One to One Relationship – take place over a designated period of time in a stable meeting
Phases (Nurse-client relationship)
Preinteraction phase – obtaining information about a client from chart or others, nurse examines feelings/anxieties about the client
Orientation/Introductory phase – trust/rapport, establish contract for intervention (goal), gather data, assess strengths & weaknesses, establish nursing dx, set goals, develop action plan, explore feelings of nurse & client.
Working phase – maintain trust & rapport, promote insight & reality, problem solve, overcome resistance, evaluate progress to goal.
Termination phase – determine progress to goal, plan for continuation of care, feelings regarding termination (Client or nurse may resist termination, be aware of manipulation)
Systems approach – composed of various subsystems
Identified client is not always the person with the most pathology Triangles – when conflict high between 2 it goes to a 3rd person Scapegoat – target of projection
Family Roles – position decided by family
Power Structure – adults usually have power
Boundaries – may be clear, diffuse or conflicting
Strains or Conflicts – within or outside of family
Pseudomutuality (regard) or Pseudohosility (conflict) – allows denial of tenderness of intimacy. False regard or false hostility. Self Fulfilling Prophecy – an idea or expectation acted out unconsciously, thus proving itself Life Script – plan decided not by fate, but by experiences early in life Schism – each parent under-minds the other, children are forced to join the warring camp of one of the parents, a split. Skew – one mate is dysfunctional, lack of partnership
Enmeshment – diffuse boundaries, exaggerated connectedness among family members, blends feelings Disengagement – abandonment, oblivious to effects of their actions on other members, separateness from family.
Goal is to change...
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