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2 The Therapeutic Nurse Client Relationship

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2 The Therapeutic Nurse Client Relationship
The Therapeutic NurseClient Relationship
Use of Therapeutic
Communication

Self Awareness & Nurse - Client
Relationship
•
•
•
•

Quad I
Open to self/public –
What you know about self
And what others also know about you

• Quad 3
• The hidden /private self
• Qualities only you know

• Quad 2
• Blind – the unaware self
• Qualities others know about you –but you are unaware of.
• Quad 4
• Unknown self
• EMPTY quad – the undiscovered self- Qualities not known by self/ others

Components of the Nurse-Client
Relationship
•
•
•
•
•
•

Trust
Genuine interest
Empathy
Acceptance
Positive Regard
Therapeutic Use of Self

Types of relationships
Social
Friendship
Companion
Use small talk superficial Intimate
Emotional
commitment
May be sexual/ emotional Intimacy

Therapeutic
Focus on client needs Experiences,
Feelings, ideas
Goal oriented

Phases of the Nurse-Client
Relationship:
• Pre-Orientation- Self assessment examine own feelings, fears, anxieties.
• Orientation – Introductory Phase establish trust, share information with client; discrete self-disclosure. convey support, facilitate healing educate Phases of Therapeutic NurseClient Relationship—cont’d.
• The Working Phase – Problems identified
Exploration- guide client to examine feelings/responses, develop new coping skills  Termination Phase – Resolution phase
Examine goals achieved;
Explore feelings regarding termination
Establish plan for continuing assistance

Obstacles to the Therapeutic
Relationship:
• Inappropriate Boundaries
• Encouraging dependence
• Non acceptance/Avoidance
• Resistance

Roles of the Nurse:
• Teacher
• Caregiver
• Advocate
• Parent- Surrogate

Therapeutic Communication
• Boundaries:
Intimate
Personal
Social
Public

Non Verbal Communication
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•
•
•
•
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Eye Contact
Body Language
Boundaries
Facial Expressions
Silence
Vocal cues

Non Verbal Communication
• Space (comfort zone)
• Touch ( action/personal space – used cautiously) • Appearance – communicates a particular
image/one’s
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