FUNDAMENTALS OF NURSING (LECTURE) MIDTERM EXAM
means to relate the message perceived to the receiver's storehouse of knowledge and experience and to sort out the meaning of the message.
DECODE
is the study of population, including statistics about distribution by age and place of residence, mortality (death), and morbidity (incidence of disease). From demographic data, the needs of the population for nursing services can be assessed.
DEMOGRAPHY
What includes secondary prevention?
DIAGNOSIS AND TREATMENT
is the most common form of electronic communication.
e is provided to clients as they awaken in the morning. This care consists of providing a urinal or bedpan to the client confined to bed, washing the face and hands, and giving oral care.
EARLY MORNING CARE
If the meaning of the decoded message matches the intent of the sender, then the communication has been
EFFECTIVE
Another form of communication has evolved with technology, example is e-mail
ELECTRONIC COMMUNICATION
Computers are playing an increasing role in nursing practice. Many health care agencies are moving toward electronic medical records where nurses document their assessments and nursing care
ELECTRONIC COMMUNICATION
g involves the selection of specific signs or symbols (codes) to transmit the message, such as which language and words to use, how to arrange the words, and what tone of voice and gestures to use.
ENCODING
No part of the body is as expressive as the face (Figure 26-5 •). Feelings of surprise, fear, anger, disgust, happiness, and sadness can be conveyed by facial expressions. Although the face may express the person's genuine emotions, it is also possible to control these muscles so the emotion expressed does not reflect what the person is feeling.
FACIAL EXPRESSION
More people are living away from the extended family and the nuclear family, and the family breadwinner is no longer necessarily the husband. Today, many single men and women rear children, and in many two-parent families both parents work. It is also common for young parents to live at great distances from their own parents. These young families need support services, such as day care centers.
FAMILY STRUCTURES
n involves a sender, a message, a receiver, and a response, or feedback
Face-to-face communication
Hand and body gestures may emphasize and clarify the spoken word, or they may occur without words to indicate a particular feeling or to give a sign
GESTURES
1. Advocate for the rights of all clients. 2. Maintain client confidentiality. 3. Take appropriate action to ensure the safety of clients, self, and others. 4. Provide care for the client in a timely, compassionate, and professional manner. 5. Communicate client care in a truthful, timely, and accurate manner.
GIVE 5 CODE FOR NURSING STUDENTS
p is two or more people who have shared needs and goals, who take each other into account in their actions, and who thus are held together and set apart from others by virtue of their interactions.
GROUP
The communication that takes place between members of any group is known
GROUP DYNAMICS
What includes primary prevention?
HEALTH PROMOTION AND ILLNESS PREVENTION
Transformation in health care delivery and financing systems accelerated in 2014 when major provisions of the legislation were implemented (Buerhaus et al., 2012, p. 318). Health care delivery's focus has shifted from acute care to primary preventive care and treatment of chronic conditions using health care teams and information technology
HEALTHCARE REFORM
is the totality of services offered by all health disciplines. It is one of the largest industries in the United States. Goal was to provide care to people who were ill or injured. However, with increasing awareness of health promotion, illness prevention, and levels of wellness, health care systems are changing, as are the roles of nurses in these areas. The services provided by a health care system are commonly categorized according to type and level
HEALTHCARE SYSTEM
Nurse-client relationships are referred to by some as interpersonal relationships, by others as therapeutic relationships, and by still others as
HELPING RELATIONSHIP
can be a positive and powerful tool in the nurse-client relationship, but it must be used with care. It can be used to help clients adjust to difficult and painful situations. The physical act of laughter can be an emotional and physical release, reducing tension by providing a different perspective and promoting a sense of well-being
HUMOR
as "rude or disruptive behavior that may result in psychological or physiological distress for the people involved and, if left unaddressed, may progress into threatening situations."
INCIVILITY
WHAT ARE THE 3 DISRUPTIVE BEHAVIOUR DURING COMMUNICATION?
