse is professionally and legally accountable for his/her practice. The professional registered nurse may delegate to and supervise qualified personnel who provide patient care. Association of Women’s Health, Obstetric, and Neonatal Nurses. (1998). Standards for the nursing care of women and newborns (5th ed.). Washington, D.C.: Author. • What do maternal-child health nurses need to know about alternative therapies such as herbal remedies to keep their practices current? The answers to these and other questions provided by research help to bolster a foundation for specific actions and activities that have the potential to improve maternal and child health care. The Focus on Evidence-Based Practice boxes included in chapters throughout the text contain summaries of current maternal and child health research studies and are designed to assist you in developing a questioning attitude regarding current nursing practice and in thinking of ways to incorporate research findings into care. Nursing Theory One of the requirements of a profession (together with other critical determinants, such as member-set standards, monitoring of practice quality, and participation in research) is that the concentration of a discipline’s knowledge flows from a base of established theory. Nursing theorists offer helpful ways to view clients so that nursing activities can best meet client needs—for example, by seeing a pregnant woman not simply as a physical form but as a dynamic force with important psychosocial needs, or by viewing children as extensions or active members of a family as well as independent beings. Only with this broad theoretical focus can nurses appreciate the significant effect on a family of a child’s illness or of the introduction of a new member. Another issue most nursing theorists address is how nurses should be viewed or what the goals of nursing care should be. At one time, the goal of nursing care could have been stated as “Providing care and comfort to injured and ill people.” Most nurses today would perceive this view as a limited one, because they are equipped to do preventive care as well. Extensive changes in the scope of maternal and child health nursing have occurred as health promotion, or keeping parents and children well, has become a greater priority. A third issue addressed by nurse theorists concerns the activities of nursing care: as goals become broader, so do activities. For example, when the primary goal of nursing was considered to be caring for ill people, nursing actions were limited to bathing, feeding, and providing comfort. Currently, with health promotion as a major nursing goal, teaching, counseling, supporting, and advocacy are also common roles. In addition, with new technologies available, nurses are caring for clients who are sicker than ever before. Because care of women during pregnancy and of children during their developing years helps protect not only current health but also the health of the next generation, maternal-child health nurses fill these expanded roles to a unique and special degree. Table 1.2 summarizes the tenets of a number of common nursing theorists and suggests ways in which they could be applied to maternal-child health care through the situation of one child. The third column of the table (“Emphasis of Care”) demonstrates that although the theoretical bases of these approaches to nursing care differ, the result of any one of them is to provide a higher level of care. These different theories, therefore, do not contradict but rather complement each other in the planning and implementation of holistic nursing care. 8 UNIT 1 Maternal and Child Health Nursing Practice Checkpoint Question 1 Suppose Melissa Chung asks you whether maternal child health nursing is a profession. What qualifies an activity as a profession? a. Members supervise other people. b. Members use a distinct body of knowledge. c. Members enjoy good working conditions. d. Members receive relatively high pay. ✔ MATERNAL AND CHILD HEALTH NURSING TODAY At the beginning of the 20th century, the infant mortality rate in the United States (i.e., the number of infants per 1,000 births who die during the first year of life) was greater than 100 per 1,000. In response to efforts to lower this rate, health care shifted from a treatment focus to a preventive one, dramatically changing the scope of maternal and child health nursing.
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