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Vincent Ejakait, profile picture
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Therapeutic nurse patient relationship in psychiatry

This document discusses the nurse-patient relationship and the different phases it progresses through. It outlines the pre-orientation, orientation, working, and termination phases. It also discusses transference and countertransference, as well as the importance of viewing the patient in a holistic, non-judgmental manner to build rapport and trust. Finally, it briefly touches on the concepts of mental hygiene, mental health maintenance, and rehabilitation as approaches to promoting mental health.

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Psychiatric Nursing•Mental Health Nursing•
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By Mr. Vincent Ejakait
10/5/2017Psychnebppt. 2  Series of interactions between the nurse and the patient in which the nurse assists the patient to attain positive behavioral change
10/5/2017Psychnebppt. 3  Goal-directed  Focused on the needs of the patient  Planned  Time-limited  Professional
10/5/2017Psychnebppt. 4  Trust  Rapport  Unconditional positive regard  Setting limits  Therapeutic communication
10/5/2017Psychnebppt. 5  Pre-orientation phase  Orientation phase  Working phase  Termination phase
10/5/2017Psychnebppt. 6  Begins when the nurse is assigned to a patient  Phase of Nurse-Patient Relationship in which the patient is excluded as an actual participant  Nurse feels certain degree of anxiety
10/5/2017Psychnebppt. 7  Includes all of what the nurse thinks and does before interacting with the patient  Tasks include data gathering, planning for the first interaction  Major task is to develop self-awareness
10/5/2017Psychnebppt. 8  Begins when the nurse and the patient interacts for the first time  Parameters of the relationship are to be laid  Nurse begins to know about the patient  Tasks include establishing rapport, developing trust, assessment (and formulation of a nursing diagnosis).  Major task is to develop a mutually acceptable contract
10/5/2017Psychnebppt. 9  It is highly individualized  More structured than the orientation phase  The longest and most productive phase of the nurse- patient relationship  Limit-setting is employed  Tasks include planning and implementation  Major task is identification and resolution of the patient’s problems
10/5/2017Psychnebppt. 10  It is a gradual weaning process  It is a mutual agreement  It involves feelings of anxiety, fear and loss  It should be recognized in the orientation phase  Tasks include evaluation  Major task is to assist patient to review what has been learned and to transfer his learning to his relationship with others
10/5/2017Psychnebppt. 11  Occurs when the client displaces onto the nurse attitudes and feelings that the client originally experience in other relationships  These patterns are automatic and unconscious  Example: A client falls in love with the nurse.
10/5/2017Psychnebppt. 12  Occurs when the nurse displaces onto the client attitudes or feelings from his or her past.  Example:  A female nurse who has teenage children and who is experiencing extreme frustration with an adolescent client may respond by adopting a parental or chastising tone.  The nurse is countertransfering her own attitudes and feelings toward her children onto the client.
 Development of ambivalent feelings toward self-exploration 10/5/2017Psychnebppt. 13
10/5/2017Psychnebppt. 14
10/5/2017Psychnebppt. 15  The nurse views the patient as a holistic human being.  The nurse accepts the patient as a unique human being..  The nurse should focus on the patient’s strengths and assets.  The nurse views the patient’s behavior non- judgmentally.  The nurse has the potential for rapport.
10/5/2017Psychnebppt. 17  Review definition of mental hygiene  Interventions aimed at the promotion of mental health and lowering incidences by altering the stressors. Examples: Health education Information dissemination Counseling
10/5/2017Psychnebppt. 18  Interventions that limit the severity of a disorder.  Has two components: Case finding. Prompt treatment. Examples: Crisis intervention Administration of medications
10/5/2017Psychnebppt. 19  Interventions aimed at reducing the disability after a disorder.  Has two components: Prevention of complication Active program of rehabilitation Examples: Alcoholics Anonymous groups. Occupational therapy