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BSN 111 Final Exam Notes
Self-awareness - correct answer An individual's ability to understand their personal strengths, weaknesses, and influence on others Values - correct answer A strong personal belief and an ideal that a person or group (such as nurses) believes to have merit Ethics - correct answer Philosophical ideals of right and wrong behaviour Code of Ethics - correct answer Canadian Nurses Association (CNA) (2017) "publishes a code of ethics that outlines nurses' professional values and ethical commitments to their patients and the communities they serve" Advocacy - correct answer speaking on behalf of those who cannot speak for themselves acting on behalf of another person Accountability - correct answer We are accountable to CNO and the organization we work for Responsibility - correct answer Duty to perform actions adequately and thoughtfully A nursing code of ethics - correct answer Provides guidance for relationships, behaviour, and decision making Deontology - correct answer essence of right and wrong
Utilitarianism - correct answer Utilitarianism is like a moral compass that focuses on maximizing overall happiness or well-being by considering the outcomes or consequences of our actions Bioethics - correct answer looks at ethics from a medical and healthcare perspective Feminist ethics & relational ethics - correct answer persons relationships with others Autonomy - correct answer Providing adequate information to allow patients to make their own decisions based on their beliefs and values, even if they aren't the ones the nurse chooses (self determination) Beneficence - correct answer Relates to ensuring that the patient's best interest is considered, regardless of the nurse's personal opinion (promotion of good) Nonmaleficence - correct answer The avoidance or minimization of harm Justice - correct answer Relates to impartiality regarding a patient's age, ethnicity, economic status, religion, or sexual orientation (unbiased) Relational ethics - correct answer A way of being" demonstrated in day-to-day relations Patient safety - correct answer CNA (2009) "believe that patient safety is the reduction and mitigation of unsafe acts within the health care system as well as through the use of best practices shown to lead to optimal patient outcomes" Value formation - correct answer •Family experience •Moral development
Step 7: Evaluate the action and the outcome Effective communication - correct answer A two-way exchange of information among persons and health care providers Communication - correct answer Communication is an exchange of information, sharing of ideas, seeing things from multiple perspectives Metacommunication - correct answer describes all factors on how messages are perceived Person centered communication - correct answer Focuses on health issues, but also considers the person's social care influenced by cultural contexts, values, family, diversity, social circumstances, and lifestyles Basic elements of communication process: Linear Model - correct answer
- sender
- message
- receiver
- channels of communication
- context Transactional model - correct answer - complex
- reciprocal interaction process Therapeutic communication - correct answer - words/expression
- exchange of information
- shared decisions
- documentation
- behaviours
Nontherapeutic communication - correct answer - incongruency in tone, voice
- using medical jargon
- Inappropriate touch
- avoiding eye contact
- Interruptive
- dismissing patient perspectives, values Elements of person-centred communication - correct answer
- honesty, empathy
- nonverbal communication supports
- verbal responses
- health-related purpose
- active listenting Active listening (SOLER) - correct answer S = Sit facing the person O = Keep an open posture L = Lean toward the person E = Initiate and maintain eye contact R = Relax Verbal responses - correct answer •Matching responses •Using plain language •Focusing •Presenting reality •Giving feedback •Validation
Planning: takes place along with the patient Intervention: what can be done to work on the issue Evaluation: make sure interventions are effective Why are theories in nursing important? - correct answer They provide a systematic view of explaining, predicting, and describing phenomena. Types of theories - correct answer Grand: offer broad framework for addressing complex theories and concepts for nursing Middle range: address narrow defined phenomenon - less abstract Descriptive: attempt to describe a phenomenon - why they occur, consequences Prescriptive: addresses nursing interventions - action oriented Metaparadigm - correct answer concepts of a person, environment, health, nursing Major theoretical models - correct answer -Practice based theory guides and shapes nursing practice -Need theorists talks on human basic needs -Interactionist theories focus on relationship btwn nurses and patients -Systems theories are a study of complex portions that work together as a whole -Simultaneity theories Concept of caring - correct answer Being an advocate for your patients in the healthcare setting Ways of knowing - correct answer Empirical: the science of nursing - looking at facts (scientifically driven) Ethical: looks at moral knowledge - what's right and wrong Personal: focusing on the individual self - unique for everyone Aesthetic: art nursing - looking at the client holistically
