THERAPEUTIC NURSE
PATIENT
RELATIONSHIP
INTRODUCTION
Mutual learning experience
Corrective emotional experience
Based on the humanity of Nurse and
Patient.
Includes mutual respect and acceptance
of socio cultural differences
Nurse use personal attributes ,clinical
techniques
DEFINITION
RELATIONSHIP
It is defined as a state of being related or
state affinity between two individuals
Example : Friendship and colleagues
THERAUPATIC RELATIONSHIP
It is a relationship where the Nurse and client
work together towards the goal of assisting the
client to regain the inner resources to meet life
challenges and facilitate growth of health.
COMPONENT
Components of therapeutic relationship:
1.Rapport: is a relationship or communication
especially when useful and harmonious.
It is :
A willingness to become involved with
another person
Growth towards mutual acceptance and
understanding of individuality
The end result of one’s care and concern for
another
2.empathy:is an ability to feel with the
patient while retaining the ability to
critically analyze the situation.
3.Warmth
4.Genuineness
5.Confidentiality
PHASES OF NURSE PATIENT
RELATIONSHIP
The phases of Nurse patient relationship
are as follows:
1. Preinterection /preporientation phase
2. Orientation phase
3. Working phase
4. Termination phase
PREINTERECTION / PREORIENTATION
PHASE
This is a phase in which a nurse goes
through before the actual interaction of
the client.
This phase begins when the Nurse is
assigned to a client to develop
therapeutic relationship with him, till she
goes to him for interaction.
Tasks
Explores own feelings and fears
Analyze own professional strengths and
limitations
Gather data about client
Plan for first meeting with client
Takes help of the clinical supervisor or
co- worker to overcome fears
ORIENTATION PHASE
This is a phase which begins when the
nurse goes to the client introduces self
and gets introduction about him
- The nurse and the client who are
strangers meet for the first time and
become acquaintances.
- The ends when the client and Nurse
accept each other as a unique human
being.
Tasks
-Establishment of contact,rapport,trust
and acceptance
- Gather data including the client’s
feelings, strength and weaknesses
-Define client’s problems, set priorities for
nursing intervention
- When the nurse and client meet and get
to know one another
-Assess the client’s health status
WORKING PHASE
Nurse patient relationship starts when the
nurse and the client are able to overcome
the barriers of orientation or
introductory(period) phase.
During this phase the Nurse and client actively
work on meeting the goals which they had
established during the orientation phase.
The characteristic features of this phase are
that the Nurse is able to overcome anxiety
and the client’s fear of unknown is also
decreased
TASKS
The nurse assists the client to identify
his or her problems, share feelings and
get socialize
Help the client to communicate.
Encourage and help the client to express
feelings about his or her health.
Provide information needed to
understand and change behavior.
Encourage and help the client to set
goals
TERMINATION PHASE
It is also called as resolution phase or end
phase
Goal: To bring a therapeutic end to the
relationship
TASKS
During the ending of the relationship:
Remind the client the termination is
near.
Evaluate goal achievement with the
client.
Separate from the client by relinquishing
responsibility for his or her care
Establish reality of separation
Formulate plans for meetings future
therapy needed
TECHNIQUES OF THERAUPATIC
COMMUNICATION
The techniques of therapeutic communication are as
follows:
1.Listening
Observing and listening skills.
LADDER
L – Look at others, keep good eye contact.
A- Ask appropriate questions only
D – Do not interrupt
D – Do not change the subject
E – Express emotions with control
R – Responsively listen
2.Restating
Repeating the main through expressed by
the client.
Example – You say that your mother
left you when you were 5 years old.
3.Broad opening
Encourage the client to select topics for
discussion.
Example – What are you thinking about?
4.Clarification
Attempting to put unclear thoughts of
the client into words to enhance nurse’s
understanding or asking the client to
explain what he / she means.
Example: 'I am not sure about what you
mean; could you tell me again’’?
5. Reflection
Directing back the client’s ideas, feelings,
questions and content.
Example: You are feeling anxious and tense and
it is related to a conversation you had with your
husband last night?
6.Humor
The discharge of energy through the comic
enjoyment of the imperfect. That gives a whole
new meaning to the word ‘nervous’ said with
shared kidding between nurse and the patient.
7.Informing
The skill of information sharing.
Example: 'I think you need to know more
about your medications’.
8. Focusing
Questions or statements that help the
patient expand on a topic of importance.
Example:’ I think we should talk more
about your relationship with your father’
9.Sharing perceptions
Asking the client to verify nurse’s understanding of what
the client is thinking or feelings.
Example: 'You are smiling, but I sense that you are really
very angry with me’.
10. Theme identification
This involves identification of underlying issues or
problems experienced by the client that emerge
repeatedly during the course of the nurse client
relationship.
Example: 'I noticed that you said you have been hurt or
rejected by the man. Do you think this is an underlying
issues?’’
11.Silence
Lack of communication for
therapeutic reason.
Example: Sitting with a client
and non-verbally
communicating interest and
involvement
12. Suggestion
Presentation of alternative ideas for the
client’s consideration relating to problem
solving.
Example:’’ Have you thought about
responding to your Bose in a different
way when he raises that issue with
you?’’
