Term
Goals of
Nursing Education |
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Definition
~To teach you to think like a nurse
~To see the world of health care through the lens of nursing
~To respond to the effects of both educational and clinical experiences by developing professionalism
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Term
Professional
Socialization |
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Definition
˜
~absorbing and assimilating the culture of nursing: its rites, rituals, and valued behaviors. |
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Term
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Definition
~Classroom lectures
~Assignments
~Laboratory experiences
~New vocabulary |
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Term
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Definition
~This includes unplanned observations, participating in a student nurse association, and hearing nurses discuss patient care.
~Informal experiences are often the most powerful.
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Term
Cohen's Model of Student Socialization |
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Definition
~Stage 1: Unilateral dependence
~Stage 2: Negativity/independence
~Stage 3: Dependence/mutuality
~Stage 4: Interdependence |
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Term
Benner's Stages of Nursing Proficiency |
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Definition
~Stage 1: Novice
~Stage 2: Advanced beginner period
~Stage 3: Competent practitioner
~Stage 4: Proficient practitioner
~Stage 5: Expert practitioner |
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Term
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Definition
~commitment to public service
~autonomy
~commitment to lifelong learning and education |
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Term
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Definition
~Nursing shortages
~Difficult working conditions
~Nursing staff retention
~Older, more chronically ill patients
~Absence of positive reinforcement
~Lack of frequent communication
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Term
Reality Shock
Kramer 1974
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Definition
~Lack of support
~Gap between ideals and actual work setting
~Inability to implement desired nursing care |
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Term
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Definition
~Some new nurses "drop out" at this point, in any of several ways:
-Disengaging mentally and emotionally
-Driving oneself and others to the breaking point
-"Job hopping"
-Prematurely returning to school
-Burning out
-Leaving the nursing profession entirely |
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Term
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Definition
~Coping with reality shock involves taking responsibility for getting support, finding a mentor, learning more about the profession, and improving self-care. |
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Term
Reality Shock:
The Two Worlds of Nursing |
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Definition
~Disparity between the values in nursing education and those in the clinical area
~Results in role confusion and difficulty finding a personally and professionally acceptable version of the nursing role |
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Term
Bachelor's Degree
in
Nursing
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Definition
4-year bachelor's of science in nursing (BSN) degree program |
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Term
Bachelor's Degree in Nursing Programs |
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Definition
~University of Minnesota (1909): first bachelor's degree program established
~Brown Report (1948): by the Carnegie Foundation, recommended that basic schools of nursing be placed in universities and colleges
~Educational Preparation for Nurse Practitioners and Assistants to Nurses (1965): By the ANA
-BSN should become the basic foundation for professional practice.
-This was controversial and fostered conflict and division within nursing.
-Practicing nurses vehemently protested its recommendations.
~National League for Nursing (NLN; 1982): Affirmed BSN as minimal educational level
~The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice (1996): By AACN |
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Term
Bachelor's Degree in Nursing Programs
(cont.)
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Definition
~Provide college education and preparation for licensure after passing NCLEX-RN®, as well as advanced college education for established RNs
~4-year curriculum with general and nursing focus on:
-Liberal arts
-Nursing science and clinical nursing skills
-Communication
-Decision making
-Leadership
-Care to all patients in a variety of settings
~Faculty qualifications usually high
~Equips graduates to practice within complex health care systems and to assume multiple nursing roles |
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Term
Associate Degree
in
Nursing
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Definition
~Provide basic education for licensure
~24-month or longer curriculum
~Focus on:
-Nursing science and clinical nursing skills
-Decision making
-Leadership
~Popularity the result of accessibility, low cost, part-time and evening study options, shorter duration of education, eligibility for licensure
~Often used as a step in progression toward BSN or master's of science in nursing (MSN)
˜ ~Graduate the most RN candidates of all basic programs |
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Term
Accreditation
of
Programs
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Definition
~All nursing programs require approval by the state board of nursing.
~Accreditation is a supplementary, voluntary review process.
~Courses/programs are reviewed by professional nursing organizations.
