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NSE 12 Weekly Objectives-Fall (1).doc

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Michelle Maroto

1 NSE 12A: Weekly Objectives ***Please note that the content from these objectives have come from lecture slides, Potter & Perry, and Arnold & Boggs. Even though I did not use citations, I am not taking credit for the material below.*** Learning Objectives Week 1: 1. Discuss the course syllabus with a specific focus on content, accountability, attendance and evaluation process. Refer to syllabus for course content, accountability, attendance, and evaluation process. 2. Discuss the use of the Ryerson, Centennial, George Brown Collaborative Nursing Degree Program: Student Handbook 2012 – 2013. Refer to Student Handbook 2012-2013 for the use of the program. 3. Explore the College of Nurses (CNO) Standards of Practice and how they relate to your role as a student nurse. Refer to the College of Nurses (CNO) Standards of Practice. 4. Discuss the CNO National Competencies in the context of entry-level Registered Nurse practice and how they relate to you as a student nurse. The CNO National Competencies in the context of entry-level RN practice include: professional responsibility and accountability, ethical practice, service to the public and self-regulation. Learning Objectives Week 2: 1. Define self-concept and self-esteem. Self-concept refers to how you see yourself. It includes personal identity, role performance, body image and self-esteem. Self-concept biases are what a person focuses on in communication, what a person expects from others, and what a person remembers of a conversation. Self-esteem refers to how you feel about yourself. Self-esteem is only one component of self-concept. It is the evaluation of self and the comparison with the ideal; changes over time based on life situations/status. 2. Illustrate how self-concept and self-esteem affect communication. Self-concept and self-esteem can be affected by illness and the nurses response to the patient. They can be affected by self-awareness of the nurse. Self-concept and self-esteem may be 2 affected by behaviours related to health and alterations related to health status regarding the client. 3. Explore concepts related to the personal and professional self (i.e. self awareness, self reflection, personal and professional values). Self-awareness refers to the means by which a person gains knowledge and understanding of all aspects of self-concept. A nurses behaviours are linked to his or her self-concept and values. Values are a set of personal beliefs and attitudes about truth, beauty and the worth of any thought, object or behaviour. Who you are as a personal self cannot be separated from who you are as a professional self. Self-reflection refers to the mental process through which we consciously examine our actions and motives to determine their meaning. 4. Describe the components and stressors of self-concept. Self-concept contains 4 major stressors and components which influence the outcome, they include: body image, role, self-esteem, and identity 5. Explain the nurse’s effect on a client’s self-concept. The nurses effect on a client’s self-concept can negatively or positively impact the interaction and relationship with the client. The nurse can assist a client in improving their self-concept. The way the nurse communicates and responds can affect a client’s self-concept. 6. Explore how culture affects values and beliefs. A nurses values and beliefs serve as a framework for decision making. They give meaning to our life. Culture affects values and beliefs because people from different cultures were raised in different societies, practice different religions and have varied spiritual outlooks. Learning Objectives Week 3: 1. Describe the basic concepts related to groups and group communication in the health care setting. A group is more than a random number of individuals occupying the same space. A group can be defined as two or more individuals who are connected by and within social relationships. Groups are categorized by an informal structure and social process. Secondary groups differ from primary groups in structure and purpose; they have a planned, time-limited association, a prescribed structure, a designated leader, and a specific, identified purpose. People join secondary groups for one of 3 reasons: to meet personally established goals, to develop more effective coping skills, or because it is required by the larger community system to which the individual belongs. Group dynamics is the term used to describe the communication processes and behaviours occurring during the life of the group. Group communication encompasses characteristics of individual communication. Acceptance, respect, understanding, and listening 3 responses are essential components of effective group communication. Using open-ended questions, listening responses and minimal cues are important in group communication. In group communication, each member brings to the group a different set of perspectives, perception of reality, communication style, and personal agenda. 2. Discuss professional and interdisciplinary team collaboration as an example of a secondary group. Rodts and Lamb (2008) state that “any new role requires an understanding of what it is and what it is not.” An interdisciplinary, collaborative role is no different. Nursing students must have a solid understanding of their own discipline’s specific roles and responsibilities so that they can articulate them clearly to professionals in other disciplines. Although interdisciplinary collaboration is still in its infancy as an integral part of professional curriculums, shared elective classes involving interdisciplinary education for 2 or more disciplines are increasing at the baccalaureate and graduate level. 3. Discuss factors that influence group dynamics. Group dynamics consist of communication variables: linking, clarifying, reflecting, paraphrasing, and summarizing. Factors that affect group dynamics are member variables and group variables. Member variables include: motivation, functional similarity, and previous experience. Group variables include: purpose, norms, role functions, decision styles and cohesiveness. 