Week+4+Caring%2Bin%2BNursing%2Bpractice-1++Review+Slides+_1_.pptx

Caring in Nursing Practice Copyright © 2017, Elsevier Inc. All Rights Reserved. Copyright © 2017, Elsevier Inc. All Rights Reserved. 2 Objectives Discuss Compare and contrast Discuss the role that caring plays in the nurse-patient relationship. Compare and contrast theories on caring. Discuss Discus...

Caring in Nursing Practice Copyright © 2017, Elsevier Inc. All Rights Reserved. Copyright © 2017, Elsevier Inc. All Rights Reserved. 2 Objectives Discuss Compare and contrast Discuss the role that caring plays in the nurse-patient relationship. Compare and contrast theories on caring. Discuss Discuss the evidence about patients’ perceptions of caring. Explain Explain how an ethic of care influences nurses’ decision making. Describe Describe ways to express caring through presence and touch. Describe Describe the therapeutic benefit of listening to patients. Explain Explain the relationship between knowing a patient and clinical decision making. Discuss Discuss the relationship of compassion to caring. Copyright © 2017, Elsevier Inc. All Rights Reserved. 3 What is caring as a nurse? Copyright © 2017, Elsevier Inc. All Rights Reserved. 4 AONE Guiding Principles for Future Care Delivery Caring: a universal phenomenon that influences the way we think, feel, and behave. Theoretical Views on Caring Since Florence Nightingale, nurses have studied caring. Caring is at the heart of a nurse’s ability to work with all patients in a respectful and therapeutic way. Copyright © 2017, Elsevier Inc. All Rights Reserved. 5 Copyright © 2017, Elsevier Inc. All Rights Reserved. 6 Theoretical Views on Caring (Cont.) Caring is primary Caring determines what matters to a person. Caring helps you provide patient-centered care. Leininger’s Transcultural Caring Caring is an essential human need. Caring helps an individual or group improve a human condition. Caring helps to protect, develop, nurture, and sustain people. Mrs. Levine is an 82-year-old patient diagnosed 2 months ago with lymphoma, a cancer of the lymph tissue. She has been experiencing weakness and fatigue. Over the past 4 weeks, she has lost 8 pounds. Case Study Mrs. Levine had been relatively independent before her diagnosis, playing bridge each week with friends and going to lunch with fellow church members. But now she has much less energy to do the things she enjoys. Copyright © 2017, Elsevier Inc. All Rights Reserved. 7 Theoretical Views on Caring (Cont.) Watson’s Transpersonal Caring Swanson’s Theory of Caring Promotes healing and wholeness Rejects the disease orientation to health care Places care before cure Emphasizes the nurse-patient relationship Defines caring as a nurturing way of relating to an individual States that caring is a central nursing phenomenon but is not necessarily unique to nursing practice Copyright © 2017, Elsevier Inc. All Rights Reserved. 8 Copyright © 2017, Elsevier Inc. All Rights Reserved. 9 14 components of Henderson’s Theory Virginia Henderson identified 14 basic needs: Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and modifying environment Copyright © 2017, Elsevier Inc. All Rights Reserved. 10 14 components of Henderson Theory cont’d Keep the body clean and well-groomed and protect the integument Avoid dangers in the environment and avoid injuring others. Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to one’s faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Copyright © 2017, Elsevier Inc. All Rights Reserved. 11 Maslow’s Needs Theory Maslow's hierarchy of needs is a theory of psychology explaining human motivation based on the pursuit of different levels of needs. The theory states that humans are motivated to fulfill their needs in a hierarchical order. This order begins with the most basic needs ( priority needs before moving on to more advanced needs. When the basic needs and the needs for love and belongingness are fulfilled, the esteem needs can become dominant. Nursing caring theories have common themes. Caring is highly relational. Summary of Theoretical Views Caring theories are valuable when assessing patient perceptions of being cared for in a multicultural environment. Enabling is an aspect of caring. Knowing the context of a patient’s illness helps you choose and individualize interventions that will actually help the patient. Copyright © 2017, Elsevier Inc. All Rights Reserved. 12 Case Study (Cont.) Mrs. Levine’s son, Jim, lives only a few miles away and is a consistent resource when she needs transportation to the physician or trips to the grocery store. She will begin a research protocol for chemotherapy treatments this week at the oncology clinic. Copyright © 2017, Elsevier Inc. All Rights Reserved. 13 Patients value the affective dimension of nursing care Patient’s Perspective of Caring Copyright © 2017, Elsevier Inc. All Rights Reserved. Connecting with patients and their families Being present Respecting values, beliefs, and health care choices 14 In any patient encounter a nurse needs to know what behavior is ethically appropriate. Ethic of Care An ethic of care is unique, so professional nurses do not make professional decisions based solely on intellectual or analytical principles. Instead, an ethic of care places caring at the center of decision making. Copyright © 2017, Elsevier Inc. All Rights Reserved. 15 Sue is a nurse who has worked in the oncology clinic for more than 10 years. She enters the examination room where Mrs. Levine is waiting, introduces herself, and sits down next to her patient. Case Study (Cont.) Sue states, “Mrs. Levine, I am here to understand your story. I want to listen and learn how I can best help you.” Sue uses eye contact while talking and leans toward Mrs. Levine to establish a physical presence. Mrs. Levine nods, smiles, and begins her story. Copyright © 2017, Elsevier Inc. All Rights Reserved. 