Intro Midterm: Professional Socialization & Communication

Professional Socialization
– Socialization involves a process by which a person acquires the knowledge, skills, and sense of identity that are characteristic of a profession
– involved internalization of values and norms of that profession

Goals of Professional Socialization
– to learn the technology of the profession
– to learn to internalize the professional culture
– to find a personally and professionally acceptable version of the role
– to integrate this professional role into all of the other life roles
*professional nursing is a culture

Distinguising Characteristics of a Profession
– requirement of prolonged, specialized training to acquire a body of knowledge specific to the work performed
– commitment toward service
– Profession: has a specialized body of knowledge and a commitment to service

Professional Nursing Values
– commitment to public service
– Autonomy (having a unique body of knowledge; being accountable to ourselves and to the profession)
– commitment to lifelong learning and education
– belief in the dignity and worth of each person

Historical View of Nursing Values
– obedience, loyalty, and character development
– shift from obedience to more self-directed practice

Socialization Process
– Structural Conditions: refer to the rules that determine roles
– Cultural Conditions: are the idea systems prevalent in a society as expressed in words, symbols, and ceremonies
– structural and cultural conditions are interrelated

Cohen’s Model of Professional Socialization: Cognitive Development
– Stage 1: Unilateral Dependence – extremely dependent on faculty; lots of concern about doing things right and being unsure of your knowledge
– Stage 2: Negativity/Independence – like a toddler in terrible 2s (“no”); an I’ll do it myself attitude where you are confident in your skills and stuff gets old and boring
– Stage 3: Dependence/Mutuality – recognize that you may not know it all and can still use some guidance
– Stage 4: Interdependence – recognize that you know so much but you will never know it all; use resources including faculty to help you throughout your nursing career

Professional Role Development: Social Influences
– Stage 1: Complaince: doing things exactly as you are told; “this is how they taught me in lab, so that’s how I’m going to do it”
– Stage 2: Identification: looking at the nurses in your unit and taking on their characteristics
– Stage 3: Internalization: values of nursing become your own

Benner’s Stages of Skill and Knowledge Acquisition
– Stage 1: Novice: at least 1 year out of school; lots of questions and insecurities
– Stage 2: Advanced Beginner: 1-2 years; getting good experience but still not a lot of self confidence
– Stage 3: Competent: 2-3 years; feels competent, organized; plans and sets goals; thinks abstractly and analytically; coordinates several tasks simultaneously
– Stage 4: Proficient: 3-5 years; views pt holistically; easily recongizes subtle changes and sets priorities; focuses on long-term goals
– Stage 5: Expert: 5+ years; performs fluidly; grasps pt needs automatically; responses are integrated; expertise comes natrually

Characteristics of the Professional Nurse
– high esteem for self and others
– ability to view conflict as potentially positive
– ability to be open to perspecitves of others
– willingness to take risks with a stong sense of integrity and accountability
– high tolerance to ambiguity (unclearness by virtue of having more than one meaning)
– views power as that of power with others
– confidence in practice and self-directed
– values collaboration and interdependence
– exhibits strong sense of internal locus of control, practice in intrinsically rewarding
– practices caring for self and others
– values self reflection

Therapeutic Use of Self
– term originated by Hildegard Peplau in 1952
– Peplau believed that the nurse as a person is the most important tool in treating a pt
– 3 phases in the traditional Nurse-Patient Relationship: orientation, working, and termination

Phases of the Nurse-Patient Relationship
– Orientation: introductory “getting to know you” phase; begins the development of trust; trust enables participation; each other as individuals; ID major problems and needs; estimate length of the relationship
– Working: nurse and pt accomplish tasks towards goals outlined in phase 1; pt may exhibit alternating periods of effort and resistance to chage; regression as a defense mechanism in reaction to stress (usually precedes positive change)
– Termination: nurse and pt take on those activities taht enable them to end the relationship in a therapeutic manner; positive and negative feelings often accompany this process

Characterstics of the Helping Relationship
– Dynamic: relationship is constantly changing and evolving
– Purposeful and time limited: therapeutic relationships are time limited; goals are established and assessed at some set point
– Person providing assistance is professionally accountable for the outcomes; the nurse is always held professional accountable for the outcomes of the relationship

Factors that Promote Effective Communication
– Dispositional Traits: warmth & friendliness; openness & respect; empathy; honestly, authenticity, trust; caring; competences; genuiness *always think about the image you are giving the pt the first time you walk into the room, don’t get wrapped up in the skills part **always focus on the pt’s FEELINGS (test)
– Rapport Builders (things you can do to build the relationship within the environment): comfortable environment; privacy; confidentiality; pt vs task focus; utilization of nursing observations (tell pt you are observant and intereted in what is going on with them); optimal pacing; providing personal space (explain what you are doing and ask “do you mind if..”

