Principles of Nursing

MODULE 1
 IN YOUR OWN
OPINION WHAT DO
YOU THINK IS A
CHARACTERISTIC
OF A GOOD
CAREGIVER?
A characteristic of a good
nurse/caregiver is one that shows
empathy to each patient, making a
true effort to put themselves in
their patients' shoes. By practicing
empathy, nurses and caregivers
are more likely to treat their
patients as “people” and focus on
a person-centered care approach,
rather than strictly following
routine guidelines.
Characteristics of a Good Caregiver

1. C-heerful
2. A-lert
3. R-esponsible
4. E-nergetic
5. G-od fearing
6. I-nitiative
7. V-alue your
work
8. E-mpathy
9. R-espectful
ALWAYS REMEMBER:

DO NOT WEAR A HEAVY

MAKEUP
ALWAYS TRIMMED YOUR FINGER NAILS
WEAR A WATCH WITH SECONDHAND
 ALWAYS WEAR A
PROPER UNIFORM
 Principles of Nursing

1. The caregiver assumes the primary responsibility for

providing necessary physical expertise to administer care ,
and recognizes clues that alert her to initiate and modify
care according to each patient’s unique needs.

2. Primary nursing is based on the idea that the health

care of an individual or family can be best achieved
through a relationship with one health practitioner who
coordinates total care. It was planned to help overcome
the fragmentation that often results when various health
services are offered by a variety of people but no one is
accountable for continuum of total care.

3. Primary nursing is a continuous 24 hours

responsibility, which assume by one health practitioner
for the patients total care.
 Use understanding as an approach to
patient care

1. Think that patient as an individual person

who needs help. If you can be sincerely
courteous to all patients, your approach is
already good.
2. Keep in mind that most patients have fears
and worries about their illness or injury. The
patient may feel uneasy about what is going to
happen to him.
3. Allow the patient to maintain his identity that
is to see that he is called by his name.
4. Allow the patient to maintain self-esteem and
dignity.
 Use understanding as an approach to
patient care

5. Respect the patients right and privileges to

continue in the practice of his own religious faith
without discussion. Also respect his right to
continue the customs and patterns of his race or
nationality even though these are different from
yours.
6. Allow the patient to continue in his ways and
habits as well as the little practices that formed part
of his personality.
7. Let the patient know what are you going to do.
Explain what is going to happen to him before
starting each procedure.
 Present a good appearance

1. When you feel good about your appearance as well

as your work and personal relationships, your whole
day is likely to go better because you think well of
yourself.
2. If possible, give yourself a mirror test before
reporting for work. Look at yourself in a full length
mirror.
3. Start the day in spotlessly clean, well fitting uniform.
The men should wear fresh shirt each day.
4. Be clean. Look clean. Feel clean.
5. Check the way you stand and walk. Try to correct
faulty posture. Habits.
6. Bathe daily and use effective underarm deodorant
so you don’t become offensive to patients and others.
 Present a good appearance
7. Wear underclothing that is washed daily and in
good fix.
8. Give your face special skincare.it should be
impressively clean.no eye makeup.
9. Maintain hair in neat arrangement, in order to
keep a good taste for work and abide by the
practices of particular hospital or agency.
10. Take particular care of your hand, for health
reasons as well as appearance.
11. Wear well fitting shoes. Keep shoes clean,
polished and in good taste.
12. Be in good taste wearing uniform(no jewelry, no
gum chewing, no noisy talk ).
 Maintain a good personal hygiene

1. Command yourself and others the responsibility

to stay healthy. Staying in top physical condition is
necessary when working with ill people.
2. Understand that maintaining a good health
requires daily attention to the health needs.
3. Learn what type of foods are essential to have a
good heath. Start the day with substantial breakfast.
4. Make a check on the amount of water you drink
daily.
5. If you are overweight or underweight, bring this
problem to your health service, or a family doctor.
 Maintain a good personal hygiene

6. Get enough sleep and rest daily to keep you

on top performance.
7. Bathe daily for health and social reasons.
8. Give particular attention and care to the
skin of your face. Cleanse often with mild
soap.
9. Form a good habit for daily mouth care.
10. Take excellent care of you feet. They serve
you well.
Principles of nursing

 The scope of nursing care activities

is increasing quantitatively and
qualitatively , and continues to
move forward steadily to help
provide society with an increasingly
higher quality of care, a gap between
the demand and supply of nursing
is being felt . Therefore it is needed
to have caregivers program to fill up
this gap by providing nursing care in
different set - up and roles , under
the supervision and / or in
cooperation or coordination with all
health personnel.
 Principles of Nursing

Principles of the Nursing Profession

Ethics are fundamental to nursing.
All nurses/caregivers should respect their patients,
maintain patients’ dignity and protect patients'
rights. Nurses/caregivers must create an
environment of mutual trust and respect between
patients and healthcare professionals.
CORE ETHICAL PRINCIPLES
 the state of keeping or
being kept secret or
private.

