HUMAN RELATIONSHIP

  IN
NURSING

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HUMAN RELATIONSHIP

The term “Human relationship” stands for relations

of human beings among themselves living in a
society.

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 HUMAN RELATIONSHIP

MEANING:

•The way in which two people, groups and

countries behave towards each other.

•An aggregation of all forms of interactions

between/among persons Or groups in a particular
situation.

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HUMAN RELATIONSHIP
MEANING(contd…)

•In the workplace, it is the aggregation of all

forms of interactions between an individual
worker and another group of workers.

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 Types of the Relationship

Social Intimate Therapeutic

Friendship Emotional Focus on client
Companion commitment needs
Use small talk May be sexual Experiences,
superficial Emotional- Feelings, ideas
Intimacy Goal oriented

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SOCIETY:
Formed by people, their social
relationships, interactions and communication
among themselves which they mutually influence
each other. Language is must for social
interactions
SOCIAL INTERACTIONS & ROLES:
Society is
the continual process of associating with others
and being influenced by them. Social
interactions form the basis of formation of social
relationships and society.

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SOCIOLOGY :
The study of social interaction
and social acts.
Knowledge of sociology helps to understand
social relationships and social influences.
SOCIAL ACTS:
Through which persons
influence or modify the behavior of other
persons.
SOCIAL EXPECTATIONS:
Expected acts in
appropriate situations.
We often express this by saying,” I do what I
am supposed to do,” or “he did not do what he is
supposed to do.” 7
SOCIAL GROUPS:
A human or social group is
formed by the interaction of two or more
persons.
It is the simplest definition of a social group.

CULTURE:
It is defined as the total way of life.

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Basic human needs for relationships:
There are nine basic human needs, which can be listed
down as:
1. Security
2. Adventure
3. Freedom
4. Exchange
5. Power
6. Expansion
7. Acceptance
8. Community
9. Expression

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Basic human needs for relationships:

SECURITY:
Need to feel safe & assured which has
different meaning for different people.
ADVENTURE:
Need to have new experiences, travel &
drama in life.
FREEDOM:
Need for independence, spontaneity, choices
& to feel control of making choices.
EXCHANGE:
Need to trade information and knowledge and
receive something of value like friendship,
services, money, gifts, love, justice etc.
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Basic human needs for relationships:

POWER:
Need to be in a position of leadership,
authority and responsibility.
EXPANSION:
Need to build something, to add onto, to
create an empire, to expand horizons & to go
where no one has gone before.
ACCEPTANCE:
Need to accept yourself and be accepted by
others.  This includes a feeling of belonging. 
COMMUNITY:
Need for having people around , gatherings,
parties & relationships.
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Basic human needs for relationships:

EXPRESSION:
Need to be artistic, to be seen, heard, felt &
to express oneself through words, speech,
actions, dress, art and self-creations.

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 Principles of Human Relationship:

•APPRECIATION: Defined as a full or sympathetic

Understanding of a person.

•RESPECT: This is defined as the feeling of

admiration for people and polite behavior resulting
from practice of mutual exchange in interactions.

•EMPATHY: This is the ability to imagine and

share another person’s feelings.

•INTEGRITY: Always act in an honest and truthful

way.
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 Principles of Human Relationship:

•MANNERS: Never being selfish, boorish or

undisciplined.

•PERSONALITY: Always communicate your own

values, attitudes and opinions.

•APPEARANCE: Always present yourself to best

advantage.

•CONSIDERATION: Always see yourself from the

other person’s standpoint.
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THEORY OF HUMAN
RELATIONS

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 THEORY OF HUMAN RELATIONS

The Human Relations Theory of organization

came in to existence in 1930s.

 Human relations theory is also known by

various names like Humanistic Theory,
Neoclassical Theory, etc.

Elton Mayo an American Sociologist is the

founder of the Human Relations Theory.

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 THEORY OF HUMAN RELATIONS

The Hawthorne Experiment (1924-1932)

conducted in the Western Electric Company at
Hawthorne near Chicago by the Harvard
Business School under the leadership of Elton
Mayo formed the basis for the rise of the Human
Relations Theory of Organization

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  Features:
Human Relations Theory has three elements or
features.

 Individual
Informal Organization
Participative Management.

