👩⚕️ Nursing is both an art and a science | 📚 Each theory highlights a unique perspective | 💡 Important for exams & practice
🗨️ “Nursing is to put the patient in the best condition for nature to act upon him.”
🌿 Focus: Environment (air, water, light, cleanliness)
📌 Key Idea: Health can be improved by modifying the environment.
🗨️ “Nursing is assisting the individual, sick or well, in the performance of activities contributing to health or its recovery (or peaceful death).”
📌 Key Idea: Nurse helps when the patient cannot meet basic needs.
🔑 Emphasis: Independence of patient
🗨️ “Nursing is a helping service needed when an individual is unable to meet their own self-care needs.”
📌 Key Idea: Support self-care ability of the patient.
🏥 Common in rehabilitation & chronic care
🗨️ “Nursing is a therapeutic interpersonal process that functions cooperatively with others to make health possible.”
📌 Key Idea: Nurse–patient relationship is central to care.
🧩 Phases: Orientation, Working, Termination
🗨️ “Nursing is a problem-solving art to meet physical, emotional, and sociological needs of patients.”
📌 Key Idea: Nursing focuses on solving patient-centered problems.
🗨️ “Nursing is a human science of persons and health-illness experiences that are mediated by professional, personal, scientific, aesthetic, and ethical human care transactions.”
📌 Key Idea: Caring is the essence of nursing.
💞 Uses Carative Factors to promote holistic healing
🗨️ “Nursing is a humanistic science dedicated to compassionate concern for maintaining and promoting health, preventing illness, and caring for and rehabilitating the sick.”
📌 Key Idea: Focus on energy fields, wholeness, and environment
🗨️ “Nursing is the promotion of adaptation in each of four adaptive modes: physiological, self-concept, role function, and interdependence.”
📌 Key Idea: Nurse helps patient adapt to changes in health.
🗨️ “Nursing is a process of human interactions that leads to goal attainment for individuals.”
📌 Key Idea: Communication is key to setting and achieving goals with the patient.
🗨️ “Nursing is a transcultural care profession that focuses on comparative study of cultures to provide culturally congruent care.”
📌 Key Idea: Nurses must provide care that respects cultural values and beliefs.
✅ Q: Who defined nursing as ‘putting the patient in the best condition for nature to act’?
🅰️ Florence Nightingale
✅ Q: Who introduced the ‘Self-Care Deficit Theory’?
🅰️ Dorothea Orem
✅ Q: Which theorist emphasized interpersonal relationships in nursing?
🅰️ Hildegard Peplau
✅ Q: Who believed that caring is the essence of nursing?
🅰️ Jean Watson
✅ Q: Which nursing theory focuses on cultural values?
🅰️ Madeleine Leininger
👩⚕️ Caring | Competence | Commitment | 📚 Science + Art | 🏥 Service-Oriented & Ethical
🗨️ A nurse is a trained and licensed healthcare professional who provides care, support, and education to individuals, families, and communities to achieve and maintain optimal health and quality of life.
🔹 A nurse plays multiple roles:
✅ Nurses work in hospitals, communities, schools, homes, military, disaster zones, and more.
🗨️ “Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well and in all settings.”
— World Health Organization
✅ Nursing is recognized as a noble, regulated, and evidence-based profession.
It is both a science and an art that requires specialized education, training, ethical practice, and continuous professional development.
| 🌟 Trait | 💡 Nursing Fulfillment |
|---|---|
| 🎓 Specialized Education | B.Sc., GNM, M.Sc., PhD in Nursing |
| 📜 Licensing & Regulation | Indian Nursing Council (INC), State Councils |
| 💼 Code of Ethics | Based on ICN & TNAI standards |
| 🧠 Autonomy in Decision Making | Clinical judgment, care plans |
| 👩🏫 Continuous Education | CME, research, specializations |
| ❤️ Commitment to Public Service | 24/7 care for individuals and society |
| 💬 Professional Associations | TNAI, ICN, SNA |
🔹 Provide holistic, patient-centered care
🔹 Act as a patient advocate
🔹 Maintain ethical standards & confidentiality
🔹 Collaborate with health teams
🔹 Lead and manage nursing teams
🔹 Promote health and prevent disease
🔹 Engage in lifelong learning and research
✅ Q: Who is a nurse?
🅰️ A trained and licensed healthcare professional who provides care to individuals and communities.
✅ Q: Nursing is considered a __________.
🅰️ Profession
✅ Q: Which council regulates nursing education in India?
🅰️ Indian Nursing Council (INC)
✅ Q: What is the key focus of nursing?
🅰️ Patient-centered, holistic care
✅ Q: Name one professional body for nurses in India.
🅰️ TNAI (Trained Nurses’ Association of India)
👩⚕️ “A blend of knowledge, behavior, ethics, and commitment to lifelong service.”
💡 Professionalism builds public trust, improves patient outcomes, and strengthens the nursing identity.
🗨️ Professionalism in Nursing is the demonstration of core values such as competence, accountability, respect, ethics, communication, and compassion in all nursing roles and settings.
It reflects how nurses think, behave, communicate, and uphold the dignity of the profession.
| 🌟 Trait | 📖 Description |
|---|---|
| 👩🎓 Competency | Possessing the right knowledge & clinical skills |
| 🕊️ Ethical Behavior | Respecting codes of conduct & patient rights |
| 🗣️ Effective Communication | Clear, therapeutic, and respectful exchange |
| 🔍 Accountability | Accepting responsibility for one’s actions |
| 🫱 Empathy & Compassion | Understanding and supporting patient emotions |
| 📘 Lifelong Learning | Committing to continuous growth & evidence-based practice |
| 👥 Collaboration | Working as part of an inter-professional team |
| 🏥 Advocacy | Standing up for patients’ needs and rights |
1️⃣ Knowledge – Scientific foundation, updated education
2️⃣ Behavior – Ethical, disciplined, and respectful conduct
3️⃣ Service – Dedication to patient well-being
4️⃣ Identity – Strong personal and professional integrity
5️⃣ Autonomy – Clinical judgment & independent decision-making
🔹 Altruism – Selfless concern for others
🔹 Dignity – Respect for human rights and patient privacy
🔹 Integrity – Honesty, trustworthiness
🔹 Social Justice – Fair care without discrimination
🔹 Accountability – Legal and moral responsibility
✅ Builds patient trust
✅ Enhances clinical care quality
✅ Promotes team effectiveness
✅ Fosters ethical decision-making
✅ Elevates the status and recognition of nursing as a noble profession
✅ Q: What is professionalism in nursing?
