什么是人际关系和人际沟通.ppt

1 Chapter6 RoleRelationshipPatterns 2 whatkindsofoutlinearethemostimportantinthechapter RoleRelationshipPatterns 3 BasicConcepts Definitions RelatedTerms PersonalInterpretationsofRole SocietalInterpretationsRole EffectsofAlterationinRolePerformanceonOthers OUTLINE p 108 RoleRelationshipPatterns 4 Applications ProfessionalNurseRole TypesofProfessionalRoles RoleSocializationRoleStress Self awarenessintheProfessionalRole OUTLINE p 108 RoleRelationshipPatterns 5 ClientRole Patient sBillofRights RolePerformanceasaNursingDiagnosis SupportiveInterventions DevelopingNewSolutions Summary OUTLINE p 108 RoleRelationshipPatterns 6 Whataretheobjectivesoflearningorstudyinginourlesson RoleRelationshipPatterns 7 Attheendofthechapter thestudentwillbeableto 1 Defineroleandroleperformance 2 Describethefourcomponentsofprofessionalrolesocialization3 Discusstheprofessionalrolesofthenurse 4 Discussthecharacteristicsofthesickrole Objectives p 108 RoleRelationshipPatterns 8 RoleRelationshipPatterns ObjectiveOne Defineroleandroleperformance 9 Whatisrole Aroleisdefinedasasetofexpectedbehavioralstandardsestablishedbythesocietyorcommunitytowhichapersonbelongs Creasia 1991 Definitions p 109 110 RoleRelationshipPatterns 10 Whatisrolerelationship Rolerelationshipsinfluencecommunicationcontentandprocess Consideryourown role asanursingstudentandhowitinfluencescommunicationcontentandprocess Definitions p 109 110 RoleRelationshipPatterns 11 什么是人际关系和人际沟通 人际关系 人际关系是人们通过交流与相互作用而形成的比较稳定的心理关系 反映着个体或群体满足其社会需要的心理状态 其发展变化取决于双方社会需要的满足程度 人际关系外延很广 包括朋友关系 夫妻关系 师生关系 同学关系 同事关系等 内涵是个体之间的心理上的关系 表现为亲近或疏远 敌对或友好等心理上的距离 p 310 RoleRelationshipPatterns 12 什么是人际关系和人际沟通 人际沟通 人际沟通是指人际间的信息交流 可以是面对面的 也可以是非面对面的 可以是语言的 也可以是非语言的 旨在传达思想 交换意见 表达感情和需要等 它包括关系沟通与内容沟通 即每个沟通都包含着一定的内容和确定一定的关系 内容是指沟通中所传信息的实质含义 关系是指沟通各方在沟通中所处的地位和联系方式 p 303p 310 RoleRelationshipPatterns 13 你能举例说明人际关系沟通和内容沟通之间的联系吗 护士 昨晚我给xx 患者 的药为什么没吃 护患关系内容沟通效果 很熟悉成功一般有心理距离但可能成功紧张很难有效 患者家属可能说 我怎么知道 没吃药到底是谁的责任 RoleRelationshipPatterns 14 Whatisroleperformance Roleperformancereferstoaperson scapacitytofunctioninaccordwithsocialexpectationsofaparticularrole Perceptionsofbehavioralstandardsforroleperformancedifferfrombasedoncultural gender institutional andfamilyexpectations Peoplestillexpectdifferentrolebehaviorsfrommenandwomendespitetremendousadvancesinequalopportunity Definitions p 109 110 RoleRelationshipPatterns 15 Roletransitiondescribeschangesinroleexpectationsthatoccurasdevelopmentallifecrisesorwhenunexpectedlifeeventssuchasillnessorinjuryalterrolefunction Forexample newmotherexperiencesasignificantroletransitionwiththebirthofherfirstchild asdoesayoungathletestruckdowninaballgamewithaspinalcordinjury Whatisroletransition Definitions p 109 110 RoleRelationshipPatterns 16 Whatisposition Positionrepresentsastandardizeddescriptionofaroleandassociatedexpectationsthatmakesitunderstandabletoothersinthecommunityorgroup Socialpositionrelatestothestatusandidentitythepersonholdsinthecommunity Theconceptofpositionsometimesplaysaroleinhowhelpingprofessionalsrespondtoclients theysometimestreatclientsinhighpositionsdifferentlythanthosewithnomoneyorlowsocialstatus Definitions p 109 110 RoleRelationshipPatterns 17 Whereasitisimportantforthenursetorecognizedifferencesinpositionasrelevantfactorsinsupportingclientintegrityandself esteem nursesneedtoviewallclientsasveryimportantpersons treatingthemallwiththesamerespectandgivingthemallqualitycareregardlessofposition Definitions p 109 110 Whatisposition