1、1,Chapter 6Role Relationship Patterns,2,what kinds of outline are the most important in the chapter?,RoleRelationshipPatterns,3,Basic ConceptsDefinitionsRelated TermsPersonal Interpretations of RoleSocietal Interpretations RoleEffects of Alteration in Role Performance on Others,OUTLINE,p.108,RoleRel
2、ationshipPatterns,4,ApplicationsProfessional Nurse RoleTypes of Professional RolesRole SocializationRole StressSelf-awareness in the Professional Role,OUTLINE,p.108,RoleRelationshipPatterns,5,Client RolePatients Bill of Rights Role Performance as a Nursing DiagnosisSupportive InterventionsDeveloping
3、 New Solutions Summary,OUTLINE,p.108,RoleRelationshipPatterns,6,What are the objectives of learning or studying in our lesson?,RoleRelationshipPatterns,7,At the end of the chapter, the student will be able to 1. Define role and role performance2. Describe the four components of professional role soc
4、ialization3. Discuss the professional roles of the nurse4. Discuss the characteristics of the sick role,Objectives,p.108,RoleRelationshipPatterns,8,RoleRelationshipPatterns,Objective One:Define role and role performance,9,What is role?,A role is defined as a set of expected behavioral standards esta
5、blished by the society or community to which a person belongs (Creasia, 1991).,Definitions,p.109-110,RoleRelationshipPatterns,10,What is role relationship?,Role relationships influence communication content and process. Consider your own “role” as a nursing student and how it influences communicatio
6、n content and process.,Definitions,p.109-110,RoleRelationshipPatterns,11,什么是人际关系和人际沟通？,人际关系人际关系是人们通过交流与相互作用而形成的比较稳定的心理关系，反映着个体或群体满足其社会需要的心理状态，其发展变化取决于双方社会需要的满足程度。人际关系外延很广，包括朋友关系、夫妻关系、师生关系、同学关系、同事关系等。内涵是个体之间的心理上的关系，表现为亲近或疏远、敌对或友好等心理上的距离。,p.310,RoleRelationshipPatterns,12,什么是人际关系和人际沟通？,人际沟通人际沟通是指人际间的信
7、息交流。可以是面对面的，也可以是非面对面的，可以是语言的，也可以是非语言的，旨在传达思想、交换意见、表达感情和需要等。它包括关系沟通与内容沟通，即每个沟通都包含着一定的内容和确定一定的关系。内容是指沟通中所传信息的实质含义，关系是指沟通各方在沟通中所处的地位和联系方式。,p.303 p.310,RoleRelationshipPatterns,13,你能举例说明人际关系沟通和内容沟通之间的联系吗？,护士：“昨晚我给xx（患者）的药为什么没吃？,护患关系 内容沟通效果,很熟悉 成功 一般 有心理距离但可能成功 紧张 很难有效，患者家属可能说“我怎么知道？没吃药到底是谁的责任。”,RoleRela
8、tionshipPatterns,14,What is role performance?,Role performance refers to a persons capacity to function in accord with social expectations of a particular role. Perceptions of behavioral standards for role performance differ from based on cultural, gender, institutional, and family expectations; Peo
9、ple still expect different role behaviors from men and women despite tremendous advances in equal opportunity.,Definitions,p.109-110,RoleRelationshipPatterns,15,Role transition describes changes in role expectations that occur as developmental life crises or when unexpected life events such as illne
10、ss or injury alter role function. For example, new mother experiences a significant role transition with the birth of her first child, as does a young athlete struck down in a ball game with a spinal cord injury.,What is role transition?,Definitions,p.109-110,RoleRelationshipPatterns,16,What is posi
11、tion?,Position represents a standardized description of a role and associated expectations that makes it understandable to others in the community or group. Social position relates to the status and identity the person holds in the community. The concept of position sometimes plays a role in how hel
12、ping professionals respond to clients: they sometimes treat clients in high positions differently than those with no money or low social status.,Definitions,p.109-110,RoleRelationshipPatterns,17,Whereas it is important for the nurse to recognize differences in position as relevant factors in support
13、ing client integrity and self-esteem, nurses need to view all clients as very important persons, treating them all with the same respect and giving them all quality care regardless of position.,Definitions,p.109-110,What is position?,RoleRelationshipPatterns,18,RoleRelationshipPatterns,Objective Two
14、: Describe the four components of professional role socialization,19,Unlike other forms of education, the nursing student must simultaneously(同时地)adjust to learning new material while starting on the job training in which the stakes(风险)are high.Cohen identified four goals of professional socializati
15、on (see Box 6-4). ,Which is the four components of professional role socialization ?,Professional Nurse Role,p.114-115,RoleRelationshipPatterns,20,Box 6-4.Steps in the Socialization Process Learn the technology of the profession: the facts, skills, and theory. Internalize(使内在化)the professional cultu
