FUNDA MIDTERM Flashcards
one must understand not only past events but also
contemporary nursing practice and the sociologic and historical factor that affect it.
alluded directly to the myth of Hermes, who saw two snakes fighting and touched them with his rod so that the two animals would stop fighting.
Caduceus symbol
•A look at nursing’s beginnings reveals its continuing
struggle for autonomy and professionalization.
From the beginning of time, women have cared for infants and children;; thus nursing could be said to have its roots in
The home
WHO IS THE FIRST EVER MALE NURSE?
In 1955, 2nd Lt. Edward T. Lyon
it was the Christian value of
“love thy neighbor as thyself” and Christ’s parable of the Good Samaritan
dedicated themselves to the care of people with leprosy, syphilis, and chronic skin conditions.
Knights of Saint Lazarus
organized care for victims of the Black Plague in the 14th century
in Germany.
• The Alexian Brothers
the inadequacy of care given to soldiers led to a public outcry in Great Britain.
During the Crimean War (1854-1856),
Florence Nightingale’s Environmental Theory defined Nursing as
“the act of utilizing the patient’s environment to assist him in his recovery.”
The practice of nursing is controlled from within the profession through the
state boards of nursing and professional nursing organizations.
Nursing leaders
Florence nightiangale
Lillian wald
Clara barton
Lavinia dock
Linda richards
Margaret higgins sanger
Mary mahoney
Mary breckinbridge
Definition of nursing
Nursing is caring.
Nursing is adaptive.
Nursing is an art
Nursing is a science.
Nursing is client centered.
Nursing is concerned with health promotion, health maintenance, and health restoration.
Nursing is holistic.
Nursing is a helping profession.
Latin word meaning “to suffer” or “to bear”;
Patient
person who is waiting for or undergoing medical treatment and care. Usually, people become patients when they seek assistance because of illness or for surgery.
Patient
person who engages the advice or services of another who is qualified to provide this service.
Client
the main practice setting open to most nurses.
Acute care hospital
or legal acts for professional nursing practice, differ in various jurisdictions, they all have a common purpose: to protect the public.
Nurses are responsible for knowing their state’s ———-
as it governs their practice.
Nurse Practice Acts
the purpose is to describe the responsibilities for which nurses are accountable. Establishing and implementing standards of practice are major functions of a professional organization.
Standards of Nursing Practice
describe behaviors expected in the professional
nursing role.
•Standards of Professional Performance
Scope of nursing
PROMOTING health and wellness
PREVENTING illness
RESTORING health
CARE for dying
Roles n functions of the nurses
Caregiver
Communicator
Teacher
Change agent
Client advocate
Research consumer
Manager
Counselor
Leader
These two words were the early beliefs of health and illness in the Philippines.
MYSTICISM AND SUPERSTITIONS
To disperse their influence, gunpowder were exploded from a —————- close to the head of the sufferer.
Bamboo cane
The context of nursing has
manifested through simple nutrition, wound care, and taking care of an ill member of the family
HOSPITAL SCHOOL OF NURSING’S FORMAL TRAINING (1901 – 1911)
Iloilo mission hospital school of nursing
SAINT PAUL’S HOSPITAL SCHOOL OF NURSING (MANILA)
Philippine general hospital school of nursing (manila)
ST. LUKE’S HOSPITAL SCHOOL OF NURSING (QUEZON CITY)
MARY JOHNSTON HOSPITAL AND SCHOOL OF NURSING (MANILA)
PHILIPPINE CHRISTIAN MISSION INSTITUTE SCHOOLS OF NURSING
SALLIE LONG READ MEMORIAL HOSPITAL SCHOOL OF NURSING
(LAOAG, ILOCOS NORTE)
THE FIRST HOSPITAL IN THE PHILIPPINES, WHICH TRAINED FILIPINO NURSES ESTABLISHED BY THE BAPTIST MISSIONARIES.
ILOILO MISSION HOSPITAL SCHOOL OF NURSING (ILOILO CITY)
The hospital was established by the archbishop of manila, jeremiah harty under the supervision of the sisters of st. Paul de chartres located in Intramuros.
