ISoN, SBN Approach, Professional Practice Flashcards
What is a metaparadigm?
Global concepts that identify the phenomena or central interests to the discipline, the description of these concepts and the relations between these concepts
What are the four central concepts of the nursing metaparadigm, identified by Jacqueline Fawcett?
Nursing, Person, Environment, and Health
How does the nursing metaparadigm help us in our practice?
It guides us in our practice (assessment, intervention, evaluation of nursing care, research) and provides us with a language (common nursing terminology) to communicate with other health professionals. It enhances professional identity.
What is the difference between Virgina’s and Callista Roy’s conceptual models of the nursing metaparadigm?
Callista Roy’s definition is about adaptation.
True or false. There are many nursing metaparadigms and many nursing theories/conceptual models/approaches.
False. There is only one nursing metaparadigm (the rest is true)
What is the difference between the science and the art of nursing?
The science of nursing consists of theories, evidence-informed knowledge, research, and clinical guidelines and practices
The art of nursing relates to human interactions and relationships, caring, and is harder to be taught.
What is ISoN’s mission?
Educate current and future nurses, advance the art and science of nursing, and optimize health and health equity through academic excellence, strengths-based nursing, and innovation.
What are the underlying assumptions of the McGill Model of Nursing?
Health of a nation is its most valuable resource
Everyone aspires and is motivated toward better heatlh
Health is best learned by personal discovery and active participation
What are key concepts of the McGill Model of Nursing?
Health promotion
Family minded
Strengths-Based Nursing
Collaborative approach
What is a health promotion? What does it do?
Increasing people’s control over their own health with health education, nutrition, sanitation, advocacy, community participation, and prevention. This helps them understand the determinants of health and develop skills to improve and maintain their own health.
What are things that we have done for health promotion (Ottawa Charter)?
Build healthy public policy (unemployed insurance, child daycare)
Create supportive environments (living and working conditions)
Strengthen community action (self-help and social support)
Develop personal skills (learn throughout life)
Reorient health services (shared responsabilities)
The strengths-based nursing approach considers the whole person, as it focuses on…
What is working/functioning
What the person does well/best
Resources available to the person
What are the four pillars of the SBN approach?
Person/Family-centered care
Empowerment
Relational care
Innate health and healing
Briefly describe what is Person/Family-centered care (pillar of SBN).
Considering the patient’s preferences, needs and values, and ensuring their values guide all clinical decisions.
Briefly describe what is Empowerment (pillar of SBN).
Working with the patient’s existing and potential strengths, and helping them have more control over their health and attain their health goals
Briefly describe what is Relational care (pillar of SBN).
Nurse-patient relationship is crucial for health promotion and the healing process, and is powerful and long-lasting
Briefly describe what is Innate health and healing (pillar of SBN).
For example, the abilities to form relationships, regulate emotions, be curious, and seek for novelty.
They develop over a lifespan and help individual adapt, develop, and cope with adversity.
Nurses create conditions for optimal health and healing, and refer to these innate capacities as the person’s inner strengths.
What are the 8 core values of Strenghts-Based Nursing? Hint : HELPED US
Health and healing
Embodiment and holism
Learning, readiness, and timing
Partnership (collaborative)
Environment (and person are integral)
Determination (self)
Uniqueness
Subjective/objective reality and created meaning
How do the values of SBN guide a nurse’s practice?
How we engage with patient/family
What we choose to explore with patient/family
What questions we want to ask patient/family
Briefly describe Health and healing (SBN value).
Health is not the absence of illness
Health is a state of balance in well-being, and healing happens when they are not in a state of equilibrium.
Promote health and healing and alleviate suffering.
Briefly describe Embodiment and holism (SBN value).
Patient’s understanding of their condition and how they are dealing with it
Mind-body connection
Briefly describe Learning, readiness, and timing (SBN value).
Desire to change and take action to change, in order for an intervention to be successful
Briefly describe Collaborative partneship (SBN value).
Nurse and patient both involved in health and healing, and learn from each other
Briefly describe Person and environment are integral (SBN value).
Internal, relational, physical, cultural environments
People thrive when there’s a good fit between them and the environment
Briefly describe Self-determination (SBN value).
Value their choices
Decisions are best made when they are well-informed
Creating conditions to help them make their own decisions
Briefly describe Uniqueness (SBN value).
Knowing the patient, being curious (coping mechanisms, concerns)
Identifying strengths and weaknesses
Briefly describe Subjective/objective reality and created meaning (SBN value).
Know their understanding of their situation, how it affects their actions and responses
What is the difference between collaboration and cooperation?
Cooperation is working together in a helpful way. Collaboration requires cooperation, but also assertiveness and active involvement.
What are the essential ingredients for a collaborative partnership? Briefly describe each of them.