RoleRelationshipPatterns 18 RoleRelationshipPatterns ObjectiveTwo Describethefourcomponentsofprofessionalrolesocialization 19 Unlikeotherformsofeducation thenursingstudentmustsimultaneously 同时地 adjusttolearningnewmaterialwhilestartingonthejobtraininginwhichthestakes 风险 arehigh Cohenidentifiedfourgoalsofprofessionalsocialization seeBox6 4 Whichisthefourcomponentsofprofessionalrolesocialization ProfessionalNurseRole p 114 115 RoleRelationshipPatterns 20 Box6 4 StepsintheSocializationProcessLearnthetechnologyoftheprofession thefacts skills andtheory Internalize 使内在化 theprofessionalculture Findapersonallyandprofessionallyacceptableversionoftherole Integratethisprofessionalroleintoalltheotherliferoles RoleRelationshipPatterns 21 Box6 4 StepsintheSocializationProcess学会专业技能 专业法规 技术和理论 与专业文化融为一体 找到就个人和职业而言都可接受的角色类型 把职业角色整合到所有其它生活角色中 RoleRelationshipPatterns 22 ExerciseLookingatMyDevelopmentasaProfessionalNurse Purpose Tohelpyoufocusonyourself developmentasaprofessionalnurse RoleRelationshipPatterns 23 ExerciseLookingatMyDevelopmentasaProfessionalNurse Procedure Writethestoryofhowyouchosetobecomeanurseinaone totwo pageessay maybedoneasahomeworkassignment Therearenorightorwronganswers thisissimplyyourstory Youmayusethefollowingasguidesindevelopingyourstory RoleRelationshipPatterns 24 ExerciseLookingatMyDevelopmentasaProfessionalNurse Procedure Whatareyourreasonsforchoosingnursingasaprofession Whatfactorsinfluencedyourdecision people circumstances orsituations Describeyourvisionofyourselfasanurse Whatfearsdoyouhaveaboutyourabilitytofunctionasaprofessionalnurse Howdoyouthinkbeinganursewillaffectyourpersonallife RoleRelationshipPatterns 25 Inwhatwaysisyourstorysimilartoordifferentfromthoseofyourclassmates Asyouwroteyourstory wereyousurprisedbyanyofthedataorfeelings RoleRelationshipPatterns Discussion 26 Studentscandiscusssomeoftherealisticdifficultiesencounteredasnursingstudentsbothprofessionallyandpersonallyandwaystohandlethem Explorethroughdiscussionthefollowing ThepracticesnursingstudentswillneedtofollowtoachievetheirvisionThetypesofsupportsnursesneedtofostertheirongoingprofessionaldevelopment RoleRelationshipPatterns Discussion 27 RoleRelationshipPatterns ObjectiveThree Discusstheprofessionalrolesofthenurse 28 WhicharethereProfessionalNursingRoles P 116 1 Caregiver a Providescompleteorpartialcompensatorycareforclientswhocannotprovidetheseself carefunctionsforthemselves b Implementssupportive educativeactionstopromoteoptimumhealthReinforcesthenatural developmental andhealingprocesseswithinapersontoenhancewell being comfort function andpersonalgrowth ProfessionalNurseRole RoleRelationshipPatterns 29 2 Teacher a Provideshealthteachingtoindividualclientsandfamiliesb Developsandimplementspatienteducationprogramstopromote maintainhealthfulpracticesandcompliancewithtreatmentrecommendationsc Guidesindividualsintheirhumanjourneytowardwholenessandwell beingthroughpsychoeducation WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 30 3 Clientadvocate a Protectsclient srighttoself determinationb Motivatesindividualsandfamiliestobecomeinformedactiveparticipantsintheirhealthcarec MediatesbetweenclientandothersinthehealthcareenvironmentActsasclient sagentincoordinatingeffectivehealthcareservices WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 31 4 Manager a Coordinatesstaffandproductivity b DelegatesdifferentiatedtaskstoappropriatepersonnelFacilitatescommunicationwithinandamongdepartments