Nurse/Client Relationship, Therapeutic Communication -Psychiatric Mental Health Nursing |@LevelUpRN

Summary

In this video, Cathy from Level Up RN explains the nurse-client relationship, covering its four phases: Pre-orientation, Orientation, Working, and Termination. She also delves into transference and countertransference, highlighting their impact on nurse-patient interactions. Cathy emphasizes the importance of therapeutic communication techniques such as broad opening remarks, open-ended questions, and presenting reality, while also discussing non-therapeutic techniques like false reassurance and judgment. The video concludes with a quiz to reinforce key concepts, providing viewers with practical knowledge to apply in nursing practice.

Takeaways

• 😀 The nurse-client relationship has four phases: Pre-orientation, Orientation, Working, and Termination.
• 😀 The Pre-orientation phase involves preparing for the patient encounter, including reviewing charts and reflecting on personal feelings about the patient.
• 😀 In the Orientation phase, nurses perform introductions, establish rapport, clarify boundaries, and discuss confidentiality with the patient.
• 😀 The Working phase focuses on data collection, problem-solving, teaching, and evaluating progress toward established goals.
• 😀 The Termination phase involves summarizing progress, discussing new coping mechanisms, and allowing patients to express feelings about the relationship ending.
• 😀 Transference occurs when a patient projects feelings about someone from their past onto the nurse, while countertransference happens when the nurse’s past influences their response to the patient.
• 😀 Nurses should offer therapeutic communication, such as broad opening remarks, open-ended questions, and sharing observations, to foster open and effective dialogue with patients.
• 😀 Techniques like clarification and reflection help nurses ensure they understand patients correctly and encourage them to think through their decisions.
• 😀 Offering self is an important technique in which a nurse makes themselves available to the patient, creating a supportive presence during stressful moments.
• 😀 Non-therapeutic communication techniques to avoid include false reassurance, passing judgment, close-ended questions, and why-questions, all of which can hinder the therapeutic relationship.
• 😀 A quiz at the end of the video reinforces key communication concepts, encouraging viewers to assess whether certain statements are therapeutic or not.

Q & A

What are the four phases of the nurse-client relationship?

The four phases are Pre-orientation, Orientation, Working, and Termination.

What is the focus during the Pre-orientation phase?

The focus during the Pre-orientation phase is preparing for the patient interaction by reviewing the patient's chart and reflecting on personal thoughts and feelings about working with the patient.

In which phase of the nurse-client relationship is patient confidentiality discussed?

Confidentiality is discussed during the Orientation Phase.

What key activities take place in the Working Phase of the nurse-client relationship?

In the Working Phase, nurses gather data, identify problems, practice problem-solving and coping skills, provide education, and evaluate progress toward the patient’s goals.

What happens during the Termination Phase of the nurse-client relationship?

During the Termination Phase, the nurse summarizes the goals achieved, discusses discharge plans, and allows the patient to express their feelings about the end of the relationship, which may cause grief.

What is transference in the context of the nurse-client relationship?

Transference is when a patient redirects their feelings about a person from their past onto the nurse, such as treating the nurse negatively because they remind the patient of an abusive parent.

How is countertransference defined in nursing practice?

Countertransference occurs when a nurse’s feelings and responses toward a patient are influenced by their own past relationships, potentially causing them to treat the patient differently.

What is the purpose of therapeutic communication in nursing?

Therapeutic communication aims to build rapport, engage patients, promote open discussion, and provide emotional support, enhancing patient care and understanding.

What are some examples of non-therapeutic communication techniques to avoid?

Non-therapeutic techniques to avoid include false reassurance, passing judgment, giving advice, using close-ended questions, asking 'why' questions, leading or biased questions, and changing the subject.

Why is it important to avoid 'why' questions in therapeutic communication?

'Why' questions often put the patient on the defensive, making it harder for them to express their feelings openly, which is counterproductive to effective communication.