Self Awareness

steps in the caring process

*C.onnect* with your patient/offer attention *A.ppreciate* the patient's situation *R.espond* to what your patient needs *E.mpower* your patient to problem solve with you

describe the *orientation* phase of the nurse client relationship

*characteristics* -nurse and client first meet -nurse explores reasons for the patient seeking help -flexibility required each patient approached differently *tasks to be accomplished* -establish rapport -develop trust -*ESTABLISH A CONTRACT* -assess patients strengths, limitations, problem areas 1) *Establishing a contract* -names, roles, purpose of relationship -meeting locations/times -terms of condition 2) *Introductions* -ask the patient how they would like to be addressed -discuss confidentiality 3) *initiating the interview* -use open ended statements -encourage patient to take the initiative -"where should we start" -"tell me a little bit about what has been going on with you"

the *working* phase of the nurse/patient relationship

*characteristics* -patient begins to trust and accept the nurse -gather further data -maintain the relationship -patient still requires support -evaluate problems and goals together *tasks to be accomplished* -be aware of themes -problem solve with patient related to health care -facilitate expression of feelings -assist patient in coping with present problem -assist patient to practice new behaviors

the *termination* phase of the nurse/client relationship

*characteristics* -patient no longer needs intensive support -patient has grown in self-understanding -relationship may end abruptly (eg. nurse leaves) *tasks to be accomplished* -summarize goals and objectives achieved -discuss ways for the patient to incorporate coping strategies into daily life -assist patient to be as independent as possible -exchange memories and review progress made during relationship -work through feelings of loss due to closure

how would you compare/contrast personal versus professional relationships?

*personal/social* -mutual satisfaction *professional/therapeutic* -patient centered -goal directed

how does one develop self awareness?

*self-monitoring* -stay conscious of what you are doing -develop the skill of keeping your attention focused on your actions, verbal and non verbal *introspection/self reflection* -reflect on experiences, thoughts, and feelings *feedback from other people* -remain open to the verbal and non-verbal behaviors of others

zones of attention: internal and external

*zone 1: outer experience* -what you notice with your 5 senses -by keeping attention "out" you are paying more attention to: -who you are with -the person you are with -the current situation being experience *zone 2: inner experience* -turn your attention inward -notice what you are thinking/feelings -notice your assumptions about yourself and others ex. imagining what others thing of you imagining characteristics and qualities about others *zone 3: mindfulness/meditation* -closing your eyes -focus in -shift attention to zone 3 *premise of mindfulness*

what is self awareness?

-basic pre-requisite of all skillful nursing -conscious use of the self -enhances interpersonal relationships and skills

helping the patient with termination

-help the patient discuss his or her feelings -encourage the patient to talk about progress made in the nurse patient relationship -give feedback to the patient about growth you have observed -express your feelings about leaving the relationship

examples of self awareness training

-journaling -therapy -role-playing -assertive skills training -meditation -body work, yoga, tai chi -sports

describe the pre-interaction phase of the nurse client relationship

-nurse gathers data about patient, situation, and condition -explores own feelings, fears, and anxieties -analyzes own professional strengths and limitations *tasks to be accomplished* -auto diagnosis -commit to be nonjudgemental -plans for session ---let the patient take the lead/initiative if necessary

what are the four quadrants of the johari window?

1 - known to self and others 2 - known only to others (unknown to self) 3 - known only to self 4 - known neither to self nor others

what is the johari window?

a model for the representation of the self -divided into four quadrants -change in one quadrant effects all quadrants -the smaller the first quadrant (self awareness) the poorer the communication -greater the self awareness the greater the communication

what are possible patient responses to termination?

grief anger acting out temporary regression repression acceptance

methods to increase self awareness

introspection self disclosure feedback leisure

what are the phases of the nurse-client relationship

pre-interaction orientation working termination

the greater the _______ __________, the greater the communication.

self awareness!