Adviser (NCM100A): Laicherry Yuzon Man, RN • differentiates important factors from less important
Prof: Bryan T. Savellano Man, RN aspects of care
• coordinates multiple complex care demands. NURSING AS A PROFESSION PROFICIENT (stage IV) • has 3 to 5 years’ experience NURSING AS A PROFESSION REQUIRES: • receives situations as wholes not as parts 1.) special knowledge • uses instincts as guides for what is considered in a 2.) skill -something you perfect through practice situation 3.) preparation -baccalaureate education • has holistic understanding of the client, which improves decision making CRITERIA TO DETERMINE PROFESSION: • focuses on long-term goals 1.) specialized knowledge EXPERT (stage V) (6 years or more) 2.) body of knowledge • performance is fluid, flexible and highly proficient 3.) ethics • no longer requires rules, guidelines to connect and 4.) autonomy -not controlled by medicine, we have has an understanding of the situation for appropriate our own practice action 5.) service • demonstrates highly skilled intuitive and analytical 6.) caring - nursing is caring ability in situations • is inclined to take a certain action because "it feels PROFESSIONAL BEHAVIOR NURSES right".
1. Assesses, plans, implements and evaluates ROLES OF A PROFESSIONAL NURSE
theory, research and practice in nursing. 2. Accepts, promotes and maintains the 1. Care Provider interdependence of theory, research and practice. mothering roles (Evidence-based practice, best practice) chief goal in human relations is to convey understanding 3. Communicates and disseminates theoretical about what is important and to provide support knowledge, practical knowledge and research caring is central to effective nursing practice (Benner & findings the nursing community. Warbles, 1989) 4. Upholds the service orientation of nursing in the eyes of the public. (Moral turpitude-doing something 2. Communicator/Helper against the norm) shapes relationships between nurses and clients, nurses and support persons, nurses and colleagues BENNER'S LEVELS OF NURSING PROFICIENCY (1984, Patricia Benner, from novice to expert) 3. Teacher stage I. Novice teaching is an interactive process between the teacher stage II. Advanced beginner and one or more learners in which specific learning stage III. Competent objectives or desired behavior changes are achieved stage IV. Proficient stage V. Expert COMPONENTS OF TEACHING PROCESS A. assessing NOVICE (Stage 1) B. planning • no experience (e.g. nursing student) C. implementing • performance is limited, inflexible and governed by D. evaluating -do it in front of you context-free rules and regulations rather than experience 4. Counselor ADVANCED BEGINNER (stage II) (after graduation) counseling is the process of helping a client to recognize • demonstrates marginally acceptable performance and cope with stressful, psychologic or social problems to • recognize the meaningful "aspects" of the real develop and improve interpersonal relationships and to situation promote personal growth • experienced enough real situation to make emotional, intellectual and psychological (tell me more) judgment. COMPETENT (stage III) (charge nurses) 5. Client Advocate • has 2 to 3 years of experience Pleads the cause of another or argues, or pleads for a • demonstrates organizational and planning abilities cause or proposal advocacy involves concern for and defined actions in behalf of another person or organization to bring about 7 concepts of wellness (Anspaugh, Hamrick, Rosato) change advocacy involves promoting what is best for the client, 1.physical •positive lifestyle habits ensuring that the client's needs are met, and protecting 2. Social • interaction, respect, tolerance the client's rights. 3. Emotional • stress management 4. Intellectual • growth and learning 6. Change agent 5. Spiritual • morals, values, ethics a person or group who initiates changes over who assist 6. Occupational• balancing work and leisure others in making modifications in themselves or in the 7. Environmental • food, water, air system Illness-physical, emotional, intellectual, social development or 7. Leader spiritual functioning is thought to be diminished (IFC-individual, family, community) nursing leadership is defined as a mutual process of 5 stages of illness interpersonal influence through which the nurse helps the client to make decisions in establishing and achieving 1. Symptoms experience goals to improve the client's well-being 2. Assumption of sick role 3. Medical care contact PURPOSE OF LEADERSHIP 4. Dependent role model a. Improve health status and potential of individuals and 5. Recovery families b. Increase the effectiveness and level of satisfaction virulence-types of organisms among professional colleagues upholding care c. Raise citizens' and litigators' attitudes toward and What makes you ill? Diseases expectations of the nursing profession DISEASE 8. Manager management is defined as planning, giving direction, (ADL (activities of daily living) - nurse's responsibilities) developing staff, monitoring operations, giving rewards fairly, and representing both staff members and 1. Alteration in body functions administration as needed 2. Results in reduction of capacities or a shortening of normal lifespan 9. Researcher 3. Cause of a certain etiologic factor which may or may not participates in the research process. (Pure research- be known (Etiology-unknown) theoretical, applied research-practical) CLASSIFICATION OF DISEASES OR ILLNESSES NURSING AS A SCIENCE • Acute we have our own