Ch. 7 Relationship development Flashcards
An interaction between two people( usually a caregiver and a care receiver) in which input from both participants contributes to a climate of healing, growth promotion, and/ or illness prevention.
Therapeutic relationship
Created by Peplau The Stranger The Resource person The teacher The leader The surrogate The counselor
The roles of a psychiatric nurse
A nurse is at first a stranger to the client, and the client is a stranger to the nurse.
The stranger
Provides the person to specific answers to questions usually formulated with relation to a larger problem. The nurse explains, in language that the client can understand, information related to the client’s healthcare.
The resource person
The nurse identifies learning needs and provides information required by the client or family to improve the health situation.
The teacher
clients often perceive nurses as symbols of other individuals. They may view the nurse as a mother, sibling, teacher, or another nurse.
The surrogate
The nurse uses interpersonal techniques to assist clients to learn to adapt to difficulties or changes in life experiences.
The counselor
The ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing interventions.
-Nurses must use self-awareness, self-understanding and a philosophical belief about life, death, and the overall human condition
Therapeutic use of self
- Goal oriented
- directed at learning and growth promotion;
- goals are achieved through the problem-solving process
Dynamics of therapeutic relationship
- Rapport and trust
- Respect and genuineness
- Empathy (not sympathy)
- Confidentiality
- Non-judgmental attitude
- Understanding of self and ability to separate issues of self from issues of the patient
Essential conditions to develop a therapeutic relationship
involves preparation for the first encounter with the client. (Obtaining chart info, or listening to report, the nurse develops his or her attitude based on previous experiences. The nurse needs to be aware of these preconceptions and how they may affect his or her ability to care for the client.
the pre-interaction phase
the nurse and the client become acquainted and establish trust and rapport.
- establish a contract for intervention that details expectations and responsibilities of both client and nurse
- gather assessment data
- identify client’s strengths and limitations
- formulate nursing diagnoses
- setting goals that are mutually agreeable
- explore feelings
the orientation(introductory phase)
therapeutic work of the relationship is accomplished during this phase. Tasks include:
- maintaining trust and rapport
- promoting the client’s insight and perception of reality
- problem solving
- overcoming resistance behaviors
- continuously evaluating progress towards goals
The working phase
Summarization of relationship growth
Client may be anxious and react with increase dependence
Finiteness of relationship discussed
termination phase
Occurs when the client unconsciously displaces or transfers feelings formed toward a person from the past.
transference
