292 FINAL EXAM – BLUEPRINT SPRING 2018 Nurse-Client relationship: 2

Characteristics of Nurse-Client Relationship  Mutual respect  Client focused  Meets client’s needs  Emotional needs of nurse cannot interfere  Purposeful and goal oriented  Goals mutually established  Collaborative  Shared decision making  Promotes client’s independence  Agreement or contract is established  Boundaries are maintained Phases of the Nurse-Client relationship  Pre-interaction  begins before nurse meets client, nurse reviews data, considers personal feelings and thoughts  Orientation phase  introductory phase, initial encounter, develop trust, establish verbal contract and boundaries, collect data, formulate nursing diagnosis, develop goals, and initial plan of care  Working phase  Termination phase  end of the relationship, evaluate outcomes, express feelings about ending the relationship Conditions essential to developing a therapeutic relationship  Rapport  Trust  Respect  Genuineness  Empathy Transference  client transfers feelings and behavioral dispositions formed towards the nurse from past  Do you have a boyfriend?  Where do you live? Countertransference  nurses behavioral and emotional responses to the client  Poor boundaries  Nurse begins to interfere with patient’s health decisions Conditions that influence the nurse-client relationship Communication & Defense Mechanism <> Active listening  interactive process between nurse and client, understanding and being understood SOLER  Sit squarely facing client  Observe an open posture  Lean forward toward the client  Establish eye contact  Relax Verbal communication  vocabulary, denotative/connotative meaning, clarity, timing, relevance, pacing, intonation of voice Non-Verbal techniques  facial expression, eye contact, body posture, gestures, appearance, silence Assertive communication  promotes use of I statements, allows client to own feeling, client encouraged to make clear what he or she wants. Passive communication  personal needs are secondary to others, style is apologetic or complaining. Client Factors Nurse factors Religion and culture  Communication varies across cultures  Nurses should clarify personal preferences  Nurses needs to be sensitive and respectful Age/ Developmental level  Communication must be appropriate Emotional maturity  Self-awareness  Emotional intelligence Boundaries  Understand differences between professional and social relationships  Limit self-disclosure  “I am here to help you, this isn’t about me it about you” Touch  Use touch cautiously  Inform clients before touching them