Frame of reference for nursing care

Transkript

1 Professionalism, attitudes and values in nursing Frame of reference for nursing care

2 Frame of reference for nursing care CONTENT 1: Introduction 2 2: Purpose of the frame of reference for nursing care 3 3: The nursing profession 3 4: Frame of reference for nursing care 3 The nurse-patient encounter 4 Care 4 Patient-centred approach 5 Ability to act 5 5: References 6 1: INTRODUCTION The group of nurse managers and clinical nurse specialists at Lillebaelt Hospital focuses on professionalism, attitudes and values in nursing; on this background a frame of reference for nursing care has been developed. At Lillebaelt Hospital the patient comes first. The values in the frame of reference for nursing care support this thinking; this frame of reference is the contribution of the nursing profession to support the best treatment to patients and their relatives. With this frame of reference we also wish to develop and strengthen the nursing quality at Lillebaelt Hospital. Based on the vision and values for strategy and development of nursing at Lillebaelt Hospital, the frame of reference for nursing care reflects assumptions and values to inspire the performance, communication, leadership and development of the nursing profession. The frame of reference for nursing care sets the standard for nursing and describe the expectations patients, relatives, colleagues and multidisciplinary collaborators can have to nursing professionals at Lillebaelt Hospital. THE NURSING PROFESSIONAL FRAME OF REFERENCE IS MADE BY Kirsten D. Bisgaard, Head Nurse Ida Bhanderi, Department Nurse Approved by nurse managers at Lillebaelt Hospital. APRIL 2014 Bodil Winther, Clinical Nurse Specialist Karin Bundgaard, Clinical Nurse Specialist 2

3 2: PURPOSE OF THE FRAME OF REFERENCE FOR NURSING CARE To promote professional patient-centred nursing in all encounters with patients and relatives at Lillebaelt Hospital To strengthen the individual nurse to develop her professional skills, to act professionally and to provide excellent nursing To inspire individual nurse managers to practice professional and nursing professional leadership To visualise and promote the nursing perspective in the vision, mission and values at Lillebaelt Hospital 3: THE NURSING PROFESSION Nursing is a profession practiced on the basis of knowledge and experience from an independent nursing science field and from other sciences. Nursing is expressed as professional care in the concrete encounter with the patient and the relatives. The patient is defined from a holistic point of view and the core of planning of care and treatment is the patient s knowledge, resources and life situation. Nursing Society has clear expectations to the tasks the nursing profession should fulfil. The core services of nursing are, in collaboration with the patient, to promote and maintain health and wellbeing, to prevent disease, to support rehabilitation, to relieve suffe ring and to independently perform treatment in accordance with the doctor s prescription. To be able to continuous ly provide these core services, professional leadership, communication and development are essential dimensions. The nursing field Nursing is centred on the human being with the needs and life phenomena attached to human beings whose health is threatened, who experience acute illness or live with a chronic disease as well as to the dying human being. 4: FRAME OF REFERENCE FOR NURSING CARE The frame of reference for nursing care is the value-based and theoretical foundation of nursing and it comprises the following four key concepts: The encounter, care, patient-centred approach and ability to act (see Figure 1 below). In the following the key concepts are clarified. FIGURE 1: Model of the frame of reference for nursing care Pages 4-5 elaborate on the four key concepts of the figure: The encounter, patientcentred care and ability to act. Some of the cues for these key words are: guest of honour, live story, dignity and skills. THE ENCOUNTER PATIENT-CENTRED APPROACH CARE ABILITY TO ACT 3

4 PHOTO: CHARLOTTE DAHL Frame of reference for nursing care THE ENCOUNTER PATIENT-CENTRED APPROACH The encounter between the patient and the nurse is the frame for the practising of professional nursing care. Sig nificant prerequisites for the encounter are sense of pre sence, acknowledgements, accessibility and reciprocity. Patient-centred nursing is based on mutual respect, com munication and acknowledgement of the fact that the patient is an expert on his own life. On the basis of the patient s understanding of his situation, the nurse forms a partnership with the patient and his relatives. Central concepts in the encounter are: guest of honour, relation, presence and dialogue. Key concepts in the patient-centred approach are: life sto ry, needs, existential phenomena and suffering. The intention is for the patient to experience: To be a guest of honour and to be met with respect and kindness To feel the presence and attention in the relation with the nurse That a partnership is formed on care and treatment through dialogue 4 The intention is for the patient to experience: To be met as a human being with own life story and not just being a disease To be offered basic and specialised nursing to meet bodily, physiological and cultural needs To be met concerning existential phenomena such as vulnerability, grief, pain, suffering but also phenome na suchas life courage, life joy and hope.