It provided general hospital services. It opened its training school for nurses in 1908, with mother melanie as superintendent and miss chambers as principal.
SAINT PAUL’S HOSPITAL SCHOOL OF NURSING (MANILA)
As a small dispensary for civil officers and employees in the city of manila and later grew as a civil hospital. In 1906, mary coleman masters, an educator advocated for the idea of training filipino girls for the profession of nursing with the approval of government officials, she first opened a dormitory for girls enrolled at the philippine normal hall and the university of the philippines.
Philippine general hospital school of nursing (manila)
THE HOSPITAL IS AN EPISCOPALIAN INSTITUTION. IT BEGAN AS A SMALL DISPENSARY IN 1903. IN 1907, THE SCHOOL OPENED WITH THREE GIRLS ADMITTED. THESE THREE GIRLS HAD THEIR FIRST YEAR IN COMBINED CLASSES WITH THE PGH SCHOOL OF NURSING AND ST. PAUL’S HOSPITAL SCHOOL OF NURSING.
St. Luke’s hospital school of nursing
Quezon city
started as a small dispensary on calle cervantes (now avenida). it was called the bethany dispensary and funded by the methodist mission for the relief of suffering among women and children. in 1907, sister rebecca parrish together with registered nurses rose dudley and gertude dreisbach, organized the mary johnston school of nursing. the nurses’ training course began with three filipino young girls fresh from elementary as their first students.
Mary Johnston hospital and school of nursing
Manila
the united christian missionary society of indianapolis, indiana- a protestant organization of the disciples of christ operated three schools of nursing.
PHILIPPINE CHRISTIAN MISSION INSTITUTE SCHOOLS OF NURSING
allowing the regulation of nursing practice transpired during this period.
Promulgation of Act No. 2493
In 1919, the First True Nursing Law was enacted through Act
During this period the Board Examiners for Nursing was also created.
2808
The first executive officer of the Board Examiners for Nurses is a
Physician
The start of nursing practice 1911-1921
Mary Chilles Hospital School of Nursing (Manila, 1911)
Frank Dunn Memorial Hospital (Vigan, Ilocos Sur, 1912)
San Juan de Dios Hospital School of Nursing (Manila, 1913)
Emmanuel Hospital School of Nursing (Capiz, 1913)
Southern Islands Hospital School of Nursing (Cebu, 1918)
the nursing institution have increased their requirement. During this period, they have implemented that to enter nursing education an applicant must be able to complete secondary education. T
1933
The first collegiate nursing graduates of the Philippines graduated from
University of the Philippines School of Public Health Nursing in 1938.
made public health nurses in Manila assigned to devastated areas to attend the sick and the wounded.
World war II in ph
A year after, —— nurses who were taken prisoners of war by the Japanese army and confined at the Bilibid Prison in Manila were released to the Director of the Bureau of Health.
Thrirty-one
And just like in the US, a lot of public health nurses joined the.
Guerillas
which was based on the thesis
Nursing curriculum
Nursing curriculum presented by
Julita v. sotejo
During this period, College of Nursing was also created.
The Degree of Bachelor of
Science in Nursing: 1941 – 1951
the Philippine Nursing Act of 2002 was enacted under the Republic Act No. 9173 which entails changes on existing policies under
Republic Act No. 7164.
As a group, Filipino nurses are well liked because they are hardworking. They place high value on responsibility and seldom complain. Joyce and Hunt (1982) commented, “Many [Filipino nurses] work nights, holidays and/or overtime. So, during this time of nursing shortage, one can rely on a Filipino nurse to volunteer to cover the shift”
Work ethic
Filipino nurses are very religious people. There is a deep faith in God that is reflected in the expression of “bahala na” — “it is up to God” or “leave it to God.” Although it is an indication of acceptance of the nature of things including one’s own inherent limitations, bahala na operates psychologically to elevate one’s courage and conviction to persist in the face of adversity and improve one’s situation (Okamura & Agbayani, 1991).
