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NURS 3510 - Supportive and Palliative Care > Week 2 > Flashcards

Week 2 Flashcards

1
Q

what is caring?

A
  • a relational process
  • that involves the nurse’s intentional extension of the self to another to provide physical, emotional, and spiritual comfort and support in response to the human aspect of the health & illness experience
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2
Q

what does taking care of mean

A
  • emphasizes objective, professional care, such as the medical and psychological aspects of nursing
  • focuses on biomedical, physiological
  • task focused
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3
Q

what does “taking care for” mean

A
  • a humanistic way of interacting w pts
  • demonstrates sincere care and concern for pts simply bc they are human beings
  • emphasizes dignity and that they are whole people
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4
Q

what are the benefits of caring for a pt to the nurse (2)

A
  • increases job satisfaction

- reduces burnout

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5
Q

what are the benefits of caring for a pt to the pt and family (4)

A
  • upholds human dignity
  • promote sense of wellbeing
  • enhances disclosure
  • increases satisfaction w care
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6
Q

caring nurses… (6)

A
  • listen carefully to pts and responded to their individual, unique situations
  • are perceptive abt and supportive of pts stated and unstated concerns
  • make pts feel valued as human beings
  • make direct eye contact
  • disclose personal info
  • return to pts voluntarily (don’t wait for the call bell)
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7
Q

uncaring nurses… (5)

A
  • are hurried, never take time to talk or rlly listen
  • demonstrate a lack of interest in pts as people
  • rule-bound, appear tense, avoid eye contact
  • perceived as scolding during interactions
  • physically absent for long time, or only make short, superficial visits
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8
Q

what are the core efficiencies of human care & dignity (4)

A

Attitude
Behavior
Compassion
Dialogue

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9
Q

what is a nurse’s attitude

A
  • how they perceive themselves to be seen
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10
Q

how can behavior be used to support dignity

A
  • use behaviors towards pts that support personhood
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11
Q

how can compassion be used to support dignity

A
  • be in touch w own vulnerabilities

- recognize that there is very little that separates you from the pt

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12
Q

how can dialogue be used to support dignity

A
  • keep personhood in mind when conversing w the pt
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13
Q

at the absolute minimum, with every single person we care for, we must (8)

A
  • be present & offer undivided attention
  • introduce urself
  • find out how the person wants to be addressed and use their name in convo
  • maintain eye contact
  • smile, nod, etc. when appropriate
  • sit down at eye lvl
  • use therapeutic touch when appropriate
  • think abt ur tone
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14
Q

what is meant by being present (8)

A
  • stop and be fully engaged
  • be sensitive, willing to learn, open to human connection
  • take time to understand what they are say, not just hearing
  • demonstrate active listening
  • being available w wholeness of one’s being
  • be aware of ur physical self & enviro
  • get used to silence
  • use non verbal communication
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15
Q

what is empathy

A
  • communicating to another person that we understand something abt their world
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16
Q

what does empathy start w

A
  • being present and active listening
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17
Q

what are some verbal aspects of empathy

A
  • communicating to another individual that we have heard what they are feeling, and why they are feeling that way in your own words
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18
Q

what are nonverbal aspects of empathy

A
  • being warm and genuine in our communication
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19
Q

how can you communicate understanding to the pt

A
  • relay that you have heard what they are feeling and why they feel that way
  • do so with warmth and genuineness
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20
Q

how can you increase ur understanding of a pts situation (5)

A
  • active listening
  • undivided attention
  • dont listen to respond
  • avoid judgement
  • show that you’re listening
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21
Q

what is an example of an empathetic response

A

ex. it sounds like you are ___ (what they are feeling, in own words) about ______ (why they are feeling this way, in own words). can you tell me more about ur concerns?

22
Q

empathy is not… (5)

A
  • the same as sympathy
  • restating exactly what the person has said
  • leaving ur response at “i understand.” (include what u understand)
  • saying “i know how u feel”
  • trying to fix the situation (be in the moment w them)
23
Q

ACP is a process of (4)

A
  • reflecting on your values and wishes
  • communicating when you are capable
  • letting others know ur future and personal care wishes
  • considering who will speak for you when you are no longer capable of directing your care (your substitue decision maker)
24
Q

what are the benefits of ACP (7)

A
  • more likely to have wishes known and fulfilled
  • enhanced communicaion
  • increased satisfaction with care
  • improved quality of life and death
  • decreased stress & anxiety
  • fewer life-sustaining processes and ICU admissions
  • awareness by HCP of pt’s wishes and values
25
Q

can nurses have conversations w the pt regarding ACP?

