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Therapeutic Nurse-Patient Relationship, Promote adaptive behavior and…
Therapeutic Nurse-Patient Relationship
Introduction
A therapeutic relationship is a professional, helping relationship based on trust, where the nurse and client work together to achieve health goals.
Goals of the Relationship
Help the patient express problems verbally.
Improve the patient’s ability to relate to others.
Reduce tension and provide support.
Difference Between Social and Professional Relationships
Aspect
Purpose
Skills
Need Focus
Personal Share
Duration
Professional
Help the patient; goal-directed
Requires scientific knowledge and skills
Meets patient’s needs
Nurse’s personal matters not included
Time-limited
Social
Pleasure, companionship; spontaneous
No formal helping responsibility
Mutual need satisfaction
Personal sharing is common
Unlimited
Characteristics of a Therapeutic Relationship
Trust: Reliability, honesty, consistency, confidentiality.
Genuine Interest: Honest, caring engagement.
Empathy: Understanding the client’s feelings without losing objectivity.
Acceptance: Non-judgmental attitude.
Self-Awareness: Nurse uses self as a therapeutic tool.
Phases of the Relationship
A. Initiating (Orientation) Phase
Characteristics: Anxiety, dependency, lack of trust.
Aims: Build rapport, assess problems, set goals, establish trust.
Key Elements:
Orientation: Introduce roles, environment, routines.
Mutual Expectations: Both nurse and client have goals.
Testing Behavior: Client tests nurse’s trustworthiness.
Contract: Agreement on goals, meeting times, roles.
B. Working (Continuing) Phase
Aim: Bring about positive behavioral changes.
Activities:
Encourage verbalization.
Address problems directly.
Develop insight and coping strategies.
Provide emotional support.
Challenges:
Resistance: Client avoids change (e.g., missing appointments, hostility).
Transference: Client projects past feelings onto the nurse.
Countertransference: Nurse’s emotional response to the client.
C. Termination Phase
Begins early with clear end dates.
Readiness Signs:
Symptom relief, improved functioning, goal achievement.
Behaviors:
Withdrawal, hostility, regression due to separation anxiety.
Nurse’s Role:
Review progress, encourage independence, discuss future plans, arrange follow-up.
Promote adaptive behavior and community reintegration.
Positive Regard: Unconditional respect.