WEEK 3- NURSING AS AN ART Flashcards
lifelong process, used to develop meaningful relationships. promotes personal growth and attainment of patient’s health related goals.
COMMUNICATION
what are some ways a nurse with expertise in communication express their caring?
- becoming sensitive to self and others
- instilling faith and hope
- providing supportive environment
- assisting with gratification of human needs
- allowing for spiritual expression
morals, ethics, and an informed sense of right and wrong. awareness on personal responsibility
CONSCIENCE
convergence between one’s desire and obligations and the deliberate choice to act in accordance with them
COMMITMENT
expressed by being sensitive to the anxiety and apprehension they may feel toward receiving a call from a stranger who is asking about health-related issues
COMPASSION
expressed by being able to give the participant the information they need to have an understanding as to what they are consenting
COMPETENCE
is achieved by ensuring the participant that the information they share will be used appropriately and for the greater good.
CONFIDENCE
what are the 6cs of caring?
COMPASSION, COMPETENCE, CONFIDENCE, CONSCIENCE, COMMITMENT, COMFORTMENT
ability to take initiative in establishing and maintain communication, being authentic, appropriate response, and mutuality
INTERPERSONAL RELATIONSHIP
what are the levels of communication
intrapersonal and interpersonal
this occurs within an individual. this level is also called self talk, inner thought, inner dialogue
interpersonal communication
one-to-one interaction between the nurse and another person that often occurs face-to-face. Meaningful interpersonal communication results in exchange of ideas, problem solving, expression of feelings, decision making and personal growth.
INTERPERSONAL COMMUNICATION
occurs within a person’s spiritual domain. occurring in prayer, meditation, religious rituals to communicate with higher power
TRANSPERSONAL COMMUNICATION
occurs when small number of persons meet together. This can be seen used by nurses through group therapy
SMALL GROUP COMMUNICATION
an interaction with the audience. Nurses have opportunities to speak with groups of consumers.
PUBLIC COMMUNICATION
use of technology to create ongoing relationships with patient and their health care team.
ELECTRONIC COMMUNICATION
what are the EIGHT elements of the communication process?
SENDER MESSAGE ENCODING MEDIA DECODING RECEIVER FEEDBACK NOISE
they are the person who sends their idea to another person
SENDER
idea, feeling, suggestion, guidelines, orders or any content which is intended to be communicated
MESSAGE
process of converting the idea, thinking or any other component of message into symbols, words, actions, diagram
ENCODING
medium, passage or route through which encoded message is passed by the sender to the receiver
MEDIA
means translating the encoded message into language understandable by the receiver
DECODING
he is the person whom the message has been sent to
RECEIVER
it is the response by the receiver. marks the completion of the communication process
FEEDBACK
it is the hindrance in the process of communication
NOISE
refers to the form of communication in which the message is transmitted verbally. The goal is to have people understand what we are trying to convey
VERBAL COMMUNICATION
spoken words are used, includes f2f, speech, telephonic conversation, video, radio, television, voice over internet
ORAL COMMUNICATION
GIVE SOME ADVANTAGES OF ORAL COMMUNICATION
QUICK FEEDBACK
F2F- FACIAL EXPRESSION, BODY LANGUAGE
is the sending or receiving of wordless messages. gesture, body, language, posture, tone of voice or facial expression. This is all about the body language of the speaker
NONVERBAL COMMUNICATION
what are the three elements of nonverbal communication
appearance, body language, sounds
speaker: clothing, hairstyle, neatness use of cosmetics
surrounding: room size, lighting, decorations, furnishings
APPEARANCE
facial expressions, gestures, postures
BODY LANGUAGE
voice tone, volume, speech rate
SOUNDS
0-18inches, holding a crying infant, performing physical assessment, includes bathing, grooming, dressing, feeding a client
INTIMATE ZONE
18IN-4FT
sitting at a client’s bedside, taking the client’s nursing history, exchanging information at change of shift
PERSONAL ZONE
4-12FT
making rounds with physician, sitting at the head of the conference table, teaching a class, conducting family therapy
SOCIAL ZONE
12FT+
speaking at a community forum
PUBLIC ZONE
what are some factors influencing communication?
- developmental level
- gender
- sociocultural differences
- roles and responsibilities
- space and territoriality
- physical mental and emotional state
- values
- environment
refers to the relationship between a healthcare professional and a client (or patient)
THERAPEUTIC RELATIONSHIP
what are some other terms used alternatively for “therapeutic relationship”
helping relationship, helping alliance, nurse-patient relationship, working alliance, therapeutic alliance
_____ therapeutic nurse-patient relationship is a supportive interaction that moves a patient toward wellness. Based on trust, respect, interest, and empathy
therapeutic nurse-patient relationship
interaction process in which nurse fulfills her role by using her professional knowledge and skill in such a way that she is able to help the patient physically, socially and emotionally
therapeutic relationship
what are the four phases of a therapeutic nurse-patient relationship (in order)
- pre-interaction phase
- introductory/ orientation
- working phase
- termination phase
phase which a nurse goes through before actual interaction with the patient. begins when the nurse is assigned to a patient BEFORE they interact. involves preparation for first encounter.
