Transcript Textbook For Nursing Assistants

Textbook For Nursing
Assistants
Chapter 6 – Those We Care For
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 1
Those We Care For
There is much more to being a nursing
assistant than blood pressures and
bedpans
A health care worker can go to the most
well-known schools, receive the most
intense training, and graduate at the top of
his class, but if he is not able to connect
on a human level with his patients or
residents, he will fail
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 2
Patients, Residents, and Clients
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Assistants.
Slide 3
Patients, Residents and Clients
A Patient
A Resident
A person who is
receiving health
care in a hospital,
clinic, or extendedcare facility
A person who is
living in a long-term
care facility or an
assisted-living
facility
A Client
A person who is
receiving care in his
or her own home,
from a home health
care agency
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Slide 4
Those We Care For
There are three general types of illnesses
or conditions that can cause a person to
need health care services:
An acute illness
A chronic illness
A terminal illness
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Assistants.
Slide 5
Acute Illness
An acute illness is a condition characterized by a
rapid onset and a relatively short recovery time
Because the onset is rapid, acute illnesses are
usually unexpected
Examples:
Pneumonia
Appendicitis
A broken bone
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Slide 6
Chronic Illness
A chronic illness is a condition that is
ongoing
Examples:
Diabetes
Asthma
Arthritis
High blood pressure (hypertension)
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Slide 7
Terminal Illness
A terminal illness is an illness or condition
from which recovery is not expected
Examples:
Some types of cancer
End-stage emphysema
Some heart conditions
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Slide 8
Those We Care For: Grouping
PEOPLE
Grouped according
to ages
Grouped according
to type of illness and
medical condition
Grouped according to
special needs
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Slide 9
Those We Care For: Grouping
Terms that are often used to describe people:
Surgical patients
Medical patients
Obstetrical patients
Pediatric patients
Geriatric patients
Psychiatric patients
Rehabilitation patients
Sub-acute or extended-care patients
Intensive care patients
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 10
Surgical Patients
Have illnesses or conditions that are
treated by surgery
Examples:
Appendicitis
Certain types of tumors
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Slide 11
Medical Patients
Have an illness or condition that is treated
with interventions other than surgery, such
as medication, physical therapy, or
radiation
Examples:
Pneumonia
Myocardial infarction (“heart attack”)
Stroke
Some stomach disorders (such as ulcers)
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Slide 12
Obstetrical Patients
Are pregnant or have just given birth
Obstetric care extends throughout the
pregnancy and labor and delivery, and
then continues for about 8 weeks after
delivery
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Slide 13
Pediatric Patients
Are children and adolescents
Sometimes special considerations must be
taken into account when providing
treatment and care for younger patients,
because a child’s body does not function
in exactly the same way as an adult’s
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Slide 14
Geriatric Patients
Are older adults (i.e., those 75 years and
older)
Health care workers who specialize in
geriatrics are trained to recognize the
physical and mental effects of the normal
aging process and help older adults adjust
to these changes
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Slide 15
Psychiatric Patients
Are people with impaired mental health
Are often treated on an outpatient basis,
using a combination of counseling and
medication
If deemed a danger to themselves or
others, may be admitted to a health care
facility for treatment
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Assistants.
Slide 16
Rehabilitation Patients
Are those who are undergoing therapy to restore
their highest level of physical, emotional or
mental, or vocational functioning
Examples:
People born with physical disabilities or deformities
People who have had a stroke or are recovering from
surgery or an injury
People with substance abuse problems
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Assistants.
Slide 17
Sub-acute Patients
Are usually recovering from an acute
illness or condition
They do not need the total care provided
by a hospital, but are not quite ready to
return home
Examples:
Intravenously administered medications
Physical therapy
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Slide 18
Intensive Care Patients
Patients needing very specialized, or
intensive, care are usually admitted to an
intensive care unit or a special care unit
Examples:
After heart or brain surgery
After suffering from a heart attack or stroke
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Slide 19
Growth and Development
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Slide 20
Growth and Development
Changes that occur physically are known
as growth
Growth is demonstrated by changes in height
and weight and by physical maturation of the
body’s organ systems
Changes that occur psychologically or
socially are known as development
Development is evidenced by changes in a
person’s behavior and way of thinking
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Slide 21
Principles of Growth and Development
Occurs continuously throughout a person’s lifespan, from
conception until death
Occurs step by step and in an orderly progression. Each
stage has specific characteristics and tasks that must be
accomplished before the person can progress to the next
stage
Tasks of growth and development progress from the
simple to the complex, head to toe, and from the center
of the body outward
Occurs at variable rates for each individual, and may
occur unevenly or in spurts
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Slide 22
Stages of Growth and Development
Infancy (birth to 1 year)
Toddler hood (1 to 3 years)
Preschool (3 to 5 years)
School-age (5 to 12 years)
Adolescence (12 to 20 years)
Young adulthood (20 to 40 years)
Middle adulthood (40 to 65 years)
Later adulthood (65 to 75 years)
Older adulthood (75 years and beyond)
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Assistants.
