Department of Nursing: Philosophy

The mission of Community College of Philadelphia affirms a belief in access to higher education for all who may benefit by providing a coherent foundation for college transfer, employment, and lifelong learning. The College draws together students from a wide variety of ages and backgrounds and seeks to provide programs that increase awareness and appreciation of a diverse world, that improve students' abilities to pursue paths of inquiry, and that foster self-fulfillment through service to others and preparation for future work. As part of the larger community, the Department of Nursing builds on the College's mission by preparing students to successfully take the licensing examination for registered nurse practice, by providing options to transfer to baccalaureate programs after graduation, and by encouraging self-fulfillment based on service to others.

In concert with the College's mission statement, faculty in the Department of Nursing adheres to a philosophy based on the belief that the fundamental nature of education is growth. Educational growth is a process in which the teacher guides the learner as an active participant. Faculty function as nursing experts, as facilitators of learning and as nurturers of students. Faculty are committed to assisting students to value their own unique backgrounds and experiences as a foundation for service to others, to prepare for future work and study and to enjoy the challenges in the nursing profession.

The nursing faculty endorse the National League for Nursing Accrediting Commission (NLNAC) Core Competencies (2001) as the basis for preparing the practitioner of the future to meet society's evolving health care needs. The NLNAC encourages each nursing program to interpret these skills and competencies in the content, context, function, and structure of their unique program. The faculty in the Department of Nursing have integrated these core competencies into four broad areas of the health care needs of clients: safe, effective care environment; physiological integrity; psychosocial integrity; and health promotion and maintenance. These categories comprise the current structure of the NCLEX-RN test plan and are based on the description of the characteristics of newly licensed RNs, their practice environment and the activities in which they are engaged, reported in the Job Analysis of Newly Licensed Registered Nurses (National Council of State Boards of Nursing, Inc., 1998). Finally, faculty in the Department of Nursing adhere to the definition of nursing practice in Pennsylvania, which states that the practice of nursing "means diagnosing and treating human responses to actual and potential health problems through such services as case finding, health teaching, health counseling, and provisions of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed physician or dentist" (Pennsylvania Act No. 179, P.L. 1607, December 1986).

Nursing education at the Community College of Philadelphia supports the notion that nursing is challenging, satisfying work that benefits individuals, families, communities and the society at large. The practice of nursing involves knowledge, skills and abilities that are grounded in the discipline of nursing and its ethical/legal practice, as well as natural, behavioral and social sciences. Faculty believe that through the use of evidenced-based practice, nurses must strive to assist individuals, families and communities to achieve optimal functioning, consistent with the delivery of safe and effective nursing care in a variety of care settings. Nurses engage clients, families and communities as partners in care delivery. Teaching health promotion and disease prevention, as well as supporting clients and families toward attainment of physiological and psychosocial integrity within safe and effective care environments are essential components of nursing practice

Graduates of associate degree nursing programs are accountable, adaptable generalists who are prepared to successfully take NCLEX-RN and function as registered nurses in a variety of care settings. As registered nurses, graduates are members of the community of nursing, collaborating with clients, families and communities together with support persons and other members of the health care team to achieve optimal functioning for all. Nursing students represent the diverse demographics of the larger community. The faculty are proud that the majority of alumni remain in Philadelphia to serve their neighbors as RNs, contributing to the health and economy of the region.

Although associate degree nursing programs are complete educational programs, the faculty believe that graduates must recognize the need for formal and informal continuing education to maintain and develop the practice of nursing. Faculty are committed to providing educational mobility for students and graduates who wish to continue their formal education.

In summary, faculty in the Department of Nursing are strong advocates of the College's mission. Faculty believe that our associate degree nursing graduates are prepared with the knowledge, skills and abilities necessary for practice, transfer and self-fulfillment. In this way, the nursing faculty honor and acknowledge a deep commitment to the health and welfare of the Philadelphia community.

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Department of Nursing Curriculum Organizing Framework

The organizing framework of the nursing curriculum represents the faculty's plan for learning activities designed to assist each student to achieve program goals. The faculty have made choices about the knowledge, skills and abilities considered essential for students to take the licensing examination for registered nurse practice. These choices ensure that students acquire competencies that will be demanded of them in nursing practice. This framework is based on core competencies developed by the National League for Nursing Accrediting Commission (NLNAC, 2001) and organized around four categories of client needs (National Council of State Boards of Nursing, Inc., 1998): safe, effective care environment; physiological integrity; psychosocial integrity; and health promotion and maintenance.

These categories, which reflect the basic needs of clients, families and communities, are introduced in the first nursing course and developed as the student progresses through the nursing program. Concepts of safe and effective care environment, physiological integrity, psychosocial integrity, and health promotion and maintenance provide a framework for the organization of nursing knowledge, skills and abilities. In addition to these categories, core competencies, as suggested by the NLNAC, are used to frame the acquisition of knowledge. These competencies include but are not limited to: use of evidence based practice, development of skills associated with population-based health, use of outcome measures to ensure comprehensiveness of care, involvement of clients and families in the decision making process, understanding the role of primary care, facilitating access to effective care, and the performance of ethical and accountable behaviors in all professional activities. Throughout the program of learning, in classroom and seminar activities and during clinical experiences, faculty assist students to develop the knowledge, skills and abilities for these core competencies.

