Nursing 104

N104: Essentials of Nursing Care – Health Safety Study Guide o Role-playing: This allows the patient or caregiver to take on different roles in a non- threatening scenario based on a current patient situation. It can be very helpful to have the nurse assume the role of the patient while the patient takes on the role of the other person in the situation. In this way, the nurse can model healthy behaviors and responses in the stressful situation. • Teaching should begin at the simplest or most familiar concepts and should progress to the more complex or unfamiliar concepts. • If the steps in a process must happen in a specific order, teaching the process frombeginning to end will ensure quicker mastery of the task. Learning Principles In order for sustained learning to occur, the patient or caregiver must: • Be ready to learn. The patient must be physically and mentally able to learn new knowledge or skills. If the patient’s cognitive, mental, or emotional capacity is not up to the task, the patient will not be able to learn the new skill and will become increasingly frustrated. • Be motivated to learn. People learn more, and learn it more quickly, when they have the desire to learn. The nurse can help motivate the patient by ensuring that the needs being addressed are the patient’s needs, as identified by the patient. • Be in an environment that is conducive to learning. If the environment is noisy with many distractions, the patient or caregiver will be less able to concentrate on learning the new skill. Therapeutic Nurse/Patient Relationship The therapeutic nurse/patient relationship is different in that it focuses on the patient and is limited in time to the interactions during the patient’s visit to the healthcare setting. The relationship is based on achieving mutually established goals that will help the patient move to a more desirable state of health or comfort. In this relationship, the nurse becomes the teacher/helper for the patient who is seeking knowledge/help. This therapeutic relationship is a dynamic one, which may evolve over long periods of time or over a few minutes. The therapeutic relationship will be characterized by respect, unconditional and genuine caring, non-judgmental respect for the patient, and an awareness of each individual’s values, ethics, and empathy. The relationship will typically develop through three phases: • Introductory phase: Although short, this phase sets the stage for the rest of the relationship. The nurse introduces herself and her role as helper. During this phase, the patient and nurse clarify the problem and establish the roles for the relationship. In the introductory phase, it is critical that the nurse convey a caring and genuine interest in the patient in order to develop the trust that will allow the patient to believe that the nurse can and will help him. • Working phase: This phase will typically be the longest phase in the relationship since this is where the work of the relationship actually happens. During this phase, the nurse and patient will work together first to understand thoughts and feelings, and then to take action to resolve the problem or issue. • Termination phase: In this final phase of the therapeutic relationship the nurse and patient review the care, teaching, and responses that have occurred in the previousphases. Evaluation of the goals will occur during this phase and gaps in achievement will be identified. The patient may leave the relationship with a set of goals and tasks to continue outside of the relationship with the nurse.

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