🅰️ A set of values and behaviors that reflect the ethical, accountable, and competent practice of nursing.
✅ Q: Name any 2 values of professional nursing.
🅰️ Altruism, Integrity
✅ Q: Which behavior shows professionalism?
🅰️ Accountability for actions
✅ Q: What is the importance of professionalism in nursing?
🅰️ It ensures safe, ethical, and high-quality patient care.
⚖️ “Doing what is right, even when no one is watching.”
👩⚕️ Nursing ethics guide professional decisions, safeguard patients, and uphold human dignity.
🗨️ Ethics in Nursing is a system of moral principles, values, and standards that guide nurses in their decisions and actions during the care of patients, families, and communities.
It reflects the moral duties and obligations a nurse holds toward patients, colleagues, and society.
| 🧭 Principle | 💬 Meaning |
|---|---|
| ❤️ Autonomy | Respecting the patient’s right to make their own decisions |
| 🛡️ Beneficence | Doing good and promoting well-being |
| ⛔ Non-maleficence | Do no harm (avoid causing injury) |
| ⚖️ Justice | Providing fair and equal treatment |
| 💬 Veracity | Telling the truth and being honest |
| 🕊️ Fidelity | Being loyal and keeping promises |
| 🔒 Confidentiality | Keeping patient information private and secure |
🔹 Refusing treatment vs. life-saving intervention
🔹 Telling the truth vs. protecting the patient from emotional harm
🔹 Protecting patient privacy in public spaces
🔹 End-of-life decisions (e.g., DNR, withdrawal of life support)
🔹 Use of restraints or seclusion
1️⃣ Nurses and People – Respect human rights, dignity, culture, beliefs
2️⃣ Nurses and Practice – Maintain competence, responsibility
3️⃣ Nurses and the Profession – Promote the profession and research
4️⃣ Nurses and Co-workers – Maintain ethical team relations
✅ Ensures safe and fair patient care
✅ Protects patients’ rights and dignity
✅ Builds trust between nurse and patient
✅ Guides nurses in complex decision-making
✅ Supports legal and professional standards
✅ Q: What is the meaning of autonomy in nursing ethics?
🅰️ The patient’s right to make their own healthcare decisions.
✅ Q: Which ethical principle means ‘do no harm’?
🅰️ Non-maleficence
✅ Q: Which code of ethics is followed internationally in nursing?
🅰️ ICN Code of Ethics
✅ Q: What is fidelity in nursing?
🅰️ Being faithful to commitments and promises made to patients.
✅ Q: What principle is involved in protecting patient information?
🅰️ Confidentiality
👩⚕️ The heart of ethical, compassionate, and safe nursing practice | 💡 Guides attitude, behavior, and patient care
🗨️ Professional values in nursing are the core beliefs and principles that guide nurses’ actions, decisions, and interactions with patients, families, and healthcare teams.
They shape the identity and integrity of a nurse and are reflected in daily practice, ethics, and accountability.
| 🌟 Value | 💬 Explanation |
|---|---|
| ❤️ Altruism | Selfless concern for the well-being of others |
| 🛡️ Autonomy | Respect for patients’ rights to make their own decisions |
| ⚖️ Social Justice | Fair and equal treatment of all individuals |
| 🔍 Integrity | Honesty, strong moral principles, and trustworthiness |
| 🤝 Accountability | Responsibility for one’s actions and their outcomes |
| 🕊️ Human Dignity | Respect for the inherent worth of each individual |
| 📚 Commitment to Learning | Dedication to lifelong growth and evidence-based practice |
✅ Guide ethical and legal nursing practice
✅ Build patient trust and nurse-patient relationships
✅ Promote unity and standards in the profession
✅ Improve quality, safety, and consistency of care
✅ Foster respect and human rights in all settings
✅ Q: What does altruism in nursing mean?
🅰️ Selfless concern for others without expecting reward.
✅ Q: What is integrity in nursing?
🅰️ Honest, ethical behavior, and keeping promises.
✅ Q: Which value focuses on respecting patient decisions?
🅰️ Autonomy
✅ Q: Which value promotes fairness in care delivery?
🅰️ Social Justice
✅ Q: Accountability in nursing means?
🅰️ Taking responsibility for one’s actions and outcomes.
🩺 Beyond Bedside Care | 📈 Leadership, Autonomy, Research, Education, Advocacy
🗨️ Expanded role of the nurse refers to the broadening of traditional nursing functions into advanced and specialized roles across clinical, educational, research, administrative, and community health domains.
It empowers nurses to practice with more autonomy, responsibility, and leadership in complex healthcare settings.
✅ Higher clinical knowledge & decision-making skills
✅ Works interdependently or independently
✅ Requires advanced education or specialization
✅ Focuses on prevention, promotion, and policy making
✅ Involves leadership, teaching, and research
| 🩺 Role | 📝 Description |
|---|---|
| 📚 Nurse Educator | Teaches students and staff; develops curriculum |
| 🧑⚕️ Nurse Practitioner (NP) | Diagnoses, treats illness; prescribes meds |
| 🧪 Nurse Researcher | Conducts studies to improve nursing science |
| 🧑💼 Nurse Administrator | Manages healthcare teams and policy-making |
| 🏥 Clinical Nurse Specialist (CNS) | Expert in a specialty area (e.g., ICU, Cardiac) |
| 🌍 Community Health Nurse (CHN) | Delivers health services to populations |
| ⚖️ Legal Nurse Consultant | Assists in legal cases and forensics |
| 🧘 Mental Health Nurse | Cares for patients with psychological disorders |
🔹 Improves access to healthcare
🔹 Promotes continuity of care
🔹 Strengthens health education & prevention
🔹 Enhances team-based care & leadership
🔹 Advances nursing science and practice
✅ Q: What is the expanded role of the nurse?
