Podcast
Questions and Answers
What is identified as the fundamental basis for psychiatric nursing practice?
What is identified as the fundamental basis for psychiatric nursing practice?
- The therapeutic nurse–patient relationship (correct)
- Implementing hospital protocols efficiently
- Maintaining detailed patient records
- Administering medications accurately and safely
Which element is considered essential within the therapeutic nurse-patient relationship?
Which element is considered essential within the therapeutic nurse-patient relationship?
- Mutual recognition of each participant as a unique and valuable individual (correct)
- Focusing primarily on the nurse's expertise to guide patient care
- Establishing a hierarchical structure with the nurse in authority
- Maintaining professional distance to ensure objectivity
According to Peplau's perspective, what is the ideal approach for a nurse when working with a patient?
According to Peplau's perspective, what is the ideal approach for a nurse when working with a patient?
- To observe the patient passively and document their behaviors
- To educate the patient primarily through formal instructional sessions
- To collaborate with the patient, engaging in shared problem-solving and goal achievement (correct)
- To direct the patient by independently carrying out necessary tasks for them
Which of the following best defines a therapeutic relationship in the context of healthcare?
Which of the following best defines a therapeutic relationship in the context of healthcare?
What primary benefit is intended to arise from a therapeutic relationship in nursing?
What primary benefit is intended to arise from a therapeutic relationship in nursing?
When did nursing begin to emerge as a recognized profession?
When did nursing begin to emerge as a recognized profession?
Who are the typical participants in a therapeutic relationship as described in the text?
Who are the typical participants in a therapeutic relationship as described in the text?
What is a key outcome of an effective therapeutic relationship according to Peplau's perspective?
What is a key outcome of an effective therapeutic relationship according to Peplau's perspective?
In Peplau's theory, what is the initial approach a nurse should adopt when first interacting with a patient?
In Peplau's theory, what is the initial approach a nurse should adopt when first interacting with a patient?
What is the primary characteristic of 'acting' in the context of values?
What is the primary characteristic of 'acting' in the context of values?
When acting as a 'resource person,' what is the nurse's primary responsibility according to Peplau's model?
When acting as a 'resource person,' what is the nurse's primary responsibility according to Peplau's model?
According to the provided text, what is the significance of consistently and repeatedly demonstrating a behavior related to a value?
According to the provided text, what is the significance of consistently and repeatedly demonstrating a behavior related to a value?
In the Johari Window model, what does the 'Public Self' quadrant represent?
In the Johari Window model, what does the 'Public Self' quadrant represent?
In the 'teacher' role, what is the nurse primarily focused on achieving for the patient or family?
In the 'teacher' role, what is the nurse primarily focused on achieving for the patient or family?
Which leadership style, as described by Peplau, is most conducive to empowering patients in their care?
Which leadership style, as described by Peplau, is most conducive to empowering patients in their care?
What does the 'Unknowing Self' quadrant of the Johari Window describe?
What does the 'Unknowing Self' quadrant of the Johari Window describe?
Which quadrant of the Johari Window is characterized by information known to oneself but intentionally kept hidden from others?
Which quadrant of the Johari Window is characterized by information known to oneself but intentionally kept hidden from others?
What does the 'surrogate' role in nursing primarily involve, according to Peplau?
What does the 'surrogate' role in nursing primarily involve, according to Peplau?
When functioning as a 'technical expert,' what is a core competency of the nurse?
When functioning as a 'technical expert,' what is a core competency of the nurse?
What does the 'Unknown Self' in the Johari Window signify?
What does the 'Unknown Self' in the Johari Window signify?
What is the main objective of the 'counselor' role in nursing, as defined by Peplau?
What is the main objective of the 'counselor' role in nursing, as defined by Peplau?
What is the primary goal of utilizing the Johari Window to increase self-awareness?
What is the primary goal of utilizing the Johari Window to increase self-awareness?
Which of the following best describes 'rapport' in the context of a therapeutic relationship?
Which of the following best describes 'rapport' in the context of a therapeutic relationship?
According to Travelbee's perspective, what is essential for a genuine nurse-patient relationship to develop?
According to Travelbee's perspective, what is essential for a genuine nurse-patient relationship to develop?