Servesoncommitteestoimproveandmaintainqualityofcare e Makesdecisionsanddirectsrelevantchangestoensurequalitycare WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 32 5 Evaluator a Setsqualityassurance carestandards Reviewsrecordsandmonitorscompliancewithstandards c Makesrecommendationsforimprovement WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 33 6 Researcher Developsandimplementresearch grantproposalstobroadenunderstandingofimportantissuesinclinicalpracticeandvalidatenursingtheoriesasabasisforeffectivenursingpractice WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 34 7 Consultant Providesspecializedknowledge advicetoothersonhealthcareissuesb Evaluatesprograms curricula andcomplexclinicaldata c Servesasexpertwitnessinlegalcases WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 35 8 CaseManager a Administerscareforacaseloadofclients b Coordinatescost effectivecareoptions Monitorsclientprogresstowardexpectedbehavioraloutcomes Collaborateswithotherprofessionalstoensurequalitycareacrosshealthcaresettings WhichareProfessionalNursingRoles P 116 RoleRelationshipPatterns 36 RoleRelationshipPatterns ObjectiveFour Discussthecharacteristicsofthesickrole 37 Fromtheclientperspective lossoforchangesinnormalroles rolerelationships androleperformanceareimportantdimensions 尺度 元 oftheemotionalpainclient sexperienceinhealthcaresituations Howwellpeopleareabletoperformtheirroleswithinthefamilyandsocietyinfluencestheirreputationwithinthecommunityandtheirsenseofself esteem Whenillnessorinjuryaffectsroleperformance italsoimpactsrolerelationshipswithothersandself esteem HowtounderstandClientrole rolerelationships performanceandtransition p 119 RoleRelationshipPatterns 38 Thenursemaybetheonlypersonwhohastheexpertiseandwillingnesstofacilitatediscussionsoftheimplicationsofrolechangesstemmingfrom 源于 alteredhealthstatusfortheclientinanobjective compassionatemanner p 119 HowtounderstandClientrole rolerelationships performanceandtransition RoleRelationshipPatterns 39 Talkingaboutthemeaningofrolechangeisjustasimportantastalkingabouthowtochangeadressingorwhataphysicalsymptommeans Lossofrole changesinroleexpectationsandperformance rolerelationshipsandroletransitionscanoccurasaresultofage illness lossofjoborsignificantperson injury andmentaldisorders HowtounderstandClientrole rolerelationships performanceandtransition p 119 RoleRelationshipPatterns 40 Mostpeopledonotassumethesickrolevoluntarily Illnessortrauma 外伤 canchangeanindividual ssocialrolefromoneofindependentself sufficiencytooneofvulnerability 脆弱性 andvaryingdegreesofdependencyonothers apersonalrolefromoneofindependencetodependence Whenclientsenterahealthcaresituation theyencounteraninterpersonalenvironmentthatencouragesthedevelopmentoffeelingsofanonymity 无名 andhelplessness HowtounderstandClientrole rolerelationships performanceandtransition p 119 RoleRelationshipPatterns 41 Atthehospitaldoor theclientforsakes 放弃 recognizedsocialrolesinthefamily worksituation andcommunity temporarilyorpermanently Regardlessofhowcompetentthepersonmaybeinotherliferoles whenillnessstrikes 打击 questionsaboutroleperformanceinevitablyarise Oftenclientsmustlearnnewrolebehaviorsthatareunfamiliarandunsettlingtopreviouslyheldself concepts HowtounderstandthetransitionofClientrole rolerelationships androleperformance RoleRelationshipPatterns p 119 42 Adjustmenttoachangeinhealthcarestatusrequiresawholenewsetofcopingskillswithoutnecessarilyhavingthesamesocialsupports