Learning Center Articles

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.

June 4, 2020