– you have to know about yourself so you know how you will influence a relationship
– self-awareness is basic to effective interpersonal relationships
– Goal of self-awareness: nurses can distinguish their own emotional needs from their pt’s needs and get their own emotional needs met outside of the nurse-pt relationship

Factors Involved in Self-Awareness
– Reflective Practice: looking back at what happened during your time of pt care, how you felt about it, how other nurses acted toward you, etc; taking time to focus on own thoughts and feelings and understand how these can affect behaviors toward pts
– Avoiding Stereotypes: prejudices and attitudes that are biased toward pts; goal: accept all pts as idividuals of dignity and worth who deserve the best nursing care possible

Professional Collaboration Skills
– professional collaboration skills are the key to effective teamwork
– collaboration is working jointly with other professionals, all of whom are respected for their unique knowledge and abilities
– collaboration involves willingness to work together and supportive attitude and behaviors of the organization
– collaborating and working together in an interdisciplinary environment are the most important skills to have: medical errors are mainly due to lack of communication/collaboration
– understand the roles of inidividuals in different disciplines in order to respect their role and work together

The Collaborative Process
– ID problems to be solved
– ID barriers or roadblocks to solutions
– Clarify desired outcomes
– Clarify the process that will be used and who will be responsible to accomplish steps
– Evaluate the degree of success in meeting the goals and generating a solution

Nurse-Physician Collaboration
Can be a problematic relationship because of:
– education and status differences
– different levels of willingess to work collaboratively
– hierarchial and control-oriented model for physicians in medical schools
– different personality sturctures between nurses and physicians

Nurse-Patient Collaboration
– Pts often feel intimidated in health care settings: fail to say what is on their minds or to convey important feelings
– goal of nurses is to empower pts and families to partner with them
– Pt’s dependent/vulnerable role cause by: reluctance to ask questions; fearfulness; anger; argumenativeness; unappreciative; challenge authority

Nurse-Assistive Personnel Collaboration
– ensure mutual respect and cooperation
– attend to language and cultural barriers
– differences in beliefs, values, perceptions, or priorities can cause conflict
– problems can result in poor teamwork, reduced job satisfaction, and a negative impact on pt care

Factors Influencing Communication
– developmental level
– gender
– sociocultural differences
– roles and responsibilites
– space and territoriality
– physical, mental, and emotional state
– environment

Forms of Communication
– Verbal (language)
– Nonverbal (body language): facial expression, posture, gait, gestures, general physical appearance, mode of dress and grooming, sounds, silence

Developing Conversational Skills
– control the tone of your voice
– be knowledgable about the topic of conversation (always be prepared and go in with info about the diagnosis; be knowledgable about your pt)
– be flexible
– be clear and concise
– avoid words that might have different interpretations
– be truthful
– keep an open mind

Developing Listening Skills
– sit when communicating with a pt
– be alert and relaxed and take your time
– keep the conversation as natural as possible
– maintain eye contact if appropriate
– use appropriate facial expressions and body gestures
– think before responding to the pt
– if you are unsure of what the pt is asking, rephrase the question back to them so you can answer their question to the best of your ability

Therapeutic Touch
– therapeutic touch may be used to convey a message
– be aware of how people interpret touch
– always let pt know before you are going to touch them

Interviewing Techniques
– Open-ended ?s/comments: best way to get info; gets them to elaborate on info
– Closed ?s/comments: to gather specific info quickly
– Validating ?s/comments: rephrasing something back to them; checking to see if what you heard is what they said
– Clarifying ?s/comments: put pt’s ideas into a simple statement; “Are you saying..”
– Reflective ?s/comments: take something the pt said and repeat it back to them
– Sequencing ?s/comments
– Directing ?s/comments
– use minimal encouragers to get pt to open up and continue talking; periods of silence are also useful and important

Techniques of Therapeutic Communication
– listening
– silence
– broad openings
– restating or reflection of content
– clarifying
– reflection
– focusing
– informing
– confrontation
– minimal encourager
– giving recognition
– summarizing

Techniques of Therapeutic Communication: Listening
– silence, eye contact, attitude of being full present
– permits pt to be heard
– conveys interset in what the pt is saying

Techniques of Therapeutic Communication: Silence
– not breaking the quiet
– allows pt time to form thoughts
– don’t use too much or pt will think you aren’t interested or aren’t listening

Techniques of Therapeutic Communication: Broad Openings
– “What’s been going on”; “Tell me what’s been on your mind”
– initiates the conversation
– puts the pt in control of the content

Techniques of Therapeutic Communication: Restating/Reflection of Content
– “Are you saying you were angry when your wife has to work late?”
– provides feedback, letting the pt know you understoof the message
– lets the pt know you are attentive

Techniques of Therapeutic Communication: Clarifying
– “Are you saying you want to move out of your apartment? Could you explain more about that to me?”
– Puts the pt’s ideas into a simple statement
– makes the pt’s ideas explicit

Techniques of Therapeutic Communication: Reflection
– “So you start feeling depressed when no one calls you over the weekend?”
– presents themes that have emerged through a series of interactions
– helps the pt focus on feelings and allows the nurse to communicate empathy

Techniques of Therapeutic Communication: Focusing
– “Let’s go back to the situation at school where you felt uncomfortable in class”
– directs the conversation back to an area of importance
– explores a topic in depth

