Chapter 7: Nurse-Client Relationships

___________ ___________: refers to association between nurse and client
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___________ ___________: refers to association between nurse and client
Professional relationship
Nurse-client relationship requires response to __________ __________.
client needs
The National Council of State Boards of Nursing (NCLEX-PN) identifies four categories of needs and these are.......
- Safe and effective care environment
- Health promotion and maintenance
- Psychosocial integrity
- Physiologic integrity
To meet client needs nurses perform four basic roles these roles are?
Caregiver, Educator, Collaborator, Delegator
______________ performs health-related activities person cannot perform independently
Caregiver
____________ works with others to achieve common goal
Collaborator
___________ assigns tasks to someone
Delegator
______________ provides information
Educator
What do collaborators do?
Exchange information
What are some examples of collaborators?
nurse, physician, and other healthcare workers, Dietitian, physical therapist, respiratory therapist, discharge planner
Who avoids giving advice, shares potential alternatives, and empowers involvement with self-help groups?EducatorWho restores or maintain physical or mental problems, especially during acute illness, maintain functionCaregiverWho has knowledge of appropriate tasks for healthcare workers; and is accountable for the resulting outcome?DelegatorRelationship begins with __________________ phase which begins before first contact with client then progresses through three phasespreinteractionWhat is obtained in the preinteraction phase?Gathering of information including but not limited to diagnosis, age, medical records, etc.What are the three phases of nurse-client relationships?Introductory phase, working phase, and terminating phaseIn the ____________ phase there is an agreement that nurse's services are no longer necessaryTerminatingIn the __________ phase there is mutual planning of client's care and plan into action and the nurse supports client's independence in self-care; promotes self-esteem and dignity.WorkingDoing too much is as ___________ as doing too littleharmfulThe ____________ phase is the initial contact; preconceived ideas are confirmed or dismissed. This phase demonstrates courtesy, active listening, empathy, competence, and appropriate communication. It also demonstrates partnership and advocacy and encourages client participation in problem-solving.Introductory___________ is the exchange of information; sending and receiving informationCommunicationWhat are two types of communication?verbal and nonverbal communicationThe _________ _____________ set standards/goals that promote high quality, safe, and effective care across all healthcare settingsJoint Commission- Demonstrate leadership, cultural competence, and client-/family-centered care. - Improve effectiveness of caregiver communication. - Encourage client's involvement in safety. - Essential for nurse-client relationship, licensing, and healthcare organization accreditation These are all examples of what?Standards/Goals that the Joint Commission put in placeUnderstanding _______1_______ of ________2_________ is essential for developing an effective nurse-client relationship1) principles 2) communicationWhat are 3 types of verbal communication?Speaking, reading, and writingAttention, concentration, language compatibility, verbal skills, hearing and visual acuity, interpersonal attitudes, cultural similarities, listening are all variables of __________ communicationverbal__________ means becoming fully involved in what the client saysListening____________ _____________ is when the nurse attempts to perceive the client's emotions and meanings (usually demonstrated by nonverbal means)Empathetic listeningWhat is the exchange of information without words?Nonverbal CommunicationWhat are the 5 types of nonverbal communication?kinesics, paralanguage, proxemics, touch, and silence___________ refers to body language; facial expressions, postures, gestures, and body movementsKinesics____________ refers to space when communicating: four zones; intimate space, personal space, social space, public spaceProxemics_____1_____ is broken into task-oriented ___1_____ which involves personal contact or affective ____1_____ and it is used to demonstrate concern or affection; can have variations in responseTouch__________ encourages verbal communication/process informationSilence___________ refers to vocal sounds; crying, laughing, vocal inflections (volume, pitch, or rate)ParalanguageDescribe a comfort zonephysical closeness that causes no anxiety______________ considerations are used purposefully to reinforce message; may perceive from caregivers as culturally inappropriate or offensive; obtain permissionGerontologic__________ _________ can be verbal or nonverbal; promotes physical and emotional well-beingTherapeutic communicationNurses must respond to ____1____ and _____2______ responses and allow the client to respond without fear of retaliation Examples: broad