What is the primary focus of a therapeutic nurse-patient relationship according to the text?
What is the primary focus of a therapeutic nurse-patient relationship according to the text?
Discussing non-health-related topics is suggested as a method to establish what in a therapeutic relationship?
Discussing non-health-related topics is suggested as a method to establish what in a therapeutic relationship?
In a therapeutic relationship, who ideally determines the goals of the interaction?
In a therapeutic relationship, who ideally determines the goals of the interaction?
In the context of therapeutic relationships, what is the essence of 'trust' according to the text?
In the context of therapeutic relationships, what is the essence of 'trust' according to the text?
Which theorist emphasized the importance of interpersonal relationships in addressing emotional problems?
Which theorist emphasized the importance of interpersonal relationships in addressing emotional problems?
Why is concrete communication particularly important for establishing trust with psychiatric patients who exhibit concrete thinking?
Why is concrete communication particularly important for establishing trust with psychiatric patients who exhibit concrete thinking?
What is the intended outcome of a therapeutic nurse-patient relationship in terms of the patient's future interactions?
What is the intended outcome of a therapeutic nurse-patient relationship in terms of the patient's future interactions?
According to Erikson's stages of development, which task is foundational to the development of trust in relationships?
According to Erikson's stages of development, which task is foundational to the development of trust in relationships?
Increased self-awareness, achieved through tools like the Johari Window, ideally leads to improved:
Increased self-awareness, achieved through tools like the Johari Window, ideally leads to improved:
Within the context of the 'surrogate' role, what is the nurse's responsibility regarding the patient's potential regression to earlier behavioral patterns?
Within the context of the 'surrogate' role, what is the nurse's responsibility regarding the patient's potential regression to earlier behavioral patterns?
What is the relationship between consistently demonstrating a behavior and holding a value?
What is the relationship between consistently demonstrating a behavior and holding a value?
What is a key aspect of the 'counselor' role specifically highlighted for psychiatric nursing?
What is a key aspect of the 'counselor' role specifically highlighted for psychiatric nursing?
In the problem-solving model example provided for therapeutic relationships, what is the initial intervention step?
In the problem-solving model example provided for therapeutic relationships, what is the initial intervention step?
According to Travelbee, what is at the 'core' of establishing rapport?
According to Travelbee, what is at the 'core' of establishing rapport?
In inpatient psychiatric settings, what is identified as the MOST crucial element for nurses to establish with patients, especially given the potential for involuntary admissions?
In inpatient psychiatric settings, what is identified as the MOST crucial element for nurses to establish with patients, especially given the potential for involuntary admissions?
Which nursing intervention best demonstrates the promotion of trust for a patient with concrete thinking?
Which nursing intervention best demonstrates the promotion of trust for a patient with concrete thinking?
According to Travelbee's concept of 'therapeutic use of self', what primary ability must a nurse possess to effectively deliver interpersonal nursing?
According to Travelbee's concept of 'therapeutic use of self', what primary ability must a nurse possess to effectively deliver interpersonal nursing?
What is the primary reason trust is considered essential in a therapeutic nurse-patient relationship?
What is the primary reason trust is considered essential in a therapeutic nurse-patient relationship?
Carl Rogers' concept of 'unconditional positive regard' in nursing practice is best exemplified by which action?
Carl Rogers' concept of 'unconditional positive regard' in nursing practice is best exemplified by which action?
Self-awareness in nursing practice is described as the recognition of one's values, attitudes, beliefs, behaviors, emotions, and needs. Why is this particularly emphasized in psychiatric nursing?
Self-awareness in nursing practice is described as the recognition of one's values, attitudes, beliefs, behaviors, emotions, and needs. Why is this particularly emphasized in psychiatric nursing?
What is the primary purpose of values clarification in the context of self-awareness for a nurse?
What is the primary purpose of values clarification in the context of self-awareness for a nurse?
Which nursing behavior most effectively conveys respect to a patient in a psychiatric setting?
Which nursing behavior most effectively conveys respect to a patient in a psychiatric setting?
How does recognizing a patient as unconditionally accepted contribute to their well-being?
How does recognizing a patient as unconditionally accepted contribute to their well-being?
