exam i: ch8 - therapeutic relationships

Question 1

the basis of all psychiatric nursing treatment, “facilitates forward movement” - Hildegard Peplau

Answer 1

nurse-patient relationship

Question 2

what is the purpose of the nurse-patient relationship

Answer 2

to establish a nurse that is
- safe
- confidential
- reliable
- consistent
- with clear boundaries

Question 3

what is considered the “art” of psychiatric nursing

Answer 3

interpersonal skills

Question 4

using personality consciously and in full awareness
- establish relatedness
- structures interventions
- positive alliance
- improve adherence to tx and positive outcomes

Answer 4

therapeutic use of self

Question 5

type of relationship where
- purpose = friendship, socialization, task completion
- mutual needs are met
- communicate for advice
- little evaluation

Answer 5

social relationships

Question 6

type of relationship where
- purpose: PT NEEDS are id’d and explored
- clear boundaries
- problem solving approaches
- behavioral change, coping skills

Answer 6

therapeutic relationships

Question 7

when relationship slips into social context, NURSE’S needs are met at expense of pt needs

Answer 7

blurring of boundaries

Question 8

what are the 3 types of boundary blurs

Answer 8

1. boundary crossings
2. boundary violations
3. professional sexual misconduct

Question 9

brief excursions across professional lines of behavior that may be inadvertent, thoughtless, or even purposeful, while attempting to meet the needs of the pt (no ethical wrongdoing)

Answer 9

level 1: boundary crossings

Question 10

• spending long periods of time with patient
• doing personal tasks for patient
• sharing too much personal info
• thinking about pt outside care setting

Answer 10

examples of boundary crossings

Question 11

when there is confusion between the needs of the nurse and the needs of the patient, causes distress to the pt (adv of pt vulnerability and ethically wrong)

Answer 11

level 2: boundary violations

Question 12

• Personal disclosure
• Secrecy
• Reversal of roles

Answer 12

examples of boundary violations

Question 13

extreme form, any behavior that is seductive, sexually demeaning, harassing, or interpreted as sexual

Answer 13

level 3: professional sexual misconduct

Question 14

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

Answer 14

transference

Question 15

nurses displaces feelings related to people in nurse’s past onto the patient

Answer 15

countertransference

Question 16

guide us in decision making and taking actions; abstract standards and represent ideals (our judgment)

Answer 16

values

Question 17

any opinion that you hold true

Answer 17

beliefs

Question 18

nurses must possess _____ in order to help others

Answer 18

self-awareness

Question 19

phase of nurse-patient relationship:
prep for assignment, recognizing thoughts and feelings

Answer 19

pre-orientation phase

Question 20

phase of nurse-patient relationship:
the first time nurse/pt meet
- Establishing rapport
- Parameters of the relationship
- Formal/Informal contract, confidentiality
- Terms of termination

Answer 20

orientation phase

Question 21

phase of nurse-patient relationship:
nurse and pt ID and explore areas that are causing problems in patient’s life
- Maintain relationship
- Share information
- Gather further data
- Promote pt dev + improve independence
- Eval problems and goals
- Transference and Countertransference can occur here

Answer 21

working phase

Question 22

in which phase can transference and countertransference occur?

Answer 22

working phase

Question 23

phase of nurse-patient relationship:
final integral phase, when pt discharged or clinical rotation ends
- Summarize goals and objectives
- Review pt education + handouts
- Review situations that occurred during nurse-patient relationship
- Exchange memories

Answer 23

termination phase

Question 24

nurse’s ability to be open, honest, authentic in interactions with patients; self awareness of one’s feelings as they arise within relationship

Answer 24

genuineness

Question 25

implies respect, ability to view another person as being worthy of caring about and someone who has strengths and achievement potential

Answer 25

positive regard

Question 26

helping person attempts to understand the world from pt perspective (put yourself into their shoes)

Answer 26

empathy

Question 27

what question can you ask to gain further empathy for someone?

Answer 27

“what thoughts and feelings are you having”

Question 28

culturally + individually appropriate; being in the moment

Answer 28

attending