Culture
thoughts, communications, actions, customs, beliefs, values, & institutions of groups (racial, ethnic, religious, or social)
Ethnicity
shared identity r/t social & cultural heritage (eg: values, language, geographical space, & racial characteristics)
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Cultural competence
process of acquiring specific knowledge, skills, & attitudes to ensure delivery of culturally congruent care
Components of cultural competence
-awareness (in-depth self-examination)
-knowledge (comparative knowledge of diverse groups)
-skills (ability to assess factors influencing care & tx)
-encounters (engagement in cross-cultural interactions)
-desire (motivation & commitment to caring)
Communication
lifelong learning practice & essential attribute of RN. Builds relationship to share information
Intrapersonal communication
communication within an individual. Self-talk or inner thought
Interpersonal communication
one-on-one interaction. Heart of nursing practice - means to establishment of help-trust relationship
Transpersonal communication
communication within spiritual domain (prayer, meditation, guided reflection)
Small-group communication
interaction with a small number of people
Public communication
interaction with an audience
Referent
motivation for communication
Sender/receiver
people involved in active process of communication
Message
content of communication (verbal, nonverbal, & symbolic language)
Channels
means of conveying & receiving messages - auditory, visual, & tactile channels
Feedback
message receiver returns to sender. Indicates if receiver understood original message
Components of verbal communication
vocabulary, intonation, denotative & connotative meaning, clarity & brevity, and timing & relevance
Denotative & connotative meaning
denotative - literal (dictionary) meaning
connotative - interpretation of a word influenced by thoughts or feelings people have about the word
Components of nonverbal communication
personal appearance, posture & gait, facial expression, eye contact, gestures, sounds,and territoriality & personal space
Territoriality
need to gain, maintain, & defend one's right to space. Provides identity, security, & control
Personal space
invisible, individual, & travels with person
Symbolic communication
verbal & nonverbal symbolism to convey meaning. Eg: art, music, & dance
Metacommunication
broad term; all factors influencing communication. Sometimes incongruence btw word & body language
Phases in nurse-pt communication
1 - preinteraction phase
2 - orientation phase
3 - working phase
4 - termination phase
Therapeutic communication
encourages expression of feelings & ideas; conveys acceptance & respect
Active listening - therapeutic
SOLER: Sitting forward, Open posture, Leaning in, Eye contact, Relax
Nontherapeutic communication techniques
personal questions, personal opinions, changing the subject, automatic responses (stereotypes), false reassurance, sympathy, asking for explanations, approval or disapproval, arguing, and defensive, passive, or aggressive responses
SBAR benefits
-standardizes & organizes essential info
-pertinent & focused
-common expectations
Situation (SBAR)
name, unit, patient, problem
Background (SBAR)
admission date & dx, pertinent medical hx & tx
Assessment (SBAR)
vital signs, on oxygen, pt complaints, change from prior nursing assessment
Recommedation (SBAR)
testing, medication, notification, when to call again
SBAR trigger phase
"I need some clarification..."
SBAR documentation
-change in condition
-notification of HCP
-orders
-reassessment
Nurse Practice Act - components specific to documentation
-recording & reporting nursing assessment
-recording & reporting the plan for care, care provided, & pt response
Core standards for documentation
client-focused, relevant, comprehensive & concise, accurate, timely, confidential, permanent record of care
Pt education goals
-maintenance of health and illness prevention
-restoration of health
-coping with impaired functioning
Teaching
interactive process that rpomotes learning
Learning
purposeful acquisition of new knowledge, attitudes, behaviors, & skills
Basic learning principles
-motivation to learn
-ability to learn
-learning evironment
Domains of learning
cognitive: intellectual behaviors; requires thinking
affective: expression and acceptace of feelings, attitudes, opinions, & values
psychomotor: integration of mental & muscular ability
Analogy
supplement of verbal instruction with familiar images. Eg: blood through arteries is like water in hose
Role play
people are asked to play themselves or someone else
Simulation
teaches problem-solving, application, & independent thinking
Ethics
study of conduct & character
Beneficence
helping others
Nonmaleficence
"do no harm"; not using a tx that causes more harm than good
Nurse's primary committment
patient
Value
personal belief influencing behavior
Ethical issues involve at least one of what 3 criteria
-cannot be solved through review of data
-difficult to make a decision re problem
-answer will have a profound meaning to a human interest
Tort
civil wrong made against person/property: assault, battery, false imprisonment, defamation, negligence (falls below standard), malpractice (professional negligence)
Assault
person is fearful
Battery
intentional touching w/o consent