Mission, Values and Theoretical Framework

Mission
The Mission of Exeter Health Resources is to improve the health of the community.  This mission will be principally supported through the provision of health services and information to the community.


Nursing Values
Nursing places a high value on the delivery of safe, quality care.  Practice is guided by principles that include standards of professional practice, scope of service, research, patient rights, nursing quality, collaboration, ethics, and advocacy
 

Practice

Empowerment: We encourage the nursing staff of Exeter Hospital to engage in opportunities that build their knowledge base, skills and growth potential by actively participating in the change process.

Continual Professional Growth and Development:  We value life long learning, through both formal and informal educational opportunities and the advancement of nursing practice to maintain the intensive and dynamic body of knowledge required to facilitate excellence in the care of patients, families and communities. Nurses are encouraged to attain their BSN and a certification within their chosen area of specialty practice.

Self-awareness and Individual Accountability:  We value the responsibility of individuals to maintain a high level of professional practice and competence through a continuous process of self-evaluation and commitment to action in fulfilling self-directed goals.

Integrity: Nurses have a duty to remain consistent with both their personal and professional values and not compromise those values that could jeopardize the dignity or well being of self or others.

Accountability:  Individual nurses have a responsibility for the quality of nursing care that their patients receive and are accountable for their own practice and conformity with established standards of care.

Autonomy: We value accountability for individual nursing practice and the appropriate delegation and supervision of tasks while providing optimum patient care.

 
Research
Evidence Based Practice: Through the development and continuous review of practice and policies, nurses utilize research, experience and national standards, implementing this research into practice.

 
Patient Rights
Self-determination and Patient Centered Care:  We value that each individual has a right to ask questions and to make informed choices for their health and future.  The nurse’s primary commitment is to the patient, whether an individual, family, group or community.  The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.

 
Nursing Quality
Excellence in Direct Patient Care:  We value direct patient/family interaction and care as the foundation of our mission to promote and sustain the health of the community.

Process Improvement:  We strive for excellence, and in this pursuit, we evaluate where we excel and where we have opportunities for growth.  Evaluation may include:  Press Ganey scores for patient satisfaction, quality indicators, outcome data, chart reviews, physician feedback, occurrence reports, and staff feedback.

 
Collaboration
Collaboration:  We value individuals working together, using their unique skills and knowledge to deliver better healthcare to those in the community. 

Mutual Trust, Recognition and Respect: We value the expertise of all health care providers and hospital staff and their contributions to the patient and to the healthcare team.

 
Ethics
Compassion, Dignity and Human Worth: We value, in all professional relationships, compassion and respect for the inherent dignity, worth and uniqueness of every individual, regardless of social or economic status, personal attributes, or the nature of health problems.

Professional Boundaries: The nurse is responsible for recognizing and maintaining boundaries that establish appropriate limits to relationships with colleagues and patients.

 
Advocacy
Patient Advocate: Nurses actively participate in assessing and advocating for the responsible and appropriate use of interventions to minimize unwarranted or unwanted treatment and patient suffering.  In addition, the nurse is vigilant and takes action in instances of incompetent, unethical, illegal, or impaired practice by any member in the health care team or the health care system that places the rights or best interests of the patient in jeopardy
 

Framework

Relationship Based Care (RBC) is the theoretical framework for nursing practice at Exeter Hospital. The principles of RBC that nursing has adopted are based primarily on the Theory of Caring (Swanson 1991). The fundamental constructs are: knowing yourself as a provider, knowing your patient/family, and knowing your colleagues. The two key concepts are: knowing and caring. The five caring processes within the Theory of Caring are:

(1) Maintaining belief in each person’s capacity to make it through events and transitions;
(2) Knowing is striving to understand the event and its meaning;
(3) Being emotionally present with the other person;
(4) Doing for each person what he/she cannot do for themselves; and
(5) Enabling/informing by facilitating passage through life events. This includes explaining, informing, generating options, supporting, advocating, validating, anticipating, and preparing for future needs.

The shared vision for the Relationship Based Care framework is that the interaction between the patient and the clinical care team members forms the basis of a knowing and caring relationship. This relationship leads to a high level of engagement between patients and care team members, and is the foundation of the patient care experience.