LECTURE 1: Therapeutic Relationships: Elements of a helping relationship 🫶

Question 1

Purpose of Nursing Theory?

Answer 1

• offers a sense of identity for nurses in healthcare
• theories develop overtime to changing knowledge and changes in society
• nursing theory explains, describes, predicts, and prescribes nursing care

Question 2

Nursing as an art and a science, meaning?

Florence Nightingale contribution?

Answer 2

• helping people deal with day-to-day life events and choices that affect their health, as well as recover from insults to the body
• Florence Nightingale (1860), first nursing theorist and delineated the scope of nursing practice as separate from medicine

Question 3

Why is nursing theory important?

Answer 3

• encourage us to think creatively and out of norm
• theory provides nurses with an identity and direction
• sense of pride that our work is meaningful and valuable

Question 4

Nursing Theorists Timeline

Answer 4

1860 - Florence Nightingale
1950 - Peplau
1960’s Orlando
1980’s on - Watson

Question 5

Interaction Theories, Peplau

Answer 5

• Interaction theorists resolve around the relationships nurses form with patients, Peplau (1988)

Question 6

N - C relationships: What is effective helping? Meaning of “effective”?

Answer 6

• act of enabling individuals/groups to become better ability to solve problems, meet needs, or achieve aspirations
• permits greater sense of individual/group control over its developmental course
• “effective” in nursing care context refers to interpersonal interactions between nurses and patients that are helpful to patients

Question 7

N - C relationships: Consequences of ineffective helping?

Answer 7

• Learned helplessness
• Paternalism (inability to make own decisions)
• Decreased self-esteem

Question 8

N - C relationships: Consequences of effective helping?

Answer 8

The health of the client may be enhanced
- assists rate of recovery
- decreases reported pain
- decreases postoperative complications

Question 9

N- C relationships: What are therapeutic relationships (RNAO, 2006)?

Answer 9

• purposeful, goal directed relationships directed at advancing the client’s best interest and outcome
• grounded in an interpersonal process that occurs between the nurse and the client
• “interpersonal relationships between nurses and patients humanize healthcare”

Question 10

RNAO best practice guideline (2006) establishing therapeutic relationships: recommendations

Answer 10

• nurse must acquire necessary knowledge to participate effectively in therapeutic relationships
• establishing therapeutic relationships requires “reflective practice”
• nurse needs to understand the process of therapeutic relationships and recognize the current phase
• nurses place themselves in a position to understand the client

Question 11

CNO therapeutic nurse-client relationship standard statements, nurse’s accountabilities (2006) MCPT

Answer 11

There are four standard statements, describing a nurse’s accountabilities in the nurse-client relationship:
1. therapeutic communication
2. client-centred care
3. maintaining boundaries
4. protecting the client from abuse

Question 12

CNO therapeutic nurse-client relationship building blocks (2006) TREPP

Answer 12

There are 5 building blocks (TREPP)
1. Trust
2. Respect
3. Empathy
4. Power
5. Professional Intimacy

Question 13

Strengths - Based Nursing Care (Gottlieb) : Strengths of Relationships

Answer 13

Gottlieb (2010) describes four categories of nurse strengths, one being strengths of relationships

strengths underlying the skills involved in relationship building include:
- respect and trust
- empathy
- compassion and loving kindness