SPIRITUALITY
so they try to find a way to say things diplomatically.
also reflected in the way Filipino nurses conduct patient teaching, especially with the elderly, immigrants, and the less fortunate.
SENSITIVITY
Filipinos are generally quiet. Very conservative families do not allow their younger members to join the conversation of adults without an invitation.
•Engaging in arguments, especially with someone who is older or holds an authority position, is considered uncivilized. Filipinos also have difficulty turning down requests from supervisors to whom they feel obligated.
INTERPERSONAL RELATIONSHIP
One’s position in society, professional achievements, and age carry a lot of weight in the Philippine society. Physicians, lawyers, priests, engineers, teachers, and nurses are among the well-respected professionals in the Philippines. Hence, their opinion is generally accepted without question.
•Filipino nurses highly value their elderly clients. Elderly individuals are given high respect and revered. Family commitment fosters a sense of pride, and therefore, caring for others is embedded in the culture.
RESPECT AND REVERENCE
Filipino nurses find it uncomfortable to accept even a well-deserved compliment. Filipino nurses are less likely to use “I” to express what they have achieved. More than likely, they will use we to acknowledge others’ contributions no matter how insignificant the contributions might be.
• This may explain why they work well with others. This may come from the practice of Bayanihan. In the Philippines, if you want something done, it is easy to get a group together to work on a project so that it will get done faster and better.
MODESTY
Respect is integrated in the Filipino language. Reference to the elderly is the use of the third person.
LANGUAGE
They tend to eat the same food and mingle with individuals of the same ethnic background. Hence, the old health beliefs and practices continue.
CLOSE FAMILY TIES
is defined as the “totality of socially transmitted pattern of thoughts, values, meanings, and beliefs” (Purnell 2005). It is not limited to any specific ethnic group, geographical area, language, religious belief, manner of clothing, sexual orientation, and socioeconomic status (Fisher 1996).
CULTURE
Namamana
Inheritance
Lihi
Conception or maternal cravings
Sumpa and gaba
Curse
Pasma
Hot and cold syndrome
Namaligno
Mystical and supernatural causes
Kaloob ng Diyos
God’s will
It was believed that
evil spirits could be driven away by persons with power to banish demons. Belief in special gods of healing, with the priest -physician (called “word doctors”) as intermediary.
Herbolarios
Herb doctors
Herbolarios
Herb men, meaning one who practiced witchcraft.
Herbicheros
manggagaway)
suffering from without any identified cause were believed bewitched by these people.
Mangkukulam
difficult childbirth,
and some diseases were attributed to “nunos”. Midwives assisted in childbirth.
Pamao
During labor, the “———” (good midwife) was called in.
mabuting hilot
are, for the most part, centered at maintaining social harmony, motivated primarily by the desire to be accepted within a group.
Filipino values
The main sanction against diverging from these values are the concepts of
Hiya (sense of shame) and amor propio (self-esteem)
The main sanction against diverging from these values are the concepts of
Hiya (sense of shame) and amor propio (self-esteem)
Growth of microorganisms in body tissue where they are not usually found.
Infection
•Types of microorganisms that cause infection:
Bacteria
Viruses
Fungi
Parasites
most common infection-causing microorganisms
Bacteria
consist primarily of nucleic acid and therefore must enter living cells to reproduce
Viruses
includes yeasts and molds
Fungi
live on other living organisms
Parasites
Process by which strains of microorganisms become resident flora.
Colonization
Types of infection
Local
Systemic
Acute
Chronic
Limited to specific part of the body where the
microorganisms remain
Local infection
When microorganisms spread and damage different parts of the body
Systemic infection
when a culture of the person’s blood reveals microorganisms
Bacteremia
WHEN BACTEREMIA RESULTS IN SYSTEMIC INFECTION
Septicemia
GENERALLY APPEAR SUDDENLY OR LAST A SHORT TIME
Acute infection
OCCUR SLOWLY, OVER A VERY LONG PERIOD, AND MAY LAST MONTHS OR YEARS
Chronic infection
Prevents or stops the spread of infections in
healthcare settings.
