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Questions and Answers
What is the best analysis of the scenario where a nurse invites a patient, diagnosed with a mental illness, to the annual staff picnic?
What is the best analysis of the scenario where a nurse invites a patient, diagnosed with a mental illness, to the annual staff picnic?
- The nurse's action assists the patient's integration into community living.
- The invitation facilitates dependency on the nurse.
- The invitation is therapeutic for the patient's diversional activity deficit.
- The nurse's action blurs the boundaries of the therapeutic relationship. (correct)
The nurse's statement 'I am the only one who truly understands this patient. Other staff members are too critical.' indicates what?
The nurse's statement 'I am the only one who truly understands this patient. Other staff members are too critical.' indicates what?
- Advocacy.
- Positive regard.
- Sexual harassment.
- Boundary blurring. (correct)
Which descriptors exemplify consistency regarding nurse-patient relationships? (Select all that apply)
Which descriptors exemplify consistency regarding nurse-patient relationships? (Select all that apply)
- Having the same nurse care for a patient on a daily basis. (correct)
- Offering solutions to a patient's problems.
- Encouraging a patient to share initial impressions of staff.
- Providing a schedule of daily activities to a patient. (correct)
- Setting a time for regular sessions with a patient. (correct)
Which actions by the nurse should be included in the termination phase when ending a relationship with a patient? (Select all that apply)
Which actions by the nurse should be included in the termination phase when ending a relationship with a patient? (Select all that apply)
Which are the best ways for a novice psychiatric nurse with a parent having bipolar disorder to cope with feelings of embarrassment about the parent's behavior? (Select all that apply)
Which are the best ways for a novice psychiatric nurse with a parent having bipolar disorder to cope with feelings of embarrassment about the parent's behavior? (Select all that apply)
Which behaviors will help a novice nurse convey to patients that they are interested and want to listen? (Select all that apply)
Which behaviors will help a novice nurse convey to patients that they are interested and want to listen? (Select all that apply)
Which response is the nurse demonstrating when assessing a confused older adult and feeling sadness, reflecting, 'The patient is like one of my grandparents...so helpless.'?
Which response is the nurse demonstrating when assessing a confused older adult and feeling sadness, reflecting, 'The patient is like one of my grandparents...so helpless.'?
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?
After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?
How should the nurse respond when a patient says, 'Please don't share information about me with the other people.'?
How should the nurse respond when a patient says, 'Please don't share information about me with the other people.'?
What should the nurse do when interrupted during a session with a patient by another patient who needs to talk?
What should the nurse do when interrupted during a session with a patient by another patient who needs to talk?
Termination of a therapeutic nurse-patient relationship has been successful when the nurse:
Termination of a therapeutic nurse-patient relationship has been successful when the nurse:
What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate:
What is the desirable outcome for the orientation stage of a nurse-patient relationship? The patient will demonstrate behaviors that indicate:
During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?
During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?
At what point in the nurse-patient relationship should a nurse plan to first address termination?
At what point in the nurse-patient relationship should a nurse plan to first address termination?
A nurse introduces the matter of a contract during the first session with a new patient because contracts:
A nurse introduces the matter of a contract during the first session with a new patient because contracts:
Which is the nurse's best response when a patient gives a necklace as a gift?
Which is the nurse's best response when a patient gives a necklace as a gift?
Which remark by a patient indicates passage from orientation to the working phase of a nurse-patient relationship?
Which remark by a patient indicates passage from orientation to the working phase of a nurse-patient relationship?
A nurse explains how a nurse-patient relationship differs from social relationships. Which is the best explanation?
A nurse explains how a nurse-patient relationship differs from social relationships. Which is the best explanation?
Which action demonstrates genuineness with a patient diagnosed with schizophrenia?
Which action demonstrates genuineness with a patient diagnosed with schizophrenia?
What should a nurse do when feeling anger toward a suspicious patient?
What should a nurse do when feeling anger toward a suspicious patient?
Which action by a nurse demonstrates valuing autonomy?
Which action by a nurse demonstrates valuing autonomy?
What is the nurse's best action when a patient gives a card of appreciation at discharge?
What is the nurse's best action when a patient gives a card of appreciation at discharge?
What is the nurse's best response when a patient requests to change their off-unit activity restrictions?
What is the nurse's best response when a patient requests to change their off-unit activity restrictions?
When a novice nurse begins work with a patient previously cared for by another nurse, what is the starting point for the relationship?
When a novice nurse begins work with a patient previously cared for by another nurse, what is the starting point for the relationship?
Flashcards
Countertransference
Countertransference
A nurse's emotions are influenced by their own past experiences related to the patient, impacting how they respond.
Empathy
Empathy
Understanding and reflecting on the patient's feelings, making them feel seen and validated.