🅰️ A role that goes beyond traditional bedside care to include education, leadership, research, and clinical specialization.
✅ Q: Name two expanded roles of a nurse.
🅰️ Nurse Practitioner and Nurse Educator
✅ Q: Who is a Clinical Nurse Specialist?
🅰️ A nurse with advanced expertise in a specific clinical area.
✅ Q: Which expanded nursing role contributes to policy and hospital administration?
🅰️ Nurse Administrator
✅ Q: What role involves conducting research in nursing science?
🅰️ Nurse Researcher
👩⚕️ “A nurse’s duty is not only to care but to care within the boundaries of law and ethics.”
⚖️ Legal = What you MUST do | Ethical = What you SHOULD do
🔹 Legal aspects in nursing are the laws, rules, and professional standards that ensure safe, lawful, and accountable practice.
🔹 Ethical aspects involve moral obligations, values, and professional codes that guide nurses in doing what is right, fair, and respectful in any situation.
| 📚 Type of Law | 📝 Description |
|---|---|
| Statutory Law | Made by legislative bodies (e.g., INC Act, 1947, Nursing Education Act, Mental Health Act) |
| Common Law | Based on judicial decisions (e.g., past judgments on malpractice) |
| Criminal Law | Involves offenses like assault, illegal abortion, theft, euthanasia |
| Civil Law | Covers issues like negligence, defamation, breach of confidentiality |
🔹 Maintain professional registration under INC/State Nursing Council
🔹 Provide standard care according to protocols
🔹 Ensure accurate and timely documentation
🔹 Obtain valid informed consent before procedures
🔹 Maintain confidentiality and patient privacy
🔹 Avoid medication errors, negligence, and malpractice
🔹 Report suspected abuse, unethical acts, or dangerous practice
🔹 Act within legal scope of nursing practice
| 🧾 Term | 📘 Meaning & Example |
|---|---|
| Negligence | Failing to act as a reasonable nurse (e.g., not raising bed rails in a confused patient) |
| Malpractice | Professional misconduct (e.g., giving the wrong drug dose leading to death) |
| Informed Consent | Patient’s voluntary agreement after knowing the risks (e.g., before surgery) |
| Battery | Touching or performing a procedure without consent |
| Assault | Threatening to inject forcibly |
| False Imprisonment | Restraining a patient without justification |
| Defamation | False statement harming reputation (written = libel, spoken = slander) |
| ⚖️ Principle | 💬 Explanation |
|---|---|
| ❤️ Autonomy | Respect the patient’s right to make their own decisions |
| 🛡️ Beneficence | Do good and act in the best interest of the patient |
| ⛔ Non-maleficence | Do no harm intentionally or unintentionally |
| ⚖️ Justice | Provide fair and equal treatment to all patients |
| 🔒 Confidentiality | Maintain privacy of patient records and discussions |
| 🕊️ Fidelity | Be faithful, loyal, and keep promises made to patients |
| 📢 Veracity | Always tell the truth to the patient, even if difficult |
🔹 Nurses and People: Promote health, respect dignity, cultural beliefs
🔹 Nurses and Practice: Provide competent, evidence-based care
🔹 Nurses and the Profession: Support research, advocacy, and growth
🔹 Nurses and Co-workers: Cooperate ethically and report violations
| ⚖️ Legal Aspect | 🕊️ Ethical Aspect |
|---|---|
| Enforced by government laws | Guided by moral principles |
| Breach leads to legal action or penalties | Breach leads to guilt or disciplinary action |
| Example: Performing surgery without consent | Example: Telling harsh truths without compassion |
| Documented in Acts & Rules | Outlined in professional codes (e.g., ICN, TNAI) |
🔹 Indian Nursing Council Act, 1947
🔹 Mental Healthcare Act, 2017
🔹 Consumer Protection Act, 2019
🔹 Protection of Children from Sexual Offences (POCSO) Act, 2012
🔹 Biomedical Waste (BMW) Management Rules, 2016
🔹 Medical Termination of Pregnancy Act (MTP), 1971
🔹 HIV & AIDS (Prevention and Control) Act, 2017
✅ Q: What is malpractice in nursing?
🅰️ Professional misconduct or negligence causing patient harm.
✅ Q: Which act regulates nursing education in India?
🅰️ Indian Nursing Council Act, 1947
✅ Q: What is autonomy in ethics?
🅰️ Patient’s right to make their own decisions.
✅ Q: What legal document is required before any procedure?
🅰️ Informed consent
✅ Q: Which principle focuses on “doing no harm”?
🅰️ Non-maleficence
⚖️ “A tort is a civil wrong — not a crime, but still harmful.”
👩⚕️ Nurses can be legally responsible for torts committed during patient care.
🗨️ A TORT is a civil wrong (not a criminal act) committed against a person or their property that causes harm or injury and leads to legal liability.
🔹 In nursing, torts occur when a nurse’s action (or inaction) harms a patient, whether intentionally or unintentionally.
