Transcript Medical Tech Prep 1 Lancaster High School Mrs. Carpenter

Medical Tech Prep 1
Lancaster High School
Mrs. Carpenter
Chapter 7: Understanding the Person
Pages:81-96
Objectives
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• Define the key terms listed in this chapter
• Identify the parts that make up the whole person
• Explain Abraham Maslow’s theory of basic needs
• Explain how culture and religion influence health and illness
• Identify the emotional and social effects of illness
• Describe the persons cared for in health care agencies
• Explain the American Hospital Association’s The Patient Care Partnership:
Understanding Expectations, Rights, and Responsibilities
• Identify the elements needed to communicate.
• Describe how to use verbal and nonverbal communication.
• Explain the methods and barriers to good communication.
• Explain why family and visitors are important to the person.
• Identify the courtesies given to the person and visitors.
• Explain how to deal with behavior issues.
HOLISM
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Holism is a concept that considers the whole person.
The physical, social, psychological, and spiritual
parts are woven together and cannot be separated.
Patients and residents often complain that they are
treated as things, not as people.
They are often treated as physical diseases or
problems.
Each part relates to and depends on the other parts.
BASIC NEEDS
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A need is something necessary or desired for
maintaining life and mental well being.
basic needs must be met for a person to survive and
function.
Maslow’s Heirarchy
1. The needs are arranged in order of importance.
2. Lower-level needs must be met before the higherlevel needs.
Basic Needs
lowest level to the highest level:
 Physiological or physical needs
 Safety and security needs
 Love and belonging needs
 Self-esteem needs
 The need for self-actualization
MASLOW’S HEIRARCHY
SELF
ACTUALIZATION
SELF ESTEEM
LOVE AND BELONGING
SAFETY AND SECURITY
PHYSICAL
Focus on long-term care:
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safety and security needs
Many persons do not feel safe and secure
when admitted to a nursing center and
become scared and confused.
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Be kind and understanding.
Show them the new setting.
Listen to their concerns.
Explain all routines and procedures.
Be patient.
CULTURE AND RELIGION
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Culture
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the characteristics of a group of people passed from one generation to
the next.
Culture includes language, values, beliefs, habits, likes, dislikes, and
customs.
Culture affects behavior during illness.
People come from many cultures, races, and nationalities.
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Family practices, food choices, hygiene habits, and clothing styles
may differ from your own.
speak a foreign language.
beliefs about what causes and cures illness.
beliefs and rituals about dying and death
factor in communication.
CULTURE AND RELIGION
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Religion relates to spiritual beliefs, needs, and
practices
influences health and illness practices.
people find comfort and strength during
illness.
Hospitals and nursing centers have chapels for
prayer and religious services.
Religion
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A person may want to see a spiritual leader or
advisor.
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Report this to the nurse.
Make sure the room is neat and orderly.
Provide privacy during the visit.
The nursing process reflects the person’s culture
and religion
Focus on home care: Culture and
Religion
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Culture is reflected in the home.
Whether rich or poor, treat each person and
family with respect, kindness, and dignity.
Do not judge the person’s lifestyle, habits,
religion, or culture.
APPLICATION
TERMINAL ILLNESS EXERCISE
ILLNESS
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People do not choose sickness or injury.
The physical, psychological, and social effects of sickness and
injury include
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Disabilities may occur.
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may be temporary or permanent.
Normal activities may be hard or impossible.
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People often feel angry, upset, and useless.
Sick people fear death, disability, chronic illness, and loss of function.
You need to understand the effects of illness.
Sick people are expected to behave in a certain way.
Culture and religion affect how people think and behave when
ill
PERSONS YOU WILL CARE FOR
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People are grouped in health care agencies by their problems,
needs, and age.
Mothers and newborns
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Obstetrics
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the branch of medicine concerned with the care of women during
pregnancy, labor, and childbirth and for the 6 to 8 weeks after birth.
Women are seen in clinics or doctors’ offices during pregnancy.
When labor begins, mothers usually go to a hospital’s obstetric
(maternity) department.
Children
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Pediatrics
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the branch of medicine concerned with the growth, development, and
care of children.
range in age from newborns to adolescents.
nursing staff meets the child’s physical, safety, and emotional needs.
PERSONS YOU WILL CARE FOR
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Adults with medical problems
Medical problems are illnesses, diseases, or
injuries that do not need surgery.
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Acute, chronic, and terminal illnesses can occur.
