Caring Interventions: Caring Encounters and Knowledge
The nursing instructor asks the class to describe empirical knowing. Which student responses are most accurate?
"It incorporates nursing-related facts." "It can be developed through ongoing academic education." "It includes observations related to nursing." "It's also called the science of nursing." -Empirical knowing, also referred to as open double quote"the science of nursing,close double quote" is based in nursing-related facts and observations, and in nursing theories and analyses that seek to explain these facts and observations. Methods of developing empirical knowing include ongoing academic nursing education. Empirical knowing is objective in nature.
knowing: aesthetic
"art of nursing" *subjective* nurses personal style during care delivery key elements: empathy, holistic thinking, compassion, sensitivity -work toward increasing your awareness and respect of others' experiences and perspectives
knowing: ethical
"moral component" of nursing knowledge know the current nursing codes of ethics know the rules/regs and values held by employer -every intentional action and behavior by the nurse that may be subject to being judged right or wrong
knowledge: empirical
"science of nursing" based on nursing-related facts/observations nursing theories- analyzes that attempt to explain those facts/observations -developed thru ongoing edu and increasing skills *objective*
At a nurses' retreat, participants are discussing the characteristics of a self-aware nurse. Which descriptions are most accurate?
A self-aware nurse is more likely to be respectful toward others The self-aware nurse is able to recognize personal strengths Empathy toward others is a characteristic of the self-aware nurse -Characteristics of the self-aware nurse include the ability to identify personal strengths and weaknesses. The self-aware nurse is aware of assumptions, beliefs, values, and prejudices that can impair judgment. Self-awareness promotes the nurse's understanding, respect, and empathy for others.
caring behaviors
Appreciating the client as a human being Demonstrating respect for the client Being sensitive to the client Talking with the client Maintaining confidentiality of client information Treating the client as an individual Encouraging the client to call with problems Being honest with the client Listening attentively to the client.
Which statements best reflect Western cultural views of asking for help as part of self-care?
Autonomous coping is highly valued in Western culture Western cultural beliefs may influence an individual to practice ineffective self-care. -In Western culture, autonomous coping is highly valued. As such, seeking social support may be viewed as a sign of weakness. To avoid appearing to be weak, individuals influenced by Western culture tend to avoid asking for help when needed; ineffective self-care may result.
Which statement best describes caring in the context of nursing?
Caring extends beyond implementing interventions or feeling interest or concern. -In the context of nursing, caring extends beyond simply implementing interventions or feeling interest or concern. In nursing, the term "care" often equates to behaviors, which may or may not reflect caring. In particular, client care comprises the implementation of collaborative and independent nursing interventions. Nursing interventions can be implemented even in the absence of genuine interest or concern for the client's well-being. Likewise, genuine interest or concern for the client's well-being does not necessary equate to safe, proficient client.
The staff nurse is writing a journal article that explores the principle of caring as it applies to nursing. Which statements should she include in the article?
Caring in nursing extends beyond feelings of interest or concern. Nursing interventions can be implemented in the absence of genuine caring. In nursing, demonstration of caring includes the safe, proficient implementation of nursing interventions. -Client care comprises the implementation of collaborative and independent nursing interventions that are intended to restore health, prevent illness or injury, or promote wellness. Yet nursing interventions can be implemented even in the absence of genuine interest or concern for the client's well-being. Likewise, genuine interest or concern for the client's well-being does not necessarily equate to safe, proficient implementation of nursing interventions. In nursing, the meaning of caring extends well beyond simply implementing interventions or feeling interest or concern.
nursing interventions: characteristics
Cognitive ability Participation in professional development Awareness of ethical and legal practices Provision of high-quality, safe nursing care Establishment of relationships with clients and fellow nurses.
nursing interactions of compassion
Comforting the client in ways that are meaningful to the client Validating the client's experience through attentive listening and eye contact Holding the client's hand Adjusting the client's bed position Providing gentle personal hygiene care Respecting the client's spiritual beliefs or lack thereof, regardless of the nurse's personal opinions and values.
