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Verified| Updated Fall 2025/2026.
Role of the Nurse
Stranger, resource person, teacher, leader, technical expert, surrogate, counselor
Dynamics of a Therapeutic Nurse-Client Relationship
Therapeutic use of self, gaining self-awareness, values clarification, essential conditions to
development
Essential Conditions to Development of Relationships
Rapport, trust, respect, genuineness, and empathy
Human Relationship Principles
- A person's reaction is more about them than you, and their inner experience is prompting that
reaction
- Your reaction is about your needs
Transference
Client portrays feelings surrounding someone they know onto you
Countertransference
You push your feelings onto your client
Boundaries in a Nurse-Client Relationship
- confidentiality
- material boundaries
- personal boundaries
-professional boundaries
Personal Integration in the Nurse-Client Relationship
- Detached concern
- Negotiated reality
- Self-awareness
- Beliefs and values
Therapeutic Communication
,- getting acquainted and establishing rapport
- demonstrating trustworthiness
- respect for the client / unconditional positive regard
- genuineness
- acceptance
- availability
- spontaneity
- hope
- vision
- accountability
- advocacy
- cultural sensitivity and competence
- spirituality
- empathy
Development of Empathy
- Identification
- Incorporation
- Reverberation
- Detachment
- Burnout as a consequence or achievement of empathy
Therapeutic Techniques
- Using silence
- Acceptance
- Giving recognition
- Offering self
,- Giving broad openings
- Offering general leads
- Placing event in time or sequence
- Making observations
- Encouraging description
- Encouraging comparison
- Restating
- Reflection
- Focusing
- Exploring
- Seeking clarification or validation
- Presenting reality
- Voicing doubt
- Verbalizing the implied
- Translating feelings into words
- Formulating a plan of action
Nontherapeutic Communication Techniques
- False reassurance
- Rejecting/Approving/Disapproving
- Agreeing or disagreeing
- Giving advice
- Probing
- Defending
- Requesting an explanation
, - Existence of an external source of power
-Belittling expressed feelings
- Making stereotyped comments
- More than one question at a time
The Preinteraction Phase
Obtain information about the client from the chart, significant others or other health team
members. Examine one's own feelings, fears, and anxieties about working with a particular client.
The Orientation (Introductory) Phase
-Create an environment for trust and rapport.
-Establish contract for intervention.
-Gather assessment data.
-Identify client's strengths and weaknesses.
-Formulate nursing diagnoses.
-Set mutually agreeable goals.
-Develop a realistic plan of action.
-Explore feelings of both client and nurse
- Clarify purpose of work, role of nurse, and responsibilities of client
- Address client suffering .
Nursing Interventions in the Orientation (Introductory) Phase
- Education
- Use facilitative characteristics such as empathy
- Avoid premature reassurance
- Be explicit about access to client revelations and degree of confidentiality
- Delineate specific goals, address interpersonal behavioral patterns, and designate degree of change
necessary for client
Behavioral Analysis in the Working Phase