1. Chapter 11 Nursing, Healing, and Caring Fundamentals of Nursing: Standards & Practices, 2E

2.  Copyright 2002 by Delmar, a division of Thomson Learning 11-2 Nursing’s Therapeutic Value  Nursing is both an art and a science that leads to therapeutic outcomes in clients.  The term therapeutic describes actions that are beneficial to the client.  The “art” of nursing refers to the caring, compassionate manner in which interventions are performed.

3.  Copyright 2002 by Delmar, a division of Thomson Learning 11-3  A therapeutic relationship is one that benefits the client’s health status.  Nurses who demonstrate caring behaviors enhance the quality of care provided; thus clients are more satisfied with the care that is delivered.

4.  Copyright 2002 by Delmar, a division of Thomson Learning 11-4 Healing  Healing is the process of recovery from illness, accident, or disability.  Healing encompasses the physical, emotional, and spiritual domains of individuals.  Nursing and caring are essential components in the healing process.

5.  Copyright 2002 by Delmar, a division of Thomson Learning 11-5 Caring Behaviors Demonstrated in Nursing Practice  Demonstration of concern  Anticipation of client needs  Providing pre-procedural information  Alleviation of anxiety and fear  Effective communication  Responding to client requests

6.  Copyright 2002 by Delmar, a division of Thomson Learning 11-6 Caring  Caring is a universal value that directs nursing practice.  Though clients cannot always be cured, caring is ongoing within the nurse-client relationship.  Caring occurs when a nurse acts in a genuine, authentic manner with the client.

7.  Copyright 2002 by Delmar, a division of Thomson Learning 11-7  Some specific behaviors that indicate caring include Provision of information Relief of pain Spending time with clients and families Promoting client autonomy Treating each client in a courteous and dignified manner

8.  Copyright 2002 by Delmar, a division of Thomson Learning 11-8  As society continues to place a high value on technology, caring is often undervalued.  Nursing makes a crucial contribution by valuing both care and technology.

9.  Copyright 2002 by Delmar, a division of Thomson Learning 11-9 Theoretical Models of Caring  Watson’s Theory of Human Caring  Leininger’s Theory of Transcultural Caring  Benner’s Novice to Expert Model

10.  Copyright 2002 by Delmar, a division of Thomson Learning 11-10 Nurse-Client Relationship  There is a one-to-one interactive process between client and nurse, directed at improving the client’s health status or assisting in problem solving.  The primary goal of this relationship is the client’s achievement of therapeutic outcomes.

11.  Copyright 2002 by Delmar, a division of Thomson Learning 11-11  The nurse-client relationship is a planned process that focuses on meeting the needs of the clients.  Interpersonal skills are the foundation for establishing the therapeutic relationship.  Interaction allows the nurse to assess client needs, teach, empower the client, and evaluate outcomes.

12.  Copyright 2002 by Delmar, a division of Thomson Learning 11-12 Phases of a Therapeutic Relationship  Orientation phase  Working phase  Termination phase

13.  Copyright 2002 by Delmar, a division of Thomson Learning 11-13 Therapeutic Use of Self  This is a process in which nurses deliberately plan their actions and approach the relationship with a specific goal in mind before interacting with the client.  It involves verbal and nonverbal communication.

14.  Copyright 2002 by Delmar, a division of Thomson Learning 11-14  A nurse’s expression of humanistic concern for a client is shown by taking time to simply “be with” the client.

15.  Copyright 2002 by Delmar, a division of Thomson Learning 11-15 Characteristics of Therapeutic Relationships  Catharsis refers to the relief experienced from verbalizing one’s problems “Getting things off one’s chest” is a universal experience that is therapeutic for individuals experiencing anxiety

16.  Copyright 2002 by Delmar, a division of Thomson Learning 11-16  Characteristics of therapeutic nurses Warmth Hope Rapport Trust Empathy

17.  Copyright 2002 by Delmar, a division of Thomson Learning 11-17 Acceptance Humor Compassion Self-awareness Flexibility Risk-taking

18.  Copyright 2002 by Delmar, a division of Thomson Learning 11-18 Therapeutic Value of the Nursing Process  The nursing process is therapeutic because it focuses on the client’s response to illness, disease, or disability rather than just on the problem.

19.  Copyright 2002 by Delmar, a division of Thomson Learning 11-19 Nursing Roles  Caregiver  Counselor  Teacher  Client advocate  Change agent  Team member  Resource person