Nursing Concepts and Practices

Week 4 Notes

Practice Questions and Prioritization

• Scenario for Prioritization:
  • A nurse has five patients:
  • Recently returned from surgery (large abdominal dressing, on oxygen, IV line).
  • Newly admitted patient.
  • Patient requesting pain medication.
  • Patient needing assistance with a meal tray.
  • Stable and resting patient.
  • Greatest Priority: Patient who returned from surgery
  • This patient requires immediate assessment for potential post-operative complications and needs closer monitoring compared to the others.

Procedures and Guidelines

• Unfamiliar Procedures:
  When asked to perform an unfamiliar procedure, a nurse should:

  • Check scientific literature or institutional policy.
  • Determine if additional assistance is required.
  • Collect all necessary equipment.
  • Consider all possible consequences of the procedure.
  • Delegation can be appropriate, but prioritize personal capability and support.

• Clinical Practice Guidelines:

  • Purpose:
  • Allows nurses to act more quickly and with clinical excellence.
  • Incorporates evidence-based interventions.
  • Does not eliminate the need for an individualized care plan.

Evaluation Process in Nursing

• Evaluation Process Characteristics:
  • Involves reflection on the care approach.
  • Determines the completion of nursing interventions.
  • Encompasses making clinical decisions.
  • Requires effective assessment skills.
  • Should not be limited to cases of condition changes; ongoing evaluation is essential.

Patient Evaluation and Expectations

• Assessing Patient's Expectations:
  • Questions to evaluate patient's understanding of care:
  • “Do you believe that you received the information you needed to follow your diet?”
  • This approach helps in understanding patient compliance and expectations.

Cultural Competence in Healthcare

• Defining Culture:

  • Culture includes learned beliefs, values, norms, and traditions.
  • Important concepts in cultural interactions:
  • Ethnocentrism - belief in the superiority of one's own culture.
  • Cultural Humility - ongoing self-reflection and recognition of personal biases.

• Culturally Congruent Care:

  • Necessitates understanding and respecting cultural beliefs.
  • Benefits include increased trust and adherence to treatment plans.

Developing Cultural Competence

1. Seek knowledge about diverse cultural groups and their health-related practices.
2. Acknowledge personal biases towards other cultures.
3. Engage in face-to-face interactions to lessen biases.
4. Conduct culturally sensitive assessments including health beliefs and practices.
5. Maintain motivation to develop cultural awareness and skills.

Performing a Cultural Assessment

• Key Areas to Assess:
  • Health beliefs and practices
  • Faith-based influences
  • Family roles
  • Sources of support
  • Dietary practices
  • Language and communication preferences

Use of Interpreters

• Best Practices:
  • Always inform clients about the availability of language assistance at no cost.
  • Use trained professional interpreters; avoid family members for complex topics.
  • Communicate in first-person, keep language clear, and check for understanding regularly.

Family Dynamics and Health

• Understanding Family:

  • Families are complex systems with diverse structures (nuclear, blended, extended, etc.).
  • This complexity influences individual health outcomes and care.
  • Each family has its own strengths, weaknesses, and dynamics that affect health.

• Family-Centered Care:

  • Implementing care that promotes health at both individual and family levels.

• Family Characteristics:

  • Durability: Support system within family beyond household walls.
  • Resiliency: Ability to cope with stresses.
  • Diversity: Uniqueness of each family unit impacting health.

Nursing Education and Learning Processes

• Role of the Nurse as Educator:

  • Distinguish between teaching and learning.
  • Educate with an individualized approach based on the patient's learning needs.

• Domains of Learning:

  • Cognitive (knowledge acquisition).
  • Affective (emotional aspects and values).
  • Psychomotor (skill development).

• Effective Teaching Strategies:

  • Cognitive: Discussions, lectures, and Q&A.
  • Affective: Role-play and group discussions to express feelings.
  • Psychomotor: Demonstration, practice, and feedback.