Podcast
Questions and Answers
A patient consistently misunderstands medication instructions, leading to non-adherence. Which element of the communication process should the healthcare provider primarily focus on improving to ensure clarity?
A patient consistently misunderstands medication instructions, leading to non-adherence. Which element of the communication process should the healthcare provider primarily focus on improving to ensure clarity?
- The stimulus initiating the communication.
- The receiver's comprehension of the message.
- The medium used to transmit the message.
- The sender's encoding of the message. (correct)
A nurse aims to establish continuity in their therapeutic communication with a patient who has fluctuating emotional states. Which strategy would be LEAST effective in achieving this goal?
A nurse aims to establish continuity in their therapeutic communication with a patient who has fluctuating emotional states. Which strategy would be LEAST effective in achieving this goal?
- Setting predictable meeting schedules.
- Maintaining consistent non-verbal cues and body language.
- Regularly summarizing key discussion points and decisions.
- Adapting communication style to match each emotional shift. (correct)
A psychiatric nurse is working with a patient who hesitates to express their feelings openly. Which communication technique would be MOST effective in encouraging the patient to share?
A psychiatric nurse is working with a patient who hesitates to express their feelings openly. Which communication technique would be MOST effective in encouraging the patient to share?
- Using closed-ended questions to gather specific information.
- Sharing personal experiences to build rapport.
- Directly asking detailed questions about their feelings.
- Creating a non-judgmental environment and using open-ended questions. (correct)
In a therapeutic relationship, a patient frequently uses sarcasm, which makes it difficult for the nurse to understand the underlying emotions. What should the nurse do?
In a therapeutic relationship, a patient frequently uses sarcasm, which makes it difficult for the nurse to understand the underlying emotions. What should the nurse do?
A nurse is communicating with a patient who speaks a different language. While a translator is available, what INITIAL step should the nurse take to ensure effective communication?
A nurse is communicating with a patient who speaks a different language. While a translator is available, what INITIAL step should the nurse take to ensure effective communication?
During which phase of the nurse-patient relationship is a formal or informal contract established?
During which phase of the nurse-patient relationship is a formal or informal contract established?
A patient is in the working phase of a therapeutic relationship. Which nursing intervention is most appropriate during this phase?
A patient is in the working phase of a therapeutic relationship. Which nursing intervention is most appropriate during this phase?
Which activity is most characteristic of the termination phase of the nurse-patient relationship?
Which activity is most characteristic of the termination phase of the nurse-patient relationship?
Which factor, if absent, is most likely to hinder the development of a therapeutic nurse-patient relationship?
Which factor, if absent, is most likely to hinder the development of a therapeutic nurse-patient relationship?
A nurse consistently follows through on promises and appointments with a patient. Which element of the nurse-patient relationship is best demonstrated by this behavior?
A nurse consistently follows through on promises and appointments with a patient. Which element of the nurse-patient relationship is best demonstrated by this behavior?
What nursing statement to a patient readmitted to the hospital with bipolar disorder would most contribute to establishing trust?
What nursing statement to a patient readmitted to the hospital with bipolar disorder would most contribute to establishing trust?
During the working phase, a patient displays resistance behaviors. What should be the initial nursing intervention?
During the working phase, a patient displays resistance behaviors. What should be the initial nursing intervention?
Which of the following is an appropriate goal for the orientation phase of the nurse-patient relationship?
Which of the following is an appropriate goal for the orientation phase of the nurse-patient relationship?
A nurse is communicating with a patient who has a different cultural background. What is the most important consideration for the nurse to ensure effective communication?
A nurse is communicating with a patient who has a different cultural background. What is the most important consideration for the nurse to ensure effective communication?
Which of the following reflects the best use of assertive communication by a nurse when addressing a potential conflict with a colleague?
Which of the following reflects the best use of assertive communication by a nurse when addressing a potential conflict with a colleague?
