Elements of Effective Milieu General Principle for developing a therapeutic

nurse-patient relationship
Safety of being safe
1. Be calm when talking to patients
- Freedom from psychological harm
2. Accept patients as they are, but do not
Psychological harm – Stn served with golden
accept all behaviors
spoon = increase self- awareness
Even if you were disliked by client, don’t
words/facial expression
allow them to change nurses, instead you
- Freedom from physical harm
tell them you will be there, you can play
physical harm – scissors, sharps, pencils,
with them
ballpen, rope(measurement)
3. Keep promises
Structure Unkept promise will let pt be little
themselves
- There could be pts na confused, atleast they Pt asks for oreo but that’s contraindicated
know their routine in hospital to them, so you tell your patient you will
- Hyperactive pt, when it comes to meal, wala give it to the staff nurse, if doctor allow, let
mauna or malate dapat pt ask the staff nurse for the oreo(with
Balance name)
4. Be consistent
- Giving freedom to choose, what if they choose if you violate rule for one client, you violate
spaghetti type, you explain to them the reasons for all
why not. You allow them to be independent but sharing, everyone should share. If one is not
still you balance things you need to decide for ready, you go back to them sa last
them 5. Be honest
Norm *nothing follows: lupad na utok*
- We also need to provide our own norms
- Game, one of your norm is to employ
sportsmanship (walang mag away, walang
magkasakitan)
- Activity, biglang maghubad, so norms can be
used

Limit Setting

- You give them options but still they can’t

invalidate the norms
- Hannah is sitting, while norms says everyton
must join the exercise, so you let them see why
Hannah is sitting (namaga ang paa)

Environmental Modification

- Modifying the environment conducive for

activity

Roles of the Nurse

- Individualized, even if the same na schitz, still

you individualize