ICU Nursing: A Holistic Approach

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Questions and Answers

What is a potential communication breakdown between doctors and nurses, according to the texts?

  • Doctors and nurses may have differing values due to their professions. (correct)
  • Nurses focus on patients' physical needs, while doctors prioritize psychological care.
  • The focus on emotional care could limit nursing's recognition as a profession.
  • Doctors are more concerned with performing technical procedures, nurses focus on the patient's emotional needs.

What does the text suggest is the role of ICU nurses in relation to doctors?

  • ICU nurses should prioritize psychological care, while doctors focus on physical needs.
  • ICU nurses should collaborate with doctors, but maintain their own unique role and values. (correct)
  • ICU nurses should act as assistants to doctors, primarily carrying out their instructions.
  • ICU nurses should act as technicians, performing tasks under the direction of doctors.

What is the difference in focus between ICU nurses and patients, according to Cochran and Ganong (1989)?

  • ICU nurses are concerned with psychosocial stressors, while patients are more concerned with their physical care. (correct)
  • ICU nurses are more concerned with emotional costs, while patients are more concerned with practical needs.
  • ICU nurses prioritize the patient's physical needs, while patients are more concerned with their emotional well-being.
  • ICU nurses focus on technological tasks, while patients prioritize holistic care.

What is the significance of the increasing emphasis on psychology in the nursing profession?

<p>It emphasizes the importance of psychological care as an essential part of holistic patient care. (D)</p> Signup and view all the answers

How does the text address the potential for robots to replace ICU nurses?

<p>The text acknowledges that robots could replace nurses in some technical roles, but emphasizes the unique and irreplaceable role of nurses in providing holistic care. (A)</p> Signup and view all the answers

What does the text suggest is a key factor in ensuring effective collaboration between ICU nurses and doctors?

<p>A clear understanding of each other's professional values and roles is essential for effective communication. (B)</p> Signup and view all the answers

What does the text suggest is the potential consequence of the gap between nurses' and patients' priorities?

<p>This gap can lead to misunderstandings and communication breakdown between nurses and patients. (A)</p> Signup and view all the answers

How does the text present the concept of 'holistic care' in the context of ICU nursing?

<p>Holistic care involves addressing both the physical and emotional needs of the patient, going beyond technical procedures. (C)</p> Signup and view all the answers

What can be considered a covert socialisation in nursing?

<p>The use of 'pyjama suits' in intensive care units (A)</p> Signup and view all the answers

What is a key limitation of the behaviourist theory in nursing, as discussed in the text?

<p>It does not account for internal motivators and values (B)</p> Signup and view all the answers

Which of the following is NOT considered a characteristic of the behaviourist approach to nursing?

<p>Recognition of internal motivators (C)</p> Signup and view all the answers

What is the 'hidden curriculum' in nursing education, as described by Holloway and Penson (1987)?

<p>The unspoken norms and values transmitted through the learning environment (A)</p> Signup and view all the answers

How does the text suggest that humanism can be integrated into nursing practices?

<p>By adopting Maslow's hierarchy of needs in nursing models (B)</p> Signup and view all the answers

What is the implication of the statement "People can adopt various behaviours in response to external motivators (e.g. senior nursing/medical staff), but once stimuli are removed, behaviour may revert"?

<p>Behavioral changes achieved solely through external motivators are often temporary (D)</p> Signup and view all the answers

What is the main implication of the reference to Pavlov’s animal experiments in the context of nursing?

<p>Behaviourist theory, based on animal studies, may not fully account for human complexity (C)</p> Signup and view all the answers

How is the behaviourist theory, according to the text, related to social control?

<p>It promotes a single set of socially desirable behaviours in the nursing profession (A)</p> Signup and view all the answers

How does the ICU nursing environment sometimes challenge traditional nursing values?

<p>The emphasis on technology can lead to a dehumanized approach to patient care. (A)</p> Signup and view all the answers

What is the primary reason for placing the chapter on nursing perspectives first in the book?

<p>To establish a foundational understanding of nursing values before delving into specific medical treatments. (C)</p> Signup and view all the answers

What does the text suggest is the fundamental basis for the economic value of ICU nursing?

