ACTIVE LEARNING TEMPLATE: Basic Concept Priority Action when establishing Nurse-Client relationship CONCEPT ________________________________ ______________________________________________ Related Content Underlying Principles (E.G., DELEGATION, LEVELS OF PREVENTION, ADVANCE DIRECTIVES) *Roles of the nurse in a therapeutic nurse-client relationship *Benefits of the therapeutic relationship *Boundaries & physical safety *Milieu Therapy *Activities within the Therapeutic Milieu. *Phases and tasks of therapeutic relationships: Orientation Working Termination Nursing Interventions WHO? WHEN? WHY? HOW? There are priority actions in each of the three phases of the therapeutic relationship. It is important to begin with building trust and a foundation as well as setting limits and boundaries. As you and the client move through each stage, focusing on priorities that fit that stage helps the patient progress in their therapy as well as maintain open communication about the inevitable termination; which can be difficult for many clients. Many clients have experienced difficult losses in their lives and it's important to prepare them for the ending of the nurse-client relationship as it draws to a close. *Orientation: Introduction, discuss confidentiality, set the contract, establish a date of termination, build trust, set goals, explore the client's ideas and needs, and enforce limits on testing or other inappropriate behavior. *Working: Maintain relationship according to the contract, perform ongoing assessments, encourage the patient to problem solve, promote the client's self-esteem, foster positive behavioral changes, explore and deal with resistance and defense mechanisms, support the client's new coping skills and adaptation,continue to reassess as needed, and remind the client of the date of termination. *Termination: Provide opportunity for the client to discuss their thoughts and feelings about the termination, remember this can be a loss for them. Discuss client's previous experience with separation and loss, summarize the goals and achievements, review memories of the sessions, discuss ways for the client to incorporate new healthy behaviors into every day life, and maintain limits of final termination