Meaning of caring - correct answer Watson: Caring is the moral ideal central to nursing Banner: Caring is the essence of nursing Leininger: Care is the essence and focus of nursing Relations ethics - correct answer Relational ethics focuses on the role of relational context or the experience of relationships in shaping moral choices 4 themes: •Environment •Embodiment •Mutual respect •Engagement Elements of relational practice - correct answer •Listening & Questioning •Empathy •Support Zones of personal space - correct answer Intimate Zone (0 to 45 cm): Holding a crying infant, Performing physical assessment, Bathing, grooming, dressing, feeding, and toileting a patient, Changing a patient's dressing Personal Zone (45 cm to 1 m): Sitting at a patient's bedside, Taking a patient's health history, Teaching an individual patient, Exchanging information with health care staff at change of shift Social Zone (1 to 4 m): Participating in patient-centred care rounds, Sitting at the head of a conference table, Teaching a class for patients with a specific disease Conducting a family support group session
- the more the sender and receiver have in common, the closer the relationship Elements of Professional Communication - correct answer Courtesy: respect for each other, politeness, greet and say goodbye to patients Use of names: to avoid misunderstanding, respect, means you care Trustworthiness: trust leads to other elements of communication Assertiveness: shows confidence, this is not always negative, we need to be professionally assertive Autonomy (freedom of choice) and responsibility: allowing them to be independent in their own self management, we promote autonomy and independence Communication in relational practice - correct answer initiative: reaching out and listening authenticity: being genuine mutuality: equal participants in nurse-patient relationship questioning beyond the surface: using deeper questioning to foster inquiry Therapeutic Communication Techniques - correct answer Clarifying: check if their understanding is accurate, ask patient questions to make sure they understand Focusing: need to bring focus back to questions we ask, one at a time Paraphrasing: if patient does not understand, we can rephrase it in similar terms to allow them to understand
Asking relevant questions: when we have a goal, we need to have relevant questions, one question at a time, open ended questions Summarizing: information Is clear from both ends, having a general understanding without miscommunication Self-disclosure: revealing parts about yourself within professional boundaries, self disclosing for therapeutic reason Confrontation: help the other person become more aware of the inconsistency of their behaviours reducing barriers in communication - older persons - correct answer
- capture pts attention before speaking
- check for hearing aids/glasses
- introduce yourself
- choose a quiet, well lit environment
- minimize visual and auditory distractions
- face the pt
- do not shout, speak clearly and at a moderate rate
- allow time for pt to respond Motivational interviewing - correct answer Motivational interviewing is an evidence-informed clinical framework designed to help people incorporate the functional abilities and skills they will need to fully engage in health promotion and disease prevention activities Process of motivational interviewing - correct answer Engaging: introduction, developing a professional relationship, making the environment comfortable to the client Focusing: finding a clear direction and goal when it may not be clear from the outset, what is the particular goal for this client
Assist - correct answer - Refers to health-care provide activities that address barriers to change Arrange - correct answer - follow up contact
- giving patient a copy of the action plan
- Arrange for patient to contact specific community resources that could support their goals Patient and family centred care - correct answer Recognizes importance of family and in a patient's life their active involvement in planning and making decisions on health care, services and treatment, and health system reform Elements of person-centred care - correct answer •Respect for the person's values, preferences, and expressed needs •Coordination and integration of care through collaboration and teamwork •Accessibility and free flow of information, communication, and education •Physical comfort •Sensitivity to the nonmedical and spiritual dimension of care •Emotional support Involvement of family and friends Social relationships - correct answer Social relationships are established and maintained to meet mutual needs Hildegard Peplau's Interpersonal Nursing Theory - correct answer •Pre-interaction •Orientation •Working phase •Termination
Carl Rogers' Client-Centred Model - correct answer •Authenticity and Empathetic Understanding •Trust and Respect Maslow's Needs Theory - correct answer - need to meet basic needs before we move up the pyramid
- physiological needs, safety & security, love & belonging, self-esteem, self- actualization Professional Boundaries - correct answer - Represent invisible structures imposed by legal, ethical, and professional standards of nursing that respect the rights and privacy of the person and protect the functional integrity of the relationship between the nurse and person
