what are the 2 parts of work of nursing?
doing + being
explain doing
tasks, procedures, assessments
visible + measurable
explain being
relational profession in which nurse and pt enter into partnership
skills of being
heart of nursing
art of nursing
why are relationships so critical to nursing?
nursing is a relational phenomenon because everything a nurse sees, does and experiences arises from relationship
what is being in SBN approach?
the way nurse is with pt
the way nurse engages, connect and is involved with pt
giving the other voice
being committed to and caring for another with compassion, respect and dignity
what is caring?
creating conditions that fosters a persons growth and development
what does communication connect people + ideas through?
words, nonverbal behaviours + actions
who has interpersonal communications in healthcare settings?
pt
family
staff (I.e., security)
healthcare pros
how does effective interpersonal communication impact quality of care?
helps develop a collaborative care partnership
better understanding of person + situation
identify health issues + earlier recognition
helps create individualized plan
what is therapeutic communication?
dynamic process entered into by health care providers, with the person and significant others for purpose of achieving health-related goals
encompasses many skills; both verbal + nonverbal
helps pt meet goals + places them in better condition to heal
what is a therapeutic relationship?
a type of social involvement that the nurse creates with pt to help promote health, help them deal with suffering, recover and facilitate self-healing
connecting with person through knowing them
what are the 3 elements to building a connection with a patient?
mutual attentiveness - attend to others concerns + communicate understanding
positivity - focus on strengths
coordination - tailoring ur response to the other in a way that respects and matches their individual
what are the 3 As of therapeutic relationships?
Attunement and Awareness
Authentic presence
Authentic listening
explain Attunement and Awareness
nurse + pt are attuned to one another's thoughts + feelings and are responding in ways that are in sync
become a sharp observer + attentive listener
being aware of our thoughts and feelings and effects that we may have on others
explain Authentic presence
being fully present (mentally + physically)
communicating our interest in pt via our verbal + nonverbal
adopting stance of a learning (respect + humility)
explain Authentic listening
being fully present
adapting an unhurried stance
listening for underlying message, stated or not
being comfortable with silence
not interrupting
use open ended questions
what is Attunement?
how reactive a person is to another's emotional needs and moods
well attuned = will respond with appropriate language and behaviours based on another person's emotional state
what are the best practice guidelines of establishing therapeutic relationships?
its purposeful directed at advancing the best interest + outcome of pt
requires reflective practice: self awareness, self knowledge, empathy
awareness of boundaries + limits of professional role: focus on pt, health related, involve thought/reflection, avoid disclosing personal info
must place clients needs before his own needs
what is a clinical conversation?
can be brief or long, can have many forms (discussion, interview)
getting to know ur pt so that u can deliver appropriate care
clinical inquiry: gathering relevant info that will inform interventions, monitoring pt situation
opportunity for nurses to promote health, alleviate suffering, and promote healing
why should you use open ended questions
it facilitates dialogue, helps with getting to know pt
what are 4 types of questions in SBN?
focused: when did this start? what makes it better/worse? what have you done?
clarification: I am not sure what you mean, can you describe it further?
elaboration: did anything else happen when you tried this?
circular: differences (can you help me understand how this is different from the last time?), hypothetical (if you could change one thing what would it be?), future oriented (what are you hoping you will achieve?)
give question examples for health and healing value
how would you describe your health at the moment?
are there things about your current state of health you wish were different?
what kind of things do you do to help you feel better?
give question examples for uniqueness value
is this the first time you've experienced this health concern?
what concerns you the most?
tell me how you typically respond to this treatment.
give question examples for holism and embodiment value
do you see yourself differently since you've been experiencing this health concern?
how is your health concern affecting your mood?
do you see yourself differently since you've been experiencing this health concern?
give question examples for reality + created meaning value
tell me how you see this situation. what do you think is contributing to your health concern?
help me understand how your health concern is impacting your daily life.
give question examples for environment value
how is your workplace impacting your health concern? what makes it better/worse?
how are your health concerns affecting how you function within your family?
how is your family being affected by your health concern?
give question examples for self-determination value
what decisions are you considering related to your health concern?
what info would help you with making your decision?
what do you think is possible for you to try?
give question examples for collaborative partnership value
tell me how I can be of most help. what's been most helpful in the past?
share with me what you would like to see happen in the future
give question examples for learning value
is this a good time to find ways of addressing this health concern?
what info would you like to know at this time?