<p>The nurses' personal values and beliefs. (B)</p> Signup and view all the answers

Which of the following is NOT a way ICU nursing can assert its value?

<p>Focusing on the technical aspects of nursing care. (D)</p> Signup and view all the answers

What is the main argument made by the text regarding the role of ICU nurses?

<p>ICU nurses play a vital role in creating a humanized environment for their patients. (A)</p> Signup and view all the answers

How does the text suggest that nurses can best ensure their patients' needs are met?

<p>By prioritizing the patient's experience and perspective. (D)</p> Signup and view all the answers

What is a key takeaway concerning the role of nurses in technology-driven healthcare environments, as presented in the text?

<p>Nurses should embrace technology while prioritizing patient-centered care. (A)</p> Signup and view all the answers

How does the concept of person-centered care apply to ICU nursing?

<p>It requires nurses to be present for their patients, providing emotional support in addition to medical care. (D)</p> Signup and view all the answers

What are some common 'hospital' smells experienced in the ICU?

<p>Disinfectant and body fluids (D)</p> Signup and view all the answers

What psychological condition is noted to occur more frequently in ICUs compared to general wards?

<p>ICU psychosis (D)</p> Signup and view all the answers

What are hallucinations and psychosis considered in the context of patient care?

<p>Forms of psychological pain (B)</p> Signup and view all the answers

What physiological responses result from stress in an ICU environment?

<p>Tachycardia and hypertension (B)</p> Signup and view all the answers

Which of the following can reinforce perceptions of deprivation in ICU patients?

<p>Abnormal human smells like perfume (C)</p> Signup and view all the answers

What can cause hallucinations in healthy adults after a period of sensory deprivation?

<p>Acute psychotic reactions (A)</p> Signup and view all the answers

Why might patients in the ICU perceive nurses as tormentors?

<p>Misinterpretation of their own hallucinations (C)</p> Signup and view all the answers

What is one effect of catecholamine release in response to stress?

<p>Increased oxygen consumption (C)</p> Signup and view all the answers

What is a key conflict associated with humanism in research methodologies?

<p>Individualism versus objective approaches (C)</p> Signup and view all the answers

How do inner values influence nursing practices according to humanist ideals?

<p>They ensure that changes in practice are sustained over time. (C)</p> Signup and view all the answers

What does humanist education prioritize over factual knowledge?

<p>Development of critical thinking skills (B)</p> Signup and view all the answers

What is one limitation of training compared to humanist education in nursing?

<p>Training equips learners to respond reactively to situations. (B)</p> Signup and view all the answers

How does over-familiarity with terms in humanism affect their application in nursing practice?

<p>It simplifies complex concepts into clichés. (B)</p> Signup and view all the answers

What was the primary focus of behaviourist education as opposed to humanist education?

<p>Achieving conformity among learners (A)</p> Signup and view all the answers

Why are stimulus-response reactions significant in a nursing context?

<p>They offer immediate guidance during emergencies. (A)</p> Signup and view all the answers

What aspect of humanism makes it compatible with healthcare and nursing?

<p>Concern for inner values and holistic care. (C)</p> Signup and view all the answers

What role do discharge liaison nurses play in the ICU setting?

<p>They facilitate discharge planning and reduce psychological stress. (D)</p> Signup and view all the answers

Which of the following should be included in post-discharge support for patients?

<p>Follow-up clinics and discharge liaison nurses. (C)</p> Signup and view all the answers

What is a primary consideration for nurses when facilitating patient sleep in the ICU?

<p>Planning care to include four sleep cycles lasting at least 90 minutes. (A)</p> Signup and view all the answers

What is the significance of maintaining sensory balance in the ICU?

<p>It helps manage psychological health and reduces stress-related complications. (D)</p> Signup and view all the answers

What factor can contribute to sensory imbalance in patients?

<p>Sleep deprivation in terms of quality or quantity. (C)</p> Signup and view all the answers

How can nurses create a psychologically 'safe' environment for patients?

<p>Through maintaining confidentiality and privacy. (D)</p> Signup and view all the answers

What is one of the main roles of relatives in patient care as per the ICU practices?

