Relationship 1

Practical Nurse Theory 402

Kim King/500059566

Arlene Bissette/PNUR2012

November 29, 2010

 Relationship 2

Therapeutic nurse-client relationship

The therapeutic nurse-client relationship involves caring attitudes, behaviours, together with

knowledge and skills that are necessary to deliver best possible nursing care.

Therapeutic communication is a practice used by nurses to consciously influence a client, or

helps the client to a better understanding through verbal or nonverbal communication.

Therapeutic communication involves the use of specific strategies that encourage the patient to

express feelings and ideas and that convey acceptance and respect. (Mosby, 2009)

The nurse also uses nonverbal communication to send a message without the use of words

and may involve any or all of the five senses. Body language is a set of nonverbal signals,

including body movements, postures, gestures, spatial positions (where you place yourself in the

room), and facial expression. Including body adornment that gives expression to various

physical, mental, and emotional states.[ CITATION Mos09 \l 4105 ]

Kinesics is the study of body position, posture, movement, facial expression in relation to

communication, and is the observation of nonverbal behaviour. To summarize; it's not what you

say but how you say it, and it is an important part of health assessment. Kinesics is used during

the mental health assessment as an objective and measurable tool for diagnosing disturbances of

communication and behavioural disorders. [ CITATION Mos09 \l 4105 ]

When dealing with cultural differences the nurse should be aware of using touch and/or eye

contact as a form of nonverbal communication. Some cultures find this type of nonverbal

communication offensive.
 Relationship 3

The preinteraction phase allows you to prepare for your client and set aside your feelings,

fears, and anxieties about working with a particular client based on your past experiences. As a

result the nurse can effectively be able help others in their time of need.

Trustworthiness is demonstrated through nursing interventions and although trust cannot be

presumed, it must be earned. By providing the simple needs in life for example; a blanket when

the client is cold, keeping promises, providing food when the client is hungry, being honest,

keeping the client informed of policies and procedures with explanations when asked, along with

ensuring confidentiality as many times as needed.[ CITATION Mar08 \l 4105 ] This is the clients’

basic needs for safety and security which is part of Maslow’s hierarchy of needs; without this it

will be difficult to build a rapport.

By allowing the client to reflect on what has happened to them, the nurse can encourage the

client to show emotions such as sadness and anger if they desire. The nurse should be sitting

squarely facing the client, making sure to stay with them, and making the patient feel

comfortable knowing that you are interested in what they have to say. Using open posture,

leaning slightly forward, and maintaining eye contact is important during this interaction. The

nurse should feel relaxed and comfortable with the client to show that he/she is confident in

assisting them, and is interested in meeting their needs.

Social boundaries are set by what is accepted behaviour during a hospital stay and involve the

interdisciplinary team. Professional boundaries inform the client of the difference between

therapeutic and emotional needs. Crossing these boundaries can threaten the nurse-client

relationship.
 Relationship 4

As a mental health nurse you would ask your team for assistance when you need it in order to

better assist your client including all outside resources available to the client through the local

mental health services in their community.

Understanding how everyone deals with life stresses through anger, denial, fear, grief and

humour are a few ways in which the client can cope with stress in everyday situations. This is

part of our basic needs for survival using our fight or flight response to overcome what might be

called upon us at any given time.

The nurse shall remind the client of their rights to accept or refuse care at anytime unless safety

is an issue of the client or health care providers. Also, provide access to religion and ritual needs;

let them know that we are available to assist them to accept changes in their new behaviours as

they develop into new healthy habits. These changes may happen many times in order to meet

their needs. This thought had me reflect on the serenity prayer; refer to last page.

Praise when appropriate is useful to assist in the therapeutic nurse-client relationship, for

example letting the client know that you appreciate that they attended a group meeting.

When caring for the client nurses should also provide therapeutic support to immediate family

members by letting them know that the client may or may not want them to visit at this time.

Reassure significant others that their family member is being well looked after and their needs

are being meant.

 Relationship 5

The Serenity Prayer

God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.

Living one day at a time;

Enjoying one moment at a time;
Accepting hardships as the pathway to peace;

Taking, as He did, this sinful world

as it is, not as I would have it;
Trusting that He will make all things right
if I surrender to His Will;
That I may be reasonably happy in this life
and supremely happy with Him
Forever in the next.
Amen.

--Reinhold Niebuhr

[ CITATION Rei02 \l 4105 ]

 Relationship 6

References

Mosby. (2009). Mosby's dictionary of medicine, nursing & health professions 8th edition. St.

Louis: Mosby Elsevier.

Niebuhr, R. (2002, July 14). Serenity prayer. Retrieved October 27, 2010, from © Bread on the

Waters Web Pages : www.cptryon.org/prayer/special/serenity.html

Potter, P. R.-K. (2006). Canadian Fundamentals of nursing. In P. Perry, Canadian Fundamentals

of nursing 3rd edition (pp. 288-291). Toronto: Elsevier Canada.

Townsend, M. C. (2008). Essentials of psychiatric mental health nursing 4th edition. In M. C.

Townsend, Essentials of psychiatric mental health nursing 4th edition (pp. 95-112).

Philadelphia: F. A. Davis Company.