Nursing Mission & Philosophy

Mission of Columbia Basin College

Nursing Program

Philosophy of Education
We believe education is a continuing process requiring involvement of the total individual. Education is enhanced by building upon earlier learning/life experiences, and is proportionate to the degree of active individual involvement. Learning is evidenced by behavioral changes. Optimum development of potential is dependent upon achieving program outcomes. Learning is facilitated when experiences occur on a continuum of simple to complex and within a framework that allows career mobility and continuing education.

Philosophy of Nursing
Nursing is interpreted as a service to mankind in fulfillment of basic human needs. This includes health education; prevention and treatment of disease; rehabilitation of the recovering individual; and support of the dying. The individual is viewed as a member of a family and of a community, all of whom are concerned with preservation and restoration of health or achieving a peaceful death. We believe that the individual exists in a dynamic equilibrium with the environment. We believe that individuals influence, and are influenced by, the internal and external forces that surround them. We believe that each individual regardless of age, gender, race, creed, or ethnic background, has as an inherent right to comfort, dignity, and autonomy in healthcare decisions. To achieve these rights, nursing care should be directed toward assisting the patient to make informed choices. This holistic approach is implemented through the use of the nursing process and appreciation of scientific and social principles.

We believe nursing education is an integration of the philosophies of education and nursing, correlated with concepts from the humanities, social sciences, and life sciences. There are multiple roles and practice levels for beginning practitioners, each with identifiable competencies. The primary objective of nursing education is the preparation of safe, competent graduates that function as professionals in multiple roles and practice levels while fulfilling their educational and professional goals.

The CBC Nursing program exists to:

1. Offer a high quality PN/ADN program preparing graduates for entry-level nursing;
2. Be responsive to the current and projected healthcare needs of the residents of south central Washington state;
3. Offer excellence in nursing education by providing students with a dynamic curriculum, and state-of-the art equipment and facilities;
4. Prepare students for differing levels of nursing practice using a career ladder nursing curriculum.
5. Provide the means for students to transfer to a baccalaureate nursing program;
6. Develop and maintain partnerships with local health care agencies to facilitate student learning and work-force development;
7. Promote racial, ethnic, cultural, and gender diversity among the nursing faculty, staff, and students.
8. Promote and support faculty development and excellence.

Conceptual Framework
The statements included in the conceptual framework are representative of the values, beliefs, and practices of the Columbia Basin College Nursing program. The nursing faculty developed this framework to form the basis for the selection of theory content, practical experiences, levels of learning, and curriculum evaluation.

Four major concepts were determined by the faculty to define nursing. These concepts include individual, health, nursing, and environment. Learning objectives are organized on a continuum from simple to complex so that new information presented builds on previous learning experiences. The curriculum incorporates a holistic approach to the health-illness continuum encompassing the human life span. Using a career ladder approach, the curriculum design allows the learner to accomplish individual goals.

Definition of Major Concepts

Major Concept: Individual
An individual is viewed as a holistic being interacting with the environment. Human functioning occurs developmentally through the lifetime in physiological, psychological, social, cultural, and spiritual dimensions. An individual is viewed as a member of a family and community all of whom are concerned with the preservation and restoration of health or achieving a peaceful death.

The application of the concept individual is reflected in the focus of course content on the individual as part of a family and part of a community. Physiological systems provide organization for much of the course content; however, other aspects of the individual such as psychological, social, cultural, and spiritual are included in each course as applicable.

Major Concept: Health
The physical, social, and mental health of individuals changes throughout the lifespan. The Nursing program presents various theories of health and wellness, but accepts and supports the individuals own perception of health and wellness. Health and illness may be viewed as a state of being that can be located on a wellness-illness continuum. The concept of health also includes the subconcepts of health education, prevention and treatment, rehabilitation and restoration, and support for the dying. Each of these subconcepts is described below:

• Health Education: Health education is defined as the identification of health-related learning needs and the development and implementation of teaching strategies for common health problems of individuals and/or groups.
• Prevention and Treatment: Health prevention and treatment is achieved through specific activities by the client and the healthcare team that prevents or reduces the risk of illness, screen for early identification, and provide for prompt treatment.
• Rehabilitation and Restoration: Rehabilitation and restoration is the science and art of alleviating actual or potential responses to illness.
• Support of the Dying: Support of the dying involves assisting the client to achieve a peaceful and dignified death.

In relation to health, beginning nursing students focus on individuals and families whose needs relate to basic health maintenance. As students' understanding of nursing concepts develops and clinical skills are acquired, they are prepared to care for patients whose health needs are more acute and complex. By the completion of the nursing program, students are able to identify the complex healthcare needs of individuals, families, groups, and communities and subsequently plan, implement, and evaluate appropriate care, including health teaching.

Major Concept: Nursing

Nursing is a professional service to man, an interpersonal-caring process, a technological entity (scientific methods and techniques), and a scientific process (the nursing process) which demands specific actions. The goals of nursing are directed towards illness prevention, treatment, rehabilitation, and maintenance of an optimal state of health as well as supporting death with dignity. Subconcepts of nursing include the nursing process, critical thinking, legal and ethical principles, leadership and delegation, career mobility, and education articulation.

