History/Wellness/Communication Flashcards
Maslow’s hierarchy
State prioritization in order
1) Physiological 2) Safety & Security 3) Love & Belongingness 4) Esteem 5) Self-Actualization
NFLPN
Who founded it? Why do we have it?
National Federation of Licensed Practical Nurses; founded by Lillian Kuster. This organization is the official membership organization for LPN/LVN’s, worked in conjunction with NAPNES to set standards for PN and VN practice, promote and protect interests, educate and inform the general public about practical and vocational nursing.
Saint Thomas Hospital
A nursing school, in London, within the hospital founded by Florence Nightingale (1860). With the hospital’s reputation as a progressive medical facility, it was the ideal place to promote new standards for nursing.
The nursing program operated separately and was financially independent from the hospital, to ensure education emphasis on the nursing students.
Students had to pass strict procedures for admission, and were provided residence. The training program lasted 1 year, included formal instruction and practical experience. Complete records were kept on each students progress; this practice was known as the “Nightingale Plan”, which became the model for nursing in the 20th century. After graduation, records were also kept on places of employment. This “register” that resulted became a standard for nursing, and the beginning of a movement to exercise control over the nursing grad.
Students admitted into the nursing program needed to provide excellent references, show a strong commitment to a career in nursing, and demonstrate intellectual competence to pass.
The “Nightingale Nurses” improved patient care through: good hygiene and sanitation, patient observation, accurate record keeping, nutritional improvements, and introduction to the use of new medical equipment.
Biologic Program Theory
Select it
Who issued the Patient Bill of Rights?
AHA, issued in an effort to ensure the patients fundamental rights for treatment with dignity and compassion were protected
Wellness vs. Illness continuum
is ever-changing and is influenced by an individuals physical condition, mental condition, and social well-being
Goal for patients as a nurse
to provide them with the highest level of care and place them in the highest state of well-being
multi-disciplinary approach
patient care plan is comprehensive/holistic
Long term, 60+ yr patient scenario
reminisce w/ them
Expressive Aphasia
develop a communication strategy, allow the patient to talk as much as possible
Comms w/ older adult
Allow more time to process information and respond
Communications w/ unfamiliar culture
Use an interpreter if available (do not use family member)
Find dominant language, use translator, pantomime basic words for understanding, etc.
Cultural Comm. Patterns: Explore meaning of touch, eye contact, personal space, and various facial expressions. Explore willingness of individuals to share thoughts, feelings, and ideas.
Explore formats of time: social time vs clock time
Explore name formats; how does the patient expect to be greeted by strangers and healthcare professionals
Zones (pg. 70-71)
Intimate space : face - 18in. //
Personal space : 18in. - 4ft. // A nurse must enter a patient’s personal space quite often (changing dressings, inserting catheters, bathing), approaching these in a professional manner can alleviate some of the discomfort for both the nurse and patient
Social space : 4ft. - 12ft. // Ex. A nurse conducting a diabetes class for multiple patients
Public space : 12ft.+ //
Patient Care Partnership
Patients are assured they can expect high-quality hospital care, a clean and safe environment, involvement in their care and decision making process, protection of privacy, help when leaving the hospital, and help with nilling concerns
Mary Breckenridge
Pioneer in nurse-midwifery
Est. the Frontier Nursing Service to deliver obstetric care to mothers in the hills of Kentucky; nurses traveled on horseback to reach them
Mary Adelaide Nutting
A leader in nursing education
Developed curriculum concepts and guidelines for student nurses
Assisted in development of the International Council of Nurses
Therapeutic communication techniques : Verbal
Open-ended Questioning
Does not require a specific answer and cannot be answered by yes/no; begins with “how”, “what”, “can you tell me about”
Allows the patient to elaborate freely; useful for feelings; elicit’s patients thoughts without influencing their response
How do you feel about having the surgery tomorrow?
What concerns do you have about going home?