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The Individual 

The Theory recognizes the importance of

emotions and perceptions of individuals.

 It holds the view that the level of worker’s

production and organizational output is
determined by the human relations at work and
not so much by the physical and economic
conditions of work.

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 Informal Organizations

The Human Relations Theory emphasizes the

informal organizations.

Attention is focused on the social aspects of

man whose overriding need is seen as a desire
to belong, to be accepted by and stand well in
his work group.”

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 Participative Management

Human Relations Theory advocates the style

of participative management.

In other words, the manager should consult the

work groups and their informal leaders before
introducing a change of programme.

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 Participative Management(contd…)
This participative management is
meritorious because it permits the workers
to influence the decisions that affect them
 Develops a sense of participation in the
group
Makes the working environment more
pleasant
Prevents the alienation of workers from
the management
 Facilitates the acceptance of
organizational goals by the workers, and
above all, results in higher productivity.
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 WHAT IS
NURSING IN
SOCIAL
TERMS???

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DEFINITION OF NURSING IN TERMS OF
SOCIAL RELATIONSHIP:

Nursing: A significant therapeutic interpersonal

process. It functions cooperatively with other
human personnel, that make health possible for
individuals in communities 

•Nursing is therapeutic and healing art,

assisting an individual who is sick or in need of
health care.

•Nursing is an interpersonal process because it

involves interaction between two or more
individuals with a common goal.
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Social relations of the Nurse

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 Social relations of the Nurse in
hospital:
•Hospital director
•Nurse director
•Head nurse
•Doctors
•Practical nurses
•Nurse aides
•Orderlies
•Student nurses
•Patients
•Patient families & friends
•General duty nurses
•Private duty nurses
•Other specialty nurses
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 WHY DO WE NEED
RELATIONS IN
PROVIDING NURSING
CARE????

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The ‘Human touch’..or ‘No touch’?

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Importance of society in human
relationships in nursing:
In a recent study it is stated that, “most
nursing takes place where there are several kinds
of people at work so that any change in the work
of one must alter the work of others”. To
understand human relationships, we need to study
subjects such as sociology. Nurses have to
interact with people in hospitals, community to
deal with their sufferings.

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Importance of social relations in
nursing:
•Nurses have to interact with people in hospitals,
community to deal with their sufferings.

•Helps to gain knowledge R/T practical

problems.

•Clear understanding of one’s own personality as

well as the personality of each patient and
colleagues.

•Understanding the role & place of each special

type of nurse in hospital and community. 30
Importance of social relations in
nursing (contd…):

•Understanding of the independent relations of

nursing service with other health, welfare and
educational services

•Understanding of danger of over-simplification

of social blame and prejudice among various
groups.

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Hospital….
A part of social system dealings with…..
 Professionals – Nurses, doctors, technicians,
paramedics
 Other personnel– housekeeping, dietary,
laundry, supplies, accounts…
 Clients, relatives, friends visitors, other
customers.

All lead to public relations within the hospital.

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Public relations spring from human relations

Client –

A bundle of expectations,
anxieties, hopes and fears
Wants effective & satisfactory services
Forms impressions of the hospital set up

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Health workers –
Have personal and professional needs
Want job satisfaction & recognition of their efforts
Hospital administration –
Wants efficiency and maximum satisfaction of
staff and patients.
THE ULTIMATE OUTCOME DEPENDS ON
HUMAN RELATIONS……

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 PROFESSIONALS IN HEALTH TEAM

Nursing team

Physicians Nutritionist

Physical therapist Occupational therapist

Immunologist Dietician

Respiratory therapist Radiologist

Pharmacist Lab technologist

Social workers Spiritual advisors 35

Relationship of nurse with the
members of health team

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 Nurse and the Physician

Have team spirit & co-worker

relationship

Be loyal and honest

Carry out instructions

intelligently

DO NOT take verbal orders

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 Nurse & Nursing superintendent

Respect & cooperate

Reporting punctually

Maintain courtesy when taking ward rounds

Take assistance for

problem solving

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 Nurse and the Head nurse

Respect & support her

Cooperate intelligently

Reporting on duty and leaving off duty

Hand over & take over important

issues

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 Nurse and fellow nurses

Treat seniors with respect

Maintain good team work/ spirit

Share information to achieve best care

of the sick

Correctly hand over and take over

patient concerning information

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 Nurse and other hospital personnel

Maintain good relationship with all

departments

Maintain smooth coordination between

patient unit and the departments

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Nurse and the non professional workers

Be decent & considerate

Maintain good relationship

Provide guidance and teaching

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 Nurse and the Client
Treat as an individual
Understand and help
No discrimination
Do not accept any gifts/ favour
Help to adjust, cooperate and
accept treatments
Create confidence.

