Week 1: Elements of a Helping Relationship

Question 1

Nursing Theory: What is it?

Answer 1

-aims to describe, predict and explain the phenomena of nursing
-offers a sense of identity and provides an understanding of nurses’ purpose and role in healthcare
-IN ESSENCE ~ Nursing theory guides practice

Question 2

Nursing Theory: Roots (EDPP)

Answer 2

Theories are rooted in the discipline’s history and traditions
-Explains
-Describes
-Predicts
-Prescribes

Question 3

Nursing: What is it

Answer 3

An art and a science
-it is about understanding the human condition, in all its complexity, to help deal with anything that affects their health

Question 4

Importance of Nursing Theory

Answer 4

-Encourages us to think creatively and look beyond norms
-Encourages us to examine day-to-day practice in order to understand the complexities of nursing
-Provide nurses with identity, clarity and direction
-Provide sense of pride that our work is meaningful and valued

Question 5

Classification of Nursing Theories

Answer 5

Metatheory - Abstract concepts and phenomena

Grand Theory - Conceptual frameworks ~ explains how nurses organize knowledge about nursing to understand client’s situation

Middle Range Theory - More precise and specific to limited situations

Practice Theory - Explores a particular situation found in nursing

Other Classifications - Include Needs’ Theories, Outcome Theories, Interaction Theories and Humanistic Theories

Question 6

Nursing Theorists Timeline (1860 - 1980’s on)

Answer 6

1860 - Florence Nightingale
1950 - Peplau
1960’s - Abdellag; Orlando; Weidenbach; Hall
1970’s - Rogers; Orem; King; Neuman; Roy; Newman; Paterson; Zderad
1980’s on - Watson; Parse; Leininger; Benner; Wrubel

Question 7

Interaction Theories

Answer 7

Revolve around the relationships nurses form with patients (Peplau, 1988)

Question 8

Social Relationship

Answer 8

-Equal Responsibility
-Spontaneous
-Self-disclosure expected

Question 9

Therapeutic Relationship

Answer 9

-Helper responsible for conduct of relationship
-Specific purpose/goal
-Focus on needs of client
-Self-disclosure limited

Question 10

Effective helping

Answer 10

An act of enabling individuals or groups to become better able to solve problems, meet needs, or achieve aspirations
-“Effective” in the nursing care context refers to interpersonal interaction between nurse and patients that are helpful to patients

Question 11

Consequences of effective helping

Answer 11

-The health of the client may be enhanced
-Assists the rate of patient recovery, decreases reported pain, drug usage, postoperative complications, and length of stay

Question 12

Consequences of ineffective helping

Answer 12

-Learned helplessness
-Paternalism
-Decreases self-esteem
-Non-contingent helping or Materialism

Question 13

Therapeutic Relationship: What is it

Answer 13

-Is grounded in an interpersonal process between nurse and client(s).
-Are purposeful, goal-directed relationships that are directed at advancing the best interest and outcome of the client

Question 14

RNAO Best Practice Guideline (2006): Establishing Therapeutic Relationships

Answer 14

-Acquire the necessary knowledge to participate effectively in therapeutic relationships
-Requires reflective practice
Understand the process of a therapeutic relationship and be able to recognize the current stage with patients
-Empathy
-Interpersonal relationships between patients and nurses humanize healthcare

Question 15

CNO Therapeutic Nurse-Client Relationship (2006): Four statements of nurse accountabilities

Answer 15

-Therapeutic Communication
-Client-centered care
-Maintaining boundaries
-Protecting the client from abuse

Question 16

CNO Therapeutic Nurse-Client Relationship: Components

Answer 16

-Trust ~ opinions, values, beliefs
-Power ~ positionality
-Respect ~ treat with respect, make them feel valued
-Empathy ~ empathy vs sympathy, validate their feelings
-Professional Intimacy ~ bedside manners, knowledge of patient

Question 17

Trust

Answer 17

-Build trust ~ trust is built in small amounts
-Sliding door moments ~ opportunities to build trust
-As nurses, we need to ask for help to:
-we can’t assume we know their story
Definition: “Choosing to make something important to you vulnerable to the actions of others”

Question 18

Fill in the blanks:
The nurse assumes the role of professional helper and comes to know the client as an _______________ who has unique ___________.

Answer 18

Individual
Needs

Question 19

Fill in the blank:
The nurse-client relationship is a ____________________ relationship.

Answer 19

Therapeutic

Question 20

Fill in the blank:
The relationship is characterized by the nurse’s ___________________ acceptance of the client.

Answer 20

Non-judgmental

Question 21

Fill in the blank:
A helping relationship does not just happen between a nurse and client, nurses must create it through the development of ___________.

Answer 21

Trust