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COMMUNICATIONS AND INTRODUCTION TO NURSING ANITA CATLIN, DNSc KATHLEEN ROCKET, MSN FALL 2003.

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Presentation on theme: "COMMUNICATIONS AND INTRODUCTION TO NURSING ANITA CATLIN, DNSc KATHLEEN ROCKET, MSN FALL 2003."— Presentation transcript:

1 COMMUNICATIONS AND INTRODUCTION TO NURSING ANITA CATLIN, DNSc KATHLEEN ROCKET, MSN FALL 2003

2 PLAN FOR DAY Read article in class Read article in class Discuss what is a nurse Discuss what is a nurse Communication Tool Communication Tool Discuss confidentiality Discuss confidentiality Do nursing interview on classmate Do nursing interview on classmate View Video on American Oncology Nurses View Video on American Oncology Nurses

3 Who Can I Think of as a Mentor?

4 DEFINITION OF NURSING HENDERSON, 1939 Nursing is primarily helping people (sick or well) in the performance of those activities contributing to health, or its recovery (or to a peaceful death) that they would perform unaided if they had the necessary strength, will, or knowledge. It is likewise the function of nurses to help people gain independence as rapidly as possible.

5 Virginia Henderson, Definition of Nursing International Council of Nurses, 1960 Nursing is primarily assisting individuals (sick or well) in the performance of those activities contributing to health, or its recovery (or to a peaceful death) that they would perform unaided if they had the necessary strength, will, or knowledge. Nursing is a process through which care is provided to individuals, families, or community groups. Nursing is primarily assisting individuals (sick or well) in the performance of those activities contributing to health, or its recovery (or to a peaceful death) that they would perform unaided if they had the necessary strength, will, or knowledge. Nursing is a process through which care is provided to individuals, families, or community groups.

6 WEIDENBACH, 1964 Delineation between medicine and nursing: The physician’s role is to treat the patient’s primary condition. The physician’s role is to treat the patient’s primary condition. The nurse’s role is to treat the patient’s response to this condition. The nurse’s role is to treat the patient’s response to this condition.

7 ANA CODE OF ETHICS Last written in 1985 Last written in years of discussion 10 years of discussion Brought to nurse ethicists for review Brought to nurse ethicists for review Input from nation Input from nation Revised in 2001 Revised in 2001

8 Compassion and respect, regardless and unrestricted Compassion and respect, regardless and unrestricted Commitment to patient; individual, family, group, community Commitment to patient; individual, family, group, community Advocates for health, safety, and rights of patient Advocates for health, safety, and rights of patient Responsible and accountable Responsible and accountable Maintains moral self respect and competence Maintains moral self respect and competence

9 Maintains health care environment Maintains health care environment Advances profession by maintaining standards and active involvement Advances profession by maintaining standards and active involvement Collaborates with other health care professionals, local and worldwide Collaborates with other health care professionals, local and worldwide Promotes nursing values and social reform Promotes nursing values and social reform

10 NURSES TRAINED TO SEE OUTSIDE THE BED History Sociology Ethnicity Social Economics Family Dynamics Spirituality Love Hope

11 Imogene King, 1981 MUTUAL INTERACTION MODEL Exploration Information and Analysis Mutual Goal Setting Strategies Implementation of Alternatives Evaluation

12 DEFINITION OF CARING IN NURSING Swanson, 1983 Knowing Being With Doing For Enabling Maintaining Belief Caring for patients with community prevention or in tertiary settings, living or dying, throughout the lifespan

13 THOUGHTFUL DELIBERATION Fostering critical thinking Fostering critical thinking Using the nursing process Using the nursing process Socratic method helpful Socratic method helpful Purposeful conversation Purposeful conversation

14 ACCOUNTABILITY Using critical thinking before taking actions Using critical thinking before taking actions Being responsible for your actions Being responsible for your actions Entering the professional role Entering the professional role Working at the level of your peers Working at the level of your peers Using the nursing process Using the nursing process

15 MEDICAL EDUCATION Science based Science based Cellular/molecular understanding of disease process Cellular/molecular understanding of disease process Medical school, internship, residency, fellowship; all honed to specific understanding Medical school, internship, residency, fellowship; all honed to specific understanding “War” against disease “War” against disease Death is the “enemy” Death is the “enemy”

16 GOALS OF MEDICINE Promotion of health and prevention of disease Promotion of health and prevention of disease Relief of symptoms, pain and suffering Relief of symptoms, pain and suffering Cure of disease Cure of disease Preventing untimely death Preventing untimely death Improvement of functional status or maintenance of compromised status Improvement of functional status or maintenance of compromised status Education and counseling of patients regarding their condition and its progress Education and counseling of patients regarding their condition and its progress Avoid harm to the patient in the course of care Avoid harm to the patient in the course of care

