professional relationships Flashcards
(85 cards)
1
Q
What are some characteristics of therapeutic relationships?
A
- Responsibility is the nurses
- There’s a specific purpose
- Termination occurs
- Focused on client
- no choice of who is in the relationship
- self disclosure is minimal
- understanding should always be put into words
2
Q
Define therapeutic relationships
A
When a nurse and client join together for a defined period of time, to achieve a health related treatment goal
3
Q
Name the 8 Foundations of a therapeutic relationship.
A
- Respect
- Caring
- Empowerment
- Trust
- Empathy
- Mutuality
- Veracity
- Confidentiality
4
Q
What are the 4 phases of therapeutic relationships?
A
- Pre-interaction Phase; prep and plan
- Orientation Phase; Clarify purpose, assess and communicate goals
- Working Phase: Define problem and develop realistic goals
- Termination Phase; Conclude and refer
5
Q
What are some therapeutic uses of self?
A
- Presence
- Authenticity
- Self awareness
6
Q
What are some barriers that may inhibit therapeutic relationships?
A
- Lack of; caring, support, appropriate resource use, confidentiality, trust
- Stereotyping or bias
- Lack of personal space
7
Q
Define Professional boundaries
A
Professional boundaries are structure set in place by legal, moral, and professional standards of nurses that respect rights of both the client and nurse.
8
Q
What is structure set in place by legal, moral, and professional standards of nurses that respect rights of both the client and nurse?
A
Professional boundaries
9
Q
What are 9 key assumptions of communication
A
- Impossible not to communicate
- Every communication has a content and relationship aspect (metacommunication)
- We only know about ourselves and others through our communication
- Faulty communication results in flawed feelings or actions
- feedback is the only way we know our perceptions or feelings are valid
- silence is a form of communication
- all parts of communication systems are interrelated
- Intercommunication process is either systematic or complementary
9 all forms of communication are equally important to interpret message
10
Q
What does symmetric communication refer to?
A
a linear model
Sender>message>receiver
11
Q
What does a linear model of communication look like?
A
a linear model
Sender>message>receiver
12
Q
What is a circular transactional model of communication?
A
sender>message>receiver>clarifies message back to sender
13
Q
What is complimentry communication?
A
there is a verification from sender to receiver that the message was received accurately;
CIRCULAR transactional model
14
Q
What are 2 main factor that effect communication?
A
What you say…(appropriate vocab, clarity, & brevity)
How you say it.. (denotive and connective meaning, pace, pitch, tone, timing, and relevance)
15
Q
What are some non-verbal factors of communication?
A
- personal appearance
- posture and gait (how you work)
- facial expressions
- eye contact
- gestures and touch
- sounds
- territoriality and personal space
16
Q
What are some contextual factors of communication?
A
- Physical and emotional factors (accute or chronic physical or emotional illness)
- Developmental factors ( age and intellect)
- Social-cultural factors
- gender
17
Q
What are 4 characteristics of therapeutic communication?
A
- client centered
- goal directed
- rules and boundaries
- individualized strategies
18
Q
What is active listening according to potter and perry?
A
Active listening means to be attentive to what the client is saying both verbally and non-verbally.
19
Q
What does SOLER stand for?
A
SOLER is a means of active listening: Sit facing the client Observe an open posture Lean toward the client Establish and maintain eye content Relax
20
Q
List some listening response techniques in therapeutic communication?
A
- minimal cues and leads
- clarifying
- restatement
- paraphrasing
- reflections
- summarization
- silence
- touch
21
Q
What are 4 types of therapeutic questioning techniques?
A
- open ended questions
- closed ended questions
- focused questions (require more than yes or no, and focus on a specific issue)
- Circular questions ( focus on interpersonal context of illness)
22
Q
List some therapeutic verbal responses.
A
- using simple understandable language
- focussing
- presenting reality
- giving feedback
- asking for validation
- humour
- reframing
23
Q
Denotive means.
A
to indicate; to signify directly
24
Q
Metacommunication
A
Refers to all factors that effect how a message is received
25
What are 5 points that RNAO mass in there best practice guidelines for therapeutic relationships?
- Must acquire knowledge
- Must have a reflective practice
- Must understand the process of a therapeutic relationship in order to understand what phase they are in
- partnering with client as experts in their own lives
- providing structured decision support
26
What are 3 points that CNO make in their professional standards on therapeutic relationships?
