N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide Goals of milieu therapy: • Manipulate the environment so that all aspects of patient’s hospital experience are considered therapeutic. • The patient is expected to learn adaptive coping, interaction, and relationship skills that can be generalized to other aspects of his or her life. • Achieve patient autonomy. Principles of milieu therapy: • To promote a fundamental respect for individuals (both patients andstaff). • To use opportunities for communication between the patient and staff for maximum therapeutic benefit. • To encourage patients to act at a level equal to their ability and to enhance their self-esteem (autonomy is reinforced). • To promote socialization. • To provide opportunities for patients to be part of unit management. • Individuals are held responsible for ownactions. • Peer pressure is utilized to reinforce rules andregulations. • A team approach is used. • Group discussions and temporary seclusions are favored approaches for actingout behavior. • The nurse’s function is to act in ways that consistently promote thesegoals. Therapeutic Nurse-Patient Relationship This is one of the most important aspects of nursing care. It requires the nurse to first assess his/her feelings about the patient and his/her condition. This way, the nurse can avoid negative attitudes that will conflict with patient care. The nurse must approach the patient in a nonjudgmental, supportive, and empathetic manner. The nurse must also be committed to walking with the patient through his/her crisis. Maintaining a neutral approach encourages the patient to verbalize and helps to establish a sense of trust that may enable the patient to change his/her dysfunctional behavior. In mental disorders, it is usually recommended that nursing exposure be limited to a few nurses. This allows the patient to establish trusting relationships with one or two nurses. The nurse must take care when the decision to use therapeutic touch is involved. Some disorders, such as depression or grief, welcome a friendly touch, while others with psychosis or paranoia may perceive touch as an act of aggression. When experiencing difficulty in communicating with a patient, it is important to ask direct, concrete questions that require concrete answers. Use open ended questions when interviewing the patient or trying to get more information. Peplau's theory explains the phases of interpersonal process, roles in nursing situations, and methods for studying nursing as an interpersonal process. The theory explains the purpose of nursing is to help others identify their felt difficulties. ©2017 Achieve Test Prep Page 17 of 140