Sharing power : heart of the collaborative partnership
Open and respectful : willingness to develop a relationship, honouring differences and finding a common ground to manage them, value and respect the other
Being non-judgmental and accepting : tolerance, understanding the other’s perspective
Living with ambiguity : tolerating uncertainty, being flexible and adaptable
Being self-aware and reflective : self-awareness and awareness of the other (dynamics) through reflection
What are benefits of building a therapeutic relationship?
Showing that you care makes the individual more likely to engage and connect with you.
Easier to promote health, help them deal with suffering and recover from insults, and facilitate self-healing.
Requires empathy
What are the 3 elements to building a connection with a patient?
Mutual attentiveness (listen to their concerns and communicate understanding)
Positivity (focus on strengths)
Coordination (tailoring your response)
What are 3 skills that are essential for effective communication?
Attunement and awareness
Authentic presence
Attentive listening
How can we set interpersonal boundaries?
Focusing on person/family and putting their needs before our own
Thinking about the choice of words
Being self-aware
Avoiding disclosing personal info
What is the difference between doing and being in the nursing practice?
“Doing” is about the task and procedures, and is visible and measurable.
“Being” refers to the way a nurse is with the person/family, committing to and caring for another (compassion, respect, dignity)
Why are relationships so critical to nursing?
Nursing is a relational phenomenon because everything a nurse sees, does, and experiences arises from the relationship.
… is a process that helps grow and actualize ourself, foster development.
Caring
Caring creates conditions that foster a person’s growth and development, therefore it promotes…
health and healing
… is for a person to become everything one is capable of becoming (meeting their goals).
Self-actualization
Communication connects people and ideas through…
words, nonverbal behaviors and actions
What are benefits of effective communication skills?
Helps develop a collaborative care partnership, better understand the person and their situation, identify their health issues and challenges, and create individualized care plans
What is compassion?
Daily practice of recognizing and accepting our shared humanity so that we treat ourselves and others with loving kindness, and taking action in the face of suffering
What is empathy?
Most powerful tool of compassion
Understand what they are feeling without feeling it
Not relating to an experience, but connecting to what they are feeling about an experience.
True or false. We can respond empathically even if we are not willing to be present to someone’s pain.
False
Name active listening responses.
Minimal cues and leads
Clarification
Restatement
Paraphrasing
Reflection
Summarizing
Silence
Touch
Name negative listening responses.
False reassurance
Giving advice
False inferences (false assumptions)
Moralizing (own values)
Value judgements (good, bad, nice)
What should you avoid when communicating with a patient?
Why questions
Leading questions
Negative phrasing
Unfamiliar language
When is it useful to use close ended questions?
Assessment (Do you have allergies?)
Emergency situations (Does the pain radiate down to your left shoulder and arm?)
What are the phases of a therapeutic relationship? Briefly describe each of them.
Pre-interaction : review information, might plan and deal with feelings
Introductory : get to know them, develop trust, make them feel understood and respected
Working : explore and understand thoughts and feelings, taking actions, set goals and work towards them together
Termination : feelings of loss, sharing feelings about termination
Develop clinical reasoning skills through…
deliberate and continuous practice
What is the Nursing Process?
A systematic and organized process of thinking used to deliver patient centered care.
An organizing framework that guides nurses and nursing students in making clinical judgements and decisions.
ISoN Nursing Process utilizes the … to facilitate the cognitive process of clinical decision making and is guided by … It incorporates … It is transmitted using language adapted for …
Clinical Reasoning Cycle
Evidence Based Practice
Strengths Based Nursing
Interprofessional Communication
Why is it important to question assumptions?
Because assumptions can result in clinical reasoning errors and negatively impact patient care
What are the steps of the Clinical Reasoning Cycle?
Consider the patient situation
Collect cues and information
Process information
Identify problems / issues
Establish goals
Take action
Evaluate outcomes
Reflect on process and new learning
What are the competencies that facilitate a nurse’s clinical reasoning skills?
Knowledge (nursing and related disciplines, personal knowledge)
Skills (observation, health and physical assessment, communication, technical)
Attitude (curiosity, engaged in learning, self-awareness)
What are the steps of Evidence-Based Practice?
0 - Cultivating curiosity
1 - Asking answerable questions
2 - Searching the evidence
3 - Appraising the evidence
4 - Integrating evidence into practice
5 - Evaluating practice change
6 - Disseminating results of evaluation
What is the Spiraling Process in SBN? Briefly describe each step.
Exploring : collecting cues / informations
Zeroing in : identifiy problems / issues (patient identifies, nurse helps identify)
Working out : taking action
Reviewing : reflect on process and new learning
True or false. The Spiraling Process helps uncover and discover a person’s strengths.
True
What are the approaches for getting to know your patients?
Continuously look for strengths
Get in touch with your first impressions
Sensing, recognizing and noticing strengths
Becoming attuned to the person
Ask directly about their strengths
Complete a genogram and ecomap
Offer commendation
Ask about strengths that were developed through meeting past challenges
What are the 3 forces that govern human development?
