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Scenario #2 - Grand Rounds Seminar

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by

Kiran Kang

on 14 October 2014

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Transcript of Scenario #2 - Grand Rounds Seminar

Nursing Actions and
Decisions

Any Ideas?
Grand Rounds Seminar

Personal Values
Professional Values
Ways of Knowing
Effective Nursing Teams
Purpose
Presenters
Diana Marginean
Kiran Kang
Zach Zacharewicz
AGENDA
Effective Nursing Teams
Metalanguages
Person
Health
Environment
Scenario
Personal and Professional Values
Applicable Ways of Knowing
So What? - Actions & Decisions
Metalanguages
Human Being
Health
Environment
Story Time!

http://www.sos03.lt/files/images/Ligoninese%20gydyti%20privalo%20net%20sienos.jp g
http://www.modernantiaging.com/wp-content/uploads/2012/09/osteoporosis.jp g
Hi, I'm
Mr.
Green
----
>
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WHAT
DO
I
DO

References
Thank you!

Any Questions and/or Comments?
Personal Knowing
Emancipatory Knowing
Ethical Knowing
Is this right?


Knowing the Scenario
Do I know what I do?

What is wrong with this picture?
+
Ask for reassignment
Explain circumstances to the client
Therapeutic communication
Preformed Trustful relationship
Health teaching
HCP Training for similar situations
Confidentiality
Ways of perceiving and understanding the self and the world by interaction with multiple sources


Knowledge collectively judged by standards that are shared among all members of the community
Expressed through actions, movements, sounds
Knowing:

Knowing of a
Discipline:
Is this responsible?
Do I do what I know?

What changes are needed?
Who benefits?
Barriers to freedom?

PERSON:
ENVIRONMENT:
HEALTH:
PERSON:
ENVIRONMENT:
HEALTH:
aka: Metaparadigm
General, Interdependent
Serves to define a world of thought
Meta: Greek, "that which is behind"
reinforces something else
conceptual basis
In NURSING: Framework of perspectives that supports the entire conceptual universe of the nursing profession
______
______________
Guides and directs how nurses morally behave
in their practice
Clarification of conflicting values, exploring alternative interests, principles, actions.

Ethical principles/codes: formal expression of ethical knowledge
Knowing one's own self & self in relation to others through personal experiences
Increases personal authenticity:
requires questioning, acknowledgment, understanding of personal biases/strengths/weaknesses, feelings, values, attitudes
Recognize inner self, choose aspects of self that best serve intentions as a nurse

Critique the social/cultural/political Status-Quo & Imagine what can change to create a more equitable, fair, and just world for ALL
Seeks freedom from institutionalized social/political situations that create advantage for some & disadvantage for others
________________
____________
____________
____________
___________________
____________
___________________________
_________________
_______________
______________________________
Status-Quo or Institutionalized social situation:
Altruism & Concept of favouring "Kin"
Altruism: unselfish concern for others
increase shared-gene transmission to future generations
desire to help
Reasons: guilt, obligation, duty, rewards
Advantaged = Mr. Green
i.e.: extra hot water for bath, cleaned better, more comfortable, etc.
Disadvantaged = health care team, other patients on the unit
partially neglected, less comfortable
https://encrypted-tbn3.gstatic.com/images q=tbn:ANd9GcQ4tgyzYhMNpBha85bqAm2K_TtaJD wPBEQMPeQHK3AK-NdniqkI_g
Personal Values
#1 Driving Factor - Role Reversal
"What If?"
Person = synergistic
Holistic care
Influence of defining groups
Non-judgemental & avoid assumptions
NO discrimination
Empathy
Faith
Enabling - Knowledge IS power
Respectful/Appropriate body language & speech
Practice what you preach

Professional Values
Individual = Biological + Sociological + Psychological components
Reductionism
Not an object of professional care
sociocultural comfort
Personal Values
Professional Values
Professional Values
Preserve dignity
Realistic optimism
Appropriate interaction & collaboration
Trustworthy two-way relationship
I.e:
HOT
/
COLD

