Adviser (NCM100A): Laicherry Yuzon Man, RN
Prof: Bryan T. Savellano Man, RN
NURSING AS A PROFESSION
NURSING AS A PROFESSION REQUIRES:
1.) special knowledge
2.) skill -something you perfect through practice
3.) preparation -baccalaureate education
CRITERIA TO DETERMINE PROFESSION:
1.) specialized knowledge
2.) body of knowledge
3.) ethics
4.) autonomy -not controlled by medicine, we have
our own practice
5.) service
6.) caring - nursing is caring
PROFESSIONAL BEHAVIOR NURSES
1. Assesses, plans, implements and evaluates
theory, research and practice in nursing.
2. Accepts, promotes and maintains the
interdependence of theory, research and practice.
(Evidence-based practice, best practice)
3. Communicates and disseminates theoretical
knowledge, practical knowledge and research
findings the nursing community.
4. Upholds the service orientation of nursing in the
eyes of the public. (Moral turpitude-doing something
against the norm)
BENNER'S LEVELS OF NURSING PROFICIENCY
(1984, Patricia Benner, from novice to expert)
stage I. Novice
stage II. Advanced beginner
stage III. Competent
stage IV. Proficient
stage V. Expert
NOVICE (Stage 1)
• no experience (e.g. nursing student)
• performance is limited, inflexible and governed by
context-free rules and regulations rather than
experience
ADVANCED BEGINNER (stage II) (after graduation)
• demonstrates marginally acceptable performance
• recognize the meaningful "aspects" of the real
situation
• experienced enough real situation to make
judgment.
COMPETENT (stage III) (charge nurses)
• has 2 to 3 years of experience
• demonstrates organizational and planning abilities
• differentiates important factors from less important
aspects of care
• coordinates multiple complex care demands.
PROFICIENT (stage IV)
• has 3 to 5 years’ experience
• receives situations as wholes not as parts
• uses instincts as guides for what is considered in a
situation
• has holistic understanding of the client, which
improves decision making
• focuses on long-term goals
EXPERT (stage V) (6 years or more)
• performance is fluid, flexible and highly proficient
• no longer requires rules, guidelines to connect and
has an understanding of the situation for appropriate
action
• demonstrates highly skilled intuitive and analytical
ability in situations
• is inclined to take a certain action because "it feels
right".
ROLES OF A PROFESSIONAL NURSE
1. Care Provider
 mothering roles
 chief goal in human relations is to convey understanding
about what is important and to provide support
 caring is central to effective nursing practice (Benner &
Warbles, 1989)
2. Communicator/Helper
 shapes relationships between nurses and clients, nurses
and support persons, nurses and colleagues
3. Teacher
 teaching is an interactive process between the teacher
and one or more learners in which specific learning
objectives or desired behavior changes are achieved
COMPONENTS OF TEACHING PROCESS
A. assessing
B. planning
C. implementing
D. evaluating -do it in front of you
4. Counselor
 counseling is the process of helping a client to recognize
and cope with stressful, psychologic or social problems to
develop and improve interpersonal relationships and to
promote personal growth
 emotional, intellectual and psychological (tell me more)
5. Client Advocate
 Pleads the cause of another or argues, or pleads for a
cause or proposal
 advocacy involves concern for and defined actions in
behalf of another person or organization to bring about 7 concepts of wellness (Anspaugh, Hamrick, Rosato)
change
 advocacy involves promoting what is best for the client, 1.physical •positive lifestyle habits
ensuring that the client's needs are met, and protecting 2. Social • interaction, respect, tolerance
the client's rights. 3. Emotional • stress management
4. Intellectual • growth and learning
6. Change agent 5. Spiritual • morals, values, ethics
 a person or group who initiates changes over who assist 6. Occupational• balancing work and leisure
others in making modifications in themselves or in the 7. Environmental • food, water, air
system
Illness-physical, emotional, intellectual, social development or
7. Leader spiritual functioning is thought to be diminished
(IFC-individual, family, community)
 nursing leadership is defined as a mutual process of 5 stages of illness
interpersonal influence through which the nurse helps the
client to make decisions in establishing and achieving 1. Symptoms experience
goals to improve the client's well-being 2. Assumption of sick role
3. Medical care contact
PURPOSE OF LEADERSHIP 4. Dependent role model
a. Improve health status and potential of individuals and 5. Recovery
families
b. Increase the effectiveness and level of satisfaction virulence-types of organisms
among professional colleagues upholding care
c. Raise citizens' and litigators' attitudes toward and What makes you ill? Diseases
expectations of the nursing profession
DISEASE
8. Manager
 management is defined as planning, giving direction, (ADL (activities of daily living) - nurse's responsibilities)
developing staff, monitoring operations, giving rewards
fairly, and representing both staff members and 1. Alteration in body functions
administration as needed 2. Results in reduction of capacities or a shortening of
normal lifespan
9. Researcher 3. Cause of a certain etiologic factor which may or may not
 participates in the research process. (Pure research- be known (Etiology-unknown)
theoretical, applied research-practical)
CLASSIFICATION OF DISEASES OR ILLNESSES
NURSING AS A SCIENCE • Acute
 we have our own body of knowledge -severe symptoms of short duration
 everything that we do in nursing has a corresponding -symptoms appear abruptly and subside quickly
rationale -may or may not require intervention
 it is improved through evidence-based research -following illness, most people return to normal level of
wellness
NURSING AS AN ART
 the art of nursing refers to skill (each individual has their • Chronic (extended)
own unique skill) -lasts for an extended period; six months or longer
 skill is something that you are not born with -slow onset and often has period of remission (symptoms
 you acquire the skill to be about proper nursing care in disappear) and exacerbation (symptoms reappear)
school
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CONCEPT OF HEALTH AND ILLNESS COMMUNICATION is the process of exchanging the
information, and the process of generating and transmitting
Health-a state of complete physical, mental and social well- meanings, between two or more individuals. it is the
being and not merely the absence of disease or infirmity foundation of society and the most primary aspect of a nurse
(WHO) patient interaction

THERAPEUTIC COMMUNICATION - is defined as the
face-to-face process of interacting that focuses on advancing
the physical and emotional well-being of a patient.
