Formations Midterm

Communication

A process of interaction between people using symbols to create, exchange, and interpret messages about ideas, emotions, and mind states.

Levels of Communication

Intrapersonal, Interpersonal, Transpersonal, Small-group, and Public communication.

Intrapersonal Communication

Occurs within an individual; also known as self-talk or inner thought.

Interpersonal Communication

One-to-one interaction between two people.

Transpersonal Communication

Interaction within a person’s spiritual domain.

Small-group Communication

Interaction with a small number of people, often goal-directed.

Public Communication

Interaction with an audience, such as in teaching or presentations.

Verbal Communication

Spoken or written words; requires clarity, appropriate vocabulary, intonation, and pacing.

Nonverbal Communication

All communication that is not spoken or written, such as gestures, facial expressions, eye contact, and posture.

Symbolic Communication

Using art, music, or symbols to convey meaning.

Metacommunication

All factors that influence how a message is perceived, including tone and context.

Effective Communication

Clear, concise, accurate, timely, and relevant information exchange between sender and receiver.

SBAR

A communication tool: Situation, Background, Assessment, Recommendation — used for structured and effective reporting.

Therapeutic Communication

Purposeful use of communication to build and maintain helping relationships in a healing environment.

Nontherapeutic Communication

Blocks effective communication, e.g., giving advice, false reassurance, or changing the subject.

Professional Presence

Demonstrating respect, confidence, integrity, empathy, and engagement consistent with professional standards.

Relational Practice

Conscious participation with patients using skills like listening, empathy, reflection, mutuality, and questioning beyond the surface.

Relational Communication

Includes initiative, authenticity, mutuality, and questioning beyond surface-level understanding.

Therapeutic Communication Techniques

Includes active listening, empathy, hope, humor, touch, silence, and summarizing.

Advocacy

Speaking up for patients to ensure their health needs are met — a critical communication skill.

Contextual Understanding

Recognizing the influence of physical, cultural, emotional, and relational factors in communication.

Self-talk

Internal dialogue that can influence self-awareness and performance; positive self-talk supports professional growth.

Zones of Personal Space

Intimate (0–45cm), Personal (45cm–1m), Social (1–4m), Public (4m+).

SBAR Example

S: Situation, B: Background, A: Assessment, R: Recommendation — provides structure for critical communication.

Professional Identity

A sense of oneself influenced by nursing values and norms, resulting in thinking, acting, and feeling like a nurse.

Attributes of Professional Identity

Doing, Being, Acting Ethically, Flourishing, Changing Identities.

Doing

Skill-oriented aspect; the sociological component of nursing practice.

Being

Personal or psychological aspect of professionalism; doing the right thing even when not observed.

Acting Ethically

Upholding integrity and moral principles in all nursing actions.

Flourishing

Ongoing growth and development as a nurse within the discipline.

Changing Identities

Deconstruction and reformation as professional roles and experiences evolve.

Ways to Build Professional Identity

Seek feedback, engage in reflection, build relationships, embrace learning opportunities, and develop self-care habits.

Integrity

Doing what one says they will do and acting consistently with purpose.

Compassion

Empathy combined with action to help alleviate suffering.

Courage

Standing up for what is morally right and advocating for change.

Humility

Having a realistic view of oneself without excessive pride or blame.

Advocacy

Defending and supporting patients’ rights and well-being.

Human Flourishing

Promoting environments and actions that enable individuals and communities to thrive.

NSCN

Nova Scotia College of Nursing; regulates nurses to protect the public.

CNA

Canadian Nurses Association; national voice advocating for nursing and public health.

Code of Ethics

Guiding document for safe, compassionate, and ethical nursing practice.

Standards of Practice

Legal and professional requirements for nurses that guide safe and competent care.

Scope of Practice

Defines the roles, functions, and accountabilities nurses are educated and authorized to perform.

Delegation

Transferring responsibility for a task to someone not authorized to perform it; nurse retains accountability.

Assignment

Allocating duties to team members authorized to perform them.

Self-Regulation

The profession’s ability to set standards, license members, and ensure accountability to protect the public.

Entry-Level Competencies

Observable abilities that integrate knowledge, skills, and judgment required for safe, ethical nursing practice.

Clinical Judgment

Interpretation or conclusion about a patient's needs, and the decision to act (or not) appropriately in context.

Critical Thinking

A cognitive process involving analyzing, evaluating, and drawing conclusions using evidence-informed reasoning.

Clinical Reasoning

Thinking process by which a nurse reaches a clinical judgment.

Critical Thinking Skills

Interpretation, Analysis, Inference, Evaluation, Explanation, Self-Regulation.

Critical Thinking Dispositions

Truth-seeking, Open-mindedness, Analytic thinking, Systematic approach, Self-confidence, Inquisitiveness, Maturity.

