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Preorientation, Orientation, Working and Terminating Phases
Terms in this set [7]
Pre-orientation Phase
This phase is when the nurse plans for the first session with the patient by gathering information and reviewing records.
Orientation Phase
This phase can last for a few meetings or extend over a longer period of time. The initial interview includes the following aspects:
1. An atmosphere is established in which rapport can grow.
2. The nurse's role is clarified and the responsibilities of both the patient and the nurse are defined.
3. The contract containing the time, place, date and duration of the meetings is discussed.
4. Confidentiality is discussed and assumed.
5. The
terms of termination are introduced [these are also discussed throughout the orientation phase and beyond].
6. The nurse becomes aware of transference and counter-transference issues.
7. Patient problems are articulated and mutually agreed upon goals are established.
Working Phase
During the working phase, the nurse and patient together identify and explore areas that are causing problems int he patient's life.
Tasks of the Working Phase
1. Maintain the relationship.
2. Gather further data.
3. Promote the patient's problem solving skills, self esteem and use of language.
4. Facilitate behavioral change.
5. Overcome resistance behaviors.
6. Evaluate problems and goals, and redefine them as necessary.
7. Promote practice and expression of alternative adaptive behaviors.
Terminating Phase
This phase is the final, integral phase of the nurse-patient relationship. Termination is discussed during the first interview and again during the working stage at appropriate times.
Tasks of the Termination Phase
1. Summarizing the goals and objectives achieved in the relationship.
2. Discussing ways for the patient to incorporate
into daily life any new coping strategies learned.
3. Reviewing situations that occurred during the nurse-patient relationship.
4. Exchanging memories, which can help validate the experience for both nurse and patient and facilitate closure of that relationship.
Important reasons for the student or nurse to address the termination phase are:
1. Feelings are aroused in both the patient and the nurse with
regard to the experience they have had; when these feelings are recognized and shared, patients learn that it its acceptable to feel sadness and loss when someone they care about leaves.
2. Termination can be a learning experience; patients can learn that they are important to at least one person, and nurses learn continually from each clinical experience and patient encounter.
3. By sharing the termination experience with the patient, the nurse demonstrates caring for the patient.
4.
this may be the first successful termination experience for the patient.
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