Establish relatedness and to structure nursing

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