Which of the following BEST exemplifies a 'rational belief' as described in the context of beliefs?
Which of the following BEST exemplifies a 'rational belief' as described in the context of beliefs?
What is the core principle of genuineness in the context of a nurse-patient relationship?
What is the core principle of genuineness in the context of a nurse-patient relationship?
An 'irrational belief' is defined as an idea held as true despite contradictory evidence. Which scenario below is MOST indicative of an irrational belief in the context of addiction?
An 'irrational belief' is defined as an idea held as true despite contradictory evidence. Which scenario below is MOST indicative of an irrational belief in the context of addiction?
In what circumstance is self-disclosure by a nurse considered appropriate in a therapeutic relationship?
In what circumstance is self-disclosure by a nurse considered appropriate in a therapeutic relationship?
What distinguishes 'faith' as a type of belief from rational or irrational beliefs?
What distinguishes 'faith' as a type of belief from rational or irrational beliefs?
Why is genuineness considered crucial for establishing trust in a nurse-patient relationship?
Why is genuineness considered crucial for establishing trust in a nurse-patient relationship?
Which of the following statements is the BEST example of a 'stereotype' as a type of belief?
Which of the following statements is the BEST example of a 'stereotype' as a type of belief?
What is the central component of empathy in nursing practice?
What is the central component of empathy in nursing practice?
An 'attitude' is described as a frame of reference with an emotional component. What primary role do attitudes serve for an individual?
An 'attitude' is described as a frame of reference with an emotional component. What primary role do attitudes serve for an individual?
How does empathy differ from sympathy in a therapeutic nursing context?
How does empathy differ from sympathy in a therapeutic nursing context?
Values are distinguished from attitudes and beliefs primarily because values are considered to be:
Values are distinguished from attitudes and beliefs primarily because values are considered to be:
What is a crucial nursing action to communicate empathy to a patient?
What is a crucial nursing action to communicate empathy to a patient?
What is the relationship between values, attitudes, and beliefs?
What is the relationship between values, attitudes, and beliefs?
Which of the following is considered the bedrock upon which a therapeutic relationship is built?
Which of the following is considered the bedrock upon which a therapeutic relationship is built?
The Johari Window is a tool used to enhance self-awareness. What does the 'Open or Public Self' quadrant represent?
The Johari Window is a tool used to enhance self-awareness. What does the 'Open or Public Self' quadrant represent?
In Raths and associates' seven-step process of values clarification, the 'Choosing' level of operations includes which critical criteria?
In Raths and associates' seven-step process of values clarification, the 'Choosing' level of operations includes which critical criteria?
What primary skill must a psychiatric nurse refine to effectively foster therapeutic relationships?
What primary skill must a psychiatric nurse refine to effectively foster therapeutic relationships?
According to the values clarification process described, what is the initial level of operation involved in recognizing a personal value?
According to the values clarification process described, what is the initial level of operation involved in recognizing a personal value?
What is the overarching goal of establishing trust, respect, genuineness, and empathy in psychiatric nursing?
What is the overarching goal of establishing trust, respect, genuineness, and empathy in psychiatric nursing?
What is a potential negative consequence of the prevailing stigma associated with mental illness, as mentioned in the text?
What is a potential negative consequence of the prevailing stigma associated with mental illness, as mentioned in the text?
A nurse responds to a patient's angry outburst by saying, 'I understand you're upset, let's explore what led to these feelings instead of reacting physically.' Which therapeutic principle is best demonstrated?
A nurse responds to a patient's angry outburst by saying, 'I understand you're upset, let's explore what led to these feelings instead of reacting physically.' Which therapeutic principle is best demonstrated?
What is an example of a boundary violation in a nurse-patient relationship?
What is an example of a boundary violation in a nurse-patient relationship?
Which behavior might indicate countertransference in a nurse?
Which behavior might indicate countertransference in a nurse?
What are characteristics that enhance a therapeutic nurse-patient relationship?
What are characteristics that enhance a therapeutic nurse-patient relationship?
What phase involves setting goals and addressing patient's problems in a therapeutic relationship?
What phase involves setting goals and addressing patient's problems in a therapeutic relationship?
