1.3 Flashcards
describe a therapeutic nurse-client relationship
- can occur only when each views the other as a unique human being. When this occurs, both participants have needs met by the relationship; therapeutic relationships are goal-oriented and directed at learning and growth promotion; movement towards wellness
identify the goals of a nurse-client relationship
- ID the client’s problem
- Promote discussion of desired changes (in tune with their values)
- Discuss aspects that cannot realistically be changed and ways to cope with them more adaptively
- Discuss alternative strategies for creating changes that the client desires to make
- Weigh benefits and consequences of each alternatives
- Help clients select an alternative (realistic)
- Encourage client to implement the change
- Provide positive feedback for client’s attempts to create change
- Help client evaluate outcomes of the change and make modifications as required
what are the essential conditions for a therapeutic relationship to occur
- the nurse client relationship is the foundation on which psychiatric ns is est.
- the therapeutic interpersonal relationship is the process by which nurses provide care for clients in need of psychosocial intervention
- mutual for client and ns- both have to have input; self-awareness
1. Therapeutic use of self: instrument for delivery of care to clients in need of psychosocial intervention - ability to use one’s personality consciously in a full awareness in an attempt to establish relatedness and to structure nursing interventions
2. Interpersonal communication: techniques are the “tools” of psychosocial interventions (nonverbals; not intervention but tool to do intervention)
pre-interaction phase
Obtain information about the client from the chart, significant others or other health team members. Examine one’s own feelings, fears, and anxieties about working with a particular client.
- prepare for first interaction with client
orientation (intro) phase
- Create an environment for trust and rapport.
- Establish contract for intervention.
- Gather assessment data.
- Identify client’s strengths and weaknesses.
- Formulate nursing diagnoses.
- Set mutually agreeable goals.
- Develop a realistic plan of action.
- Explore feelings of both client and nurse.
working phase
Maintain trust and rapport
Promote client’s insight and perception of reality
Use problem-solving model to work toward achievement of established goals
Overcome resistance behaviors
Continuously evaluate progress toward goal attainment
- transference: Occurs when the client unconsciously displaces (or “transfers”) to the nurse feelings formed toward a person from the past
- countertransference: The nurse’s emotional/behavioral reaction to the patient based on significant relationships in the past; Underscores the importance of maintaining self-awareness and seeking supervisory guidance as therapeutic relationship progresses
termination phase
Therapeutic conclusion of relationship occurs when:
Progress has been made toward attainment of the goals.
A plan of action for more adaptive coping with future stressful situations has been established.
Feelings about termination of the relationship are recognized and explored.
what preexisting conditions influence the outcome of the communication process
Both sender and receiver bring certain preexisting conditions to the exchange that influence the intended message and the way in which the message is interpreted
• Values, attitudes, and beliefs.
- Example: Attitudes of prejudice
- Are expressed through negative stereotyping
• Culture or religion. Cultural mores, norms, ideas, and customs
- Provide the basis for ways of thinking
1. Social status: high-status persons often convey their high power position with gestures of hands on hips, power dressing, greater height, and more distance when communicating with individuals considered to be of lower social status
2. Gender: masculine and feminine gestures influence messages conveyed in communication by others (body lang)
3. Age: age or develop level - the influence of develop level on comm is especially evident during adolescence with texting words
4. Environment: the environment in which the transaction takes place - territoriality, density, and distance are aspects of environment that communicate messages
territoriality
the innate tendency to own space
density
the number of people within a given environmental space
distance
the means by which various cultures use space to communicate
components of nonverbal expression
physical appearance and dress, body movement and posture, voice tone, touch, facial expression, eye behavior, vocal cues or paralanguage
