DSN

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

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

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

NRS 438 NRS 438 Topics of Professional Nursing Practice IITopics of Professional Nursing Practice II

VisionVision

Development of clinical competency & critical Development of clinical competency & critical thinking skills to foster a lifetime of thinking skills to foster a lifetime of professional growth & learning. professional growth & learning.

MissionMission

NRS 438 NRS 438 Topics of Professional Nursing Practice IITopics of Professional Nursing Practice II

Students will learn toStudents will learn to Integrate holistic and Integrate holistic and traditional health care values in order to traditional health care values in order to partner with diverse clients, health care partner with diverse clients, health care colleagues, and the community at large. colleagues, and the community at large. Additionally, students will gain an Additionally, students will gain an understanding about the legal aspects of the understanding about the legal aspects of the nursing profession, global health care issues nursing profession, global health care issues & high quality health care outcomes& high quality health care outcomes. .

Application of Benner to DSN Philosophy

Relationship-BasedCare

Structure Process Outcomes

NURSING

PERSON

ENVIRON-MENT

WELLNESS

Integration by RBC Values

Patient Advocate

Care-Giver

Educator

Change Agent

Leader

Using RBC

Values/Practice

12 Values Assumptions that guide the 12 Values Assumptions that guide the process of process of internal changeinternal change are are

1.1. The meaning and essences of care is a The meaning and essences of care is a connection in the moment connection in the moment 2.2. Feeling connected creates harmony and healingFeeling connected creates harmony and healing3.3. Each person on the team plays a partEach person on the team plays a part4.4. Relationship is at the heart of all of thisRelationship is at the heart of all of this5.5. Care providers knowledge of self and self-care Care providers knowledge of self and self-care > quality of care, healthy relationships.> quality of care, healthy relationships.6.6. Healthy relationships among health care Healthy relationships among health care member is essential to the quality of care provided member is essential to the quality of care provided to patients.to patients.

12 Values Assumptions that guide the 12 Values Assumptions that guide the process of process of internal changeinternal change are are

7. 7. People are most satisfied when in alignment with their People are most satisfied when in alignment with their personal and professional valuespersonal and professional values8.8. We must understand and value of Relationship in We must understand and value of Relationship in patient care.patient care.9.9. A therapeutic relationship is essential for quality careA therapeutic relationship is essential for quality care10.10. Patient experiences improve measurably when staff Patient experiences improve measurably when staff own their own practiceown their own practice11.11. People willingly change when they are inspired to a People willingly change when they are inspired to a shared common vision. When an infrastructure is implemented shared common vision. When an infrastructure is implemented for it working, when relevant education is provided for personal for it working, when relevant education is provided for personal professional development, and when they see evidence of professional development, and when they see evidence of success (Isuccess (I22EE22))12.12. Transformational change happens one relationship at a Transformational change happens one relationship at a time. time.

RBC Model for the ClinicianRBC Model for the Clinician

Colleagues

Self-Clinician

Patient & FamilyAt the core

“The CORE of the healing environment is your Relationship to the patient and family”, p. 29

MODELS OF CARINGMODELS OF CARING

THE FOUNDATION FOR THE FOUNDATION FOR RELATIONSHIP BASED CARERELATIONSHIP BASED CARE

WATSON

SWANSON LEININGER

WATSON DINGMAN

Caring & Healing TheoriesCaring & Healing Theories

Watson – Model of Caring - 31Watson – Model of Caring - 31 Patient can only change selfPatient can only change self Healing comes from inside outHealing comes from inside out Nurse is a facilitator of changeNurse is a facilitator of change Understanding of pts needs, hx, life experiencesUnderstanding of pts needs, hx, life experiences Must be present in every interactionMust be present in every interaction Leave your baggage at the doorLeave your baggage at the door Nurse must have self-awareness to have facilitate Nurse must have self-awareness to have facilitate

healinghealing


Swanson – 5 Caring Processes - 33Swanson – 5 Caring Processes - 33 Belief & Knowing are internal processes of Belief & Knowing are internal processes of

caringcaring ““Being With”, “Doing For” & Being With”, “Doing For” &

“Enabling/Informing” are action elements of “Enabling/Informing” are action elements of caringcaring

