Caring
Swanson’s Five Caring Processes
Barriers to communication
Medical Jargon, Noise and Distractions, Anxiety fear or pain, Cultural assumptions, Hearing or cognitive impairment, Language barriers.
Professional Concepts/Domains in Nursing (4)
◦Values and Ethics: A set of core values and principles that guide conduct.
◦Knowledge: Analysis and application of information derived from experiences, critical reflection, and scientific evidence.
◦Leadership: Inspiring self and others to transform a shared vision into reality.
◦Professional comportment: A nurse’s professional behavior demonstrated through presence, words, and action.
Errors and Near Misses: Nursing Responsibilities
If an Error Occurs
Social Determinants of Health (SDOH) The conditions where people are born, live, learn, work, and age that can affect their health and quality of life. (5)
These five “rights” help a nurse determine whether a task can be safely delegated.
What are the right task, right circumstance, right person, right direction/communication, and right supervision/evaluation?
A nurse respects a client’s personal values and preferences when they differ from the recommended plan of care.
Person-Centered Care. The nurse must ask about client values and preferences.
What are dismissive or nontherapeutic responses?
"Don't Worry" " Try not to think about it"
Giving advice, changing the subject, false reassurance, asking “why,” minimizing feelings, or giving approval/disapproval.
Patient Advocacy in Nursing: Patient advocacy means speaking up for and supporting a patient's rights, needs, preferences, and choices. HOW?
◦Nurses Advocate By:
◦Protecting patient rights and promoting dignity and respect
◦Listening to the patient's concerns, values, and preferences
◦Supporting informed decisions about care and treatment
◦Speaking up when care may be unsafe or inappropriate
◦Communicating patient needs to the healthcare team
◦Promoting equitable care for all patients
◦Encouraging self-advocacy so patients can express their own needs and preferences
◦Collaborating with the interdisciplinary team to achieve patient-centered outcomes
What is a Just Culture?
A Just Culture promotes safety, accountability, and learning instead of blame.
When an error occurs, the focus is on:
Roles: Provider, RN, LPN/LVN, Assistive Personnel (AP), Respiratory Therapist (RT), Occupational Therapist (OT), Physical Therapist (PT), Speech-Language Pathologist (SLP), Social Worker, Pharmacist, Chaplain/Spiritual Care
Accountability in Delegation
Professional nursing responsibility means taking ownership of your actions, decisions, and the care you provide. We follow up!
When caring for a client from a different cultural background, the nurse should assess what areas to provide culturally responsive, person-centered care?
What are the preferred language, cultural health practices, religious or spiritual beliefs, and dietary preferences
This therapeutic communication technique involves being present and available without pressure, allowing the client to engage when ready.
Offering Self
Ethical Principles: Autonomy; Beneficence; Nonmaleficence; Justice; Fidelity; Veracity
What are INTENTIONAL Torts
Primary, Secondary, and Tertiary Care
◦Primary = Prevent & Maintain
◦Secondary = Specialized Care
◦Tertiary = Highly Specialized & Complex Care
Types of Communication
Nurse Client Relationship (3 phases)
This structured communication tool helps nurses clearly communicate a patient’s Situation, Background, Assessment, and Recommendation.
What Is Professional Negligence?
LPN Responsibilities Scope of practice
◦Collect patient data and report findings
◦Contribute to the nursing care plan
◦Provide basic nursing care and treatments
◦Administer medications as permitted by state law
◦Monitor and document patient responses
◦Reinforce patient and family education
◦Communicate changes in patient condition
◦Collaborate with the healthcare team
◦Advocate for patient safety and quality care
Chain of Command and When to Use
◦When Should You Use It?
◦A patient's condition is worsening.
◦A safety concern is not being addressed.
◦You need guidance beyond your scope of practice.
◦An urgent issue cannot be resolved at the current level.
Closed Loop Communication
Closed-Loop Communication: The sender gives a message, the receiver repeats it back, and the sender confirms it is correct.
This caring theory focuses on caring for the whole person—mind, body, and spirit.
What is Watson’s Theory of Human Caring?
CUS Tool
CUS is a structured communication tool that supports assertive communication by allowing the nurse to express concern, state that they feel uncomfortable, and identify a safety issue (Concerned, Uncomfortable, Safety).
To prove negligence, all 5 elements must be present.
1. Duty: The nurse had a responsibility to provide care.
2. Breach of Duty: The nurse failed to meet the expected standard of care.
3. Foreseeability: A reasonable nurse could predict that harm might occur.
4. Causation: The nurse's actions (or failure to act) directly contributed to the patient's injury.
5. Harm: The patient experienced actual injury ordamage.
Scope of Practice: When in Doubt?
◦Is it legal in my state?
◦Am I competent to perform it?
◦Does my employer allow it?
◦Is it safe for the patient?
◦If the answer to any of these questions is no, do not perform the task until you seek guidance.
WHERE TO FIND? Nurse Practice Act
For planning client advocacy - steps
When using this resource, the nurse should speak directly to the client, use short clear sentences, pause for interpretation, and verify understanding rather than speaking to the person providing the translation.
What is a medical interpreter?
Before signing this, the client must understand the procedure, risks, benefits, and alternatives and make the decision voluntarily.
What is informed consent? Nurse witnesses the signing and notifies provider if client does not understand.
Characterized by emotional exhaustion, decreased empathy, irritability, and detachment from clients
Compassion Fatigue
Roles of State Board of Nursing
◦ Enforces the Nurse Practice Act
Interprets nursing laws and regulations
◦ Issues and renews nursing licenses
◦ Investigates complaints
◦ Takes disciplinary action when appropriate
◦ Protects the public by promoting safe
nursing practice
Human Flourishing
Supporting the client in achieving a state of health, dignity, and quality of life that aligns with their values and aspirations.