~Accreditation promotes adherence to standards that:
-Protect quality of education
-Protect public safety
-Protect the nursing profession
~Accrediting bodies include:
-Commission on Collegiate Nursing Education (CCNE)
-Accreditation for BSN, MSN, and doctoral programs
-National League for Nursing Accreditation Commission (NLNAC)
-Four councils for ADN, diploma, BSN, and MSN/doctoral programs |
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Term
Master's Degree
in
Nursing
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Definition
-Prepare for roles in administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, certified nurse practitioner (CNP), certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), and others
-Emphasis on advanced practice through clinical specialization
-Increased demand for CNPs has resulted in tripling the number of CNP programs in the United States. |
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Term
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Definition
˜Definition: non–degree-seeking ways to maintain expertise in nursing; "life-long learning"
- Pursued by individual nurses
-Take place in a variety of settings and available in many formats
˜ANCC is responsible for:
-Standards of continuing education (CE)
-Accreditation of CE programs
-Transferability of CE from state to state
-Development of guidelines for states' recognition systems
˜The nationwide need is for mandatory CE as a prerequisite for license renewal. |
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Term
Challenges in
Nursing
Education
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Definition
˜Inability of nursing programs to produce enough nurses to meet society's need as a result of several causes, including:
-Lack of capacity in nursing schools
-Faculty shortages
-Retirement and low salaries
˜Need to transform nursing education for complex U.S. health care needs (IOM, 2003) based on:
-Students not educated to care for diverse patient types
-Students not educated to work in teams
-Students not educated to access and use scientific evidence in practice
-Students unprepared to identify and eliminate errors or problems
-Students not provided basic informatics training
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Term
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Definition
˜-An occupation is a job or employment
-˜A career is a course of professional life or employment that affords the individual opportunities for personal advancement, progress, or achievement
˜-Career management is a planned logical progression of one’s professional life that includes defined goals and objectives and a plan for achievement |
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Term
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Definition
~First step in career management is to know where you want to go professionally
˜Do goals involve a decision to return to school?
-Personal values
-Professional values
-Family issues and responsibilities
-Lifestyle choices
-Economic factors
-Community and recreational involvement |
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Term
Career
Management
Strategies
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Definition
~Assess current position
-Are you engaged in work that is fulfilling?
-Do you respect the people with whom you work?
-Do you look forward to going to work?
-Are the salary and benefits reasonable?
-Are there opportunities for advancement? |
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Term
Career
Management
Strategies
(cont.)
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Definition
~Choice: Either stay where you are or find a new position to meet your personal and professional needs
~Technology can assist with job search
~Create a positive first impression whether by phone, letter, resume, email or interview
~Resume preparation
-Essentials
-Content
-Checkup
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Term
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Definition
~Developmental, empowering, and nurturing relationship that extends over time and in which mutual sharing, learning, and growth occur in an atmosphere of respect, collegiality, and affirmation |
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Term
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Definition
~Steps to take when you solicit feedback:
-Get focused
-Allocate sufficient time
-Understand the feedback
-Ask for guidance
-Show appreciation
-Think about the feedback |
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Term
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Definition
~Halo Effect: overrating an employee’s total performance based on a single positive event
~Horns Effect: underrating an employee’s total performance based on a single negative event |
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Term
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Definition
˜
~Paul and Elder (2005)
-Definition: a process by which the thinker improves the quality of his or her thinking by taking charge of the structures inherent in thinking and imposing intellectual standards upon them |
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Term
Critical
Thinking
in Nursing
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Definition
~Involves four questions
-What assumptions have I made about this patient?
-How do I know my assumptions are accurate?
-Do I need any additional information?
-How might I look at this situation differently? |
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Term
Critical
Thinking
in Nursing
(cont.)
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Definition
~Begins with reflective thinking
~Is a complex, purposeful, and disciplined process
~Is undergirded by standards and ethics of nursing
~Improves with practice and professional experience
~Critical thinking requires:
-The ability to describe how you came to a conclusion
-The ability to support your argument with explicit data and rationales |
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Term
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Definition
~The nursing process is a method of critical thinking focused on solving patient problems in professional practice.
-A conceptual framework that enables the student or nurse to think systematically (Huckabay, 2009)
~It is taught in schools of nursing across the United States.
~Many states refer to it in their nurse practice acts.
