NRS 101 Entry Into Professional Nursing Session 2

NRS 101 Entry Into Professional Nursing Session 2 Health & Wellness, Caring in Nursing, Ethics & Values

HEALTH AND WELLNES • IS IT THE ABSENSE OF DISEASE? • MULTIDIMENSIONAL CONCEPT – CONCEPTS OF: • WELLNESS • ILLNESS • HEALTH

HEALTH AND WELLNESS • ILLNESS BEHAVIOR—REACTION TO ILLNESS • HEALTHY PEOPLE 2000 FOCUS ON HEALTH PROMOTION AND DISEASE PREVENTION • HEALTHY PEOPLE 2010 INCREASE QUALITY AND YEARSS OF LIFE, ELIMINATE DISPARITIES IN HEALTH • HOW DO YOU DEFINE HEALTH?

HEALTH AND WELLNESS • WORLD HEALTH ORGANIZATION DEFINES HEALTH O AS A STATE “OF COMPLETE PHYSICAL, MENTAL, AND SOCIAL WELL BEING” • VARIABLES DEFINE HEALTH IN RELATION TO VALUES, LIFESTYLE, PERSONALITY, MENTAL, SOCIAL, AND SPIRITUAL WELL BEING

VIEWS OF HEALTH • VIEWS OF HEALTH DEPENDENT ON: – AGE – GENDER – RACE – CULTURE CONDITIONS OF LIFE HAVE NEGATIVE OR POSITIVE EFFECTS ON HEALTH

VIEWS OF HEALTH • PHYSIOLOGICAL • PSYCHOLOGICAL • SOCIOECONOMIC • LIFESTYLE CHOICES HEALTH DEFINED IN TERMS OF INDIVIDUAL NOT EVERY ILLNESS/DISEASE AFFECTS EVERYONE IN THE SAME WAY—WHY?

HEALTH BELIEF BEHAVIORS • HEALTH BELIEF BEHAVIORS – ATTITUDES ABOUT HEALTH – FACTS/MYTHS – FALSE EXPECTATIONS/REALITY POSITIVE/NEGATIVE HEALTH BEHAVIORS

HEALTH MODELS • HEALTH BELIEF MODEL--PREDICTS PT’S BEHAVIOR IN RELATION TO HEALTH COMPLIANCE WITH HEALTH CARE THERAPIES • HEALTH PROMOTION MODEL-DEFINES HEALTH AS NOT JUST ABSENSE OF DISEASE BUT AS A POSITIVE DYNAMIC STATE – HEALTH PROMOTING BEHAVIOR – MODIFIED THROUGH NURSING

HEALTH MODELS • BASIC HUMAN NEEDS MODEL (MASLOW) • HIERARCHY OF NEEDS • INTERRELATIONSHIP OF BASIC HUMAN NEEDS • PEOPLE SHARE BASIC HUMAN NEEDS • EXTENT TO WHICH NEEDS ARE MET DETERMINES PERSON’S LEVEL OF HEALTH

MASLOW BASIC NEEDS MODEL • PHYSIOLOGICAL – OXYGEN – FLUIDS – NUTRITION – BODY TEMP – ELIMINATION – SHELTER – SEX

MASLOW’S BASIC NEED MODEL • EMERGENT PHYSIOLOGICAL NEED ALWAYS TAKES PRECEDENT OVER A HIGHER LEVEL NEED • FOCUS ON PT NEEDS INSTEAD OF ADHERING TO HIERARCHY OF NEEDS • MUST PRIORITIZE—RELATIONSHIP OF DIFFERENT NEEDS AND REASONS DETERMINE PRIORITY

MASLOW’S BASIC NEED MODEL • SAFETY AND SECURITY— PHYSIOLOGICAL AND PSYCHOLOGICAL • LOVE AND BELONGING • SELF ESTEEM • SELF ACTUALIZATION

VARIABLES • INTERNAL VARIABLES AFFECTING/INFLUENCING HEALTH AND HEALTH BEHAVIOR – DEVELOPMENTAL STAGE – INTELLECT – PERCEPTION OF FUNCTIONING – EMOTIONAL FACTORS – SPIRITUAL FACTORS

VARIABLES • EXTERNAL VARIABLES AFFECTING/INFLUENCING HEALTH AND HEALTH BEHAVIORS – FAMILY PRACTICES – SOCIOECONOMIC – CULTURE

LEVELS OF PREVENTATIVE CARE • PRIMARY PREVENTION – AIMED AT PREVENTING DISEASE – PRECEDES DISEASE – HEALTH PROMOTION • • • IMMUNIZATIONS PERSONAL HYGIENE ALLERGENS NUTRITION STRESS

LEVELS OF PREVENTATIVE CARE • SECONDARY PREVENTION – FOCUS ON PT WHO IS EXPERIENCING DISEASE OR AT RISK OF DISEASE • DIAGNOSIS—PROMPT INTERVENTION • REDUCE SEVERITY • DELAY CONSEQUENCES OF ADVANCING DISEASE • SCREENING, TREATING EARLY DISEASE EVALUATE OUTCOMES

LEVELS OF PREVENTATIVE CARE • TERTIARY – DISEASE IS PERMANENT/IRREVERSIBLE – MINIMIZE EFFECTS OF LONG TERM DISEASE, DETERIORATION • REHABILITATION • PREVENT FURTHER DISABILITY • ACHIEVE AS HIGH A LEVEL OF FUNCTIONING AS POSSIBLE

