Transition to Registered Nursing

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Transition to Registered Nursing

• Patient Education Therapeutic Communication
• West Coast University
• Week 4

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Objectives

• Patient Education
• Learning types
• Therapeutic Communication
• Communication concepts
• Phases of the nurse-patient relationship
• Proper use of delegation

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Learning

• Pedagogy
• Referred to as children learning
• Art or science of teaching
• Correct use of teaching strategies

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Learning

• Andragogy
• Referred to as adult learning
• Need to be involved in planning and evaluation
• Experience provides the basis for learning
• Have immediate relevance to job or personal life
• Problem-centered rather than content centered

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Learning Domains

• Cognitive
• Knowledge
• Affective
• Values attitudes
• Psychomotor
• Manipulative skills

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Learning Styles

• Visual
• Auditory
• Kinetic (motion)
• Kinesthetic (sensory)

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Active Learning

• The process of acquiring knowledge or skill
  engaging in an action or an activity
• Part of learning to be an RN
• Use higher level thinking skills
• Analyze, synthesis and use judgment

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Growth Development of communication

• Somatic language used by infants crying,
  kicking, turning red in the face, making faces
• Action language used by toddler, points
  purposefully, holding out of hand
• Culture influence language development
• Interpersonal communication dynamic interaction
  between two or more persons in which ideas,
  goals, beliefs, values, feelings, even feelings
  about feelings are exchanged

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Communication

• Basic communication
• Sender encodes ???
• Receiver decodes ???
• Feedback response of the receiver to the message
  for clarification

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Characteristics of Therapeutic Communication

• Trust
• Empathy vs sympathy
• Humor
• Nonverbal communication
• Active listening
• Silence
• Paralanguage
• Eye contact, body language, gestures
• Simplicity
• Appearance
• Touch

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Characteristics of Therapeutic Communication

• Verbal communication
• General leads
• Open-ended questions
• Open-ended relevant questions
• Sharing observations
• Restating
• Clarification
• Silence
• Summarization

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Blocking Communication

• False assurances dont worry
• Giving advise how knows best?
• Moralistic everybody does it
• Changing the subject - ignoring
• Why statements think defensive

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Nurse-Patient Relationship

• Pre-interaction phase gathering data
• Orientation phase setting goals, accepting
  patients feelings beliefs
• Working phase - implementation
• Termination phase evaluate achievements

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Nursing Practice Implications Delegation

• Task
• Can it be delegated by the nurse
• Circumstance
• Setting and resources available
• Person
• By the right person to the right person

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Nursing Practice Implications Delegation

• Direction/Communication
• Provides clear, concise description with
  limitations and expectations
• Supervision
• Appropriate supervision maintained

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Self-Perception Hopelessness

• Nursing Diagnosis
• Hopelessness
• A sustained subjective emotional state in which a
  person sees no alternatives or personal choices
  available to solve problems or to achieve what is
  desired and cannot mobilize energy on won behalf
  to establish goals (Carpenito-Moyet, p. 392)

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Self-Perception Powerlessness

• Nursing Diagnosis
• Powerlessness
• A state in which an individual or group perceives
  a lack of personal control over certain events or
  situations that affects outlook, goals, and
  lifestyle
• (Carpenito-Moyet, p. 569)

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Ms. R. How would you develop a Nursing Plan?

• Ms. R. is a 75 y/o widow who has recently been
  admitted to a SNF. On admission she stated that
  she did not want to be there and wanted to go
  back home. The staff, used to hearing such
  comments, usually ignore them and try to comfort
  the new residents. Ms. R. refused to eat anything
  the first day and did not talk to any residents,
  but spent her time alone in her room.
• Two weeks later she continues not to speak to
  anyone and only picks at her food. She sleeps a
  lot during the day and does not want to
  participate in activities. During a staff meeting
  the residents behavior is identified and the
  staff doesnt know what to do. The staff
  complains about being too busy to let the
  resident express her feelings.

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Assessment
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Nursing Diagnosis
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Planning
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Intervention
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Evaluation
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Assignment

• Reading
• Duncan DePew Chapter 11