- Must maintain respectful, collaberative, therapeutic and professional relationships
- Professional relationships are based on trust and respect and result in improved client care
- Indicators for each identified
27
What is part of the pre-interaction phase of a therapeutic relationship?
Creating s psychological and physical environment in preparation to meet client.
Need skills in planning and self awareness
Activities include planning and self awareness
28
What is part of the orientation phase of a therapeutic relationship?
This phase clarifies purpose of relationship, assesses client needs, participant observation, communication strategies and goal setting
Need to negotiate relationship, and explore understanding
Skills include; active listening, attending, open ended questions, verbal cues and prompts
29
What is involved with the working phase of a therapeutic relationship?
This phase defines the problem, pacing, developing realistic expectations, implementing a plan and challenging resistant behaviour
- Need to set goals and action plan, and help client change behaviour, feeling or perceptions
- Skills involve attending, listening, giving info, supporting, and self disclosure
30
What is involved in the termination phase of therapeutic relationships?
The nursing interventions and behavioural responses occuring at the closure of a therapeutic relationship
- Activities include ending relationship and referring to other resources
- Skills include giving information and supporting
31
What are self-concepts?
Self-concepts refers to the acquired set of thoughts, feelings, attitudes and beliefs that individuals have about nature and organization of their personality.
32
What are some characteristics(8) of healthy self-concepts?
- Congruency btw real and ideal self
- Spiritual well being
- Satisfaction with body image
- Emotional stability
- Satisfaction with role performance
- high self-esteem
- Distinct sense of identity
- Realistic life goals
33
Define self-esteem.
The emotional value a person places on his or her personal self worth in relation to others and the environment;
How you feel about yourself
34
Define self-awareness.
Being aware of your own traits feelings and behaviours;
| Knowing yourself
35
Self-identity
Awareness of and identification of oneself
36
What are 4 aspects of self concepts?
- body image
- personal identity
- self esteem
- spirituality
37
What is a group?
Two or more individuals connected within a social relationship
38
What is a therapeutic group?
A group with the purpose to increase knowledge of oneself and others, helping to clarify the changes that are wanted and to develop the told needed to make changes
39
What is a primary group?
- usually spontaneous
- linked to the values of individuals
- informal structure and social process
- Membership is automatic or voluntary
- Important to self concepts and personal development (ie soccer team, church grp)
40
What is a secondary group?
Have a planned association
- have structure and purpose
- time limited
- designated leader
- designated goals and specific purpose
- group disbands when goals are met (i.e., therapy grp)
41
Name 4 types of therapeutic groups.
- Therapeutic Activity Group
- Community Support Group
- Educational Group
- Focus Group
42
Define Group Dynamics.
Group dynamics are the communication processes and behaviour occurring during day to day life; include individual and group characteristics, and influence successfulness.
43
What are the three main factors that effect group dynamics?
- Member variables ( motivation, function, experience)
- Group dynamics ( Communication variables; clarifying, reflecting, linking, paraphrasing, and summarizing)
- Group variables ( purpose, norms, role function, cohesion, and decision making)
44
What characteristics are needed for leadership?
- Commitment to group purpose
- Self awareness
_Open attitude; good listener, supportive, ability to convey warmth and understanding
- Ability to adapt to meet the needs of the group
45
Name three leadership styles.
1. Authoritative; leader takes full direction and responsibility for the group, controlling interactings
2. Democratic; leader involves members in active discussion and decision making, encouragings open expression of feelings and ideas
3. Laissez-faire; hands off approach
46
What is an authoritarian leader?
A leader who takes full direction and responsibility for the group, controlling interactions
47
What is a democratic leader?
A leader who involves members in active discussion and decision making process
48
What is a Laissez-faire leadership approach?
Hands off approach
49
What factors effect group dynamics?
- verbal and nonverbal communication
| - social climate
50
What are Tuckman's (5) phases of group development?
```
Forming
Storming
Norming
Performing
Adjourning
```
51
What happens in the forming phase of a group?
- desire to be accepted by others, avoid conflict and controversy
- Serious issues and feelings are avoided
- Team members behave as individuals
- IMPORTANT because individuals get to know each other and make new friends
52
What happens in the storming phase of a group?
