Term
| Therapeutic Nurse-Client Relationship |
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Definition
- basis for all psych nsg tx approaches
- establishes an understanding that the relationship is: safe, confidential, reliable, has clear boundaries
- research validates therepeutic outcomes
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Term
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Definition
| Creative process unique to each nurse |
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Term
| Goals and Fx of Therapeutic Relationships |
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Definition
- facilitates pt communitcation of prob/feelings
- assists pt w/ problem solving
- helps pt examine self-defeating behaviors and test alt
- promotes pt self-care and independence
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Term
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Definition
- purpose is friendship
- mutual needs met
- enjoyment for both participants
- roles may shift
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Term
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Definition
- focus on pt problems and needs
- boundaries and roles remain firm and clear
- knowledge applied from evidence-based research
- nonjudgmental attitude of nurse toward pt
- supervision by experienced clinician essential
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Term
| Clear (therapeutic) boundaries |
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Definition
| client's needs and role are separated from those of the nurse |
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Term
| Unclear (non-therapeutic/ "boundary blurring") |
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Definition
- nurse tries to have own needs met
- nurse tries to solve pt's problems
- nurse takes on role of family or friend toward client
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Term
| Overhelping, Controlling, Narcissism |
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Definition
| What are the three warning signs that a nurse may be blurring boundaries |
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Term
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Definition
| Doing for pts what they are able to do for themselves |
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Term
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Definition
| asserting authority and assuming control for "pts own good" |
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Term
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Definition
| focus on pt's weaknesses rather than promoting strengths |
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Term
| Transference and countertransference |
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Definition
| what are two reasons boundary blurring often occurs? |
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Term
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Definition
| pt displaces emotional rx originating in childhood experiences onto helping person in the relationship- often intensified in relationships of authority |
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Term
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Definition
| nurse displaces feelings rl/t people in one's past onto pt |
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Term
- feeling strongly negative/positive toward pt
- overidentification w/ pt and pt problems
- power struggles, competition, or arguments w/ pt
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Definition
| what are some signs a nurse may be experiencing countertransference? |
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Term
| Orientation, Working, Termination |
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Definition
| What are Peplau's phases of the Nurse-Client relationship? |
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Term
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Definition
| In this stage, student may have concerns rl/t initial psychiatric clinical experience |
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Term
| crying, asking to keep secrets, gift giving, suicide threats |
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Definition
| What are some common behaviors by pts that cause concern for students? |
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Term
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Definition
- In this phase of the nurse-client relationship rapport is established
- parameters are established: clarify role, define nurse/pt responsibilities, define contract issues (setting/times, confidentiality, terms of termination)
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Term
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Definition
- Explore areas in pt's life that cause problems
- gather data, promote pt prob solving
- facilitate/practice behavioral changes
- evaluate/redefine problems
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Term
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Definition
| In this phase, expect pts to use defense mechanisms such as: acting out, withdrawal, intellectualization, manipulation, denial. |
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Term
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Definition
This occurs on pt discharge or end of student clinical rotation
- tasks include: summarizing goals/objectives, discuss ways to incorporate new coping strategies, review situations during relationship, exchange memories
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Term
| Reawakening unresolved feelings of loss, abandonment, loneliness, and rejection |
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Definition
| Upon termination, the pt may have difficulties including. . . |
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Term
| Guilt about leaving pt and unresolved feelings of loss |
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Definition
| Upon termination, the nurse may have difficulties including. . . |
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Term
| Encourage discussion of feelings and share own feelings about termination |
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Definition
| What are some things the nurse should do to handle termination difficulties? |
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Term
| Consistency, Pacing, Listening, Positive initial impression, Promoting pt comfort/balancing control |
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Definition
| What are some factors that enhance the Nurse-Patient relationship? |
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Term
| Inconsistency, Unavailability, Lack of self-awareness on nurse's behalf |
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Definition
| Factors that hinder the Nurse-Patient relationship |
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Term
| Genuineness, Empathy, Positive regard |
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Definition
| What are three factors that enhance growth in the psych pt? |
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Term
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Definition
| This is key in building trust and includes self-awareness of feelings and ability to communicate |
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Term
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Definition
| This means to understand the feelings of others. |
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Term
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Definition
| This means to feel others' feelings. The nurse loses objectivity. |
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Term
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Definition
| This includes attending behaviors and suspending value judgment |
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Term
- pt set pace
- use a setting conductive to feeling of security
- use open ended communication
- offer leads
- attending behaviors
- appropriate clinical supervision
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Definition
| What are the responsibilities of the nurse during the clinical interview? |
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Term
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Definition
| Examples of this include: eye contact, body language, vocal quality, and verbal tracking. |
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Term
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Definition
| "It's not what you say, but how you say it". Can be used to show empathy and establish rapport. |
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Term
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Definition
| Tracking what the pt is saying and giving neutral feedback in the form of restating or summarizing what the pt has already said. |
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Term
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Definition
| Culturally and individually appropriate care, eye contact, body language, vocal qualities, and verbal tracking are all important parts. |
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Term
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Definition
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Term
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Definition
| This zone is reserved for those we trust most and with whom we feel most safe. |
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Term
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Definition
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Term
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Definition
| Reserved for those such as friends or colleagues. |
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Definition
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Term
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Definition
| This is applied to strangers or acquaintances, often in public places or formal social gatherings. |
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Definition
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Term
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Definition
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Term
| Speak briefly, when in doubt: say nothing and focus on feelings, keep focus on pt, pay attention to nonverbal communication, avoid relying on Qs, avoid advice, and don't argue |
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Definition
| Helpful tips to remember during the clinical interview. |
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Term
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Definition
| True or False. It's important for a nurse to set his or her feelings aside when interacting with pts. Use a nonjudgmental attitude and be sensitive. |
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