Persons having surgery
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Surgical patients need care before and after
surgery.
Surgeries range from simple to very complex.
PERSONS YOU WILL CARE FOR
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Persons with mental health problems
Psychiatry
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concerned with mental health problems.
vary from mild to severe mental and emotional disorders
Some persons are dangerous to themselves or others.
Persons in special care units
Special care units
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designed and equipped to treat and prevent life-threatening problems.
Special care units include
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intensive care units
Coronary care units
kidney dialysis units
burn units
Emergency rooms.
PERSONS YOU WILL CARE FOR
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Persons needing subacute care or
rehabilitation
Subacute and rehabilitation unit
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meet the needs of persons who:
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Need more time to recover than hospital care allows
Need rehabilitation
PERSONS YOU WILL CARE FOR
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Older persons
Geriatrics
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concerned with the problems and diseases of old
age and older persons.
Aging is a normal process
Body changes normally occur with aging.
Social and psychological changes also occur.
FOCUS ON LONG-TERM CARE
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older persons need long-term care.
Alert and oriented persons
(1) These residents have physical problems.
(2) The amount and care required depends on the disability.
Confused and disoriented persons
(1) mildly to severely confused and disoriented.
(2) Some have Alzheimer’s disease or other dementias
Persons needing complete care.
(1) These persons are severely disabled, confused, or
disoriented.
(2) They cannot meet their own needs.
FOCUS ON LONG-TERM CARE
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Short-term residents
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recover from fractures, acute illness, or surgery.
They usually return home.
Life-long residents
(1) Some disabilities occur before age 22
(2)Impairments may be physical, intellectual, or
both.
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The person needs lifelong assistance, support, and special
services.
PERSONS YOU WILL CARE FOR
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Mentally ill persons
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Mental illness affects behavior and function.
Self-care and independent living may be
impaired.
Terminally ill persons
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The person is dying.
The goal is a peaceful, dignified death.
THE PERSON’S RIGHTS
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The American Hospital Association (AHA)
has adopted The Patient Care Partnership:
Understanding Expectations, Rights, and
Responsibilities.
Focus on Long-Term Care: The
Person’s Rights
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Residents have:
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Rights as United States citizens
Rights under OBRA
Centers must protect and promote resident rights.
Residents must be free to exercise their rights
without interference.
Some residents are incompetent, Legal
representatives exercise rights for these residents.
Residents are informed of their rights:
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Orally and in writing
Before or during admission
In the language the person uses and understands
COMMUNICATION
SENDER
RECEIVER
COMMUNICATING WITH THE
PERSON
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Rules of Communication
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Use words that have the same meaning for you
and the person.
Avoid medical terms and words that are
unfamiliar to the person.
Communicate in a logical and orderly manner.
Give facts, and be specific.
Be brief and concise.
Rules of Communication
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Understand and respect the patient or resident as a person.
View the person as a physical, psychological, social, and
spiritual human being.
Appreciate the person’s problems and frustrations.
Respect the person’s rights.
Respect the person’s religion and culture.
Give the person time to process information.
Repeat information as often as needed.
Repeat exactly what you said.
Ask questions to see if the person understood you.
Be patient.
TYPES OF COMMUNICATION
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Verbal communication
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Words are used in verbal communication.
Words are spoken or written.
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Face the person.
Control the loudness and tone of your voice.
Speak clearly, slowly, and distinctly.
Do not use slang or vulgar words.
Repeat information as needed.
Ask one question at a time. Wait for the answer.
Do not shout, whisper, or mumble.
Be kind, courteous, and friendly.
TYPES OF COMMUNICATION
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Nonverbal communication
 Words are not used.
 Messages are sent with gestures, facial expressions, posture, body
movements, touch, and smell.
 Nonverbal messages more accurately reflect a person’s feelings
than words do.
 Watch the person’s eyes, hand movements, gestures, posture, and
other actions.
 Touch is a form of nonverbal that means different things to
different people.
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depends on age, gender, experiences, and culture.
Cultural groups have rules or practices about touch.
See the “Caring About Culture (Touch Practices)” page 90 in the
textbook.
follow the person’s care plan.
COMMUNICATION WITH A PATIENT WHO
HAS A DISABILITY
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Hearing Problems
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Poor vision.
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The written word is used when a person cannot speak or hear.
The nurse and care plan tell you how to communicate with the person
Persons who are deaf may use sign language
Rules for written messages
(1) Keep them brief and concise.
(2) Use a black felt pen on white paper.