4. Describe the phases of group development. Group process refers to the structural development of the group, and described the phases of its life cycle. According to Tuckerman, his model of small-group development provides a framework for examining group process at different stages in the life of the group. The 5 phases of group development are: forming, storming, norming, performing, and adjourning. The forming phase begins when members come together to form a group. Minimal work on the task is accomplished, but this phase cannot be short changed without having a serious impact on the evolving effectiveness of the group. The storming phase is characterized by conflict around interpersonal issues. Members focus on power and control issues. In the norming phase, cohesiveness develops as standards evolved by members are accepted as operational norms. Individual goals become aligned with group goals. The performing phase is characterized by interdependence and cohesion and is where the groups “work” is accomplished. The adjourning phase is characterized by reviewing what have been accomplished, reflecting on the meaning of the groups work together, and making plans to move on in different directions. 5. Define conflict and explore its impact in the group process. Conflict refers to tension arising from incompatible needs, where one person’s actions make another unable to achieve his/her goal, which includes content issues and process issues. Conflict is when 2 or more values, perspectives and opinions are contradictory in nature and haven’t been aligned or agreed about yet. This includes: within yourself, when you’re not living according to 4 your values, when your values and perspectives are threatened and discomfort from fear of the unknown or from lack of fulfillment. Conflict is needed in the group process because: it helps to raise and address problems, it energizes work to be on the most appropriate issue, it motivates people to participate and it helps people learn how to recognize and benefit from their differences. Conflict is a problem in the group when it: hampers productivity, lower morale, causes more and continued conflicts, and causes inappropriate behaviours. 6. Recognize and describe personal styles of response to conflict situations. Styles of personal conflict include: competing/confronting. collaborating, avoiding, accommodating and compromising. Styles of personal conflict management include: avoidance, accommodation, competition, and collaboration. Avoidance is a common response to conflict by nurses to distance themselves from their client or to provide them less support. Use of avoidance postpones the conflict, leads to future problems, and damages your relationship with your client, making it a lose-lose situation. Accommodation refers to when we surrender our own needs in a desire to smooth over the conflict. This response is cooperative but nonassertive. By giving into others, we maintain peace but do not actually deal with the issue, so it will likely resurface in the future. This is a lose-win situation. Competition is a response style characterized by domination. In this contradictory style, one party exercises power to gain his own goals at the expense of the other person. It is an effective style when there is a need for a quick decision, but leads to problems in the long term which makes it a lose-lose situation. Collaboration is a solution- oriented response in which we work together cooperatively to problem solve. This is considered the most effective style for genuine resolution. This is a win-win situation. 7. Identify interventions that can be used to solve interpersonal conflict situations. Interventions that can be used to solve interpersonal conflict situations include: prepare for the encounter, organize information, manage your own anxiety or anger, time the encounter, put situation into perspective, use therapeutic communication skills, use clear congruent communication, take one issue at a time, make a request for a behaviour change, mutually generate some options for resolution, understand cultural implications, evaluate the conflict resolution, identify client intrapersonal conflict situations, talk about it, use tension-reducing actions, defuse intrapersonal conflict and evaluate. 8. List the objectives and describe the requirements of the Team-Based Learning: Safety Across the Lifespan Assignment. Refer to the Team-Based Learning: Safety Across the Lifespan assignment outline for objectives and requirements of the project. 9. Explain the purpose and the method of Reflective Practice and the use of the LEARN in this process. Reflective practice and nursing refers to: life-long learning, receiving and giving peer feedback, identifying learning needs, setting and meeting learning goals, and CNO requirements. Reflective practice and the student nurse involves: self assessment, reflective analysis, and 5 learning plan. Self assessment is based on CNO professional standards where you identify strengths, areas/strategies for growth and development. Reflective analysis formalizes the learning we gain from experience. It supports the development of critical thinking skills. The LEARN format consists of: Look back, Elaborate, Analyze, Revision, and New perspective. Look back recalls and briefly outlines the event described concisely. Elaborate refers to objective and subjective recall. Analyze incorporates knowledge and insights into the analysis of the event. Revision is thinking about the event based on new learning. New perspective focuses on the future and formulates recommendations for professional growth related to the analysis of the event. Learning Objectives Week 4: 1. Explain the relationship between the chain of infection and the transmission of infection. The chain of infection involves the infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and the host. This model is used to understand the infection process. Each link in the chain of infection represents a step in the transmission of infection. Each link must be present and happen in order for an infection to occur. 