Refresher: Psychiatric Nursing 1 Flashcards
What is a nurse-client relationship?
2-way; series of interaction between the nurse and the client
What is the GOAL of the nurse-client relationship?
GOAL: Positive behavioral change
What are the 5 elements of therapeutic relationship?
T - rust
R - apport
U - nconditional positive regard (Acceptance)
S - etting limits
T - herapeutic communication/therapeutic use of self
Therapeutic Behaviors:
sincerity and honesty
Therapeutic Behaviors:
Genuineness
Therapeutic Behaviors:
ability to identify one’s feelings
Therapeutic Behaviors:
Concreteness
Therapeutic Behaviors:
consideration to the pt as a unique human being; Acceptance
Therapeutic Behaviors:
Respect
Phases of Therapeutic Relationship:
no contact with the client; datas are from secondary sources (chart, book, journals)
= Self awareness
Phases of Therapeutic Relationship:
Pre-interaction
Phases of Therapeutic Relationship:
establish trust: assess the client; establish mutual agreement (goals, plans); informing about termination
Phases of Therapeutic Relationship:
Orientation
Phases of Therapeutic Relationship:
longest phase; achieving goals and sharing facts; resolve the problem
= highly individualized
Phases of Therapeutic Relationship:
Working
Phases of Therapeutic Relationship:
moving towards independence; observe regressive behaviors (going back to previous state)
Management:
- reinforce the previous management
Phases of Therapeutic Relationship:
Termination
- defined as “dynamic” (changing) process of exchanging info
= Adaptive - composed of verbal and non verbal techniques (should be combined)
Therapeutic Communication
What are the 4 elements of the Therapeutic Communication?
- Sender - encoder/source of the message
- Message - actual info being transmitted
- Receiver - decoder/recipient of the message
- Feedback - receiver’s response
What inhibits communication process?
Barriers
ex. noise
Non-verbal communication:
“physical space” between nurse and pt/sender and receiver; not too far, not to near (3-6ft/one arm and half)
Non-verbal communication:
Proxemics
Non-verbal communication:
body movements such as gestures, facial expressions, mannerisms
Non-verbal communication:
Kinetics
Non-verbal communication:
intimate physical touch; always ask for Consent
Non-verbal communication:
Touch
Non-verbal communication:
agreeing; listening; encourages the pt to talk
Non-verbal communication:
Silence
Non-verbal communication:
“voice quality” (tone, inflection); how the message is delivered
Non-verbal communication:
Paralanguage
Describe therapeutic verbal communication
therapeutic, appropriate, simple, adaptive, concise, and credible
Therapeutic Verbal Communication: S - pecific M - measurable A - ttainable R - ealistic T - imebounded
Ex: “Let me sit here with you for 5 mins”
Therapeutic Verbal Communication:
Offering Self
Therapeutic Verbal Communication:
such as “ah huh, yes, no”
Therapeutic Verbal Communication:
Active listening
Therapeutic Verbal Communication:
Ex: “You said Hannah was the best. can you describe her?”
Therapeutic Verbal Communication:
Exploring
Therapeutic Verbal Communication:
You are giving the pt an opportunity to open up
Therapeutic Verbal Communication:
Broad Openings
Therapeutic Verbal Communication:
Ex: “I noticed you have combed your hair today”
Therapeutic Verbal Communication:
Making observation
Therapeutic Verbal Communication:
Ex: “ In the past 15 mins, we have talked about…”
Therapeutic Verbal Communication:
Summarizing
Therapeutic Verbal Communication:
Pt: I am hearing voices
Ex: “What are the voices telling you?”
Therapeutic Verbal Communication:
Encouraging description of perception/Acknowledging