- Health care provider takes responsibility for guiding the relationship and for maintaining appropriate boundaries Shared Decision Making - correct answer •Provide detailed information about the different options •Ensure the person understands the available options to manage the health issue •Collaboratively assist the person to explore the options and decide on which one is the best Components of the Nurse-Client Relationship - correct answer •Trust: crucial in the nurse-client relationship •Respect: recognizing uniqueness and worth of each person, regardless of socio- economic status, personal attributes and health problem (s) •Professional Intimacy: inherent in type of care/services nurses provide, includes spiritual, social, psychological and physical •Empathy: understanding, resonating and validating with the meaning that the health care experience holds for the client
of advantage and disadvantage that have shaped the way you understand the world and in relation to others Cultural Safety - correct answer Cultural competence: the ability to effectively interact with people belonging to different cultures Cultural humility: the nurse must be humble and view persons as equal Cultural safety: focuses on power imbalances Applying Cultural Safety in Practice - correct answer •3 Ds: demeaning, devaluing or disempowering •3 Rs: revise, respect, and the rights of the person •Challenging your assumptions, stereotypes, and labelling, as well as those of others Ethnocentrism - correct answer Relates to how your culture is superior to another (the thought that ones own group/ethnic background is better than another) Discrimination - correct answer The process of making unfair distinctions between people based on groups or categories in which they belong Cultural Imposition - correct answer Imposing your own culture upon another person Critical Self-Reflection - correct answer Integrating values, beliefs, attitudes and emotions felt during an experience to understand and examine the experience through multiple perspectives
To what does culturally competent care refer? - correct answer Culturally based care and health knowledge expressed in sensitive, creative, and meaningful ways Cultural Assessment - correct answer A systematic and comprehensive examination of the cultural care values, beliefs, and practices of individuals, families, and communities Historical Perspectives on Communications and Indigenous Peoples - correct answer Communication is rooted in land, culture, traditions, and Indigenous governance systems Colonialism - correct answer Foreign power rules and area and tries to assimilate their culture on others Truth and Reconciliation Commission (TRC) - correct answer -TRC addresses the impacts of the Residential School system -Calls to action were implemented to attempt to fix what had occurred to the Indigenous people Indian Act - correct answer States that the federal parliament has responsibility for Indians and the land of the Indians The Sixties Scoop - correct answer Children were taken away "for the benefit of the child", but the reality was to assimilate them into Western society and strip them of their culture Intergenerational Trauma - correct answer Traumatic experiences being passed down the line (mental health, addiction) Decolonization - correct answer Decolonization is an approach to undo colonization which requires the following to create space and support for Indigenous Peoples UNDRIP (United Nations Declaration on the Rights of Indigenous Peoples) - correct answer Been endorsed and implemented in Canada
behavioural crisis: occurs when a crisis escalates to a point where situation requires immediate intervention (violent interpersonal behaviour, suicide, homicide) Crisis Intervention - correct answer - use of theory based problem solving to resolve crisis
- time-limited interventions
- nurses function as advocates, resources, partners, and guides in helping pts resolve crisis situations Theoretical Frameworks (Lindemann & Caplan) - correct answer
- shock: initially, one is in shock (emotions, anger, social withdrawal)
- recoil: on the outside, it looks as if one is okay but deep down the crisis has not been dealt with (can last 2-3 weeks) - nightmares, phobias, flashbacks
- restoration: a plan and constructing action to resolve the crisis they may be in Nursing Model - correct answer - crisis state develops bc of a distorted perception of a situation or bc patient lacks resources to cope with it
- interventions focus on increasing balancing factors needed to restore a pt to pre- crisis functioning Structuring Crisis Intervention Strategies - correct answer
- Assess lethality, mental status
- The Violence Assessment Tool (VAT)
- Establish rapport and engage patient
- Identify chief problems
- Explore options, solutions
- Develop realistic action plan
- Implement plan
- Develop a termination and follow-up protocol Mental Health Emergencies - correct answer - Require an immediate coordinated response designed to alleviate the potential for harm and restore basic stability
- Triage assessment system (TAS) for mental health crises that can help nurses understand a patient's responses across three domains: affective, behavioural, and cognitive De-escalation Tips for Mental Health Emergencies - correct answer
- Identify yourself; talk calmly; respond calmly
- Provide additional personal space
- Respect needs to communicate in different ways
- Reassure people but set professional boundaries Types of Mental Health Emergencies - correct answer - Violence: safety and well-being is at question
- Sexual assault: everything should be done to make the pt feel safe and supported
- Psychosis: acute psychotic break is a serious mental health emergency. Delirium, reduced insight, impaired personal judgement, hallucination