| 📂 Type | 📝 Description | 🔍 Example |
|---|---|---|
| ❗ Intentional Torts | Willful actions that violate patient rights | Hitting a patient |
| ⚠️ Unintentional Torts | Actions done without intent but still harmful | Giving wrong medication |
| 🔒 Quasi-Intentional Torts | Involve communication that harms reputation or privacy | Gossiping about patient info |
| 🛑 Type | 💬 Meaning | 🧪 Example |
|---|---|---|
| 💢 Assault | Threatening to touch/harm someone | “I’ll give this injection even if you scream!” |
| ✋ Battery | Unwanted physical contact | Giving an injection without consent |
| 🔐 False Imprisonment | Restricting movement unlawfully | Tying a patient without doctor’s order |
| 🧭 Invasion of Privacy | Disclosing personal info without consent | Posting patient photo online |
| 🧾 Fraud | Intentional misrepresentation | Falsifying patient records |
| ⚠️ Type | 💬 Meaning | 🧪 Example |
|---|---|---|
| 🚨 Negligence | Failure to act as a reasonable nurse | Forgetting to check vital signs |
| 🧬 Malpractice | Professional negligence causing harm | Administering wrong drug dosage |
| 🗣️ Type | 💬 Meaning | 🧪 Example |
|---|---|---|
| 📢 Defamation | Damaging someone’s reputation | |
| 📝 Libel | Written defamation | Writing false notes in a chart |
| 🗣️ Slander | Spoken defamation | Saying a patient is faking illness |
| 🔒 Breach of Confidentiality | Sharing patient data without permission | Telling friends about a patient’s disease |
✅ Always obtain informed consent before any procedure
✅ Follow standard protocols and guidelines
✅ Maintain complete and accurate documentation
✅ Respect privacy, dignity, and rights of every patient
✅ Never share patient info without permission
✅ Report any abuse, fraud, or misconduct
✅ Act within your legal scope of practice
✅ Q: What is a tort in nursing?
🅰️ A civil wrong causing harm to a patient that may lead to legal action.
✅ Q: Giving treatment without consent is an example of which tort?
🅰️ Battery
✅ Q: What is the difference between negligence and malpractice?
🅰️ Negligence = unintentional carelessness; Malpractice = professional negligence
✅ Q: Writing false statements in patient records is an example of?
🅰️ Libel (written defamation)
✅ Q: Gossiping about a patient’s condition to others is considered?
🅰️ Breach of confidentiality
⚠️ “Carelessness in care can cost a life — and your license.”
👩⚕️ Both are unintentional torts, but malpractice is specific to professional duties.
🗨️ Negligence is the failure to act as a reasonable and prudent nurse would under similar circumstances, resulting in harm to the patient.
🔹 It is an unintentional tort (civil wrong), not a crime.
🔹 No intent to harm — but harm still happens.
🗨️ Malpractice is a type of negligence committed by a licensed professional (nurse/doctor) who fails to meet standards of care, resulting in injury or death.
🔹 Malpractice = Professional negligence
| 📌 Factor | ⚠️ Negligence | ⚕️ Malpractice |
|---|---|---|
| 🧑 Who? | Anyone (trained or untrained) | Only licensed professionals |
| 💬 Intent | Unintentional | Unintentional |
| 💉 Involves Professional Duty? | No | Yes |
| 📄 Legal Claim Type | Civil | Civil (professional liability) |
| 💡 Example | Not cleaning a wet floor | Giving medication without checking the chart |
1️⃣ Duty – Nurse had a responsibility to care for the patient
2️⃣ Breach of Duty – Nurse failed to meet the standard of care
3️⃣ Causation – The breach directly caused injury
4️⃣ Damages – Patient suffered actual harm or loss
✅ Know and follow standard care protocols
✅ Maintain accurate and honest documentation
✅ Double-check medications and dosages
✅ Communicate clearly with doctors and families
✅ Attend training and updates regularly
✅ Provide care within your scope of practice
✅ Never perform procedures you are not trained or authorized for
✅ Q: What is negligence in nursing?
🅰️ Failure to provide proper care, resulting in patient harm.
✅ Q: What is the difference between negligence and malpractice?
🅰️ Malpractice is negligence by a licensed healthcare professional.
✅ Q: Which of the following is an example of malpractice?
🅰️ Giving the wrong medication leading to death.
✅ Q: What are the four elements needed to prove malpractice?
🅰️ Duty, Breach, Causation, Damages
✅ Q: What is a nurse’s best protection against malpractice claims?
🅰️ Providing standard care and accurate documentation.
🩺 “Patients are not guests, they are the purpose of our care.”
⚖️ Ensures safety, dignity, and empowerment of every patient.
🗨️ Patients’ rights are a set of legal, ethical, and moral standards that protect the interests of individuals receiving medical care, ensuring they are treated with respect, fairness, and autonomy.
| ✅ Right | 📖 Description |
|---|---|
| 🧍♂️ Right to Respect and Dignity | Treated with courtesy, irrespective of race, religion, or gender |
| 🧠 Right to Informed Consent | Patient must agree voluntarily after full explanation |
| 🔐 Right to Confidentiality | All health info must remain private |
| 📚 Right to Information | Patient has access to diagnosis, treatment, and prognosis details |
| 🚫 Right to Refuse Treatment | Patient can refuse any procedure or medication |
| ⚖️ Right to Safety & Privacy | Safe environment and personal space maintained |
| 🗣️ Right to Voice Grievance | Right to file complaint against improper care |
| 💵 Right to Transparency in Billing | Clear, itemized bill for all services |
| 👨👩👧 Right to Family Participation | Family can be involved in decisions when needed |
| 🛏️ Right to Second Opinion | Can seek alternative medical opinion |
📝 “No procedure without understanding.” | ⚖️ Consent is legal protection for both patient and nurse.
🗨️ Informed consent is the legal and ethical process of obtaining voluntary agreement from a patient after explaining the purpose, risks, benefits, alternatives, and consequences of a procedure or treatment.
| 🧾 Element | ✅ Criteria |
|---|---|
| 💡 Information | Complete explanation in understandable language |
| 📣 Comprehension | Patient must fully understand the details |
| 🤝 Voluntariness | Consent must be given freely without pressure |
| 🧍♀️ Capacity | Patient must be mentally competent and of legal age |
| ✍️ Documentation | Written or verbal consent recorded with witness (for procedures) |
✅ Surgical procedures
✅ Invasive diagnostics (e.g., biopsy, endoscopy)
✅ Administration of anesthesia
✅ Blood transfusions
✅ High-risk treatments (e.g., chemotherapy, electroconvulsive therapy)
✅ Research participation
✅ Photography or video for education or publication
🚨 In emergencies where the patient is unconscious and delay may cause harm
👶 When guardian consent is applicable for minors or mentally incompetent persons
⚖️ When required by law or court order
🔹 Ensure patient understands the explanation
🔹 Witness the consent form if required
🔹 Clarify doubts (within scope of practice)
🔹 Inform physician if patient is hesitant or confused
🔹 Ensure consent is obtained before initiating procedure
🔹 Document consent and communication clearly
✅ Q: What is informed consent?