- different ideas compete
- uncomfortable
- necessary for growth
- IMPORTANT because apon resolution group works better together
53
What happens in the Norming phase of groups?
- setting goals and mutual plans
- cohesiveness develops
- individual goals become aligned with group goals
IMPORTANT because all team members take the responsibility and have ambition to work toward the group process
54
What happens in the performing phase of group development?
- some high preformers reach this stage
- members function as a group as they get the job done soothly and effectively
IMPORTANT because team is competent, autonomous and not in need of supervision
55
What occurs in the adjourning phase of group development?
- Review accomplishments
- reflect on meaning of the group
- involves completing task and breaking up the team
56
Is the following statement therapeutic or non therapeutic;
| 'Would you like to talk about it?'
Therapeutic questioning
57
Is the following statement therapeutic or non therapeutic;
| 'Everything will be alright"
Not therapeutic; false hope
58
Is the following statement therapeutic or non therapeutic;
| "I'm glad you decided to do that"
Not therapeutic; your opinion
59
Is the following statement therapeutic or non therapeutic;
| "you appear tense"
Therapeutic; observation
60
Is the following statement therapeutic or non therapeutic;
| "Dr. Dee is a very good physician. You should learn to trust him."
Not therapeutic; defending, not validating
61
Is the following statement therapeutic or non therapeutic;
| "how did that make you feel"
Therapeutic; open ended question
62
Is the following statement therapeutic or non therapeutic;
| "I am not sure I understand"
Therapeutic; clarifying
63
Active listening facilitates which of the following?
a. trust
b. self-awareness
c. communication
d. self-concept
trust and communication
64
Is conflict viewed as positive or negative?
positive
65
What is conflict?
When tension arises btw 2 or more people in which the action of one frustrates the other and prevent accomplishing goals
66
What is the nature of conflict?
Content ( goals, values, beliefs)
| Process (relationship with self or others)
67
What causes conflict?
misunderstanding
68
What are the (6) types of conflict?
```
Intrapersonal (within self)
Interpersonal (btw 2 or more)
Overt (observable)
Covert (invisible)
Functional (moving forward and growth)
Dysfunctional (no growth, not moving forward)
```
69
What is intrapersonal conflict?
conflict within self
70
What is interpersonal conflict?
conflict btw 2 or more people
71
What is overt conflict?
observable conflict
72
What is covert conflict?
invisible conflict (behind closed doors)
73
What is functional conflict?
move forward and grow from conflict
74
What is dysfunctional conflict?
no growth from conflict
75
Conflict in a therapeutic relationship occurs when...
you fail to validate the clients feelings
| PERCEPTION is REALITY
76
What are 4 ways to manage conflict?
- avoidance (lose-lose)
- accommodation (win-lose)
- competing (lose-lose)
- collaboration (win-win)
77
What are 6 principles of conflict resolution?
1. identify the issue
2. know your resonse to conflict triggers
3. seperate the problem from the people involved
4. Stay focussed on the issues
5. identify options
6. establish standard for decision making
78
What are some nursing strategies to enhance conflict resolution?
- prep for encounter
- manage own anxiety
- time the encounter
- put in perspective
- use therapeutic communication
- one issue at a time
- identify any intrapersonal conflict
- mutually generate options for resolution
- request a behaviour change
- understand culture and gender implications NEVER ASSUME
- evaluate conflict resolution
79
What is assertiveness?
Assertiveness is making goals, acting on those goals in a clear and consistent manner, and taking responsibility for the consequences of those actions.
80
What is the goal of assertiveness?
To accommodate your needs without infringing on the rights of others
81
What are some components of assertiveness?
being able to;
- say no
- ask for what you want
- appropriately express positive and negative thoughts and feelings
- initiate, continue and terminate the interaction
82
An "I" statement is considered
a. assertive
b. aggressive
c. non-assertive
assertive
83
A "you" statement is considered
a. assertive
b. aggressive
c. non-assertive
aggressive
84
Giving is is...
a. assertive
b. aggressive
c. non-assertive
non- assertive
85
What are some assertive responses?
Expressing empathy. "I understand that"
Describe the feeling of the situation. "I feel that"
State expectations. "I want"
List consequences."If you...then its likely that..."
