establish relatedness and to structure nursing interventions o Nurses must possess self-awareness, self-understanding, and a philosophical belief about life, death, and the overall human condition Gaining Self-Awareness o Values clarification is one process by which an individual may gain self-awareness o Beliefs Ideas that one holds to be true They may be: Rational Irrational Held on faith Stereotypical o Attitudes Frames of reference around which an individual organizes knowledge about his or her world Attitudes have an emotional component They may be judgmental, selective, and biased Attitudes may be positive or negative o Values Abstract standards, positive or negative, that represent an individual’s ideal mode of conduct and ideal goals Values differ from attitudes and beliefs in that they are action oriented or action producing Attitudes and beliefs become values only when they have been acted on Attitudes and beliefs flow out of one’s set of values The Johari Window o The Johari Window is a representation of the self and a tool that can be used to increase self-awareness; it has four quadrants The open/public self The unknowing self The unknown self The private self o The goal of increasing self-awareness by using the Johari Window is to increase the size of the quadrant that represents the open or public self o Increased self-awareness allows an individual to interact with others comfortably, to accept differences in others, and to observe each person’s right to respect and dignity Conditions Essential to Development of a Therapeutic Relationship o Rapport o Trust o Respect o Genuineness o Empathy Phases of a Therapeutic Nurse-Client Relationship
o Preinteraction Phase Obtain information about the client from chart, significant others, or other health team members Examine one’s own feelings, fears, and anxieties about working with a particular client o Orientation (Introductory) Phase Create an environment for trust and rapport Establish contract for intervention Gather assessment data Identify client’s strengths and weaknesses Formulate nursing diagnoses Set mutually agreeable goals Develop a realistic plan of action Explore feelings of both client and nurse o Working Phase Maintain trust and rapport Promote client’s insight and perception of reality Use problem-solving model to work toward achievement of established goals Overcome resistance behaviors Continuously evaluate progress toward goal attainment Transference Occurs when the client unconsciously displaces (or “transfers”) to the nurse feelings formed toward a person from the past Countertransference Refers to the nurse’s behavioral and emotional response to the client o Termination Phase Therapeutic conclusion of relationship occurs when: Progress has been made toward attainment of the goals
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- Spring '17