Purpose
The Associate Degree Nursing (ADN) faculty supports
the mission, values and goals of Rowan-Cabarrus
Community College (RCCC) which seeks to provide
excellence in education while promoting personal
development, accountability and life long learning. The
ADN program is designed to prepare students for
entry-level positions as registered nurses. Graduates
of this program are eligible to apply to take the
National Council Licensure Examination (NCLEX-RN),
which is required for practice as a registered
nurse.
Client
The faculty views clients across the lifespan as recipients
of nursing care, whether as an individual, family,
or community. The client is comprised of physiological,
psychosocial, developmental, sociocultural, and spiritual
needs, which are constantly changing within the environment. Clients
attain or maintain health by adapting to environmental
and developmental changes.
Society
The faculty believes that the client’s larger
environment is society, the total environment in which
they function. Society is viewed as human beings
living in groups who behave and function in ways that
are unique to their community, ethnic, cultural, spiritual,
socioeconomic, and psychosocial conditions.
Health
Health is a dynamic state that progresses from birth
to death, and describes an individual’s complete
physical, mental, social, and spiritual well-being. Health
is best perceived on a continuum, which encompasses
high-level wellness on one end and extreme illness
and/or death on the other end.
Nursing and Nursing Practice
Nursing is, as defined by the American Nurses’ Association, “the
diagnoses and treatment of human responses to actual
or potential health problems”. Nursing
is both an art and a science. The art of nursing
involves intuition, creativity, caring, and application
of nursing therapeutics, communication skills, and
compassionate interpersonal processes. The science
of nursing involves principles derived from biological,
social, and behavioral sciences through critical thinking
and logical exploration. Contemporary nursing practice
merges the art and science of nursing, and collaboration
with the health care interdisciplinary team. The
nurse, interdisciplinary team, and the client determine
a client centered plan of care. The
integration of research, clinical expertise, and client
values promote optimal client care using evidence-based
practices. Together the art and science of nursing
provide insights for the nurse in the performance of
caring behaviors contributing to health, recovery,
or peaceful death.
Nursing practice involves both accountable and ethical
professional behaviors as directed by the North Carolina
Nurse Practice Act. The practice of nursing represents
all the actions performed in the delivery of nursing
care encompassing both direct and indirect client care. Indirect
nursing practice involves registered nurses engaged
in roles such as educators, administrators, researchers,
consultants and journalists. Such roles facilitate
and support nursing practice through the provision
of services and advancement of nursing knowledge.
Nursing Process
The nursing process is a problem-solving and clinical
decision making approach to the identification of
client needs and the utilization of nursing interventions
designed to promote, maintain, or restore health
status. The desired outcome of the nursing
process is client-centered competent care, which
involves clients in decision-making and care management. A
component of the nursing process involves critical
thinking. Critical thinking challenges the
registered nurse to interpret and evaluate information
in order to derive judgments necessary for safe,
effective nursing care. The major components of the
nursing process are assessment, diagnosis, planning,
implementation, and evaluation.
Practice of the Associate Degree Nurse
The associate degree nurse practices in a variety of
health care settings where policies and
procedures are specified and guidance is available.
The associate degree nurse functions in three roles: provider
of care, manager of care and member of the discipline.
Within these roles, the associate degree nurse plans
and implements individualized care for clients from
diverse and multicultural populations. The
three roles of the associate degree nurse, nursing
process, and client needs form the organizing framework
for the nursing curriculum at RCCC.
The faculty has identified eight essential behaviors/competencies
for contemporary nursing practice which reflect the
Council of Associate Degree Nursing Competencies Task
Force (2000) Educational Competencies for Graduates
of Associate Degree Nursing Programs. The eight essential
behaviors/competencies are: professional behaviors;
communication; assessment/nursing process; clinical
decision making; caring interventions; teaching and
learning; collaboration; and managing care. The competencies
are the integrating concepts of the curriculum and
are performed within the roles of the associate degree
nurse. The associate degree nurse demonstrates competencies,
skills, ethical, and accountable behaviors to fulfill
the needs of society.
