Theory Chapter 7 (E3)
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 spent with the family. Whenever the nurse enters the room or approaches the patient to give care, the nurse touches his shoulder and states, "I am your nurse, and I am here for you." This is an example of what type of touch. 1. Caring touch 2. Protective touch 3. Task-oriented touch 4. Interpersonal touch
1
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.
1
A nurse needs to use clinical judgment before planning and implementing any touch interventions. What does the nurse need to understand about the use of touch? (Select all that apply.) 1. Some cultures may have specific restrictions about non-skill-based touch. 2. Touch is a form of nonverbal communication. 3. Touch reduces only physical pain. 4. Touch can successfully influence a patient's level of comfort. 5. There is never a problem with using touch at any time.
1, 2, 4
A nurse is caring for a patient who has just transferred from an intensive care unit and still has a long hospitalization ahead. Because of the complexity of care and the number of caregivers for this patient, the family members feel disconnected from their loved one and not part of the care team. Which interventions would demonstrate care by helping family members? (Select all that apply.) 1. Helping family become active participants in care 2. Removing family members from assisting with the patient's personal care 3. Allowing the family to offer opinions on health care decisions for the patient 4. Providing the family opportunities to discuss their concerns with the health care team 5. Planning uninterrupted time for the family and patient to be together
1, 4, 5
what are Watson's 10 Carative Factors?
1. forming a human-altruistic value system 2. instilling faith-hope 3. cultivating a sensitivity to one's self and to others 4. developing a helping, trusting, human caring relationship 5. promoting and expressing positive and negative feelings 6. using creative problem-solving, caring processes 7. promoting transpersonal teaching-learning 8. providing for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment 9. meeting human needs 10. allowing for existential-phenomenological-spiritual forces
what are the 8 factors and items constituting the caring assessment tool?
1. mutual problem solving 2. attentive reassurance 3. human respect 4. encouraging manner 5. appreciation of unique meanings 6. healing environment 7. affiliation needs 8. basic human needs
Match the following caring behaviors with a nursing action. 1. Knowing 2. Being with 3. Doing for 4. Maintaining belief a. Encouraging a patient or family to use resources and trust previous decisions that have helped to resolve issues. b. Asking a patient to talk about what the loss of a loved one means for the patient and the family. c. Telling a family that you understand their anger about the side effects of chemotherapy. d. Providing an opportunity for a patient's specific religious practice as the patient would do it.
1b, 2c, 3d, 4a
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 practices 4. Promoting autonomy of practice 5. Encouraging increased input concerning nursing functions from health care providers
2, 3, 4
A nurse encounters the patient's wife, who is tearful and worried. Her husband was just transferred from his room to the operating room for a complex cardiovascular surgery. The nurse brings the wife a glass of water and encourages her to talk about her fears. The nurse remains in the room quietly listening. What caring behaviors is the nurse demonstrating? (Select all that apply.) 1. Touching 2. Listening 3. Knowing 4. Presence 5. Spiritual care
2, 4
A young woman comes to a clinic for the first time for a gynecological examination. She asks about the procedure, who will be in the room with her, and does she have to remove all her clothes. 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
3
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. What is the best response by the patient's nurse? 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."
4
An example of a nurse caring behavior that families of patients who are acutely ill 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.
4
what is allowing for existential-phenomenological-spiritual forces?
Allow spiritual forces to provide a better understanding of yourself and your patient
what is using creative problem-solving, caring processes?
Apply critical thinking in the nursing process to systematically make sound clinical judgments
what is attentive reassurance?
Are available; Seem interested; Support sense of hope; Help me believe in self; Anticipate my needs
what is appreciation of unique meanings?
Are concerned with how I view things; Know what is important to me; Acknowledge my inner feelings; Show respect for things having meaning
what is affiliation needs?
Are responsive to my family; Talk openly with my family; Allow my family to be involved
what is healing environment?
Check up on me; Pay attention to me when I am talking; Make me feel comfortable; Respect my privacy; Treat my body carefully
what is providing for a supportive, protective, and/or corrective mental, physical, societal, and spiritual environment?
Create a healing environment at all levels, physical and nonphysical; This promotes wholeness, beauty, comfort, dignity, and peace
what is mutual problem solving?
Help me understand how I am thinking; Ask me how I think treatment is going; Help me explore alternative ways of dealing; Ask me what I know; Help me figure out questions to ask
what is meeting human needs?
Intentionally help patients meet basic needs with a caring consciousness
what is cultivating a sensitivity to one's self and to others?
Learn to accept yourself and others for their full potential; A caring nurse matures into becoming a self-actualized nurse
what is developing a helping, trusting, human caring relationship?
Learn to develop and sustain helping, trusting, authentic caring relationships through effective communication with your patients
what is promoting transpersonal teaching-learning?
Learn together while educating the patient to acquire self-care skills; The patient assumes responsibility for learning
what is human respect?
Listen to me; Accept me; Treat me kindly; Respect me; Pay attention to me
what is basic human needs?
