NURS1003 Midterm Study Guide

Includes information on slides, and noted textbook pages and tables.

Professional identity

A sense of oneself, and in relation to others, that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.

Integrity

Basis for trust. Person does what they say they will do and acts with consistency and purpose.

Compassion

Responding to another with the intention to help. Not equal to sympathy or empathy. Interconnected with caring.

Courage

Wanting to make a change. Stand in opposition for moral rightness. Can be physical or moral.

Humility

Not taking too much credit or blame. The sense that you are no better than anyone else

Advocacy

Defending/speaking up for ithers. Acting on behalf of others.

Human flourishing

Aims to help others flourish/be successful

Caring

Intentional human action characterized by commitment and a sufficient level of knowledge and skill to allow you to support basic integrity.

Therapeutic relationship

an interpersonal process that occurs between the nurse and patient. Is purposeful, goal directed, for the advancement of the values, interests, and health outcomes of the patient.

Interpersonal communication

Two-person face-to -face interaction

Communication (for the purpose of therapeutic relationships)

Process of interaction between people n which symbols are used to create, exchange, and interpret messages about ideas, emotions, and mind states.

Verbal communication

To create meaning and to accect one another. Words are important symbols that create meaning and elicit shared thoughts.

Nonverbal/non-symbolic communication

Interaction that can be unintentional yet enhances interpretation of verbal communication. Essential in ensuring that the intended meaning of the verbal message is received.

Utilitarian/Utilitarianism

Ethical theory, considers greatest good for greatest number of people

Deontology

Ethical theory, considers the duty to act. Certain things that you are duty-bound to do.

Human Rights

Ethical consideration, must balance with utilitarianism.

Relational ethics

What is happened to that relationship. Decision based on what is applying in that time.

Autonomy

Self-determination.

Beneficence

The want to do good, to help someone

Nonmaleficence

Do no harm

Justice

What is fair, what is right

Cognitive dissonance

Having two opposing ideas at the same time

Moral distress

Trying to the right thing, but a system or policies are preventing it.

Self-Awareness

Intrapersonal process that allows nurses to self-reflect on aspects of their personal feelings and beliefs Includes conscious recognition of personal values, beliefs, thoughts, (etc.), and how each can influence behaviour in a professional relationship

Self-concept

Totality of each person’s beliefs about their inner self. Helps people make sense of what is happening, how to communicate in different situations, and to see how they are developing as individuals. Can change over time and develop.

Self efficacy

Person’s belief about their ability and capacity to accomplish a task and to deal with the challenges of life. Plays a role in determining if a person will be successful in accomplishing what they want to achieve

Personal Identity

An intrapersonal psychological process consisting of a person’s beliefs and values, characteristics and abilities, relationships with others, how the fit into the world, and personal growth potential.

Perception

Process of interpreting sensory information and transforming it into connected personalized understanding.

Cognition

The thinking process people use in making sense of the world

Self esteem

The emotional value a person places on their self-concept and worth as a person.

Spirituality

Whatever or whoever gives ultimate meaning and purpose to one’s like, that invites ultimate meaning and purpose in one’s life, that invites particular ways of being n the world in relation to others, oneself and the universe.

Hildigard Peplau

A nurse clinician, scholar, and theorist. Introduced the first interpersonal relations paradigm and theory of therapeutic relationships.

Preinteraction and orientation phase

Phase for preparing to collaborate with the patient and define the problem and goals.

Working phase

Phase for selecting appropriate assistance and problem-solving options.

Termination phase

Phase for resolution and evaluation of the patient’s problem and response.

Professional boundary

Line drawn between therapeutic actions and those actions that do not promote the values, interests and health outcomes of the patient. Imposed by legal, ethical, and professional nursing standards. Nurses are responsible for maintaining.

Boundary violation

taking advantage of the vulnerability of patients, a conflict of interest, harmful to goals of the therapeutic relationship.

Boundary crossings

Less serious, appear as an “impropriety” but given the context, the behaviour can be appropriate.

