Chapter 8 Therapeutic Relationships

Question 1

Attending listening

Answer 1

special kind of listening
foundation of therapeutic relationship
intensity of presence or being with the patient

Question 2

beliefs

Answer 2

self-awareness
opinion or conviction
confidence, trust or faith (in a doctor)
religious tenets, creeds or faith

Question 3

Boundary crossing

Answer 3

relationship becomes personal

nurses need for attention affection and emotional support are met at the expense of the patient’s needs.

Question 4

boundary violations

Answer 4

ethically wrong
reversal of roles where needs of nurse met not needs of patient.
context important

examples include:
accepting cash or gifts,
planning a business together
excessive touching
influencing political or religious beliefs 
putting patient info on social media.

Question 5

boundaries

Answer 5

the edge of professional behavior
exist to protect patients
nurses are RESPONSIBLE for maintaining them.
expected and accepted lega, ethical, and professional standards that separate nurses from patients.
Allows for clear boundaries
safe space for patient (no under or over involvement by nurse_)

Question 6

clinical supervision

Answer 6

nurses develop a therapeutic relationship with a patient while having support of clinical faculty and nursing staff.
Mentoring relationship characterized by feedback and evaluation.
Autonomy and responsibility are increased.

Question 7

confidentiality

Answer 7

information being held in confidence unless authorization is being made to share it.
the patient has a right to know who else will be give the information shared with the nurse.
that the information may be shared with specific people in post conference.
know not shared with relatives, etc except in extreme situations.
ETHICAL and LEGAL.
breach is a common law tort, civil wrong

Question 8

contract

Answer 8

nurse does something with the patient not for the patient

stated or written contains place, time, date, and duration of the meetings and discuss termination of the relationship.

Question 9

counseling

Answer 9

supportive face to face process that helps individuals problem solve, resolve personal conflicts, and feel supported.

Question 10

countertransference

Answer 10

Reverse of transference
nurse unconsciously displaces feelings related to significant figures in the nurse’s past onto the patient.
can result in OVERINVOLVEMENT by the nurse.
patients seen not as individuals but extensions of ourselves.
strong positive or strong negative reaction - is a sign
over identification with the patient
symptoms can be power struggles, competition, or arguments with the patient

Question 11

empathy

Answer 11

occurs when the helping person attempts to understand the world from the patient’s perspective. putting oneself in the others shoes.

Sympathy - we feel pity or sorrow for others.

Question 12

genuineness

Answer 12

nurse’s ability to be open, honest, and authentic in interactions with patients. helps to build trust. outside and inside of person is congruent. therapeutic communication spontaneous not rigid

Question 13

orientation phase

Peplau

Answer 13

first time nurse and patient meet. can last past first meeting.
patient express thoughts feelings
identify problems
discuss realistic goals

introductions
establishing rapport
specifying a contract
explaining confidentiality

Question 14

Patient-centered care

Answer 14

dignity and respect
information sharing
patient and family participation
collaboration in policy and program development 
 gold standard

Question 15

personal relationships

Answer 15

primarily initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task. Mutual needs are met. Little emphasis on the evaluation of the interaction.

Question 16

positive regard

Answer 16

respecting a person and view them as worthy of being cared about and as someone that has strengths and achievment potential.

Question 17

preorientation phase

Peplau

Answer 17

Before meeting patient 
preparing for assignment
looking at the chart
research the condition
learn about meds
understand lab results
recognize your own thoughts and feelings.

Question 18

Professional nurse - patient relationship

Peplau 4 phases

Answer 18

4 phases

preorientation
orientation
working
termination

Question 19

professional nurse-patient relationship

Answer 19

nurse who has skills and expertise and
patient who wants to feel better, find solutions to problems,
explore different ways to improve quality of life or
find an advocate
Peplau - facilitates toward forward movement. for both

Question 20

psychotherapy

Answer 20

a formalized approach to talk therapy that is based on theoretical models.

Question 21

Psychotherapy - who can practice it

Answer 21

AP adv practice PA RN
psychiatrists
psychologists

Question 22

rapport

Answer 22

relationship characterized by genuineness,
empathy,
and unconditional positive regard from the nurse.

being consistent, helping with problem solving essential part

Question 23

self-awareness

Answer 23

requires we understand what we value and those beliefs that guide our behaviour
it helps us accept uniqueness and differences in others.

Question 24

termination phase

Answer 24

discussed during first meeting
summarizing goals achieved
reviewing patient education
new coping skills
reviewing situations that occurred
exchanging memories to validate experience and to effect closure.
may trigger strong feelings. loss

Question 25

therapeutic encounter

Answer 25

Limited relationship with nurse and patient.
Could be informal and not extensive, but can be substantial and useful to the patient.
nurse shows genuine concern for another with positive regard and empathy.

Question 26

therapeutic relationship

Answer 26

nurse maximizes communication skills, understanding of human behaviors, and personal strengths to enhance the patient’s growth. Focus is on the patient’s ideas, experiences, and feelings.

Question 27

therapeutic use of self

Answer 27

we all have gifts that we can learn to use to form positive bonds with others. the use of these gifts to promote healing in others.

Question 28

transference

Answer 28

patient unconsciously and inappropriately displaces (transfers) on the nurse feelings and behaviors related to significant figures in the patient’s past.

more common with parental figures.
can be positive or negative.

Question 29

values

Answer 29

abstract standards and represent an idea, either positive or negative. Your judgement of what is important in life.
ie self-reliance, honesty, cleanliness, organization, justice, respect, healthy lifestyle.

Question 30

working phase

Answer 30

gathering further data
id problem solving skills and self estem
providing ino
promoting symptom management 
med education
eval progress
essential is patient education