Exam (elaborations) Nr 222 H_W_exam_2

Make sure we’re not unconsciously biased  Evaluate our own values Therapeutic communication  Purposeful use of communication  Build+ maintain helping relationships with patients, families, significant others  Purpose to our conversation  Patient-centered/ planned/ goal directed  Factors o Rapport  Harmony + affinity between people in relationships o Empathy  Understand another’s feeling without losing personal identity + perspective o Trust o Reliance on pt to carry out responsibilities + prmises o Proxemics  Personal space  Intimate: 0-1.5 ft  Personal: 1.5-4 ft  Social: 4-12 ft  Public: 12 – 25< ft  techniques o active listening o sharing o touch o silence o clarifying o reflecting o focus o paraphrase o summarize o humor health promotion/ sensitivity to each pt. goals + values  goals to have pt adopt health promoting behaviors o info not enough therapeutic effectiveness  self-awareness + self-reflection  openness  self-confidence + strength  genuineness  concern for individual  respect for individual  knowledge  ability to empathize  sensitivity  acceptance  creativity  ability to focus + confront Emotional/ spiritual/ physical care  Listening o Shows pt you care o Get info  Silence o Nonverbal response  Open ended questions  Listen/ silence/ touch/ convey acceptance Health people 2020  Improve health literacy o Health promotion requires effective communication o Read, comprehend, + follow through on health info. Values clarification  Method discovering 1’s values + importance of these values  Own values + biases  Helps people recognize what values they hold + evaluate how those values influence their actions  Pt values lead to behaviors that conflict with RN value of promoting health o Ethical dilemmas o RN examine conflicting values o Possible outcomes to promote health interventions Steps in self-awareness  Listening to oneself o Self-concept  Mental picture of self o Self-esteem  How people feel about way they see themself o Judgement + attitudes about self  Listening to + learning from others o feedback  Self-disclosure o Share aspects of self o Disclosure in 1 triggers disclosure in another  Practical reflection o Understand 1’s own thoughts + actions to take action in future  Need self awareness + clarifications of values o Therapeutic use of self impaired Relationship stages  Orientation/ introductory phase/ RN + pt meet o RN structure interaction o Establishing a connection  Consistency  Sensitive pacing of communication  Active listening  Conveying concern + warmth  Pay attention to comfort + control  Working phase o RN + pt work together to promote pt’s health  Termination phase o Ending relationship  For therapeutic relationships Ethical communication  How receiver getting message  Treat people with respect  Barriers o Sender o Message o Receiver o Anxiety/ attitudes/ noise/ activity/ distance/ language/ beliefs/ touch/ eye contact/ appearance/ emotion/ body language/ gestures/ interruptions/ distractions/ illness/ medications o 90% communication nonverbal o Did they just receive news  Effective communication o Listening  Reciprocity  RN matches nuances of pt style + behavior, pt interpret RN as active listening increase, misinterpretations decrease o Flexibility o Silence o Humor o Touch o space Forms of communication  Verbal o Using words/ spoken, written o Vocabulary o Word meaning o Pacing o Intonation o Clarity+brevity o Timing+relevance  Non-verbal o Messages not spoken, written o Transmit info about another’s thought + feeling o silence o Posture+gait o Facial expressions o Eye contact o Gestures o Sounds o Territoriality + personal space o Personal appearance Non-therapeutic communication  T o Is it true  H o Is it helpful  I o Is it inspiring  N o Is it necessary  K o Is it kind Communication techniques  Open-ended ? o Describe the problem o Tell me how I can help you o When did the pain start o How have you been feeling since your last appointment o You mentioned abdominal pain. Tell me more about that  Closed-ended ? o Do you eat healthy food o Do you exercise o Do you follow a particular diet o When do you shop for food o Do you sleep well o Very specific  Special needs o Can’t speak clearly o Are cognitively impaired o Hearing +/or visually impaired o Unresponsive o Don’t speak English  C o Connect with pt  A o Appreciate pt situation  R o Respond to pt  E o Empower pt Holistic health: taking care of whole person Complementary  Using healing practices  Products that work in conjunction with traditional western medicine Alternative  No western medicine  Healing practices only Chiropractor/ primary health provider American holistic rn association  Support pt natural healing  Consider whole person  Consider environment  Connect pt spirit/ thoughts/ body Rn healer  Rn presence can contribute to healing  Pt-centered  Facilitative decision-making  Being with instead of being there Holistic principles for rn  Examine own thoughts about healing + rn  Be aware of effect of thoughts, voice, words  Incorporate holistic healing in own life Holistic health  Acupuncture  Cupping  Whole medical systems o Traditional Chinese medicine o Naturopathy  Healing power of nature o Homeopathy  Treats whole person  Symptoms body’s effect to rid itself of disease o Ayruvedic/ india  Biological based o Herbal  Treat of enhance body systems o Probiotics  Live microorganisms in gut o Hydrotherapy  H2O, ice, steam, hot + cold, maintain + restore health o Aromatherapy  Oils, smells  Movement o Qi gong  Relaxed movements  With meditative aspect + controlled breathing  Move qi energy through energy channels + increase vital energy o Tai chi  Physical movement, breath control, meditation/ slow o Yoga  Postures, controlled breathing, medication  Meditation o Transcendental o Mindfulness o Walking o Breathing  Prayer + distance healing  Mind-body o Guided imagery  Access inner pharmacy  Body responses to sensory images o Music therapy  Impact limbic system/ emotions o Hypnosis  Energy-based o Acupuncture/ stimulate mapped points on skin  Manipulates life energy o Acupressure o Reflexology o Therapeutic touch o Healing touch  Touch o Therapeutic touch o Healing touch o Reiki/ japanese Health promotion/ holistic technique  Manipulative/ body based o Chiropractic medicine  Spine + joints  Spinal alignment for optimal nervous system function o Spinal/ bone manipulation o Massage o Cranio-sacral therapy/ originally osteopathy/ skull o Physical therapy  Massage, manipulation, hot+cold, movement, electrical impulses Nurturing self  Environment  Sleep  Exercise  Communication  Nutrition  Herbs  Aromatherapy  Love + healing Accessible therapies  Relaxation  Meditation+breathing  Guided imagery