Examples of Therapeutic Communication
- Introducing self and title, as well as length of relationship
- Address client by name/preferred title
- Give
... [Show More] client time/opportunity to explain self and listen to them
- Informing client information with be shared with health care team
- Awareness of body language interpretation by client
- Accommodate for communication styles (language)
- Assess clients knowledge, beliefs and wishes to find best care plan
- Listen to concerns of family and significant others
- Consider client preference when promoting advocacy
- Providing information to promote client choice
- Recognizing that all behaviors have meaning
- Refraining from self disclosure
- Reflecting on interactions
- Discuss throughout plans to meet needs after termination of relationship
Examples of Client Centered Care
- Making the clients goals, wishes and preferences that basis of the care plan
- Understanding clients limitations and needs for nursing assistance
- Discuss clients expectations, and how realistic it is regarding health and available resources
- Recognizing client well being is affected by establishing and maintaining relationship
- Recognize biases and feelings established through life that could affect relationship
- Acknowledging and managing stress
- Engaging client in evaluating the nursing care
- Committing to availability
- Requesting therapeutic transfer of care if relationship does not evolve
Examples of Maintaining Boundaries
- Helping clients understand when requests are beyond limits of boundaries
- Following care plan aiming to clients needs
- Make sure any action that could be seen as crossing boundaries is in care plan (having coffee with mental health client may be appropriate)
- Nurse does not interfere with personal relationships
- Abstaining from disclosing personal information
- Continually clarifying his/her role in situation
- Coexisting relationships do not interfere
- Consult with health care team when it is unclear if boundaries have been crossed
- Goals are made to meet the needs of the client and not the nurse
- Consider cultural value of the context of maintaining boundaries
When do you accept a gift?
When refusal will harm the nurse-client therapeutic relationship
- Consider that the gift was not solicited by the nurse, the client is mentally competent, and the clients intent of offering the gift
When can you give a gift?
- The client knows the nurses want nothing in return
- Does not change the dynamic of the relationship
- No potential for negative feelings
Examples of Protecting Client from Abuse
- Always intervene and report
- Intervene when the client feels abused
- Intervening and reporting health care team members abusing clients
- Not entering friendship, romantic, sexual or personal relationship with the client
- Not engaging in behaviors that may be perceived as violent/abusive
- Not neglecting basic needs
- Not accepting POA positions and other positions of power over the client
When can you enter a personal relationship with a client after termination of nurse-client relationship?
- When determined that relationship with not have negative impact on future care for client
- Client is clear that relationship is no longer therapeutic
- The relationship is not based off of therapeutic relationship previously established
Warning Signs of Boundary Crossing
- Spending extra time
- Changing client assignments to care for client
- Feeling health care team doesn't understand the relationship
- Disclosing personal information
- Dressing differently when seeing the client
- Thinking about client away from work
- Feeling guarded when questions are asked about client
- Spending off duty time with client
- Ignoring agency policies for client
- Keep secrets with client, away from health care team
- Client is only willing to speak with you
What do you do if you see a colleague crossing boundaries with a client?
1. Assess and address the colleague regarding what was observed, how the behavior was perceived, the impact on the client, and the College practice standard
2. ^^ if not possible, address the colleague's supervisor by putting concerns in writing with date, time, witnesses and type of client identification (file number)
3. ^^ if not possible, report to next highest authority or College
4. If ABUSE, the nurse must intervene and report any incident of unsafe practice to employer
5. ALWAYS inform the clients right to inform police
What is fast acting insulin used for?
Control blood sugar during meals, snack [Show Less]