Sub-concepts which add depth of meaning to the nursing
courses are dispersed throughout the curriculum as
applicable to course content. The identified
curriculum sub-concepts included (but not limited to)
are the following: community; health promotion;
health care delivery systems; trends; therapeutic interventions;
critical thinking; cultural
awareness/competence; evidence based practice; ethics/values/
accountability; legal issues; standards of care; technology;
informatics; quality improvement; interdisciplinary
care; client-centered competent care; coordination
of care; leadership, supervision and delegation of
others; and life long learning.
The associate degree nurse is a member of the interdisciplinary
health care team, works within a democratic work environment,
and participates in goal directed behaviors. As
a member of the health care interdisciplinary team,
the associate degree nurse provides leadership in coordination
and management of continuous, client centered culturally
competent client care through cooperation, communication,
and collaboration.
The associate degree nurse supports quality improvement
processes to measure client outcomes, identify hazards
and errors, and develop changes in the processes of
client care. Evidence base practices are used
to promote optimal client care. Informatics is used
to communicate, manage knowledge, mitigate error, and
support decision- making.
Nursing Education
The faculty believes that nurses should be educated
to deliver patient-centered care as members of an
interdisciplinary team, emphasizing evidence-based
practice, quality improvement approaches, and informatics. Nursing
education is dynamic and responds to current and
future needs of people in a changing health care
delivery system. Nursing education consists
of basic preparation and continuing education. Basic
education prepares graduates who are eligible to
take the national licensure examination for registered
nurses. Continuing education enhances nurses’ health
related knowledge and skills.
Learning is a lifelong process enabling students to
assimilate knowledge and develop values, skills, and
competencies. The faculty recognizes that students
enter the nursing program with a variety of educational
and life experiences. The faculty believes that
learning and teaching are interactive processes and
expects the student to assume an active role. The
faculty uses a variety of instructional strategies
to facilitate critical thinking and problem solving. These
skills enable the associate degree nurse to make decisions
and take actions that are consistent with standards
for nursing practice and licensing laws.
Differentiated Practice
The faculty believes that associate degree graduates
possess a generalist foundation and are prepared
to function in settings such as hospitals, extended
care facilities, and some community settings such
as physicians’ offices. Depending upon
continuing education experience, personal characteristics,
and motivation, the associate degree nurse is capable
of performing in the roles of provider of care, manager
of care and member within the disciple of nursing. Levels
of practice are determined by educational preparation. The
baccalaureate level of nursing education prepares
graduates to deliver nursing care in an unstructured
environment to clients who have complex health problems
or unpredictable outcomes. The associate degree
graduates are prepared and encouraged to continue
their nursing education at the baccalaureate level
through the established Comprehensive Articulation
Agreements with the North Carolina university system
and various private colleges.
Conceptual Framework
The program’s educational and program outcomes
are derived from the philosophy. The conceptual framework
for the curriculum flows from the educational outcomes
to form an organizing framework consisting of three
major concepts: the roles of the nurse; the nursing
process: and client needs. Content incorporated within
the concept of client needs includes life span, pharmacology
and nutrition. Each nursing course is based
on the three organizing concepts.
The program’s integrating concepts are eight
competencies essential to the contemporary practice
of nursing and are included in each nursing course. They
are: professional behaviors; communication; assessment/nursing
process; clinical decision making; caring interventions;
teaching and learning; collaboration; and managing
care. The competencies are performed within the roles
of the associate degree nurse. Course competencies,
laboratory, and clinical competencies flow from the
integrating concepts and are the basis for student
performance and course evaluation. The program’s
educational outcomes are used for end of program evaluation
of graduate competencies.
Sub-concepts, which add depth of meaning to the nursing
courses, are dispersed throughout the curriculum as
applicable to course content. The identified
curriculum sub-concepts, included (but not limited
to) are the following: community; health promotion;
health care delivery; trends; therapeutic interventions;
critical thinking; cultural awareness/competence; evidence
based practice; ethics/values/accountability; legal
issues; standards of care; technology; informatics;
quality improvement; interdisciplinary care; client-centered
competent care; coordination of care; leadership, and
supervision and delegation of others; and lifelong
learning.
The effectiveness of the curriculum design is evaluated
based on the program outcomes.
