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NURS1511 > midterm 1 > Flashcards

midterm 1 Flashcards

1
Q

Relational practice: ( 6 words)

A

self, other, context, knowing, being, doing

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2
Q

Relational practice CNO definition

A

conscious participation with clients using listening, questioning, empathy, mutuality, reciprocity, self-observation, reflection and a sensitivity to emotional contexts.

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3
Q

Dr. Bonofiglio, key concepts

A

Empathy, Compassion, Self-Compassion, Gratitude, Resilience.

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4
Q

Constructivism

A

active process in which learners construct new ideas or concepts based upon their current or past knowledge

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5
Q

Andragogy

A

based on four assumptions: self-concept, adult learner experience, orientation to learning, and motivation to learn.

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6
Q

SMART GOAL

A

Specific, Measurable, Attainable, Relevant, Time-limited

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7
Q

Domains of learning

A

1) Cognitive: knowledge, comprehension, application, analysis, evaluation, synthesis
2) Affective: attitudes, values, embodiment
3) Psychomotor: development of skills

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8
Q

Intrapersonal

A

self and other (individual vs self).

awareness within your own mind and considering what is going on within the patient, yourself and others in the situation (family)

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9
Q

Interpersonal

A

self with other (individual vs other people)

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10
Q

Situation

A

(the context)

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11
Q

CNO code of conduct states?

A

what nurses are accountable for AND helps the public know what to expect from nurses.

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12
Q

6 principles of CNO stated in the code of conduct

A

1) dignity of patients
2) promote patient well-being
3) maintain patient trust by providing safe and competent practice
4) Nurses work respectfully with colleagues to best meet patients needs
5) act with integrity to maintain patient’s trust
6) Nurses maintain public confidence in the nursing profession

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13
Q

List the 7 CNO ethical values:

A
  • Client well-being
  • Client choice
  • Privacy and confidentiality
  • Respect for life
  • Maintaining commitments
  • Truthfulness
  • Fairness
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14
Q

CNA code of ethics states (definition)

A

ethical values of nurses and their commitments to persons w/healthcare needs and persons receiving care.

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15
Q

CNA 7 primary Values:

A

1) safe, compassionate, comptent and ethical care
2) Promoting health and well-being
3) Promoting and respecting informed decision making (autonomy)
4) Dignity
5) Maintaining privacy and confidentiality
6) Promoting justice
7) Being accountable

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16
Q

define Othering

A

process that identifies those that are thought to be different from ourselves or the mainstream and in so doing reinforces and reproduces positions of power and subordination

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17
Q

synonyms of othering

A

marginalization, stereotyping, stigmatizing

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18
Q

the 5 W’s of relating

A
  • What are you relating to?
  • Who are you relating to?
  • Why are you relating?
  • When are you relating?
  • Where are you relating?
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19
Q

GIBB’S reflective cycle

A

1) Description on what happened
2) Feelings: what were you thinking/feeling?
3) Evaluation: what was good or bad about the situation?
4) Analysis: what sense can you make of the situation?
5) Conclusion: what else could you have done?
6) Action plan: if situation occurs again, what would you do?

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20
Q

define Reflection

A

Act of wondering about a phenomenon and seeking its deeper understanding.

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21
Q

Reflection on actions

A

Thinking BACK on what we have done and considering hose we contributed

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22
Q

Reflection in action

A

Occurs IN the moment, helps us think about whether we are getting things done right.

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23
Q

What are the 3 reflective questions

A

what? (What happened), So what? (Did you learn a new skill? Likes/dislikes?), Now what? (How can you apply this later?)

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24
Q

define Reflexivity

A

leads us to question our values and assumptions. It causes us to look at privilege, power, biases, and stereotypes

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25
Q

define mutuality in nurse-client relationship

A

1) Nurses work with client
2) Nurses focus on the client’s needs
3) Nurses plan with the client through mutual goal setting
4) Client is the centre of the relationship

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26
Q

describe the 4 metaparadigm

A

1) Person
2) Environment
3) Health
4) Nursing

27
Q

define Complexity theory

A

helps us to understand that nursing practice is not linear independent practice. Rather, your nursing actions and the impact of those actions are mediated by many intrapersonal, interpersonal, and contextual variables, including what is happening for and around the person with who you are relating. Not relating is NOT an option. We are always relating. But we have a choice of How we choose to relate.

28
Q

define Developmental theory

A

humans development occurs in sequential stages. Each stage build on the previous stage.

