Quiz #1: Nursing as a profession and discipline & Thinking like a nurse- nursing process Flashcards
explain the mechanisms by which nursing can “lose it’s way”
-w/o a clear disciplinary orientation
-can be guided by hospital culture and pressure to conform to medicalized/clinicalized views of humanity
(A medical technical view of human experiences isn’t the same as a nursing unitary disciplinary world view)
What is nursing views of humanity based on?
-timeless values, a philosophical orientation to unity of mid, body, spirit, whole person health, caring-healing knowledge that sustains global humanity
What is the foundation for discipline specific knowledge
Theories and philosophies of science
-foundational philosophies, values and worldview transcend specific events and provide explanations that can reflect the ethical-philosophical foundation and value’s
What does the discipline of nursing help define
What counts as knowledge, how we pursue knowledge and values about what it means to be human
What do discipline specific approaches to knowledge address?
- What is the nature of the human healing experiance
- how to sustain human caring when threatened
- what is the relation between human-environment, global planetary health and science
List the essential aspects of nursing discipline
- Holds nursing to timeless values, heritage and knowledge developement
- holds and honors ontology of whole person: unity of mind, body, spirit and unitary world view
- adheres to nursing philosophical orientation towards humanity to sustain human caring-healing-health for all
- holds the theories, orientation toward knowledge, development and what counts as knowledge
- Expands science and medical epistemologies
- nursing research traditions, diverse approach to knowledge development
- Adresses diverse and innovative methodologies and methods consistent with human caring-healing-health-illness experiances
- grand, middle and specific theories to provide a shared evolved unitary world view ( where health is related to social-moral justice and the whole person and comes from connectedness)
What can having disciplinary knowledge lead to?
A professional identity and a clear visibility of the uniqueness of nursing knowledge
What could be a cause of the nursing profession no longer existing?
- no identity, disciplinary clarity and commitment to support and promote + lack of a unique nursing knowledge
- Without a discipline specific language to give voice to our role in society we will remain invisible and non-existent
What are the factors that have caused nursing to move away from its disciplinary roots?
- Economics
- Management science
- Technology
- Medicalization
- Hospital-based practice policies
What is kind of science is nursing….?
A distinct human caring healing-health science
What is the goal of the nursing (as a profession)
To provide service to human kind through the living art of science
Who is a (professional) nurse
People who have received a specialized nursing discipline education which is based on regulated, defined and monitored standards
What is the goal of nursing (as a discipline)
expand the knowledge about human experiences, there is a community of scholars
What is the function of the nursing knowledge generated by the disciplinary side of nursing and the community of scholars?
It is the scientific guide to living the art of nursing and provides the professions clear disciplinary orientation
Define the discipline of nursing
- The science of nursing: groups collectively accepted knowledge base, accepted methods of practice.
- ***Necessary for profession to remain
Define the profession of nursing
The living art of nursing science build on a disciplinary foundation
Define scholarship
Activities that systematically advance the teaching, research and practice of nursing through rigorous inquiry
Define quantitative research
Empirical investigation of observable phenomena via statistical, math or computer techniques
Define qualitative research
exploratory to gain an understanding of reasons, opinions or motivations
define positivist research
an approach to the study of society that relies on scientific evidence to reveal the true nature of society
Define post-positivist research
Recognizes that all observation is fallible, has error and all theory is revisable
Define research methodology
How research is done scientifically and logically to solve a problem, help to understand the process and not jus the product of the research
What is critical thinking not?
- Simple
- step by step
- linear
- learnt over night
What is critical thinking?
- A process and set of skills
- use of knowledge + reasoning to make accurate clinical judgements
- the recognition of an issue, anaylize info, evaluate info, draw conclusions
- helps you realize what is important, any alternative solutions and ethical principles
- all for informed decision making
- context of situation
- involves the pt. in the decision
- can promote pt. centred care
- avoid standardized care
- with more experience, you come to recognize patterns of behaviour
- reflecting on experiance and knowledge
How can using evidence informed knowledge effect pt. outcomes and critical thinking
Improves pt. outcomes and improves critical thinking
What things need to be examined during critical thinking
- Ideas
- assumptions
- beliefs
- principles
- actions
- conclusions
- context of situation
What does critical thinking require?