~It should be used as a creative approach to thinking and decision making. |
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Term
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Definition
~Nursing diagnosis as part of the nursing process: defined as "a clinical judgment about individual, family or community responses to actual or potential health problems or life processes which provide the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability" (North American Nursing Diagnosis Association International [NANDA-1], 2009) |
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Term
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Definition
~National Group for the Classification of Nursing Diagnosis (1973)
-First list of nursing diagnoses
-Now known as NANDA-I; international |
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Term
Nursing
Process
Phase 1: Assessment
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Definition
˜~Two types of data
-Subjective data: obtained through patient's description; called symptoms
-Objective data: obtained through observation; called signs
˜~Organizing data: use of a standard framework to sort and organize patient data
˜~Attend to confidentiality through Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance |
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Term
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Definition
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Term
Nursing
Process
Phase 2: Diagnosis
(Analysis and Identification of the Problem)
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Definition
~Data must be validated and compared to norms.
~Data must be clustered and grouped.
~Observe relationships among pieces of data.
~Identify one or more problems amenable to nursing intervention.
~These problems are characterized as nursing diagnoses.
-Carefully distinguish between nursing and medical diagnoses.
-Nursing diagnoses involve human responses to disease and must be found within a nurse's scope of practice. |
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Term
Nursing
Process
Phase 2: Diagnosis
(Nursing Diagnosis)
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Definition
~Five components of nursing diagnoses: NANDA-1
-Label
-Definition
-Defining characteristics
-Risk factors
-Related factors
~Nursing diagnoses must be supported by data.
~Nursing diagnoses must be accurate.
~Nursing diagnoses must be prioritized.
-Life-threatening
-Potential to cause harm or injury
-Related to overall health |
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Term
Nursing
Process
Phase 3:
Planning
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Definition
~Identify patient goals.
~Determine ways to meet those goals.
~Goals are used to guide selection of interventions.
~Goals are also used to evaluate patient progress.
~Goals should be agreed on by both nurse and patient, if possible. |
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Term
Nursing
Process
Phase 3:
Planning
(cont.)
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Definition
~Writing patient goals and outcomes requires using:
-Outcome criteria, which are specific and make the goal measurable
-Time frames, which are short-term to long-term
~Goals should be realistic and accessible.
~Goals should be culturally congruent.
~Nursing orders are written on the basis of these goals.
-Nursing orders are actions to assist the patient in achieving a stated goal.
-Nursing and medical orders differ. |
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Term
Nursing
Process
Phase 3:
Planning
(cont.) |
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Definition
~Three types of nursing interventions
-Independent: do not require supervision or direction by others
-Dependent: require instructions, written orders, or supervision of another health professional with prescriptive authority
-Interdependent: require nurse to collaborate or consult with another health professional before carrying out the action |
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Term
Nursing
Process
Phase 3:
Planning
(cont.) |
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Definition
~Writing the plan of care is done once the interventions are selected.
~Care plans are individualized.
-Based on standardized care plans OR
-Based on an individually created care plan
~Some settings use "critical paths" as multidisciplinary frameworks for plans of care.
~Critical paths are written in collaboration with physicians and other health care providers. |
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Term
Nursing
Process
Phase 4: Implementation of Planned Interventions
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Definition
~Implementation is the actual carrying out of orders.
~This must be done in an orderly and competent manner.
~Continually assess the patient as implementation progresses.
~Documentation of nursing actions is an essential and integral part of the implementation phase. |
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Term
Nursing
Process
Phase 5:
Evaluation
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Definition
~The nurse examines the patient's progress.
~The nurse measures progress against goals and outcome criteria to determine whether problem is:
-Resolved
-In the process of being resolved
-Unresolved
~Evaluation is critical; it identifies changes that need to be made to resolve the problem or meet outcomes goals.
~The nursing process is dynamic, continually moving from one phase to another and then beginning the process again. |
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Term
Traditional
Nurse-Patient
Relationship
Orientation Phase
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Definition
~Orientation phase
-Introductory phase: "Getting to know you"
-Begins the development of trust building in the relationship
-Four tasks of the orientation phase
•Trust enables continued participation in the relationship.
•Patient and nurse regard each other as individuals.
•Nurse and patient identify major problems and needs.
•Approximate length of the relationship will be estimated. |
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Term
Traditional
Nurse-Patient
Relationship
Working Phase
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Definition
~Working phase
-Nurse and patient tackle tasks outlined in orientation phase.
-Patients may exhibit alternating periods of intense effort and periods of resistance to change.
-Regression is an ego defense mechanism that occurs as a reaction to stress.