Clientsclearlyneedthesupportofthenursetoincorporatetherapidlychangingmeaningoftheenvironmentalandpersonalchangesencounteredinillnessintoanotherwisebasicallyhealthyself concept HowtounderstandthetransitionofClientrole rolerelationships androleperformance RoleRelationshipPatterns p 119 43 Differencesinperspectivesplayamajorpartindeterminingwhichillnessesanddisordersarerecognizedaslegitimate 合理的 therolesclientsassumeintheirhealthcare andwhobecomestheculturallyassignedexpert 在 中当专家 inpromoting maintaining andrestoringhealth Forexample someculturesbelievethatillnessispunishmentfromGodoranimbalanceofenergythatinterfereswiththebody sfunctioning Theseculturalunderstandingscanaffectrolerelationshipsinhealthcaresettings HowtounderstandthetransitionofClientrole rolerelationships androleperformance RoleRelationshipPatterns p 119 44 ClientRole Clientsareexpectedtoactasparticipating cooperativeagentsintheirrecoveryprocess However anAsianclientmayappearasapassiverecipientofhealthcare strikinglydependentonfamilyandhealthcaregiverforallguidanceandcare Withoutaclearunderstandingofthisculturallyacceptableexpressionofthesickrole thenursemayrespondinappropriately p 120 RoleRelationshipPatterns 45 WhatisaPatient sBillofRights p 121 1 Thepatienthastherighttoconsiderateandrespectfulcare ClientRole RoleRelationshipPatterns 46 WhatisaPatient sBillofRights p 121 2 Thepatienthastherightto andisencouragedtoobtainfromphysiciansandotherdirectcaregivers relevant current andunderstandableinformationconcerningdiagnosis treatment andprognosis Exceptinemergencieswhenthepatientlacksdecisionmakingcapacityandtheneedfortreatmentisurgent thepatientisentitledtotheopportunitytodiscussandrequestinformationrelatedtothespecificproceduresandtreatments risksinvolved lengthofrecuperation andmedicallyreasonablealternativesandtheiraccompanyingrisksandbenefits ClientRole RoleRelationshipPatterns 47 WhatisaPatient sBillofRights ClientRole 3 Patientshavetherighttoknowtheidentityofphysicians nurses andothersinvolvedintheircare aswellasthestatusofthecaregivers e g whenthoseinvolvedarestudents residents orothertrainees p 121 RoleRelationshipPatterns 48 WhatisaPatient sBillofRights ClientRole 4 Thepatienthastherighttomakedecisionsabouttheplanofcarebeforeandduringthecourseoftreatment torefusearecommendedtreatmentorplanofcaretotheextentpermittedbylawandhospitalpolicy andtobeinformedofthemedicalconsequencesofthisaction p 121 RoleRelationshipPatterns 49 WhatisaPatient sBillofRights ClientRole 5 Thepatienthastherighttohaveanadvancedirective suchaslivingwill healthcareproxy ordurablepowerofattorneyoverhealthcare concerningtreatmentordesignatingasurrogatedecisionmakerwiththeexpectationthatthehealthcareinstitutionwillhonortheintentofthatdirectivetotheextentpermittedbylawandhospitalpolicy Healthcareinstitutionsmustadvisepatientsoftheirrighttomakeinformedmedicalchoices p 121 RoleRelationshipPatterns 50 WhatisaPatient sBillofRights ClientRole 6 Thepatienthastherighttoeveryconsiderationofprivacy Casediscussion consultation examination andtreatmentshouldbeconductedsoastoprotectthepatient sprivacy 7 Thepatienthastherighttoexpectthatallcommunicationsandrecordspertainingtocarewillbetreatedasconfidentialbythehospital exceptincasessuchassuspectedabuseandpublichealthhazards whenreportingispermittedorrequiredbylaw p 121 RoleRelationshipPatterns 51 WhatisaPatient sBillofRights ClientRole 8 Thepatienthastherighttoreviewrecordspertainingtomedicalcareandtohavetheinformationexplainedorinterpretedasnecessary