Textbook of Medical-Surgical Nursing 3e

Chapter 2

Thoughtful practice

K E Y T E R M S

L E A R N I N G O B J E C T I V E S

Model for thoughtful practice The conceptual model provides a representation of how the important concepts inherent in professional, person-centred practice interrelate. In the context of medical-surgical nursing, a thoughtful practitioner is a nurse who is considerate and com- passionate, keeping the person at the centre of deliberation in order to promote the humanity and dignity of the person being cared for. At the same time, the nurse acts as a moral agent, preserving respect for the person and providing the care while examining the situation in order to learn. Inherent in thoughtful practice is an acknowledgement of the influence of power within institutional systems. Thoughtful care seeks to empower individuals to choose their own health pathway. To achieve this, essential care is delivered through processes that are holistic and tailored to meet the individual needs of the person. Care-related decisions are based on ethical and On completion of this chapter, you should be able to: 1 Examine the components of thoughtful practice and define the links between thoughtful practice, motivation, moral agency and person-centred care. 2 Outline the key components of clinical reasoning and explain how different types of thinking inform clinical reasoning. 3 Explain how clinical judgement and decision making relate to clinical reasoning. 4 Discuss ethical principles and how these relate to nursing care. 5 Explain the importance of reflection and self-awareness for professional self-assessment and development. 6 Identify key components of cultural assessment and apply culturally safe nursing principles, concepts, and theories when providing nursing care to individuals, families, groups, and communities. 7 Identify the use of the nursing process for optimising patient outcomes during a period of nursing care. 8 Identify the use of the nursing process conceptually by describing the purposes and significance of health education and health promotion and the role of the nurse in patient education using the nursing process.

moral agency moral dilemma moral distress moral problem moral uncertainty morality nursing diagnoses nursing process planning personhood person-centredness person-centred care problem solving reflection responsibility self-awareness subculture teaching teleological theory or consequentialism therapeutic regimen transcultural nursing utilitarianism wellness

assessment clinical judgement clinical reasoning collaborative problems community creative thinking critical thinking cues cue acquisition culturally competent nursing care cultural nursing assessment culture decision making deontological or formalist theory ethics evaluation

health education health promotion implementation intuitive thinking

learning minority

systematic reasoning processes that are evaluated and reviewed through reflective practice so that there is continual learning in and from practice for the benefit of future care encounters. Definition and theoretical basis The Macquarie Dictionary (2009) defines being thoughtful as being given to or marked by thought, being careful or mindful, and being considerate. Therefore, being thoughtful is an amalgamation of the reasoning for practice, the consideration of all aspects of the situation including its practicalities, the learning from practice, and the affective process of considering the needs of others. Medical-surgical nursing is an example of how these processes are integrated into a form of practice that requires well-developed cognitive processes of clinical rea- soning that is founded on a solid knowledge base of anatomy, physiology, epidemiology, pharmacology and sociology. The application of this knowledge and learning through reflection

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