1, be a trusted friend of the patient and be a loyal confidante. When the patient tells you all the puzzles in his heart, the disease will be cured by half;
2. Avoid preaching and arguing with patients, talk less, listen more and do more, mainly to gain the trust of patients and inspire them to open their hearts;
3. Take different nursing methods according to different patients, master certain professional knowledge and cooperate closely with psychologists;
4, pay attention to protect themselves, mobilize their own psychological defense mechanism, resist and evacuate patients' psychological garbage, and prevent patients from falling. (1) Comprehensive knowledge
Nursing talents should be able to integrate the knowledge of natural science and humanities and social science to know themselves and others; Master basic nursing knowledge and professional knowledge combined with practice; Master certain basic medical knowledge to meet the needs of nursing work; Develop and apply problem-solving and critical thinking skills; Using scientific data and methods to plan, implement and evaluate nursing measures; Apply social, political, economic and historical knowledge to analyze professional problems; Communicate effectively in written and oral form, and can clearly express personal views; Establish an effective working relationship with others; Understand the impact of different cultures on health; Understand the characteristics of nursing specialty.
(2) Professional values and moral concepts
The professional values and moral concepts that nursing talents should possess include altruism (caring for the interests and health of others); Autonomy (providing information to patients to obtain informed consent; Dignity: respect for the uniqueness and intrinsic value of individuals and groups); Integrity (abide by professional ethics, abide by moral standards and professional standards); Justice (observing moral, legal and humanitarian norms). (3) nursing core competence
Nursing talents should have the ability to work independently; Health education and preventive health care ability; Teaching ability; The ability of critical thinking; Communication skills; Ability to make decisions and solve problems; Organization and coordination ability
(4) autonomous learning and professional development ability
Nursing talents should have certain scientific research ability, information acquisition and utilization ability, critical thinking ability, innovation ability and self-development ability.
(5) Physical and mental quality
Nursing talents should have good health, good emotional characteristics, good adaptability and adaptability.
(6) Infiltration of holistic nursing concept
Holistic nursing is guided by modern nursing theory, using nursing procedures, according to the patient's physiological, psychological, social, cultural, spiritual and development status, to provide physical and mental care suitable for individual health needs, with the aim of ensuring patients get satisfactory and continuous care. These include:
1) Patients were satisfied with the nursing service provided during hospitalization;
2) Patients know their own diseases and health conditions and can actively cooperate with the treatment;
3) Patients should know the functions and side effects of the main drugs they take, and be able to carry out self-observation correctly;
4) Patients learn some methods to promote their health;
5) When discharged from the hospital, patients and their families should master the matters needing attention in rehabilitation nursing after returning to China;
6) When discharged from the hospital, patients and their families know the date when they need a follow-up visit, and the indications and ways of seeing a doctor again;
7) Satisfaction of doctors and nurses. At present, there are problems in the implementation of holistic nursing (Source: Speech by Wang Yu, Deputy Director of the Department of Medical Administration of the Ministry of Health, 200 1)
1) Insufficient number of nurses: reasons for hospital management, such as department bundling and nursing management, such as scientific basis for human resource allocation;
2) Definition of nurses' responsibilities: the definition is unclear and the auxiliary system is not in place; The workload of nurses brought by computer management has increased;
3) Nurses' concept: attaching importance to technical operation and neglecting professional ability; Pay attention to the implementation of doctor's advice and ignore the observation of illness; Pay attention to treatment measures and ignore the provision of health education, psychology and rehabilitation.
4. In a word, the present situation and limitations of holistic nursing practice in China are mainly:
Holistic nursing has been popularized from model ward to all-round, but there is still a lack of corresponding nursing system and holistic nursing concept.
As a basic working method, nursing procedure has penetrated into all fields of nursing, but nurses still stay in the form of nursing procedure.
● The conflict between the writing requirements of holistic nursing medical records and current laws and regulations: identification of subjective and objective data and understanding of risk factors.
An attempt of clinical pathway.
Characteristics of clinical pathway:
Adapt to the needs of medical and health system reform; Reflect multi-disciplinary and multi-sectoral cooperation; Reflect the continuity of nursing in the form of case management; Update the way the file is written. Therefore, the clinical pathway is concise, efficient and comprehensive, which can reflect the individual differences in treatment and nursing, and has a good prospect, but it should be adapted to the reform of medical care system, especially the reform of medical insurance system.
On the Development of practical nurse —— Evidence-based Nursing Practice
1. Evidence-based nursing: basic concepts * theoretical basis:
Positivism) * "Evidence-based Practice" (EBP): It refers to the process that medical staff prudently, accurately and wisely apply the best scientific evidence, combine skilled clinical knowledge and experience, and refer to patients' wishes to make clinical changes that meet patients' needs in specific fields.
2. Implementation steps of evidence-based nursing The first stage: evidence-based stage-systematic review;
1) Find problems in clinical practice and make them concrete and structured;
2) Make a systematic review according to the questions raised, so as to find evidence from scientific research;
3) Carefully examine the validity and practicability of scientific research evidence;
The second stage: evidence-based nursing;
4) Combine the obtained evidence with clinical professional knowledge and experience and patients' needs to obtain clinical evidence and formulate nursing plans;
5) Implement the nursing plan, and dynamically evaluate the monitoring effect and project implementation.
3. Level of evidence and recommended level * Level 1 evidence:
● Systematic Review of Randomized Controlled Trials (I-a)
● Single RCT (95% narrow 95% confidence interval) (I-B) * I-B)* II evidence
● Systematic review of group studies (II-a)
● Single cohort study (including poor quality RCT, such as follow-up rate below 80%) (II-B) * Level III evidence.
● Systematic review of multi-case control studies (III-a)
● Single case-control study (III-B) * Level 4 evidence
A series of low-quality case studies, descriptive studies and case control studies.
● Expert opinions without analysis and evaluation.
The characteristics of evidence in nursing field (RCT) can provide the most powerful evidence, is the most carefully designed evidence in the practice of medical and health system, and can scientifically reflect the intervention effect, so it is called "the best evidence". The unique humanity of nursing specialty determines that nursing is both a science and an art, so descriptive research, qualitative research and expert reports also provide nursing evidence.