- Cognitive skills
- Nurses disposition
- open minded, inquisitive, systematic
- well reasoned judgements
- more than problem solving: improves how you apply knowledge when faced with problems in pt. care
What are cognitive skills
Interpret, analyze, inference, evaluation, explanation and self regulation
What is a nurses disposition
To ask question, be informed, honest, unbiased, always reconsider issues
What are some nursing dispositions/ habits?
- Truth seeking
- Open mind
- Analyticity
- systematicity
- self-confidence
- inquisitiveness
- maturity
What is the outcome of critical thinking
nursing judgement that’s relevant to the nursing problem in a variety of settings
What is the 1st critical thinking component
Knowledge base (prepares u for clinical judgements)
Explain the basic level of critical thinking
The thinking is concrete and based on a set of rules and principles or a procedure manual that isn’t adjusted for pt. need… answer to complex questions is just a yes or no
Explain complex level of critical thinking
analyzed and examined choices more independently, realize alternative, conflicting solutions to a problemm or issue exist. Risk and benefits are weighed before decision. Creative, innovative and examines different points of view
Explain commitment critical thinking level
Anticipate the need to make choices with out assistance
responsibility and accountabilities
choose an action of belief on the basis of viability of alternative solutions available. Stand by choices
An action can be not taking an action and evaluating more instead
What are the 5 Components of critical thinking
1) Specific knowledge base
2) Experience
3) Competencies
4) Attitudes
5) Standards
Explain the specific knowledge base
- Info + theories form science, humanities, behavioural sciences and nursing
- using knowledge in holistic way
- physical, psychological, social, moral, ethical, legal and cultural view of patients and their health concerns
- need info literary skills
Explain the experiance aspect of critical thinking
Learn from observing, sensing, talking with patient and reflecting
-revise textbook approaches
-understand situations, recognize cues and interpret them
weak new knowledge as needed
act when events change
What are the 3 different categories of competencies
1) General thinking competencies
2) Specific critical thinking competencies
3) Specific CT competencies in nursing
What are the 2 categories of standards
1) Intellectual standards
2) Professional standards
- Responsibility
- ethical criteria for nursing judgement
- criteria for evaluation
What are the 3 subcategories of general critical thinking competencies
1) Scientific method
2) Problem solving
3) Decision making
What are the 2 specific critical thinking competencies in clinical situation
1) Diagnostic reasoning, clinical inference and clinical reasoning
2) Clinical decision making/ judgement
When does diagnostic reasoning start
when you receive info abt pt.
Define diagnostic reasoning
Process of determining a pt.’s health status after you make physical and behavioural observations. You assign meaning to the behaviours, signs and symptoms. You see the context of a situation, observe patterns, themes and chose interventions
What is clinical inference
A part of diagnostic reasoning
Process of drawing conclusion from related pieces of evidence
*forming patterns with data before diagnosis
What to do when diagnosis is uncertain
collect more data
What is clinical reasoning
Thinking about pt.’s issues, making inferences and deciding on actions to be implemented.
Collecting cues, process information, understand pt. issue, planning and implementing interventions, evaluating outcomes and reflecting + learning.
decide which problems need immediate attention. Incorporates Critical Thinking and is essential to clinical decision making
What is clinical decision making/ clinical judgement
Focus on defining pt. probs and selecting interventions.
Distinguishes nurses from techs. Critical judgment includes critical and reflective thinking and action plus the application of the scientific and practical knowledge
pick out important info
What are the 4 components of clinical judgement
1) Notice/grasp situation
2) interpret or develop a sufficient understanding
3) respond or decide on course of action
4) reflecting or revising actions and outcomes
What to rely on during clinical judgement
- consider context
- rely on: * Analytical processes
- intuition
- narrative thinking
- spend more time on initial assessment
What is the selection of nursing actions built on?