17 AMERICAN MEDICAL ASSOCIATION PRINCIPLES OF MEDICAL ETHICS, 1997 Physician shall have competency, compassion and respect for human dignity Shall be honest and expose those engaging in fraud or deficient character Respect the law and work to change law that is bad for patient care Respect the rights and confidences of others Continue to study, use consultation, advance scientific knowledge Freedom to choose own patients and own practice environment Participate in improving the community

18 PHYSICIAN DESCRIPTION Catlin study, 1998 I think if you really want the truth on the whole, you are asking somebody who is medically trained to wear more hats than that of a physician. You are asking them to be a physician; you are asking them to be ethicist; you are asking them to be an economist; you are asking them to be a minister of religion; you are asking them to be a judge and jury and it is a big mantle of responsibility. And peer pressure, family pressure, societal pressure, and fear of litigation all play a role in the decisions that are being made.

19 GOALS OF MEDICINE WORK GROUP, Germany Germany Hungary Hungary Scotland Scotland USA USA Slovak Republic Slovak Republic Spain Spain Chile Chile Italy Sweden Czech Republic Denmark Indonesia The Netherlands China

20 MOVING TOWARDS EACH OTHER Physicians learning “context” Physicians learning “context” Advanced practice nurses accepting medical model of diagnosis and treatment Advanced practice nurses accepting medical model of diagnosis and treatment Palliative care has entered into medical practice: initiated for adults, less so for children Palliative care has entered into medical practice: initiated for adults, less so for children

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22 MARTHA ROGERS, NURSE THEORIST “When an apple is cut, others see seeds in the apple. We, as nurses, see apples in the seeds.” “When an apple is cut, others see seeds in the apple. We, as nurses, see apples in the seeds.”

23 STUDENT NURSES’ CODE OF ETHICS Code of Academic and Clinical Conduct Similar to American Nurses Association Similar to American Nurses Association Additional discussion on: Additional discussion on:  impairment in clinical  not performing skills that haven’t been taught yet  Collaborate with instructors who have your best interests at heart

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25 HEALTH According to the World Health Organization is well-being in these domains: According to the World Health Organization is well-being in these domains:  Emotional  Physical  Social  Spiritual

26 HEALTH ILLNESS CONTINUUM View of each person of where he or she sits on the health illness scale View of each person of where he or she sits on the health illness scale The patient’s opinion may be different than ours The patient’s opinion may be different than ours Ours may be different than the patient’s Ours may be different than the patient’s It is a dynamic process It is a dynamic process

27 HIGH LEVEL WELLNESS Mental health Mental health Physical health Physical health Social health Social health Family health Family health Community health Community health

28 HOLISTIC HEALTH Interaction of Interaction of  mind  body  spirit Nursing care is based on this Nursing care is based on this

29 PATIENT ADVOCACY Expressing and defending the cause of another Expressing and defending the cause of another Informing Informing Supporting Supporting Mediating Mediating Ensuring access Ensuring access

30 PATIENT’S BILL OF RIGHTS  Considerate and respectful care  Complete, current, and necessary information  Informed consent prior to procedure  Right to refuse treatment  Confidentiality of records  Privacy

31 PATIENT’S BILL OF RIGHTS Response to request for services Response to request for services Involvement in transfer Involvement in transfer Information about hospital and staff relationships Information about hospital and staff relationships Knowledge of research and right to refuse Knowledge of research and right to refuse Continuity of care Continuity of care Bill explanation Bill explanation Hospital rules and regulations Hospital rules and regulations

32 CONFIDENTIALITY Patient has the right to privacy Patient has the right to privacy Patients entrust in us and we have earned that trust Patients entrust in us and we have earned that trust Especially in small towns as we practice in Especially in small towns as we practice in No discussion other than those who need to know No discussion other than those who need to know Patients will need to disclose private data Patients will need to disclose private data Discussion with your instructor is acceptable Discussion with your instructor is acceptable Use patient initials on your work and notes Use patient initials on your work and notes No talking in cafeteria, hallways, elevators No talking in cafeteria, hallways, elevators

33 LEVELS OF CARE Primary Care Primary Care  Health promotion  Prevention  Outpatient  First line of care

34 LEVELS OF CARE Secondary Care Secondary Care  Surgery  Specialists  OB/GYN  Local hospital treatment

35 LEVELS OF CARE Tertiary Care Tertiary Care  Regional medical care  Regionalized expertise  Medical school  Advanced diagnostics  Away from home  May be done by telehealth

