Nurse-Client Relationship Quiz

The Nurse-Client Relationship

• A relationship is an association between two or more people that develops over time.
• Nurse-client relationships are established when nursing services are provided.
• The nurse-client relationship requires the nurse to respond to the client's needs.
• The nurse performs four basic roles to meet the client's needs: caregiver, educator, collaborator, and delegator.

The Therapeutic Nurse-Client Relationship

• A therapeutic relationship aims to improve health.
• It differs from a social relationship by being client-centered and focused on goal achievement.
• The relationship is time-limited and ends when goals are achieved.
• The nurse treats each client as a unique person and respects their feelings.
• The nurse promotes the client's physical, emotional, social, and spiritual well-being.
• The nurse encourages client participation in problem-solving and decision-making.

Phases of a Nurse-Client Relationship

• Introductory phase: The period of getting acquainted. Techniques for a positive first impression include: dressing appropriately, being well-groomed, smiling, making eye contact, greeting with a handshake, and showing confidence, avoiding offensive personal odors.
• Working phase: The period during which tasks are performed. Mutual planning and implementation of the client's care plan are key. The nurse should not hinder the client's independence.
• Terminating phase: The period when the relationship ends. The phase is self-limiting, occurring when the nurse and client agree the client's health problems have improved. A caring attitude and compassion help the client transition to other care services or independent living. 

Barriers to a Therapeutic Relationship

• Failing to identify oneself.
• Showing disinterest.
• Sharing personal or work-related problems with the client.
• Using distasteful language.
• Revealing confidential information about other clients or staff.
• Being inattentive to the client's needs.
• Leaving the client in a stressful situation.
• Failing to keep promises.

Communication

• Communication is the exchange of information between two or more people.
• Feedback is important to ensure the information was understood or requires clarification.
• Communication can be verbal (using words) or nonverbal (body language and tone).
• Verbal communication includes speaking, reading and writing. Clients and nurses use verbal communication to gather facts, instruct, clarify, and share ideas.

Purposes/Functions of Communication

• To give information.
• To receive information.
• To answer questions.
• To express feelings.
• For clarification.
• To give a message.
• To offset isolation and loneliness.
• To share ideas.

Therapeutic Communication

• Therapeutic communication should be brief, clear, and concise.
• During therapeutic communication, do not ask personal questions, give personal opinions, be judgmental, belittle client's feelings, give advice, or give false reassurances.

Elements of Communication

• Message
• Sender
• Receiver
• Channels
• Feedback

Factors Affecting Verbal Communication

• Attention and concentration.
• Language compatibility.
• Verbal skills.
• Hearing and visual acuity.
• Motor functions (e.g., throat, tongue, teeth).
• Sensory distractions.
• Interpersonal attitudes.
• Literacy.
• Cultural similarities.

Therapeutic Verbal Communication

• Crucial when exploring client problems or encouraging expression of feelings.
• The nurse should not assume a quiet, uncommunicative client is problem-free.

Therapeutic Verbal Communication Techniques

• Broad opening statements.
• Giving information.
• Open-ended questions.
• Reflecting.
• Paraphrasing.
• General leads.
• Sharing perceptions.
• Clarification.
• Summarizing.
• Silence.

Listening

• Listening is as important as speaking during communication.
• Active listening involves attending to and becoming fully involved in what the client says.
• Giving attention to the client provides stimulus for meaningful interaction.
• Avoid giving signals of boredom or impatience (e.g., eye contact, nodding).

Silence

• Silence plays an important role in communication.
• Avoiding excessive talking is important.

Nonverbal Communication

• Nonverbal communication is the exchange of information without using spoken or written words.
• Facial expressions, posture, gestures and body movements communicate messages. 

Body Language (Kinesics)

• To create a positive impression, assume a position at eye level with the client.
• Relax arms, legs, and feet; do not cross body parts.
• Maintain eye contact.
• Lean forward to demonstrate interest and attention.
• Keep legs as still as possible.

Paralanguage

• Vocal sounds that are not words but still communicate a message.

Touch

• Touch can be task-oriented or affective.
• Affective touch is therapeutic in various situations (e.g., loneliness, discomfort, near-death, anxiety, disorientation, coma, disfigurement, visual impairment).

Active Listening

• Demonstrates full attention to what's being said (content and unspoken messages).
• Gives clients the opportunity to be heard to organize thoughts and evaluate the situation.
• Nurses use empathy to perceive client's emotional state and needs for support, understanding client's experience.