Week 8-12 Flashcards
Relational Inquiry Definition
- Approach to practice
- Paying attention to contexts & people
- Understanding relating to others
Relational Orientation
- Detail oriented
- Between & among people
- Within individual contexts
Inquiring Action
- Deepen understanding of situation
- Determine significant factors
- Identify needed knowledge
- Continually asking questions
Contexts
- Shaping lived experiences
- Patient/family & healthcare situations
Service Provision Model (1989)
- People with health problems require outsiders to meet needs
- Becomes habitual
- Healthcare systems based on service proposition
Reference Points
- Formed habits that become a default
- Fall back point
Nursing Capacities
- Compassion
- Curious
- Committed
- Competent
- Correspond
Morals
- Individualized principles
- Regarding right/wrong
Ethics
- Nature & justification of principles
- Applied to moral problems
- Branch of philosophy concerned with moral good
- Standards, beliefs, values, ideals, morals
CNA Code of Ethics Purpose
- Expectations, obligations, standards
- Assess nurse conduct
- Nurses accountable to public
- Public trust for nurses
- Ethical issues inherent in nursing
Ethical Principles
- Autonomy
- Beneficence
- Nonmaleficence
- Fidelity
- Justice
Nursing Values & Ethical Responsibilities
- Safe, compassionate, competent care
- Promoting health & well-being
- Promote/respect informed decision making
- Preserving dignity
- Privacy & confidentiality
- Accountability
- Promoting justice
CNO Ethical Framework
- Client well-being
- Client choices
- Privacy & confidentiality
- Respect for life
- Maintaining commitments
- Truthfulness
- Fairness
Ethical Uncertainty
- Indecision/lack of clarity
- Unable to identify problem
- Feeling uneasy/uncomfortable
Ethical Dilemma
- Conflicting courses of action
- Underlying values conflict
Ethical Distress
- Constrained from acting on ethical proper belief
- Can’t prevent harm/perform action
- Effects integrity as moral agents
Ethical Residue
- Moral distress compromises personal integrity
Ethical Decision-Making
- Reflection
- Knowing & acknowledging personal beliefs
- Ethical theory & principles
- CNA & CNO values
- Practice standards
Boundary Benefits
- Security & order
- Constraints
- Containment
- Limits
- Delineates edge of appropriate behaviours
Boundary Crossing
- Crossing lines in a professional relationship
Boundary Violation
- Preceded by boundary drifts
- Progress to crossing & potentially violations
- Harmful to patient, professional, treatment
Boundary Verification
- Was it too helpful
- Was it not helpful enough
- What facilitates healthy independence
- What enables unhealthy dependency
Slippery Slope
- Preceded by boundary drifts
- Progressing to violations/crossings
- Violation that causes harm
Protecting Clients from Abuse
- Intervene & report behaviours
- Disrespect, violence, threat, romance, sexual abuse
- Therapeutic relationships don’t include friendship, romantic, sexual
Gift Giving
- Client understands nurse doesn’t expect anything in return
- No change to dynamic of therapeutic relationship
- No potential for negative feelings among others
- Only accept as group of nurses
Healthy Workplace Importance
- Practice setting
- Health & well-being of nurses
- Quality of client outcomes
- Organizational performance
Competencies of Client-Centred Collaborative Practice
- Patient, client, family, community centered
- Interprofessional communication
- Clarifying roles
- Team functioning
- Collaborative leadership
- Interprofessional conflict resolution
New Nurse Experience
- Adopting passive role
- Establishing credibility
- Building trust
- Engaging in active role
Shared Language/Communication
- Enabler or inhibitor of collaboration
- Medical jargon can keep knowledge within a group
Role Clarifying
- Gaining better understanding of everyone’s roles
- Value knowledge & contribution
- Patient/family considered as participating team members
Power Sharing
- Balance between provider & patient
- Shared decision-making
- Referral/inviting other professionals to team
Power
- Source of conflicts/negative behaviors
- Exercised rather than possessed
- Spread throughout society
Sources of Power
- Legitimate
- Reward
- Coercive
- Expert
- Information
- Referent
Nurse Power
- Requisite workplace structures to promote empowerment
- Belief in self ability
- Understanding power in relationships
Horizontal Conflict
- Individuals involved same level of role
Vertical Conflict
- Individuals involved in different levels of roles
Cause of Conflict in Healthcare
- Decreased work satisfaction
- High staff turnover
- Generational difference/views
- Stress
- Physical/emotional exhaustion
- Lack of autonomy
- Lack of managerial support
Workplace Bullying Types
- Work-related
- Person-related
- Physically intimidating
Consequences of Workplace Bullying (Nurse)
- Increase PTSD symptoms
- Decrease physical/mental health
- Increase job stress
- Increase burnout
Consequences of Workplace Bullying (Patient)
- Increase errors & adverse events
- Decrease perceptions of patient safety
Consequences of Workplace Bullying (Organization)
- Increase job turnover
- Decrease productivity
Conflict Prevention
- Understand meaning of behavior
- Avoid arguing, criticizing, judging
- Reflect on personal attitudes, values
- Recognize impact of personal stress
- Learn from conflict
DESC Resolution
- Describe
- Express
- Suggest
- Consequences
Aggressive Approach
- Dominate
- Lead to alienation/emotional distance
- Loneliness & frustration
Assertive Approach
- Ability to stand up for rights of others & self
- Learned behavior
- Requires practice
Conflict Management Styles
- Force
- Avoidance
- Compromise
- Accommodation
- Collaboration