Basic Concepts of Nursing Notes by Lovely Jovellanos BSN 1-4
The Helping Relationship
- Interpersonal Relationship
- Therapeutic Relationships
- Helping Relationships
Two Basic Goals:
1. Helps clients manage their problems in
living more effectively and develop unused
or underused opportunities more fully
2. Helps clients become better at helping
themselves in their everyday lives.
Helping relationships may develop over
weeks of working with a client or within
minutes.
Keys to the helping relationship
- The development of trust and
acceptance between the nurse and
the client
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- An underlying belief that the nurse
cares about and wants to help the
client
The helping relationship is influenced by
the personal and professional
characteristics of the nurse and the client.
Characteristics of a Helping
Relationship
A helping relationship is
- an intellectual and emotional bond
between the nurse and the client and
is focused on the client
- Respect the client as an individual
including:
 maximizing the client's abilities to
participate in decision making and
treatments
 considering ethnic and cultural
aspects
 considering family relationships
and values
Basic Concepts of Nursing Notes by Lovely Jovellanos BSN 1-4
- Respects client confidentiality
- Focused on the client well-being
- Is based on mutual trust, respect,
and acceptance
The Helping Relationship
- Helping is a growth-facilitating
process that strives to achieve three
basic goals (Egan, 2014, pp. 9-12):
 Help clients manage their
problems in living more effectively.
and develop unused or
underused / opportunities more
fully.
 Help clients become better at
helping themselves in their
everyday lives.
 Help clients develop an action-
oriented prevention mentality in
their lives
Pre-Interaction or Orientation Phase
(refer to the image)
- similar to the planning stage before
an interview
- nurse should have an information
about the client before the face-to-
face meeting
Goals:
 The-patient will call the nurse
by name
 The patient will accurately
describe the roles of the
participants in the relationship
 The patient and nurse will
establish an agreement about:
1. Goals of the relationship
2. Location, frequency, and
length of the contacts
3. Duration of the relationship
Exploring an Understanding Thoughts
and Feelings
- Empathetic Listening and
responding - Nurses must listen
attentively and communicate
(respond) in ways that indicate they
have listened to what was told and
understand how the client feels.
 Nonverbal behaviors
indicating empathy - include
moderate head nodding, a
steady gaze, moderate
gesturing, and little activity or
body movement
 Empathy - the ability to
experience, in the present, a
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situation as another did at
some time in the past; the
ability to put oneself in another
person's circumstance, and
feelings" (Boyd,2012)
 Empathetic listening -
focuses on a kind of “being
with” clients to develop an
understanding of them and
their world
 The end result of empathy -
is comforting and caring for
the client and a helping,
healing relationship.
- Respect - The nurse must show
respect for the client's willingness to
be available, desire to work with the
client, and a manner that conveys the
Idea of taking the client's point of
view seriously
- Genuineness - the ability to be real
or honest with another (Kneisi and
Trigoboff,2013)
 to be effective, genuineness
must be based on a solid
relationship that is empathic
and not phony
 Phoniness - can be
expressed in a variety of ways,
such as pretending to like
someone when you do not or
over stressing your
professional role (e.g., I am
the expert, the one with all the
answers). Phoniness Is
incompatible with respect
(Egan, 2014).
 The nurse who is genuine is
more likely to help the client.
- Concreteness - The nurse must
assist the client to be concrete and
specific rather than to speak in
generalities
 When client says, “I'm stupid
and clumsy," the nurse
narrows the topic to the
specific by pointing out, “you
tripped on the rug."
- Confrontation - The nurse points-
out discrepancies between thoughts,
feelings and actions that inhibit the
client's self-understanding or
exploration of specific areas
 This Is done empathically, not
judgmentally
Basic Concepts of Nursing Notes by Lovely Jovellanos BSN 1-4
During this first stage of the working phase,
the Intensity of Interaction increases, and
feelings such as anger, shame, or self-
consciousness may be expressed.
If the nurse Is skilled in this stage and if the
client is willing to pursue self-exploration,
the outcome is a beginning understanding
on the part of the client about behavior and
feelings
Facilitating and Taking Action (Working
Phase) (refer to the image)
- Ultimately the client must make
decisions and take action to become
more effective.
- The responsibility for action belongs
to the Client
- The nurse, however, collaborates in
these decisions, provides support,
and may offer options or information.
Goals of Working Phase
- The patient will actively participate in
the relationship
- The patient will cooperate in activities
that work toward achieving mutually
acceptable goals
- The patient will express feelings and
concerns to the nurse
Termination Phase (refer to the image)
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- often expected to be difficult and
filled with ambivalence because
caring attitudes have developed, it is
natural to expect some feelings of
loss, and each person needs to
develop a way of saying good-bye
Goals of Termination Phase
- The patient will participate in
identifying the goals accomplished or
the progress made toward goals.
- The patient will verbalize feelings
about termination of the termination
Developing Communication Technique
Skills
1. Listen Actively
2. Help to identify what the person is feeling
3. Put yourself in the other person’s shoes
4. Be honest
5. Be genuine and credible
6. Use your ingenuity
7. Be aware of cultural differences that may
affect meaning and understanding
8. Maintain client confidentiality
9. Know your role and limitations
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Lifespan Considerations
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