🅰️ Voluntary agreement given by a competent patient after understanding risks and benefits.
✅ Q: What are the essential elements of valid consent?
🅰️ Information, Comprehension, Voluntariness, Capacity, Documentation
✅ Q: Can a patient refuse treatment after giving consent earlier?
🅰️ Yes, at any time before the procedure.
✅ Q: What is the nurse’s role in informed consent?
🅰️ Clarify, witness, document, and ensure the consent process is followed properly.
✅ Q: In which situation is consent not required immediately?
🅰️ In a medical emergency to save life.
🚔 “A nurse must not only care legally but stay within the law.”
⚖️ Crime = A punishable act against the law that may involve imprisonment or fine.
🗨️ A crime is a violation of public law that is prohibited and punishable by the government.
🔹 In nursing, it includes actions that intentionally or recklessly cause harm or violate legal standards.
| 🚨 Type | 📖 Description | 🧪 Examples |
|---|---|---|
| Felony | Serious crime with heavy punishment | Drug theft, patient abuse, murder, unlicensed practice |
| Misdemeanor | Less serious offense with lighter penalty | Minor assault, verbal threats, falsifying records |
✅ Q: What is a crime in nursing?
🅰️ An act against public law that may harm patients and is punishable by the state.
✅ Q: Giving care without a license is an example of?
🅰️ Felony
✅ Q: Falsification of medical documents is considered?
🅰️ Fraud – a criminal offense
🕊️ “Helping in emergencies should not become a legal burden.”
🗨️ The Good Samaritan Law is a legal protection offered to individuals (including nurses) who provide reasonable assistance in emergency situations without expecting compensation.
🔹 It encourages people to help victims without fear of being sued or arrested for unintentional harm.
✅ Applies in accidents, cardiac arrests, disasters, etc.
✅ Covers actions done in good faith (not for money)
✅ Applicable outside the hospital setting (e.g., roadside, public place)
✅ The rescuer must act within their scope of knowledge/training
✅ Does not protect gross negligence or harmful intent
🇮🇳 In India, Good Samaritan protection is provided under Supreme Court order for bystanders helping accident victims.
👮 Police, hospitals, and legal systems must not harass or delay those who help in good faith.
🔹 Ensure scene safety
🔹 Call emergency services (108 / ambulance)
🔹 Provide basic life-saving care (e.g., CPR)
🔹 Do not give invasive procedures unless trained
🔹 Stay until professional help arrives
🔹 Document if required (name, contact, time)
✅ Q: What is the Good Samaritan Law?
🅰️ A law that protects helpers from legal consequences when they assist someone in emergency without intent to harm.
✅ Q: Is Good Samaritan Law applicable in India?
🅰️ Yes, as per Supreme Court Guidelines (2016)
✅ Q: What does the Good Samaritan Law not protect?
🅰️ Gross negligence or harmful actions
✅ Q: What is the first step when acting as a Good Samaritan?
🅰️ Ensure scene safety and call emergency services
🛡️ “First, do no harm.” | 🏥 Safe care is quality care.
🗨️ Patient Safety is the prevention of errors and adverse effects associated with healthcare.
🗨️ Risk Management is the systematic identification, evaluation, and reduction of risks that threaten the safety of patients, staff, and the organization.
✅ Prevent medical errors and injuries
✅ Promote a culture of safety
✅ Improve health outcomes and patient satisfaction
✅ Minimize legal liability
✅ Encourage transparent reporting and learning
| ✅ Element | 📝 Description |
|---|---|
| 📋 Standard Protocols | Use of checklists, SOPs for procedures |
| 💊 Medication Safety | 10 Rights of medication administration |
| 🔄 Hand Hygiene | Prevent hospital-acquired infections (HAIs) |
| 🛏️ Fall Prevention | Side rails, call bells, patient assessment |
| ⚠️ Error Reporting | Incident reporting without blame |
| 🗣️ Clear Communication | SBAR format, team huddles, handoff safety |
| 🎓 Staff Training | Regular workshops on CPR, BLS, infection control |
| 💡 Patient Involvement | Educate patients about their care and risks |
🔹 Medication errors (dose, route, drug)
🔹 Patient falls and injuries
🔹 Surgical site infections
🔹 Pressure sores/bedsores
🔹 Wrong-patient/wrong-procedure errors
🔹 Use of faulty equipment
🔹 Miscommunication among team members
🗨️ Risk Management involves proactive efforts to detect, prevent, and manage potential hazards in healthcare delivery.
1️⃣ Risk Identification → Spotting unsafe practices or near misses
2️⃣ Risk Assessment → Evaluating severity and probability
3️⃣ Risk Control/Reduction → Creating policies and training
4️⃣ Risk Financing → Insurance, budgeting for safety
5️⃣ Risk Monitoring & Evaluation → Audits, feedback, reporting systems
| 🔧 Tool | 📖 Use |
|---|---|
| 📝 Incident Reports | Document safety events and near-misses |
| 📊 Root Cause Analysis (RCA) | Find the real cause of an adverse event |
| 🚦 Risk Matrix | Assess likelihood vs impact of a risk |
| 📣 Feedback Systems | Collect patient and staff concerns |
| 🗂️ Audit Tools | Evaluate compliance with standards |
👩⚕️ Frontline guardian of patient welfare
✅ Follow protocols & prevent errors
✅ Maintain clean & safe environment
✅ Encourage incident reporting
✅ Educate patients and families
✅ Collaborate with multidisciplinary teams
✅ Participate in risk assessment activities
✅ Q: What is patient safety?
🅰️ The prevention of errors and adverse effects in healthcare.
✅ Q: What is risk management in nursing?
🅰️ A process to identify, analyze, and reduce risks to patients.
