NURS 1510 3.

0
Reflection and Relational Practice in
Professional Nursing
Week 1
Archana Paul RN, MScN, CCNE, CCSNE
Assistant Professor
School of Nursing
York University
arpaul@yorku.ca
Today’s agenda
• WHO AM 1 ?
• Introduction to course
• Review of course outline
• Expectations of Self, Others and Faculty in the Course
• Exploration of nursing identity (Who am I? Who am I as
Nurse?)
• Reflection on self, lifeline that leads to becoming a Nurse
• Introduction to processes of self-awareness and self-
reflection
• Portfolio: Reflection on Lifeline exercise
NURS 1510: Reflection and Relational
Practice in Professional Nursing

Introduces nursing as a self-regulated health profession

that is guided by theory, research and standards of
practice.

Learners explore professional identity as a nurse, relational

practice, reflection, self-awareness, the meaning of health
and the nature of collaborative practice in Canada.
--> Help to practice written and oral skills

Use of clinical examples supports the development of

writing and oral skills for self-reflection and communication
in nursing.
WHO AM I?: 5 minutes

1. Pick a partner.
2. Introduce yourself.
3. Why did you choose nursing?
4. What do you want to learn from the members of this class?
5. What do you want to offer the members of this class?
 Switch your partner
Review Course Outline: 10 minutes
1. What is Course Director’s contact information?
2. What are the course concepts?
3. How will my knowledge and understanding of the course be evaluated? --> Midterm, final, reflective paper (Who am
I?) and e-portoflio
4. What are the assignment due dates?
5. What do I need to do if I need accommodation? What if I have an evaluation conflict with a
religious holiday?
6. Where are the readings for the course ?
7. What topics will I be learning each week?

--> Teacher will guide us on writing the Who am I paper?

--> E-portoflio: a collection of items

--> Make sure to do the portfolio work each week with everything to be found on the textbook

--> Make sure to mention course outcomes when doing portolio

Group Showcase Activity:
10 minutes
• Form a group with at least 4 members.
• Introduce yourselves in this group.
• Discuss
• Who am I?
• Who am I as a nurse?
• What images reflect of what nursing means to you?
• Draw these images, or a picture.
• Your group will present to class.
Becoming a Nurse Not important but just for knowlege

She made it a profession

Concept of Nursing
 Nursing encompasses autonomous and collaborative care of individuals of all
ages, families, groups, and communities, sick or well and in all settings.
--> not dependent on doctors

 Nursing includes promotion of health, prevention of illness, and the care of ill,
disabled, and dying people.
--> Care for a variety of people

 Key nursing roles:

 Promotion of safe environment --> provide safe enviroment for patient
 Advocacy
 Research
 Participation in shaping health policy & health systems management
 Education
Foundation of Professional Nursing Practice
• Indigenous healers

• “Roots of professional nursing as a distinct occupation” began with Florence Nightingale

Recognized as America’s first professional nurse

Established the first nursing school in 1860 (St. Thomas’s Hospital of London)

Introduced the roles of professional nursing

Early advocate for high quality & scientifically evidenced care

Foundation of Professional
Nursing Practice

Mary Seacole (1805-1881)

• Refusal of her application to join nursing core
during Crimean War
• Established British Hotel near battlefield and
provided care to the sick and wounded
soldiers
Foundation of Professional
Nursing Practice
Charlotte Edith Anderson Monture (1890-1996)
• First Indigenous registered nurse
• Application to study nursing in Ontario nursing
school was rejected
• Accepted in the US, served in the First World
War
• Later, returned to Six Nations Reserve in
Canada
Foundation of Professional
Nursing Practice
Bernice Redmon
• From Toronto, Canada
• First black nurse allowed to practice in public
health in Nova Scotia
• First Black woman to be awarded Victorian
Order of Nurses in Canada
One of the highest award in canada for health professionals
Evolution of Nursing as a Profession
--> Started from home to more and more

• Evidence based practice knowledge has replaced apprentice-type training

• Professional training includes theory and basic sciences, general and liberal arts courses and evidence based
clinical practice

• College level credits and clinical concepts have become educational requirements for professional nursing

THINK: Would you have met the job criteria to work as a nurse in 1895?
 Good home, basic education
 Solid Christian character
 Slight knowledge of anatomy, physiology and surgery
 Delicacy of touch
 Gentleness
Nursing Today
• Multifaceted
• Expected to provide competent evidence-based patient
centered care; (scientifically based)

• Requires up to date knowledge, clinical, technical and

communication skills
• Able to problem solve, use critical thinking skills and clinical
judgement; (Common sense)

• Expected to be compassionate, caring and communicative

Important to rememeber the bolded words

To be compassionate is always
being aware of the patients needs
The Science of
Nursing (Hard Skills) something you do
(ex. tempreture, vitals, needles,
etc...)

