Phases of Therapeutic Nurse-Patient Relationships
- Pre-interaction phase
- Obtain information about the patient from chart, significant others, or other health team members.
- Examine one’s own feelings, fears, and anxieties about working with a particular patient.
- Orientation (introductory) phase
- Create an environment for trust and rapport.
- Establish contract for intervention.
- Gather assessment data and identify patient’s strengths and limitations.
- Formulate nursing diagnoses and set mutually agreeable goals.
- Develop a realistic plan of action.
- Explore feelings of both patient and nurse.
- Working phase
- Maintain trust and rapport.
- Promote patient’s insight and perception of reality.
- Use problem-solving model to work toward achievement of established goals.
- Overcome resistance behaviors.
- Continuously evaluate progress toward
goal attainment.
- Transference: Occurs when the patient unconsciously displaces (or “transfers”) to the nurse feelings formed toward a person from the past
- Countertransference: Refers to the nurse’s behavioral and emotional response to the patient
- Termination phase
- Therapeutic conclusion of relationship occurs when
- Progress has been made toward attainment of the goals.
- A plan of action for more adaptive coping with future stressful situations has been established.
- Feelings about termination of the relationship are recognized and explored.