opening, paraphrasing, clarifying1) vocal 2) emotionalClichés, False Reassurance, and Defending are all examples of _________________ _______________Nontherapeutic CommunicationAccording to The Joint Commission caregivers must identify if the client has a ____1_____ or _______2________ need1) sensory 2) communicationAccording to The Joint Commission caregivers must identify and address communication needs during _____1_______, ______2______, _____3_______,_______4_______, and end-of-life care1) assessment 2) treatment 3) discharge 4) transferAccording to The Joint Commission caregivers must monitor changes in the client's _________________ statuscommunicationAccording to The Joint Commission caregivers must anticipate the communication needs of clients who are expected to develop communication ________________ from scheduled treatments or proceduresimpairmentsTrue or False? We must help these clients communicate their health problems, needs, give informed consent, or understand teaching.TrueThe Joint Commission requires that agencies develop a system to provide ________1______ aids and services to address the communication needs of clients with ____2_____, visual, or speech impairments or _____3______ needs1) auxiliary 2) hearing 3) literacyThe Joint Commission requires that we provide language interpreting and translation services for clients who do not speak English or who have ______________ ____________ ___________limited English proficiencyLEPLimited English ProficiencyWhat are some examples of people who would be verbally impaired?expressive aphasia, artificial airways (endotracheal or tracheostomy), traumatic brain injury, cerebral palsy, MS, facial trauma (jaw wired shut)What are some methods to help the verbally impaired communicate?- written (tablet and pencil) - communication board - electrolarynx (placed on the neck it vibrates and mechanically resonates when words or sounds are made) -computerized technology (touch to speak or touch talk)What is an example of someone who is hearing impaired?DeafWhat are some methods to help the hearing impaired communicate?-finger spelling (alphabetical substitute for words that have no sign) -webcam (video camera) -video interpreting (ASL interpreter) -TTY (Text telephone)/TDD (Telecommunication device for the deaf)A person who cannot understand English at a level that permits interacting effectively with staff in healthcare settings without the use of an interpreter is considered to be what?Limited English proficiency or LEPWhat are some methods to help people who are LEP?-professional interpreter -telephonic interpretingA _____________ ________________ is the best form of communication for someone who is LEPCertified interpreter______ _______ interpreters can be used if a certified interpreter is unavailableAd hocAd hoc interpreters include ....bilingual staff, volunteers, family, or friendsWhat is the disadvantage of using an Ad Hoc interpreter?errors in omissions, substitutions, editorializing____________ is essential and promotes the client's ability to understandTeachingBefore teaching the nurse performs a ______________ ____________Learner AssessmentFactors for a Learner Assessment is what...learning style, age, developmental level, learning needs, learning capacity, motivation, and readiness____________ ________ is the manner in which a person best comprehends new informationLearning styles_____________ learner- processes best by listening to or reading facts and descriptionsCognative__________ learner- learns best when presented with information that appeals to his or her feelings, beliefs, and valuesAffective___________________ learner- prefers to learn by doingPsychomotorScience of teaching children is ____________pedagogyScience of teaching adult learners is _____________andragogyScience of teaching older adults is _____________geragogy_____________ _________ are the skills a client or family member must acquire to restore, maintain, or promote healthLearning Needs____________ __________ refers to a person's intellectual ability to understand, remember, and apply informationLearning capacity___________ is the desire to acquire new informationMotivation___________ ___________ pertains to the optimal time for learningLearning readinessWhat type of teaching is unplanned; occurs spontaneously at bedside or at homeInformal teachingWhat type of teaching is organized arrangement; facilitates reaching goals, provides essential information, developing a plan and implementing it gradual and sequential avoids overwhelming the client with new informationFormal teachingWhat is the difference between formal and informal teaching?Formal teaching REQUIRES a plan and Informal teaching is unplannedWhat is learning comprehension for?To determine if the information was understood correctlyWhat are three techniques of learning comprehension?-Repeat back -Teach Back -Show backIn the repeat back technique what happens?client restates or paraphrases the points that were taughtIn the teach back technique what happens?You have the client to explain to validate comprehensionIn the show back technique what happens?You have the client demonstrate a skill