body of knowledge -severe symptoms of short duration everything that we do in nursing has a corresponding -symptoms appear abruptly and subside quickly rationale -may or may not require intervention it is improved through evidence-based research -following illness, most people return to normal level of wellness NURSING AS AN ART the art of nursing refers to skill (each individual has their • Chronic (extended) own unique skill) -lasts for an extended period; six months or longer skill is something that you are not born with -slow onset and often has period of remission (symptoms you acquire the skill to be about proper nursing care in disappear) and exacerbation (symptoms reappear) school @@@@@ CONCEPT OF HEALTH AND ILLNESS COMMUNICATION is the process of exchanging the information, and the process of generating and transmitting Health-a state of complete physical, mental and social well- meanings, between two or more individuals. it is the being and not merely the absence of disease or infirmity foundation of society and the most primary aspect of a nurse (WHO) patient interaction Such as "I'm not sure what you mean. Are you saying THERAPEUTIC COMMUNICATION - is defined as the that …?" face-to-face process of interacting that focuses on advancing 5. Reflection: Reflection of content is also called the physical and emotional well-being of a patient. Validation, which lets the patient know that the nurse has heard what was said and understands the Nurses use therapeutic communication techniques to provide content. It consists of repeating in fewer or different support and information to patients. (“Interpersonal words the essential ideas of the patient and communication techniques are the tools of psychosocial resembles paraphrasing. Sometimes it helps to repeat intervention.”) a patient's statement, emphasizing a key word. Reflection of feelings consists of responses to the COMPONENTS OF THERAPEUTIC COMMUNICATION patient's feelings about the content. RAPPORT - special feelings on the part of both the client 6. Focusing: Focusing helps the patient expand on a and nurse based on acceptance, warmth, friendliness, topic of importance. common interest, a sense of trust, and a nonjudgmental 7. Sharing Perceptions: Sharing perceptions involves attitude asking the patient to verify the nurse's understanding -establishing rapport may be accomplished by discussing of what the patient is thinking or feeling. non-health-related topics Perception checking is a way to explore GENUINENESS - the ability to be open, honest, and “real” incongruent or double-blind communication. "You're in interactions smiling, but I sense that you're really angry what TRUST- confidence in another person’s presence, happened." reliability, integrity, veracity, and sincere desire to provide 8. Theme Identification: themes are underlying issues assistance when requested or problems experienced by the patient that emerge -providing a blanket when the client is cold repeatedly during the course of the nurse-patient -providing food when the client is hungry relationship. -keeping promises They can relate to feelings (depression or -being consistent anxiety), behavior (rebelling against authority or -ensuring confidentiality withdrawal), experiences (being loved or hurt), or RESPECT-unconditional positive regard combinations of all three. -calling the client by name 9. Silence: Silence on the part of the nurse has varying -spending time with the client effects depending on how the patient perceives it. To -allowing sufficient time to answer the client’s questions a vocal patient, silence on the part of the nurse may or concerns be welcome, as long as the patient knows the nurse -always being open and honest is listening. -striving to understand the motivation behind the client’s With a depressed or withdrawn patient, the behavior nurse's silence may convey support, understanding, EMPATHY -process in which one is able to see beyond and acceptance. outward behavior and accurately sense another’s inner 10. Humor: Humor is a basic part of the personality and experience has a place within the therapeutic relationship. As a part of interpersonal relationships, it is a constructive THERAPEUTIC COMMUNICATION TECHNIQUES coping behavior. By learning to express humor, a 1. Listening: listening is essential to understanding the patient may be able to learn to express other patient. Therefore, the first rule of a therapeutic feelings. relationship is to lists to the patient. 11. Informing: informing or information giving, is an Real listening is difficult. It is an active, not a essential nursing technique in which the nurse shares passive, process. simple facts or information with the patient. 2. Broad Openings: Broad openings, such as "What are 12. Suggesting: suggesting is the presentation of you thinking about?" "Can you tell me more about alternative ideas, and is exploring alternative coping that?" and "What shall we discuss today?" encourage mechanisms. Suggesting or advice, also can be no the patient to select topics to discuss. therapeutic, reinforces the patient's dependence. 3. Restating: Restating is the nurse's repeating of the The nurse's intent in using the suggesting technique main thought the patient has expressed. should be to provide feasible alternatives and allow 4. Clarification: Clarification occurs when the nurse patients to explore their values in their unique life attempts to put into words vague ideas or thoughts situation. that are implicit or explicit in the patient's talking.