Fund Ch. 8 + 10 Flashcards
encourages patient to continue or elaborate
EX: “go on”. “I see”. “uh huh.” “please continue”.
general leads
Encourages patient to elaborate rather than answer in one or two words
EX: “tell me more about that feeling.” “I’d like to hear more about…”
open-ended questions or statements
shows caring, concern, and readiness to help
EX: “I’m here to listen.” “Can I help in some way?”
Offering self
Restates in different words what the patient said; encourages further communication on that topic
EX: Patient says,” I tossed and turned last night.” Nurse says, “You feel like you were awake all night”
Restatement
Reflects received message back to patient. Also encourages further verbalization of feelings. Reflects feelings. Can also be used if patient is unable to verbalize or if nonverbal information is incongruent with verbal.
EX: Patient says, “I’m so scared about the surgery; anesthesia terrifies me.” Nurse says, “Something scares you about anesthesia?” Patient looks scared. Nurse says, “you look scared”
Reflection
Seeks clarification about the source of the upset feeling. Helps the patient clarify thoughts or ideas
EX: Patient says, “Having my little girl come to visit me was so hard. I’m so upset.” Nurses says, “Something about your daughter’s visit upset you?”
Seeking clarification
Asking a goal-directed question helps the patient focus on key concerns
EX: “do you have any questions about your chemotherapy?”
Focusing
Helps the patient describe more fully the concern or problem under discussion
EX: “tell me what that felt like.” “I need more information about that.” “tell me more about that experience
Encouraging elaboration
Provides patient education relevant to specific health care needs or situation
EX: “the test results take at least 48 hours.” “You will get a preoperative injection that will make you sleepy before you are taken to the operating room”
giving information
Helps patients see options and consider alternatives to make their own decisions about health care
EX: “have you thought about…?” “You might want to think about…” “Would this be an option?”
Looking at alternatives
Allows patient time to gather thoughts and sort them out
EX: Patient says, “I don’t know if i should have chemotherapy, radiation, or both.” Nurse remains silent, sitting attentively but quietly
Silence
Sums up the important points of an interaction
EX: “You’ve identified you alternatives pretty clearly.” “You are aware of the important signs and symptoms to report to your primary care provider; you plan to call to make an appointment next week”
summarizing
occurs when one person sends a message to another person who receives it, processes it, and indicates that the message has been interpreted
communication
focusing on what is being said
active listening
return of information and how it was interpreted
feedback
in words
verbal
without words
nonverbal
conveyed by gesture, expression, body posture, intonation, and general appearance
body language
recognition and interpretation of sensory stimmuli
perception
highly aware and alert
mindful
In the United States, 18 inches to 4 feet is the distance that individuals generally place between themselves and a new acquaintance. This distance is called ___
personal space
focused on the moment
being present
representative
advocate
Communication that is focused on the patient needs and promotes understanding between the sender and the reciever
therapeutic communication
(know) silence gives the patient time to think and respond
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effective or curative
therapeutic
a relationship of mutual trust
rapport
(know) Empathy is the ability to understand the situation from another’s perspective, a desire to help, honesty, a nonjudgmental attitude, genuineness, acceptance, and respect
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difficulty expressing or understanding language
aphasia
a verbal communication on the details of a patient’s condition and treatment
shift report
Style of reporting. Introduction, situation, background, assessment, recommendation, and readback
ISBAR-R
put in information
input
(know) with sympathy, concern and perhaps sorrow are felt, indicating that the person is experiencing something difficult while empathy is understood but not felt
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(know) you cannot use a family member to interpret what you are saying to the patient. You need to get a medical or healthcare member to interpret what you are saying to the patient
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(know) approach children at their eye level and use a calm, quiet, friendly voice
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How do you interact with an infant and toddler
keep the mother within the baby’s view. With a toddler or preschooler, focus on the child’s needs and concerns
how do you interact with school-age child
give simple explanations and demonstrate how equipment works. Listen carefully to the child’s fears or concerns
how do you interact with an adolescent
adolescents need time to talk. Use active listening, avoid interrupting, and show acceptance. Try not to give advice, and avoid embarrassing questions if possible
tightly controls team members. This leader closely supervises the work of each staff member
autocratic or the authoritarian
does not attempt to control the team and offers little if any direction
laissez-faire
consults with staff members and seeks staff participation in decision making. This leader is part of the team, not above it, and accepts responsibility for the team’s actions
democratic
management of areas to decrease risk of harm to patients, occurrence of lawsuits, or excessive damages awards by juries
risk management
often used when there is new information to be shared. The team leader initiates. Included : who is in charge, lines of communication, and member responsibilities and expected behaviors
briefing
a strategy for communicating important information during an urgent or emergent patient situation to keep everyone informed about what is happening
Call-Out
