week 2 Flashcards
(44 cards)
what is recovery? what factors influenced the recovery movement?
the act, process, or event of recovering [in general]; hard to define, but meaning depends on the person (ex: being able to live independently, having a job, finding a new purpose in life, etc.)
recovery focuses on optimal functioning in ALL areas of living
factors that influenced the recovery movement:
- writings of people w/ mental illness
- development of evidenced based practice on recovery (of people w/ mental illness)
what is the recovery-oriented approach/practice?
uses the biomedical model; assumes that mental disorders are brain diseases & emphasizes pharmacological tx to target presumed biological abnormalities
recovery = may not mean a cure; seen as a path to recovery rather than a destination w/ an endpoint
includes understanding personal stories, experiences, hopes & dreams, etc.
what is the difference between clinical recovery vs. personal recovery?
clinical recovery: involves getting rid of symptoms & restoring social functioning, etc.
personal recovery: deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, &/or roles *it’s a way of living a satisfying, hopeful, & contributing life even w/in limitations caused by illness; based on what an individual perceives as a “meaningful life”
what’s the main difference???
- source of expertise
what are the 5 dimensions of recovery?
Clinical recovery: improvement/getting rid of symptoms
Existential recovery: having a sense of hope, empowerment, & spiritual well-being
Physical recovery: enhancing the physical health of ppl w/ mental illness; pursuing better health & a healthy lifestyle (ex: exercise, diet)
Social recovery: ppl w/ mental illness often lose contact w/ those close to them (ex: regain relationships, make friends, etc.)
Functional recovery: being able to maintain functions that most people take for granted (ex: valued societal roles & responsibilities; having a job, able to go to school, living independently)
*best way to understand recovery: read primary sources written by those who have mental illness & went through the recovery process themselves
list examples of recovery-orientated practices.
- asking pts. what they’re hoping to get after admission/discharge
- supporting pts. by finding out their knowledge & what can help speed their recovery process (individualized; focus on the WHOLE person)
- encouraging social/family support; family acceptance, attending peer support groups, & confiding in peer support workers (can help speed one’s recovery process)
- encouraging pts. to be involved in purposeful activities to boost recovery (ex: learning new skills, reading, doing something outdoors, doing music/art, etc.)
what is the most important element to the recovery process & one’s growth?
hope; this is the main way to recovery (hard to go on w/ life w/o hope)
true or false: authority can direct treatment plans & how ppl live their lives
false; authority can only direct tx plans, but NOT how one lives their own life
what are the 5 key points in recovery-oriented practice?
- Concept of recovery-focused care is highlighted in many mental health policies
- Recovery-focused care helps professionals understand client’s needs
- Involving family in care & discussing how mental illness affects all parts of a person’s life helps build trust
- Lack of time is often a reason for nurses not focusing on recovery; remember to communicate w/ pts. (even short conversations)
- Provide person-centered care by involving clients in their own care by allowing them to make decisions r/t care
what is mental health promotion?
the process of improving the capacity of individuals & communities to be able to take control over their lives & improve their mental health
TLDR; promoting mental health through certain interventions to improve one’s mental health
what are the 3 main themes in recovery oriented practice?
- hope
- person-centered care
- consideration of the client’s perspective
what is a wellness planner & what is its the purpose?
a client’s medical records in booklet form
purpose is to increase:
- sense of empowerment
- perceived QOL
- satisfaction w/ mental health care services
- perception of continuity of care
what is relational practice?
basically, interpersonal communication skills; focuses on relational skills including listening, questioning, empathy, mutuality, reciprocity, self-observation, reflection & sensitivity to emotional contexts *focuses on building good connections w/ family
Relational practice surrounds therapeutic nurse-client relationships & relationships among HCPs
what does “therapeutic use of self” mean?
using self to help foster a safe environment to aid clients to overcome their difficulties; everyone uses their personality & ways of being in a different way in the helping process.
what are the components of a therapeutic relationship (CRNM)?