Level of involvement

The degree of nurse attachment and active participation with patient

Under-involvement/disengagement

The nurse is only carrying out tasks, withdrawing from patient.

Over-involvement

Nurse is too emotionally affected by the patient, developed a relationship that is too close.

Culture

A pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language or live in a defined geographical region.

Ethnicity

The designation by self or others as being member of a distinct group with a historical origin and a shared heritage.

Race

A classification of human beings on the basis of erroneous biological distinctions (skin colour, hair, eyes)

Acculturation

The socialization process of adapting to facets of dominant culture including new language and behaviours.

Assimilation

The adoption of language, behaviors, as well as values and customs, with disappearance of ethnic identification, a lengthy process, over several generations.

Ethnocentrism

Convinced superiority of one’s ethnic group

Racism

Superiority of one race over another

Marginalization

Treatment of a person, group, or concept as insignificant or peripheral

Stereotyping

To believe unfairly that a person or group of people differently from other people or groups of people.

Prejudice

An unfair feeling of dislike for a person or group because of race, sex, religion, etc.,

Discrimination

The practice of unfairly treating a person or group of people differently from other people or groups of people.

Cultural sensitivity

Acknowledge cultural factors affecting health/illness experience, respect and acceptance.

Cultural relativism

View beliefs and behaviours in context of original culture worthy of respect.

Cultural accommodation

modification of healthcare services for cultural reasons

Cultural brokering

acts as a mediator between individuals of opposing culture to reduce conflict or promote change.

Cultural safety

comprised of cultural competence, humility, and safety.

Cultural competence

respectful responses to culture

Cultural humility

Willingness to learn from other cultures: being open and self-aware

Cultural safety

Revise, respect, rights of other cultures

Culturally competent care

Set of behaviors and attitudes integrated into practice methods of a system, agency, or its professionals enabling them to work effectively in inter-cultural situations. Includes practitioner’s substantive knowledge base of behavioural norms, beliefs and values eld by cultural group.

Empathy

Where the observed experiences of others come to affect our own thoughts and feelings in a caring fashion. It entails the ability to step outside oneself emotionally and to be able to suppress temporarily one’s own perspective on events to take others’

Respect:

One of four Rs. Understanding and demonstrating regard and value of cultural knowledge, traditions, values, and activities relevant to each Indigenous community

Reciprocity

one of four Rs. Mutual benefit from an interpersonal interaction, where both individuals are learning from each other, giving and receiving information.

Responsibility

One of four Rs. Need for active participation in the conversations around reconciliation and Indigenous events and activities.

Relevance

One of four Rs. Actions need to be embedded in our learning of local Indigenous protocols, acknowledgement of local lands and territories, application of cultural safety and humility in nursing practice, and advocating for dismantling structural racism embedded within organizational structures and policies.

Sympathy

Feeling sorry for patients, making assumptions based on the feelings you have about the situation because you too have had similar experience.

Active listening

Listening with total being (ears, eyes, heart), focusing on patient’s experience.

Open-ended question

Questions that elicit more than a yes or no, or one word response. More explanatory, lets patient have direction in conversation, allows the patient to think more about answer.

Focused question

Questions yields more than a yes or no, but are more focused on obtaining specific information. Questions might be helpful/more appropriate when time is of the essence or someone has limited verbal skills.

Restatement

Active listnening used by the nurse to validate or clarify a patient’s statement. Sounds repetitive if used too much.

Paraphrasing

Active listening provides an accurate interpretation of what patent is saying -transforming it into their (the nurse) own words without losing the original message.

Reflection (as a communication technique)

Active listening communication technique that focuses on affective (emotional) elements of the story. The patient is assisted to gain awareness of their emotions and to express their feelings.

Summarization

Active listening response that summarizes a variety of ideas together into a few brief sentences. Provides an opportunity to see if anything was missed

Social responses

Negative listening response, responds with polite, superficial comments. Followed by simple social chitchat and patient’s thoughts and feelings are dismissed.

