The client–Nurse Relationship
A helping relationship
Objectives
After the end of this lecture the student will be able to
1. Identify the purpose of the client-nurse Relationship.
2. Describe the cognitive, affective, and psychomotor abilities that nurses and
clients bring to the therapeutic encounter.
3. Discuss clients’ rights as consumers of health care services.
4. Explain the characteristics of successful client nurse relationship.
5. List do’s and don’ts in the client-nurse relationship.
6. Identify therapeutic communication techniques.
7. Identify nontherapeutic communication techniques.
NUTURE OF THE HELPING RELATIONSHIP
• The client-nurse relationship is established to help the client achieve and
maintain optimal health.
• A successful helping relationship between nurse and client represent a
different order of interaction than that which occurs in a friendship.
• Nursing care is planned to meet an individual client’s unique needs and
situation with respect for the patient’s and family’s goals and preferences
• Nurses provide patient education so that clients have necessary
information to make informed decisions about their health care, health
promotion, disease prevention, and attainment of a peaceful death.
Cognitive , Affective , and Psychomotor Abilities
in the Therapeutic Encounter
1-COGNITIVE
• Clients and nurses both know something about health and illness in
general, and about the individual client’s health concerns in particular.
2-AFFECTIVE
• All clients and nurses have positive and negative feelings about helping
relationships ; each also has biases about the other.
• Each has different priorities for working on particular health concerns.
The attitudes of both clients and nurses greatly affect whether they
work in harmony or discord.
• The major source of our value system is our culture.
3-PSYCHOMOTOR
• The client needs to know what skills the nurse has,
and the nurse needs to find out about the client’s
ability to participate in his or her own treatment
plan.
• Both parties must come to an agreement about
what their respective tasks will be in their effort to
improve the client’s health status.
CLIENTS’ RIGHTS IN THE HELPING RELATIONSHIP
Clients have the following rights:
 To expect a systematic and accurate investigation of their
health concerns by thorough and well-organized nurses.
 To be informed about their health status and have all their
questions answered so that they clearly understand what
nurses mean.
 To receive health care from nurses who have current
knowledge about their diagnosis and are capable of providing
safe and efficient care
 To feel confident that they will be treated courteously and that
their nurses show genuine interest in them.
 To trust that the confidentiality of any personal information will
be respected.
 To be informed about any plans of action to be carried out for
their benefit.
 To refuse or consent to nursing treatments without jeopardizing
their relationship with their nurses.
 To secure help conveniently, without hassles or roadblocks
 To receive consistent quality of care from all nurses.
CHARACTERISTICS OF CLIENT-NURSE HELPING RELATIONSHIPS
 A partnership between client and nurses, both working together to improve
the client’s health status.
 A philosophy about human nature and what motivates humans in health and
illness. As nurses, we should know our beliefs and values and be able to
articulate them clearly.

A purposeful and productive objective . Together clients and nurses agree
about the nature of the health problem in question , and they develop and
implement a plan designed to reach agreed-upon objectives.
 Preservation of the client’s present level of health and protection from future
health threats because of the increased knowledge gleaned from the helping
relationship.
 Palliation of the client’s worries and fears through nurses’
reassurances, and easing of pain through soothing comfort
measures.
 A psychic or morale boost. Clients perk up from the positive
attention and interest they receive from nurses.
 Practicality. Efficacious, effective, and efficient ways of handling
health concerns are offered.
 Portability. The helping relationship is present wherever and
whenever clients and nurses come together.
 A series of phases, with a beginning (initiation ), middle
( maintenance ), and end ( termination ) to each encounter.
 A personally tailored interaction designed to meet the needs of each
particular client .
 Platonic and not passionate expressions of caring . Even though
nurses may have strong feelings for their clients, it is expected that
they can maintain adequate objectivity and perspective to provide
therapeutic assistance .
 A sense of privacy so that clients may disclose intimate details about
their lives. Nurses are responsible for protection their clients’
confidentiality .
Points to Guide you in your client- Nurse Helping Relationships
 DO :
- Be prepared mentally, emotionally, and physically to assist your
clients in resolving their health care problems.
- Be punctual and polite in your manner of relating to clients.
- Promote clients’ well-being, comfort, and increased health status
- Be philanthropic in your approach to clients by putting their needs
and concerns first .
- Be plucky in planning and generating creative solutions to your
clients’ health concerns.
- Be proficient in the nursing skills required to safely and
successfully care for your clients.
- Praise and encourage clients in their efforts to take better care of
themselves.
- Be patient and understanding about clients’ reactions to their
particular health situations.
- Persevere in pursuing your pledge to help clients preserve their
health.
DON’T
 Patronize clients.
 Preach at them or pressure them to change .
 Pigeonhole clients with labels such as ‘good,’ ‘lazy,’ or ‘ uncooperative,’ which prevent
you from seeing clients as they really are.
 Procrastinate following through on clients’ reasonable requests.
 Put down clients by using medical jargon or in any way making them feel inadequate
or estranged.
 Punish clients for acts of omission or commission that have negatively affected their
health.
 Reveal prejudices against the race, religion, or creed of clients.
 Be pleasure seeking or try to meet your own needs through the client-nurse
relationship.
THERAPEUTIC COMMUNICATION TECHNIQUES
Technique
Definition
Listening
An active process of receiving information and examining one’s
reaction to the messages received
Remaining silent
Periods of no verbal communication among participants
Establishing guidelines Statements regarding roles , purpose, and limitations for a
particular interaction
Making open-ended
comments
General comments asking the client to determine the direction
the interaction should take
Reducing distance
Diminishing of physical space between the nurse and client
Acknowledging
Recognition given to a client for contribution to an interaction
THERAPEUTIC COMMUNICATION TECHNIQUES
Technique
Definition
Restating
Repetition to the clients of what the nurse believes is the main
thought or idea express.
Reflecting
Direction back to the clients of his or her ideas, feelings, questions
or content.
Seeking clarification
Request to additional input to understand the message received.
Seeking consensual
validation
Attempts to a mutual denotative and connotative meaning of
specific words.
Focusing
Questions or statements to help the client develop or expand an
idea.
Summarizing
Statement of main areas discussed during an interaction.
Planning
Mutual decision making regarding the goals, direction and so
forth, of future interaction.
NONTHERAPEUTIC COMMUNICATION TECHNIQUES
Technique
Definition
Failing to listen
Failure to receive the client’s intended message
Failing to probe
Inadequate date collection represented by eliciting vague
descriptions, getting inadequate answers, following standard
forms too closely, and not exploring the client’s interpretation
Parroting
Continual repetition of the client’s phrases
Being judgmental
Approving or disapproving statements
Reassuring
Attempts to do magic with words
Rejecting
Refusal to discuss topics with the client
NONTHERAPEUTIC COMMUNICATION TECHNIQUES
Technique
Definition
Defending
Attempt to protect someone or something from negative
feedback.
Giving advice
Declaration to the of what the nurse thinks should be done.
Making stereotyped
responses
Use of trite, meaningless verbal expressions.
Changing topics
Nurses’ direction of the interaction into areas of self
interest rather than areas of concern to the client.
Patronizing
Style of communication that displays a condescending
attitude toward the client.
Thank You