Therapeutic Nurse-Client Relationship Phases

Study Notes

Pre-Interaction Phase

Preparation before the first encounter with the client.
Key tasks include gathering information from charts, family, and other health professionals.
Reflecting on personal feelings, fears, and anxieties, especially regarding challenging client histories.

Orientation (Introductory) Phase

The initial stage where the nurse and client become acquainted.
Establish an environment conducive for trust and rapport.
Create a contract outlining expectations and responsibilities for both parties.
Collect assessment information to build a comprehensive client database.
Identify the client's strengths and limitations to formulate nursing diagnoses.
Set mutually agreeable goals and explore feelings of client and nurse.

The Working Phase

Main therapeutic work occurs, focusing on client progress.
Maintain trust and rapport established during the orientation phase.
Promote client insight and a realistic perception of their situation.
Engage in problem-solving as presented in previous content.
Address resistance behaviors as anxiety levels increase during difficult discussions.
Continuously evaluate progress toward established goals.

Common Phenomena in Therapeutic Relationships

Transference: Client attributes feelings and behaviors toward the nurse based on past relationships.
Countertransference: The nurse's emotional and behavioral responses to the client.

Transference

Occurs unconsciously as clients project past experiences onto the nurse, influencing their interactions.

Countertransference

Nurse's reactions influenced by their history, impacting their professional relationship with the client.
Examples include:
- Over-identifying with the client due to personal parallels.
- Engaging in personal or social relationships with clients.
- Offering excessive advice or trying to "rescue" the client.
- Encouraging dependence on the nurse.
- Feeling negative emotions such as anger or disgust toward the client.
- Experiencing anxiety or boredom during sessions.
- Difficulty enforcing boundaries with client behavior.
- Defending client behavior to colleagues.

Termination Phase

The final stage where mutually agreed-upon goals are assessed for completion.
Client may be discharged from hospital after achieving therapeutic objectives.

Description

Explore the 4 phases of the therapeutic nurse-client relationship through detailed flashcards. This quiz focuses on understanding the pre-interaction phase, including preparation and emotional examination prior to client encounters.