(3) Print in large letters.
Mute
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Ask questions that have “yes” or “no” answers.
Follow the care plan.
TYPES OF COMMUNICATION
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Body language
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People send messages through body language.
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Facial expressions
Gestures
Posture
Hand and body movements
Gait
Eye contact
Appearance
Some situations require control of body language.
Communication methods
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Listening
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Paraphrasing
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Active
passive
Summarizing what the person has said
Direct question
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Obtain information
Communication methods
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Open-ended question
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Clarifying
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To be sure the message is understood
Focusing
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Invites sharing of thoughts, feelings, or ideas
Requires more than yes or no
Directing the conversation to the topic
Silence
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Not always necessary to talk
Communication barriers
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prevent sending and receiving messages.
Using unfamiliar language
Cultural differences
Changing the subject
Giving your opinion
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Failing to listen
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Opinions involve judging values, behavior, or feelings.
Talking a lot when others are silent
Do not pretend to listen this shows lack of interest and caring.
Pat answers
the person feel that you do not care about his or her concerns,
feelings, and fears.
Illness and disability
COMMUNICATION BARRIERS
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The person who is comatose
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is unconscious.
Cannot respond to others.
can often hear and feel touch and pain.
*****Assume that the person hears and understands you.
 RULES TO FOLLOW
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Knock before entering the person’s room.
Tell your name, the time, and the place every time you enter
Give care on the same schedule every day.
Explain what you are going to do.
Tell the person when you are finishing care.
Use touch to communicate care, concern, and comfort.
Tell the person what time you will be back
Tell the person when you are leaving the room.
THE FAMILY AND VISITORS
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BENEFITS
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help meet safety and security, love and belonging, and self-esteem
needs.
offer support and comfort.
They lessen loneliness.
Some help with the person’s care.
right to visit with family and friends in private and without
unnecessary interruptions.
CAREGIVING WHEN THE FAMILY IS PRESENT
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Do not expose the person’s body in front of visitors.
Treat family and visitors with courtesy and respect.
Do not discuss the person’s condition with visitors.
Refer questions from visitors to the nurse.
BEHAVIOR ISSUES
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New as a result of illness
Life-long personality traits
Do not avoid the person
Keep control of your emotions
BEHAVIOR ISSUES
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Anger
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Causes
Fear
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Pain
Dying and death
Loss of function
Loss of control over health and life
May be shown verbally or non-verbally
Violent behavior can occur
BEHAVIOR ISSUES
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Demanding behavior
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Nothing seems to please the person.
critical of others.
Causes of demanding behavior
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Loss of independence
loss of health
loss of control of life
Unmet needs
BEHAVIOR ISSUES
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Self centered behavior
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cares only about his or her own needs.
demands the time and attention of others
BEHAVIOR ISSUES
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Aggressive behavior
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Includes
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Causes
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Swearing
Biting
Hitting
Pinching
Scratching
kicking
Fear
Anger
Pain
dementia
Protect the person, others, and yourself from harm
BEHAVIOR ISSUES
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Withdrawal
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little or no contact with others
may signal
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physical illness
depression.
BEHAVIOR ISSUES
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Inappropriate sexual behavior
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Make inappropriate sexual remarks
Touch others
Disrobe or masturbate in public
behaviors may be on purpose
May be a result of
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Disease
Confusion
dementia
drug side effects.
Care Planning Considerations
Mrs. Sarah Stein was admitted to Pine Crest Nursing Center today. She is an 80-year-old
widow of the Jewish religion. She came to America from Germany with her parents
when she was 12 years of age. She speaks German and English fluently. She was a
college professor and taught at the local university for 20 years. She was married for 55
years. Her husband died 2 years ago. Mrs. Stein is hard of hearing and has poor vision.
She walks with a cane. Before coming to Pine Crest Nursing Center, she lived with her
married daughter for 2 years. Her daughter believed it was no longer safe for her
mother to live with her because she was alone most of the day while the daughter and
her husband were at work. Mrs. Stein had fallen twice during the last month.
Answer the following questions:
1. How might Mrs. Stein’s culture affect her care plan?
2. How might Mrs. Stein’s religion affect her care plan?
3. How might the RN meet the following needs of Mrs. Stein:
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Physical needs?
Safety and security needs?
Love and belonging needs?
Self-esteem needs?
Self-actualization needs?
4. What feelings might Mrs. Stein have about moving to Pine Crest?
5. What needs might Mrs. Stein’s daughter have?