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Therapeutic Relationships.docx

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Humber College
NRS 103
Lisa Giallonardo

Therapeutic Relationships (Week 1) Definition of a TR: The relationship between nurse and client, where the client is the one receiving the benefits and help. Arnold&Boggs: A professional, interpersonal alliance in which the nurse and client join together for a defined period to achieve health-related treatment goals (pg 83) 4 phases of a TR: 1. Pre interaction phase 2. Beginning phase/orientation 3. Middle or working phase 4. Ending or resolution phase 1. Gathering information about the client, before meeting him/her. Assessing ones feelings about working with the patient, setting goals for all phases. Preparation. 2. Getting acquainted with the client, building a relationship of trust. Initial assessment of client's needs. 3. Work on meeting goals set in pre-interaction phase. Helping the patient to identify problems and find solutions. Information. 4. Termination of relationship between nurse and client. Reevaluating achievement of goals. Taking into account the loss, and celebrating goals met. Phase Description Activities Skills Pre- Creating the psychological and physical Interview planning, Planning,self- interaction environment in preparation to meet client preparing the setting awareness Orientation Clarifying the purpose of the relationship, Negotiating relationship, Active listening, assessing client needs, participant exploration for attending, open- observation, communication strategies, understanding ended question, defining goals verbal cues, Working Defining the problem, pacing, developing Goal setting, action Attending, listening, realistic goals, implementing the plan, planning, helping teaching, giving challenging resistant behaviours change behaviour, information feelings or perceptions Termination The nurse's interventions and behavioural Ending the relationship, Giving information, responses occurring at the closure of a referring to other supporting therapeutic relationship resources Role of the Nurse: Who the nurse is in relation to the client Therapeutic Use of Self: • Healing presence • Authenticity (necessary for trust, but not personal) • Self-awareness (actions, words are professional) Therapeutic vs. Social Relationships Social: Information and interaction is unlimited, more emotionally invested in other person. Can offer advice, give friendship, meet mutual needs. Therapeutic: Information and interaction is limited, nurse is meeting needs of client. Cannot offer advice. Intentional benefit is one-sided. Less emotionally invested. Successful TR • Background knowledge • Knowledge of interpersonal and development theory • Knowledge of diversity influences and determinants • Knowledge of person • Knowledge of health/illness • Knowledge of the broad influences on health care and policy • Knowledge of systems • Self-awareness • Self-knowledge • Empathy • Awareness of boundaries and limits of professional role • Active listening • Confidentiality • Authenticity • I-Thou relationship: respect, mutuality, reciprocity What is this person's human experience of living with this illness or injury? How can I as a health care professional help you at this point in time? Barriers: • Lack of respect, care, information, trust, empathy • Anxiety • Stereotyping (generalizing/categorizing) and bias (favouritism) • Violating personal space {3 spaces} • Over involvement • Failure to provide support • Mistrust • Failure to provide appropriate resources (information) • Violating confidentiality (no over-the-phone info) • Physical environment: other people, distractions Partnering: The client works in a partnership with the nurse to create the most beneficial methods. Professional Boundaries: Invisible structures imposed by lega
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