1040 Flashcards
Edith Monture
first indigenous nurse in Canada
-left Canada b/c Indian Act
Florence Nightingale
founder of modern nursing
1st school of nursing
lady with the lamp
racist
Mary Mahoney
1st black RN in US
Mary Seacole
resourceful committed woman healer
similar to NP
biomedical model of health
sees maintaining health as a mechanistic, technical process
-absence of disease
mech-ahh-nis-tic
biomedical hegemony
dominance of the biomedical model
active suppression of alternative approaches
corporatization of personal, clinical medicine into pharma and hospital centered treatment
benevolence
desire to do good
art of nursing
skillful attention and knowledge nurse posses of situations
care, compassion, communication, intuition, interpersonal relationship skills
nuances
science of nursing
knowledge of disease processes, pathophysiology, and nursing technical skills
nursing metaparadigm
> person
nursing > health
> environment
key values and foundational concepts
nursing metaparadigm critiques
developed by white privileged nursing
excludes experiences of individuals (marginalized groups)
empirical knowing
based on science, research and evidence
ethical knowing
allow you to apply principles of right and wrong
morally and ethical
personal knowing
self-awareness and understanding of your own feeling
our personal experiences influence us
Aesthetic knowing
gut feeling
understand patients experience from holistic and intuitive perspective
emancipatory knowing
addressing broad social and systemic factors that affect well-being
inequalities and advocates for social justice
professional identity
expectations of the profession
5 domains of nurses
administration, clinical, education, policy and research
RN entry to practice competincies
101
main
clinician, professional, communicator, collaborator, leader, advocate, education, scholar
CNO
college of nurses of Ontario
governing body
set standards/police nurses
practice standards-min expectations
practice guidelines-evidence base recommendations
CNO code of conduct
respect clients’ dignity
provide inclusive + culturally safe care by practicing cultural humility
provide safe and competent care
work respectfully
act with integrity in clients’ best interest
maintain public confidence
CNA
national
advocates for nursing, supports professional development and set national standard
RNAO
registered nurses’ association of ontario
like CNA but for ontario
practice guidelines
ONA
Ontario nurses’ association
labour union that represents ontario RN
advocates for workers rights
ICN
international council of Nurses
international collaboration
Patricia Benne’s Novice to expert
novice, advanced beginner, competent, proficient, expert
what do nurses need to be more competent
cognitive component, practice component and ethical comportment
RHPA
regulated health professions act
-to practice, someone must be member of regulatory college in their profession and be certified
-each province has a college
RHPA: scope of practice, controlled acts model
a scope of practice statement
-a series of controlled acts
14 controlled acts
controlled acts
activities that can harm someone if performed by unqualified persons
can be delegated
delegation
person is qualified give someone authority to perform a controlled act
nurse controlled acts
-performing a procedure on tissue below the dermis, below the surface of the mucous membrane
-Administering a substance by injection or inhalation
-Putting an instrument, hand or finger,
* beyond the external ear canal
* beyond the point in the nasal passages where they
usually narrow
* beyond the larynx
* beyond the opening of the urethra
* beyond the labia majora
* beyond the anal verge
* into an artificial opening into the body
-dispensing a drug
-Treating with psychotherapy technique, delivered through a therapeutic
relationship, an individual’s serious disorder of thought, cognition, mood, emotional
regulation, perception or memory that may seriously impair the individual’s judgement,
insight, behavior, communication or social functioning.
non-nurse controlled acts
-Communicating a diagnosis
-Performing a procedure in or below the
surface of the cornea, in or below the surface of the teeth
-Setting or casting a fracture of a bone or a dislocation of a joint
-Moving the joints of the spine beyond the individual’s usual range of motion using a fast, low amplitude thrust
-Prescribing, selling or compounding a drug or
supervising the part of a pharmacy where drugs are kept
-Prescribing or dispensing for vision or eye problems, contact lenses or eyeglasses other than simple magnifiers
-Applying or ordering the application of a form of energy
-Prescribing a hearing aid for a hearing-impaired person
-Fitting or dispensing a dental prosthesis, orthodontic or periodontal appliance or a device used in the mouth to protect teeth from abnormal functioning
-Managing labour or conducting the delivery of a baby
-Allergy challenge testing of a kind in which a positive result of the test is a significant allergic response
nursing act -NP
-communicate to client about diagnosis
-apply and ordering a prescribed form of NRG
-setting or casting fracture and dislocation
-prescription of certain meds
exceptions of controlled acts
-first aid in emergency
-student nurses under supervision
-treating a member of a person’s household
-assisting someone’ with routine activities
-treating a person by prayer or spiritually
medical directive
written protocol that allows nurses with appropriate knowledge, skill and judgement to perform actions not authorized for nursing
-standing orders
jurisprudence
exam assesses knowledge and understanding laws, regulations and practice standards
scope of RN practice
activities that RNs are authorized, educated and competent to perform in ontario same as RPNs and RNs
what activities need and don’t need an order
RNs vs RPNs -nurse factors
educating, predictable outcomes, risk of negative outcomes
RNs vs RPNs -client factors
complexity of needs
difference in autonomous practice
RNs vs RPNs -environmental factors
practice support
consultation
stability and predictability
ethics
philosophical study of morality and what is right and wrong
biomedical ethics
explores ethical questions and moral issues related with health care
moral/ethics distress
result when people aren’t able to face issues and deal effectively with them
levels of moral response-expressive
strong emotions, no strong justification
levels of moral response- pre-reflective
conventional norms are uncritically accepted
levels of moral response- reflective
A basis or ground is given for a moral
judgment
ethically fit
what to do, why how
uses knowledge and skill in ethical problem-solving
moral residue
ethical dilemma that stays with you
burnout
-phys and emotional exhaustion n/c of prolonged stress and frustration
goals of problem-solving ethics
creation of a healthy environment
contribution to patients and families.