Regulation and self-regulation
Attachment and relationships
Coping
What are the steps for effective interprofessional communication in the nursing practice? Briefly describe each of them.
Assessment : gathering data, profile / understanding of the situation, curiosity and discovery, consider context and experiences
Nursing Analysis : identified health problem, evidence / contributing factors, goals
Intervention : establish care and clinical follow-up, describe interventions linked to goals (health promotion, prevention, rehabilitation, therapeutic process)
Outcomes and follow-up : response to and effect of interventions
What is the OIIQ terminology for each steps of effective communication in the nursing practice?
Initial and ongoing (subjective and objective data)
Assessment findings (including priority problems or needs)
Promotive, preventative, rehabilitation, and therapeutic
Continuity of care : communication and coordination of care
What are the 4 categories of SBN Essential Nurse Qualities? Give examples for each.
Mindset (mindfulness, humility, open-mindness, non-judgemental attitudes)
Knowledge and knowing (curiosity, self-reflection)
Relationships (respect and trust, empathy, compassion and kindness, emotional intelligence)
Advocacy (courage, self-efficacy, influence)
Between a stimulus and a response, there is a space. This is where (quality) is demonstrated.
Emotional intelligence
The SBN Essential Nurse Qualities are required to…
Form a collaborative partnership
Engage in compassionate, competent and ethical care
How is reflection useful in nursing practice?
Reflection is a systematic way of thinking about our actions and responses that contributes to a transformed perspective or the reframing of a given situation or problem that determines future actions and responses
True or false. Reflection increases self-awareness.
True
True or false. Practicing SBN requires self-awareness.
True
What is the difference between reflection on action and in action?
Reflection on action is going over in your mind an event that happened (what went well, what didn’t, find ways to deal with it in the future)
Reflection in action is reflecting as the event is happening
True or false. We learn by experience.
True and false. We learn by reflecting on our experience.
True or false. Reflecting on negative experiences is the only way to learn, develop and grow.
False. Reflecting on positive experiences can also contribute to learning and growth.
What are the steps for reflecting on a situation (Gibb’s Reflective Model)?
Description (what, who, why)
Feelings and thoughts (self and others)
Evaluation (what went well and what didn’t)
Analysis (making sense of the whole situation)
Conclusion (other things that could’ve been done, what you learned)
Action plan (actions if it were to happen again)
True or false. Reflection is an effective strategy for enhancing emotional intelligence competencies.
True
What is resiliency? How is it linked to personal strenghts?
To adapt effectively in the face of challenge (withstand, rebound and recover from it)
Dealing with challenges make people discover strengths, so they become resilient. Having more strengths means being better equipped to face challenges.
What are the 7 classes of character strengths (Peterson and Seligman, 2004)?
Wisdom and knowledge
Courage
Humanity
Justice
Temperance
Transcendence
What are the 10 categories of strengths (Smith, 2006)?
Wisdom and spiritual
Emotional
Character
Creative
Relational and nurturing
Educational
Cognitive
Work-related and provider
Use-of-resources
Survival skills
What are the 9 characteristics of strengths?
They are developing entities
They can be developed through learning
They coexist with weaknesses and vulnerabilities
They are related to goals
They are defined by context and circumstance
They are multi-dimensional
They can be depleted and replenished
They can be transferable
They are personal constructions
What are the 3 additional senses for nursing practice?
Awareness of internal bodily sensations
Awareness of an awareness
Relational sensing
As nurses, we need to aquire, develop, and demonstrate knowledge in…
nursing science and skills, clinical reasoning skills and ethical components
What are the 2 types of learning for nursing students (apprenticeship)? What is the difference between them?
Experiential (gained while nursing, theory and practice) and situated (gained in a specific context and patient, uniqueness of the person)
What is the Professional Gaze?
The ability to grasp situations for sound clinical reasoning via observation, attunement to senses, and listening, as well as identifying important observations.
What is attunement?
Sensing another person’s internal state as well as one’s own by paying attention to potent and subtle cues and responding with appropriate language and behaviors.
Being open to another’s needs and wants.
Every sense is used for…
Assessment and therapeutic interventions or approaches (by determining what is relevant)
How does training and retraining your senses differ depending on your practice domain?
All nurses need to develop their senses for practice in the basic clinical domains of nursing practice. Specialized knowledge and skills must be developed depending on the domain of practice.
What are the experiences that help retrain senses?
Exposure, benefiting from mistakes and obstacles, practice and experience.
How much time do you need to practice a SBN approach?
SBN is a way of thinking (mindset) and of approaching situations. It can be integrated in all your interactions with patients/families. It can be applicable in 1-minute or 60-minute interaction.
Define Professional Identity in nursing.
A sense of oneself, and in relationship with others, that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting and feeling like a nurse.
True or false. Your professional identity formation starts at your first day of work as registered nurse.
False. It began the day you decided to pursue your educational journey in nursing.