✅ Q: Name one tool used to analyze causes of medical errors.
🅰️ Root Cause Analysis (RCA)
✅ Q: What is the first step in the risk management process?
🅰️ Risk Identification
✅ Q: How can nurses prevent falls in elderly patients?
🅰️ Use of side rails, non-slip footwear, and call bell accessibility.
💊 “Safety First: Right drug to the right patient, at the right time, in the right way.”
🛡️ Essential for preventing medication errors and ensuring patient safety.
🗨️ The 10 Rights of Medication Administration are evidence-based guidelines that nurses follow to ensure safe and accurate delivery of medications to patients, minimizing errors and adverse effects.
| 🆗 Right | ✅ Description |
|---|---|
| 1️⃣ Right Patient | Verify identity using name, ID band, photo, or DOB before administration. Use two identifiers. |
| 2️⃣ Right Medication | Check drug name, strength, and form three times (when taking out, preparing, and giving). Watch for look-alike/sound-alike drugs. |
| 3️⃣ Right Dose | Confirm correct dosage (mg, mL, units). Be extra cautious with pediatric or elderly doses. |
| 4️⃣ Right Route | Ensure correct route of administration – oral, IV, IM, subcutaneous, topical, etc. Never assume! |
| 5️⃣ Right Time | Administer at the prescribed time, with attention to frequency, food interactions, and time-critical drugs. |
| 6️⃣ Right Documentation | Record immediately after giving – include date, time, dose, route, and your signature. Never pre-document. |
| 7️⃣ Right Reason | Know the rationale behind giving the medication. Understand the indication and therapeutic effect. |
| 8️⃣ Right Response | Observe and evaluate the patient’s reaction to the drug. Report any side effects or lack of effect. |
| 9️⃣ Right Education | Teach the patient about what the drug is, why it is given, how to take it, and possible side effects. |
| 🔟 Right to Refuse | Patients have the right to refuse medication. Document and inform the physician as needed. Respect autonomy. |
✅ Always wash hands before and after medication handling
✅ Never leave medication unattended
✅ Use barcode systems if available
✅ Be alert for allergies, interactions, and contraindications
✅ Double-check high-alert medications (e.g., insulin, heparin) with another nurse
✅ Report and document any medication error immediately
✅ Q: How many rights are there in medication administration?
🅰️ Ten
✅ Q: What is the first right of medication administration?
🅰️ Right Patient
✅ Q: Why is the right documentation important?
🅰️ Provides legal proof and ensures continuity of care
✅ Q: What does the “Right to Refuse” mean?
🅰️ The patient can decline medication and must be respected.
✅ Q: What is the nurse’s role after giving a medication?
🅰️ Monitor and document the right response.
🧠 “The backbone of professional nursing practice.”
📚 A structured framework that defines nursing concepts, actions, and patient care.
🗨️ A nursing theory is a set of organized concepts, definitions, relationships, and assumptions that explain, describe, predict, or prescribe nursing care.
🔹 It provides scientific reasoning and guidance to nurses for decision-making and clinical actions.
✅ Guide nursing assessment, interventions, and evaluation
✅ Define roles and goals of nursing care
✅ Improve patient outcomes through structured care
✅ Promote research and evidence-based practice
✅ Establish nursing as a distinct profession
| ⭐ Feature | 💬 Explanation |
|---|---|
| 📐 Systematic | Follows a logical and structured format |
| 🧭 Predictive | Can foresee likely outcomes of care |
| 🧠 Conceptual | Based on clear concepts and definitions |
| 📚 Applicable | Useful in real-life nursing settings |
| 🌍 Culturally Sensitive | Adaptable across diverse populations |
| 🧱 Type | 💡 Focus |
|---|---|
| 🧩 Grand Theory | Broad, abstract concepts (e.g., Roy’s Adaptation Theory) |
| 🔧 Middle-Range Theory | More specific, applicable to practice (e.g., Kolcaba’s Comfort Theory) |
| 🩺 Practice-Level Theory | Directly guides daily care (e.g., Pain Management Theory) |
| 👩⚕️ Theorist | 📘 Theory | 🌟 Focus |
|---|---|---|
| 🕯️ Florence Nightingale | Environmental Theory | Cleanliness, light, ventilation |
| 👩🏫 Virginia Henderson | Need Theory | 14 basic needs of patients |
| 👩🔬 Dorothea Orem | Self-Care Deficit Theory | Supporting patient independence |
| 👩❤️👩 Hildegard Peplau | Interpersonal Relations Theory | Nurse-patient therapeutic relationship |
| 🧘 Jean Watson | Theory of Human Caring | Caring as the essence of nursing |
| 🧠 Sister Callista Roy | Adaptation Model | Helping patient adapt to changes |
| 🌎 Madeleine Leininger | Transcultural Nursing Theory | Culturally competent care |
| 🧪 Martha Rogers | Unitary Human Beings Theory | Human energy fields and environment |
| 🔍 Component | 📝 Description |
|---|---|
| 📘 Concepts | Building blocks of the theory (e.g., care, health, person) |
| 🔄 Definitions | Meaning of each concept |
| 🔗 Relationships | How concepts are connected |
| 📐 Assumptions | Accepted truths used to form the theory |
✅ In Practice – Guides assessments, interventions, and outcomes
✅ In Education – Curriculum development and teaching
✅ In Research – Forms basis for evidence generation
✅ In Administration – Supports policy and protocol development
✅ Q: What is a nursing theory?
🅰️ A set of concepts that explain or guide nursing care.
✅ Q: Who is the founder of Environmental Theory?
🅰️ Florence Nightingale
✅ Q: Which theory focuses on patient self-care?
🅰️ Dorothea Orem’s Self-Care Deficit Theory
✅ Q: What does Leininger’s theory emphasize?
🅰️ Cultural care and competence
✅ Q: Name one middle-range theory.
🅰️ Kolcaba’s Comfort Theory
📚 “Different levels of theory guide different levels of care.”
🧠 Nursing theories can be classified based on their scope, function, and abstraction level.
