Respectful and Trustworthy Interactions and Boundaries

Question 1

What is respect?

Answer 1

When you approach a person or group with regard or esteem

Question 2

What is a major factor of gaining respect?

Answer 2

Appearance

Question 3

What are the 3 HCPs Values?

Answer 3

(1) self-respect
(2) respect for colleagues
(3) respect for patients

Question 4

Why is respect difficult in institutional settings?

Answer 4

Privacy can be difficult to provide

Question 5

6 Influencing Factors Of Respect

Answer 5

• Socioeconomic status
• Ethnic diversity
• Language differences
• Educational differences
• Sexual orientation
• Religious Beliefs

Question 6

How do you demonstrate respect for your patient?

Answer 6

Help to preserve their modesty

Question 7

What are the 3 Components of Respect?

Answer 7

(1) Communication
(2) Effective Listening
(3) Responding Appropriately

Question 8

What percentage of communication is non-verbal?

Answer 8

55-97%

Question 9

What is considered someone’s Personal Space?

Answer 9

1-4 ft

Question 10

What is considered Social Space?

Answer 10

3-4 ft

Question 11

What is considered Public Space?

Answer 11

12-25 ft

Question 12

What is good therapeutic communication is associated with?

Answer 12

• Increased Ability to make Informed Consent
• Positive Clinical Outcomes
• Higher Levels of Patient Satisfaction
• Higher Patient Compliance with Treatment Programs
• Lower Levels of Patient Frustration and Anger

Question 13

Other than communication, effective listening, and responding accordingly, what are 2 other important components of trust?

Answer 13

Honesty and Reassurance

Question 14

3 concepts to avoid when trying to build trust

Answer 14

• “Thinging”
• Transference
• Countertransference

Question 15

What does “thinging” mean?

Answer 15

When someone’s image is defined as a thing rather than a living being
for example “My TKR pt” vs. “Mrs. Smith the lady that had the TKR

Question 16

What is Transference?

Answer 16

Occurs when you shift your feeling from a person of your past to a person you are treating

Question 17

What is countertransference?

Answer 17

The tendency to respond to a pt with association of others in one’s life

Question 18

3 Common qualities of Courteous Clinicians

Answer 18

• Patients are greeted in a timely fashion
• Proper and polite communication occurs throughout their time at the clinic/facility
• The needs of the patient are addressed: from basic to complex

Question 19

3 Things to avoid (being too casual)

Answer 19

• First name relationship is pushed too quickly or patient isn’t asked what they would like to be called
• Inappropriate revelations about the clinician’s personal life such as letting the patient ‘in on a secret’
• Spends extra time ‘socializing’ with a patient as compared to other patients

Question 20

What is Constructive Dependence?

Answer 20

HCP and Patient acknowledge the need for each other

 - The professional wants to apply their professional skill  
 - The patient desires the expertise of the professional  
 - The patient takes ownership for their part in accomplishing their goals

Question 21

What is detrimental dependence?

Answer 21

A relationship based on an intense sense of self depreciation and the desire to find personal identity in the relation of someone else

Question 22

How are boundaries created?

Answer 22

Boundaries are naturally created when respect is present

Question 23

Two Types of Boundaries

Answer 23

Physical and Emotional (Psychological)

Question 24

What are two examples of physical boundaries?

Answer 24

Unconsented Touching

- Sexual Touching  
- Sexual Harassment

Question 25

What is enmeshment?

Answer 25

A type of relationship in which you are unable to define boundaries

Question 26

3 Ways an enmeshment relationship forms

Answer 26

(1) Sympathy to Pity (2) Overidentification (3) Caring Too Much

Question 27

Sympathy vs. Pity

Answer 27

Sympathy is acknowledgment of the person’s problem, but also clarity that your professional role requires you to set boundaries. Pity is a level of sympathy that distorts one’s objective perspective

Question 28

How does one overidentify?

Answer 28

Your experience is so similar to the patient’s that you believe the experience to be identical. This hinders the relationship because it does not allow for the pt to be heard

Question 29

What are some characteristics of respect at its best?

Answer 29

There is an optimal form of respectful interaction between a patient and a health professional. You foster integrity which allows for a high level of consistency between what you say and what you do.

Question 30

What are the rules for receiving gifts?

Answer 30

- Let the gift be fitting for the occasion - To accept or not to accept - Know your employer’s policies

Question 31

What do you do when you have made a mistake?

Answer 31

Always admit you made a mistake and apologize for it. The pt has a right to know a mistake was made.

Question 32

4 Respectful Interactions with infants

Answer 32

(1) Respect for the pt and the family (2) Consistency in approach (3) Constancy of presence (4) Continuity of treatment

Question 33

3 Respectful Interactions with Toddlers

Answer 33

(1) Respect for the pt and the family (2) security (3) Autonomy

Question 34

4 Respectful Interactions with Children

Answer 34

(1) Try to establish a sense of independence while still maintaining dependence (2) Introduce play and toys to establish relationships (3) Importance of school related activity (4) Respecting family and child’s input

Question 35

2 Respectful Interactions with Adolescents

Answer 35

(1) Understand that peer's behavior can be of significant influence (2) There is also a high need for respect, autonomy, and relating

Question 36

6 things to consider when treating older adults

Answer 36

(1) Patient’s view on aging (2) Friendship and family ties (3) Where home is (4) Has their self-image changed? (5) Mental changes: Competence (6) Assessing a patient’s value system . . .so they don’t feel like a ‘thing’

Question 37

Describe Respectful Interaction When The Patient Is Dying

Answer 37

Understand the pt's view of the dying process -denial -fear (of pain, isolation, dependence) Set treatment priorities such as info sharing, treating losses and fears and help to main hope Say Goodbye

Question 38

4 Tips for Showing respect when patients are angry, uncooperative, manipulative, or help-rejecting

Answer 38

- Refuse to believe this is a character flaw - Set forth clear, consistent expectations in a non-defensive manner - Focus necessary critiques on patient’s behavior, as opposed to labeling the patient - Empathetic responses such as, “I know you must be frustrated . . .”

Question 39

3 tips for showing respect when a patient is aggressive or has a history of violence

Answer 39

- Avoid threatening body language - Assure you and the patient both have an exit - Treat with a partner