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2019v1.0
Success in Practical/
Vocational Nursing
From Student to Leader
is page intentionally le blank
EDITION
10
Success in Practical/
Vocational Nursing
From Student to Leader
No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, recording, or any information storage and retrieval system,
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as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:
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This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notice
Knowledge and best practice in this eld are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary. Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any information, methods, compounds or
experiments described herein. Because of rapid advances in the medical sciences, in particular,
independent verication of diagnoses and drug dosages should be made. To the fullest extent of
the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury
and/or damage to persons or property as a matter of products liability, negligence or otherwise, or
from any use or operation of any methods, products, instructions, or ideas contained in the material
herein.
Previous editions copyrighted 2021, 2017, 2013, 2009, 2005, 2001, 1997, 1993, 1988.
Printed in India
To the previous author of this textbook for many work ethic, scholarship, collegiality, and energy are
years - PATTY KNECHT. Thank you, Patty, for your unmatched and validated by all who know and work
many years of leadership and advocacy in Practical with you. As the new authors of this textbook, we
Nursing education, and for your ongoing support appreciate and cherish our years of friendship with
in nursing education at large. Your passion, spirit, you. You are truly a mentor to us all!
vi
Reviewers
vii
LPN Threads and Advisory Board
LPN THREADS
English to develop a greater command of the pro-
Standard LPN/LVN Threads series features incorpo- nunciation of scientific and nonscientific English
rated into Success in Practical/Vocational Nursing: From terminology.
Student to Leader, 9th edition, make it easy for students A wide variety of special features relate to critical
to move from one book to the next in the fast-paced thinking, leadership and management, and more.
and demanding LPN/LVN curriculum. The following Refer to the Preface on page vii for descriptions and
features are included in the LPN/LVN Threads: examples of features from the pages of this textbook.
A reading-level evaluation is performed on all LPN NCLEX Review Questions and Critical Thinking
texts to increase the consistency among chapters Scenarios presented at the end of chapters give stu-
and ensure that the text is easy to understand. dents opportunities to practice critical thinking and
Full-color design, cover, photos, and illustrations clinical decision-making skills with realistic stu-
are visually appealing and pedagogically useful. dent/patient scenarios.
Objectives (numbered) begin each chapter, provide Key Points at the end of each chapter correlate to
a framework for content, and are important in pro- the objectives and serve as a useful chapter review.
viding the structure for the TEACH Lesson Plans for A full suite of Instructor Resources, including
the textbook. TEACH Lesson Plans, Lecture Outlines, Power-
Key Terms with phonetic pronunciations are listed Point Slides, Test Bank, and Image Collection, is in-
at the beginning of each chapter. Key terms ap- cluded on the Evolve site.
pear in color in the chapter and are defined briefly, In addition to consistent content, design, and support
with full definitions in the Glossary. The goal is to resources, these textbooks benefit from the advice
help the student reader with limited proficiency in and input of the Elsevier LPN/LVN Advisory Board
ADVISORY BOARD Dawn Johnson, DNP, RN, Ed Hana Malik, DNP, FNP-BC
Practical Nurse Educator Academic Director
Nancy Bohnarczyk, MA Reno, Nevada Illinois College of Nursing
Adjunct Instructor Lombard, Illinois
College of Mount St. Vincent Mary E. Johnson, RN, MSN
New York, New York Director of Nursing Mary Lee Pollard, PhD, RN, CNE
Dorsey Schools Dean, School of Nursing
Nicola Contreras, BN, RN Roseville, Michigan Excelsior College
Faculty Albany, New York
Galen College Bonnie Kehm, PhD, RN
San Antonio, Texas Faculty Program Director Barbara Ratliff, MSN, RN
Excelsior College Program Director, Practical Nursing
Dolores Cotton, MSN, RN Albany, New York Cincinnati State
Practical Nursing Coordinator Cincinnati, Ohio
Meridian Technology Center Tawnya S. Lawson, MS, RN
Stillwater, Oklahoma Dean, Practical Nursing Mary Ruiz-Nuve, RN, MSN
Program Director of Practical Nursing
Patricia Donovan, MSN, RN Hondros College Program
Director of Practical Nursing and Westerville, Ohio St. Louis College of Health Careers
Curriculum Chair St. Louis, Missouri
Porter and Chester Institute Kristin Madigan, MS, RN
Rocky Hill, Connecticut Nursing Faculty Renee Sheehan, RN, MSN/Ed
Pine Technical and Community Director of Nursing, Vocational
Nancy Haughton, MSN, RN College Nursing
Practical Nursing Program Faculty Pine City, Minnesota Nursing Assistant Programs
Chester County Intermediate Unit Summit College
Downingtown, Pennsylvania Colton, California
viii
LPN THREADS AND ADVISORY BOARD ix
The 10th Edition of Success in Practical/Vocational Nurs- TEACH Lesson Plans are based on textbook chapter
ing: From Student to Leader was revised to reflect the objectives. ese lesson plans provide a road map to link
National Council of State Boards of Nursing (NCSBN) and integrate all parts of the educational package and can
introduction of the Next Generation NCLEX (NGN) in be modied or combined to meet your scheduling and
2023. A discussion of this change, critical thinking, and teaching needs.
NGN questions have been added to several chapters.