-Regression often precedes positive change. |
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Term
Traditional
Nurse-Patient
Relationship
Termination Phase
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Definition
~Termination phase
-Nurse and patient take on those activities that enable them to end the relationship in a therapeutic manner.
-Positive and negative feelings often accompany the termination process.
-Positive feelings are often about gains made.
-Negative feelings are often sadness, anger, and fear.
•Must be discussed toward acceptance |
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Term
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Definition
~Professional boundaries
•The spaces between the nurse's professional power and the patient's vulnerability (National Council of State Boards of Nursing [NCSBN], 1996)
~Boundary violations occur with confusion between the needs of the nurse and those of the patient. |
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Term
|
Definition
~Basic to effective interpersonal relationships
~Goal of self-awareness: Nurses can distinguish their own emotional needs from their patients' needs and get their own emotional needs met outside the nurse-patient relationship.
~Also includes professional boundaries.
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Term
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Definition
~Reflective practice
-Taking time to focus on own thoughts and feelings
-Understand how these can affect behaviors toward patients
~Avoiding stereotypes
-Prejudices and attitudes that are biased toward clients
-Goal: accept all patients as individuals of dignity and worth who deserve the best nursing care possible
~Becoming nonjudgmental
-Nurses acknowledge all patients' rights to be who they are and express their uniqueness.
-Nurse conveys acceptance to patients, neither approving nor disapproving their personal beliefs, habits, expression of feelings, or lifestyles. |
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Term
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Definition
~Communication is the exchange of thoughts, ideas, or information at the heart of all relationships.
~Levels of communication
-Verbal consists of all speech.
-Nonverbal includes all non-speech: grooming, clothing, gestures, posture, facial expression, eye contact.
•Unconscious: considered a more reliable expression of feeling |
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Term
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Definition
~Congruent versus incongruent communication
-Congruent: Verbal and nonverbal are consistent and reinforce each other.
-Incongruent: Speech and non-speech do not match. |
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Term
Elements of
Communication
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Definition
~Five major elements must be present for communication to occur.
-Sender: person sending the message
-Message: what is actually said plus accompanying nonverbal communication
-Receiver: person acquiring the message
-Feedback: response to the message
-Context: setting in which the interaction occurs |
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Term
Operations in the
Communication
Process
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Definition
~Perception
-Selection, organization, and interpretation of incoming signals into meaningful messages
~Evaluation
-Analysis of information received
~Transmission
Expression of information, verbal or nonverbal
~Communication is complex. These three factors are influenced by:
-Gender, age, culture, interest, mood, value, clarity, length of the message
-Presence or absence of feedback
-Atmosphere of the context |
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Term
How
Communication
Develops
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Definition
~Somatic language
-Early development: crying, facial expressions, reddening of the skin, fast or shallow breathing
~Action language
-Behaviors: reaching out, pointing, crawling toward a desired object, turning or nodding the head
~Verbal language
-Repetitive noises and sounds: syllables, words, phrases, and then complete sentences
-Development of verbal and nonverbal communication depends on quantity and quality of stimulation |
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Term
Criteria for Successful
Communication
|
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Definition
~Feedback
-When a receiver relays to a sender the effect of the sender's message
~Appropriateness
-When a reply fits the circumstances and matches the message
~Efficiency
-When the speaker uses simple, clear words that are timed at a pace suitable to participants
~Flexibility
When the speaker bases messages on the immediate situation rather than preconceived expectations |
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Term
Becoming a Better
Communicator |
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Definition
˜~Listen well.
-Active listening involves focusing solely on a person and acknowledging their feelings in a nonjudgmental manner.
-It includes open posture.
-Venting describes verbal "letting off steam" about frustrations.
˜~Convey empathy.
-Awareness of and sensitivity to others; identification of feelings of another person
˜~Ask open-ended questions.
-These prompt patients to answer fully with more than a "yes" or "no" answer. |
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Term
Becoming a Better
Communicator
(cont.)
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Definition
~Give information.
-Share appropriate knowledge that patients are not expected to know.
~Use reflection.
-Encourage patients to think through situations by reflecting their questions back to them to develop their own solutions.
-This helps clarify the patient's thoughts.
~Communicate meaningfully with silence.
-Being quietly "present" with patients conveys respect for patient's feelings under troublesome circumstances. |
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Term
Becoming a Better
Communicator
(cont.) |
|
Definition
~Communication across differing languages: Use professional language interpreters and translators when necessary.
