NUR 2488 Mental Health Nursing

Mental Health Exam 1 Study Guide Rasmussen Summer 2021

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Tasks in the Nurse-Client Relationship

- Pre-interaction phase

- Orientation phase

- Working phase

- Termination phase

Definition of therapeutic nurse patient (NP) relationship

- The nurse's role has evolved from custodial caregiver to a unique, independent, and

professional relationship in caring for the client. This transition requires a

therapeutic relationship with goals established with the client.

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The nurse-client relationship is the foundation on which psychiatric nursing is

established. The nurse must have a great deal of self-awareness and understanding

of others.

Pre-interaction phase

- Obtaining information about the client

- Examining one's feelings

Orientation phase

- Introduction

Create an environment for trust and rapport

Establish contract for intervention

Gather assessment data

Identify client's strengths and limitations

Formulate nursing diagnoses.

Set mutually agreeable goals.

Develop a realistic plan of action.

Explore feelings of both client and nurse.

Working phase

- Promote client insight and perception of reality

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- Problem-solving

- Evaluate progress toward established goals

**Transference and countertransference are common phenomena that may occur

during the working phase and can interfere with therapeutic relationship**

Transference

- Occurs when the client unconsciously displaces or transfers to the nurse feelings

formed toward another person from his/her past. This can be positive or negative.

Countertransference

- Refers to the nurse's behavioral and emotional response to the client. The nurse

must recognize the occurrence of this phenomenon, and remain professional at all

times.

Percent of communication that is non verbal

- 70%-80%

Boundary violations

- Self-disclosure

- Gift giving and receiving

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- Touch is avoided because it can be misinterpreted as affection or aggression 

Importance of maintaining boundaries

- There are professional boundaries in the Nurse-Client Relationship. Nurses must be

consistently conscientious in avoiding any circumstance in which they might

achieve personal gains

Silence

- This allows the client to collect and organize thoughts

Accepting

- Convey an attitude of acceptance. Nurse: 'Yes, I understand what you said."

Giving recognition

- Acknowledge awareness- "I see you made your bed."

Offering self

- Making oneself available. Nurse: "I will stay with you."

Giving broad openings

- Allowing the client to introduce the topic. Nurse: "What would you like to talk

about?"

I am offering general leads

- Offering the client encouragement to continue. Nurse: "I see. Go on."

Placing event in time/sequence

- Clarifying the relationship of events so the nurse and client can view them in

perspective. Nurse: "Was this before or after..." 

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