Infection control
Levels of Infection Control
Standard precaution
Transmission-based precaution
for all patient care oBased on risk assessment and make use of common sense practices and personal protective equipment use that protect healthcare providers from infection and prevent the spread of infection from patient to patient
Standard precaution
oUsed in addition to Standard precautions for
patients who may be infected or colonized with certain infectious agents for which additional
precautions are needed to prevent infection transmission
Transmission-based precaution
Ensure appropriate patient placement
•Use PPE appropriately
•Limit transport and movement of patients
•Use disposable or dedicated patient-care equipment •Prioritize cleaning and disinfection of the rooms
Contact precautions
Source control (put a mask on the patient)
•Ensure appropriate patient placement
•Use PPE appropriately
•Limit transport and movement of patients
Droplet precaution
•Source control
•Ensure appropriate patient place mentin an airborne infection isolation room
•Restrict susceptible healthcare personnel from entering the room
•Use PPE appropriately (including a fit-tested NIOSH- approved N(% or higher level respirator for health personnel)
•Limit transport and movement of patients •Immunize susceptible persons as soon as possible
following unprotected contact
Airborne precautions
Common types of faucet control:
Hand-operated handles
•Knee-lever faucet control
•Foot-pedal faucet control
•Elbow
•Infrared control
are goal- oriented and directed at learning and growth promotion.
Therapeutic relationships
COMPONENTS OF THERAPEUTIC NURSE-CLIENT RELATIONSHIP
Trust
Genuine Interest
Empathy
Positive Regard
builds when the client is confident in the nurse and when the nurse’s presence conveys integrity and reliability
Trust
not only you act as that you care, but you really do care and listen to what people are saying
Genuine interest
ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.
Empathy
unconditional nonjudgemental attitude of the nurse when he/she appreciates the client as unique worthwhile human
Positive regard
Is the process by which the nurse gains recognition of his or her own feelings, beliefs and attitudes
Self-awareness
To use aspects of his or her personality, experiences, values, feelings, intelligence, needs, coping skills, and perceptions to establish relationships with clients.
Therapeutic use of self
Type of relationships
Social Relationship
Intimate Relationship
Therapeutic Relationship
primarily initiated for the purpose of friendship, socialization, companionship, or accomplishment of a task
Social relationship
communication is superficial
Social relationship
usually focus on sharing ides, feelings, and experiences
Social relationship
advice is often given
Social relationship
involves two people who are emotionally committed to each other
Intimate relationship
include sexual or emotional intimacy as well as sharing of mutual goals
Intimate Relationship
focuses on the needs, ideas, experiences and feelings of the client only.
Therapeutic Relationship
the parameters are clear; the focus is the client’s needs, not the nurse’s.
Therapeutic Relationship
the nurse uses communication skills, personal strengths, and understanding of human behaviour to interact with the client
Therapeutic Relationship
Behaviors that diminish the Therapeutic Relationship
INAPPROPRIATE BOUNDARIES
NON-ACCEPTANCE AND AVOIDANCE
ÜFEELINGS OF SYMPATHY AND ENCOURAGING DEPENDENCY
Roles of the Nurse in Therapeutic Relationship
Teacher
Caregiver
Advocate
Communication
Verbal
Non-Verbal
-Is an interpersonal interaction between the nurse and client during which the nurse focuses on the client’s specific needs to promote an effective exchange of information.
-Skilled use of —techniques helps the nurse understand and empathize with the client’s experience.
Therapeutic Communication
Things to consider
Privacy and Respecting Boundaries
Touch
Active Listening and Observation
space for parents with young children, person who mutually desire personal contact, or people whispering.