INCIVILITY, LATERAL VIOLENCE, BULLYING
occurs when the receiver misinterprets the sent message
INEFFECTIVE COMMUNICATION
The Internet has already affected health care, with more and more clients becoming well informed about their health concerns. As a result, nurses may need to interpret Internet sources of information for clients and their families. Because not all of the Internet-based information is accurate, nurses need to become information brokers so they can help people to access high-quality, valid websites; interpret the information; and then help clients evaluate the information and determine if it is useful to them
INFORMATION, TELEHEALTH AND TELENURSING
was established in 1899. Nurses from Great Britain, the United States, and Canada were among the founding members. This provides an organization through which member national associations can work together for the mission of representing nursing worldwide, advancing the profession, and influencing health policy.
INTERNATIONAL COUNCIL OF NURSES
the international honor society in nursing, was founded in 1922 and is headquartered in Indianapolis, Indiana. The Greek letters stand for the Greek words storga, tharos, and tima, meaning "love," "courage," and "honor." The society is a member of the Association of College Honor Societies. The society's purpose is professional rather than social. Membership is attained through academic achievement. Students in baccalaureate programs in nursing and nurses in master's, doctoral, and postdoctoral programs are eligible to be selected for membership.
INTERNATIONAL HONOR SOCIETY SIGMA THETA TAU
, also referred to as the orientation phase or the prehelping phase, is important because it sets the tone for the rest of the relationship. During this initial encounter, the client and the nurse closely observe each other and form judgments about the other's behavior. The goal of the nurse in this phase is to develop trust and security within the nurse-client relationship
INTRODUCTORY PHASE
is the communication that you have with yourself; another name is self-talk. Both the sender and the receiver of a message usually engage in self-talk. It involves thinking about the message before it is sent, while it is being sent, and after it is sent, and it occurs constantly
Intrapersonal Communication
ADVANTAGES OF E-MAILS
It is a fast, efficient way to communicate and it is legible. It provides a record of the date and time of the message that was sent or received.
also known as horizontal violence and horizontal hostility, are terms that describe physical, verbal, or emotional abuse or aggression directed at RN coworkers at the same organizational level. It usually includes verbal or nonverbal (rather than physical) aggressive behaviors
LATERAL VIOLENCE
Legislation about nursing practice and health matters affects both the public and nursing. Legislation related to nursing is discussed in Chapter 4 . Changes in legislation relating to health also affect nursing. For example, the Patient Self-Determination Act (PSDA) requires that every competent adult be informed in writing on admission to a health care institution about his or her rights to accept or refuse medical care and to use advance directives. See Chapter 4 for more information about the PSDA and advance directives. Health care reform and the shortage of physicians calls for an increase in advance practice registered nurses such as NPs. Currently, there are wide variations in state regulation of nurse practitioner practice
LEGISLATION
suggest resistance to communication
LISTENER'S POSTURE AND DEMEANOR
what is actually said or written, the body language that accompanies the words, and how the message is transmitted.
MESSAGE
is often provided after clients have breakfast, although it may be provided before breakfast. It usually includes providing for elimination needs, a bath or shower, perineal care, back massages, and oral, nail, and hair care. Making the client's bed is part of
MORNING CARE
formed in 1952, is an organization of both individuals and agencies. Its objective is to foster the development and improvement of all nursing services and nursing education. People who are not nurses but have an interest in nursing services, for example, hospital administrators, can be members of the league.
NATIONAL LEAGUE FOR NURSING
is the official preprofessional organization for nursing students. Formed in 1953 and incorporated in 1959, became an autonomous body, although it communicates with the NLN and the ANA. To qualify for membership in the NSNA, a student must be enrolled in a state-approved nursing education program. The official journal of the NSNA is Imprint magazine.
NATIONAL STUDENT NURSES ASSOCIATION
sometimes called body language, includes gestures, body movements, use of touch, and physical appearance, including adornment
NONVERBAL COMMUNICATION
uses other forms, such as gestures or facial expressions, and touch.