A patient is reluctant to share personal information. Which therapeutic communication strategy would be most effective for the nurse to employ initially?
A patient is reluctant to share personal information. Which therapeutic communication strategy would be most effective for the nurse to employ initially?
How can a nurse best demonstrate positive regard towards a patient?
How can a nurse best demonstrate positive regard towards a patient?
In a conversation, a patient says, "I feel like nothing is going right, and it's all my fault." Which nursing response uses reflection?
In a conversation, a patient says, "I feel like nothing is going right, and it's all my fault." Which nursing response uses reflection?
A nurse notices inconsistencies between a patient's verbal and nonverbal communication. What should the nurse do?
A nurse notices inconsistencies between a patient's verbal and nonverbal communication. What should the nurse do?
A nurse is educating a newly diagnosed diabetic patient on self-care. Which communication approach would be least effective?
A nurse is educating a newly diagnosed diabetic patient on self-care. Which communication approach would be least effective?
Which action demonstrates a nurse's understanding of the difference between empathy and sympathy?
Which action demonstrates a nurse's understanding of the difference between empathy and sympathy?
Which nursing action best reflects the establishment of clear boundaries in a therapeutic relationship?
Which nursing action best reflects the establishment of clear boundaries in a therapeutic relationship?
A nurse notices they are feeling overly sympathetic and protective towards a patient reminiscent of a family member. What does this signify?
A nurse notices they are feeling overly sympathetic and protective towards a patient reminiscent of a family member. What does this signify?
What is the primary purpose of the nurse-patient relationship in psychiatric nursing?
What is the primary purpose of the nurse-patient relationship in psychiatric nursing?
Which action demonstrates a nurse utilizing their personality consciously and with awareness in a therapeutic relationship?
Which action demonstrates a nurse utilizing their personality consciously and with awareness in a therapeutic relationship?
A patient consistently expresses anger towards the nurse, which the nurse recognizes as unresolved feelings toward their parents. What is this an example of?
A patient consistently expresses anger towards the nurse, which the nurse recognizes as unresolved feelings toward their parents. What is this an example of?
Which scenario illustrates a blurring of boundaries in the nurse-patient relationship?
Which scenario illustrates a blurring of boundaries in the nurse-patient relationship?
What is the primary difference between a social relationship and a therapeutic relationship in nursing?
What is the primary difference between a social relationship and a therapeutic relationship in nursing?
Which nursing behaviour is NOT considered a necessary component of Peplau's model of the nurse-patient relationship?
Which nursing behaviour is NOT considered a necessary component of Peplau's model of the nurse-patient relationship?
A nurse is working with a patient who has a history of substance abuse and is currently in recovery. Which approach is most important for promoting the patient's self-care and independence?
A nurse is working with a patient who has a history of substance abuse and is currently in recovery. Which approach is most important for promoting the patient's self-care and independence?
Which action would be MOST effective in helping a patient examine self-defeating behaviours and test alternatives?
Which action would be MOST effective in helping a patient examine self-defeating behaviours and test alternatives?
Flashcards
Therapeutic Relationship
Therapeutic Relationship
A relationship that is fundamental and essential to effective psychiatric care, leading to positive patient outcomes.
Communication Process
Communication Process
An interactive process where people send and receive messages through various media.
Effective Communication
Effective Communication
Depends on nurses knowing what they want to say, accurately conveying it, and understanding the patient's intended and unintended messages.