🗨️ Classification of nursing theories refers to the categorization of theories based on their breadth of focus, applicability, and degree of abstraction, helping nurses choose the right theory for clinical, educational, or research settings.
🧠 Highly abstract and broad in scope
✅ Provide a comprehensive view of nursing practice
✅ Useful in curriculum design, philosophy of care
| 👩⚕️ Theorist | 📘 Theory |
|---|---|
| Florence Nightingale | Environmental Theory |
| Dorothea Orem | Self-Care Deficit Theory |
| Callista Roy | Adaptation Model |
| Martha Rogers | Unitary Human Beings |
| Jean Watson | Theory of Human Caring |
🎯 Moderate level of abstraction
✅ More specific than grand theories
✅ Directly applicable to practice and research
| 👩⚕️ Theorist | 📘 Theory |
|---|---|
| Madeleine Leininger | Transcultural Nursing Theory |
| Katharine Kolcaba | Comfort Theory |
| Nola Pender | Health Promotion Model |
| Patricia Benner | Novice to Expert Theory |
🩺 Very specific and situation-based
✅ Guide direct nursing interventions
✅ Help in clinical decision-making
| 👩⚕️ Example | 🩹 Focus |
|---|---|
| Pain Management Theory | Pain relief in post-op care |
| Wound Care Protocol Models | Healing stages, dressing techniques |
| CPR Guidelines | Emergency nursing actions |
| 🎯 Type | 💬 Purpose |
|---|---|
| Descriptive Theories | Describe phenomena (e.g., Jean Watson’s theory of caring) |
| Explanatory Theories | Explain relationships (e.g., Orem’s theory explains self-care need and support) |
| Predictive Theories | Predict outcomes (e.g., Roy’s model predicts adaptation) |
| Prescriptive Theories | Guide actions/interventions (e.g., Benner’s theory on skill acquisition) |
| 📚 Type | 🧠 Abstraction | 🏥 Use |
|---|---|---|
| Grand | High | Philosophy, curriculum |
| Middle-Range | Moderate | Practice, research |
| Practice-Level | Low | Bedside care |
| Descriptive/Explanatory | Variable | Understanding phenomena |
| Prescriptive | Action-based | Guiding practice |
✅ Q: Which type of theory is most abstract?
🅰️ Grand Theory
✅ Q: Which theory helps in direct patient care decisions?
🅰️ Practice-Level Theory
✅ Q: Leininger’s Transcultural Theory is an example of?
🅰️ Middle-Range Theory
✅ Q: Orem’s theory is classified under which type?
🅰️ Grand Theory
✅ Q: Which theory type predicts nursing outcomes?
🅰️ Predictive Theory
📚 “The foundation of all nursing theories.”
🧠 A set of global concepts that define the discipline of nursing.
🗨️ A metaparadigm is the broadest perspective of a discipline.
🩺 In nursing, the nursing metaparadigm includes the core concepts that all nursing theories are built upon.
🔹 The four major concepts of the nursing metaparadigm are:
1️⃣ Person, 2️⃣ Health, 3️⃣ Environment, 4️⃣ Nursing
👤 The receiver of care — individual, family, or community
🔹 Viewed as a unique being with physical, emotional, social, spiritual, and cultural needs
🔹 Central focus of all nursing care
🔹 Seen as dynamic, adaptive, and holistic
🔍 Example: A nurse considers the patient’s beliefs and lifestyle before planning care.
💓 A dynamic state of well-being across a wellness-illness continuum
🔹 Defined not just by absence of disease, but also by mental, emotional, and social well-being
🔹 Each theory interprets health differently — some see it as harmony, others as functional ability
🔍 Example: Watson’s theory views health as unity and harmony within mind-body-spirit.
🌍 All internal and external factors affecting the patient
🔹 Includes physical, social, cultural, economic, spiritual, and psychological environment
🔹 Environment shapes health and influences recovery
🔍 Example: Nightingale emphasized clean air, light, water, hygiene, and surroundings.
👩⚕️ The actions and interventions provided by the nurse
🔹 Includes assessment, planning, implementation, and evaluation
🔹 Focused on caring, promoting health, preventing illness, and supporting recovery
🔍 Example: Orem defined nursing as helping individuals meet self-care needs.
🌐 These four form the unifying framework of all nursing theories and practices.
✅ Q: How many concepts are included in the nursing metaparadigm?
🅰️ Four
✅ Q: Who is the focus in the nursing metaparadigm?
🅰️ Person (Patient/Client)
✅ Q: What does the concept ‘environment’ include in nursing?
🅰️ All internal and external factors affecting the patient
✅ Q: According to the metaparadigm, what is health?
🅰️ A dynamic state of well-being across physical, mental, social domains
✅ Q: What is the role of ‘nursing’ in the metaparadigm?
🅰️ To provide care that promotes health and recovery
🧠 “All models are based on theories, but not all theories are models.”
📚 Both guide nursing practice, but differ in scope, structure, and application.
🟢 Nursing Theory:
🗨️ A set of concepts, definitions, and propositions that explain, predict, or prescribe nursing care in a logical framework.
🔹 Provides scientific basis and reasoning for nursing actions.
🔵 Nursing Model:
🗨️ A representation or framework derived from a theory that shows how theoretical concepts are applied in real nursing practice.
🔹 Provides visual or structural guidance for clinical application.
| 📌 Feature | 🟢 Nursing Theory | 🔵 Nursing Model |
|---|---|---|
| 🎯 Purpose | Explains or predicts nursing phenomena | Applies theory into nursing framework |
| 🔬 Scope | Broader and more abstract | More focused and practice-oriented |
| 🏗️ Structure | Conceptual and logical | Structural or diagrammatic |
| 🧠 Focus | Describes why and how nurses care | Describes what, when, and how to do |
| 📚 Example | Orem’s Self-Care Deficit Theory | Roy’s Adaptation Model |
| 🛠️ Application | Research, education, theoretical base | Clinical practice, care planning |
| 👩⚕️ Theorist | 📘 Theory |
|---|---|
| Dorothea Orem | Self-Care Deficit Theory |
| Jean Watson | Human Caring Theory |
| Hildegard Peplau | Interpersonal Relations Theory |
| 👩⚕️ Theorist | 🏗️ Model |
|---|---|
| Callista Roy | Adaptation Model |
| Florence Nightingale | Environmental Model |
| Neuman | Systems Model |
| Roper-Logan-Tierney | Model of Living |
🧠 Theory provides the intellectual and philosophical foundation
🏗️ Model offers a practical framework for applying theory
📌 Example:
🔹 Orem’s theory explains why a patient needs self-care support
🔹 Roy’s model helps how to assess and plan care based on patient adaptation
✅ Q: What is the main difference between a nursing theory and model?
