lecture 11: 8 senses for practice + professional gaze

A broad knowledge base in nursing science that draws knowledge from health sciences, social sciences, humanities..

Skills (technical, communication...)

Clinical Reasoning Skills

Ethical Comportment

In the process of becoming a nurse, one must learn new roles, assume new responsibilities, and revise one’s own identity so that it includes “nurse”

learning that is gained while nursing (in clinical settings)

• Combines theory & practice• Clinical instructor/preceptor provides students with learning opportunities

learning that is gained in a specific context & with a specific patient

• Being aware of the context/uniqueness of the person and situation

• Clinical Instructor/preceptor coaches students (points things out, asks questions, encourages reflection....)

Term used to describe the learning and educational experiences involved in learning to nurse

Involves training and retraining the senses as well as reforming social engagement and social involvement skills

• Clinical conversation vs Social Conversations

Develops over time- learning, experience...

• Involves retraining and re-forming that builds on the person’s existing knowledge, skills, capabilities, strengths... that will be used in a new context (health care) and for a new purpose (caring for people & families)

• Retraining of sensory system

Understanding the nature/meaning of the situation you are observing

for effective clinical reasoning

Observation

Attunement to sounds, smells, touch,

observations ...

Listening to patients and families

Discriminating and identifying salience (importance) from observations

Paying attention to another’s needs

Paying attention to cues

Noticing and identifying what information is important, what needs immediate attention, and being able to respond accordingly

Making a connection with the person

Taking in information, appraising it, and interpreting it

Being open to, sensing, and monitoring one’s own internal state and bodily sensations

Noun: Five traditional senses; sight, hearing, smell, taste, and touchVerb: Perceiving something, become aware of something, and recognizing something

Senses assist us in knowing and understanding our environment & knowing and understanding ourselves.

visual system: sight + images

gustatory system: taste + flavors

somatosensory system: touch

olfactory system: smells + odors

auditory system: hearing + sound

3 inner senses:

awareness of internal bodily sensations (what is happening inside us)

awareness of an awareness (one's feelings + thoughts)

relational sensing (effect of environment on us)

Nurses make sense of the information obtained through their senses and they base their clinical decisions on their understanding of the situation.

• Sensations in our limbs, our body’s motion, the tension or relaxation of our muscles, the state of our internal milieu, including our organs such as the lungs, heart, and intestines.

Giving attention to and reflecting on our physical sensations/reactions (self- awareness)

• Aspects of mind—thoughts, feelings, intentions, attitudes, concepts, images, beliefs, hopes, dreams—of oneself or others to be brought into the focus of attention.

Giving attention to and reflecting on our thoughts, feelings...(self- awareness)

• Represents our sense of relationship, our connection, with some being.

• Perceiving non -verbal emotional signals

Giving attention to and reflecting on how we are relating with others, connecting with others, ability to from relationships with others. (self- awareness)

Building on existing knowledge and skills and using sensory system in a new way/new purpose.

Using your eight senses to understand the patient and his clinical situation.

Learning to interpret information gathered through your eight senses using a

Nursing lens & SBN lens.

Need to be a sharp observer as well as to be aware of your internal bodily sensations; be aware of your thoughts and feelings and how you are connecting/not connecting with patients, families and other health care workers.

assessment

nursing analysis

interventions

outcomes + follow up

• Exposure to novel experiences• Benefiting (Learning) from mistakes and obstacles

• Practice and experience

Take time to reflect on what is new and novel

• What did I already know?• What was new?• What surprised me?

• Had I ever seen, heard, smelled or felt anything like this before?

Write down your observations causes you to slow down, process and review information, reflect on what’s been learned, and may lead to an awareness of new details.

Share observations with others–their comments and questions area source of feedback, which leads to reflection.

Identify, what, if anything “feels”familiar, and build on that knowledge.

Historically, and sometimes culturally, mistakes were sources of shame. They can threaten our sense of self.

Today, there’s a growing trend to try and learn from mistakes.

Each mistake, is an opportunity to learn!

Mistakes can result in new skills and insights, because they force you to slow down, think, focus and correct a mental process.

Seek feedback. Timing and tone will impact its effectiveness.

Face mistakes, don’t avoid them.

Work to reflect on mistakes and try to understand what happened and what factors contributed to the mistake.

Engaged and sharp observer

Clinical Judgment and Decision Making

Nursing Actions

Quality care begins with accurate and detailed observations