nurse - patient relationship-lecture

8/3/2019 Nurse - Patient Relationship-lecture

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Ms. Maj Tomas


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1. Social

2. Intimate

3. Therapeutic

SOCIAL RELATIONSHIP is primarily initiated forthe purpose of friendship, socialization,companionship and accomplishment of a task.

Communication is usually centered around sharingideas, feelings and experiences and meets thebasic needs of people to interact together.


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2. INTIMATE RELATIONSHIP usuallyinvolves two people who are emotionallycommitted to each other and are bothconcerned about having their needs met andhelping each other do so.

The relationship may include sexual or emotionalintimacy as well as sharing of mutual goals.

It has no place in the nurse-patient relationship.


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THERAPEUTIC RELATIONSHIP- It is a TOOL

that the nurse can use to assess each patientsproblems, select and carry out specificintervention and evaluate the effectiveness ofcare.


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It is a series of interaction between the nurseand the patient in which the nurse assists thepatient to attain POSITIVE BEHAVIORAL

CHANGE.


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It is :

GOAL DIRECTED

FOCUSED ON THE NEEDS OF THE

PATIENT

PLANNED

TIME LIMITED

PROFESSIONAL


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T trust

R - rapport

U- unconditionalpositive regard

S setting limits

T- therapeuticcommunication


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Trust is built when the client/patient feelsconfidence in the nurse and nurses presenceconveys confidence, integrity and reliability.

The nurse should be CONSISTENT in his orher words and actions (Congruence) can beRELIED ON to do what he or she says.


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To establish arelationship with aclient by showinggenuine interest and

empathy.

Empathy is the abilityof the nurse to perceivethe meanings andfeelings of the client andto communicate thatunderstanding to theclient.


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Refers to warmth, caring, interest andRESPECT for the person.

Non-judgmental attitude

Respect for the person does not depend on hisor her behavior instead the person is regardedas worthwhile- has VALUE & DIGNITY simply

for being human. ACCEPTANCE


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It does not mean that the nurse accepts all

aspects of a persons behavior that is sociallyinappropriate or abusive- DO NOT LABELPATIENTS

Call the patient by name

Listen and respond in an open manner


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Outline the nurse and client responsibilities

At the outset, these responsibilities should beagreed on in an informal or verbal contract.

Time, place and length of sessions

When the sessions will terminate

Client responsibilities ( arrive on time, end on

time) Nurses responsibilities (arrive on time,

MAINTAIN CONFIDENTIALITY at all times,


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Evaluate progress with client, document

sessions.) Confidentiality- who will have the access to

clients data. Mental health team sharesappropriate information.

Boundaries must be clear.


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Is an interpersonal interaction between thenurse and client during which the nursefocuses on the specific needs of the client to

promote effective exchange of informationbetween the nurse and the client.

During therapeutic communication- nurses usethemselves as a therapeutic tool to establish atherapeutic relationship with a client to helpthe client grow, change & heal.


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Open ended questioning is best used

What rather than why

Orientation and presentation of reality

Description rather than judging

Sharing information and exploring alternativesrather than giving actual solutions


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Giving information

Giving broad opening

Reflecting

General leads

Clarifying

Validating

Silence

Focusing


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Giving advice

Rejection

Giving false assurance

Belittling

Probing

Overloading

Cliches


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1. ORIENTATION PHASE (TEACH them)

Trust and rapport

Environment (therapeutic)

Assess clients strength & weaknesses- nursebegins to know about the patient

Contract- parameters of the relationship are

laid, MUTUALLY ACCEPTABLE ( Majortask of this phase)

Help communicate


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PROVIDE therapeutic experience

Promote positive self concept

Realistic goal setting

Organize support system

Verbalize feelings (encourage)

Implement action plan

Develop positive coping behaviors

Evaluate the results of plan of action


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It is a gradual weaning process

It involves feelings of anxiety, fear and loss

It should be recognized in the orientation phase

Major task: To assist the patient to review what heor she has learned and transfer his/herlearning to his/her relationship with others.


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Take PRIDE

Promote self care

Recognize increasing anxiety

Increase independence

Demonstrate emotional stability

Environmental support


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TRANSFERENCE- the development of anemotional attitude of the patient either positiveor negative towards the nurse.

RESISTANCE- development of ambivalentfeelings towards self-exploration.

COUNTER TRANSFERENCE-

Nurse responds to the client basedOn personal unconscious needs &

Conflicts.


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1. TEACHER

2. CAREGIVER

3. ADVOCATE

4. PARENT SURROGATE


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the HEART remembers when GOODNESS

made a difference..

nurse - patient relationship-lecture

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