Chapter 10 Flashcards
Communication and the Therapeutic Relationship
Self-awareness
Self-awareness is the process of understanding one’s own beliefs, thoughts, motivations, biases, and limitations and recognizing how they affect others.
Therapeutic communication
Therapeutic communication is the ongoing process of interaction through which meaning emerges.
Verbal Communication
achieved by spoken words, includes the underlying emotion, context, and connotation of what is actually said.
Nonverbal communication
includes gestures, expressions, and body language.
Self-disclosure,
telling the patient personal information,
generally is not a good idea.
There are two types of listening:
passive and active.
Passive listening
Passive listening involves sitting quietly and letting the patient talk
active listening
active listening, the nurse focuses on what the patient is saying, interprets the underlying meaning, and responds to the message objectively.
Therapeutic techniques in establishing relationships and helping patients focus on their problems.
Asking a question, restating, and reflecting are examples of such techniques.
Strength-based communication
should be supportive, focusing on the patient’s strengths instead of potential deficits. Language that promotes acceptance and respect should be favored over language that distracts from acceptance of the person.
Four different body zones that provide varying degrees of protection against unwanted physical closeness during interactions.
- as the intimate zone
- the personal zone
- the social zone
- the public zone
Intimate Zone (distance and meaning)
for whispering and embracing)
the personal zone
close friends
the social zone
e.g., for acquaintances
the public zone
usually for interacting with strangers
Intimate zone distance
1-18 in
Personal zone distance
18-36 in
Social zone distance
4ft-12ft
Public zone distance
12-25ft
Therapeutic communication is done at what distance?
most comfortable when nurse and pt are 3ft to 6ft away
Defense mechanisms (also known as coping styles)
Defense mechanisms (also known as coping styles) are psychological mechanisms that help an individual respond to and cope with difficult situations, emotional conflicts, and external stressors.
Three phases of nurse pt relationship:
- orientation phase
- working phase
- resolution phase
Orientation phase
during which the nurse and patient get to know each other
pt develops sense of trust in the rn
The second is the working phase,
The second is the working phase, in which the patient uses the relationship to examine specific problems and learn new ways of approaching them.
The final stage, resolution phase/termination,
The final stage, resolution phase, is the termination stage of the relationship and lasts from the time the problems are actually resolved to the close of the relationship.
When does termination phase begin ?
Termination begins on the first day of the relationship, when the nurse explains that this relationship is time limited and has been established to resolve the patient’s problems and help them handle their problems.
Transference
The unconscious assignment to a therapist or nurse of a patient’s feelings and attitudes that were originally associated with important figures such as parents or siblings.
countertransference
The therapist or nurse’s reactions to a patient that are based on interpersonal experiences, feelings, and attitudes. It can significantly interfere with the nurse–patient relationship
Empathy
Empathy is the ability to experience, in the present, a situation as another did at some time in the past. It is the ability to put oneself in another person’s circumstances and to imagine what it would be like to share their feelings.