- Respect: responsibility to understand the dignity & rights of clients
- Empathy: the expression of understanding, validating & resonating w/ the client in terms of their health care experience.
- Trust: obliges the nurse to act in the client’s best interest
- Power: there’s an imbalance of power favoring the nurse
- Professional intimacy: client discloses personal information, therapeutic closeness; in this case, it’s not a friendship (this is a workplace relationship w/ the HC team)
what are the PHASES of a therapeutic relationship [peplau]?
- Orientation phase (how you start)
- first meeting (explaining self & role)
- getting to know pt. (listening to their stories, things in common, asking how they’re feeling, making them comfy, etc.) *establish rapport
- talk about discharge
- talk about personal strengths
- establishing trust
- discuss confidentiality/boundaries - Working phase
- identifying & working on pt. problems
- outcomes & interventions are planned w/ pt.
- goals are developed (clinical/personal recovery goals)
- expect defense mechanisms to surface - Termination phase (where relationship ends)
- summarize goals achieved in the relationship
- review situations that occurred during the nurse-pt. relationship
what are the 3 guiding principles of therapeutic communication?
Individuality: seeing pts. as individual ppl beyond their mental illness; demonstrating respect *promoting person-centered care
Providing support: providing support, hope, concern; helping clients feel safe & comfortable *being genuine
Being present/accessible: investing time in the pt.
traits of a good listener? bad listener?
good listener
- maintaining eye contact (depending on culture)
- allow pt. to speak & not asking questions as they speak (let them express own thoughts)
- “you don’t need to apologize”
- can use open/closed ended questions (yes/no questions)
bad listener
- speaking over pt.
- being on phone
- no eye contact
- looking uninterested
potential barriers to communication?
- disturbances in perceptions, processing &/or expression (ex: d/t anesthesia)
- disease/disorders (ex: schizophrenia)
- culture
- language barriers
therapeutic communication technique: exploring
Examination of certain ideas, experiences, or relationships more; if pt. chooses not to elaborate by saying no, nurse doesn’t pry – we respect their personal wishes
Helps the pt. feel free to talk & examine their personal issues “tell me more about what happened before your admission.”
Examples:
“tell me more about that”
“would you describe that more fully?”
“could you talk about how you learned your mom was dying of cancer?”
therapeutic communication technique: giving information
Makes available the facts the pt. needs
Gives knowledge from which decisions/conclusions can be made
Examples:
“this medication is for…”
“the test will determine…”
“my purpose for being here is…”
therapeutic communication technique: attempting to translate words into feelings (A.K.A. decoding)
Responding to the feelings expressed by pt. & not just the content
- Done to understand the deeper meaning of words said by pt.
Example:
- Pt: “I’m dead inside.”
- Nurse: “Are you saying you feel lifeless? Does life seem meaningless to you?”
therapeutic communication technique: confrontation
Bringing up a subject that has the potential of being negative, hurtful, &/or sensitive, but doing it in a way that comes across as respectful & constructive
To bring incongruencies/inconsistencies into awareness; encourages nurse & pt. to explore inconsistencies in their communication/behaviour
therapeutic communication technique: seeking clarification
Attempt by nurse to check their own understanding of what’s been said by the pt.
Helps pt. make their thoughts/feelings clearer; helps pts. clarify own thoughts & maximizes mutual understanding between nurse & pt.
Examples:
“I’m not sure I understand you”
“what would you say is the main point of what you just said?”
“give an example of a time you thought…”
therapeutic communication technique: focusing
Concentrates attention on a single point; especially if a pt. is experiencing severe anxiety (nurse shouldn’t persist until anxiety lessens) – redirecting client to an idea of important relevance
Allows client to stay w/ specifics & analyze problems w/o jumping from subject to subject
Examples:
“could we continue talking about your infidelity right now?”
“this point you are making about leaving school seems worth looking at more closely”
“you’ve mentioned many things. let’s go back to your thinking of ‘ending it all’.”
