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NURS 201: Fundamentals of Nursing and the Caring Process Topic: Caring

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Lindsey is a senior nursing student assigned to care for Mrs. Lowe, a 62-year ... Nightingale's theory. Focus on the client's environment. Peplau's theory ... – PowerPoint PPT presentation

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Title: NURS 201: Fundamentals of Nursing and the Caring Process Topic: Caring


1
NURS 201 Fundamentals of Nursing and the Caring
ProcessTopic Caring
2
Theories of Caring
  • Benner and colleagues
  • Caring is primary
  • Leininger
  • Transcultural perspective
  • Watson
  • Transpersonal caring

3
Theories of Caring (contd)
  • Swanson five processes of caring
  • Knowing
  • Being with
  • Doing for
  • Enabling
  • Maintaining belief

4
Caring Behaviors
  • Providing presence
  • Touch
  • Listening
  • Knowing the client
  • Spiritual caring
  • Family care

5
(No Transcript)
6
Caring
  • Lindsey is a senior nursing student assigned to
    care for Mrs. Lowe, a 62-year-old client being
    treated for lymphoma (cancer of the lymph nodes).
    Mrs. Lowe is to receive an injection for her
    pain. In what way can Lindsay show caring in the
    way she administers the injection to Mrs. Lowe?

7
Caring
  • Mr. Leonard is a 42-year-old man who is married
    and has two teenage daughters. He underwent
    surgery this morning for an angioplasty to
    correct obstruction of his coronary arteries. The
    recovery room nurse calls the nursing division
    and tells you that Mr. Leonard has arrived, is
    stable, and will likely be there for 2 to 3
    hours. His doctor will be up to the division
    shortly. What can you do to demonstrate caring
    for Mr. Leonard?

8
Break time!!
9
Introduction to Nursing the Caring Process
  • Theoretical and Research Foundations of Nursing
    Practice

10
So What is Nursing?
11
KCU Definition of Nursing
  • Nurses as role models must endeavor to pursue
    healthy lifestyles, promote wellness within the
    family, community, and global village and effect
    social change that promotes a healthy
    environment.
  • Nurses must be able to make responsible moral and
    ethical decisions and think logically,
    analytically, and critically.
  • Nurses must know how to seek, find, and use
    health information and commit to lifelong
    learning.

12
KCU Definition of Nursing
  • Nurses must be skilled contributors to their
    profession, committed to serving the needs of
    others, regardless of ethnic identity, race,
    gender, age, status, diagnosis, or ability to
    pay.
  • Using Jesus Christ as a model of servant
    leadership, nursing is a ministry of
    compassionate, competent, and comprehensive
    physical, psycho social, and spiritual caring,
    even if the nurse's personal beliefs do not
    coincide with those of the individual, family, or
    community receiving her/his care.

13
Characteristics of a Profession
  • Specialized Education
  • Body of Knowledge
  • Deliver Unique Service
  • Code of Ethics
  • Autonomy
  • Professional Behaviors

14
Nursing Beliefs
  • Holistic
  • Person
  • Health
  • Environment
  • Nursing

15
Components of a Theory
  • Set of concepts
  • Definitions
  • Relationships
  • Assumptions or propositions

16
Model of Nursing Beliefs
Environment
Environment
Nursing
Person
Health Continuum
Optimal Health
17
Interdisciplinary Theories
  • Systems theory
  • Basic human needs
  • Health-and-wellness model
  • Stress and adaptation
  • Developmental theories
  • Psychosocial theories

18
Selected Nursing Theories
  • Nightingales theory
  • Focus on the clients environment
  • Peplaus theory
  • Focus on interactive processes
  • Hendersons theory
  • Focus on 14 basic needs

19
Selected Nursing Theories
  • Abdellahs theory
  • Focus on holistic client needs
  • Johnsons theory
  • Focus on clients ability to adapt
  • Rogerss theory
  • Focus on unitary being as an energy field
    continuously interacting within the universe

20
Selected Nursing Theories
  • Orems theory
  • Focus on self-care
  • Neumans theory
  • Focus on systems approach and clients responses
    to stressors
  • Leiningers theory
  • Focus on cultural care

21
Selected Nursing Theories
  • Kings theory
  • Focus on interaction of personal, interpersonal,
    and social systems
  • Roys theory
  • Focus on adaptation to changing needs
  • Watsons theory
  • Focus on transpersonal caring

22
Watsons Philosophy Science of Caring
  • Person
  • Viewed as being-in-the-world
  • Three spheres of being mind, body, soul
  • Experiencing perceiving organism
  • A persons existence is embodied in experience,
    in nature, and in the physical world, but a
    person can transcend the physical world nature
    by controlling it, subduing it, changing it, or
    living in harmony with it.