16、re Find a personally and professionally acceptable version of the role. Integrate this professional role into all the other life roles.,RoleRelationshipPatterns,21,Box 6-4.Steps in the Socialization Process 学会专业技能：专业法规、技术和理论。 与专业文化融为一体。 找到就个人和职业而言都可接受的角色类型。 把职业角色整合到所有其它生活角色中。,RoleRelationshipPattern
17、s,22,Exercise Looking at My Development as a Professional Nurse,Purpose: To help you focus on your self-development as a professional nurse,RoleRelationshipPatterns,23,Exercise Looking at My Development as a Professional Nurse,Procedure:Write the story of how you chose to become a nurse in a one- to
18、 two-page essay (may be done as a homework assignment). There are no right or wrong answers; this is simply your story. You may use the following as guides in developing your story.,RoleRelationshipPatterns,24,Exercise Looking at My Development as a Professional Nurse,Procedure: What are your reason
19、s for choosing nursing as a profession? What factors influenced your decision; people, circumstances, or situations? Describe your vision of yourself as a nurse. What fears do you have about your ability to function as a professional nurse? How do you think being a nurse will affect your personal li
20、fe?,RoleRelationshipPatterns,25,In what ways is your story similar to or different from those of your classmates? As you wrote your story, were you surprised by any of the data or feelings?,RoleRelationshipPatterns,Discussion:,26,Students can discuss some of the realistic difficulties encountered as
21、 nursing students both professionally and personally and ways to handle them. Explore through discussion the following: The practices nursing students will need to follow to achieve their vision The types of supports nurses need to foster their ongoing professional development,RoleRelationshipPatter
22、ns,Discussion:,27,RoleRelationshipPatterns,Objective Three:Discuss the professional roles of the nurse,28,Which are there Professional Nursing Roles,P.116,1. Caregiver: a. Provides complete or partial compensatory care for clients who cannot provide these self-care functions for themselves b. Implem
23、ents supportive/educative actions to promote optimum health Reinforces the natural, developmental, and healing processes within a person to enhance well-being, comfort, function, and personal growth,Professional Nurse Role,RoleRelationshipPatterns,29,2. Teacher: a. Provides health teaching to indivi
24、dual clients and families b. Develops and implements patient education programs to promote/maintain healthful practices and compliance with treatment recommendations c. Guides individuals in their human journey toward wholeness and well-being through psychoeducation,Which are Professional Nursing Ro
25、les,P.116,RoleRelationshipPatterns,30,3. Client advocate: a. Protects clients right to self-determination b. Motivates individuals and families to become informed active participants in their health care c. Mediates between client and others in the health care environment Acts as clients agent in co
26、ordinating effective health care services,Which are Professional Nursing Roles,P.116,RoleRelationshipPatterns,31,4. Manager: a. Coordinates staff and productivity b. Delegates differentiated tasks to appropriate personnel Facilitates communication within and among departments Serves on committees to
27、 improve and maintain quality of care e. Makes decisions and directs relevant changes to ensure quality care,Which are Professional Nursing Roles,P.116,RoleRelationshipPatterns,32,5. Evaluator: a. Sets quality assurance/care standards Reviews records and monitors compliance with standards c. Makes r
28、ecommendations for improvement,Which are Professional Nursing Roles,P.116,RoleRelationshipPatterns,33,6. Researcher:Develops and implement research/grant proposals to broaden understanding of important issues in clinical practice and validate nursing theories as a basis for effective nursing practic
29、e,Which are Professional Nursing Roles,P.116,RoleRelationshipPatterns,34,7. Consultant: Provides specialized knowledge/advice to others on health care issues b. Evaluates programs, curricula, and complex clinical data c. Serves as expert witness in legal cases,Which are Professional Nursing Roles,P.
