Week 2 Flashcards
what is caring?
- 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
what does taking care of mean
- emphasizes objective, professional care, such as the medical and psychological aspects of nursing
- focuses on biomedical, physiological
- task focused
what does “taking care for” mean
- 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
what are the benefits of caring for a pt to the nurse (2)
- increases job satisfaction
- reduces burnout
what are the benefits of caring for a pt to the pt and family (4)
- upholds human dignity
- promote sense of wellbeing
- enhances disclosure
- increases satisfaction w care
caring nurses… (6)
- 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)
uncaring nurses… (5)
- 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
what are the core efficiencies of human care & dignity (4)
Attitude
Behavior
Compassion
Dialogue
what is a nurse’s attitude
- how they perceive themselves to be seen
how can behavior be used to support dignity
- use behaviors towards pts that support personhood
how can compassion be used to support dignity
- be in touch w own vulnerabilities
- recognize that there is very little that separates you from the pt
how can dialogue be used to support dignity
- keep personhood in mind when conversing w the pt
at the absolute minimum, with every single person we care for, we must (8)
- 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
what is meant by being present (8)
- 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
what is empathy
- communicating to another person that we understand something abt their world
what does empathy start w
- being present and active listening
what are some verbal aspects of empathy
- communicating to another individual that we have heard what they are feeling, and why they are feeling that way in your own words
what are nonverbal aspects of empathy
- being warm and genuine in our communication
how can you communicate understanding to the pt
- relay that you have heard what they are feeling and why they feel that way
- do so with warmth and genuineness
how can you increase ur understanding of a pts situation (5)
- active listening
- undivided attention
- dont listen to respond
- avoid judgement
- show that you’re listening
what is an example of an empathetic response
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?
empathy is not… (5)
- 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)
ACP is a process of (4)
- 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)
what are the benefits of ACP (7)
- 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
can nurses have conversations w the pt regarding ACP?
- yes
describe a nurse’s duty r/t ACP (6)
- 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
what are the 3 goals of care categories
- Comfort care
- Medical care
- Resuscitation
what is comfort care
- care directed at maximizing comfort, symptom control, and maintenance of quality life
- excludes attempted resuscitation
what is medical care
- includes approp investigations and interventions that can be offerred
- excludes resuscitation
what is resuscitation goal of care
- medical care including approp investigation and interventions that can be offerred
- includes attempted resus
describe the process of ACP
- an ongoing process –> their believes and wishes may change
- imp to revisit i=over time
what is critical to consider regarding ACP and goals of care
- each situation is unique
- it is critical to think abt the INTENT of the intervention
what are informal opportunities to discuss ACP and goals of care
- happen in the moment
- happen frequently throughout the day as a nurse
ex. r/t medication
what are formal opportunities to discuss ACP and goals of care
- 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
what is key for both formal and informal opportunities to discuss ACP
- documentation
what are some strategies to initiate convos regarding ACP
- introduce as a normal and importat component of any relationship between pts and the healthcare team
- ask permission to have this convo
see slide in asynchrnous ppt part 2, on sample script for how to discuss ACP
…
what is a method used to discuss ACP w patients
- ask, tell, ask
what are some examples of what the first ask in the ask, tell, ask method asks (6)
- 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?
what are some examples of what the “tell” in the ask, tell, ask method discusses (4)
- 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
what are some examples what the second “ask” in the ask, tell, ask methods asks (3)
- ask the pt to explain back what they understoof
- clarify any misunderstandings
- do u have any questions?
what should you NOT say/do when communicating with a pt (6)
- “at least”
- “i understand.”
- “i know how u feel”
- “it will be okay”
- avoid making the convo abt yourself
- use caution with “why”
what are some fears that nurses and students have associated w communicating w pts (6)
- 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”
how can we address fears associated w communicating w pts (6)
- acknowledge fears
- talk abt it
- push yourself
- remember the basics
- observe others & what they do/say
- practice
what should you do if you mess up when communicating w patient (4)
- dont panic
- acknowledge your mistake
- try again
- be gracious w yourself
what should you do if a pt or family is very distressed(6)
- 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)
what should you do if a pt/family asks a difficult question (4)
- acknowledge, validate, and normalize
- ask if there is a reason this came up
- gently explore their thoughts and understandings
- respond, if possible and appropriate
what are 2 ways to ackowledge, validate, and normalize a pt’s question
- “thats a great question”
- “many people in your circumstance wonder ___. is this something you’re worried about?”
what is advanced care planning
- a way to help you think about, talk about, and share your thoughts and wishes about future health care
who should consider ACP
- 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
when should you consider ACP
- now
- it is important to take part in convos about ACP planning before you become seriously ill
what are various ways to make your future health-care wishes known (4)
- 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
