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The Helping/Therapeutic Relationship (Ways of Knowing (Personal Knowledge …
The Helping/Therapeutic Relationship
Phases of the Therapeutic Relationship
Phase 2 - Orientation Phase:
The phase in which the purpose, roles and rules of the process of the relationship are defined.
Phase 3 - Working Phase:
The problem-solving phase that parallels the prior planning with implementation of phases of the nursing process.
Phase 1 - Preinteraction:
The phase in which the nurse develops an appropriate physical and interpersonal environment for an optimal relationship.
Phase 4 - Termination Phase:
The phase in which the nurse is discharged from the client. Goals and achievements must be discussed, along with the clients’ feelings and future goals.
Concepts of Caring
Swanson (5 Categories of Caring)
"Doing For"
Assisting the client with actions he/ she can’t do themselves
Enabling
Facilitating the other person’s passage through life transitions
"Being With"
Being emotionally present for the client
"Maintaining Belief"
Sustaining faith in the client’s capacity to face life events
Knowing
Understanding the client’s life event
Roach (Concepts of Caring)
Competence
Having the skills, knowledge, energy and motivation required to respond to the demands of one’s responsibilities
Confidence
The quality that fosters trusting relationships and builds mutual respect
Compassion
Feeling sensitivity to the pain of others
Conscience
A state of moral awareness
Commitment
Deliberately acting in accordance with the convergence between one’s desires and one’s obligations
Watson (9 Carative Processes)
Humanistic-altruistic values
Instilling or enabling faith and help
Cultivating sensitivity to oneself and others
Developing a helping-trusting, human caring relationship
Promoting and accepting expression of positive and negative feelings
Systematic use of scientific problem-solving process
Providing for a supportive, protective, or corrective
mental, social, spiritual environment
Assisting with gratification of human needs
Allowing for existential-phenomenological dimensions
Ways of Knowing
Personal Knowledge
Knowledge derived from the depth and power of the interpersonal relationship with the patient.
Ethics
(The Moral Component): Knowledge that emerges from ethical dilemmas.
Esthetics
(The Art of Nursing); Creativity, with an artistic or expressive component. Explores intangible, deeper meanings & connections.
Emancipatory Knowledge
Knowledge that allows change to occur and represents the ability to recognize social and political problems of injustice or inequity.
*Added by Chinn and Kramer in 2008
Empirics
(The Science of Nursing); Knowledge that is systematically organized into general laws and theories.
Bridges/Barriers
Bridges
Empathy
The ability to perceive accurately another person’s feelings and to convey meaning to the client
Mutuality
Shared agreement by the client and nurse regarding the client’s health problems and the means for resolving them
Trust and Veracity
Building emotional reliance on the consistency and continuity of experience
Confidentiality
Protecting the client’s sensitive and private information at all costs
Caring and Respect
Commitment that involves respect and concern for the unique humanity of every client
Ethical Behaviour
Acting based on moral awareness of right and wrong
Barriers
Stereotyping
Attributing characteristics to a group of people as though all persons in the identified group possessed them
Space Violation
Overstepping a client’s boundaries by invading his/ her personal space
Anxiety
Having a vague, persistent feeling of impending doom on an unreasonable level.
Confidentiality Violation
Disclosing of any sensitive and private information about the client without the client’s consent or knowledge