what is the definition of a profession?
an occupation who core element is work based upon mastery of body of knowledge and skills
knowledge is used in the service of others
governed by a code of ethics
what are attributes of the professional nurse?
altruism, autonomy, caring + compassion, commitment, competence, confidentiality, insight, openness, presence, respect for dignity/autonomy/resilience
what is the role of a professional order?
ensuring the protection of the public
regulating and overseeing practice of profession
fostering development of profession
who is the nursing professional order in Quebec?
OIIQ - ordre des infirmières + infirmiers du Quebec
what are example of what OIIQ does?
student + nursing permits
entry to practice exam
investigate complaints
education programs
create standards of practice
what is the Nurse's Act?
the practice of nursing consists in assessing a person's state of health, determining and carrying out of the nursing care and treatment plan, providing nursing + medical care and treatment in order to maintain or restore health and prevent illness, as well as provide palliative care
lists activities in the practice of nursing that are reserved to nurses (nurse's scope of practice)
what does the OIIQ code of ethics of nurses do?
guides our practice and defines our responsibilities toward protecting the public
what is the foundation for practice, research and education in nursing?
knowledge - we have the responsibility for generating its own body of knowledge and it requires research
what is the metaparadigm of nursing?
4 central concepts and the relationships between them
environment, nursing, person, health
explain the person metaparadigm of nursing
indivisible, unique and evolving entity who acts in accordance with his choices, values, beliefs and to the best of his abilities. persons interrelate with other persons, the family, group, community, environment
explain the health metaparadigm of nursing
dynamic + continuous process in which a person aspires state of equilibrium that fosters well-being and QOL
involves adaptation to multiple environmental factors, a learning process and commitment on the part of person and society
explain the environment metaparadigm of nursing
all components in persons surroundings with which that person interacts
includes physical (living environment), psychosocial (support), political and economic (laws), spiritual (values), cultural (ethnic origin) and organizational
explain the nursing metaparadigm of nursing
dynamic process to maintain restore and improve health well-being + QOL, prevent illness, accidents, social problems, promote rehab.
process encompasses assessment + monitoring of persons physical/mental health, determination of therapeutic nursing plan, nursing care + treatment plan, information + professional advice
what are nursing theories/conceptual models/approaches?
distinct belief/value system about nursing and its practice
address phenomena identified by metaparadigm
ONLY 1 metaparadigm but MANY theories
what are nursing theories/conceptual models/approaches role?
provide us with framework
guides practice: assessment, intervention, evaluation
guides curriculum + research
provides language: common terminology to use
enhances professional identity
what is Virginia Henderson's theory?
NEEDS
person: humans have variety of NEEDS
environment: immediate physical surroundings
nursing: meeting NEEDS
health: linked to 14 fundamental needs
what is Callista Roy's theory?
ADAPTATION
person: adapting to stimuli present as a result of their position on health-illness continuum
environment: constantly changing stimuli to which person adapts
nursing: promotion of client adaptation
health: way in which beings interact with + adapt to environment
what is science aspect of nursing?
theories
evidence informed knowledge
research
clinical guidelines
what is art aspect of nursing?
human interactions
caring
what are 5 ways of knowing in nursing?
empirical - data from science
personal - relational (ability to relate/engage) + knowing oneself
aesthetic - understanding person's experience with illness + nurse actions tailored to person uniqueness + therapeutic relationship
ethical - adhering to code of ethics, knowing right/wrong, taking responsibility for actions
emancipatory - awareness of social problems, considers SDoH, taking action to create social change
what is a health promotion?
efforts aimed at increasing peoples control over the things that affect their health
includes health education, nutrition, sanitation, advocacy, community participation + prevention of disease
help develop skills to improve and maintain their own health and well-being
what are the 5 health promotion strategies from the Ottawa Charter for Health Promotion?
build healthy public policy: unemployment insurance, child daycare
create supportive environments: safe living/working conditions, stimulating, enjoyable
strengthen community actions: empowerment of communities (social support + self-help)
developing personal skills: enable to learn, prepare themselves, to cope
reorienting health services: responsibility is shared among individuals, community groups, health pros, governments
what are the 4 primary health care principles (WHO)?
universal access to care + coverage on basis of need
commitment to health equity as part of development oriented to social justice
community participation in defining and implementing health agendas
intersectional approaches to health
what are the 3 levels of care?
primary care: healthcare provided by pros (physician, nurse, NP); early detection, routine care, health promotion, prevention
secondary: usually in hospital, specialists (cardiologist, dermatologist...)
tertiary: more complex pathologies, teaching hospitals
what are factors that influence how we practice nursing?
nursing mandates: laws, code of ethics, standards
nursing theories/approaches/conceptual models
education background
nurse's beliefs, assumptions and values
work and life experience
work environment
what is SBN approach?
approach to nursing guided by 8 core values
collaborative + strength based approach
approach that considers whole person
- focuses on what is working
- focuses on what person does best
- focuses on resources available to person
what are some SBN approach major features?
