nurse client relationship
Process of motivational interviewing
1. Engaging: to establish rapport 2. Focusing: offers alternatives for current behavior by analyzing patient 3. Evoking: covering the clients own motivation for change 4. Planning
Dynamicity
Adapting to culture change
Open ended statements
Allow for clients to elaborate what's important in their own words
Congruence
Body matches words and expressions
Maintenance
Change comes naturally and wants to prevent relapse
A nurse is reviewing the plan of care for a client. Which statement would the nurse identify as an appropriate outcome?
Client will identify one coping strategy to try by end of week."
Orientation
Collect data, assess knowledge, establish mutual goals, set boundaries, set the tone
Contemplation
Contemplate change but would rather stick to toxic tendencies
Preparation
Demonstrating minor changes to current habit and has difficulties overcoming barriers
Affirmations
Empower client behavior and decision making by giving positive words for their actions
Action
Experiencing changed behaviors
Active listening
Look interested, stay involved, stay on task, test, evaluate message, neutralize feelings
Precontemplation
Not intending to make changes within the next 6 months. Has no insight on issue
Transcultural nursing theory
Nursing care through Social, spiritual, psychological, and physiological perspectives
Fundamental therapeutic communication techniques
OARS (open ended, affirmations, reflect, summarize)
OARS in therapeutic communication
Open-ended questions Affirmations Reflective listening Summaries
Phases of Nurse-Patient Relationship
Orientation: The introduction phase is not a valid phase, yet the nurse introduces oneself during the orientation phase. identification: During the orientation phase, the nurse and client establish the tone and guidelines for the relationship working/exploitation: defines characteristics of the working phase, during which the nurse and client work together to meet the client's physical and psychosocial needs. . resolution/termination :The termination phase occurs when the nurse and client acknowledge that they have met the goals of the initial agreement or that the client would be better served by another nurse or health care provider.
Preorientation
Recognize needs of client by self evaluating
Summarize
Restate key concept about change
SMART goals
Specific, Measurable, Attainable, Realistic, Timely
identification (nurse client relationship phase)
Stage in which issues are identified
A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?
The working phase
Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?
Working phase
nurse-client relationship forms of communication
auditory non-verbal energetic emotional
closed-ended (0ARS)
can be answered with a yes or no
ATI question A client asked for their last rites before they die. What factor is influencing the clients request?
cultural
resolution (nurse client relationship phase)
end of the client-nurse relationship.
motivational questions (OARS)
example of a open- ended question requires more than a yes or no answer
exploitation (nurse-client relationship phase)
nurse is actively coaching the client towards a healthier lifestyle
nurse needs a interpreter when client speaks another language
nurse must use a facility interpreter or they are violating HIPPA
Schramm's Model of Communication
sender: sender is the nurse and the client is giving feedback channel: transmission of message feedback: letting the messenger(nurse) know that the message was properly received(client) receiver: the person receiving the message
Working phase
when the nurse and the patient work together to solve problems and accomplish goals. There is an established trust
orientation ( nurse client relationship phase)
when they first meet