16 As you deal with health and illness in your practice, you grow in your ability to care and develop caring behaviors. Caring in Nursing Practice Caring is one of those human behaviors that we can give and receive. Recognize the importance of self-care. Use caring behaviors to reach out to your colleagues and care for them as well. Copyright © 2017, Elsevier Inc. All Rights Reserved. 17 Providing Presence Being with Eye contact Body language Tone of voice Listening Positive and encouraging attitude Copyright © 2017, Elsevier Inc. All Rights Reserved. 18 Case Study (Cont.) Mrs. Levine explains, “I have had a good life. I just don't know what is going to happen. The doctor tells me the cancer is serious. I worry about what is going to happen to me and how it will affect my son, Jim. I do not want to become a burden to him.” Sue responds in a calm, soothing tone, “Mrs. Levine, your concerns are very normal. It is important for you to remain as independent as possible. Let’s talk about how we can do that.” Copyright © 2017, Elsevier Inc. All Rights Reserved. 19 Provides comfort Touch Creates a connection Noncontact touch Contact touch Task-oriented touch Caring touch Protective touch Copyright © 2017, Elsevier Inc. All Rights Reserved. 20 Copyright © 2017, Elsevier Inc. All Rights Reserved. 21 Quick Quiz! 1. A female patient has just found a large lump in her breast. The physician needs to perform a breast biopsy. The nurse helps the patient into the proper position and offers support during the biopsy. The nurse is demonstrating: A. enabling. B. comforting. C. a sense of presence. D. maintaining belief. Case Study (Cont.) Mrs. Levine has consistently relied on her son, Jim, to provide caregiving support by assisting with transportation and being a day-to-day resource. Jim brings his mother to the outpatient oncology clinic for her first chemotherapy infusion. The total treatment will last for approximately 5 hours. Sue invites Jim to sit in the treatment area with his mother. Copyright © 2017, Elsevier Inc. All Rights Reserved. 22 Copyright © 2017, Elsevier Inc. All Rights Reserved. 23 Listening Creates trust Opens lines of communication Creates a mutual relationship Develops over time Knowing the Patient The core process of clinical decision making Aspects of knowing include: Responses to therapy, routines, and habits Coping resources Physical capacities and endurance Copyright © 2017, Elsevier Inc. All Rights Reserved. 24 Case Study (Cont.) Copyright © 2017, Elsevier Inc. All Rights Reserved. Outside of the treatment room, Jim asks, “How will my mother respond to this chemotherapy? What should we be expecting?” Based on Swanson's theory of caring, what might be an appropriate response on Sue's part in “maintaining belief”? 25 Spiritual Caring Spiritual health is achieved when a person can find a balance between his life values, goals, and belief symptoms and those of others. Spirituality offers a sense of intrapersonal, interpersonal, and transpersonal connectedness. Copyright © 2017, Elsevier Inc. All Rights Reserved. 26 Performing caring nursing actions that give a Performing patient comfort, dignity, respect, and peace Relieving Symptoms and Suffering Providing Providing necessary comfort and support measures to the family or significant others Creating Creating a physical patient care environment that soothes and heals the mind, body, and spirit Comforting through a listening, nonjudgmental, Comforting caring presence Copyright © 2017, Elsevier Inc. All Rights Reserved. 27 Copyright © 2017, Elsevier Inc. All Rights Reserved. 28 Family Care Case Study (Cont.) Three hours into the infusion, Mrs. Levine asks Sue for a glass of water and begins to talk about her pet cat and her desire to return home and be able to visit with one of her bridge partners tomorrow. Sue has another patient down the hall who has an infusion that has been under way for about an hour. What should Sue do to show her caring for Mrs. Levine? Copyright © 2017, Elsevier Inc. All Rights Reserved. 29 Copyright © 2021, Elsevier Inc. All Rights Reserved. Caring is the heart of a nurse’s ability to work with people respectfully and therapeutically. Caring is specific and relational for each nurse-patient encounter. Caring in Nursing 30 Copyright © 2017, Elsevier Inc. All Rights Reserved. 31 Quick Quiz! 2. When a nurse enters a patient’s room and says “Good morning” before starting care, the nurse combines nursing tasks and conversation. An important aspect of care for the nurse to remember is the need to: A. establish a relationship. B. gather assessment data. C. treat discomforts quickly. D. assess the patient’s emotional needs. Challenges Task-oriented biomedical model Institutional demands Time constraints The Challenge of Caring Copyright © 2017, Elsevier Inc. All Rights Reserved. Reliance on technology, costeffective strategies, and standardized work processes If health care is to make a positive difference in patients’ lives, health care must become more holistic and humanistic. 32 1. Knowing 2. Being with 3. Doing for 4. Maintaining belief Copyright © 2017, Elsevier Inc. All Rights Reserved. a. Sustaining faith in the other’s capacity to get through an event or transition and face a future with meaning b. Striving to understand an event as it has meaning in the life of the other c. Being emotionally present to the other d. Doing for the other as he or she would do for self if it were at all possible 33