What reflects a potential boundary crossing in a nurse-patient relationship?
What reflects a potential boundary crossing in a nurse-patient relationship?
Who outlined the seven nursing roles within the therapeutic relationship?
Who outlined the seven nursing roles within the therapeutic relationship?
Which term describes the patient's unconscious feelings transferred to a nurse?
Which term describes the patient's unconscious feelings transferred to a nurse?
What are variables affecting boundary delineation in nurse-patient relationships?
What are variables affecting boundary delineation in nurse-patient relationships?
In a therapeutic relationship, what phase involves goal orientation and solving problems?
In a therapeutic relationship, what phase involves goal orientation and solving problems?
What type of boundaries include concerns such as self-disclosure and gift-giving?
What type of boundaries include concerns such as self-disclosure and gift-giving?
What is a potential behavior a patient may exhibit during termination due to feelings of sadness and loss?
What is a potential behavior a patient may exhibit during termination due to feelings of sadness and loss?
What aspect defines professional boundaries in the nurse-patient relationship?
What aspect defines professional boundaries in the nurse-patient relationship?
Why might cultural beliefs influence a nurse's decision to accept a gift from a patient?
Why might cultural beliefs influence a nurse's decision to accept a gift from a patient?
Which type of boundary involves expectations for professional relationships?
Which type of boundary involves expectations for professional relationships?
When is self-disclosure by a nurse considered appropriate?
When is self-disclosure by a nurse considered appropriate?
In what situation is gift-giving considered acceptable in the nurse-patient relationship?
In what situation is gift-giving considered acceptable in the nurse-patient relationship?
What must a nurse do to ensure a therapeutic closure during termination?
What must a nurse do to ensure a therapeutic closure during termination?
Under what circumstance is touching a patient NOT considered appropriate?
Under what circumstance is touching a patient NOT considered appropriate?
What is a sign that the boundaries of a nurse-patient relationship might be at risk?
What is a sign that the boundaries of a nurse-patient relationship might be at risk?
Why is it important for nurses to recognize their power imbalance with patients?
Why is it important for nurses to recognize their power imbalance with patients?
What should a nurse do if a personal relationship develops from a nurse-patient interaction?
What should a nurse do if a personal relationship develops from a nurse-patient interaction?
Which situation requires nurses to avoid touch due to potential misinterpretation?
Which situation requires nurses to avoid touch due to potential misinterpretation?
Which of these is NOT a concern related to maintaining professional boundaries?
Which of these is NOT a concern related to maintaining professional boundaries?
How can nurses exercise good judgment in deciding whether to accept a gift from a patient?
How can nurses exercise good judgment in deciding whether to accept a gift from a patient?
What is a defining characteristic of personal boundaries?
What is a defining characteristic of personal boundaries?
What is the primary distinction between empathy and sympathy in a therapeutic nurse-patient relationship?
What is the primary distinction between empathy and sympathy in a therapeutic nurse-patient relationship?
How does a nurse's empathetic response primarily benefit a patient in a therapeutic setting?
How does a nurse's empathetic response primarily benefit a patient in a therapeutic setting?
What is a potential negative consequence of a nurse reacting with sympathy rather than empathy in a therapeutic relationship?
What is a potential negative consequence of a nurse reacting with sympathy rather than empathy in a therapeutic relationship?
In a therapeutic nurse-patient relationship, what is the most crucial element that distinguishes it from a social relationship?
In a therapeutic nurse-patient relationship, what is the most crucial element that distinguishes it from a social relationship?
According to the provided text, what is considered the primary intervention used by psychiatric nurses in mental health settings?
According to the provided text, what is considered the primary intervention used by psychiatric nurses in mental health settings?
Which phase of the therapeutic nurse-patient relationship is characterized by the primary nursing goal of 'exploring self-perceptions'?
Which phase of the therapeutic nurse-patient relationship is characterized by the primary nursing goal of 'exploring self-perceptions'?
During which phase of the therapeutic relationship is establishing trust and rapport the most essential task?
During which phase of the therapeutic relationship is establishing trust and rapport the most essential task?
What is the main purpose of formulating a 'contract for intervention' during the orientation phase of a therapeutic relationship?