🅰️ Theory explains concepts; model applies them in practice.
✅ Q: Which is more abstract — theory or model?
🅰️ Theory
✅ Q: Give one example of a nursing model.
🅰️ Roy’s Adaptation Model
✅ Q: Give one example of a nursing theory.
🅰️ Watson’s Theory of Caring
✅ Q: What do nursing models derive from?
🅰️ Nursing theories
| 👩⚕️ Theorist | 📅 Year | 📘 Name of Theory |
|---|---|---|
| 🕯️ Florence Nightingale | 1859 | Environmental Theory |
| 👩🏫 Virginia Henderson | 1966 | Need Theory (14 Basic Needs) |
| 🧠 Dorothea Orem | 1971 | Self-Care Deficit Nursing Theory |
| 👩❤️👩 Hildegard Peplau | 1952 | Interpersonal Relations Theory |
| 🧘 Jean Watson | 1979 | Theory of Human Caring |
| 👩🔬 Martha Rogers | 1970 | Science of Unitary Human Beings |
| 🧍 Callista Roy | 1976 | Adaptation Model |
| 🌍 Madeleine Leininger | 1978 | Transcultural Nursing Theory |
| 🧪 Imogene King | 1981 | Goal Attainment Theory |
| 🩺 Betty Neuman | 1972 | Systems Model |
| 💫 Patricia Benner | 1984 | Novice to Expert Theory |
| 📈 Nola Pender | 1982 | Health Promotion Model |
| 💖 Katharine Kolcaba | 1994 | Comfort Theory |
| 🧍♂️ Faye Abdellah | 1960 | 21 Nursing Problems Theory |
| ⚖️ Ida Jean Orlando | 1961 | Deliberative Nursing Process Theory |
| 🧍♀️ Ernestine Wiedenbach | 1964 | The Helping Art of Clinical Nursing |
| 👩🏫 Lydia Hall | 1962 | Core, Care, Cure Model |
🟢 “People Often Help Others Just Right”
🔹 Peplau, Orem, Henderson, Orlando, Roy
🟣 “Watson Cares, Leininger Cultures, Rogers Unites”
🔹 Watson (Caring), Leininger (Culture), Rogers (Unitary)
| 🏥 Practice Setting | 📝 Application |
|---|---|
| Post-operative care, wards, ICUs | Maintain cleanliness, ventilation, lighting, warmth, quiet environment to promote healing |
✅ Example: Keeping a surgical ward well-lit, sanitized, and noise-free to promote faster recovery.
| 🏠 Practice Setting | 📝 Application |
|---|---|
| Home care, long-term care | Assist patients in performing 14 basic needs until independence is regained |
✅ Example: Helping a stroke patient with feeding, hygiene, and mobility until they can do it themselves.
| 🩺 Practice Setting | 📝 Application |
|---|---|
| Rehabilitation, geriatrics, chronic illness | Assess patient’s self-care ability; provide support when needed |
✅ Example: Teaching a diabetic patient to administer insulin and monitor blood glucose.
| 🧠 Practice Setting | 📝 Application |
|---|---|
| Psychiatric nursing, counseling, palliative care | Focus on nurse-patient relationship — orientation, working, and termination phases |
✅ Example: Building trust with a psychiatric patient to encourage medication adherence.
| 💖 Practice Setting | 📝 Application |
|---|---|
| Oncology, hospice, spiritual care | Use caring behaviors, presence, therapeutic touch, and emotional support |
✅ Example: Holding a dying patient’s hand, listening with empathy, and ensuring comfort.
| 🏥 Practice Setting | 📝 Application |
|---|---|
| ICU, trauma care, rehabilitation | Assess how a patient adapts to illness/stress and support adaptive behavior |
✅ Example: Supporting emotional and physical adjustment in an amputee patient.
| 🌐 Practice Setting | 📝 Application |
|---|---|
| Multicultural areas, rural/tribal health, global health programs | Provide culturally competent care respecting beliefs and rituals |
✅ Example: Accommodating dietary practices and prayer times for a Muslim patient.
| 🫂 Practice Setting | 📝 Application |
|---|---|
| Medical-surgical units, outpatient clinics | Set mutual goals between nurse and patient for better outcomes |
✅ Example: Collaborating with a hypertensive patient to set lifestyle and medication goals.
| 🏃 Practice Setting | 📝 Application |
|---|---|
| Community health, health education | Focus on preventive care, lifestyle change, and wellness promotion |
✅ Example: Educating teens on healthy eating and physical activity to prevent obesity.
| 🛏️ Practice Setting | 📝 Application |
|---|---|
| Palliative care, postoperative units | Promote physical, emotional, social, and spiritual comfort |
✅ Example: Giving warm blankets, pain relief, and spiritual counseling to a cancer patient.
✅ Q: Which theory focuses on self-care needs in chronically ill patients?
🅰️ Dorothea Orem’s Self-Care Deficit Theory
✅ Q: Which theory is best applied in psychiatric nursing?
🅰️ Peplau’s Interpersonal Relations Theory
✅ Q: Which theory supports culturally sensitive care?
🅰️ Leininger’s Transcultural Nursing Theory
✅ Q: Watson’s theory emphasizes what core principle?
🅰️ Caring is central to nursing
✅ Q: Which model supports helping patients adapt to illness or change?
🅰️ Roy’s Adaptation Model