什么是人际关系和人际沟通

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Chapter 6,Role Relationship Patterns,1,what kinds of outline are,the most important,in the chapter?,Role,Relationship,Patterns,2,Basic Concepts,Definitions,Related Terms,Personal Interpretations of Role,Societal Interpretations Role,Effects of Alteration in Role Performance on Others,OUTLINE,p.108,Role,Relationship,Patterns,3,Applications,Professional Nurse Role,Types of Professional Roles,Role Socialization,Role Stress,Self-awareness in the Professional Role,OUTLINE,p.108,Role,Relationship,Patterns,4,Client Role,Patients Bill of Rights,Role Performance as a Nursing Diagnosis,Supportive Interventions,Developing New Solutions,Summary,OUTLINE,p.108,Role,Relationship,Patterns,5,What are the objectives,of learning or,studying in our lesson?,Role,Relationship,Patterns,6,At the end of the chapter, the student will be able to,1. Define role and role performance,2. Describe the four components of professional,role socialization,3. Discuss the professional roles of the nurse,4. Discuss the characteristics of the sick role,Objectives,p.108,Role,Relationship,Patterns,7,Role,Relationship,Patterns,Objective One:,Define role and role performance,8,What is role?,A,role,is defined as a set of expected behavioral standards established by the society or community to which a person belongs (Creasia, 1991).,Definitions,p.109-110,Role,Relationship,Patterns,9,What is role relationship?,Role relationships,influence communication content and process.,Consider your own role” as a nursing student and how it influences communication content and process.,Definitions,p.109-110,Role,Relationship,Patterns,10,什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,Role,Relationship,Patterns,11,什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.303 p.310,Role,Relationship,Patterns,12,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。”,Role,Relationship,Patterns,13,What is role performance?,Role performance,refers to a persons capacity to function in accord with social expectations of a particular role.,Perceptions of behavioral standards for role performance differ from based on cultural, gender, institutional, and family expectations;,People still expect different role behaviors from men and women despite tremendous advances in equal,opportunity.,Definitions,p.109-110,Role,Relationship,Patterns,14,Role transition,describes changes in role expectations that occur as developmental life crises or when unexpected life events such as illness or injury alter role function.,For example, new mother experiences a significant role transition with the birth of her first child, as does a young athlete struck down in a ball game with a spinal cord injury.,What is role transition?,Definitions,p.109-110,Role,Relationship,Patterns,15,What is position?,Position,represents a,standardized description,of a role and,associated expectations,that makes it understandable to others in the community or group.,Social position,relates to the status and identity the person holds in the community.,The concept of,position,sometimes plays a role in how helping professionals respond to clients:,they sometimes treat clients in high positions differently than those with no money or low social status.,Definitions,p.109-110,Role,Relationship,Patterns,16,Whereas it is important for the nurse to recognize differences in position as relevant factors in supporting client integrity and self-esteem, nurses need to view all clients as very important persons, treating them all with the same respect and giving them all quality care regardless of position.,Definitions,p.109-110,What is position?,Role,Relationship,Patterns,17,Role,Relationship,Patterns,Objective Two:,Describe the four components of professional role,socialization,18,Unlike other forms of education, the nursing student must simultaneously(同时地)adjust to learning new material while starting on the job training in which the stakes(风险)are high.,Cohen identified four goals of professional socialization (see Box 6-4). ,Which is the four components of professional role socialization ?,Professional Nurse Role,p.114-115,Role,Relationship,Patterns,19,Box 6-4.Steps in the Socialization Process,Learn the technology of the profession:,the facts,skills, and theory.,In,t,ernalize(,使内在化),the professional culture,Find a,p,ersonally and professionally acceptable,v,ersion of the role.,I,ntegrate this professional role into all the other,life roles.,Role,Relationship,Patterns,20,Box 6-4.Steps in the Socialization Process,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。,Role,Relationship,Patterns,21,Exercise Looking at My Development as,a Professional Nurse,Purpose: To help you focus on your self-,development as a professional nurse,Role,Relationship,Patterns,22,Exercise Looking at My Development as,a Professional Nurse,Procedure:,Write the story of how you chose to become a nurse in a one- to two-page essay (may be done as a homework assignment). There are no right or wrong answers; this is simply your story. You may use the following as guides in developing your story.,Role,Relationship,Patterns,23,Exercise Looking at My Development as,a Professional Nurse,Procedure:,What are your reasons for,choosing,nursing as a profession?,What factors influenced your,decision,; people, circumstances, or situations?,Describe your,vision,of yourself as a nurse.,What,fears,do you have about your ability to function as a professional nurse?,How do you think being a nurse will affect your personal life?,Role,Relationship,Patterns,24,In what ways is your story similar to or different from those of your classmates?,As you wrote your story, were you surprised by any of the data or feelings?,Role,Relationship,Patterns,Discussion:,25,Students can discuss some of the realistic difficulties encountered as nursing students both professionally and personally and ways to handle them. Explore through discussion the following:,The practices,nursing students will need to,follow to achieve their vision,The types of supports,nurses need to,foster their ongoing professional