NONVERBAL COMMUNICATION
Professional nursing associations have provided leadership that affects many areas of nursing. Voluntary accreditation of nursing education programs by the Accreditation Commission for Education in Nursing (ACEN) and Commission on Collegiate Nursing Education (CCNE) has also influenced nursing. Many nursing programs have steadily improved to meet the standards for accreditation over the years. As a result, nurse graduates are better prepared to meet the demands of society.
NURSING ASSOCIATIONS
The manner of speech, as in the rate or rhythm and tone, will modify the feeling and impact of a message. The tone of words can express enthusiasm, sadness, anger, or amusement.
PACE AND INTONATION
Clothing and adornments can be sources of information about a person. Although choice of apparel is highly personal, it may convey social and financial status, culture,religion, group association, and self-concept. How a person dresses is often an indicator of how the person feels.
PERSONAL APPEARANCE
is provided to clients before they retire for the night. It usually involves providing for elimination needs, washing face and hands, giving oral care, and giving a back
PM CARE
indicate openness to communication
POSTURE
The ways people walk and carry themselves are often reliable indicators of self-concept, current mood, and health. Erect posture and an active, purposeful stride suggest a feeling of well-being. Slouched posture and a slow, shuffling gait suggest depression or physical discomfort. Tense posture and a rapid, determined gait suggest anxiety or anger. The posture of people when they are sitting or lying can also indicate feelings or mood.
POSTURE AND GAIT
FACTORS AFFECTING NON-VERBAL COMMUNICATION
POSTURE AND GAIT PERSONAL APPEARANCE, FACIAL EXPRESSIONS AND GESTURES
is similar to the planning stage before an interview. In most situations, the nurse has information about the client before the first face-to-face meeting. Such information may include the client's name, address, age, medical history, and/or social history
PRE-INTERACTION PHASE
TYPES OF HEALTH CARE SERVICES
Primary Prevention Secondary Prevention Tertiary Prevention
Robert Wood Johnson Foundation funded a project called
QSEN (Quality and Safety Education for Nurses)
it's goal was to "meet the challenge of preparing future nurses who will have the knowledge, skills and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems within which they work"
QSEN Project
"quality and safety are the leading contemporary issues in health care, contributing to costs and poor outcomes"
QUALITY AND SAFETY IN HEALTHCARE
the third component of the communication process, is the listener, who must listen, observe, and attend. This person is the decoder, who must perceive what the sender intended (interpretation). Perception uses all the senses to receive verbal and nonverbal messages
RECEIVER
What includes tertiary prevention?
REHABILITATION, HEALTH RESTORATION, AND PALLIATIVE CARE
is the message that the receiver returns to the sender. It is also called feedback. Feedback can be either verbal, nonverbal, or both.
RESPONSE
Nurses frequently have to use sophisticated computerized equipment to monitor or treat clients. As technologies change, nursing education changes, and nurses require increasing education to provide effective, safe nursing practice. The space program has developed advanced technologies for space travel based on the need for long-distance monitoring of astronauts and spacecraft, lighter materials, and miniaturization of equipment. Health care has benefited as this new technology has been adapted in such health care aids as Viewstar (an aid for people with visual impairments), the insulin infusion pump, the voice-controlled wheelchair, magnetic resonance imaging, laser surgery, filtering devices for intravenous fluid control devices, and monitoring systems for intensive care
SCIENCE AND TECHNOLOGY
GIVE 5 THERAPEUTIC COMMUNICATION TECHNIQUE:
SEEKING CLARIFICATION PERCEPTION CHECKING OFFERING SELF GIVING INFORMATION ACKNOWLEDGING
is to develop or use interpersonal strengths. The overall aim is to improve the person's functioning in the group to which they return, whether job, family, or community.
