Week 3 - Therapeutic Relationship Flashcards
Explain the Art of Nursing of Therapeutic Relationships
- Intuitive thinking about health from patient’s perspective.
- Influenced by the nurse’s life knowledge and professional experiences.
Explain the Science of Nursing of Therapeutic Relationships
Blends knowledge, experience, and scientific understanding
Goal for Therapeutic relationship: provide safe, quality care by integrating intuition, empathy, and evidence-based practice.
What is Theory and how does it relate to Therapeutic Nurse Client Relationship?
Theory - a set of assumptions about concepts.
- shows the relationship between concepts in a way that allows phenomena like the Therapeutic nurse client relationship to be viewed in a systematic way.
Reflecting on Peplau’s interpersonal nursing discussed Week 1. Would you describe this theory as a grand, mid-range or practice theory approach
Mid- Range theory (focuses on nurse client relationship and specific interaction)
- it provides a framework for understanding and improving nurse - client interactions but is not as broad as grand theories or as practice theories.
What is the importance of nursing theories?
It provides a knowledge base for building therapeutic nurse client relationship (TNCR) and supports person-centred nursing interventions.
(COMMUNICATION) What is a nurses capacity to be in relation with other people?
- take initiative in establishing and maintaining relationships.
- to be responsive to others’ needs and emotions. (Crucial for effective interpersonal communication)
What is relational practice?
It is guided by conscious participation with clients using number of skills including:
listening, questioning, empathy, reciprocity, self-awareness, reflection and a sensitivity to emotional contexts (CNO,2014).
Two other skills that are used when communicating with clients.
Authenticity - being spontaneous, genuine, and honest in communication. Builds trust and rapport.
Mutuality - respecting each other’s autonomy and fostering mutual understanding. It ensures collaborative and respectful relationships.
What are some Therapeutic Communication techniques?
Active listening, sharing empathy, hope and feelings, sharing observations, using touch, using silence, asking relevant questions/summarizing.
What are some Non Therapeutic communication techniques?
Asking personal questions, giving personal opinions, false reassurance, sympathy, asking for explanations, approval or disapproval, changing the subjects, arguing, etc.
What is the Carper’s Ways of Knowing in nursing?
Carper 1978 identified 4 patterns of knowing that nurses value & use in practice: Empirical, Ethics, Aesthetics, Personal Knowing.
- provides the rationale for nursing practice.
- enables us to provide safe, effective and personalized care.
What is Chinn & Kramer (2011) way of knowing?
They identified socio-political and economic ways of knowing, and described this as emancipatory knowing.
What is Ethical Knowing?
The moral aspects of nursing.
- focuses on matters of right & wrong, moral choices (what ought to be done).
- guides how nurses conduct their practice with attention to standards & codes.
- offers insights & options for advocacy without determining what should be done (sharing knowledge in a way that helps people understand issues and make their own choices, rather than telling them what to do).
What is Empirical Knowing?
Using facts, research, and real-world evidence to guide patient care.
- assumes that what is to be known can be accessed through the five senses.
- based on direct observation, the purpose is to describe, explain, and predict phenomena.
For example, using research to decide the best way to treat a wound or checking a patient’s vital signs to assess their condition. It helps nurses make informed, effective decisions based on proven knowledge.
What is Personal Knowing (Relational)?
The knowledge of ourselves and how it colours out interactions with others.
- revealed through reflection - concerns self - understanding, empathy and compassion.
- communicated to others as authentic & genuine: acknowledges humanness of one another.
- interactions with others can increase personal knowledge through reflection on self.
For example, being aware of your feelings when comforting a patient or using past experiences to connect with someone going through a tough time. It helps nurses provide compassionate, authentic, and patient-centered care.
What is Aesthetic Knowing?
Aesthetic knowing in nursing is the “art” of nursing—it’s about understanding and responding to each patient’s unique experience with creativity, empathy, and intuition.
- allows everyone, including the patient, to learn new information.
- can be enhanced through storytelling, poetry, music or art.
For example:
- Comforting a scared child with a gentle touch and a soothing voice.
- Adjusting care based on a patient’s emotions or cultural background.
- Creating a peaceful, healing environment in a hospital room.
What is Emancipatory Knowing?
Enables us to recognize social and political problems of injustice or inequity.
- focusing on the ability to notice social injustices, investigate the causes of these injustices, and identify changes necessary to correct the structure of injustice and oppression.
- allows nurses to be in a better position to act as advocates.
For example: Nightingale and her writings about the inequities in her society that affected women.
What is Grand Theories?
Broad conceptual frameworks that aim to explain a wide range of nursing phenomena, providing a general understanding of nursing practice.
- this means that grand nursing theories provide a broad and conceptual way to understand complex and abstract ideas, like human behavior, emotions, and interactions in healthcare.
- they are very broad and not specific to particular situations.
Example: Watson’s Theory of Human Caring – explains how caring relationships impact healing but doesn’t give step-by-step nursing interventions, parse, Roy
What is Middle Range Theories?
Addresses specific nursing concepts or situations within practice.
- developed from grand theories, practice, research, or literature.
- fewer concepts, less abstract, limited in scope.
- they are more practical and can be tested in research.
- they connect theory to real-world nursing problems like pain management, coping, or stress.
Ex. Bender, Henderson
What is Practice Theories?
These are the most specific and focus on direct patient care.
- address and predict consequences of interventions, support development of guidelines and protocols.
- fewer concepts, narrow scope, situation-specific, direct practice focus.
- action-oriented (e.g., procedure manuals).
What is Metaparadigm?
Key bodies of nursing knowledge used to examine abc understand clinical situations.
Caring though the lens of key nurse theorists: Parse(2004)
Human Becoming Teaching - Learning Model: Suggests that nurse and patient exist in relationship, and both benefit equally.
- caring is demonstrated through active listening, appreciating and learning from the differences between you and your patient.
Caring though the lens of key nurse theorists: Benner (2000)
Novice to Expert Theory: describes the professional development (improvement in skills) of a nurse over the course of the nursing career trajectory.
- emphasize caring as being at the center of of nursing practice.
Caring though the lens of key nurse theorists: Watson (1985)
Theory of Human Caring: described carative factors (10) that focus on the human dimensions of nursing, such as sensitivity to self and others, helping - trusting, faith - hope, etc.