30、116,RoleRelationshipPatterns,35,8. Case Manager: a. Administers care for a caseload of clients b. Coordinates cost-effective care options Monitors client progress toward expected behavioral outcomes Collaborates with other professionals to ensure quality care across health care settings,Which are Pr
31、ofessional Nursing Roles,P.116,RoleRelationshipPatterns,36,RoleRelationshipPatterns,Objective Four:Discuss the characteristics of the sick role,37,From the client perspective, loss of or changes in normal roles, role relationships, and role performance are important dimensions(尺度/元)of the emotional
32、pain clients experience in health care situations. How well people are able to perform their roles within the family and society influences their reputation within the community and their sense of self-esteem. When illness or injury affects role performance, it also impacts role relationships with o
33、thers and self-esteem.,How to understand Client role , role relationships, performance and transition?,p.119,RoleRelationshipPatterns,38,The nurse may be the only person who has the expertise and willingness to facilitate discussions of the implications of role changes stemming from(源于)altered healt
34、h status for the client in an objective, compassionate manner.,p.119,How to understand Client role , role relationships, performance and transition?,RoleRelationshipPatterns,39,Talking about the meaning of role change is just as important as talking about how to change a dressing or what a physical
35、symptom means. Loss of role, changes in role expectations and performance, role relationships and role transitions can occur as a result of age, illness, loss of job or significant person, injury, and mental disorders,How to understand Client role , role relationships, performance and transition?,p.
36、119,RoleRelationshipPatterns,40,Most people do not assume the sick role voluntarily. Illness or trauma(外伤)can change an individuals social role from one of independent self-sufficiency to one of vulnerability(脆弱性)and varying degrees of dependency on others, a personal role from one of independence t
37、o dependence. When clients enter a health care situation, they encounter an interpersonal environment that encourages the development of feelings of anonymity(无名) and helplessness. ,How to understand Client role , role relationships, performance and transition?,p.119,RoleRelationshipPatterns,41,At t
38、he hospital door, the client forsakes(放弃)recognized social roles in the family, work situation, and community, temporarily or permanently. Regardless of how competent the person may be in other life roles, when illness strikes (打击), questions about role performance inevitably arise. Often clients mu
39、st learn new role behaviors that are unfamiliar and unsettling to previously held self-concepts.,How to understand the transition of Client role , role relationships, and role performance?,RoleRelationshipPatterns,p.119,42,Adjustment to a change in health care status requires a whole new set of copi
40、ng skills without necessarily having the same social supports. Clients clearly need the support of the nurse to incorporate the rapidly changing meaning of the environmental and personal changes encountered in illness into an otherwise basically healthy self-concept.,How to understand the transition
41、 of Client role , role relationships, and role performance?,RoleRelationshipPatterns,p.119,43,Differences in perspectives play a major part in determining which illnesses and disorders are recognized as legitimate(合理的), the roles clients assume in their health care, and who becomes the culturally as
42、signed expert (在 .中当专家) in promoting, maintaining, and restoring health. For example, some cultures believe that illness is punishment from God or an imbalance of energy that interferes with the bodys functioning. These cultural understandings can affect role relationships in health care settings.,H
43、ow to understand the transition of Client role , role relationships, and role performance?,RoleRelationshipPatterns,p.119,44,Client Role,Clients are expected to act as participating, cooperative agents in their recovery process. However, an Asian client may appear as a passive recipient of health ca
44、re, strikingly dependent on family and health caregiver for all guidance and care. Without a clear understanding of this culturally acceptable expression of the sick role, the nurse may respond inappropriately.,p.120,RoleRelationshipPatterns,45,What is a Patients Bill of Rights ?,p.121,1. The patien
45、t has the right to considerate and respectful care.,Client Role,RoleRelationshipPatterns,46,What is a Patients Bill of Rights ?,p.121,2. The patient has the right to, and is encouraged to obtain from physicians and other direct caregivers, relevant, current, and understandable information concerning
46、 diagnosis, treatment, and prognosis. Except in emergencies when the patient lacks decision making capacity and the need for treatment is urgent, the patient is entitled to the opportunity to discuss and request information related to the specific procedures and treatments, risks involved, length of
47、 recuperation, and medically reasonable alternatives and their accompanying risks and benefits.,Client Role,RoleRelationshipPatterns,47,What is a Patients Bill of Rights ?,Client Role,3.Patients have the right to know the identity of physicians, nurses, and others involved in their care, as well as
48、the status of the caregivers (e.g., when those involved are students, residents, or other trainees.).,p.121,RoleRelationshipPatterns,48,What is a Patients Bill of Rights ?,Client Role,4.The patient has the right to make decisions about the plan of care before and during the course of treatment, to r
49、efuse a recommended treatment or plan of care to the extent permitted by law and hospital policy, and to be informed of the medical consequences of this action.,p.121,RoleRelationshipPatterns,49,What is a Patients Bill of Rights ?,Client Role,5.The patient has the right to have an advance directive
50、(such as living will, health care proxy, or durable power of attorney over health care) concerning treatment or designating a surrogate decision maker with the expectation that the health care institution will honor the intent of that directive to the extent permitted by law and hospital policy. Health care institutions must advise patients of their right to make informed medical choices.,
