Theoritsts
Describe Benner and Wrubels Theory of caring
novice to expert model, Maslow model
•Behner’s novice-to-expert research on nursing skills acquisition
–Forerunner of Benner and Wrubel’s theory of caring
–Focusing not on nurse caregiving but on how care informs stress and coping responses
–Nurse’s intent to care only one factor in how caring is delivered, received
▪Caring doesn’t occur in vacuum
▪Depends on factors such as situation, physical environment, nurse’s training and experience, patient’s capacities and perspectives
What is the definition of clinical decision making?
Hint (process of.......)
process we use to evaluate to select the best actions to meet desired goals
– Nurse must use critical thinking to choose among alternatives that support best patient outcomes for all patients
types of decisions made during process of solving problems
– Value decisions
– Time management decisions
– Scheduling decisions
– Priority decisions
What is Presencing?
•interpersonal arts of perception, communication
Nurse acts as a guide, PT makes own decisions abt health and they lead
–Nurse immerses self in interaction with patient that helps patient define own health choices
What is the Professional Practice Model? (PPM)
Translated caring theory into specific caring behaviors, incorporating them into practice
what is Tanners Clinical Judgement Model?
Emphasizes the importance of elements nurse uses in cognitive processing
– Different types of knowledge
– Length of nursing experience
– Values and morals
– Intuition and knowing the patient
Four features of the model: noticing, interpreting, responding, and reflecting
( KNOW THE DIFFERENCES , What type of conflict is this?)
Describe Leininger's theory of caring
–Culture care preservation, maintenance ▪Help patients retain cultural values, beliefs
–Culture care accommodation, negotiation ▪Assist patients in adapting to or working with others to achieve best care
–Culture care repatterning, restructuring ▪Support patients in evaluating, changing approaches for improved outcomes
What is Critical Thinking (describe)
all or part of process of questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity
Involves deliberate, nonlinear process of collecting, interpreting, analyzing,
drawing conclusions about, presenting, evaluating factual and belief-based
information
What is the Quality and Safety Education for Nurses (QSEN) project
Identified teamwork and collaboration as two of the six competencies needed to achieve high-quality patient care
• Successful collaboration requires that nurses
– Develop skills in communication, teamwork
– Value roles, responsibilities of other team members
– Work to establish climate of mutual respect
What are the different types of Knowledge and describe each type
•Empirical knowing–Combination of facts and observations relevant to nursing, analyses and theories that attempt to explain the facts, observations
•Aesthetic knowing–Subjective, relates to nurse’s personal style (art of nursing)
•Personal knowing–Ongoing self-exploration, self-actualization
•Ethical knowing –More extensive than ethical codes nurses must abide by
–Helps nurses grapple with situations in which values, beliefs are incompatible
–To develop, nurses must be aware and fully understand current code of ethics for nurses, values held by employing institution
What is Maslows Hierarchy Of Needs and describe it
•Lower levels must be fulfilled before an individual can move to next level
–Physiologic needs (Survival: food water air etc)
–Safety (Personal health, body safety, financial security)
–Belonging and love (relationships w others)
–Self-esteem (confidence, independence etc) ▪In nursing, based on how nurse is viewed by others
–Self-actualization (▪Development of maximum potential, full realization of abilities and qualities)
What is Roach's Theory based on?
Believed caring is core element of how humans operate, expression of interconnectedness
In critical thinking, Intellect is a needed skill, describe intellect
Ability to think, understand, reason
Salient cues
– Indicate negative or positive change in patient's health status
– Varies from norms of patient population
– Indicates a developmental delay
• Once recognized, salient clues can be clustered to look for a pattern
• Awareness of cues and their significance valuable in making essential clinical
decisions
What does interprofessional mean and describe
Interprofessional: professionals from various disciplines along with support staff, patient, family members
Interprofessional teams
– Recognize each individual profession’s value, contribution
– Atmosphere of mutual trust and respect
– Open discussion, shared decision making
What is Holistic Nursing?
•nursing practice with the goal of healing the whole person
–Goal: to go beyond addressing illness to help patients achieve balance in life
–Emphasizes patient’s personal responsibility in maintaining health
•Holistic nursing practice requires integration of self-care and personal development activities into one’s life
What is Benners Skill Acquisition Model?
• Five levels of proficiency through which a nurse progresses in gaining additional
clinical experience
– Novice
– Advanced beginner
– Competent
– Proficient
– Expert
• Levels of competence reflect four progressive changes thinking processes
– Each builds on previous one
– Critical thinking skills mastered, decision making becomes routine
How did Boykin and Schoenhofer view caring?
As an ongoing process, not a goal
Nursing is caring
Describe Clinical Reasoning and the different types
– Learned skill that novice nurses must practice
– Ability to reflect on previous situations and decisions, evaluate
their effectiveness
• Deductive reasoning – Top-down approach ▪ Nurse starts with general ideas, observations, or
principles ▪ Analyzes them to develop specific predictions
• Inductive reasoning – Bottom-up approach ▪ Nurse observes specific behaviors, symptoms ▪ Develops general conclusion by putting together
significant specific cues
• Nurse must determine whether patient information is fact, inference,
judgment, opinion
– Evaluating credibility of information sources is important step
What is team centered communication? Describe.
Team-centered communication
– Includes appreciation for member contributions
– Focuses on the “we” versus one-sided commands
– Focuses on shared responsibilities
• Effective communication occurs only if each team member
commits to understanding each member’s specific role,
appreciating member as individual
• For patients, communication is key component of effective
nursing care
what is competence and compassion?
competence:•Nurse’s ability to demonstrate attributes through nursing practice
•Specific attributes –Cognitive ability –Participation in professional development –Awareness of ethical and legal practices –Guaranteeing quality and safety in care –Building relationships with patients, fellow nurses
Compassion: •Cannot be learned through academic study, only through willingness to become intimately involved with patient’s experience
•Involves providing comfort to patient
•Competence and compassion must coexist
How does Watson view caring in his theory?
believes caring in transpersonal (both nurse and patient are benefiting from this relationship)
–10 clinical caritas processes necessary in nurse–patient caring relationship include
What is Clinical Reasoning
clinical evaluation to improve patient care
– Learned skill that novice nurses must practice
– Ability to reflect on previous situations and decisions, evaluate
their effectiveness
What is decision making
Requires healthcare team to focus on patient’s priority needs, organize interventions accordingly
Facilitated by mutual respect and timely, effective feedback
Clinical reasoning: clinical evaluation to improve patient care
The student nurse is following a preceptor on the
assigned clinical shift. Which behavior of the nurse
would the student interpret as caring?
1. Making sure that all medications and treatments
ordered for the client are completed on time
2. Using aseptic technique correctly when performing
all dressing changes ordered for the client
3. Advising the physician that the client wants to
speak to them prior to a procedure being performed
4. Explaining an invasive procedure to the client, then
asking whether it is alright to begin the procedure
4. Explaining an invasive procedure to the client, then
asking whether it is alright to begin the procedure