Make sure I get food; Help me with routine needs for sleep; Help me feel less worried
how do the patient and the nurse come to know each other so that both move toward a healing relationship?
Mobilizing hope for the patient and the nurse; Finding an interpretation or understanding of illness, symptoms, or emotions that is acceptable to the patient; Assisting the patient in using social, emotional, or spiritual resources; Recognizing that caring relationships connect us human to human, spirit to spirit
what is the challenge of caring?
Nurses have less time to spend with patients, making it much harder to know who they are; reliance on technology and cost-effective health care strategies and efforts to standardize and refine work processes all undermine the nature of caring
what is instilling faith-hope?
Provide a connection with the patient that offers purpose and direction when trying to find the meaning of an illness
what is nurse caring behaviors as perceived by families of patients with cancer?
Providing honest, clear, and accurate information; Listening to patient and family concerns, complaints, and fears; Assisting family with implementing advance directives; Advocating for patient's care preferences and end-of-life decisions; Involving family in care and teaching the family how to keep the relative physically comfortable; Informing the patient and family about the types of nursing services and the people who may enter the personal care area; Providing comfort (e.g., offering warm blanket, rubbing a patient's back); Reading patient passages from religious texts, favorite book, cards, or mail; Assuring the patient that nursing services will be available; Helping patients do as much for themselves as possible
what is promoting and expressing positive and negative feelings?
Support and accept your patients' feelings; In connecting with your patients, you show a willingness to take risks in sharing in the relationship
what is encouraging manner?
Support my beliefs; Encourage me to ask questions; Help me to see some good; Encourage me to go on; Help me deal with bad feelings
what is forming a human-altruistic value system?
Use loving kindness to extend yourself; Use self-disclosure appropriately to promote a therapeutic alliance with your patient (e.g., share a personal experience in common with your patient such as a child-rearing experience, an illness, or an experience with a parent who needs assistance)
what is knowing the patient?
complex process that occurs over time as a nurse cares for multiple patients and it develops within the context of the nurse-patient relationship
what is the ethic of care?
concerned with relationships between people and with a nurse's character and attitude toward others; sensitive to unequal relationships that lead to an abuse of one person's power over another
what is Kristen Swanson's theory of caring?
developed from three perinatal studies involving interviews with women who miscarried, parents and health care professionals in a newborn intensive care unit, and mothers who were socially at risk and received long-term public health intervention; defines caring as a nurturing way of relating to an individual
what is the caring assessment tool (CAT)?
developed to measure caring from a patient's perspective; help you, as a beginning professional, to appreciate the types of behaviors that patients in the hospital identify as caring
what is Madeleine Leininger's transcultural view of caring?
domain that sets nursing apart from other health care disciplines; skillful activities, processes, and decisions that help people in empathetic, compassionate, and supportive ways. A caring act depends on the needs, problems, and values of a patient
what is caring touch?
form of nonverbal communication, which successfully influences a patient's comfort and security, enhances self-esteem, increases confidence of caregivers, and improves mental well-being
what is protective touch?
form of touch that protects a nurse and/or patient
what is compassion?
help patients recover in the face of illness, give meaning to their illness, and maintain or reestablish connection. Research shows that nursing students identify
what is therapeutic touch?
holistic, evidence-based therapy and is an approved complementary and alternative medicine method
what are Swanson's 5 caring processes?
knowing (Striving to understand an event as it has meaning in the life of the other; Avoiding assumptions; Centering on the one cared for; Assessing thoroughly; Seeking clues to clarify the event; Engaging the self or both), being with (Being emotionally present to the other; Being there; Conveying ability; Sharing feelings; Not burdening), doing for (Doing for the other as one would do for self if it were at all possible; Comforting; Anticipating; Performing skillfully; Protecting; Preserving dignity), enabling (Facilitating the other's passage through life transitions [e.g., birth, death] and unfamiliar events; Informing/explaining; Supporting/allowing; Focusing; Generating alternatives; Validating/giving feedback), and maintaining belief (Sustaining faith in the other's capacity to get through an event or transition and face a future with meaning; Believing in/holding in esteem; Maintaining a hope-filled attitude; Offering realistic optimism; "Going the distance")
what is providing presence?
person-to-person encounter conveying a closeness and sense of caring; involves "being there" and "being with"
what is listening?
planned and deliberate act in which the listener is present and engages the patient in a nonjudgmental and accepting manner; silence yourself and listen with an open mind; Remain intentionally silent and concentrate on what the patient has to say; Give patients your full, focused attention as they tell their stories; When a person chooses to tell his or her story, it involves reaching out to another human being
what is care in nursing practice?
providing presence, touch, listening, knowing the patient, spiritual care, relieving symptoms and suffering, and family care
what is touch?
relational and leads to a connection between nurse and patient
what is Jean Watson's transformative care model?
relationship influences both the nurse and the patient for better or for worse; 10 carative factors
what is caring?
universal phenomenon influencing the ways in which people think, feel, and behave in relation to one another; people, events, projects, and things matter to people