Strengths-Based Nursing Concepts

• Strengths-Based Nursing and Healthcare (SBNH) is a philosophy and value-driven approach.
• SBNH aims to support humanized care and build nursing competency from novice to expert levels.
• SBNH-L is a unique, value-driven approach for leaders/managers, creating equitable and safe workplaces that develop individuals' strengths.
• Agency is the capacity of individuals to act, exert power, and control their lives.
• Agentic refers to an individual's power to control their goals, actions, and destiny.
• Autonomy is the ability to act freely with one's knowledge and professional capacities without inhibitions or bureaucracy.
• Structural empowerment focuses on how nurses become empowered by their work structures, from an organization-centric perspective
• Psychological empowerment involves an employee's intrinsic motivation and experiences at work, influenced by perceived meaning, competence, self-determination, and impact, which are supported thru workplace structure.
• SBNH relies on eight values and four foundations.

Eight Values of SBNH

• Self-determination
• Goodness-of-fit
• Timing, readiness, and learning
• Collaborative partnerships
• Systems thinking
• Uniqueness
• Health and healing
• Multiple perspectives and creating meaning

Four Foundations of SBNH

• Person/family centered
• Empowerment/agency
• Relationship focused
• Innate health capacities/healing mechanisms
• SBNH, developed by Laurie Gottlieb (2021), is based on the work of Florence Nightingale, the McGill Model of Nursing, and the Developmental Health Framework.
• SBNH is a paradigm shift from disease-focused, deficit-based care models, common in healthcare systems.
• The approach involves working with the inner and outer strengths of a person and their family.

Ten Recommendations to Enhance SBNH and SBNH-L Practices

• Promote Curiosity: Foster a learning environment that encourages inquiry.
• Enhance Critical Thinking: Use creative, playful learning methods
• Focus on Relational Aspects: Emphasize relationships in learning activities
• Use SBNH Values as a Guide: Link values in interactions explicitly
• Apply SBNH Foundations: Integrate reflective practices systematically
• Uncover Strengths: Identify strengths using ongoing processes, not just initial evaluations.
• Act in Partnership: Foster reciprocal, power-sharing relationships
• Promote Salutogenesis: Create supportive environments that encourage health.
• Continuous Learning Culture: Engage in training that promotes ongoing skill development
• Visionary Perspective: Inspire excellence in nursing care through evidenced-based practices.
• Transformational Leadership motivates followers by appealing to higher ideas and moral values.
• Leaders that are persuasive can motivate actions that sustain the greater good, rather than only their own interests.
• Transformational leadership is best used in conjunction with other leadership skills to optimize a workgroup's performance.

Four I's of Transformational Leadership

• Idealized influence: Behaving as role models by demonstrating ethical standards, values and behaviors.
• Inspirational Motivation: Motivating and inspiring by creating a compelling vision
• Intellectual Stimulation: Stimulating innovation and creativity by challenging critical thinking to explore new ideas.
• Individual Consideration: Acting as coaches and mentors, providing personalized support, recognizing individuals needs, and celebrating diversity.

Transformational Leader's Five Habitual Practices

• Modelling the way
• Inspiring shared vision
• Challenging the process
• Enabling others to act
• Encouraging the heart
• A transformational leader is the most effective model of leadership
• It recognizes rewards and satisfies followers' higher needs by engaging them emotionally and intellectually.
• The concept of workplace psychological safety was initially defined in 1965.
• Workplace psychological safety allows one to take chances without fear and with sufficient protection.
• Psychologically safe environments allow nurses develop interpersonal relationships that seen as supportive and trusting.
• There is a view for healthcare teams to share ideas openly and constructive criticism that is supportive rather than destructive.
• It is helpful to encourage questions, voice potential concerns and brainstorm new ideas.
• The benefits of speaking up about a concern will outweigh potential embarrassment.
• Psychological safety is associated with more effective team learning and improved performance.

