therapeutic relationship nur305

8/2/2019 Therapeutic Relationship Nur305

1/16

The Therapeutic Nurse-

Patient Relationship


2/16

In a therapeutic relationship

There are specific goals

The patients needs are the focus

(relationship is client centered) The nurse makes use of specific

communication and relationship skills


3/16

In a social relationship

There are not necessarily specific goalsbeyond friendship and socializing

The needs of both parties are the foci

The information exchanged may remainsuperficial

The skills used are the general socialization

and communications skills everyone in theculture uses


4/16

In an intimate relationship

Mutual needs are met

Each party usually cares about meeting theneeds of the other

The parties have an emotional commitmentto each other

Mutual fantasies and desires may be

satisfied Information shared may be personal and

intimate


5/16

Phases of a TherapeuticRelationship

Preorientation or preinteraction phase

Orientation phase Working phase

Termination phase


6/16

Preinteraction Stage

Self-exploration

Create the setting comfortable, safe

Prepare for the interaction/relationshipreview patients history, diagnosis, review

nursing theory

Anticipate obstacles, difficulties Consider the timing of nurse/patient

interactions


7/16

Orientation or Introductory Stage

Introductions

Discuss nurses role

Gives patient information about thepurpose, possible goals, and the time frameof the relationship

Include the patient as a partner in therelationship


8/16

Assess the patients problems and needs

Plan goals and outcomes with the patient

Develop trust and rapport with the patient

Demonstrate caring

Demonstrate that you see the patient as an

individual


9/16

Working Stage

Implement the plan of care

Evaluate intermediate outcomes

Re-plan if necessary; think of alternativesolutions

Implement alternative solutions

Refer patient, if necessary


10/16

Termination Stage

Begins during the first interaction with thepatient

Occurs when goals have been reached orreferral is advisable

Nurse and patient examine meaning and

value of the relationship Feelings are discussed


11/16

Termination Stage cont.

Plans for follow-up are made, if necessary

Anticipatory guidance and/or teachingshould be done or repeated

Evaluation of outcomes

Summarization of the relationship and thegoals achieved

Give this stage adequate time but do notdwell on it


12/16

Boundaries

Psychological, communication

Be aware of the nurses role

Limit self-disclosure

Be aware of over involvement

Confront/correct sexual innuendos or actions


13/16

Boundaries cont.

Physical

Allow the patient his/her personal space

Use touch cautiously

Be aware of patients cultural pattern


14/16

Transference

Transferencea person unconsciouslyand inappropriately displaces ontoindividuals in his or her current life thosepatterns of behavior and emotional reactionsthat originated with significant figures nchildhood.(Varcarolis, 1998)


15/16

Countertransference

Countertransferencethe tendency ofthe therapist to displace onto the clientfeelings caused by people in the therapists

past.(Varcarolis,1998)


16/16

Countertransference cont.

Dealt with best by self-examination and bysupervision by a more experiencedprofessional or by a peer.

therapeutic relationship nur305

Documents