• Nursing Process: The scientific process of nursing involves the application of research-based knowledge to the assessment of client needs, planning, implementation, evaluation of client outcomes, and of one's own practice. Under the concept of nursing, students show a progressive competence in use of the nursing process. Application of the nursing process is evident by the end of the first three quarters in the Nursing program. By this time, the student is able to complete a basic nursing care plan for clients with common alterations in health. During the last three quarters of the program, the student has increased knowledge in the application of the nursing process in acute and complex situations.
• Critical Thinking: Scheffer and Rubenfeld’s (2000) description of critical thinking has been adopted by the faculty: “Critical thinking in nursing is an essential component of professional accountability and quality nursing care. Critical thinkers in nursing exhibit these habits of mind: confidence, contextual perspective, creativity, flexibility, inquisitiveness, intellectual integrity, intuition, open-mindedness, perseverance, and reflection. Critical thinkers in nursing practice the cognitive skills of: analyzing, applying standards, discriminating, information seeking, logical reasoning, predicting, and transforming knowledge.” (Scheffer, B.K. & Rubenfeld, M.G. (2000). A consensus statement on critical thinking in nursing. Journal of Nursing Education, 39(8), 352-359.) Critical thinking skills are introduced to first year students in clinical and didactic classes using a variety of methods, including discussion, problem- solving exercises, and case study analysis. Throughout the Nursing program, critical thinking skills are emphasized through continued use of the nursing process. Students in the second year are expected to refine their use of problem-solving skills and demonstrate increasing independence.
• Legal and Ethical Principles: Ethical principles reflect the direct, focused interest in positive human values and their meaning. These principles act to promote an interest in making human values more effective through moral choices. A nursing professional is responsible and accountable for his or her actions and judgments. Professional nurses are knowledgeable of nursing standards of care, perform within their legal scope of practice, and demonstrate responsibility for their own learning. First year students are introduced to ethical and legal issues in theory and clinical courses. Professional roles in healthcare, nursing standards of care, and development of the practical and registered nurse roles are emphasized.
• Leadership and Delegation: Leadership in nursing is the process of directing the activities of others through appropriate guidance, teaching, and motivation. Delegation is the transfer of performance of selected nursing tasks in selected circumstances to competent individuals. The nurse delegating such tasks retains responsibility and accountability for the nursing care of the client. Nursing students are introduced to the roles and responsibilities of the Practical and Registered Nurse, including team leading, delegation, and leadership. Emphasis is placed on collaboration as a member of the healthcare team, with increasing autonomy and decision-making.
• Career Mobility: Four levels of practice are incorporated into the career ladder at Columbia Basin College; nursing assistant, nursing technician, practical nurse graduate, and associate degree graduate. Each is unique, and has an identifiable practice level as outlined by The Law Relating to Nursing Care and Regulation of Health Professions – Uniform Disciplinary Act.
• Education Articulation: Upon completion of the AAS degree, opportunity exists for career development through cooperation between Columbia Basin College and other institutions of higher education that provide baccalaureate outreach opportunities.

Major Concept: Environment
Environment is defined as conditions and circumstances surrounding an individual that freely influence, and are influenced by, the individual. The environment consists of both internal and external forces that exist in a state of dynamic equilibrium. When changes in the environment occur, the individual manifests coping skills in order to re-establish equilibrium. Subconcepts of environment include internal and external forces, as described below:

• Internal force: Internal forces are defined as those factors that influence an individual’s interpersonal make-up, and include physiologic, psycho logic, sociologic, cultural, spiritual, and developmental components.
• External forces: External forces are defined as those factors that influence an individual’s extra personal existence, and include such entities as education, financial status, employment, and relationships with family, friends, acquaintances, and caretakers. The concept of environment is included as an integral portion of students’ theory and clinical education in holistic nursing care. Students are required to complete a nursing health history and physical examination on their clients that incorporates an evaluation of internal and external forces. Students utilize information gathered from this database to formulate a plan of care for the client.

Conceptual Framework Threads

The nursing curriculum at Columbia Basin College integrates four conceptual framework threads throughout the program. These threads include growth and development according to Erikson’s Eight Stages of Life, Maslow’s Hierarchy of Needs, pharmacology, and nutrition. Nutrition is included as a thread since a separate nutrition course is not required for the Nursing program. These components are integrated into learning units as appropriate. Each thread is briefly explained below:

• Growth and Development according to Erikson’s Eight Stages of Life: Erikson’s Eight Stages of Life are the theoretical framework utilized in the instruction of normal growth and development through the life span. Erikson’s stages are the basis for individualizing the nursing process.
• Maslow’s Hierarchy of Needs: Maslow's Hierarchy of Needs is the theoretical framework utilized for designating priorities of care. It is the foundation for nursing decision-making and care planning. This Hierarchy is incorporated into theory content, problem-solving plans, and clinical decision-making.
• Pharmacology: Instruction in pharmacological principles is included in the Nursing program’s theory and clinical courses. Knowledge of pharmacokinetics and pharmacodynamics, accurate dosage calculation, safe administration techniques, assessment of individual response to medications, and client teaching needs is required by students.
• Nutrition: Concepts of nutrition and diet therapy are incorporated into the care of clients of all ages throughout the health/illness continuum.