Empathy
Empathy
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Therapeutic Communication
Therapeutic Communication
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Preorientation Phase
Preorientation Phase
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Orientation Phase
Orientation Phase
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Working Phase
Working Phase
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Termination Phase
Termination Phase
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Factors that enhance the nurse-patient relationship
Factors that enhance the nurse-patient relationship
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Factors hindering the therapeutic relationship
Factors hindering the therapeutic relationship
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Establishing Trust
Establishing Trust
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Therapeutic Listening
Therapeutic Listening
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Verbal Communication
Verbal Communication
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Nonverbal Communication
Nonverbal Communication
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Therapeutic Silence
Therapeutic Silence
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Active Listening
Active Listening
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Open-Ended Questions
Open-Ended Questions
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Clarifying Techniques
Clarifying Techniques
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Non-Therapeutic Communication
Non-Therapeutic Communication
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Assertive Communication
Assertive Communication
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Therapeutic Use of Self
Therapeutic Use of Self
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Goals of a Therapeutic Relationship
Goals of a Therapeutic Relationship
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Social Relationship
Social Relationship
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Necessary Nurse Behaviors
Necessary Nurse Behaviors
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Establishing Boundaries
Establishing Boundaries
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Transference
Transference
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Counter-transference
Counter-transference
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Values, Beliefs, and Self-Awareness
Values, Beliefs, and Self-Awareness
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Study Notes
- Mental Health and Crisis Management Theory covers therapeutic communication, therapeutic relationships, and group therapy.
Concepts of the Nurse-Patient Relationship
- The nurse-patient relationship is fundamental to psychiatric nursing treatment approaches.
- Establishing the nurse as safe, confidential, reliable, and consistent is important.
- Relationships should have clear boundaries.
Therapeutic Use of Self
- Therapeutic use of self involves using one's personality consciously and with full awareness.
- Attempting to establish relatedness with the patient is important.
- It is important to structure nursing interventions.
Goals and Functions
- Therapeutic relationships facilitate communication of distressing thoughts and feelings.
- They assist patients with problem-solving.
- Therapeutic relationships help patients examine self-defeating behaviors and test alternatives.
- Therapeutic relationships promote self-care and independence.
Social Relationships
- Social relationships are initiated for friendship, socialization, enjoyment, or task accomplishment.
- Mutual needs are met in social relationships.
- Communication involves giving advice or asking for help.
- The content of communication is superficial.
Therapeutic Relationships
- In therapeutic relationships, patient needs are identified and explored.
- Clear boundaries must be estalished.
- Problem-solving approaches are taken.
- New coping skills are developed.
- Behavioral change is encouraged.
Necessary Behaviors for Nurses
- Accountability is a necessary behavior.
- Focusing on the patient's needs is required.
- Clinical competence is necessary.
- Delaying judgment is an attribute of a therapeutic professional behaviour.
- Supervision is recommended.
Establishing Boundaries
- Boundaries rely on strategies from the following four areas: Treatment planning and delivery, space, comportment, and location of service delivery.
- For more, refer to CNO Practice Standard: Therapeutic Nurse-Client Relationships.
Blurring of Boundaries: Transference
- Transference happens when the patient unconsciously displaces feelings/behaviors related to significant figures in the patient's past onto the nurse.
- Transference can be intensified in relationships with authority figures.
Blurring of Boundaries: Counter-Transference
- Counter-transference happens when the nurse displaces feelings related to people in the nurse's past onto the patient.
- The patient's transference to a nurse often is reciprocated, resulting in counter-transference in the nurse.
- Over-identification with the patient may indicate counter-transference.
Values, Beliefs, and Self-Awareness
- Nurses' values and beliefs reflect their own culture/subculture.
- Values and beliefs are derived from a range of choices.
- Values and beliefs are chosen from a variety of influences and role models.
Peplau's Model of Nurse-Patient Relationship
- Necessary behaviors of all healthcare workers include nurses' accountability, focusing on patients' needs, clinical competence, delaying judgment, and reflection.
Peplau's Phases
- Peplau's Model of Nurse-Patient Relationship consists of an orientation phase, a working phase, and a termination phase.
- An additional pre orientation phase occurs during which the nurse prepares for the orientation phase.
Orientation Phase
- The orientation phase involves establishing rapport.
- The parameters of the relationship are outlined during the orientation phase.
