Preparation for the Baccalaureate Generalist Nurse Roles: Components of The Essentials
This section outlines the nine Essentials of Baccalaureate Education for Professional Nursing Practice. These Essentials are the curricular elements that provide the framework for baccalaureate nursing education. Each Essential is operationalized through the program’s curriculum and is not intended to represent a course. Essential IX describes baccalaureate nursing practice and integrates the knowledge, skills, and attitudes from Essentials IVIII. Each Essential includes a rationale explaining its relevance for the education of the professional nurse today and in the future. The rationale for each Essential is followed by outcomes that delineate the knowledge, skills, and attitudes expected of new baccalaureate generalist graduates. These outcomes serve as a guide to help faculty identify program and course objectives that are specific and measurable. Next, sample content is listed to aid faculty in selecting material suited to achieving the specific Essential. The list of content is not inclusive, nor is it intended as required. A vast selection of content is available for each Essential, and the specific baccalaureate program’s curriculum will specify the content as appropriate to their mission, community served, and student population. The Essential outcomes can be obtained through a variety of content approaches, and potential content can and will evolve over time as new knowledge develops. The sample content is offered as a guide to programs or to further elucidate the nature of the Essential with which the content is listed.
The Essentials of Baccalaureate Education for Professional Nursing Practice
Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice
Rationale
As defined by the Association of American Colleges and Universities (AAC&U), a liberal education is one that intentionally fosters, across multiple fields of study, wide ranging knowledge of science, cultures, and society; highlevel intellectual and practical skills; an active commitment to personal and social responsibility; and the demonstrated ability to apply learning to complex problems and challenges (AAC&U, 2007, p. 4). For the purposes of this document, a liberal education includes both the sciences and the arts. The sciences include:
• physical sciences (e.g., physics and chemistry), • life sciences (e.g., biology and genetics), • mathematical sciences, and • social sciences (e.g., psychology and sociology).
The arts include: • fine arts (e.g., painting and sculpture), • performing arts (e.g., dance and music), and • humanities (e.g., literature and theology).
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Liberal education is critical to the generation of responsible citizens in a global society. In addition, liberal education is needed for the development of intellectual and innovative capacities for current and emergent generalist nursing practice. Liberally educated nurses work within a healthcare team to address issues important to the profession of nursing, question dominant assumptions, and solve complex problems related to individuals and populationbased health care. Nursing graduates with a liberal education exercise appropriate clinical judgment, understand the reasoning behind policies and standards, and accept responsibility for continued development of self and the discipline of nursing.
A solid base in liberal education provides the distinguishing cornerstone for the study and practice of professional nursing. Studying the humanities, social sciences, and natural sciences expands the learner’s capacity to engage in socially valued work and civic leadership in society. A strong foundation in liberal arts includes a general education curriculum that provides broad exposure to multiple disciplines and ways of knowing. Other than the nursing major, some aspects of liberal arts study will be provided as discrete parts of the full educational curriculum; however the rich and diverse perspectives and knowledge embedded in the liberal arts and sciences will be integrated throughout the nursing curriculum, as these perspectives are integral to the full spectrum of professional nursing practice (Hermann, 2004).
Successful integration of liberal education and nursing education provides graduates with knowledge of human cultures, including spiritual beliefs, and the physical and natural worlds supporting an inclusive approach to practice. The study of history, fine arts, literature, and languages are important building blocks for developing cultural competence and clinical reasoning. Furthermore, the integration of concepts from behavioral, biological, and natural sciences throughout the nursing curriculum promotes the understanding of self and others and contributes to safe, quality care. The integration of concepts from the arts and sciences provides the foundation for understanding health as well as disease processes, and forms the basis for clinical reasoning. As noted by the Carnegie Foundation for the Advancement of Teaching, the sciences are a critical aspect of liberal education for nurses. Sciences that have clinical relevance are especially important to the profession of nursing to ensure that graduates have the ability to keep pace with changes driven by research and new technologies (Carnegie Foundation, in press).