Faculty guide students to analyze and synthesize information through the use of case studies, critical thinking assignments, discussion and other forms of interactive inquiry. In addition to observing how an expert nurse thinks and solve problems, the student develops an appreciation of the complexity of client needs in the provision of care. Students practice critical thinking and management skills through collaborative efforts with nursing faculty, peers and clinical agency staff. The student's development is enhanced by opportunities to apply nursing knowledge while caring for clients across the life span in a variety of settings, for example, hospitals, nursing homes, schools and independent living facilities. Each of these settings offers the student an opportunity to integrate knowledge, skills and abilities in order to assist clients to function at an optimal level and to work collaboratively with members of the health care team.

The program of learning is designed to help students progress toward the acquisition and integration of knowledge, skills and abilities they will need as graduate nurses to practice safely and accountably in today's health care environment. The beginning student's vision is one in which discrete pieces of nursing knowledge are seen. However, as students progress through the program, they engage in learning activities that promote integration of new knowledge with new skills and abilities. Faculty guide students in establishing a context for this knowledge by relating it to the provision of client health care needs. Over time students begin to understand how the client, the client's health care needs, and the client's family and community are interwoven. As a result of this larger view of the context of client's needs, students are able to engage in collaborative care planning and critical thinking necessary for practice, transfer to baccalaureate programs, and self-fulfillment based on service to others.

In the first nursing course (Nursing 101), classroom and seminar discussion, as well as clinical learning activities, focus on the client experiencing health promotion or health maintenance needs. Students are introduced to skills related to physical assessment, medical asepsis, medication administration and provision of basic nursing care. Students practice these skills in the clinical environment as they begin to understand ways to maintain and promote physiological and psychosocial integrity for adult clients. The nursing process, Maslow's Hierarchy of Needs, Erickson's Stages of Development, and constructs about coping and family dynamics provide a foundation to help students identify client needs and begin to apply knowledge to practice. Anatomy and physiology (Biology 109), nutrition (Diet 111) and composition (English 101) are taken concurrently and enhance the student's knowledge base for thinking and writing about health promotion and health maintenance in the context of meeting basic client needs.

The second nursing course in the curriculum (Nursing 132) builds on the knowledge, skills and abilities developed by students in the introductory semester. Classroom and clinical learning experiences focus on the client experiencing a threat to physiological or psychosocial integrity. Students continue to consider health promotion and health maintenance needs of clients and families. The needs of the family in transition are also considered. In the clinical environment, collaborating with members of the health care team to deliver safe and effective nursing care, students practice skills related to surgical asepsis and the reduction of risk for clients. In addition, faculty assist students to continue using constructs discussed in the first semester to help clients and families to function optimally and adapt to life transitions. Three co-requisite courses, anatomy and physiology (Biology 110); introduction to psychology (Psychology 101); and advanced composition (English 102) enhance the student's ability to promote physiological and psychosocial integrity during clinical experiences and to complete writing assignments that require application of critical thinking.

The organizing structure from the first two courses serves as a springboard for further development of the student's knowledge, skills and abilities in the second year of the nursing program. In the third semester (Nursing 231), students are expected to expand their context for understanding client needs by synthesizing and integrating knowledge from a variety of sources and to interweave previously acquired knowledge with new knowledge. Students use resource management and clinical decision making principles to plan, implement and prioritize safe and effective care, developing the ability to promote both physiological and psychosocial integrity, to maximize client self-care and to foster optimal functioning for clients in a variety of settings. In addition, knowledge about environmental factors influencing health is expanded as the student studies microbiology (Biology 241), introduction to sociology (Sociology 101), and a humanities elective.

In the fourth semester (Nursing 232) students have opportunities to apply knowledge, skills and abilities while caring for clients across the life span. Clinical learning experiences include possibilities for students to care for adults, infants, children and the elderly in acute care, long-term care and community-based settings. Each of these settings offers the student the opportunity to synthesize and integrate knowledge, skills and abilities learned in previous courses and to utilize management principles to develop, implement and evaluate a plan of care, in collaboration with members of the health care team, to promote optimal functioning for clients and families across the life span. Three credits of humanities or social/behavioral science and three credits of statistics or data processing electives are taken concurrently so that the student may pursue personal interests or prepare for transfer to a bachelor's degree nursing program after graduation.

Concepts related to the provision of community-based care are integrated throughout the program of learning. In each course the student is asked to address factors within a community that influence health promotion and maintenance. In the first course, students assess their local community. In the second course, students gather information from key informants within their local community in order to describe ways to promote continuity of care. In the third nursing course, students provide health teaching and disease prevention activities in community settings and specifically address the needs of families in the community who care for members with chronic health needs. In the final semester, students plan, implement and modify health promotion programs that address needs of clients across the life span in collaboration with members of an interdisciplinary team.

The organizing framework for the program of learning is congruent with the mission of Community College of Philadelphia. The program of learning provides a foundation for the acquisition and integration of knowledge, skills and abilities necessary for accountable and safe nursing practice in today's health care environment.

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