Psych Exam 1 Therapeutic Relationships and Communication

therapeutic use of self

using the unique personality traits and talents that we have to creatively form positive bonds with others - promotes the healing in others

goals/functions of the nurse-patient relationship

• facilitating communication of distressing thoughts and feelings

• assisting with problem-solving to help facilitate activities of daily living

• examining self-defeating thoughts and behaviors and testing alternatives

• promoting self-care and independence

• providing education about disorders, medications, and symptom management

Personal/social relationships

primarily initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task - mutual needs are met during social interactions

therapeutic relationships

the nurse maximizes communication skills, understanding of human behaviors, and personal strengths to enhance the patient’s growth

5 tasks included in the nurse’s role in a therapeutic relationship

• identify the needs of the patient and explore them

• establish clear boundaries

• encourage alternate problem=solving approaches

• help the patient develop new coping skills

• support behavioral change

relationship boundaries

the expected and accepted legal, ethical, and professional standards that separate the nurse from patients

boundary crossing

give the impression of ‘something isn’t quite right’ but do not actually violate ethical standards

examples of boundary crossing

when the relationship slips into a personal context; when the nurse’s needs are met at the expense of the patient’s needs

boundary violations

taking advantage of the patient’s vulnerability and are ethically wrong - they are harmful or potentially harmful to the patient - characterized by a reversal of roles where the ends of the nurse are being met rather than the needs of the patient

professional sexual misconduct

most extreme; may be physical or verbal and may include expressions of feelings and thoughts or gestures that are sexual or could be reasonably interpreted by the patient as sexual - it results in high levels of malpractice actions, loss of professional licensure, and damaged reputations

Transference

occurs when the patient unconsciously and inappropriately displaces the nurse feelings and behaviors related to significant figures in the patient’s past

Preorientation Phase

preparing for your assignment, recognizing your own tthoughts and feelings regarding this first meeting

orientation phase

first time the nurse and the patient meet and it is the phase in which the nurse conducts the initial interview - the patient may begin to express thoughts and feelings, identity problems, and discuss realistic goals

Working Phase

a strong working relationship allows the patient to safely experience increased elvels of anxiety and recognize dysfunctional responses

termination phase

final and integral phase of the nurse-patient relationship - when the patient is discharged or when the student’s clinical rotation ends

Three personal characteristics of nurses that promote patient growth

genuineness, empathy, positive regard

genuiness

the nurse’s ability to be open, honest, and authentic in interactions with patients

Empathy

the helping person attempts to understand the world from the patient’s persepctive

positive regard

respecting a person and viewing another person as being worthy of caring about and as someone who has strengths and achievement potential

Three factors that affect the communication process

personal, environmental, relationship

personal factors of communication

can impede accurate transmission or interpretation of messages

environmental factors of communication

background noise, lack of privacy, uncomfortable accomodations

relationship factors of communication

the level of equality within the relationship

why is nonverbal communication important

it can be the defining message of the conversation