Caring Nurses - Critical Thinking In Client Care

9:54 PM Internet at Every Where




Make Sense and Feeling

Sense of Commitment - Devoted , dedicated and responsive in what ever action

Sense of Belonging - Ownership � security usage and maintenance

Sense of Guilt - Aware and realize the effect of failure for not fulfilling expectations or observing correct form guideline or procedures

Sense of Sin - Realized , acknowledge and regret of whatever wrong doings.

Sense of Shame - Having strong believe in protecting and preserving self � esteem and self � pride from moral decadence as a result of wrong doings ( written and unwritten rules and practices )




PROFESSIONAL DEVELOPMENT OF NURSES




Nursing involves the giving of care to the patients together with other members of the health care team including doctors. The person in the centre of these activities is a biopsychososial being called the PATIENT. Nurses exist because of these important individuals � THE PATIENTS.

A PROFESSIONAL NURSE is one who works with her patients at the highest level of knowledge, skills and a caring attitude while adhering to a set of code of ethics.




Of importance in the definition are:

  1. Highest level � best of the highest possible standards.
  2. Knowledge � Need to be aware of advances in knowledge and technologies in medical sciences.
  3. Skill � Competency in the various skills required in nursing.
  4. Caring attitude � Recognizing the need of the patient to be managed with compassion, courtesy, respect and dignity.
  5. Code of ethics � A set of rules to guide professional behaviour.




All the above are ingredients of the professional development of a nurse.

The early professional development of a nurse is initiated by training schools but it does not end here. Professional development is a continuous process in the nurses career. This is important if we nurses are to gain respect and recognition.

There is a need for the nurse to be assertive and to function as an equal member of the health care team. This would become possible if she develops appropriately in the following three arrears:

� KNOWLEDGE

� SKILLS

� ATTITUDES




Background

  1. The level of care provided in a general intensive care unit (ICU) is more complex than delivered in a general ward.
  2. It is about 3.8 times more expensive to maintain ICU than a general ward.
  3. currently, in United States the provision of ICU costs about 15% of the total hospital care.
  4. Level of ICU care defers from hospital to hospital in Malaysia, according to facilities available.




Philosophy

The philosophy of the unit is that each patient is a person with a unique human dignity for whom medical personnel assume the responsibility of giving comprehensive, safe, effective medical & nursing care and protection.




Objectives

� To provide directions in the nursing management of ICU.

� To develop protocols and guidelines in the running of ICU since it demands an extensive commitment of time, manpower, equipment and money.

� To manage critically ill patients with potential reversible pathology who require intensive monitoring and life support system.

� To provide training and skills for medical and paramedical staffs in the field of critical care.




Our vision

To provide nursing knowledge that can be applied in the clinical setting when caring for real people.

� Reflect current knowledge of the science and art of nursing in today�s world.

� Provide clear explanations of the pathophysiologic processes of various disorders.

� Emphasize the nurse�s role in collaborative care.

� Prioritize nursing interventions specific to altered human responses to illness.

� Foster critical-thinking skills

� Offer visual tools for learners


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Nurse

8:13 PM Internet at Every Where




JURURAWAT

Dalam bidang penjagaan kesihatan, jururawat adalah seseorang yang bertugas sebagai penjagaan profesional. Jururawat bertanggungjawab bagi keselamatan dan menyembuhkan mereka yang sakit teruk, penjagaan kesihatan bagi mereka yang sihat, dan menangani kecemasan dalam semua keadaan membahayakan nyawa dalam semua bidang penjagaan kesihatan.

Jabatan kejururawatan adalah [plan penjagaan jururawat, plan penjagaan], kadang-kadang memerlukannya bekerjasama dengan ahli fizik, ahli terapi,pesakit, keluarga pesakit dan rakan sejawat.Di united state dan united kingdom,[latihan kejururawatan], seperti [pakar klinik kerujurwatan] dan [jururawat terlatih],diagnosis masalah kesihatan dan menentukan [pengubatan]dan lain-lain terapi.jururawat akan membantu koordinat membantu menjaga pesakit yang dijalankan oleh ahli kesihatan yang lain seperti ahli terapi, pembantu perubatan terlatih, pakar pemakanan dan lain-lain. jururawat akan menyediakan segala tugasan antara satu-satu jabatan contohnya seperti dengan ahli terapi dan pakar jururawat.

Menurut International Council of Nursing (ICN)...

"Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying . people environment, research, participation in shaping health policy and in patient and health systems management, and . Advocacy, promotion of a safe education are also key nursing roles� ICN - International Council of Nursing."




