PPN102 Test 1: Therapeutic Relationships Flashcards
Define Therapeutic Relationship
A purposeful, goal-oriented, time-limited relationship that is established with the intent of advancing the best interests and outcomes of the client.
Define Relational Practice
A respectful and reflexive approach to inquire into patients’ lived experiences and healthcare needs. It is the skilled action of respectful, compassionate, and authentically interested inquiry into another (and one’s own) lived experience.
According to Zou (2016), relational practice has 5 important implications in nursing clinical practice
1) Look beyond the surface of people/situations/relationships to understand the contextual factors that impact health
2) Take responsibility for articulating personal and or societal biases and discriminations in order to provide culturally safe care
3) Demonstrate respect for a patient’s culture, age, sex, beliefs and values, healthcare decisions and preferences
4) Abide by nursing codes and standards and engage in reflective practice
5) Establish policies, provide education and engage in research that explores therapeutic relationships between nurses, patients, and their families
What nursing practice is based on the belief that each person has within them the capacity to heal if given support with respect and unconditional regard in caring, authentic, therapeutic relationships?
Client-centered Care
Describe the difference between a social and therapeutic relationship
Social relationships are established and maintained to meet mutual needs or friendship. Therapeutic patient-centered relationships are established for professional health-related purposes within a specific time-setting. The focus of therapeutic relations is always on patient health concerns and outcomes.
Describe Peplau’s Interpersonal Relations Theory
Emphasis on a nurse-client relationship, instead of passively delivering treatment and following doctor’s orders. She believed that shared experiences with patients were foundational to nursing practice.
Peplau created a model of six types of roles that describe the different types of interpersonal roles existing in healthcare, name these 6 roles
1) Stranger role
2) Resource role
3) Teaching role
4) Leadership role
5) Surrogate role
6) Counselor role
This role receives the client and establishes the introduction of the nurse-client relationship
Stranger role
Define Resource Role
One who provides specific needed information that aids in the understanding of a problem or a new situation. The patient looks to this individual for knowledge.
In this role, the individual imparts knowledge in reference to a need or interest. The nurse educates the patient.
Teaching role
Define Leadership Role
The nurse empowers the patient to become a leader in their health.
In this role, a nurse may remind the patient of someone they know and they may become a surrogate in that relationship.
Surrogate Role. It helps to clarify the domains of dependence, interdependence, and independence and act on client’s behalf as an advocate.
Define the Counselor Role
The nurse encourages the patient and helps them work through their feelings. They help the patient understand and integrate the meaning of current life circumstances, and provide guidance and encouragement to make changes.
Identify Peplau’s four phases of the nurse-client relationship.
1) Pre-interaction
2) Orientation
3) Working
4) Resolution
What does the pre-interaction phase include?
Reviewing a patient’s chart or report; affords greater interpersonal sensitivity prior to meeting, and allows you to reflect and review your personal goals and/or potential biases.
In this phase, the patient identifies that they may need help. The nurse will establish boundaries, and trust, and help explain to the patient what is occurring.
Orientation phase
What does the Identification/Working phase include?
The patient has identified that they can rely on the nurse for health and will work together with the nurse to discover appropriate solutions. The leadership role may be particularly important here, as the patient may be feeling insecure.
What is the Exploitation phase?
In Peplau’s theory, this phase may occur before Resolution/Termination (phase 4). In this phase, the patient becomes overly reliant on the nurse. The nurse must re-establish boundaries and confidence in the patient.
In this phase, the nurse helps the patient in preparation for their discharge.
Resolution/Termination Phase
What are the 5 key components of the therapeutic nurse-client relationship, as described by the CNO?
1) Professional Intimacy
2) Power
3) Empathy
4) Respect
5) Trust
This component of the nurse-client relationship results from the close proximity required to maintain care
Professional Intimacy
The nurse-client relationship is one of unequal…?
Power. This is a result of specialized knowledge and ability to navigate the healthcare system, and advocate for the client.