A
  • yes
26
Q

describe a nurse’s duty r/t ACP (6)

A
  • initiate the convo
  • encourage the pt to participate in the convo
  • ensure others know pts wishes
  • honor their values and wishes
  • advocate for adherence to the pt’s wishes
  • know their wishes as an individual
27
Q

what are the 3 goals of care categories

A
  • Comfort care
  • Medical care
  • Resuscitation
28
Q

what is comfort care

A
  • care directed at maximizing comfort, symptom control, and maintenance of quality life
  • excludes attempted resuscitation
29
Q

what is medical care

A
  • includes approp investigations and interventions that can be offerred
  • excludes resuscitation
30
Q

what is resuscitation goal of care

A
  • medical care including approp investigation and interventions that can be offerred
  • includes attempted resus
31
Q

describe the process of ACP

A
  • an ongoing process –> their believes and wishes may change
  • imp to revisit i=over time
32
Q

what is critical to consider regarding ACP and goals of care

A
  • each situation is unique

- it is critical to think abt the INTENT of the intervention

33
Q

what are informal opportunities to discuss ACP and goals of care

A
  • happen in the moment
  • happen frequently throughout the day as a nurse
    ex. r/t medication
34
Q

what are formal opportunities to discuss ACP and goals of care

A
  • happen at a set time, day, or place
  • involve many members of the healthcare team, the pt, and their faily
    ex. r/t discharge planning
35
Q

what is key for both formal and informal opportunities to discuss ACP

A
  • documentation
36
Q

what are some strategies to initiate convos regarding ACP

A
  • introduce as a normal and importat component of any relationship between pts and the healthcare team
  • ask permission to have this convo
37
Q

see slide in asynchrnous ppt part 2, on sample script for how to discuss ACP

A

…

38
Q

what is a method used to discuss ACP w patients

A
  • ask, tell, ask
39
Q

what are some examples of what the first ask in the ask, tell, ask method asks (6)

A
  • what is ur understanding of the illness
  • what are ur fears or worries for the future
  • what are ur goals and priorities
  • what outcomes are acceptable to you
  • what are u willing to sacrifice or not
  • what would a good day look like to u?
40
Q

what are some examples of what the “tell” in the ask, tell, ask method discusses (4)

A
  • discuss range of treatment available
  • discuss benefits of risks to treatment
  • reassure that we will help them decide what path is best for them
  • establish a substitute decision maker
41
Q

what are some examples what the second “ask” in the ask, tell, ask methods asks (3)

A
  • ask the pt to explain back what they understoof
  • clarify any misunderstandings
  • do u have any questions?
42
Q

what should you NOT say/do when communicating with a pt (6)

A
  • “at least”
  • “i understand.”
  • “i know how u feel”
  • “it will be okay”
  • avoid making the convo abt yourself
  • use caution with “why”
43
Q

what are some fears that nurses and students have associated w communicating w pts (6)

A
  • wont say the “right” thing
  • will say the wrong thing
  • little personal experience
  • facing own mortality
  • may cry
  • uncomfortable with just “being” rather than not “doing”
44
Q

how can we address fears associated w communicating w pts (6)

A
  • acknowledge fears
  • talk abt it
  • push yourself
  • remember the basics
  • observe others & what they do/say
  • practice
45
Q

what should you do if you mess up when communicating w patient (4)

A
  • dont panic
  • acknowledge your mistake
  • try again
  • be gracious w yourself
46
Q

what should you do if a pt or family is very distressed(6)

A
  • acknowledge emotion (ex. you look upset)
  • invitation (tell me what happened)
  • explore expectations and determine boundaries (what would you like me to do to help u”
  • convey genuine concern (im so sorry this happened)
  • present the plan for moving forward (heres what id like us to do next)
  • thank the person for being open (thank you for sharing ur feelings w me)
47
Q

what should you do if a pt/family asks a difficult question (4)

A
  • acknowledge, validate, and normalize
  • ask if there is a reason this came up
  • gently explore their thoughts and understandings
  • respond, if possible and appropriate
48
Q

what are 2 ways to ackowledge, validate, and normalize a pt’s question

A
  • “thats a great question”

- “many people in your circumstance wonder ___. is this something you’re worried about?”

49
Q

what is advanced care planning

A
  • a way to help you think about, talk about, and share your thoughts and wishes about future health care
50
Q

who should consider ACP

A
  • everyone
  • you never know when you may face an unexpected event or illness & will be unable to make preferences known
  • particularly imp for older adults & those living w a chronic disease
51
Q

when should you consider ACP

A
  • now

- it is important to take part in convos about ACP planning before you become seriously ill

52
Q

what are various ways to make your future health-care wishes known (4)

A
  • talk to family & friends –> let tem know what care youd accept or refuse
  • write a Health Care Directive –> legal document to write instructions abt treatment youd accept or refuse, name proxy
  • work w HCP to complete an ACP goals of care form
  • communicate and update changes as they may change over time

NURS 3510 - Supportive and Palliative Care (11 decks)

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