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]