2. Give an example for preventing infection for each of the elements of the chain of infection. The following is an example for preventing infection for each of the following links of the chain of infection. • Infectious Agent: removal of microorganisms, use of disposable items • Reservoir: appropriate disposal of infectious wastes Portal of Exit: prevent organisms from leaving the body, wear a mask as needed • • Transmission: be aware of modes of transmission and ways to control them; hand hygiene; soiled items should not touch your clothing • Portal of Entry: limit the opportunities microorganisms have to enter the body • Host: protect the susceptible host by performing all routine practices 3. Identify the body’s normal defences against infection. The body has several mechanisms that protect it against infection. Each organ system has defence mechanisms that fight infectious microorganisms. The immune response is a protective reaction that neutralizes pathogens and repairs body cells. The immune system is composed of cells and molecules that help the body resist disease; certain responses of the immune system are nonspecific and protect against microorganisms regardless or prior exposure, whereas others are specific defences against particular pathogens. Normal flora, body system defences and 6 inflammation are responses of the immune system that are nonspecific and protect again microorganisms regardless of prior exposure. 4. Identify clients most at risk for infection. Advancing age. poor nutrition, stress, diseases of the immune system, chronic disease, and treatments or conditions that compromise the immune response increase a person’s susceptibility to infection. 5. Define the term “healthcare acquired infection”. Clients in health care settings have an increased risk of acquiring infections. A health care- acquired infection (HAI), also known as nosocomial infection or iatrogenic infection, is an infection acquired after admission to a health care facility that was not present or incubating at the time of admission. HAIs may be exogenous or endogenous. An exogenous infection arises from microorganisms external to the individual that do not exist as normal flora. An endogenous infection can occur when some of the client’s flora become altered and overgrowth results. 6. Describe and explain the rationale for Standard Precautions. Standard precautions or routine practices entail the use of generic barrier techniques in the care of all clients. You need to follow certain principles and procedures to prevent infection and control its spread. The effectiveness of infection-control practices depends on you and your colleagues’ conscientiousness and consistency in using effective aseptic technique. 7. Perform proper procedure for hand hygiene. Hand hygiene is the most important and most basic technique in preventing the transmission of infection. Hand hygiene includes using an instant alcohol hand antiseptic before and after providing client care, handing washing with soap and water when hands are visibly soiled, and performing a surgical scrub when necessary. The components of good hand washing include using an adequate amount of soap, rubbing the hands together to lather the soap and create friction, and rinse under a stream of water. Washing time of at least 15 seconds are needed to remove most transient microorganisms from the skin. Decreased nosocomial infection rates have been reported with improved hand washing. 8. Perform proper procedure for donning and removing gloves. Sterile gloves are an additional barrier to bacterial transfer. In general nursing divisions, use open gloving before procedures such as dressing changes and urinary catheter insertions. Closed gloving is performed after you apply sterile gowns and is practices in operating rooms and special treatment areas. Proper glove disposal is done by grasping the outside of one cuff with the other gloved hand, then pulling the glove off and turning it inside out - discard in receptacle, then finally take fingers of bare hand and tuck inside remaining glove cuff. Peel glove off, inside out. Discard in receptacle. Perform hand hygiene. 7 9. Discuss the specific risks to safety related to developmental ages. There are specific risks to safety related to developmental stages: • Infants & Children: unintentional injuries • Adolescents: act impulsively and engage in risk taking behaviours • Adults: lifestyle habits • Older Adults: physiological changes 10. Describe nursing interventions specific to a client’s age for reducing risk for injury. Nursing interventions for reducing risk of injury: • Infants & Children: educating parents • School-age Children: use examples; strangers; sports safety Adolescents: adults as role models; be aware of risk associated with suicide; rules and • regulations of driving a car • Adults: stress management; employee assistant programs Older Adult: risk of falls; medication organizers • 11. Discuss ways to maintain a safe environment for clients. A safe environment for clients can be maintained by utilizing standar precautions, WHMIS and effective hand hygiene. 12. Describe the four categories of risk to client safety within the healthcare environment. Four categories of risk to client safety within the healthcare environment are: lifestyle, impaired mobility, sensory or communication impairment, and lack of safety awareness. 13. Define the acronym WHMIS and describe the three main elements of WHMIS. The acronym WHMIS stands for Workplace Hazardous Material Information System. The 3 mains elements of WHMIS are material safety data sheets (MSDS), labels, and worker education. Learning Objectives Week 5: 1. Identify and describe the components of the therapeutic nurse-client relationship. 8 A therapeutic relationshop is a professional, interpersonal alliance in which the nurse and client join together for a defined period to achieve health-related treatment goals. The human interactions within each relationship are unique because each nurse and client have a distinctive personality. The term client can refer to any individual, family, group or community with an identified health care need requiring nursing intervention. The nurse-client relationship is an interdependent relationship. 2. Identify concepts to enhance therapeutic relationships. To establish a therapeutic relationship, you need to understand an apply the concepts of respect, caring, empowerment, trust, empathy, mutuality, as well as confidentiality and veracity. Additional bridges are your ability to put into practice the ethical aspects of respecting the clients autonomy and treating them in a just and beneficent manner. 