Integration of caring & healing of RBC Integration of caring & healing of RBC


Leininger – Cultural Diversity of Caring 34Leininger – Cultural Diversity of Caring 34 Always ask the patient “Always ask the patient “what does caring mean to you”what does caring mean to you” No cure without caringNo cure without caring Universal caring characteristicsUniversal caring characteristics

HelpingHelpingRespectRespectConcernConcernAttention to detailAttention to detailPresence/be there in the momentPresence/be there in the momentProtectingProtectingTouchingTouchingComfort measuresComfort measuresAdjusting the environment to meet the patients needs - Adjusting the environment to meet the patients needs - RoundingRounding

Dingman – The Caring Model 36Dingman – The Caring Model 36 PracticalPractical Customer Service ModelCustomer Service Model

Introduce SelfIntroduce Self

Call patient by preferred nameCall patient by preferred name

Use of touch appropriatelyUse of touch appropriately

SDL patients to review care plans SDL patients to review care plans

Re-enforce Company V,M & PhilosophyRe-enforce Company V,M & Philosophy Used by all members of the Care TeamUsed by all members of the Care Team


Caring Healing SummaryCaring Healing Summary

Quality care deeply rooted in dignity & respect Quality care deeply rooted in dignity & respect for individual patientfor individual patient

Centers around mind, body & spirit – holisticCenters around mind, body & spirit – holistic

Professional nurse is always present with the Professional nurse is always present with the patient– just be there patient– just be there

Professional nurse facilitates healing with Professional nurse facilitates healing with understanding & attention to individualityunderstanding & attention to individuality

Safe care rooted in service listen to the patient Safe care rooted in service listen to the patient talking to youtalking to you

What Patients WantWhat Patients Want

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

The Caring and Healing The Caring and Healing EnvironmentEnvironment

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

Disconnect Between What Drives Disconnect Between What Drives a Health Care Organization and a Health Care Organization and

What Matters MostWhat Matters Most

We want to address patient quality and We want to address patient quality and their perceptions---but we don’t do it very their perceptions---but we don’t do it very wellwell

We cannot get out of this chaos unless we We cannot get out of this chaos unless we truly focus on the patient, but we are truly focus on the patient, but we are system drivensystem driven

Disconnect page 2Disconnect page 2

We understand human behavior as being We understand human behavior as being non-rational most of the time, yet expect to non-rational most of the time, yet expect to solve these issues with rational solve these issues with rational interventionsinterventions

We realize there is a critical need for the We realize there is a critical need for the care provider to have a positive care provider to have a positive relationship to self and we tend to ignore it relationship to self and we tend to ignore it anywayanyway

Formula for Leading ChangeFormula for Leading ChangeII22EE22

II11 is inspiration: They will participate is inspiration: They will participate when they believe what they have to when they believe what they have to offer is valued and they are contributing offer is valued and they are contributing to a compelling, valuable, life affirming to a compelling, valuable, life affirming visionvision

II22 is Infrastructure: The infrastructure is Infrastructure: The infrastructure must support the organizations overall must support the organizations overall vision (strategic, operational, tactical vision (strategic, operational, tactical levels)levels)

Formula for Leading ChangeFormula for Leading ChangeII22EE22

EE11 is Education: Priorities are in self- is Education: Priorities are in self-awareness, patient-family experience of awareness, patient-family experience of care, having healthy relationships, care, having healthy relationships, proactive positive com., creative & critical proactive positive com., creative & critical thinking, and leadershipthinking, and leadership

EE22 is Evidence: measure results of your is Evidence: measure results of your actions and support inspiration.actions and support inspiration.

Implementing IImplementing I22EE22 Needs to have Needs to have the 5 Cs in Placethe 5 Cs in Place

ClarityClarity Why, benefits, how to, their part, scope or responsibility and Why, benefits, how to, their part, scope or responsibility and

authority frees actionsauthority frees actions

CompetencyCompetency Know expectations, feel skills, educateKnow expectations, feel skills, educate

ConfidenceConfidence Empowered to action, self-governance Empowered to action, self-governance

CollaborationCollaboration RB work, respect others, know your partRB work, respect others, know your part

CommitmentCommitment Ownership, headed for a shared goalOwnership, headed for a shared goal

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