It is during the introductory phase that the nurse and patient first meet. One of the nurse’s primary concerns is to find out why the patient sought help (Table 2-2). The reason for seeking help forms the basis of the nursing assessment, helps the nurse focus on the patient’s problem, and determines the patient’s motivation for treatment. It is important for the nurse to realize that help-seeking varies among different cultures, social, and ethnic groups. Another task is for the patient and nurse to establish their partnership and agree on the nature of the problem and the patient’s treatment goals. The focus is on the patient’s goals and not what the nurse believes should be done. Both the nurse and the patient may experience some degree of discomfort and nervousness in the introductory phase. Reasons that patients may have difficulty receiving help are listed in Box 2-3.
TABLE 2-2
ANALYSIS OF WHY PATIENTS SEEK PSYCHIATRIC HELP
REASONS FOR PATIENTS SEEKING PSYCHIATRIC CARE |
APPROPRIATE NURSING APPROACH |
SAMPLE RESPONSE |
Environmental Change from Home to Treatment Setting |
They desire protection, comfort, rest, and freedom from demands of their home and work environments. |
Emphasize the ability of the environment to provide protection and comfort while the healing process of the mind occurs. |
“Tell me what it was at home/on the job that made you feel so overwhelmed.” |
Nurturance |
They wish for someone to care for them, cure their illness, and make them feel better. |
Acknowledge their nurturance needs, and assure them that help and caring are available. |
“I’m here to help you feel better.” |
Control |
They are aware of their destructive impulses directed toward themselves or others but lack internal control. |
Offer sources of internal control, such as medication, if prescribed; reinforce external controls available through the staff. |
“We’re not going to let you hurt yourself. Tell us when these thoughts come to mind, and someone will stay with you.” |
Psychiatric Symptoms |
They describe symptoms of depression, nervousness, or crying spells and actively want to help themselves. |
Ask for clarification of symptoms, and strive to understand life experiences of the patient. |
“I can see that you’re nervous and upset. Can you tell me about how things are at home/on the job so I can better understand?” |
Problem Solving |
They identify a specific problem or area of conflict and express desire to reason it out and change. |
Help patient look at problem objectively; use problem-solving process. |
“How has drinking affected your life?” |
Advised To Seek Help |
Family member, friend, or health professional has convinced them to get treatment. They may feel angry, ambivalent, or indifferent. |
Confirm facts surrounding seeking of help, and set appropriate limits. |
“I see that you’re angry about being here. I hope that after we talk you might feel differently.” |
Modified from Burgess A, Burns J: Am J Nurs 73:314, 1973.
FAQs
A therapeutic nurse-patient relationship is defined as a helping relationship that's based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient's physical, emotional, and spiritual needs through your knowledge and skill.
What are the 5 principles of therapeutic nurse client relationship? ›
There are five components to the nurse-client relationship: trust, respect, professional intimacy, empathy and power. Regardless of the context, length of interaction and whether a nurse is the primary or secondary care provider, these components are always present. Professional intimacy.
What are 3 important characteristics of the nurse-patient relationship? ›
Key components include communication, active listening, and respect. Bioethical values and confidentiality must also be present to ensure that the relationship is built on equality and intimacy.
What is the most important element of a therapeutic nurse-patient relationship? ›
Key components needed to develop a therapeutic relationship include trust, respect, showing a genuine interest, and empathy. Following a pre-interaction phase, which is when the nurse must become aware of her own personal feelings, fears, and worries about working with a patient, there's an orientation phase.
What are the goals of therapeutic nurse-patient relationship? ›
The therapeutic relationship between nurse and the client differs from both a social and an intimate relationship in that the nurse maximizes inner communication skills , understanding of human behavior and personal strengths in order to enhance the client's growth.
Why is the therapeutic nurse-patient relationship important? ›
A good nurse-patient relationship reduces the days of hospital stay and improves the quality and satisfaction of both. However, in contrast, although the patient's participation in their decisions is greater, the good relationship is conditioned by the patient's submissive role [39,40,41,42].
What is the conclusion of therapeutic nurse-patient relationship? ›
Conclusion: The study showed the therapeutic relationship perceived by nurses was high while the therapeutic relationship perceived by patients was low to moderate level.
Are there 3 phases of a therapeutic nurse-patient relationship? ›
Peplau theorized that nurse-patient relationships must pass through three phases in order to be successful: (a) orientation, (b) working, and (c) termination.
How do you build a therapeutic relationship with a client? ›
Building rapport is crucial in developing a therapeutic relationship. Begin by creating a warm and welcoming atmosphere, displaying genuine interest and respect for your clients. Be attentive to their individual needs, preferences, and cultural background. Establishing trust takes time and consistency.
What are the key attributes of therapeutic nurse patient relationships? ›
In conclusion, the nurse-patient relationship is a helping relationship established with the patient and/or their family based on interaction, communication, respect for ethical values, acceptance, and empathy in order to encourage introspection and behavioural change.
The LPN utilizes a caring attitude and behaviors to meet the needs of the client. Hildegarde Peplau describes four sequential phases of a nurse-client relationship, each characterized by specific tasks and interpersonal skills: preinteraction; orientation; working; and termination.
What is the power in the nurse-patient relationship? ›
In the nurse-patient relationship, nurses hold a position of power by virtue of having: professional knowledge and skills that patients rely on for their well-being. more authority and influence in the health care system. access to patients' bodies (for example when performing physical exams)
What is the key of therapeutic relationship? ›
A strong therapeutic alliance encourages active participation by the client in their own healing process, which leads to better outcomes. Clients are more likely to follow through with treatment recommendations, discuss difficult topics, and develop insight when they trust their therapist and feel supported by them.
How do you maintain therapeutic nurse-patient relationship? ›
How to build a therapeutic nurse-patient relationship?
- Spend time getting to know the patient. ...
- Always listen. ...
- Establish trust. ...
- Showing respect. ...
- Professional intimacy. ...
- Empathy. ...
- Power. ...
- Staying positive and realistic.
Some of the factors identified by patients to impede therapeutic nurse-patient interaction include family interference, negative attitude from patients, patient condition, a discriminatory attitude of nurses, increased workload, and stress.
What is the summary of therapeutic relationship? ›
The therapeutic relationship refers to the relationship between a healthcare professional and a client or patient. It is the means by which a therapist and a client hope to engage with each other and effect beneficial change in the client.
What is summary in therapeutic communication? ›
Summarizing During Therapeutic Communication
Summarizing brings closure to the conversation by providing the patient with a summary of the key components of the conversation. It can also be used throughout the conversation to ensure that the nurse is understanding what the patient is conveying along the way.
