Nursing Professional Relationships(Week 4) PDF

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Week 5 A nurse ensures she displays genuineness in her interactions with clients. What aspect of use of self does this reflect? A. B. C. D.

Authenticity Presence Self-awareness Self-reflection

A nurse works with a client to identify two key goals for achievement during her shift. They identify: (1) assisted transfer to the chair and (2) independent oral hygiene. What phase of the therapeutic relationship does this represent? A. B. C. D.

Pre-interaction Orientation (Identifying Client Goals) Working Termination

According to the College of Nurses of Ontario (2006), what aspect of the therapeutic nurse client relationship is a nurse demonstrating when she communicates understanding and validation of a clients’ health experience? A. B. C. D. E.

Trust Respect Professional intimacy Empathy Power

A nurse abstains from disclosing personal information, unless it meets the therapeutic needs of the client (not the needs of the nurse). According to the CNO (2018) Therapeutic Nurse-Client Relationship document, which Standard Statement(s) does this reflect? (select all that apply). A. B. C. D.

Therapeutic communication Client-centred care Maintaining boundaries Protecting the client from abuse

A nurse is offered $100.00 cash from a client’s mom, in appreciation of their care for the day. The client insists the nurse take it and says ‘make sure you’re assigned to us next shift’. She decides to accept it and heads home. According to the CNO (2018) Therapeutic Nurse-Client Relationship document, which Standard Statement(s) are being violated? (select all that apply). A. B. C. D.

Therapeutic communication Client-centred care Maintaining boundaries Protecting the client from abuse (Financial abuse perpetuates a power dymanic)

Column A

Column B

1. Intentional action characterized by commitment & a sufficient level of knowledge/skill to allow you to support the basic integrity of your client CARING 2. Accurately perceiving another person’s feelings, & communicating (verbally & nonverbally) that understanding back to the client (ask for validation) EMPATHY 3. Providing info, tools, support, resources that help client build skills to reach health goals EMPOWERMENT 4. The foundation of all therapeutic relationships TRUST

A. Empowerment

B. Caring

C. Trust D. Empathy

Stereotype: Attributing a trait to a whole group of people.  Can from culture and experience A RN on a medical unit is upset with her client and says “if that lady rings the buzzer one more time, I’m going to disconnect it. Can’t she understand that I have other clients who need my attention more than she does? She just lies in bed all day long. No wonder she is so fat” 

Is there a stereotype or bias that is being demonstrated in this scenario? If so, what is it?  People that are overweight are lazy  Her stereotype is the thought and leads to biased behaviour (lack of attention to the client)  This is considered a barrier to the therapeutic relationship

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As a nurse, how would you reduce the bias in this situation?  Become aware through self-reflection and self-awareness

Case Study 1

Recommendation 1.1: Establish a therapeutic relationship with the person using verbal and non-verbal communication strategies to build a genuine, trusting, and respectful partnership.  Introduce self and role which establishes trust  First show empathy, and validate the fact that he is saying he is having chest pain  Take vitals Recommendation 1.2: Build empowering relationship with the person to promote the persons proactive and meaningful engagement as an active partner in their health care.  Provide information on the symptom (Chest Pain)  Explain that lots of people have chest pain  Giving information increases knowledge and power which helps decision making Recommendation 1.3: Listen and seek insight into the whole person to gain an understanding of the meaning of health to the person and to learn their preferences for care.  Ask for information outside of chest pain (Ex: About their family, work, stresses ect.) Recommendation 1.4: Document information obtained on the meaning and experience of health to the person using the person’s own words.  If you didn’t document it, it didn’t happen  Writing notes to self

Case Study 2

Recommendation 1: The nurse must acquire the necessary knowledge to participate effectively in therapeutic relationships 1.

Background knowledge: focus on the client (not the brother), the nurse needs to establish how the brother’s symptoms affecting her.

Recommendation 2 & 3: Establishment of a therapeutic relationship requires reflective practice. This concept includes the required capacities of: self- awareness, self-knowledge, empathy, awareness of boundaries and limits of the professional role: Boundaries culture The nurse needs to understand the process of a therapeutic relationship and be able to recognize the current phase of his/her relationship with the client. This is the orientation phase.

We e k5

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Explore the concept of metacommuncaiton Differentiate between verbal and non-verbal communication Discuss verbal and non-verbal style factors that influence the therapeutic relationship Discuss the influence of sociocultural factors on professional communication Describe the 5 levels of communication and their uses in nursing Describe the basic elements of the communication process Examine the key forms of verbal and non-verbal communication

Co mmuni c a t i o n:Th ee x c h a n g eo fi n f o r ma t i o n ,o rv e r b a la n dn o n v e r b a li n f o r ma t i o n . The r a pe ut i cCommuni c a t i o n:Th ee x c h a n g eo fi n f o r ma t i o nt ha tf o c u s e sont h ec l i e n t ’ sn e e d s . Me t a c o mmuni c a t i o n:Al lf a c t o r st h a ti nflu e n c eh o wame s s a g ei sr e c e i v e d.Describes all factors that influence how the message is perceived. This is the MOST IMPORTANT form of communication. 95% of the communication that people perceive is from metacommunication.

