Chapter 8: Therapeutic Relationships

Question 1

What are the 4 core concepts of patient- and family-centered care?

Answer 1

(1) dignity and respect, (2) information sharing, (3) patient and family participation, and (4) collaboration in policy and program development

Question 2

What is the first connection between the patient and the nurse used to establish?

Answer 2

an understanding that the nurse is safe, confidential, reliable, and consistent

Question 3

What is the therapeutic use of self?

Answer 3

the use of unique personality traits and talents that we can use to bond with others and promote healing

Question 4

Who is licensed to practice psychotherapy?

Answer 4

psychiatric-mental health advanced practice registered nurses, psychiatrists, and psychologists

Question 5

What is a therapeutic relationship between the nurse and patient focused on?

Answer 5

the patient’s ideas, experiences, and feelings

Question 6

What are 5 things a nurse must do when creating a therapeutic relationship with the patient?

Answer 6

Identify the needs of the patient and explore them.
Establish clear boundaries.
Encourage alternate problem-solving approaches.
Help the patient develop new coping skills.
Support behavioral change

Question 7

If the nurse and patient only meet a few times and the relationship is limited but may be substantial, useful, and important for the patient, what is this known as?

Answer 7

a therapeutic encounter

Question 8

Who is responsible for maintaining boundaries between the patient and the nurse?

Answer 8

the nurse

Question 9

What happens if a nurse is under-involved in a therapeutic relationship?

Answer 9

Nurses who are under-involved with patients may be at the least disinterested and neglectful and at the worst guilty of patient abandonmen

Question 10

What may over-involvement lead to in a therapeutic relationship?

Answer 10

boundary crossings, boundary violations, and professional sexual misconduct

Question 11

What is the least serious form of over-involvement?

Answer 11

boundary crossings

Question 12

What are two common circumstances in which boundaries are crossed?

Answer 12

(1) when the relationship slips into a personal context and
(2) when the nurse’s needs (for attention, affection, and emotional support) are met at the expense of the patient’s needs

Question 13

What are some examples of boundary crossing?

Answer 13

accepting gifts or cash, planning a business together, excessive touching of the patient, and trying to influence the patient’s political/religious beliefs

Question 14

What is the most extreme form of boundary crossing?

Answer 14

sexual misconduct

Question 15

What is blurring the roles in the nurse-patient relationship often a result of?

Answer 15

unrecognized transference or countertransference

Question 16

What is transference?

Answer 16

when the patient unconsciously and inappropriately displaces onto the nurse feelings and behaviors related to significant figures in the patient’s past (e.g. “you remind me of my sister, brother, father, mother, etc”)

Question 17

What kind of gifts are acceptable for the nurse to take from the patient?

Answer 17

gifts of nominal value (homemade cookies, chocolates, etc. for the whole treatment team)

Question 18

What happens during countertransference?

Answer 18

the nurse unconsciously displaces feelings related to significant figures in the nurse’s past onto the patient

Question 19

What does countertransference often result in?

Answer 19

over-involvement and it impairs the therapeutic relationship

Question 20

What are values?

Answer 20

abstract standards that represent an ideal, either positive or negative

Question 21

What is empathy?

Answer 21

when someone tries to see the world from another’s point of view

Question 22

What is sympathy?

Answer 22

feeling pity or sorrow for others

Question 23

Why is it important to encourage patients to use their own resources?

Answer 23

it helps minimize the patients’ feelings of helplessness and dependency and validates their ability to bring about change

Question 24

What is the greatest trigger for the development of a patient’s nurse-focused transference?

Answer 24

The degree of authority the nurse has over the patient