RISK FACTORS ASSOCIATED WITH ILLNESS • RISK FACTOR—HABITS, CONDITIONS, SITUATIONS THAT PREDISPOSE A PERSON TO ILLNESS/ACCIDENT • PRESENCE OF RISK FACTORS DOES NOT MEAN PERSON WILL GET DISEASE

RISK FACTORS • GENETIC AND PHYSIOLOGICAL FACTORS • AGE • ENVIRONMENT • LIFESTYLE IDENTIFY, MODIFY, AND CHANGE RISK FACTORS DO THEY WANT TO CHANGE

CHANGING BEHAVIORS • MANY FIND CHANGE DIFFICULT • MUST MOVE THROUGH DIFFERENT STAGES TO ACCOMPLISH CHANGE • NURSE ASSISTS PT WITH CHANGE – ASSESSEMENT – INTERVENTION – EVALUATION (OUTCOMES)

STAGES OF HEALTH BEHAVIOR CHANGE • • • PRECONTEMPLATION PREPARATION ACTION MAINTENANCE STAGE

ACUTE/CHRONIC ILLNESS • ACUTE ILLNESS—SEVERE, USUALLY SHORT DURATION • CHRONIC—USUALLY LONGER THAN SIX MONTH – COPING USUALLY MORE COMPLEX – NURSES HELP PT TO MANAGE ILLNESS

ACUTE/CHRONIC ILLNESS • INTERNAL VARIABLES – PERCEPTION OF ILLNESS • SEEK HEALTH CARE IF SYMPTOMS DISRUPT/AFFECT DAILY ROUTINE • THOSE WITH CHRONIC PAIN MAY NOT SEEK TREATMENT AFTER NO SUCCESS IN PREVIOUS TREATMENTS – TYPES OF SYMPTOMS • SHARP, SUDDEN, INTENSE VS ACHE

ACUTE/CHRONIC ILLNESS • EXTERNAL VARIABLES – CULTURE – FAMILY DYNAMICS – SOCIAL GROUP – DIETARY PRACTICES – ECONOMICS

IMPACT OF ILLNESS ON PT/FAMILY • BEHAVIOR/EMOTIONAL CHANGES • BODY IMAGE/ SELF CONCEPT • FAMILY ROLE CHANGES – ROLE STRAIN – ROLE CONFUSION – ROLE REVERSAL

CARING IN NURSING • NURSING AND CARING • RECENT GALLUP POLLS • CARING (BENNER, 2000)—”MEANS THAT PERSONS, EVENTS, PROJECTS, AND THINGS MATTER TO PEOPLE” – ESSENTIAL HUMAN NEED, ESSENTIAL TO POSITIVE PT OUTCOMES – ALLOWS NURSE TO DETERMINE WHICH INTERVENTIONS SUCCESSFUL – ABILITY TO KNOW CLIENT

CARING IN NURSING • TAKES EXPERIENCE • EXPRESSION OF CARING WILL DIFFER WITH EACH PT • DOES EVERYONE WHO ENTERS A NURSING PROGRAM HAVE THE CARING COMPONENT? • MANY THEORIES ON NURSING— MUTUAL GIVE AND TAKE WILL NOT HAPPEN IF NURSE IS NOT CARING

CARING IN NURSING • DIFFICULT TO SHOW CARING IF YOU DON’T UNDERSTAND WHO THE PT IS AND THEIR PERCEPTIONS OF ILLNESS • PRESENCE – BEING THERE, EYE CONTACT, BODY LANGUAGE • TOUCH – TASK ORIENTED, CARING, PROTECTIVE • KNOWING THE CLIENT – AVOID ASSUMPTIONS • INCLUDING THE FAMILY – ILLNESS AFFECTS THE FAMILY AS WELL AS THE PT

CARING IN NURSING • LISTENING – SILENCE – DON’T INTERRUPT – DON’T FINISH SENTENCES SPIRITUALITY—VERY IMPORTANT, INTERGRAL PART OF WELLNESS TO SOME PTS

ETHICS AND VALUES • AUTONOMY • BENEFICIENCE • NONMALEFICIENCE • JUSTICE

ETHICS AND VALUES • FIDELITY • ACCOUNTABILITY, RESPONSIBILITY • CONFIDENTIALITY • VERACITY

ETHICS AND VALUES • VALUE—PERSONAL BELIEF – GIVEN ATTITUDE, IDEA – CUSTOM – OBJECT REFLECTS CULTURE, RELATIONSHIPS, PERSONAL NEEDS, SOCIAL INFLUENCES

ETHICS AND VALUES • VALUE FORMATION—HOW DID YOU FORM VALUES IN YOR LIFE? • VALUES CLARIFICATION • CULTURAL VALUES • BIOETHICS

ETHICS AND VALUES • CULTURAL VALUES EXERCISE • ETHICAL DILEMMAS – STEP 1—IS THIS AN ETHICAL DILEMMS? – STEP 2—GATHER INFO – STEP 3—EXAMINE YOUR OWN VALUES – STEP 4—VERBALIZE PROBLEM – STEP 5—CONSIDER COURSE OF ACTION – STEP 6—NEGOTIATE OUTCOME – STEP 7—EVALUATE THE ACTION