1.
Counter-transference: the nurse displaces feelings onto the client related to others in the nurse's past
2.
DSMV-IV Axis: Axis I: all mental health diagnosis except for those found in Axis II
Axis II: any personality disorder diagnosis and mental retardation
Axis III: any general medical diagnosis, such as asthma
Axis IV: pertinent psychosocial problems and problems that may affect diagnosis, treatment, and prognosis of mental disorders
Axis V: global assessment of functioning (GAF) an assessment of present and past-year functioning that rates the clients level of functioning in the areas of work performance, social abilities, and psychological ability on a scale of 1 to 100
3.
Dual Diagnosis: Mental illness with mental retardation or abuse/addiction
4.
External Therapeutic Environments: Privacy
Autonomy
Safety
Group-Well being
Restrictiveness
Program Structure
Social Climate
5.
Intentional Tort: False imprisonment- confining a client to a specific area, such as a seclusion room, if the reason for confinement is for the convenience of the staff
Assault- Making a threat to a client's person, approaching a client in a threatening manner with a syringe in hand
Battery- touching a client a harmful or offensive way- if the nurse threatening the client with a syringe grabbed the client's arm and gave an injection
6.
Mental Status Examination: Affect
Physical Appearance
Behavior- mood and affect
Cognitive and intellectual abilities- orientation to time and place, remote, and recent memory, level of knowledge, ability to calculate (count back in 7s), abstract thinking, judgement, and rate and volume of speech
7.
Orientation Phase: first time the nurse and patient meet
Establish: trust, parameters of relationship (nurse's role and responsibilities of both), formal and informal contract (time, place, date, duration), confidentiality, mutual goals, discuss termination
Patient problems are articulated and mutually agreed upon goals are established
8.
Stage I: Building the therapeutic working relationship through:
- Empathy- relating to patient
- Respect
- Genuineness
-Concreteness
* In this stage, the client explores him/herself
9.
Stage II: Deeper exploration through:
- Additive Empathy
- Self disclosure (typically only helpful with abused & raped
- Feedback
- Confrontation
- Immediacy- "what I need from you right now"
*The client learns to listen non-defensively and attempts to understand his/her own personal patterns
10.
Stage III: Implementation
- Problem solving
- Support
- Action Plans
*The client collaborates with the nurse and takes personal risks to make desired changes and take action in his/her life
11.
Termination Phase: Deal with intense feelings regarding the experience
Summarize goals and objectives achieved
Review client's plan for the future and ways to implement new coping strategies into every day life
Finalize termination
12.
Working Phase: Maintain relationship
Gather further data
Promote client's: problem solving skills, self esteem, use of language and communication skills
Facilitate behavioral change
Overcome resistant behaviors
Evaluate problems and goals
Promote practice and expression of alternative adaptive behaviors
*The nurse and the patient together identify and explore areas that are causing problems in the patient's life
*Transference and countertransference typically happen here