Nursing - Notes

Nursing is a practice discipline with a specialized perspective related to:
- "Principles and laws that govern the life processes, well-being, and optimum functioning of human beings, sick or well."
- "Patterning of human behavior in interaction with the environment in critical life situations."
- "Processes by which positive changes in health status are affected."
- (Donaldson and Crowley, 1978, p. 113)

Four stages of life and health, connected by the need for coordination across time and health care:
- Staying healthy: preventative care
- Getting better: acute care
- Living with illness/disability: chronic care
- Coping with end-of-life: palliative care

Empirical: making objective observations.
Personal: connecting with people.
Aesthetic: personalizing interventions based on the person’s needs.
Ethical: basing care on ethical standards of practice.
Emancipatory: awareness of social problems and social justice issues.
- (Carper, 1978; Chin & Kramer, 2015)

An essential functional construct in professional nursing practice which defines the person-centered relationship and the development of interpersonal relationships in practice settings.
- (Wagner & White, 2010)

Effective interpersonal communication supports the safety and quality of health care delivery.
Communication connects people and ideas through words, nonverbal behaviors, and actions.
"Communication represents the very essence of the human condition." (Hargie, 2011, p. 2)

It is impossible not to communicate.
Every communication has a content and a relationship aspect.
We only know about ourselves and others through communication.
Faulty communication results in flawed feeling and acting.
Feedback is the only way we know that our perceptions about meanings are valid.
Silence is a form of communication.
Communication systems are interrelated.
People communicate through both verbal and nonverbal behaviors; both are needed to interpret a message appropriately.
- (Bateson G, 1979. Mind and nature. Dutton: New York; Watzlawick P, Beavin-Bavelas J, Jackson D [1967].)

Impacts the way care is delivered.
Develops a collaborative care partnership.
Person-centered care planning
Is as important as the care itself.
Outcomes relate to higher satisfaction on the part of the person being cared for and productive health changes.
People are more likely to understand their conditions through meaningful communication.
People are more likely to alert providers when something isn’t working.

Includes feedback loops and considers the dynamic interaction between individuals.

Serves as critical foundation for nursing praxis, education, research.
Evidence-informed nursing practice: “The ongoing process that incorporates evidence from research, clinical expertise, client expertise, client preferences and other available resources to make nursing decisions about clients.”
- (Canadian Nurses Association, 2010)

Step 1 PROCESS: Information
- Notice/assess pt situational factors
- Biophysical Data
- Incorporate pt preferences
- Seek more info if needed
Step 2 ACT: Act to apply clinical knowledge
- Interpret/identify problem
- Diagnose and set goals
- Incorporate ethical values (professional and personal)
Step 3 REFLECT: Actions and outcomes
- Implement interventions
- Evaluate outcome
- Re-evaluate actions
- Reflect on new learning

Focuses on interrelationships within given systems and is based on the whole being greater than the parts.
Foundation for understanding the quality and safety of health care and professional nursing practice.
Examines individual health issues and how they link and work together in relation to larger health system care outcomes.
- (WHO, 2007; Porter O’Grady and Malloch, 2014; Weberg 2012)

Important role in transforming the health care system.
New roles focusing on the needs of diverse populations, including people who are Indigenous.
Offering care across the life span, preventing and treating a wide range of diseases, and promoting health and well-being.
Ensuring access to care for vulnerable populations, addressing the social determinants of health through collaborative action.
- (Canadian Nurses Association, 2015; WHO, 2020)

Numerous theoretical frameworks guide the practice of nursing.
The concepts of caring and communication are central to the delivery of effective nursing care.
Health care today is undergoing dramatic changes.
Nurses have many opportunities to be involved in health care reform.