Nurse-Client Relationship Ethics

Questions and Answers

According to the College of Nurses of Ontario Practice Standard, what is the primary focus of a nurse's accountabilities in the nurse-client relationship?

Therapeutic communication and interpersonal skills

What is the purpose of the indicators accompanying the standard statements in the College of Nurses of Ontario Practice Standard?

To provide broad statements that nurses can modify to their particular practice reality

How many standard statements are described in the College of Nurses of Ontario Practice Standard?

Four

What is the significance of the indicators in the College of Nurses of Ontario Practice Standard?

They are not in order of importance Signup and view all the answers

What is the goal of a nurse's communication strategies in the nurse-client relationship?

To establish, maintain, re-establish, and terminate the nurse-client relationship Signup and view all the answers

Who published the College of Nurses of Ontario Practice Standard: Therapeutic Nurse-Client Relationship?

College of Nurses of Ontario Signup and view all the answers

What is the term used to describe the misuse of power imbalance in the nurse-client relationship, which can cause physical, emotional, or spiritual harm to the client?

Abuse Signup and view all the answers

What is the primary focus of the client-centred care approach?

Viewing the client as a whole person Signup and view all the answers

What is the purpose of the decision tree on page 11?

To determine whether an activity or behaviour is appropriate within the context of the nurse-client relationship Signup and view all the answers

What is the term used to describe the respect and professional intimacy inherent in the nurse-client relationship?

Trust Signup and view all the answers

What is the term used to describe the nurse's ability to advocate for the client and the client's community?

Advocacy Signup and view all the answers

What is the term used to describe the nurse's access to privileged information in the healthcare system?

Specialized knowledge Signup and view all the answers

What is the term used to describe the betrayal of the client's trust, violating the respect or professional intimacy inherent in the nurse-client relationship?

Boundary crossing Signup and view all the answers

What is the term used to describe a client who may be an individual, family, group, or community?

Client Signup and view all the answers

What should a nurse do if they are unsure about performing an activity with a client?

Consult with the health care team and manager to determine how to best address the client’s unmet needs. Signup and view all the answers

Why is it important for employers to have a policy regarding nurses performing certain activities?

To ensure insurance coverage for the nurse and to provide guidance on expected behavior. Signup and view all the answers

What should a nurse consider before engaging in a behavior with a client?

Whether they would want others to know they had engaged in the behavior. Signup and view all the answers

What is an important aspect of documenting a behavior or activity with a client?

Proceeding with the behavior and documenting it. Signup and view all the answers

Why is it crucial for nurses to consider the client's unmet needs when determining how to address a situation?

To ensure the client receives the best possible care and attention. Signup and view all the answers

What should a nurse do if they are unsure about abstaining from a behavior with a client?

Consult with the health care team and manager to determine the best course of action. Signup and view all the answers

What are some key components of a quality practice setting that promotes therapeutic nurse-client relationships?

A quality practice setting promotes reflective practice, supports client-centred care, provides resources for therapeutic relationships and culturally sensitive care, and has policies to prevent boundary violations. Signup and view all the answers

What is a sign of an unhealthy nurse-client relationship, according to the provided content?

Dressing differently when seeing a specific client Signup and view all the answers

How does a quality practice setting support nurses in establishing therapeutic relationships with clients?

A quality practice setting provides resources, including appropriate staffing, to support nurses in establishing therapeutic relationships and provides expert resources to assist in challenging situations. Signup and view all the answers

What is the role of leadership in a quality practice setting that promotes therapeutic nurse-client relationships?

Proactive visible leadership and clinical supervision are available to support nurses in developing therapeutic relationships and maintaining boundaries. Signup and view all the answers

What should a nurse do if they witness another nurse or a member of the health care team abusing a client?

Take action and report the incident to the employer or other authority responsible for the health care provider. Signup and view all the answers

What is the result when someone intervenes in an incident of abuse, according to CNO research?