Additionally, you will notice that Chapters 10 and 11 FOR THE STUDENT
will discuss culture and spirituality holistically, rather Evolve Student Learning Resources include NCLEX-PN®
than defining specific cultures, races/ethnicities, and Examination–style interactive review questions that test
religions. your knowledge and help you prepare for licensure.
If you are new to this textbook, Dr. Patricia Knecht Helpful Phrases for Communicating in English and
made significant changes to the 9th edition to facili- Spanish are also provided.
tate faculty and student interactions that promote Additional ancillary material is included to supplement
critical thinking, robust discussion, and deep under- the content of the chapters.
standing of the material beyond content knowledge.
The material in the textbook is meant to assist stu-
dents in their life-long learning journey and leader- READING AND REVIEW TOOLS
ship development. Objectives introduce the chapter topics.
We wish you luck in becoming a LPN/LVN and Key Terms are accompanied by simple phonetic pronunci-
with whatever comes next for you in your career. If ations. Key terms are considered essential to understand-
you would like to share any comments or sugges- ing chapter content and are dened within the chapter.
tions, we welcome you to contact us in care of the Key terms are in color the rst time they appear in the
customer service department at Elsevier (support.el- narrative and are briefly dened in the text, with complete
sevier.com). denitions in the Glossary.
Best! Each chapter ends with a Get Ready for the NCLEX-PN®
Lisa Falgiatore Carroll & Janyce Collier Examination section that includes (1) Key Points that
reiterate the chapter objectives and serve as a useful review
TEACHING AND LEARNING PACKAGE of concepts, (2) a list of Additional Resources, (3) a set
of Review Questions for the NCLEX-PN® Examination
We provide a rich, abundant collection of supplemental re- and Next Generation (NGN) NCLEX-PN® with answers
sources for both instructors and students. located in the back of the book, and (4) Scenarios with
FOR THE INSTRUCTOR answers located on the Evolve site.
References cite evidence-based information and can be
The comprehensive Evolve Resources provide a wealth found in the back of the text.
of material to meet your teaching needs. Instructors Suggested Readings provide resources for enhancing
will have access to all of the student resources, as well knowledge and are located on the Evolve site.
as the following:
An ExamView Test Bank contains NCLEX-PN® Examination–
CHAPTER FEATURES
style questions that include multiple choice and alternate for-
mat item questions. Coordinated Care boxes are presented in four ways to
PowerPoint Presentations that include approximately 400 introduce the reader to leadership andmanagement in
slides. nursing:
x
PREFACE xi
Management Tools provide practical instructions and Empowerment boxes questions to contribute to
resources and have the reader apply learned concepts to more autonomous, self-directed, positive outcomes in
specic situations. academic and practice settings.
Management Hints provide tips for handling management Keep in Mind boxes introduce the reader to the un-
situations. derlying theme of the chapter.
Leadership Activities provide students with exercises to Professional Pointers give readers advice on nurs-
practice their leadership skills. Instructions and needed ing best practices in the professional arena.
resources are provided. “Try This” boxes challenge students to imagine, vi-
Leadership Hints give helpful hints to follow and remem- sualize, and think outside the box.
ber when in a leadership situation.
Critical Thinking boxes encourage problem solv-
ing for both academic and personal situations.
