T3 Other Stuff Flashcards
Mod. 7- Leadership and Managing in Nursing- Ch. 18
Module 07 - Interdisciplinary Collaboration
“Alone we can do so little; together we can do so much.”
Teamwork Happens Daily
The above quote comes from Helen Keller (Lash, 1980). Nurses can certainly attest to this fact, for without teamwork and collaboration between departments, patient care would be severely jeopardized.
Nurses work in teams every day. Nursing care on the hospital floor is supported by nurse’s aides, LPNs, RNs, who all must work together to get the daily care accomplished. But there is often more care necessary than the nurse can provide: Respiratory, Dietary, Physical Therapy, etc.
Who, then, assesses the need for and coordinates these care issues? The provider may or may not have prescribed collaborative care but it often falls upon the nurse to further assess and suggest the inclusion of interdisciplinary care. Effective interdisciplinary teams require collaboration, which is often led by the nurse, who needs to avoid an authoritarian approach. If team members work in an authoritarian environment, they may be hesitant to make decisions for themselves and may fully depend upon the authoritarian leader. Creativity will be dampened, and creativity is mandatory for team progress.
Categories of Collaborative Care
Collaborative care falls into several categories:
1. Nurse to Patient Collaboration. Nurses coordinate with patients the many issues surrounding health promotion and disease prevention, treatment methods, lifestyle changes, and end-of-life decisions. Even Florence Nightingale taught collaboration with the patient, assessing what is needed or wanted.
- Nurse-Nurse Collaboration (Intraprofessional). Nurses work in teams in hospitals, in clinics, and in communities that provide collaboration and support in patient caregiving. Nurses from various units, fields, and with different experiences also collaborate: nurse managers, nurse researchers, nurse educators, advanced practice nurses, as well as novice nurses with expert nurses! Mentoring is one example of this collaboration. Shift “hand-offs” are also exemplars.
- Interprofessional Collaboration. This is the category that often comes to mind when thinking about collaborative care. Nurses form partnership between a team of health providers from medicine, pharmacy, occupational therapy, physical therapy, dentistry, social work, education, and even law. The ANA code of ethics and QSEN both address interprofessional collaboration as an important part of nursing care.
- Interorganizational collaboration. Nurses must be aware of and utilize resources and information between organizations which will benefit patients at the local, national, or global levels. Examples of this are Hospice Care at the local level, and Health Care Consortiums at the national level.
Nurses Are at the Forefront of this Collaboration
So why are nurses at the forefront of this care system? What makes them uniquely qualified to address this important piece of patient care?
The nurse typically knows the patient’s needs best, having assessed them at the beginning of their relationship. They have a holistic understanding of the patient and his health care wishes. Having access to post-discharge resources, nurses often coordinate suggested plans of care. Nurses own the attributes of professionalism, ethical behavior, and communication skills necessary to accomplish all the goals. They also should have an understanding of, and access to, the resources needed to formulate a partnership between patient, nurse, and the member of the incoming team. Consider the following case:
You have worked on the medical surgical floor for ten months and have noticed the same patient returning many times with the same problem: uncontrolled diabetes. You don’t feel as though the client understands the nature of, or the treatment for, the condition. You share this observation with your nurse-manager who requests that “someone” assemble a team to look closer at this problem. You have volunteered to be a member of the team. Who will you invite? A pharmacist? A diabetic educator? A nutritionist? Why were these people selected for your team?
Now think about the information these people will report back to you. What will you do with this information? (Hint: remember the Nursing Process!) Develop a plan of care with your patient, of course! You, the nurse, are uniquely qualified to disseminate this information into a working care plan for your patient to achieve optimal health. This means you must understand the various roles and backgrounds of each discipline with which you work. At the same time, you may be leading teams of different disciplines of nursing. Here again, it is critical to understand everyone’s role and job description. In addition, the collaboration needed in interdisciplinary teams cannot be created without mutual trust and respect among the members. We each have a job to do. Nurses need to remember this when assembling interdisciplinary care teams; no one job is more important than another when we are all working together for patient care!
Effective teams participate in effective problem solving, increased creativity, and safe and improved health care (Yoder-Wise, 2011). In effective teams, members are required to work together in a respectful, civil manner. They must all be committed to providing input that generates in a positive outcome for the patient. In later modules, we will explore what happens when teams do not work well together, but for now, realize the nurse’s potential in bringing about all of the key players needed to address the needs of the patient.
