DSN Vision The vision of Denver School of Nursing is to be recognized as an excellent school of choice for individuals seeking higher education leading to careers in nursing and other medical fields.

DSN Mission Denver School of Nursing is a private institution of higher education dedicated exclusively to educating students for the diverse opportunities offered by careers in nursing and other medical fields.

DSN Philosophy The philosophy of Denver School of Nursing flows from the mission of the school and supports the concepts of clinical competence, excellence in education, holistic care, professionalism, evidence-based practice and lifelong learning.

NRS 438 Topics of Professional Nursing Practice II Vision Development of clinical competency & critical thinking skills to foster a lifetime of professional growth & learning. Development of clinical competency & critical thinking skills to foster a lifetime of professional growth & learning.

Mission NRS 438 Topics of Professional Nursing Practice II Students will learn to Integrate holistic and traditional health care values in order to partner with diverse clients, health care colleagues, and the community at large. Additionally, students will gain an understanding about the legal aspects of the nursing profession, global health care issues & high quality health care outcomes. Students will learn to Integrate holistic and traditional health care values in order to partner with diverse clients, health care colleagues, and the community at large. Additionally, students will gain an understanding about the legal aspects of the nursing profession, global health care issues & high quality health care outcomes.

12 Values Assumptions that guide the process of internal change are 1. The meaning and essences of care is a connection in the moment 2. Feeling connected creates harmony and healing 3. Each person on the team plays a part 4. Relationship is at the heart of all of this 5. Care providers knowledge of self and self-care > quality of care, healthy relationships. 6. Healthy relationships among health care member is essential to the quality of care provided to patients.

12 Values Assumptions that guide the process of internal change are 7. People are most satisfied when in alignment with their personal and professional values 8.We must understand and value of Relationship in patient care. 9.A therapeutic relationship is essential for quality care 10. Patient experiences improve measurably when staff own their own practice 11.People willingly change when they are inspired to a shared common vision. When an infrastructure is implemented for it working, when relevant education is provided for personal professional development, and when they see evidence of success (I 2 E 2 ) 12.Transformational change happens one relationship at a time.

RBC Model for the Clinician Colleagues Self-Clinician Patient & Family At the core “The CORE of the healing environment is your Relationship to the patient and family”, p. 29

MODELS OF CARING THE FOUNDATION FOR RELATIONSHIP BASED CARE WATSON SWANSONLEININGER WATSONDINGMAN

Caring & Healing Theories Watson – Model of Caring - 31 Patient can only change self Patient can only change self Healing comes from inside out Healing comes from inside out Nurse is a facilitator of change Nurse is a facilitator of change Understanding of pts needs, hx, life experiences Understanding of pts needs, hx, life experiences Must be present in every interaction Must be present in every interaction Leave your baggage at the door Leave your baggage at the door Nurse must have self-awareness to have facilitate healing Nurse must have self-awareness to have facilitate healing

Caring & Healing Theories Swanson – 5 Caring Processes - 33 Belief & Knowing are internal processes of caring Belief & Knowing are internal processes of caring “Being With”, “Doing For” & “Enabling/Informing” are action elements of caring “Being With”, “Doing For” & “Enabling/Informing” are action elements of caring Integration of caring & healing of RBC Integration of caring & healing of RBC

Caring & Healing Theories Leininger – Cultural Diversity of Caring 34 Always ask the patient “what does caring mean to you” Always ask the patient “what does caring mean to you” No cure without caring No cure without caring Universal caring characteristics Universal caring characteristicsHelpingRespectConcern Attention to detail Presence/be there in the moment ProtectingTouching Comfort measures Adjusting the environment to meet the patients needs - Rounding

Dingman – The Caring Model 36 Practical Practical Customer Service Model Customer Service Model Introduce Self Introduce Self Call patient by preferred name Call patient by preferred name Use of touch appropriately Use of touch appropriately SDL patients to review care plans SDL patients to review care plans Re-enforce Company V,M & Philosophy Re-enforce Company V,M & Philosophy Used by all members of the Care Team Used by all members of the Care Team Caring & Healing Theories

Caring Healing Summary Quality care deeply rooted in dignity & respect for individual patient Centers around mind, body & spirit – holistic Professional nurse is always present with the patient– just be there Professional nurse facilitates healing with understanding & attention to individuality Professional nurse facilitates healing with understanding & attention to individuality Safe care rooted in service listen to the patient talking to you Safe care rooted in service listen to the patient talking to you

What Patients Want Interpersonal skills of staff, be a person vs. a diagnosis (press & Ganey, 1997) To be listened to, treated with respect, cared for gently (Care conf. data) Care providers responding and anticipating patient requests; ability to calm fears, good com., inform them about tests & procedures (Dingman, 1999) RBC is key to quality care (Tresolini, 1994)

The Caring and Healing Environment Preparation to RBC requires crossing the threshold into the pt’s environment It has been called sacred space (Wright and Syre-Adams, 2000) There is a physical element to this space that can be manipulated and promote better healing (room, building, view, sound, colors, traffic flow) 9Ulrich, 1984; Bilchik, 2002) At the core of the environment is the intentional caring relationship between health care provider and patient (family).

Disconnect Between What Drives a Health Care Organization and What Matters Most We want to address patient quality and their perceptions---but we don’t do it very well We cannot get out of this chaos unless we truly focus on the patient, but we are system driven

Disconnect page 2 We understand human behavior as being non-rational most of the time, yet expect to solve these issues with rational interventions We realize there is a critical need for the care provider to have a positive relationship to self and we tend to ignore it anyway

Formula for Leading Change I 2 E 2 I 1 is inspiration: They will participate when they believe what they have to offer is valued and they are contributing to a compelling, valuable, life affirming vision I 2 is Infrastructure: The infrastructure must support the organizations overall vision (strategic, operational, tactical levels)

Formula for Leading Change I 2 E 2 E 1 is Education: Priorities are in self- awareness, patient-family experience of care, having healthy relationships, proactive positive com., creative & critical thinking, and leadership E 2 is Evidence: measure results of your actions and support inspiration.

Implementing I 2 E 2 Needs to have the 5 Cs in Place Clarity Why, benefits, how to, their part, scope or responsibility and authority frees actions Why, benefits, how to, their part, scope or responsibility and authority frees actionsCompetency Know expectations, feel skills, educate Know expectations, feel skills, educateConfidence Empowered to action, self-governance Empowered to action, self-governanceCollaboration RB work, respect others, know your part RB work, respect others, know your partCommitment Ownership, headed for a shared goal Ownership, headed for a shared goal