-Interpreters orally communicate using two languages.
-Translators works with written documents in two languages.
-Do not depend on a patient's family members or colleagues. This can compromise accuracy and meaning. |
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Term
|
Definition
| ~Providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions. |
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Term
|
Definition
~Acute illness: characterized by severe symptoms that are relatively short lived
-Symptoms tend to appear suddenly, progress steadily, and subside quickly.
-Patient may or may not require medical attention.
-Some acute injuries or illness can lead to chronic illness. |
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Term
|
Definition
~Chronic illness: characterized by gradual development of symptoms that are long-lived.
-It requires ongoing medical attention.
-Chronic illness may continue for the duration of the person's life.
-Chronic illnesses have significant social and economic impact. |
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Term
|
Definition
~Chronic illness is one of the fastest growing health problems in the United States.
~In 2005, almost one-half of the U.S. population had one or more chronic illnesses.
~Chronic illnesses are caused by permanent changes that leave residual disability.
~State of health is elusive, even though disease may be managed successfully.
~Some chronic illnesses go through remissions and exacerbations |
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Term
Consequences of
Chronic
Illness |
|
Definition
~The consequences are pervasive and life-altering.
~They lead to altered individual functioning and disruption of family life.
~Long-term medical management can create financial hardship
~Patients need to make significant lifestyle changes, such as monitoring blood glucose levels throughout life for diabetes.
~Patients may not be able to do activities and tasks they are used to doing. |
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Term
|
Definition
~Stage 1: disbelief and denial
-Defense mechanism used to avoid anxiety and fear
~Stage 2: irritability and anger
-Emotions related to alteration of functioning caused by illness
~Stage 3: attempting to gain control
-Fears stimulate treatment-seeking behavior to gain control over the illness.
~Fears can also lead to further denial and avoidance. |
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Term
Adjustment to
Illness
(cont.)
|
|
Definition
~Stage 4: depression and despair
-Common mood resulting from altered lifestyle, modification of many activities, diminished sense of well-being, and pain
~Stage 5: acceptance and participation
-Patient has acknowledged the reality of the illness and is ready to participate in decisions about treatment.
~These stages are descriptive; patients do not move through these states in a linear way.
~Nurses should not use these stages to characterize a particular patient's response. |
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Term
|
Definition
~Talcott Parsons (1964) identified five attributes of the Anglo-American sick role.
-Exemption from social responsibilities
-Cannot be expected to care for himself/herself
-Should want to get well
-Should seek medical advice
-Should cooperate with the medical experts
~This definition includes behavior that is dependent, passive, and submissive. |
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Term
Contemporary View of
the Sick
Role |
|
Definition
~Patients have become increasingly likely to challenge providers and to seek out their own information.
˜~Nurses are required to be culturally competent in providing patient-centered care.
˜~There is no normative illness response based on culture.
˜~The current Anglo-American expectation is that people should accept responsibility for their own care.
-This is based on the expectation that people should want to get well and behave accordingly.
˜~Response to illness varies widely.
-Individual personality influences illness response. |
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Term
Illness
Behaviors
(Internal Influences) |
|
Definition
~Personality structure contributes to how a patient manages illness.
~Personality characteristics to consider include:
-Dependence/independence
-Coping ability
-Hardiness
-Learned resourcefulness
-Resilience
-Spirituality |
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Term
Illness
Behaviors
(Internal Influences)
(cont.)
|
|
Definition
~Dependence/independence
-Patients vary along a continuum in their response to illness.
•Some adopt a passive attitude and overly rely on others to care for them.
•Others continue denial and try to live as independently as before becoming sick.
•Most function between these two extremes.
˜~Behaviors may be the patient's way of signaling an increased need for security or support; independence may not be the desired outcome.
~Both overly dependent and overly independent behavior can be frustrating to nurses. |
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Term
Illness
Behaviors
(Internal Influences)
(cont.)
|
|
Definition
~Coping ability
-The strategies a person uses to assess and manage demands
•Each patient has a unique coping repertoire.
~With acute illness, coping behaviors are generally short-term and lead to pre-illness state.