Position paper of the American Nurses Association
Outlined recommendations for the educational levels for the nurse to enter practice. Recommended a 2yr. technical education be provided in vocational and community college settings. Graduates would earn an associates degree. The professional nurse would earn a bachelor. It did not specifically discuss LVNs, but nonetheless, LPN/LVN’s proved their worth.
Holistic health care
entails professionals from differing areas come together to provide comprehensive care; an all-inclusive approach to health care
WWII: Cadet Nurse Core
established to provide an abbreviated training program designed to meet the needs of the war effort; federally subsidized programs in nursing were developed and offered to women and men
Therapeutic communication techniques : Verbal
Offering Information
Nurse provides patient with relevant data and asks for feedback to determine patients level of understanding
Useful for patient teaching; promotes informed decision making
Diabetes education
Therapeutic communication techniques : Verbal
Summarizing
Concise review of main ideas from a discussion
Focuses on key issues and allows for additional info that was perhaps omitted; useful when interaction has been lengthy or multi-topic
Therapeutic communication techniques : Verbal
Focusing
Nurse encourages patient to select one topic over another as primary focus of discussion
Allows nurse to gather more specific information when the patients message is too vague
Therapeutic communication techniques : Verbal
Reflecting
Assists the patient to reflect on feelings and thoughts instead of seeking answers and advice from another
Promotes independent decision making; allows the patient to see that their ideas/thoughts are important
Therapeutic communication techniques : Verbal
Stating Observations
Nurse makes observations of the patient during interactions and communicates these back to the patient
Allows for clarification of the intended message when verbal cues do not match nonverbal cues
Therapeutic communication techniques : Verbal
Summarizing
Concise review of main ideas from a discussion
Focuses on key issues and allows for additional info that was perhaps omitted; useful when interaction has been lengthy or multi-topic
Approved
minimum standards set by the state agency responsible for overseeing the educational programs
Accredited
a higher standard that signifies that the accrediting organization has judged that a program has met its pre-established criteria
Pesthouses
19th century hospitals; dirty, overcrowded facilities filled with patients. Scope of care was limited, providers were untrained, hygiene was poor, which resulted in high infection and mortality rates
Portfolio
organized account of an individuals education and professional accomplishments
active listening
full attention to what the patient is saying; the nurse hears the message, interprets its meaning, and gives the patient feedback, indicating understanding
aggressive comm
Interacts with another individual in an overpowering and forceful manner to meet one’s personal needs at the expense of the other
altered cognition
physiological factor that frequently hinders communication; a patient that lacks the cognitive ability to receive, process, and send info
assertive comm
Assertiveness : confidently and comfortably express thoughts and feelings while respecting the legitimate rights of the patient.
Interaction that considers the feelings and needs of the patient yet honors the nurse’s rights as an individual
clarifying
takes restating and paraphrasing a step further and is useful when the message is incomplete or confusing; the nurse uses some of their own ideas about what the patient is trying to communicate in a manner that asks the patient for verification that the nurses understanding is accurate
non-therapeutic comm
blocks the development of a trusting and therapeutic relationship
therapeutic comm
the ideal form, which consists of an exchange of information that facilitates a positive nurse-patient relationship and actively involves the patient in all areas of care
closed question
focused, specific question that follows with a one to two word answer (yes/no, etc.)
expressive aphasia
patients who are unable to send the desired verbal message
jargon
commonplace terminology unique to people in a particular work setting, ex. the hospital;
Ex. speaking among nurses: nephrectomy
speak towards patients: removal of the kidney/s
Young Adulthood // 20-44
Intimacy vs Isolation // Seek companionship and love with another or become isolated from others
Middle Adulthood // 45-65
Generativity vs stagnation // Productive, meaningful work and raise a family or become stagnant and inactive
Late Adulthood // 65+
Ego integrity vs despair // Make sense out of their lives, seeing life as meaningful and whole or despairing at goals never reached and questions never answered
