Intro to Nursing

• Virtues


  Dispositions of character and conduct that enable us to be good human beings
• Values


  Beliefs about what matters that act as a standard guide for one's behavior
• Developing values


  1. Influenced by the environment, family, and culture

  2. Modeling: children learn what is of high or low value by observing parents, peers, and significant others
• Professional values


  • Altruism: concern for the welfare and well-being of others, especially the patient
  • Autonomy: respecting patients' rights to make decisions about their health care
  • Human dignity: respect for the inherent worth and uniqueness of individuals
  • Integrity: acting in accordance with an appropriate code of ethics and accepted standards of practice
  • Social Justice: upholding moral, legal, and humanistic principles
• Ethics


  Principles of right and wrong conduct
• Two approaches to ethics in nursing


  • Principle-based
  • Care-based
• Principle-based ethics


  Guided by autonomy, nonmaleficence (do no harm), beneficence (obligation to do good), justice, and fidelity (keeping your word)
• Care-based ethics


  How you choose to act each time you encounter a patient is a matter of ethical significance guided by kindness, attentiveness, empathy, compassion, and reliability
• Ethical dilemmas


  When attempted adherence to basic ethical principles results in two conflicting courses of action
• Feminist ethics


  Critiques societal oppression, particularly affecting women and the impoverished, advocating for policies reflecting trust in marginalized individuals' agency and dignity
• Moral Agency


  Capacity to be ethical and to do the ethically right thing for the right reasons
• Moral distress


  When you know the right thing to do, but either personal or institutional factors make it difficult to follow the correct course of action
• Moral resilience


  Capacity to respond well to morally distressing experiences and to emerge strong
• Moral injury


  When there has been a betrayal of what is right by someone who holds legitimate authority or by oneself
• Conscientious Objection


  The refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse's personal and professional ethical beliefs and standards
• Advocacy


  The protection and support of another's rights
• Promote self-determination


  Nurses should facilitate their patients' own decision making by helping to interpret findings, provide information to be considered, help them verbalize and organize their feelings, call in people who should be involved in the decision making, and help patients assess all of their options
• Whistleblowing: Every nurse who witnesses unsafe care has a duty to report it
• Political Advocacy: Nurses may share their voice in the political arena on behalf of those least well served by the health care system, including people who are homeless, minorities, women, and children
• The Nursing Code of Ethics is essential in upholding the values, principles, and standards of the nursing profession
• Nursing Code of Ethics Outlines the Following Principles


  • Respect for Human Dignity
  • Compassion
  • Advocacy
  • Integrity
  • Competence
  • Evidence-Based Practice & Research
  • Professional Growth & Development
  • Collaboration
  • Ethical Practice
  • Leadership
• Stress


  A condition in which the human system responds to changes in its normal balanced state - results from a change in a person's internal or external environment that is perceived as a challenge, a threat, or danger
• Types of Stressors


  • Physiologic Stressors: chemical agents, physical agents, infectious agents, nutritional imbalances, hypoxia, genetic or immune disorders
  • Psychosocial Stressors: environment, interpersonal relationships, life events
• Adaptation


  The change that takes place as a result of the response to a stressor
• Coping Response


  The immediate, involuntary response that occurs as result of a threatening or otherwise stressful situation
• Homeostasis


  Various physiologic mechanisms within the body respond to internal changes to achieve a constancy in the internal environment
• General Adaptation Syndrome (GAS)


  • Alarm Reaction: fight-or-flight response
  • Stage of Resistance: coping and defense mechanisms
  • Stage of Exhaustion: panic, crisis, exhaustion
• Mind-Body Interaction- Humans react to threats of danger as if they were physiologic threats, even threats on the emotional level
• Anxiety


  Vague, uneasy feeling of discomfort or dread, can be a feeling of apprehension caused by anticipating a perceived danger
• Coping Mechanisms


  Behaviors used to decrease stress and anxiety, typically learned from past experiences
• Effects of Stress on Basic Human Needs


  • Physiologic Needs: decreased appetite, increased pulse, affected sleep activity
  • Safety & Security: feels of threat, nervousness, inattentive
  • Love & Belonging: withdrawn, isolated, aggressive, overly dependent
  • Self-Esteem: workaholic, attention-seeking behaviors
  • Self-Actualization: lack of control, refuses to accept reality
• Types of Stress


  • Developmental Stress: occurs as a person progresses through the normal stages of growth and development
  • Situational Stress: does not occur in predictable patterns, progresses through life, may occur at any time
• Stress Management Techniques


  • Exercise, rest & sleep, nutrition (promote healthy activities of daily living)
  • Encouraging use of support systems
  • Promoting relaxation (deep breathing, progressive muscle relaxation)
  • Crisis intervention and resources (may require local mobile crisis teams)
  • Mindfulness practice (guided imagery)
• Sensory Experience


  Composed of reception and perception
• Types of Senses


  • Visual
  • Auditory
  • Olfactory
  • Gustatory
  • Tactile
  • Kinesthesia: awareness of body positioning and movement
  • Proprioception: Sense of position and movement, independent of vision
• Perception


  Data is organized and interpreted into meaningful information
• Reticular Activating System (RAS)


  Body's arousal mechanism that extends from hypothalamus to medulla and serves to mediate arousal
• Disturbed Sensory Perception


  • Sensory Deprivation: Perceptual disturbance, Cognitive disturbance, Emotional disturbance
  • Sensory Overload: Feeling out of control
  • Sensory Deficits: Impaired or absent sensory function
• Sensory Processing Disorder


  Alteration in way brain receives, organizes, and uses sensory information
• Factors Affecting Sensory Stimulation


  • Developmental considerations: different sensory stimuli are needed over time
  • Culture: Normal” stimulation varies culture to culture. Touch may warrant overload in some cultures, but be normal in others
  • Personality/Lifestyle: Can influence ones normal quantity/quality of stimuli. Some thrive working in the ER, while others find it overstimulating
  • Stress/Illness: During low stress, one might seek out additional stimulation. During high stress, one might want to decrease stimulation to prevent overload
  • Meds: different sensory stimuli are needed over time