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Nurse and the Client (Contd…)

Establish good Nurse Patient

relationship
 Call by name..
Be pleasant, cheerful and
courteous
Do not get too familiar. Do not
discuss personal affairs.

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Negative Impact Factors in Relationships

•Perception challenges -stereotypes, biases,

generalizations and assumptions.

•Confusing judgments for objective evaluation.

•Pretence and faking.

•Poorly defined objectives, role/goal conflicts and

ambiguities.

•Pecking orders/transferred aggression.

•Territorial Defenses –suspicion, resentment and

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 HUMAN QUALITIES IN NURSING
Good character and personality

Certain degree of maturity

Amiable and social disposition

Integrity, flexible and adaptable

Calm, reliable & sincere

Enough physical fitness

Adaptability

Strength & tolerance 46

HUMAN QUALITIES IN NURSING (contd…)

Kindness & sense of humor

Good listener, counselor & friend

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Therapeutic nurse-client relationship
(TNCR)

The core of nursing…

Nurses use their knowledge, skill and judgment

and it is applied to all nurses in all roles and
practice settings.
 Therapeutic communication

 Client-centered care

 Maintaining boundaries

 Protecting the client from abuse

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The Therapeutic Nurse-Client
Relationship
Components:

•Trust
•Genuine interest
•Empathy
•Acceptance
•Positive Regard
•Therapeutic Use of Self

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 Indicators of Therapeutic
Communication
Introduce self to client (by name and
category)

Provide freedom for expression of feelings

Ensure privacy of information

Be aware of verbal and non-verbal

communication

Modify communication style

Anticipate and provide care 50

 Indicators of Therapeutic
Communication(contd…)
 Recognize that all behaviour has meaning and
seek to understand the cause

Understand and respect the client

Involve client in planning of care

Provide information to promote client choice

Enable the client to make informed decisions

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 Maintaining
Boundaries

Nurse Client

Boundary 52
How we can Maintain Boundaries in
nurse-patient relationship????
Develop and follow plan of care with the client

Recognize when boundaries are being crossed

Set and maintain the appropriate boundaries

within the relationship

Abstain from disclosing personal information

unless it meets the therapeutic need of the client

Ensure that nursing strategies promote health

and well being of the client 53
 Principles of IPR in Nursing

Learn everyone’s name

Respect everyone’s individuality

Do not impose anything on anybody

Keep emotions under control

Do not fear to admit ignorance

Do not give and take personal favour

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 Principles of IPR in Nursing(contd...)

Develops habits of listening

Do not say hurtful things

Be loyal, honest, dependable and willing

Maintain a ‘team spirit’

Have mutual understanding among members

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Phases of the Nurse-Client Relationship

PRE-ORIENTATION PHASE

ORIENTATION PHASE

WORKING PHASE

TERMINATION PHASE

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Phases of the Nurse-Client Relationship

Pre-Orientation
Similar to the planning stage
before an interview
Nurses have information before
the face to face interaction
Nurse needs to recognize her
own feelings
Focus on plan for information to
be discussed

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 Nursing Skills for Pre-orientation Phase

Organize Data

Recognize Limits

Seek Assistance

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 Orientation(Introductory Phase)
Sets the tone for the rest of the relationship.

Closely observe each other and form judgments

about each others behavior.

Opening relationship, clarifying the problem,

building trust.

Convey support, facilitate

healing ,educate patient and
his/her family members about
the condition
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 Nursing Skills for Introductory Phase
Put client at ease Respectful Culture

Use relaxed , attentive Concerned

attitude
Mutual participant in
Resistive Behaviors plan of care

Develop Trust

Maintain Confidentiality

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 Working Phase
Problems identified
The client and nurse begin to see each
other as unique individuals.