Levels of Critical Thinking

Basic, Complex, and Commitment — from following steps to independent reasoning.

Tanner’s Clinical Judgment Model

Includes Noticing, Interpreting, Responding, and Reflecting.

Noticing

Identifying signs, patterns, and cues based on nurse’s experience and patient context.

Interpreting

Making sense of gathered information using reasoning patterns.

Responding

Implementing appropriate interventions based on interpretation.

Reflecting

Learning from experiences — Reflection-in-action and Reflection-on-action.

Nursing Process

Systematic framework for patient care: Assessment, Diagnosis, Planning, Implementation, Evaluation (ADPIE).

Nursing Diagnosis

Clinical judgment about patient responses to health problems.

Medical Diagnosis

Identification of a disease condition based on signs and symptoms.

Types of Nursing Diagnoses

Actual, At-risk, Health promotion, and Wellness diagnoses.

Planning Phase

Setting patient-centered goals and expected outcomes; prioritizing interventions.

Implementation Phase

Carrying out nursing interventions to achieve patient outcomes.

Evaluation Phase

Determining if goals were met and modifying the care plan as needed.

NCJMM

NCSBN Clinical Judgment Measurement Model — measures Recognize Cues, Analyze Cues, Prioritize Hypotheses, Generate Solutions, Take Action, Evaluate Outcomes.

Analytic Reasoning

Logical, step-by-step approach to understanding a clinical situation.

Intuitive Reasoning

Recognizing patterns and responding based on experience.

Narrative Reasoning

Considering patient’s story and context in care decisions.

Concept Mapping

Visual tool that connects patient problems, interventions, and relationships to see the whole picture.

Collaboration

Development of partnerships to achieve the best outcomes that reflect patient and community needs.

Nurse-Patient Collaboration

Occurs through all nursing process steps — assessment, planning, implementation, and evaluation.

Nurse-Nurse Collaboration

Includes mentoring and shared governance among nurses.

Interprofessional Collaboration

Working across disciplines (nursing, medicine, pharmacy, etc.) to optimize patient care.

Interorganizational Collaboration

Pooling resources across organizations to benefit patients and communities.

Attributes of Collaboration

Values and ethics, Roles and responsibilities, Communication, Teams and teamwork.

Person-Centered Care

Care guided by individual values, needs, and preferences to support realistic health goals.

Patient-Centered Care

Focus on the patient’s role in care decisions and health outcomes.

Loss

The experience of losing something or someone of value; can be actual, perceived, maturational, or situational.

Grief

Emotional response to loss; unique to each individual.

Bereavement

State of having lost someone significant; includes grief and mourning.

Kübler-Ross Stages of Grief

Denial, Anger, Bargaining, Depression, Acceptance.

Bowlby’s Phases of Mourning

Numbing, Yearning & Seeking, Disorganization & Despair, Reorganization.

Dual Process Model

Oscillation between loss-oriented and restoration-oriented coping.

Meaning-Making Theory

Finding meaning in loss helps with adaptation and healing.

Continuing Bonds Theory

Maintaining a connection with the deceased aids coping and adaptation.

Types of Grief

Normal, Anticipatory, Complicated/Prolonged, Disenfranchised grief.

Types of Death

Biological, Neurological, Social, Psychological, and Theological death.

Factors Influencing Grief

Developmental stage, relationships, socioeconomic status, culture, spirituality, and nature of the loss.

Hope

Inner strength that enhances coping and goal achievement during grief.

Palliative Care

Approach focusing on comfort, dignity, and quality of life for patients and families facing life-limiting illness.

Hospice Care

Family-centered care supporting comfort and dignity until death.

Post-Mortem Care

Providing respectful and culturally sensitive care for the body after death.

Nurse’s Own Grief

Nurses must process their emotions, seek support, and practice self-care to maintain professional well-being.

The nurse asks a patient where the pain is, and the patient responds by pointing to the area of pain. Which form of communication did the patient use?

Nonverbal

The nurse is seeking clarification of a statement that was made by a patient. What is the best way for the nurse to seek clarification?

“Am I correct in understanding that …”

When making rounds, the nurse finds a patient who is not able to sleep because of anticipation of surgery in the morning. Which therapeutic response is most appropriate?

“It must be difficult not to know what the surgeon will find. What can I do to help?”

Before meeting the patient, a nurse talks to other caregivers about the patient. The nurse is in which phase of the helping relationship?

Pre-interaction

A home care nurse (Julie) working in community receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. Julie carefully listens to the patient, considers it in light of the patient’s condition, questions its appropriateness, and examines alternative treatments. What is the Julie’s best action?

Call the physician, explain rationale, and collectively explore different medication approaches.