What is the main purpose of formulating a 'contract for intervention' during the orientation phase of a therapeutic relationship?
In the context of therapeutic relationships, what is the primary goal of the 'working phase'?
In the context of therapeutic relationships, what is the primary goal of the 'working phase'?
What is the central objective of the 'termination phase' in a therapeutic nurse-patient relationship?
What is the central objective of the 'termination phase' in a therapeutic nurse-patient relationship?
Why is it important for a nurse to 'examine one's feelings, fears, and anxieties' during the preinteraction phase?
Why is it important for a nurse to 'examine one's feelings, fears, and anxieties' during the preinteraction phase?
In the example provided, what aspect of the sympathetic response to BJ is considered non-therapeutic?
In the example provided, what aspect of the sympathetic response to BJ is considered non-therapeutic?
What role did Hildegard Peplau identify as the major role of nursing in psychiatric settings?
What role did Hildegard Peplau identify as the major role of nursing in psychiatric settings?
Which activity is specifically mentioned as a task within the preinteraction phase of the nurse-patient relationship?
Which activity is specifically mentioned as a task within the preinteraction phase of the nurse-patient relationship?
What is the primary reason for gathering assessment information during the orientation phase of the therapeutic relationship?
What is the primary reason for gathering assessment information during the orientation phase of the therapeutic relationship?
Which action is part of the orientation phase in a therapeutic relationship?
Which action is part of the orientation phase in a therapeutic relationship?
What is the primary focus during the working phase of a therapeutic relationship?
What is the primary focus during the working phase of a therapeutic relationship?
Transference involves the patient transferring feelings toward the nurse that originally were associated with:
Transference involves the patient transferring feelings toward the nurse that originally were associated with:
How can countertransference negatively affect a therapeutic relationship?
How can countertransference negatively affect a therapeutic relationship?
What should a nurse do if they suspect transference is affecting their relationship with a patient?
What should a nurse do if they suspect transference is affecting their relationship with a patient?
Which task occurs during the termination phase of a therapeutic relationship?
Which task occurs during the termination phase of a therapeutic relationship?
What emotion might a nurse feel if they are experiencing countertransference?
What emotion might a nurse feel if they are experiencing countertransference?
During the working phase, how should a nurse handle patient resistance?
During the working phase, how should a nurse handle patient resistance?
An observed behavior caused by countertransference is:
An observed behavior caused by countertransference is:
What is a common outcome when transference occurs?
What is a common outcome when transference occurs?
Why might a nurse struggle to set limits on a patient's behavior during therapy?
Why might a nurse struggle to set limits on a patient's behavior during therapy?
What defines the termination phase in a therapeutic relationship?
What defines the termination phase in a therapeutic relationship?
Which feeling might both the nurse and patient experience during termination?
Which feeling might both the nurse and patient experience during termination?
Transference might negatively impact therapy by:
Transference might negatively impact therapy by:
Why is self-awareness important for nurses dealing with countertransference?
Why is self-awareness important for nurses dealing with countertransference?
Flashcards
Therapeutic Relationship
Therapeutic Relationship
Interaction between caregiver and care receiver promoting healing and growth.
Patient-Centered Care
Patient-Centered Care
Healthcare approach prioritizing the patient's unique needs and preferences.
Hildegard Peplau
Hildegard Peplau
Nursing theorist known for her work on therapeutic relationships in psychiatric nursing.
