What about being a nurse gives us power
our knowledge
we have their attention/time
they have to be open, vulnerable and give us their trust
uniform gives authority/power, has keys to everything
Talk about milgrams experiment
BOUNDAIES
• limits that allow a safe connection between the professional and the client and are always based on the client’s needs (Peterson, M. 1992)
• Clear expectations about:
Time, Roles (of client and RPN), Purpose of relationship, Types of communication, Confidentiality
• “Boundaries create a safe place in which to work, one where they (clients) can rely upon the professional to act in the best interests of the client.”
Boundary Violations
Occurs when a professional places his or her needs above the needs of the client
Ex. Accepting gifts or money Inappropriate dress Unprofessional language Inappropriate self disclosure Inappropriate physical contact
Characteristics of a Boundary Violation
Role Reversal Secrecy Abuse of Professional Privilege Double Bind Objectification
“Red flags” for boundary violations
- Making the client special (giving extra time and attention)
- Visiting client off hours
- Doing things for the client they can do for themselves (disempowering)
- Discounting actions of other professionals
- Feeling resentment about the ways other team members care for the client
- Sharing personal issues (inappropriate self-disclosure)
- Promising availability to the client
- Persistently thinking about the client off duty
Dual Relationship
• A dual relationship exists when a professional assumes a second role with a client.
E.g. Professional, friend, employer, business partner, romantic partner
• Social relationship - You don’t need formal preparation training or distinct body of knowledge to be in a social relationship.
Social v. Theraputic Relationship
Socail
- Unpaid
- Spontaneous
- Open ended
- Equal power
- Personal choice
- Both partner’s needs met
- Rarely evaluate interactions
- Trade advice, opinions, freely
Theraputic
- Paid
- Structured
- Time limited
- Power over
- Contractual agreement
- Focus on the need of the patient
- Evaluate with patient r/t goals
- Encourage patient’s problem-solving without interjecting own pref.
Empathy
- perspective taking (cognitive)
- emotional dimension that helps us gain a sense of the other’s feelings
- genuine concern for the welfare of the other
- is more than sympathy
- feels connecton
- staying out of judgment, feeling with people, it’s a choice, its understanding other emotions.
- It almost never uses ‘at least’.
- It’s finding that deep part of yourself to connect with the other person.
Sympathy
feeling sorry/pity for them
feels more superficial and hollow, condescending, somewhat more primal
dries disconnection
Situational Empathy
empathic reactions in a specific situation
Dispositional Empathy
empathy is understood as a person’s stable character trait.
Bioethics
focuses on the moral aspects of healthcare and grew out of a concern with life and death issues
Issues like advance directives, organ and tissue recovery and donation, and informed consent are common topics of discussion.
Fidelity
principlepertainingtotheconceptoffaithfulness
Distributive justice
distribution of services and often relates specifically to the proper and most effective allocation of scarce healthcare resources.
Beneficent
taking action to promote the welfare of others. Mercy, kindness, and charity are all qualities
Nonmaleficence
do no harm
Moral Uncertainty
when a nurse identifies a problem but is unsure of the ethically correct actions
Moral Dilemma
when 2 or more mutually exclusive moral claims apply and both have equal weight
Moral Distress
occurs when one knows the morally correct action and feels responsible to the patient but institutional or other restraints make it nearly impossible to follow through
Moral Outrage
occurs when someone else in a healthcare setting performs an act that a nurse feels is immoral
Self Regard
supports the beliefrefers to duties that concern preserving one’s image and integrity.
Moral Respect
Remember that ones owns the same respect to self as others. in the worth and dignity of all humans irrespective of their personal attributes or life saturation
Stages of perception
- Selection -
- Organization -
- Interpretation –
selection
available from stimuli; pay attention to some stimuli and ignore others; tend to pay attention to more intense stimuli.