Begin to explore thoughts and feelings

Begin to take action to meet goals

Nurse helps client form long

and short term goals

 Nurse reinforces successes

and helps client to deal
realistically with failure.
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 Nursing Skills for Working Phase

Empathetic Listening Concreteness

Respect Confrontation

Genuineness Decision making and

Goal setting

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 Termination Phase
(Resolution phase)

Examine goals achieved

Explore feelings regarding termination
Establish plan for continuing assistance
The client has developed
independence and has no
feelings of anxiety or
dependence.

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 Nursing Skills for Termination Phase

Summarize or review the Follow up support

hospitalization with a focus may be needed
on accomplishments

Express feelings about Follow up phone

termination calls

Allows time for client to Ease clients

adjust to independence transition to
independence

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 Role of nurse:
•Stranger: receives the client in the same way
one meets a stranger in other life situations
provides an accepting climate that builds trust.

•Teacher: who imparts knowledge in reference

to a need or interest .

•Resource Person : one who provides a specific

needed information that aids in the
understanding of a problem or new situation.

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 Role of nurse(contd…)

•Counselors : helps to understand and integrate

the meaning of current life circumstances ,
provides guidance and encouragement to make
changes .
•Surrogate: helps to clarify domains of
dependence interdependence and
independence and acts on clients behalf as an
advocate.
•Leader : helps client assume maximum
responsibility for meeting treatment goals in a
mutually satisfying way .

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Communicating with the client is important!

We’re moving you

from intensive care
to intensive billing

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 COMMUNICATION

A common saying is that “Every word that is

spoken, every movement that is made and
every action that is taken or failed to be taken
gives a message to someone”.

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 COMMUNICATION
“Any means of exchanging information
or feelings between two or more people.

It is a basic component of human

relationships, including nursing.”

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 The communication process

COMPONENTS:

Sender or encoder
Message/content/idea/though
Media/channel
Receiver or decoder
Feedback or Response

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 Modes of Communication

Verbal Mode Nonverbal Mode

Pace and Intonation Personal Appearance
Simplicity Posture/Gait
Clarity Facial Expression
Timing and Relevance Gestures
Adaptable
Credible
Humor

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 Active Listening!!

S – Sit facing the client

O – Open Posture

L – Lean forward towards client

E – Establish eye contact

R- Relax!!

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Importance of Therapeutic Communication
Most important technique in nursing basic to all
other techniques,

Promotes understanding

Establishes a constructive relationship

between the nurse and the client

Therapeutic relationship is client and goal

directed

Respond to words and feelings

Strong emotions require more time 73

 Therapeutic
Communication(contd…)
Attentive Listening

Uses all senses

Requires energy and concentration

Receives total message—verbal and nonverbal

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 Conditions Affecting Communication
Values

Attitudes

Beliefs

Perceptions

Culture or Religion

Social Status

Gender

Age or developmental level and Environment 75

 Enhancing Communication
•Silence • Reflecting

•Support/reassurance • Clarification
•Sharing Observations • Confrontation
•Acknowledge feelings
• Offering Alternatives
•Broad – open ended
statements • Voicing doubt

•Information giving • Role-playing

•Interpretation • Use of Humor – use

cautiously/discretely
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“Be a Bridge, Not a Wall”

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 Caring for clients from different socio-
cultural backgrounds
Important !! – Analyze self! – know your own
beliefs/values/customs/behaviors

Avoid being judgmental

Rules for communication vary since they arise

from cultural norms!

Understand differences in communication

among various cultures

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Caring for clients from different socio-
cultural backgrounds (contd…)

Ask families for assistance regarding their

culture
Reflect on your emotions/journal write feelings

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CHANGING RESPONSIBILITY IN
NURSING

The acceptance of health maintenance as a

positive goal for medical and nursing services
rather than limited emphasis upon treatment and
cure.

The broader conception of health.

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CHANGING RESPONSIBILITY IN
NURSING (contd…)

The public demand for health care at home, in

schools and at work has given rise to the school
nurse & the nursing educator. The
supplementation of inadequate supply of
physicians by competent nurses.