Three ways to cultivate psychological safety

• View situations as learning opportunities, where each person's perspective is valued, as no one knows everything from the start
• Acknowledge their own fallibility and create in a safe space where they are allowed to make mistakes
• Model curiosity by asking questions and encouraging discussions
• Psychological safety is vital for enhanced learning, effective risk management, innovation, and job satisfaction in healthcare.

Strategies to promote psychological safety

• Create opportunities for dialogue and reduce perceived barriers
• Foster a professional practice environment that emphasizes collegiality, civility, and accountability
• Promote shared governance and encourage staff feedback
• Model openness and fallibility
• Collect and review data and employee performance metrics
• Develop transition support programs for novice nurses
• Offer opportunities to enhance education
• Shared governance models are important in professional practice environments
• Canadian nurses face challenges including nursing retention and shortages, excessive workloads, return of nurses after COVID, and integration of internationally educated nurses.
• According to a 2022 national survey of 4,467 practicing nurses, 94% suffer from burnout symptoms.
• 45% of nurses experienced severe burnout up from 29% pre-pandemic.
• Nurses in BC said 82% experienced a decline in their mental health during the pandemic.

Main Root Causes of Nursing Issues

• Inadequate forecasting methods
• Nursing shortages and insufficient staff
• Workloads and unhealthy workplaces
• Insufficient funds for the health sector
• Poor data for planning
• Poor nursing planning and short-term

Three Critical Rs of Nurse Workforce Sustainability

• Retain and Support: Reduce workloads, create safe workplaces, provide mental health supports, and targeted career initiatives.
• Return and Integrate: Return nurses to the public sector, return nurses from leaves or retirement, and integrate internationally trained nurses.
• Recruit and Mentor: Expand training programs and diversify, support trainees in underserved communities, and promise recruitment strategies
• NSCL is defined as applying theory and practice-derived knowledge, demonstrating competence in communication, having clinical knowledge, and being a role model from the start.

Three required attributes of nursing student clinical Leadership:

• Interprofessional competence is an ability to openly communicate with patients, applying constructive feedback, supervision and appraisal so they motivate other team members.
• Contemporary evidence-based clinical knowledge requires leaders to apply knowledge to issues, support team members to deliver care, and inform patients, creating priorities that react to challenges
• Being a role model needs clinical leaders who can reflect on insights, showing their values and skills.

Types of illustrative cases

• Model Case: An example that explains and illustrates what NSCL leadership is.
• A nursing student demonstrates leadership by teaching and working with a patient and first-year student.
• Borderline Case: An example that embodies some element of NSCL, but still falling short.
• A nursing student performs okay, but is unable to make colleagues into engaging leaders.
• Contrary Case: This is an example that doesn't align to the values of NSCL.
• A nursing student shows their bad leadership skills by not communicating for a patient's needs.
• Shared Decision-Making is the name of a partnership that has leaders making decisions when nurses have the insights that will improve patient health.
• As the definition states, accountability gets in the way of quality and excellence.
• To organize clinical standards in healthcare settings, shared govenance is used to improve quality of work, with an outcome that professional development research is well-implemented.
• Shared decision-making is patient-centered, but shared governance is organizational and involves healthcare professionals.

Conflict in health care environments

• Intraprofessional: Difficulty related to relationships, with personal and professional consequences
• Interprofessional: Conflicts tend to arise from disagreements patient related tasks

Five resolutions for conflict management

• Focus on issue rather than personal opinions.
• Concentrate on the issue rather an making assumptions
• Generate variety of options for resolution
• Agreements should be assessed objectively
• Prepare appropriately for potential failures
• Nursing is important from CNO competencies that need to apply in the healthcare partnership team settings
• All RNs have competencies that go into the collaborative roles that need to exist in practice
• Racisim is “institutional, cultural and interpersonal patterns and practices” that favour white individuals
• Sexism is discriminatory practices against both women and men

Definitions for the EDI framework

• Ableism: A process of thinking and believing that ables are the perfect model for what it is to be human, and thinking otherwise is an essential trait of the inferior
• Disability: Not fully considered of being deemed the perfect human
• Within EDI: a process that allows for implementing diversity practices that track down groups underrepresented
• Inclusion: is more complex, as it integrates groups with decision-making processes
• Equity: Often leads to social change to remove barriers, take any action against historical injustices
• Human rights: Recognized/protected entitlements to live as a human
• Patriarchy: Insists that men are dominating and should rule by violence

