The Therapeutic Nurse-Client Relationship

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The Therapeutic Nurse-Client Relationship Use of Therapeutic Communication

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Self Awareness & Nurse - Client Relationship Quad I Open to self/open – What you think about self And what others additionally think about you Quad 2 Blind – the uninformed self Qualities others think about you –but you are unconscious of. Quad 3 The concealed/private self Qualities just you know Quad 4 Unknown self EMPTY quad – the unfamiliar self-Qualities not known without anyone else/others

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Components of the Nurse-Client Relationship Trust Genuine intrigue Empathy Acceptance Positive Regard Therapeutic Use of Self

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Types of connections

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Phases of the Nurse-Client Relationship: Pre-Orientation-Self appraisal examine possess sentiments, fears, tensions. Introduction – Introductory Phase set up trust, impart data to client; discrete self-exposure. pass on support, encourage recuperating educate

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Phases of Therapeutic Nurse-Client Relationship—cont'd. The Working Phase – Problems distinguished Exploration-direct customer to analyze feelings/reactions, grow new adapting skills Termination Phase – Resolution stage Examine objectives accomplished; Explore sentiments with respect to end Establish get ready for proceeding with help

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Obstacles to the Therapeutic Relationship: Inappropriate Boundaries Encouraging reliance Non acknowledgment/Avoidance Resistance

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Roles of the Nurse: Teacher Caregiver Advocate Parent-Surrogate

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Therapeutic Communication Boundaries: Intimate Personal Social Public

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Non Verbal Communication Eye Contact Body Language Boundaries Facial Expressions Silence Vocal signals

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Non Verbal Communication Space ( safe place) Touch ( activity/individual space – utilized mindfully) Appearance – conveys a specific picture/one's mental status ( utilization of dress, make-up and so on.) Be mindful of claim non-verbal prompts!!

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Traits of Therapeutic Communication Genuineness Positive Regard Empathy Trustworthiness Clarity Responsibility Assertiveness

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Active Listening!! S – Sit confronting the customer O – Open Posture L – Lean forward towards customer E – Establish eye contact R-Relax!!

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Conditions Affecting Communication Values Attitudes Beliefs Perceptions Culture or Religion Social Status Gender Age or formative level Environment

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Enhancing Communication Silence Support/consolation Sharing Observations Acknowledge sentiments Broad – open finished proclamations Information giving Interpretation

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Enhancing Communication Restating Reflecting Clarification Confrontation Offering Alternatives Voicing question Role-playing Use of Humor – utilize carefully/discretely

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Non-restorative reactions Advising Agreeing Belittling emotions Challenging Defending Disagreeing Disapproving Probing

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Caring for customers from various socio-social foundations Important !! – Analyze self! – know your own convictions/values/traditions/practices Avoid being judgmental Rules for correspondence fluctuate since they emerge from social standards! Comprehend contrasts in correspondence among different societies Ask families for help re: their way of life Reflect on your feelings/diary compose emotions

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Therapeutic correspondence ?'s 1. The medical caretaker is meeting another customer on the unit.Which activity, by the attendant, is best in starting the attendant customer relationship? Present self and clarify the reason and the arrangement for the relationship. Portray the medical caretaker's family and request that the customer depict his/her family. Hold up until the customer demonstrates a status to set up a relationship. Ask the customer for what valid reason he/she was conveyed to the clinic.

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2. Mrs. F. has stayed near the medical attendant throughout the day. At the point when the attendant conversed with different customers amid supper, Mrs. F. attempted to recover the attendant's consideration and started to yell, "You're much the same as my mom. You pay consideration on everybody except me!" The best understanding of this conduct is that Mrs. F. is displaying resistance. Mrs. F. has been ruined by her family. The attendant has neglected to meet Mrs. F's needs. Mrs. F. is exhibiting transference.

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3. The medical caretaker is watching over a Native American customer who says, "I don't need you to touch me.I'll deal with myself." Which nursing reaction is generally remedial? "Affirm, if that is the thing that you want.I'll simply leave this container for you to gather your pee." "In the event that you don't need our care, why did you come here?" "Why are you being so troublesome? I just need to help you." "It seems as if you need to deal with yourself. How about we cooperate so you can get things done for yourself."

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4. The customer says to the medical attendant "I am going to pass on, I wish my family would quit seeking after a cure! I get so furious when they bear on like this! All things considered, I'm the person who's diminishing." The most remedial reaction is: "You're feeling furious that your family keeps on seeking after you to be cured." "I think we ought to speak more about your outrage with your family." "Well, it sounds like you're being skeptical. All things considered, years prior individuals kicked the bucket of pneumonia." "Have you imparted your sentiments to your family?"

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5. The medical attendant utilized in an emotional well-being center is welcomed by a neighbor in a nearby supermarket. The neighbor says to the medical caretaker, "How is Carol getting along? She is my closest companion and is seen at your center each week." The most fitting nursing reaction is which of the accompanying? "Shouldn't talk about this, but rather in light of the fact that you are my neighbor, I can let you know that she is doing incredible!" shouldn't examine this, but rather on the grounds that you are my neighbor, I can let you know that she truly has a few issues!" "In the event that you need to think about Carol, you have to ask her yourself." "I can't examine any customer circumstance with you."

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6. The medical attendant is setting up the customer for the end period of the medical caretaker customer relationship. The medical attendant gets ready to actualize which nursing undertaking is most fitting for this stage? Distinguishing expected results Planning transient objectives Making fitting referrals Developing reasonable arrangements

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7. Amid the end period of the medical caretaker customer relationship, the facility nurture watches that the customer consistently exhibits blasts of outrage. The most proper understanding of the conduct is that the customer Requires assist treatment and is not prepared to be released. Is showing run of the mill practices that can happen amid end. Should be admitted to the doctor's facility. Should be alluded to the therapist at the earliest opportunity.

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8. A customer takes a gander at a reflect and shouts out, "I resemble a winged animal. This is not my face." The medical attendant reacts restoratively by saying: "What sort of a winged animal do you think you are?" "That must be extremely troubling to you, your face does not look changed to me." "Perhaps the light is playing traps on you." "Why do you surmise that you resemble a flying creature?"

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9. A 32 year old mother of 2 youthful kids determined to have cervical disease with metastacies, advises her attendant "I'm going to pass on, aren't I ?" The medical attendant's most fitting reaction would be: "No, you are not . After all you are getting the most recent treatment accessible, and your specialist is one of the best around there." "We are all going to pass on at some point." "What did your specialist let you know?" "I don't have the foggiest idea. You have a genuine ailment. Do you have emotions that you might want to discuss?"

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A customer relates furiously to the medical attendant that his better half says he is egotistical. Which reaction by the medical attendant would be generally useful? "That is only her feeling." "I don't believe that you are childish." "Everybody is a smidgen narrow minded." "You sound furious – inform me all the more concerning what went on."

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11. The most helpful reaction a medical attendant could make to an understudy who starts to cry after discovering that a fizzling evaluation was gotten on a last, most decisive test is: "You'll make it next time." "Coming up short an exam is a disquieting thing to happen." "How close were you to passing?" "It won't appear to be so essential quite a while from now."