Therapeutic relationships

1
NURSE – PATIENT
RELATIONSHIP

2
NURSE-PATIENT RELATIONSHIP

Series of interactions between

the nurse and the patient in
which the nurse assists the
patient to attain positive
behavioral change

3
 CHARACTERISTICS OF THE
NURSE-PATIENT RELATIONSHIP

Goal-directed

Focused on the needs of the

patient

Planned

Time-limited
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 BASIC ELEMENTS OF THE
NURSE-PATIENT
RELATIONSHIPAL ELEMENTS
Trust

Rapport

Setting limits

Therapeutic communication

5
PHASES OF THE NURSE-
PATIENT RELATIONSHIP
Pre-orientation phase

Orientation phase

Working phase

Termination phase

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PRE-ORIENTATION PHASE

• 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
PRE-ORIENTATION PHASE

• 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
ORIENTATION PHASE
• Begins when the nurse and the
patient interacts for the first
time
• Nurse begins to know about the
patient
• Tasks include establishing
rapport, developing trust, (and
formulation of a nursing
diagnosis).
• Major task is to develop a
mutually acceptable contract
WORKING PHASE

• 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
TERMINATION PHASE

• 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
 TERMINATION PHASE

• How to terminate?

– Gradually decrease interaction time

– Focus on future oriented topics

– Encourage expression of feelings

– Make the necessary referral