SELF-AWARENESS GROUP
is a small, voluntary organization composed of individuals who share a similar health, social, or daily living problem. One of the central beliefs of the self-help movement is that people who experience a particular social or health problem have an understanding of that condition which those without it do not
SELF-HELP GROUPS
a person or group who wishes to communicate a message to another, can be considered the source-encoder. This term suggests that the person or group sending the message must have an idea or reason for communicating (source) and must put the idea or feeling into a form that can be transmitted.
SENDER
includes the use of commonly understood words, brevity, and completeness. Many complex technical terms become natural to nurses. However, laypersons often misunderstand these terms. Words such as vasoconstriction or cholecystectomy are meaningful to the nurse and easy to use but are ill advised when communicating with clients. Nurses need to learn to select appropriate, understandable, and simple terms based on the age, knowledge, culture, and education of the client.
SIMPLICITY
GIVE 5 BARRIERS TO COMMUNICATION
STEREOTYPING AGREEING AND DISAGREEING BEING DEFENSIVE CHALLENGING PROBING
is one of the most common types of work-related groups to which nurses belong. Examples are health care planning committees, nursing service committees, nursing team meetings, nursing care conference groups, and hospital staff meetings.
TASK GROUP
is to impart information to the participants. Examples of teaching groups include continuing education and client health care groups.
TEACHING GROUPS
means "distance," and is used to describe the many health care services provided via technology.
TELE
is the "use of medical information exchanged from one site to another via electronic communications to improve the patient's health status."
TELEHEALTH
is often associated with direct client clinical services
TELEMEDICINE
g is the use of telecommunications and information technology to provide nursing practice at a distance
TELENURSING
is often expected to be difficult and filled with ambivalence. However, if the previous phases have evolved effectively, the client generally has a positive outlook and feels able to handle problems independently. On the other hand, because caring attitudes have developed, it is natural to expect some feelings of loss, and each person needs to develop a way of saying good-bye.
TERMINATION PHASE
Registered nurses are the largest segment of the health care workforce. According to the Bureau of Labor Statistics (2013), the number of employed RNs will grow from 2.7 million in 2012 to 3.2 million in 2022; this number increases by an additional 1.2 million when including replacements for nurses who leave or retire from the profession. Contrast that information with an AACN statement (2012b) that the United States is projected to have a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Factors for this prediction include the concurrent nursing faculty shortage, the increasing average age of RNs, and the increasing number of aging older adults along with their increasing health care needs
THE CURRENT NURSING SHORTAGE
promotes understanding and can help establish a constructive relationship between the nurse and the client. Nurses need to respond not only to the content of a client's verbal message but also to the feelings expressed.
THERAPEUTIC COMMUNICATION
work toward self-understanding, more satisfactory ways of relating to or handling stress, and changing patterns of behavior toward health
THERAPY GROUPS
Nurses need to be aware of both relevance and timing when communicating with clients. No matter how clearly or simply words are stated or written, the timing needs to be appropriate to ensure that words are heard. Moreover, the messages need to relate to the person or to the person's interests and concerns. This involves sensitivity to the client's needs and concerns.
TIMING AND RELEVANCE
is largely conscious because people choose the words they use. The words used vary among individuals according to culture, socioeconomic background, age, and education
VERBAL COMMUNICATION
is an expression of empathy that tells "clients that you are with them, and it puts you in a position to listen carefully to their concerns"
VISIBLY TUNING IN
Many nurses, for example, hospice, emergency, and acute care nurses, experience high levels of vocational stress. Various types of group support can buffer such stress. Group members who know about the work of others can encourage and challenge members to be more creative and enthusiastic about their work and to achieve more
WORK-RELATED SOCIAL SUPPORT GROUP
the nurse and the client begin to view each other as unique individuals. They begin to appreciate this uniqueness and care about each other. Caring is sharing deep and genuine concern about the welfare of another person. Once caring develops, the potential for empathy increases.