Informed Consent
health care provider educates a patient about the risks, benefits, and alternatives of a given procedure or intervention
issues in care-harm
liberty can be restricted to prevent harm others
issues in care-paternalism
liberty can be restricted to prevent to self harm
issues in care- legal moralism
liberty can be restricted to prevent immoral behaviour
issues in care- offence
liberty can be restricted to prevent offence to others
important note about competence
competence should never be assumed
person’s wishes
failure to respect clients wishes without consent is considered to be battery
autonomy
promotes choice
-person must competent of making informed decision
veracity
be truthful
fidelity
be loyal to client
-honour commitments
beneficence
do/promote good
non-malefiacence
do good and promote no harm/ avoid harm
justice
promote fair treatment
relational orientation-mindset
interpersonal: people’s interactions (relationships)
context: situation and environment
intrapersonal: whats going on with all the people who are invovled
inquiring actions
question we ask and how we influence their response
5 c’s of nursing capacities
be compassionate
correspond to what is: relating to people in a meaningful way
be curious
be competent
be committed
strengths-based care
conversation about what is going well
balance of good and bad
placing their problems in context
increase confidence
deficit-based care
avoid
what is going wrong
trauma and violence informed care
what happened to this person
universal approach
interpersonal trauma
person to person (SA)
situational trauma
trauma b/c of a situation (war)
collective trauma
entire community (residential school)
trauma showups
emotional, cognitive, biological and psychosocial
explicit biases
attitudes and assumptions that we are aware of
implicit biases
attitudes and beliefs that we are not aware of
stereotypes
generalized beliefs about a particular group
stigma
negative beliefs that a group of people have about something
negative stereotype
characteristics of diseases
race
socially constructed
an idea that is created and accepted by people
microagressions
verbal, nonverbal and environment insults that sends negative messages to a person based on marginalized groups
cycle of oppresion
oppression>stereotype>prejudice> discrimination
reflection
process of thinking back on an experience to learn
critical reflection
question yourself
reflexivity
continuously examining your beliefs, values and reactions
reflection in action
thinking what your are doing while doing
reflection on action
reflection after event
clinical judgement
assessing patient’s condition and make informed decisions
culture
the way of life for an entire society
-process between people
-socially constructed
-fluid and dynamic
cultural imposition
someone imposing their beliefs on others because they think theirs are superior
cultural safety
learn how practices, policies and research causing inequity
cultural humility
understanding ones biases through education and self-reflection
cultural competence
having knowledge about a culture
critiqued for its promotion of stereotypes and biases towards racial/ethnic groups
neuroplasticity
brain is adaptable and can learn and change
learns new ways of thinking
nursing process
nursing assessment
nursing diagnosis
planning
implementation
evaluation
nursing assessment
revie clinical history and assess patient
nursing diagnosis
develop appropriate nursing diagnosis
adverse event and example
negative outcome to patient as result of healthcare management
-patient with infection
harm and example
physical, emotional or psychological outcome that negatively affects a person’s quality of life
you raise patients bed, patient falls and gets a head injury
error and and example
a mistake or lapse in judgement
-give wrong meds
near miss and example
an event that does not reach the patient because of timely intervention
-pharmacy sends wrong meds, but you fix it
patient safety incident and example
event that occurs in the course of providing care that may or may not cause harm
-student gives meds orally instead of topically
system errors
education and training
environment
system design
resource availability
most common types of harmful event
health care and medication associated
health care associated infections
procedure related conditions
patient accidents
3 types of violations
routine
optimizing > break rules for quickness
necessary >cutting corners b/c not enough time
PAS
personal approach to safety
blames individual for mistake
if you make mistake report it
Canadian Patient safety institute frame work 6 domains
patient safety culture
teamwork
communication
safety, risk and quality improvement
optimize human and system factors
recognize, respond to and disclose patient safety incidents
interprofessional collabortation
-communication between diff specialties
-uses everyone including patient
multidisciplinary
mainly doctors determine care
-little involvement by patient
competency framework for advancing collaboration domains
relationship-focused care/service
team communication
role clarification + negotiation
team differences processing
collaborative leadership
challenges of interprofessional collaborations
power dynamics
communication barriers
role ambiguity
culture diff
time constraints
kouzes + posner’s 5 leadership practice
honest, trustworthy + integrity
forward thinking
competent
inspiring and dynamic
optimistic about future
situational leadership
adapts to the needs of team members and demands of specific situation
authentic leadership
transparency
self-awareness
commitment to ethical practices
transformational leadership
inspires and motivates team members
competency
complex know act based on combining and mobilizing internal resources and external resources to be competent
how to develop informatic competencies
-formal nursing education
-nursing practice
-personal/professional experiences
challenegs with informatic competencies
lack of opportunity
area with lack of tech access
social media
comprises applications and websites that allow people to interact with businesses, communities and content
-interaction and sharing
social networking
-is usually understood as users building communities among themselves while social media is more about using social networking
-sites and related platforms to build an audience
6 P’s of social media use
professional, positive, patient/person free, protect yourself, privacy, pause before post
