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quality of life and professional commitment. For each of these seven dimensions, the relevant elements of practice for the new graduate are described henceforth.

1. NURSE-PATIENT RELATIONSHIP

Principle: All patients are responsible for their own health. When patients express a need or expectation, the graduate nurse, taking into account patients’  capacities, encourages them to mobilize their personal resources and those available in the environment. The nurse-patient alliance is established through a relationship characterized by mutual respect and shared objectives.

Elements of Practice:

1.1 The graduate nurse recognizes that each patient is unique as a person. The graduate nurse establishes a partnership with the patient and helps the family participate in the care of the patient.  This  partnership  is  reflected  in  the  nurse’s approach, notably by his/her attentiveness and the way in which he/she responds to needs and expectations expressed by the patient. 1.2 The graduate nurse uses a nursing process to plan care and treatment activities with patients based on their needs and expectations. In the Therapeutic Nursing Plan, the graduate nurse uses strategies that ensure continuity and follow-up of nursing and medical care and treatment, and helps patients to use their personal resources as well as resources available within their environment.

2. HEALTH PROMOTION

Principle: All patients aspire to health and well-being. The graduate nurse helps patients to implement their choices while respecting their capacities, which may vary over time.

Patients’  choices  are  dependent  upon  their  expectations,   personal resources and the resources within their environment.

Elements of Practice:

2.1 The graduate nurse helps patients to use and broaden their personal repertoire of resources to maintain or to improve their health and well-being. The graduate nurse facilitates knowledge transfer of health-related information to patients and helps them to make choices. The graduate nurse

acknowledges the health-related behaviours that patients have acquired and takes patients’  learning styles into account in the teaching-learning process.

2.2 The graduate nurse trains/informs others in the care delivery context who can help the patient in health promotion activities. The graduate nurse collaborates with the patient when choosing the most relevant educational

strategies.

3. PREVENTION of DISEASE, ACCIDENTS and SOCIAL PROBLEMS

Principle: All patients face risks related to their state of health, living habits, life transitions or to the environment. The graduate nurse helps patients to identify potential problems related to these risks and helps patients adapt to actual problems in order to maintain their health and well-being. Elements of Practice:

3.1 In collaboration with patients and other health professionals, the graduate nurse carries out programs and care activities to prevent infections, accidents, crisis situations or violence. The graduate nurse assesses risks for patients. When a risk situation is detected, the graduate nurse determines the appropriate screening and preventive measures. The graduate nurse ensures that monitoring and follow-up measures are integrated into the therapeutic nursing plan.

3.2 The graduate nurse determines the need for restraint measures to protect the patient, after evaluating alternate possible solutions and consulting members of the

interdisciplinary team as necessary. The graduate nurse determines and records the clinical monitoring parameters in the patient’s  therapeutic nursing plan. The graduate nurse carries out diagnostic procedures for screening purposes and performs vaccinations in conjunction with public health-related activities.

Nursing (180.A0)

3.3 The graduate nurse helps patients become aware of their personal resources, informs them of the resources available within their environment and helps them deal with their specific health-related situation/context. The graduate nurse pays particular attention to patients who are vulnerable or at risk.

In co-operation with other health professionals, the graduate nurse engages in activities intended to correct practices and policies that may lead to health and social problems. 4. THERAPEUTIC PROCESS

Principle: All patients who know the diagnosis of their health- related problem have a need to be cared for, treated, informed, reassured and comforted. The graduate nurse assesses the patient’s  physical  and  mental  status,  and  in   collaboration with the patient, determines the nursing care and treatment required to maintain, restore or improve their health or to help the patient die with dignity. The graduate nurse encourages patients to participate, to the best of their abilities, in the care and treatments stipulated in the therapeutic nursing plan. The graduate nurse ensures that these interventions are carried out, provides patients with the assistance they require and monitors their responses throughout the therapeutic process.

Elements of Practice:

4.1 The graduate nurse assesses the patient’s  physical  and   mental health status and formulates the therapeutic nursing plan. The graduate nurse demonstrates effective clinical skills and makes appropriate decisions based on patients’  health- related situations. The graduate nurse ensures a therapeutic presence for each patient and reassures the patient as required. The graduate nurse informs patients of their state of health, and the care and treatment they will receive. The graduate nurse provides nursing care and treatment, and carries out required invasive procedures. The graduate nurse develops the nursing treatment plan for wounds and alterations of the skin/teguments and provides the required care and treatment to patients. The graduate nurse co- ordinates care and treatment activities for a group of patients for which he/she is responsible, taking each patient’s  priorities   into account. The graduate nurse ensures that patients receive the care and treatment stipulated for them in the therapeutic nursing plan.

4.2 The graduate nurse identifies patients’  learning  needs  and   facilitates knowledge and skills acquisition, supporting patients in the process.

4.3 The graduate nurse knows the trajectory of the disease, recognizes mourning and loss reactions in patients, and accompanies patients and their families as required. The graduate nurse clarifies the meaning of mourning or loss with individual patients and their families.

4.4 The graduate nurse ensures that patients are informed about the diagnostic measures, invasive examinations and medical treatments that they are undergoing. The graduate nurse initiates diagnostic measures and performs invasive diagnostic examinations/tests, according to prescription. The graduate nurse provides and adjusts medical treatments, including medications, according to individual and/or collective prescriptions and protocols of the health care institution. The graduate nurse intervenes in emergencies, crises and situations of violence, according to patients’  needs  and  policies  of  the health care institution.

4.5 The graduate nurse ensures that patients know the desired effects and side effects of medications administered to them. The graduate nurse evaluates the effects of care, treatments and medications and monitors for their effectiveness, including adverse reactions. The graduate nurse intervenes as the situation requires, makes appropriate clinical decisions and adjusts the therapeutic nursing plan as required.

4.6 The graduate nurse ensures ongoing monitoring of patients’  physical and mental status, so as to track the

evolution of their health status and detecting complications in a timely manner. The graduate nurse evaluates the effects of care and treatments in conjunction with relevant parameters, including clinical monitoring data and patients’  reactions.  The   graduate intervenes appropriately in relation to identified problems and risks, and adjusts the therapeutic nursing plan as required. As relevant to his/her field of practice, the graduate nurse provides prenatal, perinatal and postpartum care. 4.7 The graduate nurse provides clinical follow-up for patients with complex health problems by assessing and monitoring their condition and adjusting the therapeutic nursing plan and prescribed therapeutic medical plan. This is conducted in collaboration with patients within an interdisciplinary perspective, and in collaboration with relevant departments and appropriate professional and health care institutions. The graduate nurse records all clinical information required for monitoring the patient’s  condition  and  for  ensuring  continuity   of care and treatment, including data related to clinical assessments, identified problems, the therapeutic nursing plan and its adjustments, interventions and outcomes, as well as patients’ reactions. The graduate nurse ensures that patients’   records are kept up to date.

Nursing (180.A0)