System (Jarrin, 2012)
http://www.21stcentech.com/wp-content/uploads/2011/10/maslow.jpg?w=300
Personal Values
Safety
Self Respect/Cleanliness
Culture Awareness
Financial Awareness
Emotional Support
Advocacy
Environment = KEY in healing process
i.e.: noise & stress = SAME body response
Honesty
Integrity
Promote adaptive responses
Routine Practices
What are some ways YOU can promote a positive environment?
(Internal + External)
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1) Leadership
2) Privacy
1) Honesty
2) Quality
1) Self Aware
2) Altruism
3) Emotionally Present

1) Professional Boundaries
2) Holistic Care
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1) Respect
2) Self Security

1) Discretion
2) Maintain Privacy & Confidentiality
Definition of Health
Experiences with Health
Culture based perceptions
Not absolute
Changes with time, circumstance, context
Responsibility towards Health
Differences in "normals"
Health Triad
Physical
Mental
Social
What is your definition
of health?
(Johnson, 2012)
Goals


Leadership

Communication

Cohesion

Respect
https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcSOnh4zU77wtlHXttdmahro64VVGSy8nLxcvCXjqgjiGLVd7Iv89A
Knowledge:
Knowing that can be expressed in a form that is "shareable" and can be communicated to others


Engage in a therapeutic relationship
Interaction of 5 components (CN0, 2006)
Trust
Respect
Professional Intimacy
Empathy
Power
Boundary: "The point at which a relationship changes from professional and therapeutic to unprofessional and personal" (CNO, 2006)
BUT WAIT! - there is an exception
"ensuring the co-existing relationships do to undermine the judgement and objectivity in the therapeutic nurse-client relationships" (CNO, 2006)
CNO Code of Ethics (2008) Responsibility = allocation of fair treatment
What would you do if your values
CLASHED with those of the patient?
https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcRQEJD5o_OGXhlkb2Dpfz-9jSWI3DA3o-ywOY-yB4Bv_hlX0QrL2Q
Canadian Nurses Association (CNA). (2008). Code of ethics for registered nurses. Retrieved
from http://www.cna-aiic.ca/~/media/cna/files/en/codeofethics.pdf

Chinn, P.L., Kramer, M.K. (2011). Integrated Theory and Knowledge Development in Nursing (8th
ed.). St. Louis, MO: Elsevier

Choiniere, D. (2010). The effects of hospital noise. PubMed, 34(4), 327-33. doi:10.1097/
NAQ.0b013e3181f563db.

College of Nurses of Ontario (CNO). (2006). Therapeutic nurse-client relationship.Retrieved
from http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf

Jarrin, O.F. (2012). The Integrality of Situated Caring in Nursing and the Environment. ANS Adv
Nurs Sci, 35 (1), 14-24. doi:10.1097/ANS.0b013e3182433b89.

Johnson, W. (2012). Four Basic Metaparadigm Concepts in Nursing. eHow. Retrieved from:
http://www.ehow.com/list_6106429_four-basic-metaparadigm-concepts-nursing.html

Vere-Jones, E. (2008). New Analysis: Are relationships with patients always out of bounds?
NursingTimes.net. Retrieved from: http://www.nursingtimes.net/news-analysis-are
relationships-with-patients-always-out-of-bounds/524449.article
______________
CHRE and Department of Health (2007)

38-52% of HCP - know of colleagues who have been sexually active with patients

22-26% of patients have sexually involved with a healthcare professional
(Vere-Jones, 2008)
Empathy
Competence
Humility
Willingness to learn
What do I want to do?
Relationship/attitude towards the patient
My own values/morals
Privacy
Weaknesses - interference with competency in practice
Do I KNOW what to do?
Code of Ethics
Previous similar experiences
Personal Experience
http://www.anvention.com/images/self.jp g
(Chinn & Kramer, 2011)
(Chinn & Kramer, 2011)
(Chinn & Kramer, 2011)
Full transcript