Mod. 8: Leadership and Managing in nursing- ch. 24, Nursing now- ch. 12 and 17
Module 08 - Communication
Listening
It has been said that Listening is the greatest tool to good Communicating. What does that mean to you as a nurse? Well, to be a good listener, a nurse needs to show attentiveness through eye contact and body language. Active listening means postponing judgment about what is being said and listening to all that is said (and not just the first or last words). It is motivated by a genuine desire to learn about the other person. These skills give the speaker some feedback-non-verbal communication - to indicate that what is being said is understood.
Verbal and Nonverbal Skills
Verbal and nonverbal skills are mandatory personal communication strategies; the ability to assess these messages is also critical (Yoder-Wise, 2011). Many of the messages we communicate to others are nonverbal, and when nonverbal and verbal messages are in conflict, the nonverbal message is regarded as the most powerful.
Professional nurses are constantly required to communicate patient information to other members of the nursing team. The SBAR (Situation, Background, Assessment, and Recommendation) system was developed by professionals to enhance direct, respectful communication skills among professionals with the aim of quality patient care.
Barriers to Communication
Although this may sound easy, there are several potential barriers to this communication. These barriers may be physical (too much ambient noise in the area), psychological (anxiety on the part of any of the participants), or semantic (misunderstandings based upon language and words). Nurses need to know how to discriminate between them in order to find the blockage.
Unfortunately, there seems to be an increasing amount of hostility and conflict experienced by nurses in the workplace. Why do these conflicts occur? Health care brings people of different ages, gender, income levels, ethnic groups, educational levels, lifestyles, and professions together for the purpose of caring for the patient. Sometimes, conflicts are task related. Others are primarily related to personal and social issues; these are relationship conflicts and may be more difficult to assess and solve. Disagreements over professional “territory” can occur in any setting (Whitehead, Weiss & Tappen, 2010), but often occur in the hospital. Communication strategies, practiced by nurses everywhere, but particularly in the mental health setting, can be very beneficial. Effective teams share a vision of commitment to the same goals; communicating that vision may be formal (decrease catheter-associated infection rates) or assumed (patient safety).
Dealing with Breakdowns in Communication
Nurses must recognize any breakdown in the communication process and immediately deal with it. Conflicts are often based on attempts to protect a person’s self-esteem or to perceived inequities in power. For example, when a nurse manager discovers conflict between two floor nurses with whom he or she is working, the following may help:
• Assess and identify the triggers of the event or incident.
• Discover the history and the context for each person.
• Assess how much or how little they rely on working with each other.
• Identify the issues, goals, and resources involved in the situation.
• Uncover any previously considered solutions that may or may not have worked.
This may seem time consuming, but assessing the level of working relationship between the conflicted parties is essential, particularly if they work together on a regular basis (Yoder-Wise, 2011). And nurses need to realize that some differences in ideas, perceptions, and approaches are quite normal, and often can lead to creative solutions and deepened human relationships.
Individuals develop their communication styles over the course of their lives in response to many experiences and factors (Catalano, 2013). There are two predominant styles of communication: assertive and nonassertive.
Assertive versus Nonassertive Communication
Assertive communication is honest and direct. It accurately expresses the person’s feelings, beliefs, ideas, and opinions. Assertiveness does not mean that a person will always get his way in every situation, and it is likely the individual will handle some situations better than others. A win-win goal is achieved when both parties have the ability and willingness to negotiate. Any nurse-leader can learn to use an assertive communication style.
Nonassertive behaviors fall into two categories: submissive and aggressive. Whereas assertive communication permits individuals to honestly express their ideas and opinions while respecting the opinions of others, aggressive communication strongly asserts the person’s legitimate rights and ideas with little regard or respect for the rights and opinions of others.
Aggressive communication - used to humiliate, control, or embarrass the other person or lower that person’s self-esteem - creates an “I win, you lose” situation. The other person may perceive aggressive behavior or communication as a personal attack (Catalano, 2013).
Practice and reinforcement of assertiveness skills may be helpful for all nurses who want to improve their communication techniques. By learning to ignore trivial matters, respect those around you, and use clarity and non-threatening behaviors (both verbal and nonverbal), the nurse will become more proficient in using assertive communication.
Module 08 - Communication
“I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records…if they could be obtained, they would enable us to decide many other questions…” wrote Florence Nightingale, in 1863, in response to the cost of healthcare (Connors, Warren & Popkess-Vawter, 2013). Using technology, something we take for granted today, was not even on the horizon in the 19th century. Can you imagine how Florence would feel if she could see our hand-held devices that put patient records at our fingertips?