Apakah tugas-tugas yang dilakukan oleh jururawat?

Untuk mengetahui apa yang dilakukan oleh jururawat, elok jika anda fahami kata-kata Virginia Henderson ini

"Fungsi unik kejururawatan ialah untuk membantu klien, sama ada yang sakit atau sihat, dalam melakukan aktiviti-aktiviti yang membawa kepada kesihatan, penyembuhan, atau yang memudahkan kematian (aktiviti-aktiviti yang klien akan lakukan TANPA BANTUAN sekiranya mereka mempunyai kekuatan, semangat, dan pengetahuan yang diperlukan.). Juga, untuk melakukan perkara-perkara tersebut dalam cara-cara tertentu, supaya dapat membantu klien 'berdikari' secepat yang boleh." � Virginia Henderson, 'Definition of nursing' 1955,`66,`69,`78.

"The unique function of the nurse is to assist clients, sick or well, in performing those activities contributing to health, its recovery, or peaceful death -- activities that clients would perform unaided if they had the necessasary strengh, will, or knowledge. Also, to do so in such a way as to help clients gain independence as rapidly as possible." � Virginia Henderson, 'Definition of nursing' 1955,`66,`69,`78.




Jururawat membantu pesakit untuk berdikari dengan cepat. jadi sudah tentu tugas mereka banyak. Mereka bertanggung jawab daripada perkara asas manusia (makan, minum, kebersihan, etc.), memastikan klien mengambil ubat pada masa yang ditetapkan, memerhati keadaan pesakit (tanda-tanda vital, dan sebagainya), serta MENGURANGKAN risiko pesakit daripada mendapat masalah kesihatan lain di wad. Itu cuma di wad, bagaimana di tempat lain seperti dewan bedah.

Jururawat menjalankan kerja kejururawatan,biasanya menggunakan pendekatan menyelesaikan masalah yang melibatkan pentaksiran, pengenalan masalah, perancangan, perlaksanaan dan penilaian sebagai satu kitaran berterusan. Ini menghasilkan jagaan yang khas bagi seorang pesakit dan bukan jagaan rutin untuk suatu penyakit.

Oleh kerana bidang kejururawatan amat banyak, maka terdapat jururawat yang dilatih khas untuk disiplin-disiplin (bidang) tertentu. Seperti perawatan paliatif, diabetik, dewan bedah, dan ENT (Mata, hidung, dan telinga), dan banyak lagi.





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NURSE STANDS ON TOP OF HOSPITAL ROOF

3:26 AM Internet at Every Where

Have you ever been at work and felt like screaming at the top of your lungs: I can't take it any more! I know I have. Nursing is a stressful profession. There are many studies and articles analyzing the stress associated with nursing but they don't always translate into a less stressful work environment.

Because nursing is heavily dictated by policies and procedures, many nurses feel they are powerless to bring change into the work place. Nurses deal with potential and actual life and death situations on a daily basis. Add to that poor staffing and conditions are ripe for a stressful work environment.
You might be thinking right now, what can I do? Relax, there are many different steps and approaches to reducing work stress and making positive changes to your work environment.
When you have job related stress you have 4 basic options:
a) Bring positive change to your work environment
b) Learn to use stress reduction techniques.
c) Quit
d) Do nothing.
This article addresses the first two options.
BRINGING POSITIVE CHANGE TO YOUR WORK ENVIRONMENT
If you want to change your work environment, it is important to understand a few fundamental issues. Health care is a business. Your company needs to save and make money. Your manager must follow certain company policies and protocols. Also, he or she may receive a bonus for keeping costs down in your department. Lastly, no manager wants to hear complaining without suggested solutions. You could have a fantastic solution that your manager hasn�t thought of before or your manager may not even be aware a problem exists.
1. Make it a policy to never complain to your boss unless you have a realistic solution to you complaint. Then your boss will be much more apt to listen to you.

2. Present your boss with an objective, unemotional, description of the problem. Then, provide a solution that would fix the problem and result in a better, more efficient work environment. Make sure your information is very specific. For example:
PROBLEM: Our staffing decreases by 3 RNs and 1 CNA at 1900. We receive the same number of post-ops, and pass approximately the same number of medications and answer the same number of call lights between 1500 and 1900 as we do 1900-2200.) Here are the statistics.
SUGGESTED SOLUTION: Would you consider changing the schedule so we have better coverage between 1900 AND 2200 etc.
PROBLEM: All of our supplies are located at the North end of the hall. I make approximately 8 trips a shift to the supply closet.
SUGGESTED SOLUTION: Would you consider putting either all our supplies in the middle of the hall or put one half of the supplies at each end of the hall. This would save each nurse approximately 15 minutes a shift.
3. Enlist the help of your co-workers. Encourage them to help collect data to provide a case for changing a difficult work situation.