PRE-INTERACTION PHASE
task of this phase is to obtain available information about the client from their charts, initial assessment is made. examining ONES FEELINGS, FEARS AND ANXIETIES ABOUT working with a particular client, set objective for the interaction phase, take help of the clinical supervisor
PRE-INTERACTION PHASE
- begins when the nurse goes to the patient, introduces herself and gets introduction about him.
- nurse and client get acquainted ( know someone slightly)
- this phase ends when the nurse and her patient begin to accept each other as a unique human being
INTRODUCTORY/ ORIENTATION PHASE
task of introductory/orientation phase
- establishment of contact
- making agreement or pact
- talking with the patient
- assess client needs, coping strategies, defense mechanisms, strengths and weakness
nurse introduces herself, build trust and rapport by demonstrating acceptance. establishing a therapeutic environment ensuring safety and privacy
ESTABLISHMENT OF CONTACT
Initiating a therapeutic contract by establishing a time, place and duration of each meeting as well as the length of time the relationship will be in effect
MAKING AGREEMENT OR PACT
while talking with the patient, shows trust in her behavior. patient may present a prepared spiel to a nurse.
TALKING WITH THE PATIENT
starts when the nurse and the patient are able to overcome the barriers of orientation and introductory phase. during this phase the nurse and the patient actively work on meeting the goals which they had established prior
WORKING PHASE
The characteristic feature of this phase is that the nurse is able to _____ and the patient’s fear of unknown is also decreased
OVERCOME ANXIETY
final step of the therapeutic relationship, nurse terminates the relationship when they mutually agree, and goals are reached. Separation occurs
TERMINATION PHASE
what are the therapeutic communication techniques
- listening
- broad openings
- restating
- clarification
- reflection
- humor
- information
- focusing
- sharing perceptions
- theme identification
- silence
- suggesting
active process of receiving information
LISTENING
Expression of interest, leaning forward, nodding head, frequent validation, attempt to fully understand
ACTIVE LISTENING
SOLER IN ACTIVE LISTENING STANDS FOR WHAT?
S- sit facing the client O- open posture L- lean forward towards client E- establish eye contact R- relax
encouraging the patient to select topics for discussion, eg; “what are you thinking about?” asking open-ended questions
“tell me what happened?” and “how are you today?”
repeating the main thought expressed by the patient
RESTATING
attempting to put vague ideas or nuclear thoughts of the patient into words to enhance the nurse’s understanding or asking the patient to explain what he means
CLARIFICATION
directing back the patient’s ideas, feelings, questions and content, eg; “you are feeling tense and anxious and it is related to a conversation you had with your husband”
REFLECTION
signifies understanding, empathy, interest, and respect for the patient
REFLECTING OR VALIDATING
the discharge of energy through comic enjoyment of the imperfect
HUMOR
skill of information giving
INFORMATION
questions or statements that help the patient expand on a topic of importance
FOCUSING
asking the patient to verify the nurse’s understanding of what the patient is thinking or feeling
SHARING PERCEPTIONS
this involving identification of underlying issues or problems experienced by the patient or problems experienced by the patient that emerge repeatedly during the course of the nurse-patient relationship
THEME IDENTIFICATION
lack of verbal communication for a therapeutic reason
SILENCE
presentation of alternative ideas for patient’s consideration relative to problem solving
SUGGESTING
trying to get the patient to expand upon a topic or bring up another topic
EXPLORING
THIS IS AN EXAMPLE OF WHAT?
‘So far we have talked about’
SUMMARIZING
what are non-therapeutic techniques
- reassuring
- rejecting
- giving approval
- advising
- defending
- requesting
- belittling
-this should be avoided
“everything’s going to be alright”
FALSE REASSURANCE
the process of attending to people’s needs, experiences and feelings, and intervening so that they learn particular things, and go beyond the given
TEACHING
aim to engage and empower individuals and communities to choose healthy behaviors, and make changes that reduce the risk of developing chronic diseases and other morbidities
HEALTH PROMOTION
“Enables people to increase control over their own health. covers a wide range of social and environmental interventions that are assigned to benefit and protect individual people’s health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure”
HEALTH PROMOTION - defined by WHO
differs from health promotion because it focuses on specific efforts aimed at reducing the development and severity of chronic diseases and other morbidities
DISEASE PREVENTION
health promotion and disease prevention often address ____, which influence modifiable risk behaviors.
