DSN

1. DSN • VisionThe vision of Denver School of Nursing is to be recognized as an excellent school of choice for individuals seeking higher education leading to careers in nursing and other medical fields.

2. DSN • MissionDenver School of Nursing is a private institution of higher education dedicated exclusively to educating students for the diverse opportunities offered by careers in nursing and other medical fields.

3. DSN • PhilosophyThe philosophy of Denver School of Nursing flows from the mission of the school and supports the concepts of clinical competence, excellence in education, holistic care, professionalism, evidence-based practice and lifelong learning.

4. NRS 438 Topics of Professional Nursing Practice II • Vision Development of clinical competency & critical thinking skills to foster a lifetime of professional growth & learning.

5. NRS 438 Topics of Professional Nursing Practice II • Mission Students will learn toIntegrate holistic and traditional health care values in order to partner with diverse clients, health care colleagues, and the community at large. Additionally, students will gain an understanding about the legal aspects of the nursing profession, global health care issues & high quality health care outcomes.

7. 12 Values Assumptions that guide the process of internal change are • 1.The meaning and essences of care is a connection in the moment • 2.Feeling connected creates harmony and healing • 3.Each person on the team plays a part • 4.Relationship is at the heart of all of this • 5.Care providers knowledge of self and self-care > quality of care, healthy relationships. • 6.Healthy relationships among health care member is essential to the quality of care provided to patients.

8. 12 Values Assumptions that guide the process of internal change are • 7. People are most satisfied when in alignment with their personal and professional values • 8. We must understand and value of Relationship in patient care. • 9. A therapeutic relationship is essential for quality care • 10. Patient experiences improve measurably when staff own their own practice • 11. People willingly change when they are inspired to a shared common vision. When an infrastructure is implemented for it working, when relevant education is provided for personal professional development, and when they see evidence of success (I2E2) 12. Transformational change happens one relationship at a time.

9. RBC Model for the Clinician Colleagues Self-Clinician Patient & Family At the core “The CORE of the healing environment is your Relationship to the patient and family”, p. 29

10. WATSON WATSON DINGMAN MODELS OF CARING SWANSON LEININGER THE FOUNDATION FOR RELATIONSHIP BASED CARE

11. Caring & Healing Theories • Watson – Model of Caring - 31 • Patient can only change self • Healing comes from inside out • Nurse is a facilitator of change • Understanding of pts needs, hx, life experiences • Must be present in every interaction • Leave your baggage at the door • Nurse must have self-awareness to have facilitate healing

12. Caring & Healing Theories • Swanson – 5 Caring Processes - 33 • Belief & Knowing are internal processes of caring • “Being With”, “Doing For” & “Enabling/Informing” are action elements of caring • Integration of caring & healing of RBC

13. Caring & Healing Theories • Leininger – Cultural Diversity of Caring 34 • Always ask the patient “what does caring mean to you” • No cure without caring • Universal caring characteristics • Helping • Respect • Concern • Attention to detail • Presence/be there in the moment • Protecting • Touching • Comfort measures • Adjusting the environment to meet the patients needs - Rounding

14. Caring & Healing Theories • Dingman – The Caring Model 36 • Practical • Customer Service Model • Introduce Self • Call patient by preferred name • Use of touch appropriately • SDL patients to review care plans • Re-enforce Company V,M & Philosophy • Used by all members of the Care Team

15. Caring Healing Summary • Quality care deeply rooted in dignity & respect for individual patient • Centers around mind, body & spirit – holistic • Professional nurse is always present with the patient– just be there • Professional nurse facilitates healing with understanding & attention to individuality • Safe care rooted in service listen to the patient talking to you

16. What Patients Want • Interpersonal skills of staff, be a person vs. a diagnosis (press & Ganey, 1997) • To be listened to, treated with respect, cared for gently (Care conf. data) • Care providers responding and anticipating patient requests; ability to calm fears, good com., inform them about tests & procedures (Dingman, 1999) • RBC is key to quality care (Tresolini, 1994)

17. The Caring and Healing Environment • Preparation to RBC requires crossing the threshold into the pt’s environment • It has been called sacred space (Wright and Syre-Adams, 2000) • There is a physical element to this space that can be manipulated and promote better healing (room, building, view, sound, colors, traffic flow) 9Ulrich, 1984; Bilchik, 2002) • At the core of the environment is the intentional caring relationship between health care provider and patient (family).

18. Disconnect Between What Drives a Health Care Organization and What Matters Most • We want to address patient quality and their perceptions---but we don’t do it very well • We cannot get out of this chaos unless we truly focus on the patient, but we are system driven

19. Disconnect page 2 • We understand human behavior as being non-rational most of the time, yet expect to solve these issues with rational interventions • We realize there is a critical need for the care provider to have a positive relationship to self and we tend to ignore it anyway

20. Formula for Leading ChangeI2E2 • I1 is inspiration: They will participate when they believe what they have to offer is valued and they are contributing to a compelling, valuable, life affirming vision • I2 is Infrastructure: The infrastructure must support the organizations overall vision (strategic, operational, tactical levels)

21. Formula for Leading ChangeI2E2 • E1 is Education: Priorities are in self-awareness, patient-family experience of care, having healthy relationships, proactive positive com., creative & critical thinking, and leadership • E2 is Evidence: measure results of your actions and support inspiration.

22. Implementing I2E2 Needs to have the 5 Cs in Place • Clarity • Why, benefits, how to, their part, scope or responsibility and authority frees actions • Competency • Know expectations, feel skills, educate • Confidence • Empowered to action, self-governance • Collaboration • RB work, respect others, know your part • Commitment • Ownership, headed for a shared goal