An obligation or
Accountab willingness to accept
ility responsibility

Benevole An act of kindness

nce
 AUTONOMY

 Refers to allowing patients to

be the rights of their own
care.
 Ethical principle invoked
when obtaining informed
consent.
 Respect the patients right to
refuse treatment.
 May only be limited if it
poses a risk to another.
 AUTO - SELF
 BENEFICENCE

 Refers to acting in the best interest of the patient.

 May be odds with autonomy.

Example: A 64 year old male with type 2 diabetes Mellitus is brought

to the ED complaining of foot pain. Doppler ultrasound reveals
drastically diminished blood flow to the extremity. Physical exam
reveals extensive wet gangrene and the limb is determined to be
incapable of repair. An amputation is recommended, and the patient is
educated regarding the indications, risks, benefits, and alternatives to
treatment. The patient, after hearing all the information and being
deemed to have capacity to refuse treatment.

AUTONOMY VS BENEFICENCE
(Patient decides) (best interest of the pt.)
1. Empathetically identify- tell the patient you see they
have some apprehension. (IDENTIFY)
2. Provide information – educate the patient about the
indication, risk, benefits and alternatives to treatment
(attempt to obtain informed consent) (INFORM)
3. Attempt to understand – if the patient refuses, ask
them how they made the decision (and evaluate the
capacity to refuse) (UNDERSTAND)
4. Empathetically reassure – tell the patient you respect
their decision.
(RESPECT)
 NON - MALEFICENCE

 Refers to “do no harm”

 Demands informed consent if a risky procedure is attempted.
 May be at odds with autonomy and/or beneficence.

A 21 year old male is involved in motor vehicle collision, he is brought

in to the ED where he codes three times. Return of spontaneous
circulation is achieved but the patient must be placed on a ventilator.
The patient is later determined brain dead. The physician informs the
patient family, who are the patients legal decision maker that in her
professional opinion, life sustaining measure should be withdrawn.
The patients family objects to the withdrawal of the ventilator.
AUTONOMY vs BENEFICENCE vs NON
MALEFICENCE
(Family decision) (recommendation) (withdrawal of
ventilator)
 A 56 year old hispanic female is found to have elevated
LFTs on routine screening. She is recommended to
undergo a liver biopsy. As part of the informed consent
process. She is explained all of the pertinent information.
The explanation of risk vs benefits, in this situation, is
carefully balancing which ethical principle?
A. Non maleficence vs Autonomy
B. Non maleficence vs Beneficence
C. Non maleficence vs Justice
D. Non maleficence vs Beneficence vs Autonomy
E. Non maleficence vs Beneficence vs Justice
 JUSTICE

 Refers to treating all patients

fairly, equally, and equitably.
 Requires the physician to
consider fair and equitable
distribution of resources.
 Requires the physician to
treat in the context of
competing needs of patients.
 Health equity and health
equality are NOT the
same.
Health equality
 Refers of the same health offering for everybody.
Example: all patients are asked the same screening
questions in ED triage.

Health Equity
 Refers to giving patients what the patient needs to
achieve their best health outcome.
 5 General Roles of a Caregiver

 Patient advocate – one who intercedes for or

works on behalf of the patients.
 Teacher – presents information to the patient
that will help promote healthful practices of
daily living , will prevent illness , and will assist
rehabilitation.
 Counselor – help those she / he serves to
become aware their feelings and deal with them
in a constructive manner.
 Coordinator – continuity of care refers to a
continuum of health care that provides the
transfer of services among health practitioners.
 Role Model – the public considers you as
knowledgeable about health and they look at you
as a role model.
 Specific roles of caregiver
 To provide for the Patient’s daily care
bathing , dressing , and grooming
 To provide for the patient’s comfort
create a home like environment , help patient to develop trust
offer emotional support and work with the family
 Provide patients’ safety
follow infection control practices , maintain clean safe environment
and report safety problems immediately , perform procedures correctly , and
respond to any call light immediately
 Provide for patient’s health needs
observe and report any changes in the patient appearance , behavior , or
mood
determine measurements accurately (vs and the I and O )
 The caregiver must exhibit ethical behavior , all health care employees are
expected to behave ethically
 Perform to the best of your ability , be loyal to your employer , co – workers ,
patient and their families
 Be accountable to your actions
 Respect the people and environment around you
 Maintain confidentiality
 Report incidents or errors to the nurse supervisor immediately
 Health Care System

Healthcare system is composed of different

parts designed to work together to make health
care accessible to every one.