WORKING PHASE
is the science of health and its maintenance. It is a highly personal matter determined by individual values and practices. It involves care of the skin, feet, nails, oral and nasal cavities, teeth, hair, eyes, ears, and perineal-genital areas
hygiene
MODES OF COMMUNICATION
non-verbal, verbal, electronic communication
IOM 6 Competencies to improve healthcare
patient-centered care teamwork and collaboration evidence-based practice quality improvement safety informatics
is the self-care by which people attend to such functions as bathing, toileting, general body hygiene, and grooming.
personal hygiene
5 TYPES OF HEALTHCARE GROUPS
task groups teaching groups self-help groups self-awareness groups therapy groups work-related social support groups
What are the 2 main purpose of communication?
to influence others and to gain information
The intent of any communication is
to obtain a response
WHAT ARE THE PHASES OF THE HELPING RELATIONSHIP?
-PRE-INTERACTION PHASE -INTRODUCTORY PHASE -WORKING PHASE -TERMINATION PHASE
Nurses need to consider the following when choosing words to say or write:
-pace and intonation -simplicity, -clarity and brevity, -timing and relevance, -adaptability, -credibility, and -humor.
DISADVANTAGES OF E-MAIL
-privacy insecurity -socioeconomic problems not all have laptops -literacy problems not all knows how to speak english
WHAT ARE THE 5 FUNCTIONS OF THE SKIN?
-protects the underlying tissue from injury -regulate temperature -secretes sebum -transmits sensations -produces and absorbs vitamin D
The nurse needs to alter spoken messages in accordance with behavioral cues from the client.
ADAPTABILITY
is the national professional organization for nursing in the United States. It was founded in 1896 as the Nurses Associated Alumnae of the United States
AMERICAN NURSES ASSOCIATION
What are the Nursing Organizations?
ANA (American Nurses association) NLN (National League of Nursing) ICN (International Council of Nurses) NSNA (National Student Nurses Association) IHS (International Honor Society) Sigma Theta Tau
STATE THE NURSING PROCESS:
ASEESSMENT DIAGNOSIS PLANNING IMPLEMENTATION EVALUATION
is listening actively and with mindfulness, using all the senses, and paying attention to what the client says, does, and feels as opposed to listening passively with just the ear. It is probably the most important technique in nursing and is basic to all other techniques.
ATTENTIVE LISTENING
g is defined as "repeated, unreasonable actions of individuals (or a group) directed towards an employee (or a group of employees), which are intended to intimidate, degrade, humiliate, or undermine; or which create a risk to the health or safety of the employee(s)"
BULLYING
A message that is direct and simple will be effective. This include saying precisely what is meant, and using the fewest words necessary
CLARITY AND BREVITY
based on an understanding that to practice nursing as a student is an agreement to uphold the trust with which society has placed in us. The statements of the Code provide guidance for the nursing student in the personal development of an ethical foundation and need not be limited strictly to the academic or clinical environment but can assist in the holistic development of the person.
CODE OF ACADEMIC AND CLINICAL CONDUCT
More nurses are using collective bargaining to deal with their concerns. The ANA participates in collective bargaining on behalf of nurses through its economic and general welfare programs. Today, some nurses are joining other labor organizations that represent them at the bargaining table. Nurses have gone on strike over economic concerns and over issues about safe care for clients and safety for themselves
COLLECTIVE BARGAINING
is any means of exchanging information or feelings between two or more people. It is a basic component of human relationships, including nursing
COMMUNICATION
n is a critical skill for nursing. It is the process by which humans meet their survival needs, build relationships, and experience emotions. It is a dynamic process used to gather assessment data, to teach and persuade, and to express caring and comfort. It is an integral part of the helping relationship
COMMUNICATION
Consumers of nursing services (the public) have become an increasingly effective force in changing nursing practice. On the whole, people are better educated and have more knowledge about health and illness than in the past. Consumers also have become more aware of others' needs for care. The ethical and moral issues raised by poverty and neglect have made people more vocal about the needs of minority groups and the poor
CONSUMER DEMANDS
means worthiness of belief, trustworthiness, and reliability.
CREDIBILITY