Ch. 7 Caring in Nursing Practice

2. Before implementing touch, what does a nurse need to know about touch? (Select all that apply.) 1. Some cultures may have specific restrictions about non-skillbased touch. 2. Touch is a type of verbal communication. 3. Touch can successfully influence a patient's level of comfort. 4. There is never a problem with using touch at any time. 5. Touch only reduces physical pain.

Answer: 1, 3. Some cultures have restrictions as to who can touch and when to touch. Assess your patient to determine whether there are any restrictions. Touch is a method of nonverbal communication. Touch can help improve a patient's sense of comfort and leads to a connection between nurse and patient. Not all patients perceive touch to be therapeutic. Know and understand whether your patients accept touch and how they interpret your intentions. Touching a patient can reduce physical pain and discomfort and decrease anxiety and fear.

8. A nurse demonstrates caring by helping family members to: (Select all that apply.) 1. Become active participants in care. 2. Remove themselves from personal care. 3. Make health care decisions for the patient. 4. Plan uninterrupted time for family and patient to be together. 5. Discuss their concerns.

Answer: 1, 4, 5. Caring for the family takes into consideration the context of the patient's illness and the stress that it imposes on all members. Encouraging family members to provide some care and discuss concerns helps the family to feel involved. Last, providing time for the family to just be together without any "care tasks" or interruptions encourages "presence" for the patient and family

9. A hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. This is an example of what type of touch? 1. Caring touch 2. Protective touch 3. Task-oriented touch 4. Interpersonal touch

Answer: 1. Caring touch is a form of nonverbal communication. You express this in the way that you hold a patient's hand, give a back massage, gently position a patient, or participate in a conversation. When using a caring touch, you connect with the patient physically and emotionally

6. A nurse is caring for a patient newly diagnosed with testicular cancer. He asked the nurse to help him find the meaning of cancer by supporting beliefs about life. This is an example of: 1. Instilling hope and faith. 2. Forming a human-altruistic value system. 3. Cultural caring. 4. Being with.

Answer: 1. Instilling hope and faith helps increase an individual's capacity to get through an event or transition and face a future with meaning.

10. Match the following caring behaviors with their definitions. 1. Knowing 2. Being with 3. Doing for 4. Maintaining belief a. Sustaining faith in the other's capacity to get through an event or transition and face a future with meaning b. Striving to understand an event as it has meaning in the life of the other c. Being emotionally present to the other d. Doing for the other as he or she would do for self if it were at all possible

Answer: 1b, 2c, 3d, 4a. These are from Swanson's theory (see Table 7.2). The theory describes caring as consisting of five categories or processes. Swanson defines caring as a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility. This theory supports the claim that caring is a central nursing phenomenon but not necessarily unique to nursing practice.

5. Which of the following are strategies for creating work environments that support nurse caring interventions? (Select all that apply.) 1. Increasing technological support 2. Improving flexibility for scheduling 3. Providing opportunities to discuss care 4. Promoting autonomy of practice 5. Encouraging increased input concerning nursing functions from health care providers

Answer: 2, 3, 4. These factors all affect nursing satisfaction. When nurses' job satisfaction is high, nurses are more connected with their patients and view their caring practices as part of the nursing culture. Increasing technology frequently removes the nurse from patient care and can have a negative impact on job satisfaction

3. A young woman comes to a clinic for the first time for a gynecological examination. Which nursing behavior applies Swanson's caring process of "knowing" the patient? 1. Sharing feelings about the importance of having regular gynecological examinations 2. Explaining risk factors for cervical cancer 3. Recognizing that the patient is modest and maintaining her privacy during the examination 4. Asking the patient what it means to have a vaginal examination

Answer: 3. Understanding a patient's beliefs, values, and culture enables the nurse to know the context of a patient's illness, treatments, or screening. As a result, the nurse individualizes interventions to help the patient. Knowing the patient is essential when providing patient-centered care.

7. An example of a nurse caring behavior that families of acutely ill patients perceive as important to patients' well-being is: 1. Making health care decisions for patients. 2. Having family members provide a patient's total personal hygiene. 3. Injecting the nurse's perceptions about the level of care provided. 4. Asking permission before performing a procedure on a patient

Answer: 4. Asking permission demonstrates to the patient and family that the nurse respects the patient's rights. Respecting and protecting patient rights is part of "doing for" and "being with" the patient.

4. A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies: 1. "You're correct; spiritual care should be left to a pastoral care professional." 2. "You're correct; religion is a personal decision." 3. "Nurses should explain their own religious beliefs to patients." 4. "Spiritual, mind, and body connections can affect health."

Answer: 4. Spirituality offers a sense of connectedness: intrapersonally (connected with oneself), interpersonally (connected with others and the environment), and transpersonally (connected with the unseen, God, or a higher power).

1. An experienced nurse is explaining the use of touch from a caring perspective. What information does the nurse include in the discussion with the student about touch? 1. Nurses touch patients only while performing procedures or doing assessments. 2. Touch is a type of verbal communication. 3. Nurses use touch only when a patient is in pain. 4. Touch forms a connection between nurse and patient

Answer: 4. Touch is relational and leads to a connection between nurse and patient. It involves contact and noncontact touch. Contact touch involves obvious skin-to-skin contact, whereas noncontact touch refers to eye contact