<p>To participate in care and share news or provide touch. (B)</p> Signup and view all the answers

What is an important aspect of continuing education for ICU staff related to sensory imbalance?

<p>It raises staff awareness of sensory imbalance. (B)</p> Signup and view all the answers

Flashcards

Healthcare Assistants

Individuals trained to perform technical tasks in healthcare, often at a lower cost.

ICU Nurse Roles

ICU nurses play a vital role beyond being technicians; they provide holistic and emotional care.

Doctor-Nurse Relationships

The nature of interactions between medical staff and ICU nurses, often influenced by terms set by doctors.

Communication Breakdown

Potential failure in understanding due to differing values between nurses and doctors.

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Nursing Values

Core beliefs that guide nursing practices, especially in intensive care settings.

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Psychological Needs

Emotional and mental requirements of patients, integral to holistic nursing care.

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Cognitive Dissonance

A conflict between the care focus of ICU nurses and the needs expressed by patients.

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Holistic Care

An approach to patient care that considers emotional, psychological, and physical aspects.

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Behaviorism

A theory focusing on observable behaviors and their responses to stimuli.

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Conditioning

The process of learning through association between stimulus and response.

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Hidden Curriculum

Unspoken or implicit values and norms taught in educational settings.

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Gagne's Influence

The impact of Robert Gagne on educators in focusing on behaviorist culture.

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Maslow's Hierarchy of Needs

A psychological theory outlining human needs from basic to complex.

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Covert Socialisation

Unseen influences that shape behaviors and values in a group.

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External vs Internal Motivators

Factors that drive behavior can be external (outside) or internal (inside).

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Observable Behaviors

Actions that can be seen and measured; central to behaviorism.

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ICU smells

Unusual odors in the ICU, like disinfectants and body fluids.

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Sensory imbalance

Abnormal sensory inputs can lead to misinterpretation of environments.

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ICU psychosis

Hallucinations and psychological imbalances occurring in ICU patients.

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Psychological pain

Experiences of stress or fear affecting mental health, similar to physical pain.

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Hallucinations in ICU

Vivid and often terrifying sensory experiences reported by ICU patients.

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Stress response

Physiological changes caused by stress, including increased heart rate and blood pressure.

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Catecholamine release

Hormonal response to stress causing hyperdynamic circulation effects.

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Vitamin deficiencies and taste

Lack of vitamins can alter a person’s taste perception.

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Technical Knowledge in Nursing

The essential skills and knowledge required for nursing practice, especially in critical areas like ICU.

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Holistic Patient-Centred Care

An approach where nurses focus on the overall well-being of patients, prioritizing their experiences and perspectives.

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Value of ICU Nursing

Recognizing the unique contributions of ICU nursing, including both technical skills and patient care.

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Importance of Self-Awareness in Nursing

The understanding of one's values and beliefs as a nurse, enhancing personal and team effectiveness.

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Multidisciplinary Team in ICU

A collaborative group of healthcare professionals from various disciplines working together for patient care.

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Economic Value of Nursing

The financial worth of nursing, influenced by nurses' beliefs, attitudes, and the care they provide.

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Patient Experiences in ICU

Understanding how patients perceive and feel about their care in the intensive care setting.

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Technological Aspects of ICU Nursing

The knowledge and skills related to technology that ICU nurses must integrate into their practice.

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Primacy of the Individual

A fundamental humanist belief prioritizing the individual's experience and values.

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Objective Decontextualisation

The removal of context in traditional scientific methods, making them less applicable to human experiences.

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Inner Values

Core beliefs and principles that influence an individual's actions beyond external motivators.

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Holistic Approaches

Methods of care that consider the whole individual, integrating physical, emotional, and social factors.

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Training vs. Education

Training focuses on specific responses, while education promotes critical thinking and personal growth.

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Higher Cognitive Skills

Advanced thinking skills that enable individuals to analyze and solve complex problems.

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Stimulus-Response Reactions

Automatic responses to stimuli, often simplistic and conditioned, such as Pavlov's dogs.

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Lifelong Learning

An ongoing, voluntary process of learning, emphasizing personal development throughout life.

