1, to be a patient's trusted friend, to be a faithful confiding object, when the patient to the heart of all the confusion and you said, the disease is half better;
2, to avoid didactic persuasion, to avoid debating with the patient, less talk, more listening, more to do, the main thing is to obtain the patient's trust, to inspire the patient to open up his heart;
3, according to the different Patients to take different ways of care, to master certain professional knowledge, and psychologists work closely together;
4, pay attention to protect themselves, mobilize their own psychological defense mechanism, resist and evacuate the patient's psychological garbage, to prevent the patient is good to fall down on their own. (1) Comprehensive knowledge
Nursing professionals should be able to integrate knowledge from the natural sciences and the humanities and social sciences for understanding the self and understanding of others; acquire basic and specialized knowledge of nursing integrated with practice; acquire some basic knowledge of medicine to adapt to the needs of nursing care; develop and apply problem-solving and critical thinking skills; use scientific data and methods to plan, implement, and evaluate nursing interventions; apply knowledge of social, political, economic, and historical issues to analyze professional problems; communicate effectively in written and oral form and express personal views clearly; develop effective working relationships with others; understand the impact of different cultures on health; and understand the characteristics of the nursing profession.
(2) Professional Values and Ethical Concepts
Professional values and ethical concepts that nursing professionals should possess include altruism (the concept of humanistic care, concern for the interests of others and the state of health and well-being); autonomy (giving information to the patient to achieve informed consent); dignity: respect for the uniqueness of the individual, the group and the intrinsic worth of the person); integrity (adherence to the ethics of the profession and the code of ethics and standards of practice); and the ability to communicate effectively in a verbal manner and clearly communicate one's views. (adherence to professional ethics, ethical guidelines and standards of practice); and impartiality (adherence to moral, legal, and humane guidelines). (3) Nursing core competencies
Nursing professionals should have the ability to work independently; health education and preventive health care; teaching skills; critical thinking skills; communication skills; decision-making and problem-solving skills; organizational and coordination skills
(4) Independent learning and professional development skills
Nursing professionals should have certain research skills, the ability to acquire and utilize information ability, critical thinking ability, innovation ability, and self-development ability.
(5) Physical and mental qualities
Nursing talents should have good physical, good emotional characteristics, and good adaptability and resilience.
(6) Penetration of the concept of holistic nursing
Holistic nursing is guided by modern nursing theory, utilizing the nursing process to provide physical and mental nursing care appropriate to the individual health needs of the patient according to his/her physical, mental, social, cultural, spiritual, and developmental conditions, with the aim of ensuring that the patient receives satisfactory and continuous care. These include:
1) the patient is satisfied with the nursing care provided during hospitalization;
2) the patient understands his/her own disease and health condition and can actively cooperate with the treatment;
3) the patient understands the effects and side effects of the main medicines he/she is taking and can take them correctly and observe himself/herself;
4) the patient learns certain ways to promote his/her own health.
5) patients and their families know what to pay attention to after going home to recover and take care of the patients;
6) patients and their families know the date of follow-up and the indication and way of re-medicalization when they are discharged from the hospital;
7) doctors' satisfaction and nurses' satisfaction. Current problems in the implementation of holistic care (Source: Speech by Wang Yu, Deputy Director of the Department of Medical Science, Ministry of Health, 2001)
1) Insufficient number of nurses: hospital management reasons, such as bundled contracting of departments, nursing management reasons, such as the scientific basis for the deployment of human resources;
2) Problems in defining the duties of nurses: unclear definition, auxiliary systems are not in place; increased workload of nurses brought about by computerized management;
3) Problems in defining the responsibilities of nurses: poor definition, auxiliary systems are not in place; computer management The increased workload of nurses brought about by computerized management;
3) Nurses' conceptual problems: focusing on technical operations, neglecting professional competence; focusing on the implementation of medical advice, neglecting the observation of the condition; focusing on therapeutic measures, neglecting the provision of nursing care, such as health education, psychology and rehabilitation.
4. In short, the current situation and limitations of the overall nursing practice in China are mainly:
●The overall nursing has gone from a model ward to a full spread, but still lacks the nursing system and overall nursing concepts that are compatible with it
●The nursing procedure as a basic working method has penetrated into all fields of nursing, but nurses still remain in the form of nursing procedures
Conflicts between the requirements of overall care medical record writing and the current laws and regulations: subjective and objective data identification, understanding of risk factors
Clinical care delivery system: attempts at clinical pathways
1. Characteristics of clinical pathways:
Adaptation to the needs of health care system reform; embodiment of multidisciplinary and multisectoral cooperation; case-by-case management of patients. The characteristics of clinical pathway:
Adapted to the needs of health care system reform; reflecting multidisciplinary and multisectoral cooperation; reflecting the continuity of care in the form of case management; and updating the way of writing documents. Therefore, the clinical pathway is concise, efficient, comprehensive, and able to reflect the **** of treatment and care and individual differences, and has a better future, but it should be adapted to the reform of the health care system, especially the reform of the health insurance system.
On the development of the nurse practitioner (nurse practitioner, NP) Evidence-based nursing (evidence-based nursing practice)
1. Evidence-based nursing (evidence-based nursing): basic concepts * Theoretical foundations:
Positivism * "Evidence-based practice" (EBP): refers to the process by which health care professionals judiciously, accurately, and intelligently apply the best scientific evidence and combine it with skilled clinical knowledge and experience, with reference to the patient's desires, in order to make a clinical change that meets the patient's needs in a particular area. process.
2. Steps in the Implementation of Evidence-Based Care Stage 1: Evidence-Based Stage - Systematic Review:
1) Finding a problem in clinical practice that is specific and structured;
2) Conducting a systematic review based on the question posed in order to find evidence derived from scientific research;
3) Conducting a systematic review of evidence derived from scientific research;
4) Conducting a systematic review of evidence derived from scientific research. p>3) a critical review of the validity and utility of the scientific evidence;
Phase 2: Evidence-giving phase - implementation of evidence-based care based on the evidence:
4) clinical evidence is obtained by combining the evidence obtained with clinical expertise and experience, and the patient's needs, to make a plan of care;
< p>5) implement the plan of care and monitor the effectiveness and monitor the implementation of the program through the method of dynamic review.3. Levels of evidence and grading of recommendations * Level I evidence:
● Systematic reviews of multiple RCTs (I-a)
● Single RCTs (with narrow 95% CI) (I-b) * Level II evidence
● Systematic reviews of multiple cohort studies (cohort study) (II-a)
● Single cohort studies (including poor-quality RCTs, e.g., with follow-up rates of less than 80%) (II-b) * Level III evidence
● Systematic reviews of multiple case control studies (III-a)
● Single case-control studies (III-b) * Level IV evidence
● Series of case analyses , descriptive studies and poor quality case-control studies * Level V evidence
● Expert opinion that has not been analyzed and evaluated
Characteristics of Evidence in Nursing Randomized controlled trials (RCTs) provide the strongest evidence for the most rigorously designed and scientifically sound interventions in the practice of the health care system, and have been called the " best evidence". However, the unique humanistic nature of the nursing profession dictates that nursing is both a science and an art, so descriptive studies, qualitative studies, and expert reports also provide nursing evidence.