23
Watsons Philosophy Science of Caring
  • Health
  • Unity harmony within the mind, body, and soul.
  • Goal of the person is self-actualization.
  • Illness
  • Not necessarily disease subjective turmoil or
    disharmony within the soul
  • Troubled inner soul can lead to illness, and
    illness can produce disease.

24
Watsons Philosophy Science of Caring
  • Environment
  • Phenomenal field totality of human experience
    influences how a person perceives and responds in
    a given situation
  • Two persons (nurse and other) together with their
    unique life histories and phenomenal field in a
    human care transaction an actual caring
    occasion involves action choice.

25
Watsons Philosophy Science of Caring
  • Nursing
  • Dynamic changing
  • Nurse as a person nurse as responses and
    behaviors
  • Knowledge, thought, values, philosophy,
    commitment, action, passion.
  • Human care and caring is viewed as the moral
    ideal of nursing.
  • Transpersonal human care giving-receiving
    behaviors responses between two people.

26
KCC SoN Philosophy
  • Individual
  • A physically, psychosocially, and spiritually
    integrated being endowed with dignity and worth
    who is created in Gods image and has the
    capacity to live in a loving relationship with
    God, self, others, and the environment.
  • Possesses self-direction and can be a responsible
    steward of Gods gifts of health and the
    environment.
  • Composed of larger groups family, community,
    global village.

27
KCC SoN Philosophy
  • Health
  • A gift from God.
  • Being able to optimally function as God
    originally created man.
  • Never complete on this earth but can only be
    realized in eternity.
  • Individual perception of and satisfaction with
    ones ability to optimally function.
  • Connections with family, community, global
    village can facilitate health.

28
KCC SoN Philosophy
  • Environment
  • A gift from God.
  • All factors that affect an individuals behavior
    but that are external to the individual
    includes both spiritual and physical realities.

29
KCC SoN Philosophy
  • Nursing
  • Ministry of compassionate, competent,
    comprehensive physical, psychosocial, and
    spiritual caring, even if the nurses personal
    beliefs do not coincide with those of the
    individual, family, or community receiving care.
  • Servant leaders.
  • Promote wellness and effect social change that
    promotes a healthy environment.
  • Skilled contributors to the profession.

30
The Role of Nurses in Research
31
Knowledge Acquisition
  • Tradition
  • Information seeking
  • Experience
  • Problem solving
  • Critical thinking

32
Classification of Sources
  • Primary
  • Secondary

33
Role of Nurses in Research
  • Associate degree nurse
  • Participate in research activities
  • Baccalaureate degree nurse
  • Read research critically and determine use of
    findings in practice
  • Masters degree nurse
  • Active member of the research team
  • Doctoral education
  • Design studies and conduct research independently
    and collaboratively

34
Nursing Process
  • Assessment
  • Planning
  • Implementation
  • Evaluation

35
Chapter 15
  • Nursing Assessment

36
Nursing Process
  • Steps
  • Assessment
  • Nursing diagnosis
  • Planning
  • Implementation
  • Evaluation

37
The Nursing Process
38
Nursing Process (cont'd)
  • Assessment
  • Critical thinking approach

39
Critical Thinking and the Nursing Process
40
Assessment - Steps
  • Collection and verification of data
  • Analysis of data

41
Assessment - Approaches
  • Use of a structured database format
  • Problem oriented

42
Assessment Data Collection
  • Types of data
  • Objective
  • Subjective
  • Sources of data
  • Primary
  • Secondary

43
Assessment Methods of Data Collection
  • Interview
  • Orientation phase
  • Working phase
  • Termination phase
  • Nursing health history
  • Components
  • Physical examination
  • Diagnostic and laboratory results

44
Assessment Process
  • Nursing judgments
  • Data validation and interpretation
  • Data clustering
  • Documentation

45
Chapter 16
  • Nursing Diagnosis

46
Nursing Diagnosis
  • Definition
  • Evolution
  • NANDA
  • Critical thinking approach

47
NANDA Diagnoses
  • North American Nursing Diagnosis Association
  • Purpose to develop, refine, and promote a
    taxonomy of nursing diagnostic terminology of
    general use for professional nurses (p.301)
  • pp. 301 302

48
Diagnostic Process
  • Analysis and interpretation of data
  • Identification of client needs

49
Steps of Data Analysis
  • Recognize a pattern or trend
  • Compare with standards for normal
  • Make a reasoned conclusion

