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Three Phases of Nurse-Client Relationship:

1. Orientation Stage

* Establishing therapeutic environment.

* The roles, goals, rules and limitations of the relationship are defined, nurse gains trust of the client, and the mode of communication are acceptable for both nurse and patient is set.

* Acceptance is the foundation of all therapeutic relationship

* Acceptance of others requires acceptance of self first.

* Rapport is built by demonstrating acceptance and non-judgmental attitude.

* Acceptance of patient means encouraging the patient verbally and non-verbally to express both positive and negative feelings even if these are divergent from accepted norms and general viewpoint.

* The nurse can encourage the client to share his/her feelings by making the client understand that no feeling is wrong.

* Trust of patient is gained by being consistent.

* Assessment of the client is made by obtaining data from primary and secondary sources.

* The patient set the pace of the relationship.

* During this phase, the problems are not yet been resolved but the client’s feelings especially anxiety is reduced, by using palliative measures, to enable the client to relax enough to talk about his distressing feelings and thoughts.

* This stage progresses well when the nurses show empathy provide support to client and temporary structure until the client can control his own feelings and behavior.

* Reality testing – is accepting the patient’s perceptions, feelings and thoughts as neither right nor wrong, but at the same time offering other options or points of view to the client in a non-argumentative manner for the purpose of helping the client arrive at more realistic conclusions.

* To provide structure is to intervene when the client loses control of his own feelings and behaviors by medications, offering self, restrain, seclusion and by assisting client to observe a consistent daily schedule.

2. Working/...