CNO competencies
Mrs. S tells the nurse she believes accepting palliative care means "giving up." The nurse explores her concerns and explains palliative care using language she understands.
Which CNO competency is primarily being demonstrated?
Communicator
A patient with metastatic cancer reports uncontrolled pain despite their current medication regimen. As the bedside nurse, what leadership action should be taken?
Advocating for reassessment of pain and collaborate to optimize management
According to Comfort Theory, what should healthcare providers do first?
Assess unmet comfort needs.
The nurse uses current evidence showing that early palliative care improves quality of life for patients with advanced heart failure.
Which way of knowing is demonstrated?
Empirical
What is the primary goal of palliative care?
Increased Quality of Life
Mrs. S's husband reports caregiver exhaustion and financial concerns. The nurse requests a social work consult to ensure the family receives additional support.
Which CNO competency is primarily being demonstrated?
Collaborator
An older adult with advanced heart advanced heart failure is preparing for discharge but expresses concerns about coping at home. Which healthcare professional should the bedside nurse advocate to involve?
Social worker
Managing nausea addresses which comfort context?
Physical
The nurse notices they feel uncomfortable discussing palliative care because of a previous personal experience with a dying family member. Before meeting with Mrs. S, the nurse reflects on these feelings to prevent them from influencing the conversation.
Which way of knowing is demonstrated?
Personal
Patients receiving palliative home care spent fewer days where?
The hospital
Before discharge, the nurse ensures that home care services, medications, follow-up appointments, and community resources are all arranged for Mrs. S.
Which CNO competency is primarily being demonstrated?
Coordinator
A patient with advanced COPD says they are anxious about going home because of their mobile needs and the tools they may need. Who is the healthcare professional should the bedside
PT/OT
Kolcaba defines comfort as meeting three types of comfort needs. Name one.
Relief, Ease, Transcendence
Mrs. S tells the nurse she does not want further aggressive treatment if it will not improve her quality of life. Later, her husband asks the team to "do everything possible."
Which way of knowing should primarily guide the nurse's response?
Ethical
According to caregivers in the CIHI report, what often had to happen before patients received palliative care?
Patients or caregivers had to advocate or push for it.
Before discharge, Mrs. S asks, "How will my husband and I manage everything once we're home?" The nurse hands her the discharge papers and says, "Everything you need is in there," without reviewing the information or checking if they have any questions.
Which CNO competency is NOT being demonstrated?
Educator
The patient's family members are concerned about the patient's food intake and why their diet is modified and as the nurse who can we call to clarify these concerns.
SLP and dietitian
A patient's financial situation limits access to medications. According to Comfort Theory, this is an example of what?
Intervening Variable
A nurse notices that many patients on the unit associate palliative care with "giving up." Rather than addressing only Mrs. S's concerns, the nurse proposes developing standardized education plan
Which way of knowing is demonstrated?
Emancipatory
According to Killackey et al., healthcare providers have three key responsibilities during transitions. Which responsibility focuses on ensuring communication between hospital and community providers?
Coordinating and collaborating transitional care across sectors.
The nurse notices that patients with advanced heart failure on the unit often miss the opportunity for early palliative care because referrals are consistently delayed. Instead of raising the concern or suggesting changes, the nurse accepts it as normal practice.
Which CNO competency is NOT being demonstrated?
Leader
A patient just got information they are going on palliative care for chronic conditions and are feeling super overwhelmed and feel like its the end. What interdisciplinary role in the team could help cope?
Nurse, physician, spiritual worker (if religious) and Psych.
A patient recovering from a stroke begins completing their own daily exercises at home and reports improved mobility over the next several weeks. According to Kolcaba's Comfort Theory, identify one internal and one external health-seeking behaviour demonstrated in this scenario.
Internal: Improved mobility (healing)
External: Completing self-care exercises at home
Mrs. S repeatedly says she is "fine," but avoids eye contact and becomes tearful whenever her husband talks about caring for her at home. The nurse documents, "Patient denies concerns," and ends the conversation.
Which way of knowing is NOT being demonstrated?
Aesthetic
The review (Killackey et al., 2020) found an important gap in the literature. Research has largely overlooked the experiences of healthcare providers working in what setting?
The community/home care setting.