21-30 Flashcards
an intellectual and emotional bond between the nurse and the client and is focused on the client.
Helping Relationship
nurse-client relationship, therapeutic relationship
Helping Relationship
Phases of the Helping Relationship
1 Pre interaction
2 introductory
3 working
4 termination
in this phase, the nurse has information about the client before the face-to-face meeting.
Pre-interaction
in this phase, Planning for the initial visit may generate some anxious feelings.
Pre-interaction
Also referred to as the orientation/pre-helping phase
Introductory
this phase Sets the tone for the rest of the relationship.
Introductory
(phase) Goal of the Nurse: develop trust and security within the nurse-client relationship.
Introductory
three stages of the introductory phase
opening the relationship
clarifying the problem
structuring or formulating the contract
behaviors that inhibit involvement, cooperation, or change
Resistive behavior
reliance on someone without doubt or question.
trust
in this phase, Nurse and client begin to view each other as unique individuals; appreciate this uniqueness and care about each other.
working
2 major stages of the working stage
a. Exploring and understanding thoughts and feelings.
b. Facilitating and taking action.
ability to experience, in the present, a situation as another person’s circumstances and feelings
Empathy
focuses on a kind of “being with” clients to develop an understanding of their world.
Empathetic listening
understanding that is communicated effectively
Empathetic response
this phase is Often expected to be difficult and filled with ambivalence, however, if the previous phases have evolved effectively, the client generally has positive outlook and feels able to handle problems independently.
termination
Determine the client’s primary language for communicating and whether a fluent interpreter is required.
Language Deficits
Devise a communication system like writing on a paper
Structural Deficits
Observe whether the client is attempting to see your face to read your lips.
Sensory Deficits
Determine whether the client can point, shrug, blink, or squeeze a hand
Paralysis
Assess whether these clients respond when asked a question
Assess the client’s ability to understand written words. Use large, clearly written words when trying to establish abilities in this area
Cognitive impairments
The nurse focuses on 3 areas:
Content of the message
Themes
Verbalized emotions
Verbal Communication
Consider client’s culture.
Pay particular attention to facial expression, gestures, body movements, affect, tone of voice, posture, and eye contact
Nonverbal Communication
Provides a standardized framework for communicating important information.
Situation, Background, Assessment, and Recommendation (SBAR) Model
SBAR
Situation, Background, Assessment, Recommendation
Provide your name, health agency, client name, brief information about the problem
SITUATION
Provide information pertinent to the current situation, such as admitting diagnosis, date of admission, and important clinical information that relates to the call.
BACKGROUND
Refers to the current condition of the client and any change in the assessment since the previous communication. Indicate the severity of the problem
ASSESSMENT
What is your recommendation to solve the problem, or what do you need from the healthcare provider?
RECOMMENDATION
Ability to form a work relationship with colleagues, displaying maturity in a variety of situations and resolve conflicts while taking into consideration the emotions of others
Emotional Intelligence
Promotes client safety by minimizing miscommunication with colleagues.
People who use it are honest, direct, and
appropriate while being open to ideas and
respectful to the rights of others.
An important characteristic includes the use
of “I” statements versus the “you”
statements.
assertive communication
submissive and agressive
non-assertive communication
Allow their rights to be violated by others.
Submissive
Described as “directed toward what one wants without considering the feelings of others”.
Aggressive
“__” statements encourage discussion.
I statements
__ statements s place blames and put
the listener in a defensive position.
you statements
Rude or disruptive behavior that may result in psychological or physiological distress for the people involved, and if left unaddressed, may progress into threatening situations.
Rude or disruptive behavior that may result in psychological or physiological distress for the people involved, and if left unaddressed, may progress into threatening situations.
Incivility
Also known as horizontal violence or horizontal hostility
Lateral Violence
Physical, verbal, or emotional abuse or aggression directed at RN coworkers at the same organizational level.
