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43 Cards in this Set

  • Front
  • Back
Social Vs Therapeutic Communication
Social Communication is base on giving advice, meeting dependency, content is superficial; focus on significant personal issues
Therapeutic Communication:
focus on the client in identifying and exploring clients needs
What occurs in Therapeutic relationship?
needs of client are ID and explored,
alternative problem-solving approaches are taken,
new coping skills are developed,
change in behavior is ENC
Social Relationship
friendship initiated, socialization & enjoyment,accomplishment of task, mutual needs met through social interaction, communication skills include giving advice, lending money, communication content is superficial, in social interaction roles shift, little emphasis on interaction
Intimate Relationship
emotional commitment; react natural to each other, partnership, each member cares about hte other's need and growth and satisfaction, mutual needs met and intimate desires, fantasies are shared, may or may not evaluate interaction
Therapeutic Relationship
focus is on the client, rn able to maximize communication skill, understand human behavior and personal strenght to enhance client growth, its about identifying clients nees and exploring it; focus on personal significant issues, rn may have variety of roles (teacher, counselor, socializing agent, laison)
3 Types of Relationship
Social, Intimate, Therapeutic
3 Personal Characteristic that help promote change and growth in the clients
genuiness, empathy and positive regard
self-awareness of feelings that may arise in a relationship and being able to communicate it when its appropriate; key to building trust; convey by actions such as not hiding behind the role of a rn, listening and communicate w/o distorting the message and being clear and concrete in communicating skils; ability to use therapeutic communication in a spontaneous manner-not parroting
is not empathy; its multidimensional concept; it means you understand the ideas expressed and feelings that are present;
being empathic is accurately perceiving the client's situation, perspective and feelings, you are able to communicate your understanding and check in with client for accuracy; can act on this understanding in a helpful way toward the client
conveys compassion, pity, comisseration; express agreement w/c discourage exploration
5 Concepts of Empathy
human, professional state, communication process; a caring proces and special relationship
Positive Regard
Respect; viewing the a person and worthy of caring about and as someone who has strengths and achievement potential
Respect (positive regard) can be conveyed by:
willingness to work with the client
attending, suspending value judgments, helping client develop own resources
basis of interviewing; being with the client or the intesity of presence; reflected by body posture, eye contact, body language
Suspending Valued Judgment
not imposing your judgment on client; focusing instead on the client's behavior;
work towards identifying the thoughts and feelings that influence this behavior
Helping Develop Resources
being aware of client's strengths and enc client to work at optimal level; decrease feelings of helplessness and dependency
Establishing Boundaries
roles and needs of nurse and client are different; so the boundaries are well stated; practice supervision and counterferance to prevent role blurring
Role Boundaries Blurring are due to
relationship slips into social context and the nurse's needs are met at the expense of the client
Nursing action that manifest when role boundaries are blurred:
overhelping, controlling and narcissism
How does Role boundaries blurring occur:
result in unrecognized transference or countertransference
clients displaces feelings of their current life, patterns of beh &emotional rxn originated in relation to significant figures in childhood..usually towards authority figure
projecting strong feelings in the client to the nurse
RN clinician displace feelings to clients r/t people in therapeutic past ct; When nurse feels strongly positive/negative rxn to a clt like when RN overidentification w/ the clt, or gets involve w/ power struggle, competition or argument w/ the ct
In therapeutic relationship must understand yourself and others by:
self-awareness, value clarification;
Subprocesses of value clarification:
prizing one's belief and behavior; the you choose; then you act on it
Therapeutic Encounter
short, brief encounter with the client but the relationship is helpful and important to the client
Therapeutic relationship ecounter:
encounter is longer and more formal; allows the development of nurse-client relationship
3 Phases of the nurse-client relationship
orientation, working and termination phase
planning for the firs meeting; work out common concerns such as fear of physicla harm or violence, saying ht wrong thing , using the client as guinea pig, feeling inadequate about new developing communication skills
Orientation phase
establish rapport; set boundaries/set parameters, informal/formal contract, discuss confidentiality and termination
Testing behavior that may occur during orientation phase or later phases:
test to see if nurse can set boundaries, show concern if client acts up, if nurse still comes even when client comes late, leaves early, refuses to speack
shifting focus to the nurse, asking the nurse to do something for them, sexual advances, arriving late
Working Phase:
maintain the relationship, gather further data, promote teh client's problem-solving skills, self-esteem and use of language, facilitate behavioral change, overcome resistant behaviors, evalate problems and goals and redefine them, promote practice and expression of adaptive behaviors
strong transferences and countertransference feelings may appear at what phase
working phase
Reason for termination phase
symptom relieve, improve social functioning, greater sense of identity, development of more adaptive behaviors, accomplishment of the client's goals, impass in the therapy that the nurse is unable to resolve
Arises unresolve feeling of abandonment or loneliness, or feelings of not being wanted
Termination phase
What should the nurse do to appease the client of separation anxiety?
work with the client to bring into awareness of feelings and rxn that client may experience related to separation
summarizing goals and objectives achieve is what part of the nurse-client relationship
termination phase
what are teh common response of beginign practitioners in terminating relationship
feelings of guilt
What hinders nurse-client relationship
inconsistency and unavailability, nurse's feeling and awareness (negative ideas/feelings towards the client)
What helps the nurse-client relationship
consistency, pacing, listening, initial impression, comfort & control and clients factor
Behaviors that have relevence to health care workers
accountability, focusing on the client, clinical competence, supervision
process the helps people understand and build their value systems, addressing some question in the process
Value clarification
most potent means of value education b/c it present a vivid example of values in action
validation of performance quality through regularly scheduled supervisory session
building client's trust include
genuineness, empathy, positive regard, consistency