Techniques of Therapeutic Communication: Informing
– “The medication must be taken every day”
– provides facts or recommendations

Techniques of Therapeutic Communication: Confrontation
– “You are you’re upset, but you are laughing”
– presents contraindications and inconsistencies

Techniques of Therapeutic Communication: Minimal Encourager
– “go on” “uh-huh” “I’m listening”
– indicate active listening to the pt and interest in what they are saying
– prompts the pt to continue with what was being said

Techniques of Therapeutic Communication: Giving Recognition
– “I notice you’re wearing a new dress, you look very nice”
– a superficial level of communication that inidcates attention to the pt

Techniques of Therapeutic Communication: Summarizing
– “So far we have talked about…”
– the goal is to help the pt explore significant content and emotional themes
– helps move from one phase of the interaction to another

Barriers to Effective Communication
– Stereotyping
– Agreeing or disagreeing
– Being defensive
– Challening
– Probing
– Changing topics and subjects
– Giving reassurances
– Being judgemental
– Giving advice
– Belittling

Barriers to Effective Communication: Stereotyping
– “What’s the matter? Most people don’t have pain after this type of surgery”
– offering generalized and oversimplified beliefs about groups of people that are based on experiences too limited to be valid
– categorize pts and negate their uniqueness as individuals

Barriers to Effective Communication: Agreeing or Disagreeing
– agreeing and disagreeing imply the pt is right or wrong and that the nurse is in a position to judge that
– deter clients from thinking through their position and may cause them to become defensive

Barriers to Effective Communication: Being Defensive
– attmepting to protect toher or services from negative comments
– prevents pts from expressing concerns
– blocks communication

Barriers to Effective Communication: Challenging
– statements that force pts to justify or prove their statement or point of view
– nurse isn’t considering pt’s feelings
– pt: “I didn’t feel good after that pill”
nurse: “surely you don’t think I gave you the wrong pill?”

Barriers to Effective Communication: Probing
– “I’m here to listen, I can’t help you if you won’t tell me everything”
– these statements fail to respect the pt’s decisions regarding privacy of feelings and thoughts
– considered prying
– asking “why” questions is often probing

Barriers to Effective Communication: Changing Topics and Subjects
– often done because the nurse feels uncomfortable with a topic
– conveys that what the pt is talking about is not important
– nurse might do this to talk about a topic that is of interest to them rather than the pt

Barriers to Effective Communication: Giving Reassurances
– these statements block the feelings and thoughts of the pt
– often cliches and things meant to comfort the pt
– everything might not “be ok”

Barriers to Effective Communication: Being Judgemental
– these statements give the nurse’s opinion, moralize, or imply the nurse’s values
– imply that the nurse’s opinions and values are the best and the pt should think the same

Barriers to Effective Communication: Giving Advice
– tell the client what to do
– this can backfire is the nurse gives advice and its doesn’t work out well
– advising makes the nurse rather than the pt responsible for the outcome

Barriers to Effective Communication: Belittling
– “That was 10 years ago, that shouldn’t bother you now”
– gives the message that you have not listened carefully
– makes the pt feel that the nurse is ignoring the importance of the problem

Basic Components of Assertiveness
– having empathy
– describing one’s feelings or the situation
– clarifying one’s expectations
– anticipating consequences
*Assertive vs Aggressive: being assertive means you are guiding the conversation but you aren’t being argumenative or leading the conversation in a way that the pt doesn’t want to to go – you stay focused on the facts

Blocks to Communication
– failure to perceive the pt as a human being
– failure to listen
– inappropriate comments and questions
– using cliches
– using closed questions
– using questions containing the words “why” and “how” (never ask why!!)
– using questions that probe for info
– using leading questions
– using gossip and rumors
– using aggressive interpersonal behavior; getting defensive or arguing

Define nursing Nurses provides framework for nursing practice -establishes the boundaries (parameter) of profession -Clarifies the purpose and functions of nurses’ work -Differentiates nursing from other professions Nighingale’s definition of nursing -contains many concepts that remain contemporary -includes importance of …

Socialization The process of learning and incorporating these aspects of a profession(values, skills, behaviors, and norms) into individual professional identity. When does socialization occur? 1) begins in the nursing program 2)graduating and begins again when entering a professional setting 3) …

discuss the current status of nursing as a profession -relevance to social values and needs -lengthy and required education -code of ethics – mechanism of self regulation – research based theoretical frameworks for practice -common identity and distinctive subculture -members …

Which of the following is a component of biculturalism Evaluation of personal values A mentor is assisting a new graduate nurse… Evaluates a growth by comparing progress with peers WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY …

Professional Nursing Socialization – absorbing and assimilating the culture of nursing, its rites, rituals and valued behaviors of the profession Formal Socialization – classroom lectures – assignments – lab experiences WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC …

What is the process of “professional socialization”? “a critical process in which novices become well-functioning professional nurses” — going from student to professional through a process that starts at novice and ends at expert practitioner — occurs thru workplace and …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out