Monitoring Emotional Responses
Monitoring Emotional Responses
Identifying and managing personal emotions to remain objective and prevent countertransference.
Communicating Confidentiality Limits
Communicating Confidentiality Limits
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Respecting Patient Privacy
Respecting Patient Privacy
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Effective Interruption Response
Effective Interruption Response
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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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Therapeutic Contracts
Therapeutic Contracts
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Patient Autonomy
Patient Autonomy
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Declining Gifts
Declining Gifts
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Affirming Gratitude
Affirming Gratitude
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Nonjudgmental Responses
Nonjudgmental Responses
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Genuineness
Genuineness
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Transition Between Relationships
Transition Between Relationships
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Professionalism After Termination
Professionalism After Termination
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Consistency in Care
Consistency in Care
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Handling Strong emotions
Handling Strong emotions
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Managing Feelings
Managing Feelings
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Termination Dialogue
Termination Dialogue
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Emotional Expression
Emotional Expression
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Reinforcing Expectations
Reinforcing Expectations
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Personal Experience
Personal Experience
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Recognizing Unhealthy Feelings
Recognizing Unhealthy Feelings
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Building Rapport Techniques
Building Rapport Techniques
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Positive Facial Expressions
Positive Facial Expressions
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Open Body Language
Open Body Language
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Physical Barriers
Physical Barriers
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Study Notes
Therapeutic Relationships in Mental Health Nursing
- Countertransference occurs when a nurse's emotional responses are influenced by their own past experiences and feelings linked to a patient.
- Empathy is demonstrated when a nurse accurately reflects the patient's feelings, allowing the patient to feel understood and validated.
- Monitoring emotional responses is crucial to maintain objectivity and prevent issues such as countertransference.
Communication and Boundaries
- Nurses must clearly communicate the limits of confidentiality to patients, ensuring they understand what information might be shared with other staff.
- Respecting the patient's right to privacy builds trust and fosters a therapeutic relationship.
- Effective responses to interruptions during a session should maintain boundaries and adhere to the established schedule to prevent feelings of abandonment.
Phases of Nurse-Patient Relationships
- The orientation phase focuses on building rapport and trust, which is vital before progressing to the working phase.
- The working phase is where identified patient issues are actively explored and strategies for coping are developed.
- Termination involves discussing the relationship's end, evaluating progress, and minimizing dependency on the nurse.
Contracts and Autonomy
- Contracts in therapeutic relationships outline roles and responsibilities, ensuring both the nurse and patient understand their commitments.
- Valuing patient autonomy involves discussing options with patients and supporting them in their decision-making process.
Professionalism and Boundaries
- Accepting gifts from patients can blur the lines between professional and personal relationships and should typically be declined graciously.
- Affirming the patient's gratitude while maintaining a professional boundary emphasizes the importance of therapeutic integrity.
Trust and Communication Styles
- Nonjudgmental responses by nurses encourage patients to express their feelings and explore their thoughts without fear of criticism.
- Genuineness in communication fosters a strong therapeutic relationship, where patients feel acknowledged and respected.
Transitioning Between Relationships
- When a new nurse begins working with an established patient, they must restart at the orientation phase, as previous relationships must be acknowledged and respected.
- Maintaining professionalism is crucial when moving away from therapeutic relationships, such as avoiding informal social invitations that might confuse roles.
Consistency in Care
- Consistency in nurse-patient interactions (same nurse, regular schedules) promotes stability and security for patients, enhancing their comfort in the therapeutic process.
- Predictable routines and engagement strategies are essential for effective therapeutic relationships, especially for patients with mental health disorders.
Handling Emotional Responses
- Strong emotional responses towards patients should be openly discussed in supervision, aiming for professional objectivity and effective care strategies.
- Recognizing and managing feelings such as anger or frustration towards patients is part of maintaining professionalism and therapeutic effectiveness.### Termination Phase in Patient-Nurse Relationships
- In the termination phase, focus dialogues with the patient on potential future problems.
- Assist the patient in expressing feelings about the relationship for closure.
- Reinforcing expectations and relationship parameters is crucial during termination.
Coping with Personal Experiences in Psychiatric Nursing
- Novice nurses with personal experience (like a parent with bipolar disorder) can use this understanding to empathize with patients.
- Recognizing unhealthy feelings is important; suppression is not a productive strategy.
- Acknowledging these feelings can enhance sensitivity in nursing practice, but supervision is essential.
Effective Communication Techniques in Nursing
- Building rapport with patients involves introducing oneself and clarifying the nurse's role.
- Positive facial expressions significantly enhance the message of interest and encouragement.
- An open body posture and techniques like mirror imaging foster comfort and promote open communication.
- Avoiding physical barriers (like desks) and using less intense angles in body orientation helps reduce discomfort in interactions.
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