Mental Health Chapter 5 Vocab

Front 1

Acceptance

Back 1

Avoiding judgments of the person, no matter what the behavior.

Does not mean acceptance of inappropriate behavior but acceptance of the person as worthy.

Hint 1

Ie: client puts arm around the nurse. Appropriate response would be for the nurse to remove the client’s arm and say, do not place your arm on me. Now lets continue.

Front 2

Advocacy

Back 2

The process of acting on the client’s behalf when they cannot do so

Hint 2

Ie: doctor forgets to shut curtain before examining patient, the nurse closes curtain. This is acting as an advocate for the patient.

Front 3

Attitudes

Back 3

Are general feelings or frame of reference around which a person organizes knowledge about the world.

Hopeful, optimistic, pessimistic, positive and negative, color how we look at the world and people

Hint 3

Nurse needs to be self-aware what their beliefs and attitudes are and readjust periodically

Front 4

Beliefs

Back 4

Are ideas that one holds to be true

Front 5

Compassion fatigue

Back 5

A type of secondary traumatic stress or burnout that comes from working through traumatic experiences with clients; experienced by those in the helping professions

Front 6

Confidentiality

Back 6

Means respecting the client’s right to keep private any information about their mental and physical health and related care.

Only in precisely defined conditions can 3rd party have access to this information; Ie. Many states the law requires that staff report suspected child and elder abuse.

Hint 6

Tarasoff vs regents of the university of California 1976 decision releases professionals from privileged communication with their clients should a client make a homicidal threat. Intended victims and police are to be notified (duty to warn)

Front 7

Congruence

Back 7

Occurs when words and actions match

Builds trust with the client when you say what you mean and mean what you say. Trust erodes when client sees inconsistency between what the nurse says and does

Front 8

Duty to warn

Back 8

The exception to the client’s right to confidentiality; when health care providers are legally obligated to warn another person who is the target of the threats or plan by the client, even if the threats were discussed during therapy sessions otherwise protected by confidentiality.

Hint 8

Tarasoff vs. Regents of the University of California decision 1976. Releases professionals from privileged communication with their clients.

Front 9

Empathy

Back 9

Is the ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.

Considered one of the essential skills a nurse must develop to provide a high-quality, compassionate care.

Empathy has shown to positively influence client outcomes.

Hint 9

Communication techniques that show client empathy from the nurse, reflection, restatement and clarification

Front 10

Exploitation

Back 10

Phase of nurse-client relationship, identified by Peplau, when the nurse guides the client to examine feelings and responses and to develop better coping skills and a more positive self-image; this encourages behavior change and develops independence; part of the working phase.

It is important that the nurse lets the patient do the exploring and not be judgmental or give advice. Allow the client to analyze the situations.

Front 11

Genuine interest

Back 11

Truly paying attention to the client, caring about what they are saying; only possible when the nurse is comfortable with themselves and aware of their strengths and limitations.

A client with mental illness can detect when someone is exhibiting dishonest or artificial behavior, such as asking a question and then not waiting for the answer, talking over the client, or making assurances that everything will be alright.

Front 12

Intimate relationships

Back 12

A relationship involving two people who are emotionally committed to each other; both parties are concerned about having their individual needs met and helping each other to meet needs as well; the relationship may include sexual or emotional intimacy as well as sharing of mutual goals.

The intimate relationship has no place in the nurse-client interaction.

Front 13

Orientation phase

Back 13

Begins when the nurse and client meet and ends when the client begins to identify problems to examine.

During this phase, the nurse establishes roles, the purpose of meeting, and the parameters of subsequent meeting; identifies the client’s problems; and clarifies expectations.

This is also the phase where the nurse develops trust with the client.

Hint 13

This is the time the nurse introduces herself with name, reason for being on the unit, and level of schooling

Front 14

Patterns of knowing

Back 14

The four patterns of knowing in nursing are empirical knowing (derived from the science of nursing), personal knowing (derived from life experience), ethical knowing (derived from moral knowledge of nursing), and aesthetic knowing (derived from the art of nursing); these patterns provide the nurse with a clear method of observing and understanding every client interaction.

Barbara A. Carper 1978 identified these 4 patterns

Hint 14

Bubbie (Barbara) knows

Front 15

Positive regard

Back 15

Unconditional, nonjudgmental attitude that implies respect for the person.

Call the client by name, spending time with the client and listening and responding openly are measures by which the nurse conveys respect and positive regard to the client.

Front 16

Preconceptions

Back 16

Hildegard Peplau (1952) identified preconceptions, or ways one person expects another to behave or speak, as a roadblock to the formation of an authentic relationship.

Hint 16

Nursing is woman’s work and only want female nurse

Front 17

Problem identification

Back 17

Part of the working phase of the nurse-client situation, when the client identifies the issues or concerns causing problems.

Hint 17

Other sub phase is exploitation

Front 18

Self-disclosure

Back 18

Means revealing personal information such as biographical information and personal ideas, thoughts, and feelings about oneself to clients.

Self-disclosure may help the client feel more comfortable and more willing to share thoughts and feelings, or help the client gain insight into their situation.

Hint 18

When using self-disclosure the nurse must take into account cultural factors. Keep focus on client don’t let it shift to you.

Front 19

Social relationship

Back 19

Is primarily initiated for the purpose of friendship, socialization, companionship, or accomplishment of a task.

The relationship becomes more social than therapeutic, serious work that moves the client forward will not be done.

Front 20

Termination or resolution phase

Back 20

Final stage in the nurse-client relationship. It begins when the problems are resolved and ends when the relationship is ended.

Often clients try to avoid termination by acting angry or as if the problem has not been resolved.

Not appropriate for nurse to agree to see client outside of the therapeutic relationship.

Front 21

Therapeutic relationship

Back 21

Professional, planned relationship between client and the nurse that focuses on client needs, feelings, problems, and ideas.

The nurse and client agree about the areas to work on and evaluate the outcomes.

Front 22

Therapeutic use of self

Back 22

Nurses use themselves as a therapeutic tool to establish the therapeutic relationship with clients and to help clients grow, change no heal.

Hildegard Peplau described this therapeutic us of self in the nurse-client relationship

Hint 22

One tool that is helpful in learning more about oneself is the Johari window which creates a “word portrait” of a person in four areas and indicates how well that person knows themself and communicates with others.

4 areas are: 1. Open/public 2. Blind/unaware 3.Hidden/private 4.Unknown

Page 84 has good description of this tool

Front 23

Unknowing

Back 23

4th quadrant of the Johari window which is an empty quadrant to symbolize qualities as yet undiscovered by oneself or others

Front 24

Values

Back 24

Are abstract standards that give a person a sense of right and wrong and establish a code of conduct for living.

Sample value= hard work, honesty, sincerity, cleanliness and orderliness.

There are 3 steps to values clarification process, choosing, prizing, and acting.

Choosing, is when the person considers a range of possibilities and freely chooses the value that feels right

Prizing is when the person considers the value, cherishes it and publicly attaches it to themselves

Acting is when the person puts the value into action

Front 25

Working phase

Back 25

The therapeutic relationship, the phase where issues are addressed, problems identified, and solutions explored; both nurse and client work to accomplish goals; contains Hildegard Peplau’s phases of problem identification exploitation

Hint 25

Divided into 2 sub phases

Problem identification

Exploitation