NCM 103 Fundamentals of Nursing Pre-Midterm PDF

PHILIPPINE LAST FRONTIER COLLEGE, INC College of Nursing NCM 103: FUNDAMENTALS OF NURSING Reference: Fundamentals of Nursing: Standards and Practice (4th Edition) Author: Sue C. DeLaune & Patri...

PHILIPPINE LAST FRONTIER COLLEGE, INC College of Nursing NCM 103: FUNDAMENTALS OF NURSING Reference: Fundamentals of Nursing: Standards and Practice (4th Edition) Author: Sue C. DeLaune & Patricia K. Ladner Course Instructor: Marlina T. Abbas, MAN, RN, KSA-RN, CSE ________________________________________________________________________________________________________________________________ UNIT 1: INTRODUCTION NURSING The term nurse originated from the Latin word Nutrix, which means to nourish. While the origin of the word has influenced atleast some descriptions of nursing, a satisfactory definition remains elusive. Nurse themselves often disagree ever the most appropriate definition, and arriving at once acceptable to everyone is probably impossible. However, most persons will agree that nursing maybe viewed as both an art and science. It is an art because it is concerned with skills that require proficiency and dexterity. It is a science because it requires the systematic application of scientific knowledge. Nursing is involved in the delivery of health care society. Health care - is the total of all services by various health disciplines. Health Practitioner – is one engaged in the practice of dispensing health care services. Consumer – refers to the person who uses a service. (a health-care consumer uses health care services.) Patient- the recipient of a health care whenever well or ill. (Client is used as synonym for patient.) Although differences between client and patient is not clear cut, client is most often used when speaking persons receiving care in an ambulatory setting, especially when health maintenance rather than illness care is the primary service offered. Since most health personnel continue to use the word patient, and for ease of reading, this text will use this term. Nursing today has certain Characteristics: ▪ Nursing is caring a quality that has been characteristics of nursing since its inception. It continues to be guarded fervently. ▪ Nursing involves close, personal contact with the recipient of care. ▪ Nursing is concerned with services that take human into account into physiological, psychological and sociological organism. ▪ Nursing is committed to personalized services for all persons without regard to color, creed, social or economic status. ▪ Nursing is committed to promoting individual, family community and national health goals in the best manner possible. ▪ Nursing is committed in involvement in ethical, legal, and political issues in the delivery health care. Nursing has undergone an evolutionary process to meet the changing needs of society. Since current trends and practices are influenced historical events, the nurse should have knowledge about the major events and circumstances that have influence the discipline. CARATIVE ELEMENTS Caring is the antitheses of simply using the other person to one’s needs. Mayeroff (1971) suggests that the meaning of caring is not confused with such meanings as wishing well liking, comforting and maintaining or having an interest in what happens. Dolores Gaet – caring is related to attention to or concern about, responsibility for or providing for regard or fondness of. Madeline Leininger – caring is an essential human need for full development, health maintenance and survival of human beings in all world cultures. 14 CARATIVE ELEMENTS 1. Human Altruistic Value System 2. Faith and Hope 3. Sensitivity to self and others 4. Helping trust relationship 5. Ability to accept positive and negative expressions of feelings 6. Interpersonal teaching and learning abilities 7. Personality type 8. Solid family background 9. Experiencing of having been loved and the ability to love 10. Spiritual life 11. Sense of humor 12. Relaxed attitude 13. Open-mindedness 14. Quick decision making TWO MODES OF COMMUNICATION 1. Verbal Communication - exchange of information using words: spoken or written. 2. Non-verbal communication – transmission of messages without the use of words. Eye Contact Modes of dressing/grooming Facial Expression Sounds Posture Voice Infliction Gait Silence Gestures touch Physical appearance 5 ELEMENTS OF THE COMMUNICATION PROCESS 1. Referent – stimulus motivates a person to communicate with another. it may be object, emotion, idea or act. 2. Sender – encoder, originator of message planner, person who initiates the interpersonal communication or message. 