50
Types of Diagnoses
  • Actual
  • Risk
  • Wellness

51
Components
  • Diagnostic label
  • Related factorsetiology
  • Definition
  • Risk factors
  • Support of the statement

52
Sources of Errors
  • Data collection
  • Interpretation and analysis of data
  • Clustering
  • Diagnostic statement

53
Critical Thinking and Diagnosis
54
Avoiding and Correcting Errors
  • Identify the clients response
  • Identify a NANDA statement
  • Identify a treatable etiology
  • Identify the problem caused by a treatment or
    diagnostic study
  • Identify the client response to equipment

55
Avoiding and Correcting Errors (contd)
  • Identify the clients rather than the nurses
    problems or interventions
  • Identify the clients problem rather than the
    goal
  • Make a professional judgment
  • Avoid legally inadvisable statements

56
Avoiding and Correcting Errors (contd)
  • Identify the problem and etiology
  • Identify only one problem in the diagnostic
    statement

57
Chapter 17
  • Planning Nursing Care

58
Planning
  • Establishing priorities
  • Determining client-centered goals and outcomes
  • Selecting nursing interventions

59
Planning (cont'd)
  • Priorities
  • High
  • Intermediate
  • Low

60
Planning (cont'd)
  • Goals
  • Guidelines
  • Time limited
  • Short term
  • Long term

61
Critical Thinking and Planning
62
Outcomes
  • Progressive steps
  • Linked to goals and nursing diagnoses
  • Guidelines

63
Goals and Outcomes
  • Guidelines
  • Client centered
  • Singular
  • Observable
  • Measurable
  • Time limited
  • Mutual
  • Realistic

64
Nursing Interventions
  • Types
  • Nurse initiated
  • Physician initiated
  • Collaborative

65
Nursing vs. Medical Dx
66
Nursing Interventions (cont'd)
  • Selection criteria
  • Characteristics of nursing diagnosis
  • Expected outcomes
  • Research base
  • Feasibility
  • Acceptability to the client
  • Nurse competencies

67
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68
Care Plans
  • Student (see KCU example)
  • Institution
  • Community-based settings
  • Critical pathways
  • Concept maps

69
Chapter 18
  • Implementing
  • Nursing Care

70
Implementation
  • Types of nursing interventions
  • Direct and indirect
  • Protocols and standing orders

71
Nursing Interventions
  • Critical thinking and selection of nursing
    interventions
  • Nursing diagnosis
  • Expected outcomes
  • Evidence based
  • Feasibility
  • Acceptability
  • Nurse competencies

72
Critical Thinking and Implementation
73
Implementation Process
  • Reassessing the client
  • Reviewing and revising the existing care plan

74
Implementation Process (cont'd)
  • Organizing resources and care delivery
  • Equipment
  • Personnel
  • Environment
  • Client
  • Anticipating and preventing complications
  • Identifying areas of assistance

75
Implementation Process D/C
76
Implementation Skills
  • Cognitive skills
  • Interpersonal skills
  • Psychomotor skills

77
Direct Care Measures
  • Activities of daily living (ADLs)
  • Instrumental activities of daily living
  • Physical care techniques
  • Counseling
  • Teaching
  • Controlling for adverse reactions
  • Preventive measures

78
Indirect Care Measures
  • Communicating nursing interventions
  • Delegating, supervising, and evaluating the work
    of other staff members

79
Chapter 19
  • Evaluation

80
Process
  • Identifying evaluative criteria and standards
  • Collecting data to determine if criteria or
    standards are met
  • Interpreting and summarizing findings
  • Documenting findings
  • Terminating, continuing, or revising the care plan

81
Critical Thinking and Evaluation
82
Success of Goals
  • Examine the goal statement
  • Assess the client
  • Compare the outcome with client behavior or
    response
  • Judge the degree of agreement between outcome and
    client response
  • Determine reasons for no agreement or partial
    agreement

83
Care Plan Revisions
  • Discontinuing
  • Modifying
  • Reassessment
  • Nursing diagnosis
  • Client goals and outcomes
  • Nursing interventions

84
Quality Improvement
  • Approachpurpose
  • Outcome management
  • Professional outcomes
  • Client outcomes

85
Example of a Goal, Outcome, and Evaluative Measure
  • Goal clients pressure ulcer will heal within 7
    days
  • Outcome erythema will be reduced in 2 days
  • Evaluative measure inspect color, condition, and
    location of pressure ulcer

86
Practice Time!!
  • Select scenario
  • What assessment would you perform?
  • What would you consider in planning?
  • How would you implement your plan?
  • How would you evaluate if you were successful in
    your care?
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