FIrst week theory NURSADN 1

Nursing

“To put the patient in the best condition for nature to act upon him” (Florence Nightingale, Notes on Nursing, 1858). Modern nursing is the diagnosis and treatment of human responses, and advocacy for individuals, families, groups, communities, and populations, in recognition of our shared humanity.

Patient / Client

The recipient of care — simultaneously an individual, a member of a family, a member of social groups, and a citizen of a community. May be seeking care for one or multiple health problems (comorbidities).

Health (WHO, 2006)

A state of complete physical, mental, and social well-being — not merely the absence of disease or infirmity.

Wellness

Equivalent to health

Health Promotion

Focuses on the potential for wellness

Health Care

The broader system of promoting, maintaining, and restoring health, and facilitating coping with disability or death — delivered to individuals, families, and communities across inpatient, outpatient, and community settings.

Critical thinking

A cognitive process that is purposeful, insightful, reflective, and goal-directed, used to develop conclusions, solutions, and alternatives appropriate to the situation. Involves inquiry, examination and analysis of data, and formulation of conclusions. Critical thinkers are “inquisitive truth seekers” — the skill develops over time and is used in clinical reasoning.

Metacognition

Examining one's own reasoning or thought processes in order to refine thinking skills — essentially, “thinking about your thinking.”

Clinical reasoning

The process, built on critical thinking, of applying knowledge to a specific patient situation. Used in all practice settings

Clinical judgment

The outcome or decision reached through clinical reasoning — the conclusion about a patient's status and the action to take.

Ethics

The formal, systematic study of moral beliefs used to understand, analyze, and evaluate matters of right and wrong.

Morality

Specific values, characters, or actions whose outcomes are examined through systematic ethical analysis.

Dilemma

A clear conflict between two or more ethical principles — essentially choosing the “lesser of two evils.”

Problem

Competing moral claims or principles exist, but one is clearly dominant.

Uncertainty

One cannot define what the moral situation is or which principles apply — often described as a “gut feeling.”

Distress

The nurse knows the correct course of action, but institutional constraints such as power hierarchies, lack of time, or lack of supportive services are barriers to acting on it.

Assess

Identify the ethical or moral dimensions of the problem.

Diagnosis

Identify moral distress or the specific ethical conflict.

Plan

Collect information, including values, beliefs, patient capacity, and end-of-life elements.

Implementation

List and compare alternatives using ethical theories and principles.

Evaluation

Decide on and evaluate the chosen course of action.

Sterile

Rigorous measures taken to eliminate and maintain an area completely free from living microorganisms, including spores. The strictest of the three terms.

Surgical asepsis

The absence of microorganisms in the surgical environment, aimed at reducing infection risk and preventing contamination of surgical wounds — the practice of creating and maintaining a sterile field.

Aseptic technique

The broad practice of maintaining a barrier to prevent infection — the umbrella term and skill set that includes both medical (clean) and surgical (sterile) approaches.