Relationship Based Care: A Model for Building a Nursing Program Dennis Ondrejka, Ph.D., RN, CNS , ext 209

Language Issues Nursing Model A picture of that describe what we believe A Nursing Philosophy (Conceptual Framework) The building blocks of our beliefs, the way they relate to each other, and the scope of our practice A Nursing Theorist A fast way to create your philosophy as you bring their philosophy into your program

Models Give you a Picture of How the Parts are Related

Nursing Philosophy -Theory Allows You To Organize Your Thinking and Connect it to Principles It helps to know what we believe and why These are the the building blocks of our knowledge and beliefs This allows us to move into new territory as if we have a map for the unknown We have less surprises, and then react less stressed It is an external support for our faulty thinking

Variations of Nursing Beliefs Linear Thinking Connection Thinking Systems Thinking Woven Thinking Quantum Thinking Scary stuff

If You Pick RBC to be Your Philosophy You are picking Connection Thinking at the basic Level You are picking Quantum Mechanics Thinking at the highest level

RBC Model for Your Practice Colleagues Patient & Family First The Nurse “The CORE of the healing Environment is your Relationship to the Patient and Family” Koloroutis p. 29

The RBC Nurse as advocate For care, Presences, Patient, Family.

12 Value Beliefs that guide the process of RBC Practice 1. The meaning and essences of care is a connection in the moment 2. Feeling connected creates harmony and healing 3. Each person on the team plays a part

12 Value Assumptions that guide the process of RBC Practice (page 2) 4. Relationship is at the heart of all healthcare interactions 5. Care providers knowledge of self and self-care are fundamental to quality of care and healthy relationships. 6. Healthy relationships among health care members, is essential to the quality of care provided to patients.

12 Value Assumptions that guide the process of RBC Practice (page 3) 7. People are most satisfied when in alignment with their personal and professional values 8.We must understand and value Relationships in patient care. 9.A therapeutic relationship is essential for quality care 10. Patient experiences improve measurably when staff own their own practice

12 Value Assumptions that guide the process of RBC Practice (page 4) 11.People willingly change when they are inspired to a shared common vision. When an infrastructure is implemented for it working, when relevant education is provided for personal professional development, and when they see evidence of success (I 2 E 2 ) 12. Transformational change happens one relationship at a time.

What Prevents this from Occurring Disconnect Between What Drives a Health Care Organization and What Matters Most in Nursing Our Energy May Not be Congruent, SO—Quantum Physics Principles Will Play that Out.

What Prevents this from Occurring We Fail to Understand the Differences and Needs for Both the Technical and Professional Nursing Roles We Vary Our Philosophy Based on Department, i.e. Systems Thinking versus Connection Thinking Which Causes Disconnects We Fail to See What Our Change Model Really Is

Traditional Drivers of HC vs Patient Center Driven Systems driven Risk Avoidance driven Hierarchy driven Policy driven Politically driven Re-imbursement driven Cost reduction driven Patient Center Driven (RBC)

What Patients Want They want be a person vs. a diagnosis (Press & Ganey, 1997) They want to be listened to, treated with respect & cared for gently (Care conf. data) They want care providers responding and anticipating their needs; ability to calm fears, good communication, inform them about tests & procedures (Dingman, 1999) RBC is key to quality care (Tresolini, 1994)

Development of RBC It has been developing over 25 years We have research We have theorists We have it tied to professionalism It is now found in the science of Quantum Mechanics