As the nurse is discharging a client, the client states, open double quote"You've been a great nurse. You're knowledgeable and skilled, and you have a great attitude. You're a real professional.close double quote" Which nursing caring behavior or process is the client best describing?
Competence is the nurse's ability to effectively demonstrate a set of attributes, such as professional attitude and knowledge, skills, and values, and to fulfill her professional responsibility through nursing practice.
Maslow: 4, Self-Esteem
Confidence Independence Competence Respect Achievement. -affected by perceptions of others -strive to be seen as competent and proficient -preceptor roles to gain proficiency
The nurse is creating a brochure about effective self-care for nurses. Which statements should the nurse include in the brochure?
Effective self-care promotes enhanced critical thinking ability. Effective self-care builds self-esteem. Prayer and meditation are examples of self-care activities. Self-care activities include getting adequate rest. -Effective self-care leads to more than just physiologic health and physical fitness. Along with enhancing the individual's sense of well-being, effective self-care also builds self-esteem, which in turn promotes effective use of problem solving and critical thinking skills. Effective self-care reduces the risk for burnout, the manifestations of which include depersonalization of clients. General examples of self-care activities are eating a balanced diet, exercising on a regular basis, getting adequate rest and sleep, and engaging in recreational activities.
4 types of knowledge
Empirical Aesthetic Personal Ethical.
The client tells her nurse, "You helped me learn how to recognize my own health needs without telling me how I should think." Which nursing caring behavior or process is the client best describing?
Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Competence is the nurse's ability to effectively demonstrate a set of attributes, such as a professional attitude and knowledge, skills, and values, and to fulfill her professional responsibility through nursing practice. Compassion develops as a result of being directly involved with the client's experience. Presencing involves the nurse's immersion in a nurse-client interaction that helps the client define her health choices while understanding the client's authority to make her own decisions
The new nurse tells his preceptor, open double quote"I want the other nurses to consider me competent and proficient.close double quote" Which category of Maslow's hierarchy of needs is reflected by the nurse's statement?
Esteem -In Maslow's hierarchy of needs, physiologic needs are at the most basic level; these needs include air, food, water, and shelter. The second level is safety needs, which comprise physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. The third level is love and belonging needs, which include relationships and affection. The fourth level, self-actualization, is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. The fifth and highest level is esteem needs, which include confidence, independence, competence, respect, and achievement.
Ethics
Ethical factors and dilemmas, such as conflict between clients and their families, conflicts between clients and the healthcare team, and constraining factors related to care provision (e.g., institutional or insurance barriers), increase the nurse's risk for moral distress (internal conflict) and burnout.
The nurse educator is instructing a group of students about ways of knowing. Which statement by the student best reflects ethical knowing?
Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong -Ethical knowing incorporates every intentional action and behavior by the nurse that may be subject to being judged right or wrong. Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. Empirical knowing is based in nursing-related facts and observations, and nursing theories and analyses that seek to explain these facts and observations.Aesthetic knowing relates to the nurse's specific personal style during care delivery.
The home care nurse visits a client with chronic obstructive pulmonary disease (COPD) to complete a scheduled teaching session about how to use a nebulizer. When the nurse greets the client, the client states, "I'm okay. I'm just feeling really depressed today." Although the client appears to be calm and in no physical distress, the nurse hears a faint wheeze when the client exhales. Which nursing response best reflects a competent, caring nursing intervention?
Expressing concern for the client's depression and asking him if he wants to discuss his feelings, but planning to complete the scheduled teaching session
Stress and Coping
Impaired coping can adversely affect self-care. Inadequate or absent self-care may cause stress, anxiety, or depression, all of which are associated with errors in client care.
hierarchy of needs
In Maslow's hierarchy of needs, physiologic needs are at the most basic level; these needs include air, food, water, and shelter. The second level is safety needs, which comprise physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. The third level of need encompasses love and belonging and includes relationships and affection. The fourth level, self-actualization, is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. The fifth and highest level is esteem needs, which include confidence, independence, competence, respect, and achievement.