3. Message – information that is sent or expressed by the sender. 4. Receiver – listener, decoder, person to whom the message is sent, the one who receives the message. 5. Response – Feedback – the way in which the sender determines whether the receiver got the message he intended, message that the receiver returns to the sender. THE COMMUNICATION PROCESS a. An important aspect of human relations. b. A basic tool utilized to collect data c. A basis for implementing quality client care and for achieving goals of health care. Define Communication a. Sharing information or the process of generating and transmitting meanings. b. Interchange of information between two or more people; exchange of ideas. Communication – is the transference and understanding of meaning. If no information or ideas have been conveyed communication has not taken place. A transmitted thought or idea must be perceived by the receiver exactly the same as it envisioned by the sender. FUNCTIONS OF COMMUNICATIONS: a. Establishes relationship between the persons involved in the communication act. b. Imparts new information and reinforces a person’s knowledge. c. Directs the receiver in some way to change behavior, stimulate thought, provoke questions, entertain, reinforce and change attitudes. d. Makes the receiver adopt the idea as part of his regular behavior. 10 BARRIERS TO EFFECTIVE COMMUNICATION 1. Giving an opinion 2. Offering false reassurances 3. Being defensiveness 4. Showing approval or disapproval 5. Stereotyping 6. Asking why 7. Changing the subject inappropriately 8. Advising 9. Probing/Testing/Challenging 10. Failure to listen PHASES OF INTERVIEW 1. Pre-interaction Phase- this phase is important because it is assumed that what the health worker feels, thinks and does during this time may affect her interaction with the client. 2. Orientation Phase – begins when the client meet for the first time. 3. Working Phase - longest phase, interaction is the essence of the working phase. 4. Termination Phase- it occurs when the conclusion of the initial agreement is acknowledged. Terminating the relationship is expected to be difficult and filled with ambivalence. It is natural to some feelings of loss and each person needs to develop a way of saying goodbye. METHODS OF EFFECTIVE COMMUNICATION Communication Techniques are utilized to: 1. Achieve the goals of establishing a relationship 2. Develop trust 3. Encourage client to verbalize about his problems 25 Communication Techniques 1. Giving information 13. listening attentive 2. Giving recognition 14. Verbalizing the implied 3. Showing acceptance 15. Encouraging comparison 4. Offering oneself 16. Translating into feelings 5. Making observations 17. Placing events in sequence or time 6. General leads 18. Stating reality 7. Giving broad openings 19. Voicing doubt 8. Encouraging description of perception 20. Seeking consensual validation 9. Seeking clarification 21. Silence 10. Restating 22. Encouraging evaluation 11. Reflecting 23. Suggesting collaboration 12. Exploring 24. Encouraging formulation of plan action 25. Summarizing Non-Therapeutic Techniques a. Interfere with effective communication b. Distort a listener’s interpretation c. Produce anxiety d. Block communication e. Prevent development of rapport and trust Therapeutic Techniques No. TECHNIQUE DESCRIPTION EXAMPLES 1 Using silence Accepting pauses or silences that Sitting quietly (or walking with the extends for several seconds or client) and waiting attentively until the minutes without interjecting any client is able to push thoughts and verbal response feelings into words. 2 General Leads Using statements or questions that “Can you tell me how it is for you?” (a) Encourage the client to verbalize perhaps you would like to talk about…” (b) Choose a topic of conversation (c) Facilitate continued verbalization 3 Restating or Actively listening for the client’s “You have difficulty eating yesterday” Paraphrasing basic message and then repeating those thoughts and or feelings in Client: “Yes, was very upset after my similar words. This convey that the family left.” nurse has listened and understood the client’s basic message and also “You find it difficult in talking to people offers clients a clearer idea of what you do not know” they have said. 4 Seeking Clarification A method of making the client’s broad overall meaning of the “I’m puzzled” message more understandable. It is used when the communication is “I’m not sure I understand that” rambling or garbled. To clarify the message, the nurse can restate the “Would you tell me more?” basic message or confess confusion and ask client to repeat or restate “I meant this rather than that” the basic message. Nurses can also clarify their own message with “I’m sorry that wasn’t very clear” statement. 