What Does Nursing Informatics Mean?
Nursing Informatics is a broad concept and basically means the blending of information and computer science to study processes, management, and retrieval of health- related information (Connors et al, 2013). Informatics is used to combine data sets to give information, and thus knowledge to the individual using them. Nurses have a defined need to communicate the nursing care of clients and their families, establish comparability of nursing data across clinical populations, project trends regarding nursing care provided and allocation of nursing resources, stimulate nursing research through linkages of nursing data, and provide data about nursing care to influence health policy and decision-making (Catalano, 2013).
Competition is a driving force in the pricing and delivery of health care; payment methods promote competition in the following areas:
• Medicare and Medicaid
• Prospective payment systems (PPSs)
• Health maintenance organizations (HMOs)
• Preferred provider organizations (PPOs)
Technologically-driven organizations have an improved competitive edge. Health care, the healthcare delivery system, and nursing must open themselves to new information and ideas. Computers are involved in almost every area of client care today from assessment to management to billing.
Informatics and Evidence-Based Practice
So what does all of this mean for the bedside nurse? Historically, nurses have not been very good at documenting their worth and effectiveness. Informatics gives us tools to measure effectiveness with accurate information about client care and outcomes. It also gives us a standardized language in practice and in dissemination of information. This process then forms the basis for evidence-based practice. Informatics gives nurses access to the most recent information. A new article is added to the medical literature every 26 seconds (Catalano, 2013) and no single person could read everything published!
Another reason for informatics is called Telehealth, which is health care at a distance. Providers are increasingly using Telehealth to examine and treat clients from alternative locations using video cameras and telephones. This saves money by eliminating office visits, although there is still a fee involved for the online appointment. Several nursing organizations have raised concerns about this type of care. Can you think of reasons for and against its use?
However, the use of nursing informatics for the improvement of EBP includes:
• Accessing current literature concerning the latest diagnostic techniques and treatment modalities, including drug information
• Conferring with a knowledgeable colleague or expert in the field
• Evaluating the effectiveness of previous experiences (by looking at the patient’s past medical history in the electronic chart)
This makes informatics very convenient, especially if being utilized outside of the acute care facilities. Labs, outpatient clinics, physicians’ offices, and even home health agencies may now access the chart.
Still, the picture is not all rosy. Negative points in using the increasingly higher technologies are that they are initially very expensive. There is a very large learning curve, especially among older, more experienced nurses. Electronics are, unfortunately, still subject to “going down” or having power issues. There are also concerns about privacy and access to the information available on the systems. Who owns the information? Who should be able to see it?
Nurses need to remember the Health Insurance Portability and Accountability Act (HIPAA) to keep patient information safe and secure. Our code of ethics prohibits us from sharing information without need and HIPAA makes it illegal to do so. Those two factors alone should keep nurses abreast of how nursing informatics can be abused, and the steps they can take to be sure that abuse doesn’t happen.
In addition, all nurses should have access to a free library service funded by their employer that contains appropriate literature and multimedia resources. All nurses should have equal rights, similar to those of other health-care professionals, to paid study time to update their practice. Every nurse should have access to training on the Internet and appropriate databases. Every nurse should be educated in electronic systems and services to support evidence-based practice (Catalano, 2013).
When technology and computer systems are made user friendly by incorporating their use based on human needs, they can make better efforts to monitor and prevent errors in clinical practice. Patient safety is the best reason for improved data use, storage, and retrieval. The demand for nurses trained in informatics is growing at a fantastic rate and presents nurses with exciting opportunities for future positions. Nursing, as a profession, needs to be actively involved in developing clinical information systems establishing care standards. After all, we use them the most! All nurses need to be safeguarding client privacy, using the Internet, and researching better ways of improving access and the quality of care through technology.
TERMS:
Technology- the knowledge and use of tools, machines, materials, and processes to help solve human problems. The ANA stresses the use of it to prevent difficulty in locating relevant nursing information quickly.
An informatician – a person who works in the field of informatics- a developing area for nurses to specialize in.
Information science- a science primarily concerned with the collaborative efforts of analysis, collection, classification, manipulation, storage, retrieval, and dissemination of information.
Health informatics- a field in which health data are stored, analyzed, and delivered through thr usage of information and communication technologies.
