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Ignoring unacceptable realities
Denial
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Restoring to a earlier more comfy level of functioning
Regression
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Denied entry of a threatening thought into consciousness
Repression
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Blaming others for a personal shortcoming
Projection
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Not acknowledging the significance of ones behavior
minimization
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"Why did you find yourself getting angry with your dad?"
Non therapeutic...demanding an explanation
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"You shouldnt feel so bad about this"
Belittling....non therapeutic
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"I would not do that if I were you"
Advising-non therapeutic
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"You seem more anxious today than yesterday"
Making observations-therapeutic
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"I felt the same way when I was your age"
Non therapeutic-not about you!!
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Essential component that a nurse must bring to a nurse patient relationship
Empathy
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Phases of a nurse patient relationship
- Initial
- Working
- Termination
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Getting demographic information regarding a patient
Initial phase
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Developing and implementing a plan of action
Working phase
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a sense of loss may be felt at this stage
Termination phase
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Personality is shaped by whether a series of developmental tasks are sucessfully met
Eric Erikson
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There are 3 components to the personality, and development stops at adolesence
Freud
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Stage in which pt learns how to have intimate relationships
Intimacy vs. Isolation
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Preventing a painful reality from entering conscious awareness
Defense Mechanisms
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When non verbal communication matches the spoken message
congruity
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"I can see how much your brother meant to you, this loss seems to have devastated you"
An example of empathetic response using reflection techniques
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Giving approval, disapproval, agreeing, advising "why"
Non therapeutic responses
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"You look a lot like my mother, she was a nurse too"
Transference
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Unconditional positive regard, genuine response, congruency, empathy, and trust
Elements of a nurse patient relationship
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Anger at spouse, not safe to express, yells at child
Ego defense mechanism....called displacement
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Ways of thinking, perceiving, doing, learned within society
cultural/sofical influences
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"the reason I drink is because I hurt my back and then I lost my job"
Rationalization
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Initial action a nurse should take when a patient is experiencing an emotional difficulty
Trust and Rapport
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