Ke yAs s umpt i ons 1 .I ti si mp o s s i b l en o tt oc o mmu n i c a t e . 2 .Ev e r yc o mmun i c a t i o nh a sac o nt e nta n dar e l a t i o n s h i p( me t a c ommu ni c a t i o n )a s p e c t . 3 .Weo n l ykno wa b ou to u r s e l v e sa n dot h e r st h r o u g hc o mmu ni c a t i o n . 4 .Fa u l t yc o mmu n i c a t i onr e s u l t si nfla we df e e l i n ga nda c t i n g . 5 .Fe e d b a c ki st heo n l ywa ywekn o wo u rpe r c e p t i o nsa b o utme a n i n g sa r ev a l i d .Wec a na l s o a s kf o rv e r ba lf e e d ba c k. Ex :I sy o u rp a i nb e t t e ra f t e rt a ki n gme d i c a t i on ? 6 .Si l e n c ei saf o r mo fc ommu n i c a t i o n .Si l e n c ei sa ni n t e n t i o n a la c t i o n, i ti sawa yo f c o mmu n i c a t i n gu n me tn e e d s , n o tl a c ko fi n t e r e s t . 7 .Al lp a r t so fac o mmu n i c a t i o ns y s t e ma r ei n t e r r e l a t e da n da ffe c t o n ea n o t h e r . 8 .Pe o p l ec o mmu n i c a t et h r o u g hv e r b a la n dn o n v e r b a lbe h a v i o u r swh i c ha r ee q u a l l y ne c e s s a r yt oi n t e r p r e tt h eme s s a g ea p p r o pr i a t e l y . 9 .I nt e r p e r s o n a lc o mmu n i c a t i o np r o c e s s e sc a nr e fle c t d i ffe r e n c e si nt hee q u a l i t yo ft h e r e l a t i o n s h i p.

Ve r ba lSt yl eFac t o r sa ndCo mmuni c a t i o n

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Vo c a b u l a r y :Th ewo r d st h a ty o uu s e Ge n e r a l i z e dme a n i n gEx :Goj u mpi nal a k e =Goj u mpi nal a ke )a n d De n o t a t i v e( Co n n o t a t i v eme a ni n gwhi c hc a nl e a dt omi s c o mmu ni c a t i o n( Pe r s o na l i z e dme a n i n gEx : Goj u mpi nal a k e =Gog e tl o s t ) Pa c i n g( Th er a t eo fs p e e c h ,b emi n d f u lt os l o wdo wn ) Pa r a l a ng u a g e( Pi t c ha n dTo n e , i nt o n a t i o n) Cl a r i t ya n dBr e v i t y( Cl e a ra n ds u c c i n c t ) Ti mi n ga n dRe l e v a n c e :Ap p r o p r i a t ei n f of o rt hea p p r o p r i a t et i me En c o u r a g ec l i e nti n v o l v e me n t Va l i da t ec l i e n t ’ swor t h Ad v oc a t ef o rc l i e ntwh e nn e c e s s a r y :Emp a t h y Pr o v i d ei n f o r ma t i o na p pr o p r i a t e l y

emo s ti mpo r t a n tf o r m ofc o mmu ni c a t i o n No nv e r balCo mmuni c a t i o n Th  Ma j o r i t yo fme a ni n gi sc on v e y e dno n v e r b a l l y  Smi l i ng :Co n v e y same s s a g eo fc a r i n g , t r u s t , e mpa t h y  To u c h :Co mf o r t , r e a s s u r a n c ea n dp r e s e n c e . No nv e r balCo mmuni c a t i o nSt yl eFa c t or s  Pe r s o n a l Ap p e a r a n c e  Po s t u r ea n dGa i t  Fa c i a lEx p r e s s i o n  Ey eCon t a c t  Ge s t u r e sa n dTou c h  So u n d s  Pe r s o n a l Sp a c e So c i o Cul t ur a lFa c t o r sAffe c t i ngCo mmuni c at i o n  Ag e : Di ffe r e n c e si nc o mmun i c a t i o ns t y l e sa n dp e r c e p t i o no fa u t h or i t y -c o n s i d e r a l t e r n a t i v ec o mmu n i c a t i o nt e c h n i q u e s . Ex a mp l e :Yo u n gc h i l d r e nc ommu ni c a t i n gwi t ha nu r s ev s . a4 0y e a ro l d , t r ya n dme e ti n d i vi d u a ln e e d swi t ho t h e rc o mmu n i c a t i on t e c h n i q u e ss u c ha sph o t oso rv i d e o s .  Ge nde r :Gr e a t e s ts i g n i fic a nc ei nt e r mso fn on v e r b a l .  Cul t ur e :Sup p o r t t h ec l i e n ta n dp r o v i d et h e m wi t hi n f o r ma t i o nt oma k ea ni n f o r me d c h oi c e . Ev e ni fy o ud on o ta g r e ewi t ht h ed e c i s i o n .CNODo c u me n tp a g e s3 7h a v ek e y a s s u mp t i ons : -Ev e r y o n eh a sc u l t u r e( Wh i c hi si n d i v i du a la n dun i q ue ) -Cu l t u r ei si n d i v i d u a la n du n i q u e -I ti sa ffe c t e db yr a c e , g e n d e r , c l a s s -Re a c t i o n st oc ul t u r ei ss u b c o n s c i o u s -An u r s eh a sh e ro wnt h a tg u i d e st h et h e r a p e u t i cr e l a t i o ns h i p -An u r s eh a st or e c o g n i z et h ec u l t u r eo ft h ec l i e nt  Loc a t i o n:Co n s i d e rr u r a lv su r b a n ....