SOCIAL DETERMINANTS OF HEALTH
what are DETERMINANTS OF HEALTH?
- economic, social, cultural, political conditions in which people are born, grown and live that affect health status
what are MODIFIABLE RISK BEHAVIORS?
tobacco use, poor eating habits, lack of physical activity, (which contribute to the development of chronic disease
what are typical activities for health promotion, disease prevention, and wellness programs
- communication (public service announcements, health fairs, mass media campaigns, newsletters)
- education (courses, trainings, support groups)
- Policy, systems, and Environment-
raising awareness about healthy behavior for the general public
COMMUNICATION
empowering behavior change and actions through increased knowledge
EDUCATION
making systematic changes through improved laws, rules, regulations, functional organizational components
POLICY, SYSTEMS, AND ENVIRONMENT
_______ is a guiding principle in health care that emphasizes health promotion and disease prevention rather than the management of symptoms and illness
HEALTH MAINTENANCE
give a few examples of health restoration and maintenance
- yearly/ preventive physical
- PSA COUNSELING AND TESTING
- FITNESS RECOMMENDATIONS
is defined as “set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”
- Helps a person to be as independent as possible in everyday activities and enables participation in education, work, recreation and meaningful life roles
REHABILITATION
give examples of rehabilitation
- exercises to improve a person’s speech, language and communication after a brain injury
- modifying an older person’s home environment to improve their safety and independence at home and to reduce risk of falls
- psychological support for a person with depression
is highly person-centered, meaning that the interventions and approach selected for each individual depends on their goals and preferences
REHABILITATION
made up of different health professionals, including physiotherapies, occupational therapists, speech and language therapists, orthotists and prosthetists, and physical medicine and rehabilitation doctors
REHABILITATION WORKFORCE
WHAT are some benefits of rehabilitation
- reduce impact of broad range of health conditions
- helps minimize or slow down the disabling effects chronic health conditions, such as cardiovascular disease, cancer and diabetes
- it is an investment
- enables individuals to participate in education and gainful employment
universal phenomenon influencing the ways in which people think, feel and behave in relation to each other
CARING
CARING IS _______
PRIMARY
this determines what matters to a person
CARING
____- is a human experience
ILLNESS
who said “caring is the essence of nursing”
MADELEINE LEININGER
_______ describes the concept of care as essence and central unifying and dominant domain that distinguishes nursing from other health disciplines
MADELINE LEININGER
TRUE OR FALSE: Madeline Leininger describes the concept of care as essence and central, unifying and dominant domain that distinguishes nursing from other health disciplines
TRUE
what was Madeleine Leininger theory?
TRANSCULTURAL NURSING OR CULTURE CARE THEORY
What are the cultural aspects of care
a. nurse caring behavior
b. implications for patient-centered care
this is caring which involves knowing a patients cultural values and beliefs, although need for human caring is universal, application is influenced by cultural norms
NURSE CARING BEHAVIOR
- KNOWS the patient’s beliefs and attitudes regarding health care and caring practices
- know the patient’s cultural practices regarding end-of-life care.
- determine if a member of the patients family is the best source to guide use of caring practices
- knowing patients cultural practices regarding removal of life support
- know the patients cultural practices regarding care of the body after death
IMPLICATIONS FOR PATIENT-CENTERED CARE
who made the “THEORY OF CARING”
JEAN WATSON
philosophy and science of caring is concerned on how nurses express care to their patient
her theory stresses HUMANISTIC ASPECTS OF NURSING as they intertwine with scientific knowledge and nursing practice
JEAN WATSON
according to Watson, ____ is central to nursing practice, promotes health better than simple medical care
CARING
watson defined 3/4 of metaparadigm concepts in nursing, what are they?
human being/person, health, nursing (fourth is environment)
____ a valued person in and of him or herself to be cared for, respected nurtured, understood and assisted
HUMAN BEING
_____ defined as a high level of overall physical, mental and social functioning; general adaptive maintenance level of daily functioning; absence of illness, or the presence of efforts leading to the absence of illness
HEALTH
____ as a science of persons and health-illness experience that are mediated by professional, personal, scientific, and ethical care interactions
NURSING
TRUE OR FALSE: JEAN WATSON does not define the 4th metaparadigm concept of ENVIRONMENT
TRUE
What are Watson’s 10 CARATIVE FACTORS
- FORMING humanistic-altrusistic value systems
- instilling faith-hope
- cultivating a sensitivity to self and others
- developing a helping-trust relationship
- promoting an expression of feelings
- using problem-solving for decision-making
- promoting teaching-learning
- promoting a supportive environment
- assisting with gratification of human needs
- allowing for existential-phenomenological forces