The abuse stops. Signup and view all the answers

What measures should a quality practice setting have in place to prevent and address abuse?

A quality practice setting has zero tolerance for abuse, a known procedure for reporting abuse, and ensures that reports are investigated and addressed. Signup and view all the answers

What is a nurse's responsibility if they witness unsafe practice or unethical conduct by a health care provider?

Report the incident to the employer or other authority responsible for the health care provider. Signup and view all the answers

What is the importance of debriefing after critical incidents in a quality practice setting?

Debriefing after critical incidents provides support to staff and helps determine the cause, solution, and prevention of recurrence. Signup and view all the answers

How does a quality practice setting promote positive collegial and interprofessional relations?

A quality practice setting promotes positive collegial and interprofessional relations by role modelling and promoting an organizational culture of respect. Signup and view all the answers

What should a nurse do if an unregulated care provider abuses a client?

Intervene to protect the client and notify the employer. Signup and view all the answers

What is the significance of recognizing potential boundary violations in a quality practice setting?

Recognizing potential boundary violations enables the setting to have policies in place to guide and support nurses in meeting CNO standards. Signup and view all the answers

What is a nurse's responsibility to the client after intervening in an incident of abuse?

Inform the client of their right to contact the police. Signup and view all the answers

How does a quality practice setting support staff well-being in the context of therapeutic nurse-client relationships?

A quality practice setting supports staff well-being by allowing staff to request a change of assignment due to stress or boundary issues, and providing activities to relieve stress. Signup and view all the answers

What is an example of a boundary violation in the nurse-client relationship, according to the provided content?

Keeping secrets with the client and apart from the health care team. Signup and view all the answers

Why is it important for a nurse to document all relevant discussions with the client in the health record?

To maintain transparency and accountability in the nurse-client relationship. Signup and view all the answers

Study Notes

Influencing Factors in the Nurse-Client Relationship

Nurses have an imbalance of power in the nurse-client relationship due to their specialized knowledge, access to privileged information, and ability to advocate for the client.
This imbalance can lead to boundary crossing or abuse if not managed properly.

Defining Abuse

Abuse is the misuse of power in the nurse-client relationship, which can cause physical, emotional, or spiritual harm to the client.
Abuse can take many forms, including verbal, emotional, physical, sexual, financial, or neglect.
Nurses must be aware of the potential for abuse and take steps to prevent it.

Client-Centred Care

Client-centred care involves advocacy, empowerment, and respect for the client's autonomy, voice, self-determination, and participation in decision-making.
It is not just about delivering services to the client, but rather about treating the client as a whole person.

Therapeutic Nurse-Client Relationship

The College of Nurses of Ontario has established practice standards for the therapeutic nurse-client relationship, which include four standard statements with accompanying indicators.
The indicators are not exhaustive, but rather broad statements that nurses can modify to their particular practice reality.

Standard Statements

Therapeutic communication is essential in establishing, maintaining, re-establishing, and terminating the nurse-client relationship.
Nurses must use a wide range of effective communication strategies and interpersonal skills to achieve this.

Boundary Crossing

Boundary crossing occurs when a nurse's behaviour towards a client is not appropriate, such as disclosing personal information or spending off-duty time with a client.
Nurses must be aware of their own feelings and motivations to avoid boundary crossing.

Abuse Intervention

If a nurse witnesses abuse, they must take action to stop it and report it to the employer or other authority responsible for the health care provider.
The nurse must also inform the client of their right to contact the police.

Quality Practice Setting

A quality practice setting will promote reflective practice, support client-centred care, and provide resources to support nurses in establishing therapeutic relationships.
The setting should also recognize potential risks for boundary violations, provide expert resources, and have a zero-tolerance policy for abuse.

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Description

This quiz assesses your understanding of the ethical considerations in the nurse-client relationship, including the influence of specialized knowledge and access to privileged information. It evaluates your ability to determine appropriate behaviors within this context.