development,Role,Relationship,Patterns,Discussion:,26,Role,Relationship,Patterns,Objective Three:,Discuss the professional roles of the nurse,27,Which are there Professional Nursing Roles,P.116,1. Caregiver,: ,a.,Provides complete or partial compensatory,care,for clients who cannot provide these self-care functions for themselves,b. Implements supportive/educative actions to,promote optimum health,Reinforces the natural, developmental, and healing processes within a person to,enhance well-being,comfort, function, and personal growth,Professional Nurse Role,Role,Relationship,Patterns,28,2. Teacher:,a. Provides,health teaching,to individual clients and,families,b. Develops and implements patient,education programs,to promote/maintain healthful practices and,compliance with treatment recommendations,c. Guides individuals in their human journey toward,wholeness and well-being through,psychoeducation,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,29,3. Client advocate,:,a.,Protects clients right,to self-determination,b.,Motivates individuals and families,to become informed active participants in their health care,c.,Mediates,between client and others in the health care environment,Acts as clients agent,in coordinating effective health care services,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,30,4. Manager,:,a.,Coordinates,staff and productivity,b.,Delegates differentiated tasks,to appropriate personnel,Facilitates communication,within and among,departments ,Serves on committees,to improve and maintain quality of care,e.,Makes decisions,and,directs relevant changes,to ensure quality care,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,31,5. Evaluator:,a.,Sets,quality assurance/care,standards,Reviews,records and,monitors,compliance with,standards,c.,Makes recommendations,for improvement,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,32,6. Researcher,:,Develops and implement research/grant proposals,to broaden understanding of important issues in clinical practice and,validate nursing theories,as a basis for effective nursing practice,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,33,7. Consultant:,Provides specialized knowledge/advice,to others on health care issues,b.,Evaluates,programs, curricula, and complex clinical data,c.,Serves as expert witness,in legal cases,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,34,8. Case Manager:,a. Administers,care for a caseload,of clients,b. Coordinates,cost-effective care,options,Monitors,client progress,toward expected behavioral outcomes,Collaborates with other professionals to,ensure quality care,across health care settings,Which are Professional Nursing Roles,P.116,Role,Relationship,Patterns,35,Role,Relationship,Patterns,Objective Four:,Discuss the characteristics of the sick role,36,From the client perspective, loss of or changes in,normal roles, role relationships, and role performance,are important di,m,ensions(,尺度/元),of the emotional pain clients experience in health care situations.,How well people are able to perform their,roles,within the family and society,influences their reputation within the community and their sense of self-esteem. When illness or injury affects,role performance, it also impacts,role relationships,with others and self-esteem.,How to understand Client role,role relationships, performance and,transition?,p.119,Role,Relationship,Patterns,37,The nurse may be the only person,who has the exper,t,ise and willingness to facilitate discussions of the implications of role changes,stemming from(,源于),altered health status for the client,in an objective, com,p,assionate manner.,p.119,How to understand Client role,role relationships, performance and,transition?,Role,Relationship,Patterns,38,Talking about the,meaning of role change,is just as important as talking about how to change a dressing or what a physical symptom means.,Loss of role, changes in role expectations and performance, role relationships and role transitions,can occur as a result of age, illness, loss of job or significant person, injury, and mental disorders,How to understand Client role,role relationships, performance and,transition?,p.119,Role,Relationship,Patterns,39,Most people do not assume the,sick,role,v,oluntarily.,Illness or trauma(,外伤),can change an individuals,social role,from one of independent self-sufficiency to one of vulnera,b,ility(,脆弱性),and varying degrees of dependency on others,a personal role,from one of independence to dependence. When clients enter a health care situation, they encounter an interpersonal environment that encourages the development of feelings of ano,n,ymity(,无名),and helplessness. ,How to understand Client role,role relationships, performance and,transition?,p.119,Role,Relationship,Patterns,40,At the hospital door, the client forsakes(,放弃),recognized,social roles,in the family, work situation, and community, tempo,r,arily or,p,ermanently.,Regardless of how competent the person may be in other life roles, when illness strikes (,打击), questions about,role performance,i,n,evitably arise.,Often clients must learn,new role behaviors,that are unfa,m,iliar and unsettling to previously held self-concepts.,How to understand the transition of Client,role,role relationships, and role performance?,Role,Relationship,Patterns,p.119,41,Adjustment to a change in health care status,requires,a whole new set of coping,skills,without necessarily having the same social supports.,Clients clearly need the support of the nurse to,incorporate,the rapidly changing meaning of the environmental and personal changes,encountered in illness,into,an otherwise basically healthy self-concept.,How to understand the transition of Client,role,role relationships, and role performance?,Role,Relationship,Patterns,p.119,42,Differences in perspectives play a major part,in determining which illnesses and disorders are recognized as legitimate(合理的), the roles,clients assume in their health care, and who becomes the culturally assigned,expert (在 .