Long
Health
Hospital term
care
care
team
facilities
 Health care system

 Hospital provide acute care ( Tx for illnesses

which come on suddenly and are usually of
short duration ) and either a general or
specialized
1 ) doctors offices and clinics
2 ) Rehabilitation / convalescent care
facilities –provides sub acute care after acute
phase.
 Long term care facilities provide long term
care ( Tx for chronic illnesses that may
develop slowly and continue for a long period
of time.
-home health agencies
-hospice provide terminal care
 The health care team is a group of professionals and non –
professionals with special skills who work together to meet
a patient needs . the approach creates the highest quality of
care because the information is shared.
Health
practitioners

physicians
specialist

Patient
and
family
caregiver
Non medical
Therapist
personnel

Dentist
 Body mechanics

 In order to provide for the comfort and safety of the

patient including the health practitioner , one must
understand and apply the principles of body
mechanics.
Importance of body mechanics
-Maximizes strength and minimizes stress allowing
the practitioners body to be used efficiently
-Prevents injury to the practitioner when bending ,
moving , lifting
-reduces fatigue to the practitioner at the end of the
day
-Promotes safety from the practitioner and the
patient during moves.
 Body mechanics

 Principles of body mechanics the importance of

understanding the body mechanics is universal , regardless
of health – illness status . there is a direct relationship of
body mechanics to the effective functioning of the body .
Correct use of the body is another phase of prevention of
illness and promotion of health , the caregiver has a
responsibility to teach , both directly and indirectly.
 Concepts of body mechanics The client who is on complete
bed rest is in danger of losing muscle tone. Should bed rest
prolonged , the patient is in danger also of developing
contractures if he doesn’t have exercise and joint motion if
provision is nit made for maintaining good posture.
 Mechanism that affects
movement

1. Center of gravity of an object is the point as

which it’s mass centered . In human , when
standing , the center of gravity ls located in
the center of the pelvis approximately
midway between the umbilicus and the
symphysis pubis.

Body mechanics
 Mechanism that affects
movement

 Line of gravity is the vertical line that passes

through the center of gravity .
 Mechanism that affect
movement

 Base of support is the foundation that provides an

object stability an object ‘s is stable when it’s center of
gravity goes through the base of support. The wider
the base of support and the lower center of gravity is ,
the greater the stability of the object
 Rules for the practice of good body
mechanics

1. Encourage the patient to do things as much

as she / he can for herself whenever
possible . This will provide them exercise
and maintain muscle tone .
2. Maintain a broad base of support by
standing with feet comfortably apart , one
foot forward and toes toe’s pointed in
direction of movement .
3. Stand close to your work and flex the knees
and hips when stooping .
4. Use the longest and strongest muscles of the
arms and legs to prevent back strain .
5. Carry object close to your body .
6. Move the patient by rolling or turning ,
whenever necessary , rather than lifting.
7. Pull the patient toward you when ever
possible because it is less straining than
rolling patient away from you.
 Normal body alignment and
good posture

 The head is erect hyper extended in the

 The face is in the knee locked position
forward position in the The feet are at right
same direction as the angles to the lower legs
feet  The line of gravity goes
 The chest is held through the center of
upward and forward the knee and in front of
 The spinal column is the ankle joints
elongated and the The base of support is
curves of the spine are on the sole of the feet
within normal limits and weight is
 The abdominal distributed through
muscles are held the soles of the heels
upward and the
buttocks downward

 The knees are

extended – not bent or
 Guidelines for the use of proper body
mechanics

1. Use the longest muscles of the arm and the legs to

help provide the power needed in strenuous
activities . The muscles of the back are less strong
and easily injured .
2. Work as close as possible to the object that is to be
lifted or move . This brings the body center of
gravity close to the object being moved.
3. Use the weight of the body as force pulling or
pushing
4. Slide roll , push or pull an object rather than lifting
it to reduce energy needed to lift the weight .
5. Place the feet apart to provide broad base of
support
6. Flex the knees and come down close to an object
that is to be lifted