Erikson – psychosocial development: autonomy, identity, intimacy, Ego integrity
Piaget – cognitive development: motor senses, curiosity, symbolic thinking, strategy and planning
Kohlberg – moral development: avoiding punishment, aiming at a reward, loyalty, justice, ethics.

29
Q

define Basic human Needs of Maslow

A

physiological needs: food, water, warmth, rest. Safety needs: security, safety.

30
Q

state the 5 levels of communication

A

1) Intrapersonal: occurs within an individual (self talk)
- Critical thinking
- Reflection
- Clarifying ideas
2) Interpersonal: one-to-one interaction between two people
- Requires the nurse to consider each other as a “unique” being.
3) Transpersonal: Interaction within a person’s spiritual domain
- Engaging in a communication with the client regarding spirituality
4) Small group: interaction with 2-15 people sharing common purpose
- Happens with clients: teaching, support groups, self-help groups
5) Public: interactions with a larger audience (ex: conferences)

31
Q

Explain the communication model

A

Referent : motivation for communication
Message: what is being communicated
Chanell: method of sending the message
Sender: person who initiates conversation. This person “encodes” the message
Receiver: person who receives message. This person “decodes” the message
Feedback: the message back

32
Q

what is the Nurses responsibility as sender the communication model?

A

Individualize (encode)each message taking into consideration the: age, education, literacy level, cognitive ability, emotional state, culture, language etc…

33
Q

What are the 5 Cs of communication?

A
  • Clear
  • Concrete
  • Concise
  • Complete
  • Courteous
34
Q

what is a Channel in the communication model?

A

refers to the medium or method used to send a message. Face to Face communication is the preferred channel to use because it enables the nurse to use visual, auditory, olfactory and tactical senses

35
Q

what is the preferred method for nurses in the communication model?

A

face to face

36
Q

what is noise within the communication process? name the 4 types

A
  • Physiologic (pain, fatigue, sensory impairments)
  • Pscychological (stress, embarrassent, emotions)
  • Environnemental (Equipment noises, distractions like TV, visitors)
  • Semantics(language barrier, use jargon or complex terminology)
37
Q

what is Ineffective communication? And what are the criteria for ineffective communication?

A

communication problems can occur when there are failures in one or more categories:

1) The system: absent or malfunctioning channels
2) The transmission: channels exists but message is either unclear or not sent
3) The reception: channel; exists, message is sent but the receiver misinterprets the message

38
Q

What are Factors that influence interpersonal communication:

A
  • environmental factors
  • Territory and personal space
  • Physical appearance
  • intrapersonal factors
  • nonverbal cues
  • selective of communication techniques
39
Q

define Perception

A

the process of selecting, organizing and attaching meaning to the world around us:

1) Sensory stimulation
2) Classify (often to pre-determined labels: old , pretty, thin,
3) Interpretation: to avoid mislabeling, the nurse needs to “check” perceptions by seeking more infor or validating what was perceived.

40
Q

define Metacommunication

A

describe all factors that influence how the message is perceived (basically verbal AND nonverbal communication)

41
Q

what is the purpose of Client centred communication?

A

to promote individualized quality of health outcomes. Client centred communication produces

  • comfort
  • action
  • understanding
  • information
42
Q

define Therapeutic communication

A

Nurses using effective communication strategies and interpersonal skills to appropriately establish, maintain, re-establish and terminate the nurse-client relationship

  • Purposeful
  • Goal directed
  • Time limited
  • Focus on meeting the clients needs
  • Different from social communication
43
Q

what are the 4 Non verbal communication categories?

A

1) Kinesics: movement, body postion and tension
2) Proxemics: space between clinician and client
3) Paralanguage: vocal, tone, rate, rhythm, volume
4) Autonomic physical responses: blushing, sweating

44
Q

define paralanguage

A

refers to how you deliver your message verbally ex: tone, voice inflection, speed of delivery, silence

45
Q

what are the 4 CNO standard statements?

A

1) Therapeutic communication
2) Client-centred care
3) Maintaining boundaries
4) Protecting client from abuse

46
Q

Discuss tasks in each of the four phases of the therapeutic phase

A

A) Pre-interaction: become aware of client situation, think about the environment for the interaction, plan sufficient time, be aware of your own feelings, biases and remain objective. Enter the relationship in a non-judgmental and open attitude.
B) Orientation phase: Purpose is to establish rapport and trust. NOD, acknowledge client by name, handshake. Clarify the purpose of the relationship, selecting appropriate communication techniques to engage the client to tell their story. Listen and observe client behaviours. Set timeline for termination of relationship.
C) Working phase: active problem-solving or intervention. Actions are implemented towards identified needs(comfort, action, information, understanding), nurse uses a range of therapeutic communication skills. Empowerment: client participating in care.
D) Termination phase: Bringing the relationship to a close.

