Psych -Lec2-Ch 5.8.9-Canvas-1 (1).pptx (1)
Prof. Jerry Cervantes, MSN, RN
Focus on Culture, Therapeutic Professional Communication & Relationships
Chapters 5, 8, and 9 overview.
The Importance of Attitude
Quote by Charles Swindoll:
Emphasizes the significance of attitude over facts and circumstances.
Highlights the power of personal choice in determining attitude daily.
Life is portrayed as 10% events and 90% reaction to those events.
Encourages self-reflection on personal attitude decisions.
Learning Objectives
Describe the communication process.
Analyze boundaries and the effects of transference and counter-transference on therapy.
Discuss divergent values and cultural beliefs impacting therapeutic relationships.
Explain phases of the nurse-patient relationship.
Identify patient behaviors in clinical settings.
Compare verbal and nonverbal communication.
Examine communication differences across cultures, emphasizing style, eye contact, and touch.
Address issues arising from cultural insensitivity in communication.
Explore benefits and concerns related to Information Communication Technologies (ICT).
Concepts of the Nurse-Patient Relationship
Communication is the basis of psychiatric nursing treatment approaches.
Establishing characteristics of a therapeutic nurse-patient relationship:
Safe
Confidential
Reliable
Consistent
Clear boundaries
Therapeutic Use of Self
Utilize personality consciously and purposefully.
Focus on establishing relatedness with patients.
Structure nursing interventions based on the patient’s needs.
Goals and Functions of Therapeutic Relationships
Facilitate communication of distressing thoughts and feelings.
Assist patients in problem-solving.
Help patients examine self-defeating behaviors and consider alternatives.
Promote self-care and independence.
Social vs. Therapeutic Relationships
Social Relationships:
Initiated for friendship and socialization.
Focus on mutual needs with superficial communication content.
Therapeutic Relationships:
Identifies patient needs.
Establishes clear boundaries.
Utilizes problem-solving approaches.
Develops new coping skills and encourages behavioral change.
Necessary Behaviors for Nurses
Accountability: Focus on patient needs.
Clinical competence and delaying judgment.
Establishing physical boundaries and personal space contracts.
Boundary Issues
Blurring of Boundaries: Occurs when:
Relationships slip into social context.
Nurse’s needs supersede patient’s needs.
Roles and Transference
Transference:
Patient displaces feelings related to significant figures in their past onto the nurse, often heightened in authoritative relationships.
Countertransference:
Nurse displaces feelings from their past onto the patient, leading to over-identification and potential boundary issues.
Values, Beliefs, and Self-Awareness
Nurses' values and beliefs derive from an array of cultural influences and role models.
Peplau’s Model of Nurse-Patient Relationship Phases
Pre-Orientation Phase
Orientation Phase
Working Phase
Termination Phase
Detailed Phases
Orientation Phase
Build rapport and define relationship parameters.
Establish confidentiality and terms of termination.
Working Phase
Maintain relationships, continue collecting data, and promote patient’s problem-solving skills and self-esteem.
Termination Phase
Starts from the initial visit and discusses incorporating new coping strategies, summarizes goals achieved, and exchanges memories.
Factors Enhancing Nurse-Patient Relationships
Consistency: Necessary for building trust.
Pacing: Understanding patient comfort.
Listening skills: It's critical for establishing rapport.
Factors Promoting Patient Growth
Genuineness and Empathy: Essential for positive regard without judgment.
Aiding patients in developing resources to foster independence.
Therapeutic and Nontherapeutic Communication
Verbal Communication
Comprises all spoken words conveying beliefs, values, and perceptions.
Can express interest, understanding, or conflicting messages.
Nonverbal Communication
Includes tone, emphasis, physical appearance, facial expressions, body language, and gestures.
Interaction Between Verbal and Nonverbal Communication
Nonverbal messages often convey deeper meanings than spoken words, leading to potential double-bind messages where content and process conflict.
Therapeutic Communication Techniques
Tools include:
Using silence and active listening.
Clarifying techniques: paraphrasing, restating, reflecting, exploring.
Projective questions like the “Miracle” question.
Asking Questions and Eliciting Patient Responses
Differentiate between open-ended and closed-ended questions; leveraging the power of effective inquiry.
Cultural Considerations in Communication
Key factors include communication style, eye contact, touch, and cultural biases.
Cultural Implications for Psychiatric Mental Health Nursing
Importance of culturally relevant care and understanding cultural barriers impacting mental health service efficacy.
Definitions and Concepts Related to Culture
Ethnocentrism: Belief in the superiority of one's own culture.
Enculturation: Process of integrating cultural traits.
Minority Status: Individuals identifying as part of differentiated groups based on shared characteristics.
America's Indigenous Culture and Mental Health
Emphasis on harmony with the environment and community in understanding disease.
Impact of Culture on Mental Health
Cultural barriers including stigma, misdiagnosis, and differing interpretations of distress.
Cultural Competence Framework
Cultural Awareness: Self-exploration of beliefs.
Cultural Knowledge: Learning about diverse cultures enhances nursing practice.
Cultural Encounters: Promotes individualized care and diminishes stereotypes.
Cultural Skill: Conducting sensitive cultural assessments.
Cultural Desire: Commitment to understanding and valuing patient perspectives.
Case Studies and Application Questions
Examines how cultural attitudes affect patient behavior and therapeutic relationships, including ethical dilemmas in care delivery.