~With chronic disorders, coping behaviors must be used continuously. |
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Term
Illness
Behaviors
(Internal Influences)
(cont.)
|
|
Definition
~Resourcefulness
-Refers to the use of cognitive skills that minimize the negative effects of thoughts
~Self-mastery: reduces feelings of despair and helplessness
~Resourcefulness can be taught as a form of coping. These skills include:
-Stress inoculation
-Self-regulation
-Problem solving
-Conflict resolution
-Emotion management |
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Term
Illness
Behaviors
(Internal Influences)
(cont.)
|
|
Definition
~Resilience
-Defined as a successful adaptation despite challenging or threatening circumstances (Humphreys, 2001)
-Resilience can be a result of three factors.
•Disposition: temperament, personality
•Family factors: warmth, support, organization
•Outside support factors: supportive network, success in school or work
-Study has broadened to include adolescents and adults who face difficult, traumatic, or adverse circumstances, including critical illness and abuse. |
|
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Term
Illness
Behaviors
(Internal Influences)
(cont.) |
|
Definition
~Spirituality
-Defined as belief in a higher power, interconnectedness among living beings, and an awareness of life's purpose and meaning
-Religion differs from spirituality.
~Spiritual beliefs may have psychological, medical, and financial benefits that are scientifically proven in the future.
-For instance, Herbert Benson's "relaxation response" can utilize prayer.
~Nurses are encouraged to view spirituality as one aspect of the whole person that can be used in coping with illness.
~Nurses' responsibility is to refrain from trying to influence patients' religious beliefs. |
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Term
Illness
Behaviors
(External Influences)
|
|
Definition
~Past experiences
-Messages from childhood about illness can affect one's adjustment to it.
~Nurses should determine the nature of past experiences related to health and care in order to individualize care accordingly. |
|
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Term
Illness
Behaviors
(External Influences)
(cont.)
|
|
Definition
~Culture: pattern of learned behavior and values that are reinforced through social interactions
-Culture is shared by members of a particular group and transmitted from one generation to another.
-Culture can exert considerable influence over meanings attached to health and illness.
-The Transcultural Nursing Society was started in 1988 to address this educational need for nurses. |
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Term
Culturally
Competent Nurses
|
|
Definition
~Cultural competence: a nurse's knowledge about cultural influences that she/he can use to plan appropriate approaches to a patient's needs
~Without cultural competence, nursing care can be compromised, including problems with:
-Stereotyping
-Communication difficulties
-Misperceptions about personal space
-Differing values and role expectations
-Ethnopharmacologic considerations
-Ethnocentrism |
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|
Term
Culturally
Competent Nurses
(cont.)
|
|
Definition
~Stereotyping
-Defined as "pigeon-holing" patients from different cultures with prior assumptions about their beliefs or behaviors
-Nurses need to create individualized plans sensitive to each culture's needs.
~Communication difficulties
-Patterns of communication are strongly influenced by culture.
-Cultural knowledge will help ensure that nurses understand and correctly interpret communication from different cultures. |
|
|
Term
Culturally
Competent Nurses
(cont.) |
|
Definition
~Misperceptions about personal space
-Cultures differ in the amount of personal space that is comfortable for members.
-Nurses must be sensitive to expectations about touch and personal distance.
~Differing values and role expectations
-Patients' values and role expectations about nurses, physicians, and themselves may conflict with nurses' values.
-Nurses need to understand both cultural values and role expectations as well as the patient's individual values and role expectations.
|
|
|
Term
Culturally
Competent Nurses
(cont.) |
|
Definition
~Ethnopharmacologic considerations
-People of different ethnic groups respond differently to medications.
-Nurses need to be knowledgeable about ethnic sensitivities to pharmaceutical agents.
~Ethnocentrism
-Defined as the inclination to view one's own cultural group as the standard by which to judge the value of other cultural groups
-Nurses need to identify the ways personal beliefs and expectations can influence care, thereby recognizing and eliminating prejudices.
|
|
|
Term
Culturally
Competent Nurses
(cont.) |
|
Definition
~Cultural assessment
-Begins with nurse's self assessment
-Used to identify beliefs, values, and health practices that may help or hinder nursing interventions
-Consult "Cultural Assessment Checklist" |
|
|
Term
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Definition
~Across all cultures, illness forces emotional and behavioral changes. Among these changes are:
-Guilt
-Anger
-Anxiety
-Stress
~Guilt
-Patients may experience guilt about becoming ill, especially if the illness is linked to lifestyle choices.