Mutual Learning
Mutual Learning
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Values Clarification
Values Clarification
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Phases of Therapeutic Relationship
Phases of Therapeutic Relationship
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Role of the Psychiatric Nurse
Role of the Psychiatric Nurse
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Nursing Profession Origins
Nursing Profession Origins
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Nursing Roles
Nursing Roles
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The Stranger
The Stranger
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The Resource Person
The Resource Person
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The Teacher
The Teacher
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The Leader
The Leader
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The Surrogate
The Surrogate
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The Technical Expert
The Technical Expert
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The Counselor
The Counselor
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Problem-Solving Model
Problem-Solving Model
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Goal of Therapeutic Relationship
Goal of Therapeutic Relationship
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Travelbee's Concept
Travelbee's Concept
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Emotional Care
Emotional Care
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Adaptive Coping Strategies
Adaptive Coping Strategies
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Evaluation of Outcomes
Evaluation of Outcomes
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Therapeutic Use of Self
Therapeutic Use of Self
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Self-Awareness
Self-Awareness
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Rational Beliefs
Rational Beliefs
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Irrational Beliefs
Irrational Beliefs
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Faith (Blind Beliefs)
Faith (Blind Beliefs)
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Stereotypes
Stereotypes
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Attitudes
Attitudes
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Values
Values
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The Johari Window
The Johari Window
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Open Self
Open Self
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Unknown Self
Unknown Self
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Unknowing Self
Unknowing Self
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Private Self
Private Self
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Values Assessment Process
Values Assessment Process
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Public Affirmation
Public Affirmation
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Value Behavior
Value Behavior
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Consistency in Behavior
Consistency in Behavior
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Johari Window
Johari Window
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Therapeutic Rapport
Therapeutic Rapport
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Trust in Relationships
Trust in Relationships
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Therapeutic Relationship Development
Therapeutic Relationship Development
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Non-Health Topics in Rapport
Non-Health Topics in Rapport
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Concrete Thinking
Concrete Thinking
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Safety in Therapeutic Settings
Safety in Therapeutic Settings
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Trust in Nursing
Trust in Nursing
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Unconditional Positive Regard
Unconditional Positive Regard
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Consistency in Care
Consistency in Care
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Listening Skills
Listening Skills
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Genuineness
Genuineness
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Empathy
Empathy
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Self-Disclosure in Nursing
Self-Disclosure in Nursing
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Respectful Communication
Respectful Communication
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Role of Honesty
Role of Honesty
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Patient Self-Respect
Patient Self-Respect
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Therapeutic Activities
Therapeutic Activities
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Privacy in Care
Privacy in Care
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Understanding Patient Motivation
Understanding Patient Motivation
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Facilitation of Growth
Facilitation of Growth
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Psychiatric Nursing Skills
Psychiatric Nursing Skills
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Boundary Crossing
Boundary Crossing
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Transference
Transference
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Countertransference
Countertransference
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Professional Boundaries
Professional Boundaries
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Self-Awareness in Nursing
Self-Awareness in Nursing
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Interpersonal Techniques
Interpersonal Techniques
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Role of Empathy in Nursing
Role of Empathy in Nursing
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Characteristics of Therapeutic Relationships
Characteristics of Therapeutic Relationships
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Concerns of Self-Disclosure
Concerns of Self-Disclosure
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Patient Strengths and Limitations
Patient Strengths and Limitations
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Nursing Diagnosis
Nursing Diagnosis
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Mutually Agreeable Goals
Mutually Agreeable Goals
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Realistic Action Plan
Realistic Action Plan
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Introductory Phase
Introductory Phase
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Working Phase
Working Phase
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Trust and Rapport
Trust and Rapport
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Resistance Behaviors
Resistance Behaviors
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Exploring Feelings
Exploring Feelings
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Termination Phase
Termination Phase
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Continuing Care Plan
Continuing Care Plan
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Mutual Feelings about Termination
Mutual Feelings about Termination
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Behavioral Feedback
Behavioral Feedback
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Patient Feelings at Termination
Patient Feelings at Termination
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Nurse's Professional Boundaries
Nurse's Professional Boundaries
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Material Boundaries
Material Boundaries
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Social Boundaries
Social Boundaries
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Personal Boundaries
Personal Boundaries
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Professional Boundaries Importance
Professional Boundaries Importance
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Gift-Giving Guidelines
Gift-Giving Guidelines
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Caring Touch
Caring Touch
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Cultural Sensitivity in Touch
Cultural Sensitivity in Touch
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Friendship vs. Professional Relationship
Friendship vs. Professional Relationship
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Manipulation of Termination Process
Manipulation of Termination Process
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Warning Signs of Boundaries Crossing
Warning Signs of Boundaries Crossing
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Preinteraction phase
Preinteraction phase
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Orientation phase
Orientation phase
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Rapport
Rapport
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Personal distress
Personal distress
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Positive self-concept
Positive self-concept
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Empathetic response
Empathetic response
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Nurse’s role in psychiatry
Nurse’s role in psychiatry
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Interpersonal relationship development
Interpersonal relationship development
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Study Notes
Psychiatric Nursing: The Nurse-Patient Relationship
- Psychiatric nursing is built on the nurse-patient relationship, a unique and important human interaction fostering mutual learning.