Intimate Zone (0-18 inches)
communication in social, work, and business settings
Social zone (4- 12 feet)
distance between family and friends who are talking
Personal zone (18-36 inches)
acceptable distance between a speaker and an audience, small groups, and other informal functions
Public zone (12-25 feet)
use in examinations or procedures
Functional – professional touch
involves a hug in greeting, an arm thrown around the shoulder of a good friend, or the back slapping some men use to greet friends and relatives
Friendship-warmth touch
used by lovers
Sexual arousal touch
used in greeting
Social-polite touch
involves tights hugs and kisses between lovers or close relatives
Love – intimacy touch
Recognize the issue that is most important to the client at this time
Active Listening and Observation
•Use additional therapeutic communication techniques to guide the client to describe his or her perceptions fully
Active Listening and Observation
•Know what further questions to ask the client
Active Listening and Observation
Understand the client’s perceptions of the issue instead of jumping to conclusions
Active Listening and Observation
Interpret and respond to the messages objectively.
Active Listening and Observation
The nurse offers to stay with the client and either talk or just sit quietly
OFFERING SELF
The nurse acknowledges that something or someone exists or has changed in some ways.
MAKING AN OBSERVATION
The nurse invites the client to select a topic
PROVIDING BROAD OPENING
The nurse makes an offer to work together with the client
SUGGESTING COLLABORATION
The nurse allows the verbal
conversation to stop to provide a
time for quiet contemplation of
what has been discussed, for
formulation of thoughts about
how to proceed, or for tension
PROVIDING SILENCE
The nurse provides brief interjections that let the client know that he or she is on the right track and should continue
PROVIDING GENERAL LEADS
The nurse acknowledges that he or she has heard and understood what his client has said
ACCEPTING MESSAGES
The nurse asks the client to describe something in more detail or to discuss it more fully
EXPLORING
The nurse selects one topic for exploration from among several possible topics presented by the client
FOCUSING
The nurse paraphrases what the client has said. This paraphrased message may be fed back to the client in the form of a statement or a question to provide the client the opportunity to agree or to disagree and clarify further
RESTATING
The nurse acknowledges that he or she has heard and understood what his client has said
ASKING FOR CLARIFICATION
The nurse attempts to verify with the client that a certain terms means the same thing to both parties
SEEKING CONSENSUAL VALIDATION
When the client has a misperception of the environment, the nurse defines reality or indicates his or her perception of the situation for the client
PRESENTING REALITY
Acknowledging and indicating awareness; better than complimenting, which reflects the nurse’s judgment.
GIVING RECOGNITION
Asking the client to verbalize what is being perceived; often used with clients experiencing hallucinations.
PERCEPTION CHECKING
Asking the client to compare similarities and differences in ideas, experiences, or interpersonal relationships
ENCOURAGING COMPARISON
The nurse asks the client to explain more about when an event occurred or to explain the sequence of a series of events
PLACING EVENTS IN TIME OR SEQUENCE
Indicates to the client that there is no cause for anxiety
GIVING REASSURANCE
Sanctioning or denouncing the client’s ideas or behavior
APPROVING OR DISAPPROVING
Refusing to consider or showing contempt for the client’s ideas or behavior
REJECTING
Indicating accord with or opposition to the client’s ideas or opinions
AGREEING OR DISAGREEING
implies that the nurse knows what is best for client and that client is incapable of any self-direction
GIVING ADVICE
Attempting to protect someone or something from verbal attack
DEFENDING
pushing for answers to issues the client does not wish to discuss
PROBING
asking “why” implies that client must defend his or her behavior or feeling
REQUESTING AN EXPLANATION
encourages client to project blame for his or her thoughts or behaviors on others
INDICATING THE EXISTENCE OF AN EXTERNAL SOURCE OF POWER
these are meaningless in a nurse-client relationship
MAKING STEREOTYPED COMMENTS, CLICHÉS, AND TRITE EXPRESSIONS
causes client to feel insignificant or unimportant
BELITTLING FEELINGS EXPRESSED
blocks discussion with client and avoids helping client identify and explore areas of difficulty
USING DENIAL
With this technique the therapist seeks to make conscious that which is unconscious, to tell the client the meaning of his or her experience.
INTERPRETING
Changing the subject causes the nurse to take over the direction of the discussion
INTRODUCING AN UNRELATED TOPIC
