| When we take care of our client in different | | | | Nurse: Assist and help patient to understand their |
| dimensional aspect we have to expect that there | | | | problem and accept the help available. |
| is always resistance, failures along the way. We | | | | Activity: Actively works to foster trust and |
| forget to realized that it a process both the nurse | | | | develop the relationship. Involves learning about |
| and the patient. It is a multi-factoral aspect with a | | | | the patient and their initial concerns and needs. |
| various activities can be utilized with in the | | | | Patients are being informed of the general |
| relationship to facilitate patient adaptation process. | | | | purpose of talking with the nurses. Identify the |
| There is no single theoretical model is effective | | | | problems you want to work on. Discuss to patient |
| with every patient. Even patient with the same | | | | to know that nurses cannot solve problems or |
| mental illness will have somewhat different | | | | make decisions for them rather help patient to |
| manifestations of symptoms, provided with their | | | | look at realistic options so that they can make |
| unique character, history, current life situation, and | | | | their own decisions as well. |
| emerging needs. | | | | If the orientation is successfully done and when |
| There are several approach with the nurse | | | | the nurse identifies the patients readiness to work |
| patient relationship which comprises with a goal | | | | on a behavioral modification possibly change may |
| directed interaction that utilized a non verbal and | | | | begin to rise. |
| verbal communications to convey the following; | | | | B. Working Phase |
| willingness to learn, genuine respect to patient, | | | | Goal: Stabilization of needs, reduction of |
| desire to help the client, understanding the patient | | | | symptoms and development of supportive |
| as a person, his problems, and need as well. With | | | | relationship. |
| this approach, part of the nursing process is to | | | | Nurse: Explore more the problems, identify |
| used assessment to identify client's problems or | | | | possible solutions, test out new behaviors. |
| needs, formulate nursing interventions and | | | | Problems: Changing or modifying behavior is more |
| evaluation process to evaluate effectiveness of | | | | difficult and it is a long term process to work on. |
| care. | | | | Activity: Know how well a patient understand his |
| The nurse should purposefully and carefully guides | | | | problems, there are some suggested steps of this |
| and directs the conversations toward the patients | | | | series. In depth detailed description of situation, |
| identification of needs or a problems, issues and | | | | thoughts and feelings and even behaviors. Analysis |
| selects the therapeutic strategies to facilitate | | | | step is necessary to encourage accuracy in |
| awareness, decisions, changes, or comfort. | | | | patient's conclusions about the problems. Even the |
| Privacy is strictly observed during this process | | | | patient identify the problem accurately, he may |
| and personal data can be shared but rarely | | | | not automatically decide his behavior is worth |
| discloses personal problems, because sharing any | | | | changing. Interpretation step, leads to decision that |
| information of the client is big " NO NO ". The | | | | change is necessary and appropriate. |
| nurse has the responsibility to observed any | | | | Planning step, problem solving is the main crux in |
| bizarre or unacceptable social behaviors or lack of | | | | this process. Patient here is being guided in |
| skills. Help use " free time "to develop and verbal | | | | decision about the change. In developing and |
| skills, to reality test, get feedback, and support | | | | considering alternative solutions and formulating |
| for new behaviors. Informal or recreational | | | | method for carrying out the plan. Implementation |
| encounters with patient maybe spontaneous but | | | | step, try new behaviors or solution in a safe |
| therapeutic. | | | | environment with the nurse and then a real |
| There are some important points that I would like | | | | situation. Ask the client to rehearse or practice |
| to stress out on this topic, usually the nurse | | | | the upcoming situation. Evaluation step, allows |
| patient relationship is not a" social relationship" take | | | | feedback and used to assess the success of new |
| note of this!. It would only means that | | | | behaviors and solutions to problems. Should begin |
| involvement, mutual support, intimacy is not part | | | | in a constructive manner and help client learn to |
| of this process. The nurse interest and concern | | | | ask for and use feedback appropriately. |
| here is always being misinterpreted, situation like " | | | | Reality testing and cognitive restructuring is one |
| client often ask or wish the nurse to be a friend | | | | of the most important strategy in the analysis |
| and go out for a certain date". We have to | | | | interpretation, and planning phases. Help the patient |
| remind the patient of his/her role. Try to discuss | | | | see reality more clearly and objectively where |
| their needs for friendship, love and support. | | | | they may have been past distortions or in |
| Furthermore, there are some nursing theorist | | | | accuracies, it is not a matter of arguing but |
| who believed that nurse and patient relationship | | | | PRESENTING one so that patient can consider |
| begins as strangers and move in stages to | | | | another option. Should have to be constructive |
| become collaborators in solving their problems. | | | | feedback. Cognitive restructuring is helping patient |
| Which until now it remains valid and proven to be | | | | see another viewpoint that will help him adjust his |
| very effective and has given various stages. But | | | | view to be more realistic. Patient need to redefine |
| before we discuss those phases, we must take | | | | how he interpreted a situation or change his |
| into big consideration that before interacting to | | | | perception of another person's behavior. |
| different clientele whether in mental or in medical | | | | C. TERMINATION STAGE |
| health facilities the nurse should have a self | | | | In inpatient work and changes are rarely |
| awareness. | | | | completed because patients are discharge or |
| There are several phases or stages on the nurse | | | | move or the nurse has change the unit. |
| client relationship. To discuss its background let us | | | | Synthesizing what has occurred focuses on more |
| try to identify the specific function and problems | | | | indirect outcomes of the relationship. For problems |
| of the nurse encountered of each stages. | | | | that need continuing attention after discharge |
| A. Orientation phase | | | | what we usually do is to have appropriate |
| Patient: Feel needs and seek help of their | | | | referrals such as in Doctor's clinic, self help groups, |
| problems. | | | | community agencies. |