Nursing Foundations - Unit 1 (Nurse-Client Relationship)
What type of professional relationship should nurse/clients have? a therapeutic relationship that remains within the "zone of helpfulness" neither under, nor over-involved
What are the goals of communication within the therapeutic relationship? to be purposeful and directed toward the clients' mutually established goals
What constitutes a professional relationship boundary crossing (drift)? Actions that appear inappropriate but do not actually violate ethical standards (context is important). Should be avoided.
What constitutes a professional relationship boundary violation? Ethically wrong actions that take advantage of the patient and are harmful to the therapeutic goals. Examples: sexual encounters, special favors, expensive gifts, a personal or business relationship.
What are some of the warning signs of the professional boundaries are being crossed? Excessive self-disclosure, secretive behavior, special treatment, flirtation, over-protectiveness
How can a nurse avoid crossing professional boundaries? With self-reflection, knowledge of self, and watching for warning signs
What are the phases of the nurse/client relationship? Pre-interaction, Introductory period, Working, Termination
Pre-interaction phase nurse familiarizes self with clients history or case (chart information), client is not involved in this phase
Introductory period (Orientation) Nurse/Client clarify expectations and health goals for client, establish time-frame for relationship (may be short)
Working phase Nurse/Client work towards established goals, effective communication (active listening, client feedback) is essential. Major portion of nurse/client interaction.
Termination phase Formal end of therapeutic relationship. Nurse may summarize goals/topic, asks if client has any questions
What elements are associated with a caring encounter? genuineness, respect, warmth, trust, mutuality
How do trust and empathy work together to strengthen the nurse/client relationship? empathy is the ability to perceive and convey how the client is feeling, a client cannot be open to this if they do not trust the nurse
What are attending behaviors? attentive, open posture, an appropriate non-verbal response to a persons verbal and nonverbal cues, eye-contact, allowing the other person to express themselves
How can the listening response of reflections improve patient care? it gives the patient permission to feel as they do and gives them validation. This can allow them to clarify/understand these emotions and how they relate to the pursuit of treatment options.
When is self-disclosure appropriate? only when the purpose is to help meet the clients' need (should not be used often)
How is self-awareness utilized in the nurse/client relationship? by understanding one's own values, beliefs, biases, a nurse may be able to correct her behavior towards a frustrating situation or client
How does a nurse display presence to a client? through active listening, caring communication techniques,and working with the client to share skills/knowledge
How can mutuality help to maximize patients' involvement in the client/nurse relationship? By developing a mutual respect for each others values and autonomy they may work to clearly identify and work to meet the clients' goals
What is meant by Therapeutic Use of Self? The understanding that one of the tools nurses can use to improve patients health is themselves. By recognizing one's own strengths in relating to clients, they may be fully engaged in the process health-care
What is active listening? the use of minimal cues, silence, touch, or different types of open-ended responses to help clarify, restate, paraphrase, reflect, or summarize the patients statements and encourage communication.
How can you communicate care to the client? by Connecting with them, by Appreciating their situation, by Responding to their needs, by Empowering them in goal achievement
What is Knowing the client? recognizing what makes them unique and by engaging with the client
How is Nursing presence part of a caring event? by being mentally and physically present the nurse can communicate the elements of a caring encounter (genuineness, respect, empathy, warmth, trust)
Why is it important to empower the client? it helps the client to move through an unfamiliar situation and to discover ways in which they may engage in self-care, occurs when a nurse is "advocates for" and "are advocates" for the client
What is the role of compassion in a caring event? it demonstrates a willingness to share in the patient's experience and to provide comfort (both physical and emotional)
What can help to demonstrate a nurse's competence? the ability to asses, plan, implement and evaluate a client focused plan of care with efficiency using appropriate skills (cognitive, technical, administrative)
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