3. Identify barriers to the therapeutic nurse-client relationship. Barriers to the development of a therapeutic nurse-client relationship are anxiety, stereotyping, and lack of personal space. 4. Describe the phases of the therapeutic relationship. There are 4 sequential phases of a nurse-client relationship, each characterized by specific tasks and interpersonal skills: preinteration, orientation, working, and termination. • 1) Pre-Interaction: occurs before meeting the client, the nurse prepares for the initial interaction • 2) Orientation: when the nurse and client meet and get to know one another • 3) Working: when the nurse and client work together to solve problems and achieve goals • 4) Termination: during the end of the relationship; nurse separates from the client by relinquishing responsibility for his or her care 5. Identify professional boundaries of the therapeutic nurse-client therapeutic relationship. Professional boundaries represent invisible structure imposed by legal, ethical, and professional standards of nursing that respect nurse and client rights, and protect the functional integrity of the alliance between nurse and client. Boundary violations take advantage of the clients vulnerability and represent a conflict of interest that usually is harmful to the goals of the therapeutic relationship. Boundary crossing give the appearance of impropriety, but do not actually violate prevailing ethical standards. 6. Explore how culture affects the therapeutic nurse-client relationship. Every interactions encounters a basic challenge of communicating between the culture of a client and the medical culte of the health professional. Cultural background and level of health literacy may have a powerful influence on communication practices. It is important to identify any cultural issues that will influence how your client or their family responds to your type of health 9 communication. Culturally competent communication is characterized by a willingness to try to understand and respond to your client’s beliefs. Knowledge of the client’s cultural preferences helps you avoid stereotyping and allows you to adapt your communication. Learning Objectives Week 6: 1. Describe the basic elements and forms of the communication process. Communication is an ongoing, dynamic, and multidimensional process. The communication process begins with the referent who motivates one person to communicate with another. The sender who is the source of initiator of the message. The message consists of the transmitted verbal or nonverbal expression of thoughts and feelings. The receiver is the recipient of the message. The channels of communication through which a person receives messages are the 5 senses: sight, hearing, taste, touch, and smell. The feedback is the message returned by the receiver. The environment is the setting for sender-receiver interaction. Interpersonal variables are characteristics within both the sender and receiver that influence communication. All parts of a communication system are interrelated and affect one another. Forms of Communication: • Verbal Communication: entails the use of spoken or written words; verbal language is a cobe that conveys specific meaning through a combination of words. Aspects of verbal communication include: vocabulary, denotative and connotative meaning, pacing, intonation, clarity and brevity, timing and relevance • Nonverbal Communication: makes use of all 5 senses and refers to transmission of messages that do not involve the spoken or written word; it is unconsciously motivated and therefore reflects a person’s intended meaning more accurately than do spoken words. Aspects of nonverbal communication include: personal appearance, posture and gait, facial expression, eye contact, gestures, sounds, territoriality and personal space. • Symbolic Communication: the verbal and nonverbal symbolism used to convey meaning; art and music are forms of symbolic communication that nurses use to enhance understanding and promote health • Metacommunication: a broad term that refers to all factors that influence how a message is perceived by other people; it is communication about communication that reflects the relational aspects of messages and helps people better understand what has been communicated 2. Identify factors that influence therapeutic communication Factors that influence Communication: • 1) Psychophysiological Context: refers to the internal factors that influence communication • 2) Relational Context: refers to the nature of the relationship between the participants • 3) Situational Context: refers to the reason for the communication 10 • 4) Environmental Context: refers to the physical surroundings in which communication takes place 5) Cultural Context: refers to the sociocultural elements that affect the interaction • 3. Describe communication techniques to promote therapeutic communication. Therapeutic communication strategies are specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. Communication techniques to promote therapeutic communication include: active listening, sharing observations, sharing empathy, sharing hope, sharing humour, sharing feelings, using touch, using silence, providing information, clarifying, focusing, paraphrasing, asking relevant questions, summarizing, self- disclosure, and confrontation. 4. Apply active listening and therapeutic communication strategies and skills. Active listening means to be attentive to what the client is saying both verbally and nonverbally. Active listening enhances trust and facilitates client communication because it demonstrates acceptance and respect for the client. Several nonverbal skills facilitate attentive listening. They can be identified by the acronym SOLER (Townsend, 2005): • S: Sit facing the client. The posture indicates the you are there to listen and are interested in what the client is saying • O: Keep and open posture. This posture suggests that you are receptive to what the client has to say. A closed position may convey a defensive attitude, possibly invoking a similar response in the client • L: Lean toward the client. This posture indicates that you are involved and interested in the interaction • E: Establish and maintain intermittent eye contact.
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