~Anger
-This is a common emotional response, especially in Anglo-American culture, when illness requires sacrifice and life changes. |
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Term
Impact
of
Illness
(cont.)
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Definition
~Anxiety
-Defined as diffuse feeling of apprehension and uncertainty
-Occurs as a result of some threat to an individual's selfhood, self-esteem, or identity
-Symptoms of anxiety include the physiologic, emotional, and cognitive.
-Anxiety occurs on a continuum of four levels.
•Mild produces increased alertness.
•Moderate affects the ability to concentrate.
•Severe causes thoughts to become scattered.
•Panic is when the person becomes completely disorganized and loses the ability to differentiate reality from unreality. |
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Term
Impact
of
Illness
(cont.) |
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Definition
~Stress
-Stress is both a common response to illness as well as an important factor in the development of illness.
-The many alterations in lifestyle created by illness tend to cause a great deal of stress.
-Stress is defined as the nonspecific response of the body to any demand made on it (Selye, 1956).
-It is distinguished from anxiety as having an environmental component. |
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Term
Impact
of
Illness
(cont.) |
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Definition
~Internal, external, and interpersonal stressors
-Internal: self and self-perceptions
-External: environment, such as noise, cold, malfunctioning equipment, bad weather
-Interpersonal: demands made by others; conflicts with others |
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Term
Impact
of
Illness
(cont.) |
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Definition
˜~Responses to stress can include:
-Physiologic: fatigue, muscular tension, increase in heart rate and respiration, insomnia or excessive sleeping, eating impairment
-Social and emotional: social isolation, distancing from others, hopelessness, perception of lack of control, irritability, impatience
~Cognitive: interference in cognitive functioning, decreased mental capacity and problem-solving skills, difficulty making decisions. |
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Term
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Definition
~Nurses must find balance between caring for others and self-care.
-Most nurses are not accustomed to taking care of themselves.
~Work-life balance is important for nurses.
~Diann Uustal (2009), an early proponent of work-life balance, recommends "creating a balanced life rather than merely maintaining a balancing act."
~Nurses who are filled with stress and negativity cannot provide an atmosphere conducive to healing. |
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Term
Nursing
and
Caregiving
(cont.)
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Definition
~When others' needs take too great a priority, nurses experience compassion fatigue.
~Compassion fatigue is defined as negative feelings in which one experiences loss of physical energy, burnout, accident proneness, emotional breakdowns, apathy, indifference, poor judgment, and disinterest in introspection. (Coetzee and Klopper, 2010) |
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Term
Nursing
and
Caregiving
(cont.) |
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Definition
~Choosing to work in a setting that supports caring and professional nursing practice is an important strategy to reduce stress.
~Hospitals are traditionally stressful work environments for nurses.
-This can be reduced by:
•Implementation of "caring" groups for nurses
•Institution and departmental development of vision, mission, and philosophy of caring and support for nurses
•A caring/healing room with therapy services for nurses
•Mentoring programs for new graduate nurses
~Participation in American Nurses Credentialing Center's (ANCC) Magnet Recognition Program |
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Term
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Definition
~Cognitive learning encompasses the intellectual skills of knowledge acquisition, comprehension, application, analysis, and evaluation
~Psychomotor learning refers to learning skills and performance of behaviors or skills
~Affective learning requires a change in feelings, attitudes, or beliefs |
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Term
|
Definition
What information does the patient need?
What skills does the patient need to know?
~What factors may be barriers?
~Is the patient likely to return home?
~Can the caregiver handle the care?
~Is the home situation appropriate?
~What kinds of assistance will be required? |
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Term
|
Definition
~Learning Styles
~Readiness to learn
~Health literacy
-1 in 5 adults and nearly 2 of 5 older adults reads at 5th grade level or below
-Most patient education materials are written at 10th grade level or above
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Term
Patient
Education
(cont.)
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Definition
~Material contains the information that the patient wants
~Material contains the information that the patient needs
~Patient understands and uses the material as presented |
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Term
Barriers to Patient
Education |
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Definition
~Age related barriers:
~Cognitive Changes:
~Changes in encoding and storage of information
~Changes in the retrieval of information
~Decreases in the speed of processing information
~Visual Changes:
~Smaller amount of light reaches the retina
~Reduced ability to focus on close objects
~Scattering of light resulting in glare
~Changes in color perception
~Decrease in depth perception and peripheral vision
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Term
Barriers to Patient
Education
(cont.)
