section name header

Front Matter

A chapter opener photo of a solitary tree stands atop a curved hill with sunlit golden grass under a clear sky.

© mammuth/E+/Getty Images

The development of this text is motivated by the need to provide background information about the nursing profession and critical healthcare delivery issues that affect our profession for students who are beginning their nursing education or working toward their baccalaureate degree for career development. This goal has been the same for all editions of the text, but it is even more imperative today with a healthcare system experiencing many changes and recovery from the COVID-19 pandemic. Change is part of health care, and we need to understand where we came from and update ourselves so we can effectively engage in the change process that lies ahead of us. We hear much about healthcare reimbursement, and this is important-but we cannot ignore that we have a healthcare system that needs repair and improvement. Thus, this Sixth Edition continues to emphasize quality improvement and the nurse's role in quality improvement, ensuring patient/person-centered care.

I must include some comments about the COVID-19 pandemic that has caused much stress and loss throughout the world. As I write this preface, we are moving toward improvement. Throughout this text, the virus and its impact are mentioned. Nurses have contributed to the care and given of themselves during this time of health upheaval, and they experienced stress from loss of jobs and homes, major changes in education for children and even for nursing students, isolation, and stress on a healthcare system that already had problems. Nurses will be needed to step up and advocate for patients, families, populations, communities, and the profession. The postpandemic period will undoubtedly be a time of change, and we hope these changes will be based on what we have learned during this very stressful time. It has moved us to recognize that public health is critical, and we need to be prepared to provide care to all who need it, emphasizing diversity, equity, and inclusion.

Nursing students today are asked to cover a lot of information in their courses and develop clinical competencies in a short period of time. It is critical that each student recognize that nursing does not happen in isolation, but rather, it is part of the entire healthcare experience. Nurses need to assume critical roles in this experience through their unique professional expertise and leadership. Nurses are also members of the interprofessional healthcare team. They must work with others to provide and improve care in a healthcare environment that should be a healthy workplace and a positive patient experience in which staff collaborate, coordinate, and communicate effectively. At the beginning of each chapter, nursing education standards, concepts, and values that apply to the chapter content are identified.

This text consists of 14 chapters, divided into 4 sections. Section 1 focuses on the profession of nursing. In these chapters, students will learn about the dynamic history of nursing and how the profession developed; the complex essence of nursing (knowledge and caring); nursing education, accreditation, and regulation; and how to succeed as nursing students.

Section 2 explores the healthcare context in which nursing is practiced. Health policy and political action are very important today in health care and in nursing. Students need to know about ethical and legal issues that currently apply to their student practice and issues that might apply in the future as registered nurses. Students typically think most about caring for the acutely ill, but the health context is broader than this and includes health promotion, disease prevention, and illness across the continuum of care in the community and population health supporting public health. As we have learned during COVID-19, public/community health is critical, and so is health equity. Though nursing is practiced in many different settings and healthcare organizations, the final chapter in this section focuses on acute care organizations, providing students with an in-depth exploration of one type of healthcare organization.

Section 3 moves the discussion to the core healthcare professions competencies that are expected for all healthcare professions. Each chapter in this section focuses on one of the core competencies. Though this section covers these competencies in depth, the competencies are relevant to all the content in this text. The five competencies are related to the Quality and Safety Education for Nurses competencies (QSEN Institute, 2023). These competencies provide the focus topic for the chapters in this section (IOM, 2003):

  1. Provide patient/person-centered care.
  2. Work in interprofessional teams.
  3. Employ evidence-based practice.
  4. Apply quality improvement.
  5. Utilize informatics.

Section 4 brings us to the end of this text, although not to the end of learning. The chapter in this section focuses on the transformation of nursing practice through leadership, highlighting and connecting the key concepts in the text.

This Sixth Edition also includes three appendices. The first focuses on quality improvement measurement and analysis methods, providing students with a quick reference for information about quality improvement that can be used throughout the nursing program and assist in developing their expertise in quality improvement. The other appendices provide students with important information related to staffing and healthy work environments, as well as finding the right job.

Each chapter includes objectives, an outline of the chapter to help organize students' reading, key terms that are found in the chapter and defined in the Glossary, content with headers that apply to the chapter outline, and chapter highlights. Each chapter also includes Stop and Consider statements embedded in each chapter. These statements ask the students to take a break from reading and reflect on some aspect of the content just covered. These comments are not meant to be questions or summary statements of the preceding content.

The end-of-chapter section, Engaging in the Content, includes several activities to augment student learning. Some of these activities may be done by individual students, and others by student teams, either in the classroom or in an e-learning format. This section expands on features found in previous editions.

As these learning activities indicate, the text provides opportunities for students to engage in the content-just as nursing care should be patient/person-centered; it is important that nursing education is student-focused.