- This relationship is central to patient-centered care, recognized as critical for quality and safety in healthcare.
- Hildegard Peplau's theories (1952, 1991) remain foundational in psychiatric nursing practice.
Core Concept: Therapeutic Relationship
- A therapeutic relationship is an interaction between a caregiver and care receiver where both parties contribute to healing, growth, and illness prevention.
- The relationship is goal-oriented, aiming to foster learning and growth for positive change in the patient's life.
Role of the Psychiatric Nurse
- Nursing's historical role has evolved from custodial care to a specialized, independent professional role on the healthcare team.
- Peplau (1991) identified key roles for nurses in the therapeutic relationship:
- Stranger: Initially non-personal, accepting the patient as is.
- Resource person: Provides health-related information in understandable language.
- Teacher: Identifies learning needs and provides necessary health information.
- Leader: Fosters patient participation in care planning.
- Surrogate: Serves as a substitute for significant figures in the patient's life (e.g., mother).
- Technical expert: Utilizes professional knowledge and skills to manage patient care.
- Counselor: Uses interpersonal techniques for patients to process life changes. (Peplau emphasized this role in psychiatric nursing.)
Dynamics of a Therapeutic Nurse–Patient Relationship
- Travelbee (1971) emphasized a human-to-human relationship, where both nurse and patient recognize each other as unique individuals.
- For patient care, respect, trust, genuineness, and empathy are imperative.
- Trust: Earning trust is crucial; proven through warmth, caring, honesty.
- Respect: Unconditional positive regard, accepting the patient regardless of behavior.
- Genuineness: Being open and honest with the patient while maintaining the nurse-patient dynamic.
- Empathy: Understanding the patient's perspective, without losing objectivity.
Therapeutic Use of Self
- Therapeutic use of self: The nurse's conscious, aware personality use to build rapport and structure interventions.
- Self-awareness, developed through values clarification, is essential.
Values Clarification & Self-Awareness
- It is essential to understand oneself and personal values to effectively interact.
- Values come from early experiences, culture and change over time.
- Values clarification helps gain self-awareness (a 7-step process discussed).
- Values clarification involves examining beliefs, attitudes, and values.
- Beliefs: Rational, irrational, faith-based, and stereotyped.
- Attitudes: Frameworks for organizing knowledge, often emotional.
- Values: Action-oriented, influencing attitudes and beliefs.
The Johari Window
- The Johari Window is a tool for self-awareness, showing open, hidden, unknown, and blind parts of oneself.
- Self-awareness is a key factor in positive interactions with patients.
Conditions Essential to a Therapeutic Relationship
- Rapport: Building a sense of harmony and understanding.
- The key factors of trust, respect, genuineness and empathy.
- Nurses display warmth, care, honesty, and consistency.
- Nurses listen, respecting patient's concerns and thoughts.
- Professional boundaries help maintain the nurse-patient relationship.
- Important issues: Self-disclosure, gift-giving, touch, and relationship with patients.
Phases of a Therapeutic Relationship
- The therapeutic relationship progresses through phases: preinteraction, orientation, working, and termination.
- Each phase involves specific goals and tasks.
Transference and Countertransference
- Transference: Patients unconsciously transferring past feelings to the nurse.
- Nurse must recognize unconscious influences and help the patient understand their transfer of feelings onto the nurse.
- Countertransference: Nurses unconsciously transferring past feelings onto patient.
- Nurse must self-reflect on possible influences to avoid affecting the outcome negatively.
Boundaries in the Nurse-Patient Relationship
- Nurses must maintain professional boundaries to care for patients and support well-being.
- Examples of concerns about professional boundaries include self-disclosure, gift-giving, touching, forming friendships, and confidentiality.
Summary
- Psychiatric nursing relies on the therapeutic relationship.
- Key elements include self-awareness, values, and empathy.
- Professional boundaries provide a framework for the relationship to support positive patient outcomes.
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