Clinical knowledge and pt. Data such as:
- Status +situation
- Knowledge of clinical variables
- knowledge about usual patterns of any diagnosed problem
- additional relevant info
- knowledge of nursing applications
- pt.’s desired health outcomes
What do critical thinking attitudes define
How successful a critical thinker approaches a problem or situation
-knowing when you need more info, own knowledge limits and personal biases
What are intellectual standards
guidelines or principles for rational thoughts
-thourougness, precision, accuracy and consistency (prevents rushing)
What are ethical criteria for nursing judgement
reflects sound ethical principles
pt. value and belief help making clinical decisions
faithful to pt.’s choice and beneficial to their health
code of ethics
self awareness of own beliefs
What is criteria for evaluation
evidence informed criteria to assess pt’s condition, determine course of action, and evaluate efficacy of nursing interventions
the nature of the pt’s symptoms
What is professional responsbiliity
like BCCNP standards
What are some things you can do to help develop critical thinking skills
Case based learning
reflective writing
concept mapping
What are the 5 conclusions from the thinking like a nurse article
1) Clinical judgements are more influenced by what nurses bring to situation than the objective data of the situation
2) Sound clinical judgement rests on knowing the pt.’s typical pattern of responses and an engagement with pt about their concerns
3) Clinical judgement is influenced by context of situation and culture of nursing unit
4) Nurses use a variety of reasoning patterns
5) reflection breaks down clinical judgement and helps to develop clinical knowledge and clinical reasoning
What 3 things are central to what nurses notice. how they interpret and respond and reflect
nurses background, contect of situation, relation with patient
Define clinical judgement
Interpretation or conclusion of pt.’s needs, concerns or health problems and decision to take either standard or modified approach
Define clinical reasoning
Process by which nurses make judgements, thinking of alternatives, weighing against evidence and choosing most appropriate and engaged in practical reasoning
Whats mega cognition
One particular way to think of things
What is “knowing the pt”
1) knowing their pattern of responses
2) knowing them as a person
Why should you get to know the pt.
1) certain important things will standout
2) current state compared to usual
3) individualized response
What are the 4 phases of the research based model of CJ
Noticing, interpreting, responding and reflecting
describe the research based model of CJ
1) context/background/relationship
2) Expectations & initial grasp
3) Reasoning patterns: Analytic, intuitive or narrative
4) action
5) outcome
6) reflection in action
7) reflection on action
What are the 4 aspects of scholarship
1) Discovery
2) Teaching
3) applications
4) integration
What is discovery of scholarship
New and unique knowledge
What is teaching of scholarship
Teacher bridges understandings
What is applications in clinical of scholarship
solving societies provlems
Explain the integration aspect of scholarship
nursing ++++ other disciplines
What 2 things do the values of scholarship support
Social relevance
scientific advancement
What did boyer want to do?
Move beyond focus on narrowly defined research
Define Scholarship (this is maybe a repeat oh well)
Activities that systematically advance teaching, research and practice of nursing through rigorous inquiry that:
1) is significant to the profession
2) creative
3) can be documented
4) replicated or elaborated
5) can be peer reviewed
Describe in more detail the scholarship of discovery
- disciplinary and professional knowledge
- heart of academic persuits
- primary empirical, historical, theory development, methodological studies and philosophical inquiry/analysis
- Primary empirical
- Historical
- Theory develope
- Methodological
- Philosophical
Describe the scholarship of teaching
Knowledge of discipline or specialty applied in teaching and learning from expert to novice
- development of teaching methods
- program development and learning outcome evaluation
- professional role modelling
describe the scholarship of practice
MAintanence of clinical competency and advancmnet
- Develope clinical knowlegde
- professional development
- application of technical or research skills
- service
Thats it folks
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