Health information technology (HIT)/(HIM)- the application of information processing involved both computer hardware and software.
Computer science- a branch of engineering that studies computation and computer technology, hardware and software as well as the theoretical foundations of information and computation techniques.
MOD 9: Book: nursing now- ch. 26
The Concept of Health Promotion
At first, the concept of health promotion may seem simple - it is promoting health and preventing disease, right? But this concept is actually very complex because it involves multiple dimensions. For our purpose, know that the World Health Organization’s (WHO) definition is that health promotion is the process of enabling people to increase control over, and to improve, their health (Giddens, 2013). Be aware, though, that the concept of health differs between people.
What is meant by health? The WHO defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (Giddens, 2013). Wellness is another term often used for health, but there is no WHO definition for it. Health can be the absence of disease, while wellness implies a positive state of health in mental, spiritual, environmental aspects. Disease, then, may be defined as a disturbance in a person’s health status. Illness, too, has physical attributes but both disease and illness may be highly related to the experience of the individual.
Many individuals can experience “wellness” in the presence of an illness. One example might be a person who has a chronic illness such as asthma and can, with medication management, still ride a bike, go for walks, etc. Health and wellness can be present in the face of illness.
Levels of Prevention
Remember the levels of prevention? Health promotion often falls into these categories:
Primary Prevention: The focus is on health education regarding nutrition, exercise, immunizations, safety, hygiene, and avoidance of harmful substances. Examples of this would be genetic testing for a pregnant woman, vaccinations for her child, bike helmet safety instruction for her teen, and fall prevention measures for her elderly father.
Secondary Prevention: The focus is on identifying early disease processes in order to initiate treatment. Examples here, for the same patient, are ultrasounds, vision screening for her child, and blood pressure screening for her elderly parent.
Tertiary Prevention: The focus is on minimizing the effects of the disease on the individual through treatment modalities. Examples, for our patient above, would be management of her gestational diabetes, asthma treatment for her child, and nutrition counseling for her aging parent who has hypertension.
Ideally, health promotion methods are patient centered, use evidence-based practices and research, and account for cultural differences and preferences. Optimal health, as previously mentioned, may be very individualized.
Nurses promote health in many ways, including working with an individual or family to enhance health, working with communities to enhance health, and participating in the development of health policies and laws (Giddens, 2013). All nurses use assessment, planning, and implementation of interventions and the evaluation of health promotion strategies for clients. The very nature of nursing places a huge responsibility for enhancing the health of individuals across the lifespan and this requires skillful commination by the nurse.
The nurse needs to be keenly aware of vulnerable populations. Children, particularly infants, are often vulnerable to disease and illness, as are the elderly. Keeping those simple facts in mind will help the nurse assess risk and identify learning needs to promote optimal health. However, the most vulnerable populations are those living in poverty and those of minority status (Giddens, 2013). Cultural competence is important to facilitate the use of culturally appropriate interventions, based on the values and beliefs of the targeted group. Nurses must be committed to developing skills in cultural competence.
Alternative Methods
Nurses must also respect the client’s wishes when promoting health concepts. Many patients practice methods of health care that are considered “alternative” because they are outside the realm of our traditional, western way of practicing healing and treatment modalities. These patients will seek care providers that practice the concept of holism, or the treating of the whole person, rather than just the physical symptoms of a disease.
Some of the methods nurses may encounter, in addition to the more common chiropractic and massage therapy techniques are:
Energy healing: the client views energy systems as fields, vital essences, balances, and flow which may be used to prevent illness, promote health, and heal themselves. Examples of energy medicine include biofeedback, magnet therapy, and sound or light therapy.
Nutritional therapy: Nutrition definitely plays a large part in a state of wellbeing. Some clients will focus on eliminating “bad” foods and/or adding “good” foods and supplements in an attempt to regulate health. These clients may drastically change their diets and cause imbalances of necessary nutrients. Careful attention must be given to patients taking supplements, herbal remedies, and severe diets.
Herbal remedies: Herbalism, or “botanical medicine,” is the study and use of herbs or crude-based plant products for medicinal purposes. Plants can also be used to treat illness and improve the spiritual and physical quality of life. Western medicine also uses plant based therapy in many of our medications and treatments.