5 Seeking Consensual A method similar to clarifying that “You mean he has never given you a validation verifies the meaning of specific present for your birthday or words rather than the overall Christmas?” meaning of the message. 6 Offering oneself Suggesting one’s presence, interest “I’ll stay with you until your daughter or wish to understand the client arrives” without making any demands or attaching condition that the client “We can sit here quietly for a while, we must comply with to receive the don’t need to talk unless you would nurse’s attention. like to” 7 Giving Information Providing in a simple and direct “Your surgery is scheduled for 1pm manner, specific factual information tomorrow” the client may or may not request. When information is not known, the “You will feel pulling sensation when nurse states this and indicates who the tube is removed from your has it or when the nurse will obtain abdomen” it. 8 Stating Reality Helping the client differentiate the “That telephone ring came from the real from the unreal. program or television” “Your magazines is here in the drawer, it has not been stolen.” No. TECHNIQUE DESCRIPTION EXAMPLES 9 Reflecting Directing ideas, feelings, questions “What do you think you would be or content back to the clients to helpful?’ enable them to explore their own ideas and feelings about the situation. 10 Summarizing Stating the main points of the “Tomorrow afternoon we may explore discussion. To clarify the relevant this further” points discussed. This technique is useful at the end of an interview or “In a few days I’ll review what have you to review a health teaching session. learned about the action and effect of It often act as an introduction to your insulin” future care planning. 11 Showing acceptance Indicating reception, recognizing the “Yes” other person without inserting own values or judgement; maybe verbal “I follow what you said” or non-verbal; with or without understanding. Nodding 12 Listening attentively An active process of receiving Maintaining eye contact and receptive information and examining one’s non-verbal communication reaction to messages received. 13 Broad opening Allowing the client to take initiative “Is there something that you would like in introducing the topic. to talk about” “Where would you like to begin” 14 Encouraging Asking that similarities and “Was it something like…” Comparison differences be noted. “Have you had similar experiences?” 15 Encouraging Asking the client what he or she “Tell me when you anxious” description of perceives. perception “What does the voice seem to saying?” “What is happening” 16 Exploring Delivering further to subject or idea “Tell me more about that” “Would you describe it more fully?” “What kind of work” 17 Placing an event in Clarifying relationship of events in “What seemed to lead up to…” time or sequence time “Was it before or after?” “When did this happen?” 18 Suggesting Offering to share, to strive to work “Perhaps you and I can discuss and Collaboration with the client for his benefit. discover the triggers of your anxiety?” 19 Voicing Doubts Voicing uncertainty about the patient’s statements, perception and “I find it hard to believe” conclusion No. TECHNIQUE DESCRIPTION EXAMPLES 20 Verbalizing the implied Rephrasing patient’s words to Nurse; are you thinking of killing your highlight an underlying message to self?” clarify statements 21 Encouraging Evaluation Asking for patient’s views of the “What do you think led the court to meaning or importance of commit you here?” something. “Can you tell me the reasons why you don’t want to be discharged?” 22 Giving In dealing with clients, their interest Recognition/Empathy should be the nurse’s greatest concern. Thus, emphasizing with them is the best technique as it acknowledges the feelings of the “I see you are sad, how can I help you?” clients and at the same time it allows a client talk and express his or her emotions. Here a bond can be established that serves as a foundation for the nurse-client relationship. 23 Encouraging “If you decide to leave home when your formulation of a plan of Step by step actions will be needed husband beat you again what will you action do next?” 24 Stating he observed/ Verbalizing what is observed in the “You sound angry” making observation patient to, for evaluation and to “You appear teased” encourage discussion. 25 Interpreting/translating Providing a view of the meaning or “That towel must always be with you” into feelings importance of something.