lecture four--therapeutic relationships

Question 1

how to maintain patient centered care in therapeutic relationships

Answer 1

maintain dignity and respect, discretion with information sharing, let pt. and family be involved in their care, maintain clear and appropriate boundaries, and allow for collaboration in policy and program development

Question 2

how to best do the the therapeutic use of self

Answer 2

SAFE
CONFIDENTIAL
RELIABLE
CONSISTENT

Question 3

what are the goals of talk therapy

Answer 3

facilitate communication of distressing thoughts and feelings, problem solving, help examine self-defeating behaviors (test alternatives), and promoting self care and independence are all goals of talk therapy.

Question 4

is the therapeutic relationship about you?

Answer 4

ABSOLUTELY NOT.
you are exploring and identifying the needs of the patient, and establishing clear boundaries while you work on the patients problem solving skills

Question 5

what are boundaries and why are they important?

Answer 5

BOUNDARIES are the accepted legal, professional, and ethical safeguards that separate nurses from patients. Boundaries are important so that the therapeutic relationship can continue the way it needs to continue.

Question 6

transference v. countertransference

Answer 6

transference is when the patient unconsciously and inappropriately displaces onto the nurse feelings and behaviors related to their significant past.

counter-transference is when the nurse unconsciously displaces feelings back on the patient. (over identification with patient is a key sign)

Question 7

where does over-involvement in a patients case lead?

Answer 7

NOWHERE GOOD
risk for boundary crossings and violations, including sexual misconduct :(

Question 8

Peplau’s phases

Answer 8

1. preorientation
2. orientation (establish rapport, parameters of the relationship, confidentially, contact, terms of termination
3. working (maintain relationship, gather data, promote pts. problem solving skills, self-esteem, use of language)
4. termination (summarize goals and objectives achieved, new coping strategies, discharge planning)

Question 9

what helps promote patient growth?

Answer 9

genuineness, empathy, positive regard (attitudes, actions, attending), suspending value judgements, helping pts. develop and utilize resources

Question 10

do you keep secrets for patients

Answer 10

ABSOLUTELY NOT