Comply with the standard of care o Supervise care o Adhere to the nursing process o Document carefully o Follow up as required o Develop and maintain a good interpersonal relationship with client and family Chapter 7: Relationship Development Introduction
o The nurse-client relationship is the foundation on which psychiatric nursing is established o A therapeutic relationship is an interaction between two people (usually a caregiver and a care receiver) in which input from both participants contribute to a climate of healing, growth promotion, and illness prevention Role of the Psychiatric Nurse o Nursing has evolved through various roles from custodial caregiver and physician’s handmaiden to recognition as a unique, independent member of the professional health- care team o Peplau identified seven subroles within the role of the nurse: The stranger In the beginning, nurse and client are strangers to each other The resource person The nurse provides information related to the client’s health care The teacher The nurse identifies learning needs and provides information required by the client or family to improve the health situation The leader Democratic leadership allows the client to be an active participant in planning his or her care The surrogate For the client, the nurse fulfills basic needs, which is associated with mothering The technical expert The nurse possesses the clinical skills necessary to perform the interventions that are in the client’s best interest The counselor The nurse uses “interpersonal techniques” to help clients learn to adapt to difficulties or changes in life experiences o Peplau believed that the emphasis in psychiatric nursing should be on the counseling subrole o Peplau and Sullivan, both interpersonal therapists, emphasized the importance of relationship development in the provision of emotional care Dynamics of a Therapeutic Nurse-Client Relationship o Therapeutic nurse-client relationships can occur only when each views the other as a unique human being o When this occurs, both participants have needs met by the relationship o Therapeutic relationships are goal oriented and directed at learning and growth promotion o Goals are often achieved through use of the problem-solving model: Identify the client’s problem Promote discussion of desired changes Discuss aspects that cannot realistically be changed and ways to cope with them more adaptively Discuss alternative strategies for creating changes the client desires to make Weigh benefits and consequences of each alternative Help client select an alternative Encourage client to implement the change
Provide positive feedback for client’s attempts to create change Help client evaluate outcomes of the change and make modifications as required Therapeutic Use of Self o The ability to use one’s personality consciously and in full awareness in an attempt to
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- Spring '17