Nurses use therapeutic communication techniques to provide
support and information to patients. (“Interpersonal
communication techniques are the tools of psychosocial
intervention.”)
COMPONENTS OF THERAPEUTIC COMMUNICATION
 RAPPORT - special feelings on the part of both the client
and nurse based on acceptance, warmth, friendliness,
common interest, a sense of trust, and a nonjudgmental
attitude
-establishing rapport may be accomplished by discussing
non-health-related topics
 GENUINENESS - the ability to be open, honest, and “real”
in interactions
 TRUST- confidence in another person’s presence,
reliability, integrity, veracity, and sincere desire to provide
assistance when requested
-providing a blanket when the client is cold
-providing food when the client is hungry
-keeping promises
-being consistent
-ensuring confidentiality
 RESPECT-unconditional positive regard
-calling the client by name
-spending time with the client
-allowing sufficient time to answer the client’s questions
or concerns
-always being open and honest
-striving to understand the motivation behind the client’s
behavior
 EMPATHY -process in which one is able to see beyond
outward behavior and accurately sense another’s inner
experience
THERAPEUTIC COMMUNICATION TECHNIQUES
1. Listening: listening is essential to understanding the
patient. Therefore, the first rule of a therapeutic
relationship is to lists to the patient.
 Real listening is difficult. It is an active, not a
passive, process.
2. Broad Openings: Broad openings, such as "What are
you thinking about?" "Can you tell me more about
that?" and "What shall we discuss today?" encourage
the patient to select topics to discuss.
3. Restating: Restating is the nurse's repeating of the
main thought the patient has expressed.
4. Clarification: Clarification occurs when the nurse
attempts to put into words vague ideas or thoughts
that are implicit or explicit in the patient's talking.
Such as "I'm not sure what you mean. Are you saying
that …?"
5. Reflection: Reflection of content is also called
Validation, which lets the patient know that the nurse
has heard what was said and understands the
content. It consists of repeating in fewer or different
words the essential ideas of the patient and
resembles paraphrasing. Sometimes it helps to repeat
a patient's statement, emphasizing a key word.
 Reflection of feelings consists of responses to the
patient's feelings about the content.
6. Focusing: Focusing helps the patient expand on a
topic of importance.
7. Sharing Perceptions: Sharing perceptions involves
asking the patient to verify the nurse's understanding
of what the patient is thinking or feeling.
 Perception checking is a way to explore
incongruent or double-blind communication. "You're
smiling, but I sense that you're really angry what
happened."
8. Theme Identification: themes are underlying issues
or problems experienced by the patient that emerge
repeatedly during the course of the nurse-patient
relationship.
 They can relate to feelings (depression or
anxiety), behavior (rebelling against authority or
withdrawal), experiences (being loved or hurt), or
combinations of all three.
9. Silence: Silence on the part of the nurse has varying
effects depending on how the patient perceives it. To
a vocal patient, silence on the part of the nurse may
be welcome, as long as the patient knows the nurse
is listening.
 With a depressed or withdrawn patient, the
nurse's silence may convey support, understanding,
and acceptance.
10. Humor: Humor is a basic part of the personality and
has a place within the therapeutic relationship. As a
part of interpersonal relationships, it is a constructive
coping behavior. By learning to express humor, a
patient may be able to learn to express other
feelings.
11. Informing: informing or information giving, is an
essential nursing technique in which the nurse shares
simple facts or information with the patient.
12. Suggesting: suggesting is the presentation of
alternative ideas, and is exploring alternative coping
mechanisms. Suggesting or advice, also can be no
therapeutic, reinforces the patient's dependence. 
The nurse's intent in using the suggesting technique
should be to provide feasible alternatives and allow
patients to explore their values in their unique life
situation.