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Chapter 14

Nursing, Healing, and Caring

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Nursing’s Therapeutic Value

• Nursing– Diagnosis and treatment of human responses to

actual or potential health problems (ANA, 2004)

– Blend of art and science

• Purposes of nursing

• Nursing and healing

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Theoretical Perspectives of Caring

• Watson– Theory of human caring

• Leininger– Transcultural care theory

• Benner– Novice to expert model

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Care in the High-Technology Environment

• Clients want caring from nurses

• Prevent depersonalization by:– Checking on client

• Rather than just equipment

– Responding to client promptly

– Communicating interest in what client says

– Spending time with client

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nurse-Client Relationship

• Basis of nursing (Peplau, 1952)

• Phases of therapeutic relationship:– Orientation

– Working

– Termination

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Orientation Phase

• Client behaviors:– Feel anxious

– Test

• Nurse behaviors:– Provide specific information

– Project calm, relaxed attitude

– Answer questions consistently and reliably

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Working Phase

• Client behaviors:– Ask questions

– Seek clarification

– Behave attentively

– Inquire about own role in recovery

(continued)

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Working Phase

• Nurse behaviors:– Re-evaluate goals

– Support realistic problem solving

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Termination Phase

• Client behaviors:– Welcome final phase

– Resist termination

• Nurse behaviors:– Evaluate goals

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Therapeutic Use of Self

• Deliberate plan of action

• Verbal and nonverbal communication

• Take time to “be” with client

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Caring and Communication

• Communication– How compassion and caring demonstrated to

client

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Characteristics of Therapeutic Relationships

• Warmth

• Hope

• Rapport

• Trust

• Empathy

• Acceptance

• Active listening

(continued)

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Characteristics of Therapeutic Relationships

• Humor

• Compassion

• Self-awareness

• Nonjudgmental approach

• Flexibility

• Risk taking

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Therapeutic Value of the Nursing Process

• Focuses on client’s response to illness, disease, or disability– Rather than just on problem

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing Roles

• Caregiver

• Counselor

• Teacher

• Client advocate

• Change agent

• Team member

• Resource person