Faith healing: Spirituality is an essential part of holistic treatment and may be practiced individually or with the help of a faith healer. Spirituality is the sense of connectedness to others or to the universe. For a great many people, this connectedness is with a supreme being who is sometimes called God, but may be known as other names as culture dictates. Nurses should appreciate and respect the spiritual meaning in a person’s life, no matter how unlike the nurse’s that person’s belief system may be. Spiritual care enhances comfort and may help produce a sense of inner peace with disability or death, no matter who provides it.
Therapeutic Touch or Healing Touch: No physical touch takes place in these methods of treatment. The practitioner places his or her hands above the patient and uses slow, rhythmic movements to detect energy blockages in the body. The practitioner can remove that negative energy resulting in reduction of stress and anxiety, promotion of relaxation, and relief of pain.
Whatever the treatment, the client’s belief in the effectiveness of the therapy is just as important as the therapy itself. Likewise, the practitioner must have faith in his or her ability to help the client. A caring attitude helps alleviate clients’ anxieties and fears while increasing their hope and positive expectations. Think about the times you’ve used caring touch in the clinical setting. A back rub? A pat on the arm? Holding a hand during a procedure?
Module 09 - Health Promotion and Motivational Wellness
Motivational Wellness
Motivation can be defined as an internal drive or externally arising reason to promote a change or action. Motivational wellness is a concept encompassing the actions taken by people to improve their health and overall wellbeing. It is often initiated by intrinsic needs and values of that person. Many times, the diagnosis of a disease or illness is the catalyst needed to prompt positive changes.
What Helps and Hinders Motivation?
Nurses, in their daily interactions with patients, can be very influential in bringing about change in behavior. Clients typically respond well to small amounts of praise; as the nurse develops a rapport with the patient and the family, he or she will be able to affirm positive steps and encourage change to continue.
It is important for RNs to understand and be able to use motivation techniques. Research has shown that the higher a person’s educational level, the higher the motivation to learn (Catalano, 2013). The higher the desire to learn, the greater the motivation will be to adopt the learned changes.
A health concern in a loved one, such as a diagnosis of cancer, can also motivate a patient to examine his own health risks and take appropriate actions to prevent problems. In that case, the motivation may be high, but the knowledge to make the changes may be lacking. The challenge to the nurse is to identify the patient’s level of motivation (Daniels & Nicoll, 2012).
Several factors can help or hinder the patient’s success for behavior management. The nurse needs to assess the patient’s willingness to change, to be sure, but also his physical environment, as well as his support, or nonsupport from family. Sometimes problems occur that may be outside of the patient’s control. For example, asking a patient to go for a “walk around the block” may be difficult if that patient lives in a neighborhood without sidewalks. This patient may be seen as noncompliant, when another solution needs to be found.
Letting patients direct their goals for change is beneficial in developing plans that they will actually follow. Short-term and long-term goals need to be realistic to prevent the client from becoming frustrated with perceived lack of change. Motivational interviewing is a form of counseling that aims to help patients develop healthy behaviors (Daniels & Nicoll, 2012). Motivational interviewing can be broken down into specific steps for assisting patients in their positive health behaviors:
(1) Express empathy with the client. Recognize that although beneficial, change is difficult.
(2) Develop discrepancy. Recognize the gap between their behaviors and their desires and goals in a nonjudgmental manner.
(3) Avoiding argument! There will be challenges, but ultimately, the client is responsible for changing his own behavior.
(4) Expect some resistance, and be prepared for it with positive statements and encouragement.
(5) Supporting self-efficacy and self-empowerment in the client (Daniels & Nicoll, 2012).
The nurse needs to encourage the patient to talk and formulate resolution plans for the behaviors necessary to achieve positive health outcomes. Using motivational interviewing is a proven method to achieve positive health outcomes. An example of this would be in smoking cessation. The nurse first needs to attempt to understand the reasons that the patient has difficulty stopping smoking and recognize the difficulty in effecting such a change (Daniels & Nicoll, 2012). Then, the nurse would clarify statements made by the patient that indicate his willingness to quit smoking and work with the patient in realistically developing goals for moving forward - with small steps aimed at the eventual outcome of being completely smoke-free.
Nurses can also play an important role in helping patients to adopt healthy lifestyles by using simple methods such as role modeling. It’s difficult to have patient “buy-in” about cutting out sweets while the nurse is sipping on a soda; likewise, helping a client decide to quit smoking is much easier without cigarette smoke on the nurse’s clothing. Simply realizing what we’re asking our clients to do, and then attempting to do it ourselves, makes us more likely to bring about healthy behaviors in ourselves, and at the same time, offers a glimpse of our humanity to our patients.