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Psychological stress in ICU

Psychological stress can increase during transfer from ICU, affecting recovery.

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Liaison nurses

Nurses who assist in discharge planning and support following ICU discharge.

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Post-discharge support

Support services provided to patients after leaving ICU, such as follow-up clinics.

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Significance of sleep

Facilitating sleep is crucial for patient recovery and psychological well-being.

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Circadian rhythm

The body’s natural sleep-wake cycle that can be influenced by environmental factors.

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Relatives involvement

Encouraging family participation in patient care can provide support and reduce stress.

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Sensory overload/deprivation

Excessive or insufficient sensory input can provoke stress responses in patients.

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Study Notes

ICU Nursing: A Holistic Approach

  • ICU nursing requires more than technical skills; it involves a unique blend of technical knowledge and a holistic, patient-centered approach.
  • Nurses need to define their role actively within the ICU specialty by emphasizing nursing values.
  • Collaborating with doctors is vital but should not compromise nursing's unique role, which includes aspects of technology and potentially, service roles.

Doctor-Nurse Relationships

  • Good relationships between doctors and nurses in high dependency areas are reported, but sometimes on terms set by doctors.
  • Differences in values and communication styles between doctors and nurses can lead to breakdowns in communication.
  • Nursing's focus on patient emotional needs may limit wider recognition of nursing as a profession.
  • Collaboration between nurses and doctors requires understanding and respect for each other's roles.

Psychological Needs of Patients

  • ICU nurses focus on the psychosocial stressors of patients, which contrasts with doctors' focus on physical needs.
  • There's a cognitive dissonance between nurses' emphasis on psychological support and patients' concerns about physical care, and intervening accordingly.
  • Psychological support, including handling patient sensory experiences, is crucial to holistic care.

Economic Value of ICU Nursing

  • ICU nursing is labor-intensive, consuming significant hospital budgets.
  • Nurses can assert their value through recognizing nursing knowledge and offering holistic patient-centered care, which includes being present for patients, not just the institution.
  • Nurses' beliefs and attitudes directly impact the perceived and ultimately, actual economic value of ICU nursing.

Sensory Imbalance in ICU

  • Sensory imbalance (overload and deprivation) causes altered environment interpretation – hallucinations and "ICU psychosis."
  • Psychological distress in ICU is higher than on general wards, a fact that must be addressed.
  • Sensory imbalances lead to a stress response in both patients and healthcare professionals.
  • Hallucinations from sensory imbalance can be vivid and frightening, necessitating careful assessment and care.

Stress Response in ICU

  • Stress triggers physiological responses ("fight-or-flight"), including tachycardia, vasoconstriction, and hypertension, to aid in that response.
  • Transfer from ICU can cause additional psychological stress, and liaison nurses can improve discharge planning and aid in post-discharge support, but significant problems sometimes persist.
  • Discharge liaison nurses, follow-up clinics, and patient support are beneficial and recommended.

Implications for Practice

  • Nurses play a crucial role in supporting psychological needs and sensory balance.
  • Sleep monitoring and facilitation are critical ICU nursing roles.
  • Nurses should promote healthy sensory environments and encourage family involvement.
  • The need for continuing education on sensory overload and stress is highlighted.
  • Nurses need to consider the patient perspective to avoid overlooking potential problems.

Humanistic vs. Behaviorist Approaches

  • Behaviourist approaches to ICU care often focus on outward, observable behaviors, like the role of uniform design or social conditioning.
  • However, internal factors influence behaviors. These may include values, beliefs and individual differences.
  • Humanism prioritizes the individual, which challenges the objectivity of scientific research methods.
  • Humanistic education focuses on inner values, fostering personal growth, and promoting individuality – valuable for long-term improvements.
  • ICU environments should encourage holistic assessments and acknowledge patient individuality.

Technological Aspects of ICU Nursing

  • Training healthcare assistants, and perhaps robots, in technical tasks can reduce costs.
  • Nurses are more than just technicians but must understand and apply their unique knowledge and technical expertise to patients' treatment and recovery, including understanding patient reactions to various technologies.

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