Nurse as Teacher Flashcards
Patient Bill of Rights
- right to be informed
- right to participate in decisions regarding health
ANA
identifies client teaching as an independent nursing function
JC
sets guidelines and standards for client education
NPA
teaching a legal & professional responsiblity
True teaching is….
NOT talking AT someone
Can be compared to the nursing process
- Assess, collect information, analyze client’s learning ability, readiness
- Identify knowledge deficits
- Set realistic goals
- Prepare a teaching plan
- Implement teaching plan
- Evaluate client learning
Empowerment
- encourages independence/autonomy
- allows for informed choices
- improves quality of life
- decreases hospital admissions
Specific strategies are developed to enhance person’s learning
- verbal
- nonverbal
- active listening
- organize information in a logical sequence
- simple complex
- check for feedback from the patient frquently
Meet the patient…
- where he or she is
- what do they already know
Assessment basics when client teaching
Gather relevant information:
- nursing hx
- physical exam
- readiness/motivation to learn
- reading level
- language barriers
- anxiety level
- nursing dx
Implementation basics when client teaching
use teaching plan and verbal/nonverbal communication skills to present the material
Evaluating basics when client teaching
- final step in the learning process
- “teach back method”
Planning basics when client teaching
- set goals, determine objectives, plan the learning experience
- learner should participate in making the plan and setting priorities
- written specific learning objectives
- selecting teaching strategies
- date and time
- method
Examples of written learning objectives..
subject: “The client will…”
actual behavior: “self administer an insulin injection…”
conditions: “under which behavior is to occur” or “in front of the RN”
specific criteria: “using correct technique…”
date/time: to be accomplished
Required “tools” a nurse needs as a teacher
- Knowledge of subject
- communication skills: clear, simple language
- empathy/relationship building: stepping into the shoes of the other person
3 Domains of learning
- Cognitive
- Affective
- Psychomotor
- learning may involve one or all of these domains
- characteristics of learning in each domain affects the teaching approach
Cognitive Learning Domain
- intellectual behaviors
- involves 6 intellectual skills:
- knowledge
- comprehension
- application
- analysis
- synthesis
- evaluation
Example of using all 3 domains in teaching with a colostomy
- teaching how much fluid to use when irrigating a colostomy (cognitive)
- teaching when to irrigate a colostomy (cognitive)
- client how to irrigate colostomy (psychomotor)
- helping the client accept the colostomy (affective)
- helping the client maintain self-esteem (affective)
Affective learning domain
includes feelings, emotions, interests, attitudes, and appreciations
Psychomotor learning domain
skills include mental and muscular activity
- ranges from:
- using senses to obtain cues to guide motor activity
- creating new movement patterns to suit a particular problem
Factors facilitating learning
- Motivation
- Readiness
- Active Involvement
- Feedback
- Simple to complex
- Repetition
- Timing
- Environment
- Methods
- Organization
- Maintaining Client’s Attention
- Build on client’s existing knowledge
- teaching aids
Motivation
- desire to learn
- greatly influences how quickly and how much a person learns
- motivation is greatest when a person recognizes a need and believes that need will be met through learning…
- client says “I need this”
- learning is more effective when it is in response to a felt need of learner/family
- adults learn what they feel they have a need to know
- adults learn based on life experiences (builds on past knowledge/experiences)
Nurses can increase cleint’s motivation in several ways..
- relating the learning to something the client values and helping the client see the relevance of learning to achieving that goal
- make the learning situation pleasant and non-threatening (threatening=barrier)
- encouraging self-direction and independence
- demonstrating a postive attitude about client’s ability to learn
- offering continuing support and encouragement
- creating a learning situation where the client is likely to succeed (reinforce what they already know and add new information in small amounts and reinforce)
Readiness
another factor that facilitates learning
- in order for your client to be able to focus on what is to be learned, you must:
1. have met basic survival needs
2. have met basic comfort needs
Assessing readiness to learn
- ability to concentrate
- ability to remember
- freedom from discomfort
- motivation
- valuing health care (belief that learning improves health)
Assessing ability to learn
- comparing what the client can do with what you want them to master
- deciding if the client possesses adequate physical strength, size, coordination to perform the taks
- senses intact?
- can the client read? They may not always tell you/admit they can’t
- What is their developmental level
- socioeconomic status supplies a clue to health beliefs, past experiences, and ability to buy required items
- what is composition of client’s family, expected roles, support etc.
Factors that inhibit learning
- emotions
- physiological events
- cultural barriers
Goals
- clearly written
- must be measurable/observable
- must be realistic
- must be written in client language: “Client will be able to correctly self-administer accurate dosage of insulin by 5/30/06”
Physiological factor affecting learning
-physical needs must be met before learning can occur (food, water, pain relief)
Psychological
- moderate anxiety enhances learning
- severe anxiety or lack of anxiety inhibits learning
- health beliefs of the client are important for them to take health action
- intelligence is the cognitive ability to learn (will affect rate, quantity, and complexity of learning
Sociocultural/spiritual factors affecting learning
- these factors influence the client’s health beliefs and attitudes because culture determines our experiences, education, health practices, and lifestyle
- many cultural groups have their own beliefs and practices related to diet, health, illness, and life style
- nurse should not assume that because a client belongs to a certain cultural group, that they have those beliefs
- ask questions relating to cultural factors and beliefs
- economic factors may also affect client’s learning (cannot afford materials needed to learn, suggest foods)
Teaching plan basics
- when developing a teaching plan, need to involve the patient
- promotes the formation of a more meaningful plan
- stimulates the client’s motivation
- determine teaching priorities: rank learning needs according to priorities
- client’s principles must be considered