Slide 23
Stages of Growth and Development
Infancy (birth to 1 year)
Physical and psychological changes occur most
rapidly
New tasks are accomplished on a weekly and
monthly basis
The infant begins to smile and laugh, recognize
parents and siblings, play peek-a-boo, and say simple
words
He progresses from drinking only mother’s milk or
formula to feeding himself solid foods
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Assistants.
Slide 24
Stages of Growth and Development
Toddler hood (1 to 3 years)
Physical growth slows down during toddler hood
Development of the muscular and nervous systems
allows the toddler to become quite active and permits
greater control of the bladder and bowels
Toilet training begins
The toddler learns the words to express emotions,
such as “sad” or “scared”
Remember that medical procedures that require
separation of the child and the caregiver can be very
frightening for a toddler
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Slide 25
Stages of Growth and Development
Preschool (3 to 5 years)
The preschooler’s physical coordination improves a
great deal, and she learns to dress herself and tie her
own shoes
Toileting becomes more independent
Children become aware of gender differences
Begins to develop a conscience and is able to more
easily follow rules
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Assistants.
Slide 26
Stages of Growth and Development
School-age (5 to 12 years)
Major physical growth spurts lead to increase in both
height and weight
Improvement in writing and drawing ability
Actively seeks approval from authority figures and
peers
Morals develop and school-aged children may feel
very strongly about issues being either right or wrong,
with no gray area
Spirituality and religious beliefs, as well as a concern
for other living things, also take root during this
developmental stage
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Assistants.
Slide 27
Stages of Growth and Development
Adolescence (12 to 20 years)
Adolescence begins at the onset of puberty
Physical growth and development during adolescence
is considerable
Psychologically, the period of adolescence is stormy
Adolescents may be self-conscious about their
changing bodies and increased awareness of their
own sexuality
They begin to question the moral teachings of
authority figures and parents
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Assistants.
Slide 28
Stages of Growth and Development
Young adulthood (20 to 40 years)
Young adults typically enjoy stable, supporting
friendships and good health
The physical changes that occur in young adults are
generally minor
The adult height is achieved during adolescence
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Slide 29
Stages of Growth and Development
Middle adulthood (40 to 65 years)
Middle adulthood frequently finds people at the height
of their careers and productivity
Adults find themselves in the role of caretaker to their
children as well as to their aging parents
Physically, the middle adult begins to show signs of
aging, such as wrinkles or a few gray hairs
Women typically experience menopause
While good health is usually still enjoyed, some
chronic illnesses, such as hypertension and diabetes,
become apparent during this stage
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Assistants.
Slide 30
Stages of Growth and Development
Later adulthood (65 to 75 years)
The physical signs of aging and the development of
chronic illnesses become more prevalent
Strength diminishes, as do many senses, such as
hearing and sight
During this stage, many people must cope with the
loss of friends or a spouse due to death
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Assistants.
Slide 31
Stages of Growth and Development
Older adulthood (75 years and beyond)
A primary task in this stage is preparing for one’s own
death
Many must adjust to failing health and a growing
dependency on others
Enjoy sharing the wisdom of their years with younger
people
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Assistants.
Slide 32
Basic Human Needs
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Assistants.
Slide 33
Basic Human Needs
Clearly, all patients and residents are not alike
The people you will care for will be in different growth
and development stages, and as such, they will have
different needs
The primary mission of health care is to administer to the
physical and emotional needs of those we care for
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 34
What Exactly are Needs?
Maslow’s hierarchy of human needs
A need can be defined as something that is essential for a
person’s physical and mental health
Abraham Maslow (1908–1970), a famous American
psychologist, defined what he thought to be the basic human
needs
Maslow’s pyramid, called Maslow’s hierarchy of human needs,
reflects Maslow’s belief that the more basic, lower-level needs
must be met, at least to some degree, before the higher-level
needs can be met
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 35
Maslow’s Pyramid
Needs to be met first
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Assistants.
Slide 36
Physiologic Needs
Oxygen, water, food, shelter, elimination, rest and sleep,
physical activity, and sexuality
Meeting the physiologic needs is essential for survival
and is of the highest priority
A person must have enough oxygen or he will die within minutes
Nursing assistants perform many duties that assist
patients in meeting their physiologic needs:
Assisting with meals
Toileting
Ambulating
Providing a relaxing environment in which to sleep
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Assistants.
Slide 37
Safety and Security Needs
Safety and security needs are both physical and
emotional
Nursing assistants follow policies and procedures that
are designed to ensure their own safety, as well as that
of their patients or residents
To prevent the spread of infection, a nursing assistant follows the
procedure for handwashing
In order to protect a resident who is at risk for falling, the nursing
assistant always makes sure that the resident has his walker
close at hand
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Assistants.