False inferences

Negative listening response, Jumping to conclusions about what a patient means or what their body language and facia expressions convey.

Giving advice

Negative listening response that does not promote patient autonomy. When not asked, it takes the choice away from the patient. Telling them they “should” do something does not promote independent decision making and does not respect patient’s self-determination.

Moralizing

Negative listening response when nurse imposes own values by telling patient what is right and wrong.

Bridges

Establish and maintain therapeutic relationships via this.

Empowerment

Assisting patients to take charge of their lives. Equip patient with information, tools, resources to achieve health goals.

Trust

The foundation, starts with first impressions. Patients feel safe, not judged, can depend on the nurse, comfortable revealing views and feelings, expectations are met.

Mutuality

involve patients in all steps of identifying the health problem and finding solutions (accept value system and promote autonomy)

Veracity

truthfulness and honestly in communication

Patient-centered communication

interactions are patient-focused

Acceptance

Goal is to reduce bias and stereotyping

Confidence

Nurse competence comes from education and practice.

Proxemics

How much personal space is needed to make a patient feel comfortable

Workload

More patients, more complex care situations, less staff

Production expectations

Do more in less time

Inconsistent caregivers

Lack of regular staff, increased relance on casual staff on a call-in basis/ float staff to different units.

Doing: Involves professional codes and standards

Being: Personal or psychological view of the nurse profession. “Doing the right thing when nobody is looking.”

Acting Ethically: Ethics—to live well, what is right and good from a societal and professional perspective

Flourishing: Positive and transformational growth. Striving for excellence.

Changing Identities: Being awre of the different identities one has (child, parent, volunteer, employee, etc.)

What are the attributes and criteria of Professional Identity: (5)

Integrity, compassion, courage, humility, advocacy, human flourishing.

Exemplars of Professional Identity: (6)

Create ways to reduce breakdowns in communication (fragmentation), using standardized communication tools. Set expected goals and outcomes for safe communication. Collaborate with other staff and patients and families. Create a non-punitive work climate where errors can be reported.

How to avoid errors in communication? (4)

 

a.       Standards of Practice

i.         Canadian nurses association

ii.       CRNNL

b.       Code of ethics, CAN

c.       CASN’s Baccalaureate Competencies

Three professional guides for communication to consider:

 

a.       Spatial distance/position

b.       Physical appearance

c.       Posture and body movement

d.       Gaze and facial expressions

e.       Eye contact

f.        Movement of ead, hands and legs

g.       Vocal characteristics: pitch, tone, speed, pauses, and speech disfluencies

 

Examples of non-verbal communication: [7]

Using facial cues:

a.       Forehead muscles relaxed, not furrowing brows.

b.       Eye contact maintained, eyes are not open and staring gaze is not fiated or darting

c.       Relaxed jaws, no pursed lips, no biting lip. Jaw is relaxed, not chelnches

d.       Facial expressions of interest and attentiveness, no signs of worry, fret or distraction

How to convey warmth nonverbally? [4]

a.       Moderate pitch and tone

b.       Vary vocalization

c.       Encourage involvement

d.       Validate patient’s worth

e.       Advocate for the patient when necessary

f.        Provide needed information appropriately

g.       Allow therapeutic silences

h.       Use congruent nonverbal behaviors

i.         Use facilitative body language (posture, facial expressions, ee contact and gestures)

j.         Use touch appropriately

k.       Proxemics: respect patient’s space

l.         Attend to verbal cues

How can a nurse incorporate verbal and non-verbal style factors when communicating? [9]

a.       Autonomy

b.       Beneficence

c.       Nonmaleficence

d.       Justice

What are the biomedical principles? [4]

a.       Attitudes and habits

b.       Cognitive dissonance

c.       Personal values versus professional values

What are some barriers to critical/ethical thinking? [3]

a.       Moral distress

b.       Privacy

                                                               i.      PHIA (personal health information act)

                                                             ii.      Privacy in clinical situations

                                                            iii.      Confidentiality

What are some legal/ethical issues to consider when communicating with a patient? [2]