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CHANGING RESPONSIBILITY IN
NURSING (contd…)
 The role of nurse to make patients to
understand themselves their situations in
order to “get well and stay well”.

 The transfer of technical procedures formerly

rendered by physicians, such as taking BP,
testing BMR, preparing medications, starting
IV fluids.

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CHANGING RESPONSIBILITY IN
NURSING (contd…)

The growth of independent nursing practice

enables the nurse to take decisions.

The increasing demand for essential

investigation and reporting by the nursing
profession.

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CHANGING RESPONSIBILITY IN
NURSING (contd…)

The transfer of beside care and routine services

to practical nurses aides and technicians in order
to devote time to educating others, supervision
and maintaining records.

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RESEARCH ARTICLES :

TNAI Workshop Report

The theme of the TNAI's
workshop organized at its headquarters, New
Delhi during January, 2003 was "Human
Relations and Communication Skills"
Nursing Journal of India,  May 2003  
Subbiah, Nanthini

85
 CONCLUSION:

•Nurses are becoming more concerned about

their patients as persons who have been taken
out of their social relationships by illness.

• Human relations, interaction, knowledge of

society, culture and understanding of personality
along with communication, socialization and co-
operation can lead to better patient care by
nurses.

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QUERIES
???

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 BRAIN
STORMIN
G

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1. The nurse is meeting a new client on the unit. Which
action, by the nurse, is most effective in initiating the
nurse-client relationship?

A. Introduce self and explain the purpose and the

plan for the relationship.
B. Describe the nurse’s family and ask the client to
describe his/her family.
C. Wait until the client indicates a readiness to
establish a relationship.
D. Ask the client why he/she was brought to the
hospital

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 2.The client says to the nurse “I am going to die, I
wish my family would stop hoping for a cure! I get so
angry when they carry on like this! After all, I’m the
one who’s dying.” The most therapeutic response is:

A. “You’re feeling angry that your family continues to

hope for you to be cured.”
B. “I think we should talk more about your anger with
your family.”
C. “Well, it sounds like you’re being pessimistic. After all,
years ago people died of pneumonia.”
D. “Have you shared your feelings with your family?”

90
 3.The nurse employed in a mental health clinic is
greeted by a neighbor in a local grocery store. The
neighbor says to the nurse, “How is Carol doing?
She is my best friend and is seen at your clinic every
week.” The most appropriate nursing response is
which of the following?

A. “I’m not supposed to discuss this, but because

you are my neighbor, I can tell you that she is
doing great!”
B. I’m not supposed to discuss this, but because you
are my neighbor, I can tell you that she really has
some problems!”
C. “If you want to know about Carol, you need to ask
her yourself.”
D. “I cannot discuss any client situation with you.”

91
 4.A client relates angrily to the nurse that his wife
says he is selfish. Which response by the nurse
would be most helpful?

A. “That’s just her opinion.”

B. “I don’t think that you are selfish.”
C. “Everyone is a little bit selfish.”
D. “You sound angry – tell me more about what
happened.”

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REFERENCES:
•Wayland J. Hayes; Rana Gaza way, Human relations in
nursing a textbook in sociology, 3rd Ed, page no 3-13,
31-103.
•Patricia A. Potter; Perry Anne Griffin: Fundamentals of
nursing, 6th Ed, MOSDY An imprint of Elsevier, page no
6-9.
•Rev Gauche Enferm, 2007 Sep, 28(3) 409-15.PMID-
18183703, PubMed: indexed for MEDLINE.
•Journal of clinical nursing, volume 13, issue 1, page no
41-49. Published online 22nd Dec, 2003, journal
complication @ 2008, Blackwell publishing Ltd.
•www.googles.com
•Ytlin@ncu.edu.twPMID:18270928 PubMed: indexed for
MEDLINE.

93
•Nursing journal of India, May 2003.
•www.sciencedirect.com
•www.pubmed.com
•Nursing Times 4 Sep, 2007, volume 103, no
36.www.nursingtimes.net.
•http://happytreeflash.com/the-doctor-nurse-
relationship-ppt.html
•AJN The American Journal of Nursing
•Articles from British Medical Journal are
provided here courtesy of BMJ Publishing
Group, Br Med J. 1948 February 14; 1(4545):
305–306.

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THANK YOU

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