36 CONTINUITY OF CARE Care that begins with maintaining health, treats someone with an acute illness, and follows to home care for recovery or stabilization Care that begins with maintaining health, treats someone with an acute illness, and follows to home care for recovery or stabilization A goal of good nursing A goal of good nursing Rehabilitation begins with admission Rehabilitation begins with admission

37 TYPES OF NURSING CARE Curative: Return to level of health Curative: Return to level of health Preventive: Prevent disease process from occurring Preventive: Prevent disease process from occurring Restorative/Rehabilitation: Restore function after disease Restorative/Rehabilitation: Restore function after disease Supportive: Care for emotional aspects Supportive: Care for emotional aspects Holistic: Body, mind, spirit Holistic: Body, mind, spirit Palliative: Care for dying patient Palliative: Care for dying patient

38 ILLNESS Acute Acute Chronic Chronic Remission Remission Exacerbation Exacerbation

39 INDEPENDENT NURSING FUNCTIONS Licensed to initiate based on knowledge and skills Licensed to initiate based on knowledge and skills Physical care Physical care Gathering health information Gathering health information Support and comfort Support and comfort Teaching, counseling Teaching, counseling Environmental support Environmental support Referrals Referrals

40 DEPENDENT/COLLABORATIVE NURSING FUNCTIONS Under physician orders Under physician orders Under protocols Under protocols Decisions under parameters Decisions under parameters Student reports to faculty member Student reports to faculty member

41 METHODS OF CARE DELIVERY Functional Functional Team Nursing Team Nursing Primary Care Nursing Primary Care Nursing Nurse Practitioner Nurse Practitioner Independent Nursing Practice Independent Nursing Practice Private Duty Nursing Private Duty Nursing Home Care Nursing Home Care Nursing

42 HEALTH CARE PERSONNEL Physician: Medical diagnosis and treatment, cure oriented, often given more leadership than trained for Physician: Medical diagnosis and treatment, cure oriented, often given more leadership than trained for Nurse Practitioner: MSN, Advanced practice, can Dx and Tx Nurse Practitioner: MSN, Advanced practice, can Dx and Tx Clinical Nurse Specialist: Advanced role in acute care settings Clinical Nurse Specialist: Advanced role in acute care settings Nurse: LVN, ADN, BSN, PHN, MSN, PhD, DNSc, JD Nurse: LVN, ADN, BSN, PHN, MSN, PhD, DNSc, JD Midwife: Advanced Practice, MSN Midwife: Advanced Practice, MSN

43 HEALTH CARE PERSONNEL Dietician: Trained in nutrition and food services Dietician: Trained in nutrition and food services Physical Therapist: Muscular-skeletal focus Physical Therapist: Muscular-skeletal focus Pharmacist: Preparation/Dispensing Meds Pharmacist: Preparation/Dispensing Meds Respiratory Therapist: Management of airway, lung, and ventilator issues Respiratory Therapist: Management of airway, lung, and ventilator issues

44 HEALTH CARE PERSONNEL Social Worker: College degree, support and counsel patients and staff, transfers and placement Social Worker: College degree, support and counsel patients and staff, transfers and placement Hospital chaplain: Issues of spirituality and death and dying Hospital chaplain: Issues of spirituality and death and dying Occupational therapist: Fine motor training and activities of daily living Occupational therapist: Fine motor training and activities of daily living Speech therapy: Speech and swallowing Speech therapy: Speech and swallowing Paramedical technologist: Skills blood draw, EKG Paramedical technologist: Skills blood draw, EKG

45 HEALTH CARE FINANCING Employment linked insurance Employment linked insurance Prepaid insurance policies Prepaid insurance policies Federally and state funded programs Federally and state funded programs Millions of Americans uninsured Millions of Americans uninsured

46 CONSUMER INFLUENCE & SOCIAL CHANGES IMPACT ON HEALTH CARE Women’s movement led to improved access to birth control Women’s movement led to improved access to birth control Consumers demanded that families be present at deliveries Consumers demanded that families be present at deliveries Men’s movement made prostate cancer more discussed Men’s movement made prostate cancer more discussed Breast cancer activists have increased attention to this disease Breast cancer activists have increased attention to this disease

47 FUTURE CHALLENGES Nursing shortage Nursing shortage Increased telehealth care Increased telehealth care Increased use of life extending technologies Increased use of life extending technologies Increased training in pain control and end of life comfort Increased training in pain control and end of life comfort


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