Lecture 10- Caring in Nursing

What is the definition of caring?

-universal phenomenon that influences the ways in which people think, feel, and behave

-the essence of nursing

-the heart of nursing practice, education, and research

-provided in healing environment of comfort, peace, and support

What is person (patient) centered care?

-pt is the source of control for their care

-common focus from healthcare team on the best interests and personal goals of the pt

-families and friends are an essential part of the care team

-care is customized and reflects pt needs, values, and choices

What are some examples of patient centered care?

-pt preferences

-info and education

-coordination

-emotional support

-physical comfort

-family and friends

-continuity and transition

-access to care

What are some cultural aspects of caring?

-knowing pt cultural values, practices and beliefs

-let pt tell their stories

-clarify with pt/family if unsure

- respecting privacy, diversity, and individual needs

-interacting and listening to pt and family

-clarify role of family and/or cultural group

- pt family is a resource

What are he 6 elements of patient-centered care?

1) empathy

2) shared goal-setting and decision-making

3) active listening

4) open-ended questions and reflective conversations

5) involvement of family and friends

6) understanding of individual preferences

What are the theoretical views on caring?

-Benner's Caring is Primary

-Leininger's Transcultural Caring

-Watson's Transpersonal Caring

-Swanson's Theory of Caring

What is Patricia Benner's Theory?

Caring is primary

-people, events, projects and things matter

-provides motivation and direction for people to care

-being connected

Helping role of the nurse

-est a healing relationship

-providing comfort measures

-inviting active pt participation

What is Madeleine Leininger's Theory?

Transcultural Caring

-understanding helps to individualize care

- a caring act depends on the needs, problems, and values of a pt

-acts of caring are nurturing and skillful activities, processes, and decisions

What is transcultural caring?

Different cultures have different caring behaviors and various health and illness values, beliefs and patterns of behavior

What is the Jean Watson Theory?

- Transpersonal Caring

-promotes healing and wholeness, places care before cure, and emphasizes the nurse-patient relationship

-central focus of nursing

-a conscious intention to care

- focuses on interaction and communication

What are Watson's 10 Caritive Factors

1) forming a human-altruistic value system

2) instilling faith-hope

3) cultivating a sensitivity to one's self and to others

4) developing a helping, trusting, human caring relationship

5) promoting and expressing positive and negative feelings

6) using creative problem-solving, caring processes

7) promoting Transpersonal teaching-learning

8) providing for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment

9) meeting human needs

10) allowing for existential-phenomenological-spiritual forces

What is Kristen Swanson's Theory?

-theory of caring

-a nurturing way of relating to an individual

-it is a central nursing phenomenon

-5 caring processes: helps nurses gain confidence when providing pt centered care

1) knowing

2) being with

3) doing for

4) enabling

5) maintaining belief

What are some common themes of caring?

-human interaction/communication

-appreciation of the uniqueness of individuals

-improvement in the welfare of patients and families

Caring is ....?

Relational, enabling, understanding who the pt is and their perceptions

What are some patients perspective of caring?

-connecting with pt and their families

-honest, clear, accurate info

-asking permission

- helping pt help themselves

-teaching family

-Build a nurse-pt relationship to learn what is important to your pts

What are the 8 categories of the Caring Assessment Tool (CAT)?

1) mutual problem solving

2) attentive reassurance

3) human respect

4) encouraging manner

5) appreciation of unique meanings

6) healing environment

7) affiliation needs

8) basic human needs

What is the ethic of care?

Places the nurse as the patient's advocate, influences nurse judgment, helps guide clinical decision making regarding ethical dilemmas

What are some characteristics of ethic of care?

-the term "ethic" refers to the ideals of right and wrong behavior

-standard applied in the critical thinking process for clinical judgment

-focuses on the pt

-places caring at the center of decision making

What are the steps of caring in nursing practice?

-reflective practice (uses self-evaluation)

-recognize the importance of self-care

-use caring behaviors to reach out to your colleagues and care for them as well

-benefits pt, colleagues, and the organization

How to care with caring

-providing presence

-touch

-listening

-knowing the pt

-spiritual caring

-relieving symptoms of suffering

-family care

How can you provide presence in care?

Being with, body language, listening, eye contact, time of voice, positive and encouraging attitude

How can you provide touch in care?

-provides comfort

-creates a connection (noncontact and contact touch)

-because touch conveys many messages, use it with discretion

What are some examples of contact touch?

Task-oriented touch, caring touch, protective touch, therapeutic touch

How can you provide listening in caring?

-necessary for meaningful interactions with pts

-true listening leads to knowing and responding to what really matters to a pt and family

-to listen effectively you need to silence yourself and listen with an open mind

-through active listening you being to truly know your pt and what is important to them

Knowing the patient has two elements:

Continuity of care, development of clinical expertise

What are some factors of knowing the pt:

Time, continuity of care, teamwork of the nursing staff, trust, experience

Knowing the patient is ...

The core of clinical decision making and patient-centered care

What is spiritual caring?

-spiritual health

-achieved after finding a balance between life values, goals, and belief systems and those of others

-spirituality offers a sense of connectedness

-intrapersonal

-interpersonal

- Transpersonal

How to relieve symptoms and suffering?

-requires caring nursing actions that give a pt comfort, dignity, respect, and peace

-conveying a quiet, caring presence, touching a pt, or listening helps you to assess and understand the meaning of your pts discomfort

-provide comfort through a listening, nonjudgmental, caring presence

What is family care?

Caring for an individual includes caring for their family

-encourage family caregivers to be active participants

-understand the stress the pts illness places on family members

-caregiver stress

What is empathy?

-experiencing the feelings of another

-you have similar personal experiences

-emotion

What is sympathy?

-understanding the suffering of another

-you acknowledge another's circumstances

-recognition

What are some challenges of caring?

-task oriented

-time constraints

-reliance on technology

-cost effective strategies

-standardized work processes

-compassion fatigue ("burnout")