Lateral Violence
Repeated, unreasonable actions of individuals directed towards an employee (or group of employees), which are intended to intimidate, degrade, humiliate, or undermine or which create a risk to the health or safety of the employees
Bullying
Assisting, supporting, or enabling another individual or group with evident or anticipated needs to ameliorate or improve a human condition or lifeway, or to face death.
caring
sharing deep and genuine concern about welfare of another person.
caring
connection, mutual recognition, and involvement between nurse and client.
caring practice
the nurses involved in these situations experience caring through knowing they have made a difference in their client’s lives
caring practice
he has proposed that to care for another person is to help him grow and actualize himself
Milton Mayeroff (1990)
8 Major Ingredients of Caring (Mayeroff)
knowing
alternating rhythm
patience
honesty
trust
humility
hope
courage
understanding the other’s needs and how to respond to these needs.
Knowing
moving back and forth between the immediate and long-term meanings of behavior, considering the past.
Alternating rhythms
enables the other to grow in his own way
and time.
Patience
awareness and openness to one’s own feelings and a genuineness in caring for the other
Honesty
letting go, allowing the other to grow in his own way and own time.
Trust
acknowledging that there is always more to learn, and learning may come from any source.
Humility
belief in the possibilities of other’s growth.
Hope
sense of going into the unknown, informed by insight from past experiences
Courage
Five viewpoints according to Morse, Solberg, Neander, Battorff, and Johnson, 1990:
caring as a moral imperative
caring as an affect
caring as human trait
caring as an interpersonal relationship
caring as a therapeutic intervention
when we are nursing our patient, caring must be included.
Caring as a Moral Imperative
→ how we present ourselves (our demeanor) towards our client
Caring as an Affect
→ as a person, it is innate for us to care.
Caring as a Human Trait
→ caring involves two or more people.
Caring as an Interpersonal Relationship
→ what we usually do: giving support and comforting our patient.
Caring as a Therapeutic Intervention
Proposes that “caring is the essence of nursing, and
the distinct, dominant, central, and unifying focus of
nursing.”
Proposes that “caring is the essence of nursing, and
the distinct, dominant, central, and unifying focus of
nursing.”
Cultural congruent care is provided in 3 major ways:
preserving
accommodating
repatterning
Leininger — Culture Care Diversity and Universality
Focuses on caring as a philosophical concept and proses that caring is the human mode of being
Roach — Human Mode Model
6C’s of caring:
compassion
competence
confidence
conscience
commitment
comportment
awareness of one’s relationship to others, sharing their joys, sorrows, pain, and accomplishments (participating in the experience of another person)
compassion
having the “knowledge, judgment, skills, energy, experience, and motivation required to respond adequately to the demands of one’s professional responsibilities.”
competence
comfort with self, client and others that allows one to build trusting relationships.
confidence
moral, ethics, and an informed sense of right and wrong
conscience
→ deliberate choice to act in accordance with one’s desires as well as obligations
commitment
appropriate bearing, demeanor, dress, and language that are in harmony with a caring presence; presenting oneself as someone who respects others and demands respect.
comportment
(Nursing as Caring)
Boykin & Schoenhofer
(Theory of Caring)
Swanson
(Theory of Nursing Care
Watson
— Primacy of Caring
Benner and Wrubel
direct personal interactions between the nurse and patient.
Direct care
work on behalf of the client to improve health status
Indirect care
Activities are any that foster the highest state of well-being of the recipient of activities.
Health Promotion
Focuses on avoidance of disease.
Illness Prevention
Encompasses activities that foster a return to health
for those already ill
Health Restoration
Nurses have been active in promoting the respectful care of those who are terminally ill or dying.
End-of-Life Care
The nurse aims to know who the client is in his/her
uniqueness.
Knowing the client
caring encounters
knowing the client
nursing presence
empowering the client
compassion
competence
Being emotionally present to the client and family
Nursing presence
Nurse identifies and builds upon the client/family
strengths.
Empowering the client
The caring nurse is described as warm and
empathic, compassionate and concerned.
Compassion
The competent nurse employs the necessary
knowledge, judgment, skills and motivation to
respond to the client’s needs
Competence