Culture
In Western culture, autonomous coping is highly valued. As such, seeking social support may be viewed as a sign of weakness. To avoid appearing to be weak, individuals influenced by Western culture tend to avoid asking for help when needed; ineffective self-care may result. The nurse should provide education to the client regarding seeking care from others when needed.
Professional Behaviors
Inadequate self-care can lead to decreased physical and psychosocial wellness. In turn, decreased wellness may contribute to impaired work performance, as well as a weakened affiliation with the profession of nursing. As a result, the nurse's demonstrated professionalism toward clients, peers, and other members of the healthcare team may suffer.
The nursing instructor is teaching a class about the relationship between the concept of self-care and the concept of professional behaviors. Which statement should he include in the teaching?
Inadequate self-care can impair professional work performance by leading to decreased physical wellness -Inadequate self-care can lead to decreased physical and psychosocial wellness. In turn, decreased wellness may contribute to impaired work performance as well as a weakened affiliation with the profession of nursing. As a result, the nurse's demonstrated professionalism toward clients, peers, and other members of the healthcare team may suffer.
Which statement by the nurse best describes personal knowing?
Knowledge is a journey toward self-actualization. -Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. Aesthetic knowing encompasses the "art of nursing" Empirical knowing encompasses the "science of nursing" Moral and ethical care reflects ethical knowing.
During a classroom discussion about Maslow's hierarchy of needs, a nursing student asks, open double quote"What is the most basic level of need?close double quote" What is the best response by the nursing instructor?
Physiologic needs are the most basic; these include shelter and water
Mr. Terisson, a 53-year-old male client, is diagnosed with pancreatic cancer. His nurse, Layne, is with him when he receives the news from the physician. After the physician leaves the room, Mr. Terrison slams his fist against the wall and then silently stares out the window. Which nursing behaviors best reflect Layne's use of presencing in Mr. Terrison's care?
Speaking with the client face-to-face Quietly sitting in the client's room -When presencing, the nurse does not direct the client; rather, by being present, the nurse serves as the client's guide. During presencing, the nurse remains receptive, open, and available without judging or labeling the client's perceptions, feelings, or behaviors.Forms of presencing include face-to-face discussions and lingering presence.
nursing actions to promote empowerment
Teaching clients about self-care Promoting the client's maximum involvement in implementing the plan of care Providing information and resources to clients and their families Explaining what clients can expect beyond their hospital stay Advocating for clients and their loved ones by sharing their concerns with administrators and other members of the healthcare team.
The student nurse asks her nurse mentor to explain the factors that shape the caring process in nursing. Which statements should the nurse mentor include in her reply?
The process of caring can be influenced by the client care setting. Factors that influence the caring process may include the timing of the interaction -The caring process is shaped by many factors, including an individual's perceptions, experiences, and values. The nurse's level of development also shapes the caring process as do circumstances such as the time and setting of the care being provided.Unseen processes, such as thoughts and emotions, may affect the client's concerns at any given time and impact the nature of care.
A terminally ill client says to the hospice nurse, "I'm afraid to die. Just thinking about it scares me so much. Will you please hold my hand?" When the nurse offers to pray with the client, the client states, "I'm an atheist. I think prayer is a waste of words." Which response best demonstrates compassion in nursing care?
Using attentive listening as a communication technique Maintaining eye contact with the client Holding clients hand -Examples of nursedash-client interactions that both reflect and facilitate the development of compassion include validating the client's experience through attentive listening and eye contact. Encouraging the atheist client to speak with the hospital chaplain is not congruent with compassionate care. Compassion is reflected when the nurse comforts the client in ways that are meaningful to the client.
Which nursing behavior best reflects caring in nursing?
Verbalizing concern regarding a client's complaint of anxiety and providing a back massage per the client's request -Caring in nursing combines genuine interest or concern for the client's well-being with safe, proficient implementation of nursing interventions that are intended to restore health, prevent illness or injury, or promote wellness. Caring in nursing is best reflected by the nurse's verbalizing concern regarding a client's complaint of anxiety and providing a back massage per the client's request. Repositioning an uncomfortable client primarily to prevent the client from complaining suggests an absence of genuine interest or concern. Silently empathizing with a client who is in pain is an incomplete representation of caring in nursing, as no nursing intervention is implemented. Taken alone, proficiency with clinical skills (such as insertion of intravenous access devices) does not fully reflect caring in nursing.