A liberal education for nurses forms the basis for intellectual and practical abilities for nursing practice as well as for engagement with the larger community, both locally and globally. Skills of inquiry, analysis, critical thinking, and communication in a variety of modes, including the written and spoken word, prepare baccalaureate graduates to involve others in the common good through use of information technologies, team work, and interprofessional problem solving. Liberal education, including the study of a second language, facilitates the development of an appreciation for cultural and ethnic diversity.
Strong emphasis on the development of a personal values system that includes the capacity to make and act upon ethical judgments is a hallmark of liberal education. Students educated in a liberal education environment are encouraged to pursue
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meaningful personal and professional goals as well as to commit to honesty in relationships and the search for truth. The development of leadership skills and acceptance of responsibility to promote social justice are expected outcomes of a liberal education.
Liberal education allows the graduate to form the values and standards needed to address twentyfirst century changes in technology, demographics, and economics. These trends include an aging population, diverse family and community structures, and increasing global interdependence, as well as economic and political changes in the United States healthcare system. Liberal education provides the baccalaureate graduate with the ability to integrate knowledge, skills, and values from the arts and sciences to provide humanistic, safe quality care; to act as advocates for individuals, families, groups, communities, and/or populations; and to promote social justice. Liberally educated graduates practice from a foundation of professional values and standards.
The baccalaureate program prepares the graduate to:
1. Integrate theories and concepts from liberal education into nursing practice.
2. Synthesize theories and concepts from liberal education to build an understanding of the human experience.
3. Use skills of inquiry, analysis, and information literacy to address practice issues.
4. Use written, verbal, nonverbal, and emerging technology methods to communicate effectively.
5. Apply knowledge of social and cultural factors to the care of diverse populations.
6. Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen.
7. Integrate the knowledge and methods of a variety of disciplines to inform decision making.
8. Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system.
9. Value the ideal of lifelong learning to support excellence in nursing practice.
Sample Content
• selected concepts and ways of knowing from the sciences • selected concepts and ways of knowing from the arts • principles related to working with peoples from diverse cultures
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• concepts related to intellectual diversity, tolerance, and social justice • concepts related to globalization and migration of populations
Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety
Rationale
Organizational and systems leadership, quality improvement, and safety are critical to promoting high quality patient care. Leadership skills are needed that emphasize ethical and critical decisionmaking, initiating and maintaining effective working relationships, using mutually respectful communication and collaboration within interprofessional teams, care coordination, delegation, and developing conflict resolution strategies. Basic nursing leadership includes an awareness of complex systems, and the impact of power, politics, policy, and regulatory guidelines on these systems. To be effective, baccalaureate graduates must be able to practice at the microsystem level within an ever changing healthcare system. This practice requires creativity and effective leadership and communication skills to work productively within interprofessional teams in various healthcare settings.
As a member of a healthcare team, baccalaureate graduates will understand and use quality improvement concepts, processes, and outcome measures. In addition, graduates will be able to assist or initiate basic quality and safety investigations; assist in the development of quality improvement action plans; and assist in monitoring the results of these action plans within the clinical microsystem, which is embedded within a larger system of care.
An important component of quality is safety. Safety in health care is defined as the minimization of “risk of harm to patients and providers through both system effectiveness and individual performance” (Cronenwett et al., 2007). Research has demonstrated that nurses more than any other healthcare professional are able to recognize, interrupt, evaluate, and correct healthcare errors (Rothschild et al., 2006) The baccalaureate graduate implements safety principles and works with others on the interprofessional healthcare team to create a safe, caring environment for care delivery.
Baccalaureate graduates will be skilled in working within organizational and community arenas and in the actual provision of care by themselves and/or supervising care provided by other licensed and nonlicensed assistive personnel. They will be able to recognize safety and quality concerns and apply evidencebased knowledge from the nursing profession and other clinical sciences to their practice. Baccalaureate nursing graduates are distinguished by their abilities to identify, assess, and evaluate practice in care delivery models that are based in contemporary nursing science and are feasible within current cultural, economic, organizational, and political perspectives.