Online Companion: Fundamentals of Nursing Standards and Practice 2E

Frequently Asked Questions

What is the therapeutic value that the nurse offers to the client?

The term therapeutic describes actions that are beneficial to the client. The science of nursing informs the nurse of the interventions that are beneficial for the particular health state of the client, i.e., post surgery for fractured hip, or during the labor stage of the childbirth process. The art of nursing provides the caring manner in which the interventions are carried out. The nurse may be an excellent technician when starting an intravenous infusion; the nurse's explanation of the procedure, the reassurance and attention to the client's comfort needs during the procedure are actions that recognize the client's human response to having an intravenous infusion. The nurse's technical expertise and caring behaviors together are beneficial ( therapeutic) to the client.

Does the nurse have time for the three phases of the therapeutic relationship in today's busy clinical settings?

When the nurse is deliberately planning goals and using methods appropriate to each phase, the therapeutic relationship is happening in interactions with the client. The three phases may be compressed in time as in a brief stay in an emergency room. The phases may occur over a long period of time as with nurses and clients living in a nursing home. The alternative to the therapeutic relationship is a social relationship. In the social relationship, the client is expected to like the nurse; there is no planned agenda. This is not a situation that benefits the client.

How does the nurse know if a therapeutic relationship exists with a client?

The nurse is cognizant of and deliberately employs goal-setting in each phase of the therapeutic relationship. For instance, during the orientation phase, the nurse is assessing the client to determine the client's needs and strengths. The nurse observes the client for pertinent clues. The nurse uses methods such as introducing self, outlining confidentiality aspects and the reasons for the nurse's questions in order to reduce anxiety and promote trust. The nurse deals with the client's anxiety during this phase by having a calm manner and by answering the client's questions. The nurse observes the client's responses throughout the orientation phase. The nurse recognizes that the working phase is starting when the client agrees to accept care offered by the nurse.