1. . Nurses form partnership between a team of health providers from medicine, pharmacy, occupational therapy, physical therapy, dentistry, social work, education, and even law.
2. The ANA code of ethics and QSEN both address interprofessional collaboration as an important part of nursing care.
3. What is the meaning of “Medical home model” under the ACA?
Offers opportunity for states to reduce costs and improve care for the chronically ill.
- How do the tenets of the ACA address interdisciplinary care and client outcomes?
- What is the purpose of SBAR and what does it stand for?
-DELEGATION
Right Task
Right Circumstance
Right Person
Right Direction/Communication
Right Supervision/Evaluation
- What are each of these “Rights” referring to?
- Task
Appropriate and legal
8. Circumstance
Appropriate environment/resources/ equipment
9. Person
Willing and able with expertise
10. Direction/Communication
Clear/concise instructions
11. Supervision
Monitor and evaluate patient
- What examples can you think of from your own experience?
- Foundation of C’s to Create an Effective Team
Commitment
Communication
Connectedness
Creative Problem-Solving
- Times of stress are times of increased incivility. What can a Nurse Manager do to head off problems from developing?
Vision Cast –- Accomplishing Specific Tasks
Encourage
Allow people to handle disputes between themselves but respond to quickly when it is evident that the dispute is not being resolved.
Teambuilding Activities
Modes of conflict resolution:
- Avoiding
- Accommodating
- Competing
- Compromising
- Collaborating
- Task
Yes
- . Nurses form partnership between a team of health providers from medicine, pharmacy, occupational therapy, physical therapy, dentistry, social work, education, and even law.
True
- The ANA code of ethics and QSEN both address what
interprofessional collaboration as an important part of nursing care.
- What is the meaning of “Medical home model” under the ACA?
Offers opportunity for states to reduce costs and improve care for the chronically ill.
- How do the tenets of the ACA address interdisciplinary care and client outcomes?
?
- What is the purpose of SBAR and what does it stand for?
Right Task
Right Circumstance
Right Person
Right Direction/Communication
Right Supervision/Evaluation
What are each of these “Rights” referring to?
Task
-Appropriate and legal
Circumstance
-Appropriate environment/resources/ equipment
Person
-Willing and able with expertise
Direction/Communication
-Clear/concise instructions
Supervision
-Monitor and evaluate patient
- What examples can you think of from your own experience?
?
- Foundation of C’s to Create an Effective Team
Commitment
Communication
Connectedness
Creative Problem-Solving
- Times of stress are times of increased incivility.
What can a Nurse Manager do to head off problems from developing?
Vision Cast –- Accomplishing Specific Tasks
Encourage
Allow people to handle disputes between themselves but respond to quickly when it is evident that the dispute is not being resolved.
Teambuilding Activities
Modes of conflict resolution:
- Avoiding
- Accommodating
- Competing
- Compromising
- Collaborating
- Task
The focus is on health education regarding nutrition, exercise, immunizations, safety, hygiene, and avoidance of harmful substances. Examples of this would be genetic testing for a pregnant woman, vaccinations for her child, bike helmet safety instruction for her teen, and fall prevention measures for her elderly father.
Primary Prevention:
The focus is on identifying early disease processes in order to initiate treatment. Examples here, for the same patient, are ultrasounds, vision screening for her child, and blood pressure screening for her elderly parent.
Secondary prevention
The focus is on minimizing the effects of the disease on the individual through treatment modalities. Examples, for our patient above, would be management of her gestational diabetes, asthma treatment for her child, and nutrition counseling for her aging parent who has hypertension.
Tertiary Prevention
- the knowledge and use of tools, machines, materials, and processes to help solve human problems. The ANA stresses the use of it to prevent difficulty in locating relevant nursing information quickly.
Technology
????? communication is honest and direct. It accurately expresses the person’s feelings, beliefs, ideas, and opinions. Assertiveness does not mean that a person will always get his way in every situation, and it is likely the individual will handle some situations better than others.
A win-win goal is achieved when both parties have the ability and willingness to negotiate. Any nurse-leader can learn to use an assertive communication style.
Nonassertive behaviors fall into two categories: submissive and aggressive. Whereas assertive communication permits individuals to honestly express their ideas and opinions while respecting the opinions of others, aggressive communication strongly asserts the person’s legitimate rights and ideas with little regard or respect for the rights and opinions of others.
Assertive