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Definition
~Changes in Hearing:
~Reduced ability to hear sounds as loudly
~Decrease in hearing acuity
~Decrease in ability to hear high pitched sounds
~Decrease in ability to filter background noise
~Slow the pace of presentation
~Give smaller amounts of information
~Repeat information frequently
~Reinforce verbal teaching with audiovisuals, written materials, and practice
~Reduce distractions
~Allow more time for self-expression |
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Term
Barriers to Patient
Education
(cont.) |
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Definition
Make sure glasses are clean and in place
Use printed materials with 14- to 16- point font and serif letters
Use bold type on printed materials and do not mix fonts
Avoid use of dark colors with dark backgrounds but instead use large, distinct configurations with high contrast
Avoid blue, green, and violet to differentiate type, illustrations, or graphics
Use line drawings with high contrast
Use soft-white light to decrease glare
Light should shine from behind learner
Use color & touch to help differentiate depth
Position materials directly in front of learner
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Term
Barriers to Patient
Education
(cont.) |
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Definition
Speak distinctly
Do not shout
Speak in a normal voice or lower pitch
Decrease extraneous noise
Face person directly while speaking at a distance of 3 to 6 feet
Reinforce verbal teaching with visual aids or easy to read materials |
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Term
Barriers to Patient
Education
(cont.) |
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Definition
˜Speak distinctly
˜Do not shout
˜Speak in a normal voice or lower pitch
˜Decrease extraneous noise
˜Face person directly while speaking at a distance of 3 to 6 feet
˜Reinforce verbal teaching with visual aids or easy to read materials |
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Term
Cultural Considerations in
Patient
Education |
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Definition
˜Change information to more specific or more relevant terminology
˜
˜Create descriptions or explanations that fit with different people’s understandings of key concepts
˜
˜Incorporate a group’s cultural beliefs and practices into the program content and process |
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Term
|
Definition
~Quantitative research involves standardized experimental designs driven by hypotheses, measurable variables and outcomes, and statistical analyses. |
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Term
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Definition
~Qualitative research involves exploration of human experience, described and interpreted by the researcher. Manipulation of variables and statistical analysis is not done, because there is no experimental design and no hypotheses driving the analysis.
-Excellent type of research to explore patients' experience through "field work" |
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Term
|
Definition
~Inductive reasoning
-The process begins with a particular experience (experiment or research inquiry) and proceeds to generalizations.
-Repeated observations of an experiment or event enable the observer to draw general conclusions.
-This type of inferential reasoning may lead the researcher to infer that this is an effective intervention, based on the responses from a small sample. |
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Term
|
Definition
~Deductive reasoning
-Deductive reasoning proceeds from the general case to the specific case.
-Conclusions are drawn by logical inference from given premises.
-If it is applicable generally, then it will be applicable to one similar case.
-The premises used must be correct or the conclusions will not be. |
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Term
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Definition
~Defined: The systematic investigation of phenomena related to improving patient care.
~Ideas for nursing research arise from clinical observations.
~Problems are appropriate for research and will more likely be funded if:
-A conceptual framework exists or can be constructed to logically fit with previous knowledge.
-The proposed research is based on related findings published in peer-reviewed journals.
-Research is carefully designed so results will be applicable in similar situations or generate hypotheses. |
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Term
|
Definition
~Problem solving is specific to a given situation.
~Problem solving is designed for immediate action.
-Provides an effective intervention in one set of circumstances that has immediate application |
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Term
|
Definition
~Evidence-based practice (EBP) is defined as an approach to the delivery of health care that "integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values." (Melnyk, et al., 2009)
~In nursing, EBP requires research that supports the specific interventions. (Alfaro-LeFevre, 2006) |
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Term
Evidence-Based
Practice
(cont.)
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Definition
~Focusing on evidence of effective interventions prevents practice from deteriorating into routine or traditional care based on "what has always been done" without concern for advances in care. |
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Term
|
Definition
~Bachelor's-degree–prepared nurses can:
-Read, interpret, and evaluate research for applicability to nursing practice
-Identify nursing problems that need to be investigated
-Participate in implementation of studies by assisting senior researchers in data collection
-Disseminate research-based knowledge by sharing useful findings with colleagues |
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