5 Nursing is a profession practiced on the basis of know ledge and experience from an independent nursing science field and from other sciences. Nursing is expressed as professional care in the concrete encounter with the patient and the relatives. CARE Professional care takes the starting point in meeting the patient with trust and respect for his life situation. This means that the nurse is conscious of her own professional power, choosing the best possible health professional solution in collaboration with the patient. Central concepts are: care is linked to respect, trust, dignity and self-determination. The intention is for the patient to experience: To be met with trust and respect this means as a valuable human being That integrity, dignity and the right to self-determination are respected ABILITY TO ACT The ability to act is a person s ability to translate thoughts and knowledge into something valuable for others. Ability to act is based on judgement, which is connected to the nursing profession s ability to act, embracing critical reflection, formation and professional knowledge. The nurse uses her ability to judge in the concrete relation to the patient. Central concepts in ability to act are: responsibility, skills, evidence and nursing professional judgement. The intention is for the patient to experience: That the nurse demonstrates responsibility in both known and unknown patient situations by acting on the basis of a qualified nursing professional judgement, knowledge and experiences That the nurse is skilled and performs nursing with technical ingenuity, sense of presence and excellence That the nurse goes through and discusses relevant possibilities for care and treatment with the patient based on the most recent evidence, best clinical practice and the patient s preferences 5

6 References SECTION 3: THE NURSING PROFESSION Delmar, C. (2013). Tiltrædelsesforelæsning. Professionel omsorg for patienter og pårørende hvor svært kan det være? // Klinisk Sygepleje; 27 (2):8-20 Scheel, M. (2005) Interaktionel sygeplejepraksis. 3. udgave. // Munksgaard Danmark. Sygehus Lillebælt (2013). Tværgående dokument Info Net: Inddragelse af patient og pårørende som partner (ID ) Nursing Husted J. (2013) Etik og værdier i sygeplejen. Hans Reitzels Forlag. Kirkevold, M. (2003). Videnskab for praksis. // Gad. Ministeriet for sundhed og forebyggelse (2008). LBK nr. 877 af 04/08/2011. Bekendtgørelse af lov om autorisation af sundhedspersoner og om sundhedsfaglig virksomhed Sundhedsministeriet (1995). Redegørelse fra udvalget vedrørende analyse af sygeplejerskeområdet. The nursing field Delmar, C. (2013). Tiltrædelsesforelæsning. Professionel omsorg for patienter og pårørende hvor svært kan det være? // Klinisk Sygepleje; 27 (2):8-20 SECTION 4: THE ENCOUNTER Den danske ordbog. A6 dersg%c3%a6st (søgedato ) Eriksson, K. (1995). Vårdforskning. Institut for vårdvetenskap. Reports from the deparment of caring science 5/1995. Frederiksen, L. (1999). Modes of relating in a caring conversation: A research synthesis on presence, touch and listening. Journal of Advanced Nursing (30) side ) Holopainen G., Kasen A. og Nyström L. (2014). The space of togetherness a caring encounter. // Scandinavian Journal of Caring Sciences (28) side Martinsen, K. (2005). Samtalen, skjønnet og evidensen. // Akribe, Oslo Patient-centred care Care Delmar, C. (2012). Beyond the drive to satisfy needs: in the context of health care. Medicine, Healthcare and Philosophy, 16 (2) s Delmar, C. (2013). Tiltrædelsesforelæsning. Professionel omsorg for patienter og pårørende hvor svært kan det være? // Klinisk Sygepleje; 27 (2):8-20 Eriksson K (2003). Det lidende menneske. Munksgaard, Danmark Horsdal, M. (2002). Livets Fortællinger. // Borgen. Ponte, PR et al(2003). Making Patien-centered Care Come Alive. JONA; 33 (2): Ramhøj, P. (1999). Narrativer. I: Lyngaa (red) Sygepleje Fag refleksion og handlinger. // Munksgaards Forlag. Sygeplejefagligt Råd (2012). Strategi for udvikling af sygepleje Sygehus Lillebælt. Sygehus Lillebælt (2013). Tværgående dokument InfoNet: Inddragelse af patient og pårørende som partner (ID ) Delmar, C. (2013). Tiltrædelsesforelæsning. Professionel omsorg for patienter og pårørende hvor svært kan det være? // Klinisk Sygepleje; 27 (2):8-20 Husted J. (2013) Etik og værdier i sygeplejen. Hans Reitzels Forlag. Løgstrup, S.E. (2006). Den etiske fordring. Gyldendal. Ministeriet for Sundhed og Forebyggelse (2007). LBK nr. 913 af 13/07/2010. Sundhedsloven. Ability to act Den danske ordbog. dersg%c3%a6st (søgedato ) Gjallerhorn (red.) (2009). Temanr.: Professionsdannelse. Nr. 9. VIA. Hørdam B., Overgaard, D. og Pedersen, U. (2008) Kliniske sygeplejeforskning udvikling og implementering. Gads forlag. København Martinsen, K. (1985). Fra Marx til Løgstrup. Munksgaard Danmark 6

7 Patient-centred nursing is based on mutual respect, communication and acknowledgement of the fact that the patient is an expert on his own life. PHOTO: CHARLOTTE DAHL 7

8 Lillebaelt Hospital Kabbeltoft Vejle Denmark Tel.: Skovvangen Kolding Denmark Tel.: At Lillebaelt Hospital the patient comes first. The values in the frame of reference for nursing care support this thinking; this frame of refe rence is the contribution of the nursing profession to support the best treatment to patients and their relatives. With this frame of reference we also wish to develop and strengthen the nursing quality at Lillebaelt Hospital.