47
Q

how does short term relationship differ from long term therapeutic relationship?

A

Short term relationships include only: orientation, working and termination phase.

48
Q

Describe fundamental differences between a therapeutic and a social relationship.

A

Therapeutic puts client above nurses needs, nurse is responsible for conduct of the relationship and maintain boundaries, specific health goals need to be met, guided by professional codes of behaviour/ethics. Social is guided by personal beliefs, both parties have equal responsibility, both parties have needs to be met.

49
Q

Discuss key characteristics of therapeutic nurse-client relationships.

A
  • authenticity
  • self awareness
  • active listening
  • empathy
  • trust
  • mutuality and intentionality
50
Q

What are the 4 Components of the nurse-client relationship?

A
  • trust
  • power
  • respect
  • empathy
51
Q

define Warmth

A

sets tone, client feels welcomed and not judge. Facial expressions, body gestures, posture, eye contact, hands, voice tone and pitch.

52
Q

what are some warmth indicators?

A

head position, shoulders, arms, hands, feet etc..

53
Q

list ALL 7 Therapeutic ways of asking questions

A

1) Open-ended questions: provides opportunity for client to give a more detailed response about their need(s). This allows the client to express their own thoughts and feelings.
2) Probing/focusing/providing general leads encourages the client to expand or further explore thoughts or feelings. Ex: “Tell me more about…”
3) Seeking clarification: did you hear the client correctly? Used to verify information. Ex: “I’m not sure I Understood what you said- can you tell me again”
4) Acknowledging something about the client/sharing observations: the nurse verbal shares observations about how the client looks, behaved, or sounds. Ex: “I sense you are feeling frustrated with not being able to go home yet.”
5) Restating or paraphrasing: say in your own words what the client is trying to convey. Shows that to are actively listening. Ex: “ I had trouble eating dinner today, I had so much heartburn and felt very nauseated.” Then nurse states “ your heartburn and nausea made eating dinner difficulty”. Be careful not to PARROT to the client
6) Silence: intentional pauses to allow client and nurse to think(is it intentional, compassionate or awkward) how much time should you give after asking a question?
7) Summarizing: “During this session, we talked about the connections between the food you eat, your exercising and insulin requirements”

54
Q

List ALL 6 ways of asking non-therapeutic questions

A
  • Offensive misuse of “why?”
  • Misuse of closed-ended questions: patient undergoes procedure and ask them if it went okay, this only allows the patient to say yes or no as it doesn’t invite the patient to fully elaborate on their experience.
  • Thunder stealer: allowing patients to offer their ideas and not stealing their spotlight.
  • Incomprehensible and cryptic codes: medical jargon and using your own abbreviations for medical terminology at the patient.
  • Long-winded buildup: overboard and rambling before posing question. Keep the question short and simple for the patient.
  • Multiple choice mmix-ups: asking too many questions
55
Q

how can non -therapeutic communication make the client feel?

A

1) Unsupported
2) Not heard
3) Devalued
4) Disrespected

56
Q

what are some Non-therapeutic communication technique?

A

Changing subject, automatic responses, cliches, false reassurance, expressing approval or disapproval, belittling the client’s feelings, responding defensively.

57
Q

Define Active listening

A 
concentrated listening rather than passively hearing the message. 
S - sit
U - uncross
R – relax
E – eye contact
T – touch 
Y – your intention

Basically, STOP talking, Look at the client non-verbals, Listen

58
Q

what does a nurse listen for?

A

Content themes, communication patterns, discrepancies, feelings, the nurse’s own inner responses, what is not being said as well as what is being said, the effect communication produces in others involved with the client.

59
Q

what are some techniques to demonstrate active listening?

A
  • minimal cues
  • clarification
  • restatement
  • paraphrasing
  • reflection
  • summarization
  • silence
  • touch
60
Q

define empathy

A

ability to put yourself into another’s situation, to feel what the other is feeling, to see experience from the other’s perspective. And to communicate that to the client.

61
Q

define sympathy

A

the acknowledgement of another’s feelings with a focus on the nurse’s feelings

62
Q

self-disclosure: how does it differ from social vs helping?

A

1) Social: you disclose to help others understand you better
2) Helping: you disclose to show the client that you understand their experience – it should be close to empathy (that you’ve had similar experiences feelings)

63
Q

define therapeutic humour

A

consider timing, client receptivity and content

NURS1511 (6 decks)

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