Nurse-Patient Relationship

• The most important element in nurse-patient in psych relationship is acceptance.
• The purpose of nurse-patient relationship in psych is to help client develop new and effective coping mechanisms
• Phases of Nurse-Patient Relationship

  Mnemonic: POWT
• Phases of Nurse Patient Relationship (POWT)

  Pre-orientation

  • Nurse’s Responsibility: Read the patient’s chart
  • Goal: Self – awareness
  • Problem: Reluctance of the nurse
• Phases of Nurse Patient Relationship (POWT)

  Orientation

  • Nurse’s Responsibility: Formulate Nursing Diagnosis
  • Goal: Establish TRUST
  • Problem: Resistance of the patient
• Phases of Nurse Patient Relationship (POWT)

  Working

  • Nurse’s Responsibility: Promote the client’s insight
  • Goal: RN (explore); Patient (verbalize)
  • Problem: Emotional Attachment
• Phases of Nurse Patient Relationship (POWT)

  Termination

  • Nursing responsibility: client’s feelings about end of the relationship  
  • Goal: Evaluate effectives of intervention
  • Problem: Separation Anxiety
  • Prevention: Constantly remind patient about the contract for every session
  • Intervention: Encourage verbalization of feelings
• In Orientation phase, there needs to be congruence, wherein words are parallel to action
• As a nurse, always undergo self-awareness to explore own feelings especially in dealing with manipulative patients
• Rapport - relationship built on trust
• Reaction formation during termination phase e.g. the patient is angry at the nurse is due to separation anxiety
• One of the best ways to practice self-awareness for nurses is to write autobiography
• When to formulate contract?

  Orientation Phase
• When to established acceptance and boundaries?

  Orientation Phase