The Nature of Helping Relationship

The Nature of Helping Relationship

• A set of pre established rules and expectations direct the course of client nurse interaction.
Cognitive Affective and Psychomotor Abilities in the Therapeutic Encounter

1. Cognitive :-both client and nurses know something about health and illness and both of them has preferred way of observing world and making decision using 2 common mental process:

1)sensing :-patient look to discrete pieces of information

2)intuitive :- client look to pattern of data

2. Affective:- both nurse and client have positive and negative feeling about helping relationship and attitude of both of them determine whether they will work in harmony or discord.

3.Psychomotor :-client need to know what skills nurses have and nurses needs to find out the client ability to participate.


• Interchange of knowledge attitude and skills between client and nurse in the helping relationship table 2-1

• Client Right's in the Helping Relationship

 Expect systemic and accurate investigation of health by well organized nurse .

 Be informed about health status and all of his questions answered .

 Receive health care from nurse who have current knowledge about the diagnosis and provide efficient care.

 Courteous treatment by nurse.

 Trust that personal confidentiality will be respected.

 Be informed about plans of action.

 Refuse or consent nursing care without jeopardizing their relationship.







Characteristic of Client –Nurse Helping Relationship

1) Partnership between client and nurse booth working to improve client health status.

2) Philosophy about human nature and what motivates human in health and illness.

3) Purposeful and productive objective .

4) Preservation at client presents level of health and prevents future threat.

5)Palliation of client worries and fears through reassurance

6)Practicality:-affective way of handling health

7)Portability

Thereapeutic and non therapeutic

communication technique


Therapeutic Relationship: - healing relation between health care profession and a person in need of care; no 2 are a like but share common characteristic
Table 5-1

Basic concept
1) Client centered approach
2) Empowerment:-helping people develop the knowledge skills and other resources they need to set their own health agendas and take primary role in their health care.

3) Role of the nurse:-purposeful thinking distinguish nurse role from other type.

4) Self awareness :- help the nurse to treat each pt with respect even when he cant approve certain behaviour .

5) Professional Boundaries:-invisible structures imposed by legal moral and professional standard of nursing that respect nurse and client rights.

6)Level of involvement:-maintain emotional objectivity and avoid overinvolvement.

Sign of Overinvolvement

 Give extra time tocertain patient.

 Visiting client in of hour.

 Discounting the action of other professionals.

 Feeling resentment about the way other health take care for client.

 Persistentently thinking about client ofduty

Actions to Regain Perspection

i. Assume responsibility for care with acknowledging that out come may be out of your control.

ii. Fuscous on the thing that you can change while acknowledging that there are thing over which you have no control.

iii. Monitor your reaction and seek assistance when you fell uncomfortable about any aspect of relationship .

iv. Balance giving care for pt .

7) Empathy:-by able to understand the experience of other without loss of self box 5-1

8)Therapeutic use of self:-nurse must have self-awareness authenticity.

Phases of Relationship

Preinteraction Phase

1) Creating psychological environment – professional goal

2) Creating physical environment

Orientation Phase
 Introduction (im a registered nurse ……).

 Clarifying purpose of relationship .

 Assessing client need.

 Defining goal.

 Developing a therapeutic contract that support the aim of relationship, the contract should contain the frequency and nature of interpersonal Contact ,Mutually agreed on goal and expected role behavior of both participant.
Working phase :-it involve 2components: Identification and Exploitation

Identification:-mutual clarification of ideas and expectations.

Exploitation:-nurse assists their client to seek out and use health care services and personal strength in resolving treatment issue.

• Defining problem :-identify all element that have the potential to interfere with goal achievement
• Pacing --recognizing the legitimacy of the client need to proceed at a personally comfortable momentum
• Developing realistic goals assist pt to develops shorter objective to meet long term goal
• Challenging resistant behaviours ( Constructive confrontation with patient):

Constructive confrontation should be attempted only when the following criteria have been met
1) The nurse established firm trusting bond with client .
2) Timing and environmental circumstars are appropriate.
3) The confrontation is derived in non judgemental and empathetic manner.
4) Only thesese behavior capable of being changed by client are addressed
5) The nurse support client right to self determination

• Referral


Termination Phase

The cessation of relation ship and summarizing the major achievements when the outcomes are achieved , the client is discharged or the number of visit is reached.