Slide 38
Love and Belonging Needs
All people need to feel loved, accepted, and appreciated
by others
People meet this need for one another by showing
affection and forming close (intimate) relationships
By taking an interest in the person and showing respect
for the person’s specific likes and dislikes, nursing
assistants can help to meet that person’s need to feel
loved, accepted, and appreciated by others
A smile
A kind word
A gentle touch
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Assistants.
Slide 39
Self-esteem Needs
Self-esteem is influenced by how a person perceives
herself, and how she thinks others perceive her
Everyone wants to be respected and thought well of by
others
Many things can affect the self-esteem of a person who
is receiving health care, such as:
Having to wear a hospital gown
Having surgery that might cause the person’s physical
appearance to change
Having to depend on others for something he used to be able to
do for himself
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Assistants.
Slide 40
Self-esteem Needs
Nursing assistants help to preserve their
patients’ and residents’ self-esteem by:
Providing for privacy when it is necessary to expose
someone’s body
Allowing people to wear their own clothing
Assisting people with basic grooming
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Assistants.
Slide 41
Self-actualization Needs
The highest level on the hierarchy of needs is selfactualization
In order to achieve self-actualization, a person must
reach his or her fullest potential
Examples of goals that patients or residents may have
include
taking one step (for a person who has had a stroke)
delivering a healthy baby (for a pregnant woman)
returning home (for a person who has broken a hip)
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 42
Basic Human Needs
By helping people to meet their most essential needs
first, you will enable them to meet their higher-level
needs. For example
It is difficult to work on a person’s self-esteem if he is struggling
to breathe!
Recognizing needs that people have difficulty meeting
on their own, and helping them to meet these needs, is
one of the most valuable contributions you will make as
a nursing assistant
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Assistants.
Slide 43
Human Sexuality and Intimacy
All human beings are sexual beings
Heterosexuals are attracted to members of the opposite
sex
Homosexuals are attracted to members of the same sex
Bisexuals are attracted to members of both sexes
Transsexuals believe that they should be members of
the opposite sex
A transvestite is a person who becomes sexually excited
by dressing as a member of the opposite sex
In fact, most transvestites are heterosexual men
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Assistants.
Slide 44
Nursing Assistants and Sexuality
There are many ways that, as a nursing assistant, you
can help patients and residents to fulfill their need to be
thought of as sexual beings
Avoid being judgmental
Help your patients and residents with rituals that make
them feel either feminine or masculine
Allow for privacy
Always knock before entering a person’s room
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Assistants.
Slide 45
Culture and Religion
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Assistants.
Slide 46
Culture and Religion
Culture is another thing that makes human beings
human. Culture is made up of the beliefs (including
religious or spiritual beliefs), values, and traditions that
are customary to a group of people
While racial identity is often mixed with a person’s
culture, race is a general characterization that describes
skin color, body stature, facial features, and hair texture
A person’s spiritual beliefs, or religion, are often very
closely linked with his or her culture
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Assistants.
Slide 47
Culture and Religion
Throughout your career, you may be lucky enough to
care for people from many different cultural and religious
backgrounds
You will most likely encounter situations, practices, and
beliefs that no book could have prepared you for!
Take time to listen to your patients or residents, and to
learn from them
Exposure to cultures other than your own is enriching,
both professionally and personally
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 48
Respecting The Individual
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Assistants.
Slide 49
Respecting The Individual
As a health care professional, you are trained to care for
a person’s physical needs
A holistic approach to health care takes into
consideration a person’s emotional needs as well as his
or her physical ones
Making an effort to accommodate a person’s cultural
beliefs and practices and allowing patients and residents
to make decisions related to their own quality of life is
one way that health care workers provide holistic care
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 50
What is it like to be a Patient or
Resident?
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Assistants.
Slide 51
Being a Patient or a Resident
What is it like to be a patient?
Patients feel scared and lonely
They feel sick
They are unsure about their health, now and in the future
What is it like to be a resident?
Must adjust to loss of independence
Must adjust to new home, and possibly a roommate
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 52
The Nursing Assistant and the Individual
When you must care for a patient or resident who makes
you wish you had never chosen to be a nursing assistant
(and you can be certain you will encounter patients or
residents like this), stop and think for a moment about
the reasons that person may be acting out of sorts
When you look beyond the illness or condition, past the
technical duties and procedures, and into that person’s
eyes, you will find your reason for choosing to be a
nursing assistant
…a person who needs you very much
Copyright © 2005. Lippincott Williams & Wilkins. Instructor's Manual to Accompany Lippincott's Textbook for Nursing
Assistants.
Slide 53
End of Presentation
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Assistants.
Slide 54