Week 1: Nurse at Therapeutic Instrument Flashcards Preview

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Flashcards in Week 1: Nurse at Therapeutic Instrument Deck (12):

4 phases of nurse patient relationship

  • Pre-interaction phase
  • Introductory/orientation phase
  • Working phase
  • Termination phase


Pre-interaction phase

when you get your report (before you've ever met your patient) and decide how you're going to interact with them.


Introductory/orientation phase

  • Find out why patient sought help
  • Explore patient’s feelings, identify problems
  • Establish trust, understanding, acceptance, open communication
  • Establish goal consensus, collaboration
  • Formulate contract, explaining roles, confidentiality, responsibilities, expectations of patient and nurse


Working Phase

  • Nurse and patient explore stressors
  • Promote development of insight by linking perceptions, thoughts, feelings, actions
  • Translate insight into action/behavior change
  • Master anxieties, increase self-responsibility, develop constructive coping mechanisms
  • Standoff, impasse, or plateau may develop if patient resists moving forward


Termination Phase

  • Learning maximized because of higher levels of trust, intimacy
  • Exchange feelings and memories to evaluate patient progress, goal attainment
  • Establish reality of separation; explore feelings of rejection, loss, sadness, anger
  • Make referrals if needed for continued care or treatment



  • Concern for welfare of others
  • Love for humanity and helping people
  • Nurses need to balance altruism with their needs for satisfaction, compensation, recognition
  • Can be self-destructive if overzealous


Congruent communication

nonverbal message matches the verbal message


Incongruent communication

the nonverbal message doesn't match the verbal message


Responsiveness dimensions

  • Genuineness
  • Respect
  • Empathy
  • Concreteness


Action Dimensions

  • Confrontation
  • Immediacy
  • Self Disclosure
  • Catharsis
  • Role Playing




4 Therapeutic Impasses

  • Resistance
  • Transference: patient to nurse
  • Countertransference: nurse to patient
  • Boundary Violation