- A formal or informal contract is created.
- Confidentiality is also explained.
- Terms of termination are set.
Working Phase
- It is important to maintain the therapeutic relationship.
- Gathering further data is also part of the working phase.
- Promoting problem-solving skills, self-esteem, and use of language are also important aspects of the working phase.
- The working phase involves facilitating behavioral change, overcoming resistance behaviors, and evaluating problems and goals.
- The evaluation of goals may require redefining goals if neccessary.
- Promoting practice and expression of alternative adaptive behaviors are also important aspects of the phase.
Termination Phase
- The termination phase involves summarizing goals and objectives achieved.
- Ways for patients to incorporate new coping strategies learned are discussed.
- Situations of the relationship are reviewed..
- Memories are exchanged.
Enhancing & Hindering Factors
- Factors that enhance the nurse-patient relationship include consistency, pacing, listening, initial impressions, promoting patient comfort, balancing control, and trust.
- Factors that do not progress therapeutic relationships are inconsistency and unavailability.
Therapeutic Communication Part 2
- Therapeutic relationships involves communication as a basic necessity to effective psychiatric care.
- Patients experience positive outcomes when engaged in therapeutic relationships.
- Therapeutic communication is central to forming and maintaining therapeutic relationships.
- These skills take time, with development of own style and rhythm.
- Empathy skills must be used.
Communication Process Defined
- Communication is an interactive process between two or more people who send and receive messages to one another.
- In communications there is a stimulus, a sender, a message, a variety of media, and a reciever.
Effective Communication in Therapeutic Relationships
- Effective communication depends on nurses knowing what they are trying to convey, communicating to patients what is meant, and comprehending the meaning a patient intentionally or unintentionally conveys.
- Peplau identifies two main principles to guide communication: clarity and continuity.
Communication Factors
- Personal, environmental, and relationship factors all affect communication.
Verbal Communication
- Verbal communication includes all words a person speaks.
- Communications is 10% verbal.
- It communicates beliefs and values, and perceptions and meaning.
- Communications can convey interest and understanding, insult and judgement, clear or conflicting messsages, and honest or distorted feelings.
Nonverbal Communication
- 90% of communication is nonverbal.
- Nonverbal communications includes tone of voice, emphasis on certain words, physical appearance, facial expressions, body posture, amount of eye contact, and hand gestures.
Interaction of Verbal and Nonverbal Communication
- Verbal and nonverbal communication provides interpretation of feelings and attitudes plus meaning based on body language and vocal tones.
- Nonverbal behaviours and cues influence communication.
- Messages are not always simple.
- Verbal messages are the content of the message, and nonverbal behaviour is method of communication for the message.
Communication Skills for Nurses
- Therapeutic communication strategies (e.g. silence) can be used.
- Active listening with empathy is important.
- Clarifying techniques include paraphrasing, restating, reflecting, and exploring.
- Asking questions and eliciting patient responses are important.
- Open-ended questions
- Close-ended questions
- Nontherapeutic Communication Techniques
- Excessive questioning
- Giving approval or disproval
- Giving advice
- Asking "why questions”
Cultural Considerations
- Cultural considerations are consequential for interpretation of verbal and nonverbal cues.
- These include communication style, use of eye contact, perception of touch and cultural filters.
- Cultural filters form of bias or prejudice;
Assertive Communication
- Assertive communications: are communications with respectful language and behaviours to challenge/ promote alternatives, de-escalate behaviours, provide and provoke new lines of thinking while acting as an advocate for oneself or others.
Promoters of Growth
- Factors That Promote Patient Growth include genuineness, empathy and positive regard by showing kindness, and appropriate attitudes and actions and helping patients develop resources.
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Description
Explore the fundamentals of nurse-patient relationships in mental health. Learn how to establish safety, confidentiality, and clear boundaries. Understand therapeutic communication and the importance of structured nursing interventions to promote self-care and independence.