focus on what is working
avoid labels
uses strengths to build confidence to deal
person involved in choosing solutions
positive language
collaborative partnership
values subjective + objective info
knowledge created through experience and reflection
plan of care built on person strengths
person + family determines outcome
explain the overview of SBN approach
place person at centre of own care (person-centred care)
empowers ppl to achieve their own goals (empowerment)
encourages to take charge and be responsible of their own health recovery and healing (health promotion, prevention + self care)
collaborative relationship between pt + healthcare provider (collaborative partnership)
works with persons strengths to help them deal + meet goals
what are the 4 pillars of SBN?
person/family entered care
empowerment
relational care
innate health and healing
explain person/family centered pillar
providing care that is respectful of and responsive to pt preferences, needs and values, and ensuring the pt values guide clinical decisions
place pt at centre of care
pt is engaged + involved in decision making
pt beliefs + values respected
pt given opportunity to talk about his experience living w/health issue
care is tailored to unique needs/concerns
health challenges understood within person context
explain empowerment pillar
a social process of recognizing, promoting, and enhancing peoples abilities to meet their own needs, solve their own problems, and mobilize the necessary resources in order to feel in control of their life
by working with strengths, uncovering new strengths, helping turn deficits into strengths, the nurse helps person experience greater control over their health + helps them attain their health goals
explain innate health and healing pillar
ppl are born w/capacities, potential to heal, grow and thrive
innate abilities include the ability to form relationships, emotional regulation, curiosity, need to learn
abilities develop over lifespan, they help adapt, develop and cope with adversity
nurses promote support, supplement restore and help develop persons capacities and natural healing processes (inner strengths)
explain relational care pillar
everything a nurse sees, does and experiences arises from relationship with pt
SBN values nurse-pt relationship
what are 8 core values of SBN?
holism and embodiement
reality and created meaning
self determination
learning/readiness/timing
collaborative partnership
health and healing
uniqueness
environement
explain the health and healing core value
nurses promote health and healing and alleviate suffering
health = being in state of balance/harmony, NOT absence of illness, encompasses ones physical, psychological, spiritual well-being
when person not in state of equilibrium, they are healing their state of harmony
ex: how would u describe your health? what kind of things do you do to feel better?
explain the uniqueness core value
nurses respect + acknowledge persons uniqueness by getting to know the pt in their care
curious to know what makes a person who they are, what is diff apt their experience, what Sx are like for them, how they have responded in the past
ex: how do you usually respond to this Tx?
explain the environment core value
nurses address the persons environment in order to provide quality care: the internal, physical cultural and social environments are all considered
the quality of ones environment will affect ones health and healing; people thrive when there is a goodness of fit between them and their environment
ex: how is your family affected by your illness?
explain the holism and embodiment core value
nurses view person as a whole, they explore all aspects of individuals health challenge - how it impacts their psychological and physical states - because nurses recognize mind-body connection
ex: how is your health concern affecting your mood?
explain the reality+created meaning core value
nurses look at persons objective data + subjective reality and meaning they have created to understand situation
must explore persons understanding of his experience to create complete picture of person + provide care in a sensitive/meaningful/responsive way
ex: what do you think is contributing to your health concern
explain the self-determination core value
nurses value the pt's choices and believe the decisions are best made when pt + families are well informed
ex: what info would help u make ur decision?
explain the learning/readiness/timing core value
nurses recognize that learning is essential for a person to navigate his environment + to live to their fullest
nurses need to know their pt to be able to determine when an intervention is most likely to be successful; readiness to learn is linked to timing
ex: is this a good time to find ways to address this health concern?
explain the collaborative partnership core value
nurses view the nurse-pt relationship as collaborative: both involved in setting goals, developing plan + evaluating outcomes
nurses learn from patients + other way around
each partner brings own knowledge skill + experiences to relationship and is open to learning from each other; built on mutual respect + trust
ex: tell me how I can help
what is difference between collaboration and cooperation?
cooperation = planning + working together in a helpful way: person can be unassertive, passive but be cooperating
collaboration = cooperation but also assertiveness and active involvement
what are the 5 essential ingredients of a collaborative partnership?
sharing power
open + respectful
being non judgemental
living with ambiguity
being self aware and reflective
explain sharing power
the heart of a collaborative partnership
both partners set agenda + determine plan
both partners share responsibility
info and knowledge flow in both directions
explain open + respectful
willingness to develop a relationship with each other
willing to share info, ideas + perspectives
willing to experiment, change + learn
respects knowledge, skill, experience, expertise of other
honouring differences + looking for common ground to manage differences
explain being non-judgemental and accepting
showing tolerance for others beliefs, values, behaviours and perspectives
try to understand other persons perspectives
explain living with ambiguity
there are 2 drivers
not clear to either partner how situation will unfold
both must be able to tolerate uncertainty and unpredictability
both must be flexible and adaptable
explain being self-aware and reflective
requires both self awareness + awareness from other
need to be aware of dynamics + impact of ones behaviour having on other
using reflection