Two factors of EDI

• Demographic Shift: Low birth rates and immigration
• Wealth inequality: 1% controls about half the world's wealth
• Mobilized movements: Factor of more inclusion of the black lives matter groups
• Research microaggressions: Insults towards marginalized groups from different groups

Types of Microaggressions

• Microassaults: Are overt and use offensive terms to demean or attack biases against those who are different
• Microinsults: rude actions that disregard a person
• Micro invalidations: Unintentional behaviours that minimize feelings a discrimated person For employers, it is important to promote the the well-being for the EDI framework so they can implement it

Strategies to microaggression

• Call out people and their behaviour
• Seek support
• Educate or call out to the perpetrator
• Individuals and groups show similar commitments to core principles and outcomes.
• Ally ship*

Examples

• Men are showing they align with feminists

• White people align to black people to show support

• It is normal to assume everyone is into hetero relationships

• It is normal to assume everyone is sis-gendered

• Gender identity: Can be both, neither, or not

• Gender expression: How a person appears in terms of hair, language expression, and voice

• Sexual Orientation: Who a person likes

• Racism has been an ongoing detrimental effect that can cause internal and external damage

• National commission of racism was in 2021 to address black nurses

• Best practice create LGBTQ environments

Interpersonal

• Quality needs the use of inclusive and respectful terms when taking down rapport
• Visual need visual art cues
• Admin covers first interaction with a patient
• Workforce culture should include leadership and procedure
• Clear steps through training to implement care, including specific knowledge areas and procedures
• Data service assessment

Developmental areas of inclusive leadership

• Creating change
• Vision
• Building relationships
• Self awareness
• An approach that upholds worthiness through shared responsibility
• DEI is a 4 step plan

1. Share perspective
2. Enhance collab
3. Data vision
4. Accountable

• There is an impactfull calling:
• "Call in": a conversation aimed at addressing microaggression that is biased in a compassionate manner
• "Call Out": public confrontation against organizations
• Call for actions 24 in 2008 asked medical students to take classes for Aboringal students and treaties

Important to know when action is being taken

• To involve difficult conversation with those who are willing When "calling in" or "Calling out" it is important to involve:
• Influence relationship
• Immediate harm
• Safety will be given the opportunity of well-being
• Involve openness of prior attempt ex.
• What didyou meant to say
• Show the impact of the words Listen to each sides perspective

Response:

• Pausing to reflect
• Listening in a trustworthy matter
• Respond
• Avoid being critical of themselves
• Do not make the process out to be burdensome
• In 2020 chief diversity shows DEIB framework
• Public health address adverse effects from communities
• Letters are presented, leadership in organizations for different individuals to be equal and show their unique challenges
• Toronto is Dish with One Spoon
• 6000 Canadians shared their accounts,
• There are 94 steps for indigenious to have actions done to support actions target healthcare which have impacted idengeounous peoples

Indigenous

• 19th century, assimilation through traumas and neglect
• In 1909, 8000/10000 students died in a tragic manor from residential schools,
• Must incorporate human rights with new teachings and practices
• "Allies that support, do no take" is one ideal in the work that must be done.
• Jordan and Joyce principles support and help guide healthcare
• Indigenous issues relate to communication
• Ramseden 5 principle for health pros:
• Reflect on actions
• Minize power
• Engage people
• Deconolizaiton via leaning

Ineffective

• Communication
• Negative experineces
• Intuitional, where culture can be safe
• Rejection
• "CPR" is a safe enviroment
• Culture must respect people as diverse cultures and show the potential of everyone.

Explore Strengths-Based Nursing and Healthcare (SBNH), a philosophy supporting humanized care and nursing competency. Understand agency, autonomy, and empowerment within nursing practice. Learn how SBNH principles foster equitable and safe workplaces.