 Scientific profession based on

research theory and concepts;
 Practice guided by the best
available evidence;
 Care provided is safe, cost effective
and quality nursing care
 Uses evidence to make informed
decision to provide individualized
patient care
The Art of Nursing
(Soft Skills)
(something you present yourself doing not physically but through
emotions)

--> Also take into attitude and beliefs even when you feel insulted
Which Nurse is Demonstrating
the Art and Science of Nursing? Art

Science

Science
 Very important

Patterns of Knowing in Nursing

--> Meaning how do we know what to do (ex. medication)

 Bridges the interpersonal space between scientific

understandings and patient centered health experiences

 Patterns of knowing (Carper 1978)

 Empirical --> 5 patterns of knowing which are important for test stuff

 Personal
 Aesthetic
 Ethical
 Emancipatory (Chinn and Kramer 2015)
Patterns of Knowing in Nursing
Empirical
• Incorporating logical reasoning and problem solving
• Evidence Based Practice (EBP)
* Scientific (ex. covid wearing mask proven by scientist)

Personal
• Relational
• Self awareness (biases, beliefs) --> Be aware of your bias (think of doctor house
and weird episodes like the episode where
• Able to engage and relate with others there are fat phobia)
*How well you know your patient and the way you build your relationship

Aesthetic
• Links humanistic components of care with the scientific application (art and science)
• Understands the client’s experience (the reason behind their anger)
--> Never abuse patients
--> This is both science and personal
 Patterns of Knowing in Nursing
Ethical Moral aspects of nursing care
--> Be aware
of the good and
bad
What is right and wrong

--> Know the right

and wrong Attention to professional standards and codes in making
moral choices
Emancipatory Awareness of social problems and social justice issues as
ways of contributory determinants of health disparities
knowing
--> What is
happening around With improved knowledge of social, political and economic
--> Social justice determinants of health and well being, nurses can serve as
(ex. homeless better advocates in helping patients individually.
person prejudice)

--> understand the many factor that help to understand the way the world works to make
conculsions
 How the world view nursing

Nursing Metaparadigm Very important

“Global framework or the way a professional discipline views the world”

Person --> Understand what make up the person and need to see them as a whole (ex. they are a mother, daughter.
etc...)
• Knowledge of the “Patient as a Person”, Family, Community
--> Make sure to interact and sit down with
• Gender, lifestyle, coping styles, habits, cultural values patients
• Nurses have a legal responsibility to protect each patient’s integrity and
health rights to self determination in health care.
Understand what goes around the patient making sure
to ask them what is going on to better understand to help
Environment them.

• Internal and External Environment

--> Internal is the stuff going on inside (temp,vitals,etc...)

Can you name some socioenvironmental factors that influence a person’s

health behavior?
 --> Understand how people view health (varying in belief of medication, vaccines, etc...)

Nursing Metaparadigm
Health

Multidimensional concept having physical, psychological, sociocultural,

developmental and spiritual characteristics
“A state of complete physical, mental and social well being, and not
merely the absence of disease or infirmity” (WHO 1948)
Shift in focus to healthy lifestyle promotion, disease prevention, early risk
assessment and chronic disease self-care management
Nursing
--> What is nursing?:

Empower clients and strengthen their skill sets by providing them with
the support they need to achieve optimal health and well being
--> Provide them with info and tools to help them excel (proving exercise, etc...)
Empathy: The Human Connection to
Patient Care

https://www.youtube.com/watch?v=cDDWvj_q-o8
Self-Awareness
&
Self-Reflection
--> Veery important to know who we are
Self-concept & Self-esteem
• Self-concept --> What someone belief about themselves (I believe I'm pretty or something for an example)
• The sum of one’s beliefs about oneself, which develops over time.
• An essential part of the nursing role is to provide therapeutic care that will nurture a positive self-concept in
clients and families.

• Self-esteem
• Person’s personal sense of worth and well-being
--> Doing things ti keep yourself up

• Self-clarity
• Extent to which a person clearly and confidently knows who they are
--> Knowing your flaws

• Self-efficacy
• Person’s beliefs about their ability and capacity to accomplish a task and to deal with the challenges of life
--> Giving all into something and not giving up early
 • The competence to be cognizant and reflective of one’s own thoughts, feelings, attitudes,
attributes, and actions

Self-Awareness
(Emotional
• Critical component in establishing therapeutic relationship and relational space

Intelligence) • Consciously engaging in self awareness by reflecting on his/her inner world of past
experiences, thoughts, feelings, needs, fears, strengths and weaknesses
--> Knowing who you are

• Helps understand how the above factors knowingly and authentically guide the behavior
and actions
Self-Reflection --> Things to think of

• “Why do I feel the way I do ?”

• “Why do I react to people and situations the way that I
do?”
• “What needs to change?”
• “What strategies are available to me?”
• “How will these changes enhance the therapeutic
relationship?”
Development of
Self-Concept
( for more of your own information)

• Life experiences

• Social status

• Significant relationships

• Opportunities

• Associated with cultural contexts

Enhancing Self-
Awareness
• Listen and watch others
• Self-disclosure
• Seek feedback
• Any other ways?
DO not be afraid of getting help and asking
“Lifeline Exercise” (will be done next week)

Objectives To become more aware of the encounters you have had during
your life with those who are different than you, especially with
respect to such differences as age, race, religion, sex, physical
and mental ability, national origin and economic and social
status.

To understand how the feelings, attitudes, and values you now

hold about others are rooted in the past.

To link those past experiences with your current day-to-day

behavior toward others at school, work, and in social settings.
Process
• Think back over your life and focus on situations in which
you felt different from others or noticed that others were
being treated differently from you.
• Now, on the flip chart, draw a line on your paper that
depicts your “lifeline”.
• Use symbol to portray any critical events that accounted for
the peaks and valleys.
• Present to your group.
Portfolio: Reflection on Lifeline
exercise

1. How did you feel about what you had

portrayed on your “lifeline”?

2. What new things did you learn about

yourself- your attitudes, beliefs, or
behaviors?

3. What surprises came out of this

exercise for you?

4. In what ways might these learnings

apply to your work, school, or social life?
Fun Activity (20 minutes)
NSTAMP (Nursing Students Association of YorkU)
Presentation
Thank you!