4. Put your suggestions in writing, Ask for follow-up and feedback by a certain date and request that a copy of your suggestions be put in your personnel file.

5. Create an atmosphere of joyful work Be kind, for everyone you meet is fighting a hard battle Plato. Make it a habit of complimenting one co-worker a day, and make it a habit of helping one co-worker a day.

6. Ask your manager for an in-service on stress reduction. Here are some statistics that might sway his or her answer: The bottom line for nursing administrators is that employee stress and burnout incur significant financial obligations to agencies; specifically, estimates, nationally, based on government, industry, and health groups, place the cost of stress at approximately $250 to $300 billion annually). This includes estimates of the dollar effects of reductions in operating effectiveness, poor decision making, medical expenses, and attrition resulting from stress. (Jones, Tanigawa, & Weisse, 2003)

7. If you boss is doing a good job, let them know! Be specific. For example, if your manager changed the format for giving report and it resulted in your getting better information and spending less time in report, let him/her know.

8. Always ask for an exit interview when you leave a job. Be very frank in giving feed back to your human resources department. This could lead to improvements in your department

KEEPING YOUR STRESS DOWN, MOMENT BY MOMENT
First, you need to recognize when you are stressed. Here are some of the many physiological and psychological responses to stress identified by the American Holistic Nurses Association: heart disease, strokes, susceptibility to infections, immune disorders, gastrointestinal problems, irritable bowel syndrome, peptic ulcers, inflammatory bowel disease, weight gain, weight loss, eating disorders, muscular and joint pain, headaches, sleep disturbances, sexual and reproductive dysfunction, premenstrual syndrome, fertility issues

Live your life as though every act were to become a universal law - Immanuel Kant
1. Make it a habit of taking about solutions, not problems.

2. Treat your co-workers how you would like to be treated. A good attitude is infectious and you will be its first beneficiary.

3. Remember to breathe. It is human nature to hold your breath or breathe shallowly when in a stressful situation. Practice, right now, taking in a deep breath in. This triggers a relaxation response in the body. Do this at least 10 times a shift.

4. Just before you go to sleep, think of everything you did well on the job. Do this every day.

5. Become familiar with the labor laws in your state. They usually include a 30-minute break and two 15-minute breaks. Unless there is a work emergency, take those breaks, it is the law!

6. Learn to say no. Many nurses over-commit themselves. No one can read your mind so you must speak up for yourself. If you don't want to or can't do something, and the request is unreasonable or not part of your job description, just say no.

7. Learn to laugh.
8. Take care of yourself. Instead of plopping yourself in front of the TV, go for a walk or do any exercise that is enjoyable.
9. Eat well, eat healthy, and eat less. Love yourself.

Each work situation is different. Sometimes you can positively influence it and sometimes it just isn't the right match. Never give up. There are many tools available to help reduce stress and create positive working environments. Use them, be kind to your self and others don't forget to take the bull by it's horns and be an agent of positive change.


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DOES YOUR JOB ORIENTATION FEEL LIKE TRYING TO GET A PhD IN 2 MONTHS?

11:49 AM Internet at Every Where

Almost everyone experiences increased stress during a job orientation. As a nurse, a shortened and inadequate orientation can lead to unsafe care and rapid burnout. Unfortunately, sometimes the orientor may have great clinical skills but may not have great teaching skills. Also, the person orienting may be carrying a full load of patients, making it impossible for them to give you the help you really need. So, what do you do?

Protect yourself. Carry a notepad at all times and take a lot of notes. Write down your questions and make sure you get them answered. Identify specific areas that you need further help with and ask for more orientation time in that particular area. If at the end of orientation, you feel you are not ready to take on a full patient load, then set your limits. Submit a request, in writing (or email), to your supervisor requesting help in the areas you do not feel comfortable in. In nursing, you are liable for any medical errors you make.

Also, your company should have a list of tasks that your organization expects you to be competent in by the end of your orientation. Make sure you understand every single one of those items before you sign off on it.

In summary, understand your weaknesses and strengths and make sure you get help with the areas you need to improve and you will be fine!


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