Contents
How the Law Affects Licensed Practical Nurses Types of Questions, 113
and Licensed Vocational Nurses, 94 Nurse–client Communication Evaluation, 113
Common Law Versus Statutory Law, 94 Blocks to Communication, 114
Criminal Versus Civil Action, 94 Avoiding Blocks, 114
Intentional Torts, 94 Communication and Body Posture, 115
Unintentional Torts, 96 Cultural Differences, 115
Negligence, 96 Role Changes for The Client, 115
Malpractice (professional Negligence), 96 It Begins with “hello, My Name is . . .”, 115
Malpractice Insurance for Nurses, 97 Nursing Jargon, 116
Four Elements Needed to Prove Negligence, 97 Fear of the Unknown, 116
Steps for Bringing Legal Action, 97 Personal Factors, 116
Depositions, 97 Environmental Factors, 116
Attorney Procedures, 98 Communicating with Instructors and Staff, 116
Giving Testimony, 98 Respect, 116
Liability, 98 Trust, 116
Kinds of Liability, 98 Honesty, 117
Common Causes of Nursing Liability, 99 Empathy, 117
Responsibility and Accountability in Sensitivity, 117
Nursing, 99 Humor, 117
Liability of Student Nurses and Instructors, 99 Knowledge, 117
Functioning Beyond the Scope of Practice and Patience, 117
Experience, 99 Commitment, 117
Specic Client Situations, 100 Self-esteem, Thoughts, and Straightforward
Privacy and Condentiality, 100 Communication, 117
Information That Must Be Revealed, 100 “I” Messages, 118
Clients’ Rights, 100 Situation, Background, Assessment,
Health Insurance Portability and Accountability Recommendation, 118
Act, 101 SBAR for The Shift Report, 118
Client Competency, 103 Life Span Communication, 119
Client’s Right to Consent, 103 Infants, 119
End-of-life Issues, 104 Preschoolers, 119
Patient Self-determination Act, 104 School-age Children, 119
Advance Directives, 104 Teenagers, 119
Do-not-resuscitate Order, 105 Adults, 119
Removal of Life Support Systems, 105 Generational Differences, 120
Physician-assisted Suicide and Euthanasia, 105 Elders, 120
Organ Donation, 106 Digital Communication, 120
End-of-life Care, 106 Electronic Documentation, 120
Good Samaritan Act, 106 E-mail, 120
Cell Phones and Text Messaging, 121
Social Media, 121
UNIT III RELATIONSHIP-CENTERED Conict Resolution, 121
CARE, 109
9 Assertiveness: Your Responsibility, 124
8 Effective Communication: Health Care Team, Nonassertive (Passive) Behavior, 124
Clients, Faculty, and Peers, 109 Aggressive Behavior, 125
Communication Process, 110 Assertive Behavior, 126
One-way Versus Two-way Communication, 110 Negative Interactions: Using Coping
Essential Components of the Communication Mechanisms, 128
Process, 110 Gossip Hurts, 129
Factors That Affect Communication, 110 Guidelines for Moving Toward
Types of Communication, 111 Assertiveness, 129
Verbal Communication, 111 The Problem-Solving Process, 129
Nonverbal Communication, 112 Problem-Solving Steps, 130
Affective Communication, 112 Negative Manipulative Interactions, 132
Communication Strategies, 112 Aggressiveness And Work-Related Issues, 133
Active Listening, 113 Assault, 133
Active Listening Behaviors, 113 Contributing Factors, 134
CONTENTS xv
*****
Tuskin hän oli sen tehnyt, kun oven saranat päästivät surkean
ulvahduksen, mikä kaikui sydämessäni kuin kuolevan voihkaisu.
Kiraa värisytti, hänen silmänsä salamoivat ja heittäytyen sohvalle
minun oikealle puolelleni hän kuiskasi korvaani:
*****
»Saanko kysyä, miksi lähdette ulos näin varhain?» kysyi hän hyvin
kunnioittavasti turkinkielellä.
»Abu Hassan, me pelkäämme poliisia ja isäämme», vastasi Kira
samalla kielellä.
En koskaan ole päässyt selville siitä, mikä hän oli miehiään, enkä
hänen suhteestaan äitini perheeseen; sen vain tiedän, ettei kukaan
häirinnyt meitä hänen luonaan eikä isästäni näkynyt jälkeäkään. Ja
kun pelkomme oli haihtunut, etäännyimme talosta kiellosta
huolimatta. Silloin alkoi tuo kaunis ja surunvoittoinen elämä, jota
kesti kuukauden, ja joka oli niin täynnä aurinkoa ja joutilasta
harhailua.
*****
»Jos joskus haluat purjehtia joko yksin tai sisaresi kanssa, tarjoan
mielihyvällä veneeni käytettäväksenne».
»Sinä et ole kiltti!» sanoi hän. »Sinä huvittelet ja jätät minut yksin
ikävään!»
Kira juoksi laituria pitkin ja hypähti notkeana kuin nuori hirvi alas
veneeseen. Seuratessani häntä minä kuulin erään soutajan sanovan
takanani nämä sanat, jotka myöhemmin muistin onnettomuudessani:
*****
DRAGOMIR
Neljä vuotta oli kulunut siitä päivästä, jolloin Adrien oli kuullut
Stavrolta Kiran tarinan. Huolimatta hänen etsiskelyistään ja
ponnistuksistaan onnettoman mehukauppiaan löytämiseksi, jolle hän
tahtoi vakuuttaa kiintymystään ja ystävyyttään, pysyi tämä kateissa.
Hän luuli hänen jo kuolleen. Ja kiihkomielisen nuorukaisemme
elämä, joka nyt oli hyvin häilähtelevää, kulki kohtalon sille
määräämää rataa.