used to make sure information was received correctly. Sender communicates a message; receiver acknowledges that message was received and states it back; sender verifies that the message was received correctly
check-back
an impromptu meeting held when the need arises. Is a chance for team members to touch base with each other, evaluate changes in the plan that might be needed, and reorganize the work flow
huddle
an informal meeting held after a situation or event to discuss the event; usually including what went well, what didn’t work, and how the situation might be handled differently next time
debrief
(know) if a conflict does arise, try to remain calm and open and actively listen to the problem. Accept responsibility for any part you played in development of the conflict. Focus on the issue rather than on the feelings of those involved. Mediate by communicating openly. Sort out the issues involved by identifying key themes in the discussion. Consider the options and weigh the consequences of each option. Choose the option for conflict resolution that offers the best outcome
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(know) once you are hired, become familiar with the organizational structure of the facility where you work
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(know) be certain you know the chain of command for your area
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(know) When delegating you must be certain that the individual to whom you are about to delegate is competent to perform such a duty, that the patient situation is stable, and that the task has a predictable outcome
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(know) the initial delegation guidelines are decided by the states nurse practice act
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(know) a minimum of 1 year of staff nurse experience is often required before taking on charge nurse duties
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(know) the computer is used to place orders to the various departments for supplies, medications, diets, laboratory and diagnostic tests, and engineering and housekeeping needs
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(know) all orders written preoperatively are considered cancelled at the time the patient enters surgery
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When you delegate a task, how should your directions be?
Concise, through,specific , measurable, deadline
(know) After defining a problem a good problem solver looks at all different kinds of ways to solve the problem, once you figure out all the different ways you can fix the problem you have to weigh the pros and cons and make the best clinical judgement/decision.
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(know) Transcribing provider orders you want to be sure to read all of them before handling each one. Read through for clarity to make sure you understand them then go back and input them into the computer entry
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How do you define leadership?
Leadership requires a good understanding of one’s self and a good grasp of basic management techniques
(know) Effective communication being a team leader: Strong nursing leaders use good communication skills and recognize that every team member has a valuable role in patient care. Communicating in direct, concise terms in a tactful, friendly, non threatening way is essential to create a supportive and healthy work environment. Obtaining feedback about directions given and listening actively and mindfully to reports, suggestions, and complaints establishes a pattern for two-way communication
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(know) if someone is on a bladder training program for incontinence your UAP can toilet that person. Someone fresh out of surgery needing their blood pressure checked cannot be delegated to a UAP because it is not a stable or predictable situation
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(know) Know that techs can never assess for tissue perfusion or focused assessments or anything of the sorts
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what are the responsibilities of a charge nurse as oppose to a team leader
charge nurse is an advanced leadership role, therefore is responsible for the assessments of all patients on the unit and is responsible for the care given on the shift
How can you minimize a liability of a lawsuit against the facility
gather a rapport with the patient and tend to their complaints
Know the best nursing documentation for reimbursement to a facility
Documentation that shows the use of the nursing process and provides data for quality-assurance studies
(know) the joint commission : Orders may be transmitted via text messaging under specific guidelines including secure sign-on process, encryption of messages, date/time stamping, and other specifications
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(know) The two rule challenge : voicing your concern at least twice to promote acknowledgment by the receiver. The first challenge is usually in the form of a question. The second challenge should provide support for the concern and may be presented by the person making the initial challenge or by another team member. The two challenge rule ensures that the concern has been heard, understood, and acknowledged
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Elements of good communication
retinitis, non threatening manner, attentiveness
Characteristics of effective communication
eye contact, concise statements when giving information, obtain feedback
(know) “He said you can’t go home until saturday” is an example of summarizing
“Go on” is an example of general leads
“He said the pain wasn’t bad” or “pain when you move” is an example of would be clarifying
“How was your night last night” is an example of open ended question
“Tell me what the doctor said” is an example of seeking elaboration
“You think it was the coffee that kept you awake?” is an example of restatement
“Your surgery is scheduled for 10am” is an example of giving information
“I’ll check on it and be right back” is an example of offering self
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