Which nursing action best reflects the principle of aesthetic knowing?
Viewing the client holistically Being sensitive to the client's needs Providing compassionate client care Demonstrating empathy toward the client -Key elements to the pattern of aesthetic knowing include empathy, holistic thinking, compassion, and sensitivity. Application of nursing-related facts is reflective of empirical knowledge.
how the 4 styles work together
While empirical knowing affords the nurse the facts and skills that support proficiency in nursing care, aesthetic knowing is the source of the compassion that must accompany proficiency. Personal knowing leads the nurse to view the client as a unique individual and build an authentic personal relationship with the client, as opposed to simply viewing the client as the object of care. Through application of ethical knowing, the nurse abides by laws, regulations, codes, and moral standards that are designed to protect both the client and the nurse from harm.
characteristics of self-aware nurse
ability to identify personal strengths and weaknesses, as well as an awareness of the assumptions, beliefs, values, and prejudices that can impair judgment. Self-awareness promotes the nurse's understanding, respect, and empathy for others
empowerment
assists the client to autonomously identify her own health needs in lieu of being instructed how to do so.
Maslow: 5, Self-Actualization
attainment of goals making time for yourself hobbies self-aware, self-discovery
Presencing
combines the interpersonal arts of perception and communication -helps the client define his health choices -nurse doesn't direct the client, more of a guide -key elements: being receptive, open, and available -Face-to-face discussions Silent immersions Lingering presence be *intentional*
compassion
develops as a result of being directly involved with the client's experience
Which conditions or behaviors are most likely to be exhibited by an individual who is bullied?
emotional distress anxiety depression sense of isolation increased work absenteeism
presencing
involves the nurse's immersion in a nurse-client interaction that helps the client define her health choices while understanding the client's authority to make her own decisions.
promoting self-awareness in yourself as a nurse
making a practice of pausing to reflect and consider their reasons for choosing to enter the nursing profession and their motivation for going to work each day
A new nurse is meeting with his mentor. During their conversation, the new nurse states, "I want to be able to take care of my clients without always needing help. I want to feel like I know what I need to do, and I want to be able to provide my clients with the best care." Considering Maslow's hierarchy of needs, how should the mentor interpret the new nurse's statement?
needs are r/t self-esteem -In Maslow's hierarchy of needs, esteem needs comprise confidence, independence, respect, competence, and achievement. In particular, the new nurse's statements reflect a desire for independence, confidence, and competence. Safety needs include physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. Self-actualization is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. Love and belonging needs are reflective of the individual's need to be cared about by and to fit in with others.
competence
nurse's ability to effectively demonstrate a set of attributes, such as professional attitude, personal characteristics, knowledge, skills, and values, and to fulfill her professional responsibility through nursing practice.
knowing: personal
nurse's ongoing self-exploration and journey toward self-actualization personal relationship with client v. viewing them as an object critically evaluate: thoughts, actions, emotions
compassion
nurses develop compassion as a result of becoming intimately involved with the client's experience
Maslow: 2, Safety and Security
physical safety financial stability harmonious family relationships freedom from psychological threats
empowerment
process through which clients develop the autonomy to identify their own health needs in lieu of being instructed how to do so - taking action to generate results that positively impact not only individuals, but entire organizations.
intentionality
refers to a nurse working in conjunction with those involved in a given situation as a cooperative force rather than attempting to impose the nurse's will
Considering Maslow's hierarchy of needs, which category of needs includes financial stability and harmonious family relationships?
safety -In Maslow's hierarchy of needs, safety needs comprise physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. Physiologic needs include food, water, air, sleep, and shelter. Self-actualization is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. Esteem needs include confidence, independence, competence, respect, and achievement.
Maslow: 3, Love and Belonging
support networks relationships with family, friends, etc
Maslow: base, Physiologic
survival needs food, water, air, shelter, sleep