exceptwhenrestrictedbylaw 9 Thepatienthastherighttoexpectthat withinitscapacityandpolicies ahospitalwillmakereasonableresponsetotherequestofapatientforappropriateandmedicallyindicatedcareandservices Thehospitalmustprovideevaluation service andreferralasindicatedbytheurgencyofthecase p 121 RoleRelationshipPatterns 52 WhatisaPatient sBillofRights ClientRole 10 Thepatienthastherighttoaskandbeinformedoftheexistenceofbusinessrelationshipsamongthehospital educationalinstitutions andotherhealthcareprovidersorpayersthatmayinfluencethepatient streatmentandcare p 121 RoleRelationshipPatterns 53 WhatisaPatient sBillofRights ClientRole 11 Thepatienthastherighttoconsentdeclinetoparticipateinproposedresearchstudiesorhumanexperimentationaffectingcareandtreatmentorrequiringdirectpatientsinvolvementandtohavethosestudiesfullyexplainedbeforeconsent p 121 RoleRelationshipPatterns 54 WhatisaPatient sBillofRights ClientRole 12 Thepatienthastherighttoexpectreasonablecontinuityofcarewhenappropriateandtobeinformedbyphysiciansandothercaregiversofavailableandrealisticpatientcareoptionswhenhospitalcareisnolongerappropriate Thepatienthastherighttobeinformedofhospitalpoliciesandpracticesthatrelatetopatientcare treatment andresponsibilitiesandtobeinformedofavailableresourcesforresolvingconflicts p 121 RoleRelationshipPatterns 55 licensurelegalconfidentialityidentificationinformedconsentethicalcodeconsiderationinconsiderateimpulseappetitecapriceparameterssequenceassumedisciplineprescribeappropriatemutuallyperformance Vocabulary compensationsubstantialfindingcounselingsupervisiondelegationexecutionregimenregisterednurseaccountableresponsiblecompetencystatuteterritorymonitorprioritizecoordinatepersonnelboardmandate representativeviolationrevisearticulatebenchmarkoncologicalgerontologicalpsychiatrictenetrelevancetortbenchmarkjudgenegligencebreachdocumentfalsifywithholdprivilegedcommunication compromisemandatecommunicablestatutoryInadditiontoinanywayInformedConsentknowledgeable 56 57 BasicConceptsAmericanNursesAssociation sDefinitionofProfessionalNursingPracticeProfessionalLicensureNursePracticeActsProfessionalStandardsofCareLegalStandardsConfidentialityInformedConsentProtectingClientRights OUTLINE 58 OUTLINE EthicalCodeforNursesApplicationsNursingProcessNursingProcessandProfessionalRelationsAssessmentDiagnosisPlanningandOutcomeIdentificationImplementationEvaluationCriticalPathwaysSummary 59 OBJECTIVES 1 Defineprofessionalnursing2 Discusstheimplicationsofnursepracticeactsinthenurse clientrelationship3 Identifyprofessionalstandardsofcare4 Discusslegalstandards5 Discussimplicationsofthecodeofethicswithinterpretivestatementsforthenurse clientrelationship6 Describethenursingprocessasaframe workforprofessionalnursingpracticeandthenurse clientrelationship7 Discusscriticalpathwaysasamethodofcommunication 60 Ifaman sactionsarenotguidedbythoughtfulconsiderations thentheyareguidedbyinconsiderateimpulse unbalancedappetite capriceortheCircumstancesofthemoment JohnDewey 1933 如果一个人的行为不被深思熟虑的思想所指导 那么他们就受轻帅的冲动 不平衡的欲望 反复无常或片刻的环境所左右 约翰 Dewey 1933 61 ProfessionalLicensure Theregisterednurse sprofessionallicenseensuresthateachindividualnursehassuccessfullycompletednursingprogramrequirementsandcandemonstratetheknowledge skills andcompetenciestofunctionasahealthproviderofsafe effectivenursingcare Allpersonspracticingnursingarerequiredbylawtohaveacurrentlicenseinthestateinwhichtheypracticeandtoupdatetheirlicensureyearly Thislice