中当专家) in promoting, maintaining, and restoring health.,For example, some cultures believe that illness is punishment from God or an imbalance of energy that interferes with the bodys functioning.,These cultural understandings can affect role,relationships in health care settings.,How to understand the transition of Client,role,role relationships, and role performance?,Role,Relationship,Patterns,p.119,43,Client Role,Clients are expected to act as participating, cooperative agents in their recovery process.,However, an Asian client may appear as a passive recipient of health care, strikingly dependent on family and health caregiver for all guidance and care.,Without a clear understanding of this culturally acceptable expression of the sick role, the nurse may respond inappropriately.,p.120,Role,Relationship,Patterns,44,What is a Patients Bill of Rights ?,p.121,1. The patient has the right to considerate and respectful care.,Client Role,Role,Relationship,Patterns,45,What is a Patients Bill of Rights ?,p.121,2. The patient has the right to, and is encouraged to obtain from physicians and other direct caregivers, relevant, current, and understandable information concerning diagnosis, treatment, and prognosis. Except in emergencies when the patient lacks decision making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and treatments, risks involved, length of recuperation, and medically reasonable alternatives and their accompanying risks and benefits.,Client Role,Role,Relationship,Patterns,46,What is a Patients Bill of Rights ?,Client Role,3.Patients have the right to know the identity of physicians, nurses, and others involved in their care, as well as the status of the caregivers (e.g., when those involved are students, residents, or other trainees.).,p.121,Role,Relationship,Patterns,47,What is a Patients Bill of Rights ?,Client Role,4.The patient has the right to make decisions about the plan of care before and during the course of treatment, to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy, and to be informed of the medical consequences of this action.,p.121,Role,Relationship,Patterns,48,What is a Patients Bill of Rights ?,Client Role,5.The patient has the right to have an advance directive (such as living will, health care proxy, or durable power of attorney over health care) concerning treatment or designating a surrogate decision maker with the expectation that the health care institution will honor the intent of that directive to the extent permitted by law and hospital policy. Health care institutions must advise patients of their right to make informed medical choices.,p.121,Role,Relationship,Patterns,49,What is a Patients Bill of Rights ?,Client Role,6.The patient has the right to every consideration of privacy. Case discussion, consultation, examination, and treatment should be conducted so as to protect the patients privacy.,7.The patient has the right to expect that all communications and records pertaining to care will be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards, when reporting is permitted or required by law.,p.121,Role,Relationship,Patterns,50,What is a Patients Bill of Rights ?,Client Role,8.The patient has the right to review records pertaining to medical care and to have the information explained or interpreted as necessary, except when restricted by law.,9.The patient has the right to expect that, within its capacity and policies, a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. The hospital must provide evaluation, service, and referral as indicated by,the urgency of the case.,p.121,Role,Relationship,Patterns,51,What is a Patients Bill of Rights ?,Client Role,10.The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, and other health care providers or payers that may influence the patients treatment and care.,p.121,Role,Relationship,Patterns,52,What is a Patients Bill of Rights ?,Client Role,11.The patient has the right to consent decline to participate in proposed research studies or human experimentation affecting care and treatment or requiring direct patients involvement and to have those studies fully explained before consent.,p.121,Role,Relationship,Patterns,53,What is a Patients Bill of Rights ?,Client Role,12.The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.,The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment, and responsibilities and to be informed of available resources for resolving conflicts.,p.121,Role,Relationship,Patterns,54,licensure,legal,confidentiality,identification,informed,consent,ethical code,consideration,inconsiderate,impulse,appetite,caprice,parameters,sequence,assume,discipline,prescribe,appropriate,mutually,performance,Vocabulary,compensation,substantial,finding,counseling supervision delegation execution regimen,registered nurse,accountable responsible,competency,statute,territory,monitor,prioritize,coordinate,personnel,board,mandate,representative,violation,revise,articulate,benchmark,oncological,gerontological,psychiatric,tenet,relevance,tort,benchmark,judge,negligence,breach,document,falsify,withhold,privileged,communication,compromise,mandate,communicable,statutory,In addition to,in any way,Informed Consent,knowledgeable,55,56,Basic Concepts,American Nurses Associations Definition of Professional Nursing Practice,Professional Licensure,Nurse Practice Acts,Professional Standards of Care,Legal Standards,Confidentiality,Informed Consent,Protecting Client Rights,OUTLINE,57,OUTLINE,Ethical Code for Nurses,Applications,Nursing Process,Nursing Process and Professional Relations,Assessment,Diagnosis,Planning and Outcome Identification,Implementation,Evaluation,Critical Pathways,Summary,58,OBJECTIVES,1.Define professional nursing,2.Discuss the implications of nurse practice acts in the,nurse-client relationship,3.Identify professional standards of care,4.Discuss legal standards,5.Discuss implications of the code of ethics with interpretive,statements for the nurse-client relationship,6.Describe the nursing process as a frame-work for,professional nursing practice and the nurse-client,relationship,7.Discuss critical pathways as a method of communication,59,If a man