“THERAPEUTICIMPASSES”

PRESENTED BY:POOJA SAHARAN 1ST YR. M.SC NURSINGM.M UNIVERSITY,MULLANA,AMBALA

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THERAPEUTICHEALING,

CURATIVE, CURING, REMEDIAL,

MEDICINAL……

IMPASSESCAN’T OR

WON’T MOVE FORWARD 2

THERAPEUTIC IMPASSES

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THERAPEUTIC IMPASSES ARE BLOCKS IN THE PROGRESS OF THE NPR.IMPASSES PROVOKE INTENSE FEELINGS IN BOTH NURSE AND THE PATIENT, WHICH MAY RANGE FROM ANXIETY AND APPREHENSION TO FRUSTRATION, LOVE OR INTENSE ANGER.

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TYPES

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RESISTANCE IS THE PATIENT’S

ATTEMPT TO REMAIN

UNAWARE OF ANXIETY

PRODUCING ASPECTS WITHIN

THE SELF.

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•ACTIVE LISTENING•CLARIFICATION•REFLECTION•EXPLORE BEHAVIOUR TO FIND POSSIBLE REASONS.•MAINTAIN OPEN COMMUNICATION

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TRANSFERENCE ???

IT IS AN UNCONSCIOUS RESPONSE IN WHICH

THE PATIENT EXPERIENCES FEELINGS AND

ATTTUDES TOWARDS THE NURSE THAT WERE

ORIGINALLY ASSOCIATED SIGNIFICANT

FIGURES IN THE PATIENT’S EARLY LIFE.

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• NO NEED TO TERMINATE THE RELATIONSHIPUNLESS POSES A SERIOUS BARRIER TO THERAPY.•ASSIST PATIENT IN IDENTIFYING THE TRANSFERENCE.•WORK WITH PATIENT IN SORTING OUT PAST FROM THE PRESENT.

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COUNTER TRANSFERENCE ???

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IT IS A THERAPEUTIC IMPASSES CREATED BY

THE NURSE. IT REFERS TO THE NURSE’S

SPECIFIC RESPONSE GENERATED BY THE

QUALITIES OF THE PATIENT

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POWER TOOLS IN EXPLORATION POTENT INSTRUMENTS FOR UNCOVERING INNER STATESIT CAN BRING LIGHT TO NEW MATERIALS OR INFORMATION.HELPS NURSE TO MAINTAIN A WORKING RELATIONSHIP WITH THE PATIENT.

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• SUPPORT THE NURSE•ASSIST HER IN IDENTIFYING COUNTER TRANSFERENCE.•DISSCUSS WITH THE SUPERIORS.•SELF - EXAMINATION•PURSUE TO FIND OUT SOURCE AND SOLUTION OF THE PROBLEM.•PEER CONSULTATION

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RECEIVING A GIFT FROM THE PATIENTS MAKE NURSES TO INHIBIT INDEPENDENT DECISION MAKING AND CREATE A FEELING OF ANXIETY AND GUILT

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IT OCCURS WHEN A NURSE GOES OUTSIDE THE BOUNDARIES OF THE THERAPEUTIC RELATIONSHIP AND ESTABLISHES A SOCIAL, ECONOMIC OR PERSONAL RELATIONSHIP WITH THE PATIENT.

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•HAS DIFFICULTY IN SETTING LIMITS WITH THE PATIENTS•RELATES TO PATIENT LIKE A FRIEND OR FAMILY MEMBERS

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•HAS SEXUAL FEELINGS TOWARDS PATIENT.•FEELS THAT HE OR SHE IS TOO INVOLVED WITH THE PATIENT OR FAMILY•BELIEVES THAT THE OTHER STAFF MEMBERS ARE GETTING JEALOUS OF YOUR RELATIONSHIP WITH THE PATIENT.

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THERAPEUTIC IMPASSES IN VARIOUS PHASES OF NPR…

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PRE INTERACTION PHASE

DIFFICULTY IN SELF ANALYSIS

ANXIETYBOREDOMANGERDEPRESSION

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WAYS TO OVERCOME :

•HELP FROM PEERS AND SUPERVISORS IN SELF ANALYSIS AND FACING REALITY•ANALYZE HERSELF AND RECOGNISE HER LIMITATIONS.

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ORIENTATION PHASE

PERCEPTION OF EACH OTHER AS UNIQUE INDIVIDUAL MAY NOT TAKE PLACEPROBLEMS RELATED TO ESTABILISHING AN AGREEMENT OR PACT BETWEEN PATIENT.

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WAYS TO OVERCOME

•SHARE WITH THE SUPERVISORS•AN ALERT SUPERVISOR CAN•DETECT THIS AND GUIDE HER IN THE RIGHT DIRECTION.

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WORKING PHASE

•TESTING OF THE NURSE•UNREALISTIC ASSUMPTIONS •NURSE’S FEAR OF CLOSENESS•RESISTANCE BEHAVIOUR•TRANSFERENCE AND COUNTER TRANSFERENCE.

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TERMINATION PHASE

•ANGER•DEPRESSION•LIGHT TO ILLNESS•FLIGHT TO HEALTH•UNWILLINGNESS TO MAKE PLAN

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WAYS TO OVERCOME

•NURSE MUST BE AWAREOF PATIENT FEELIN.•ASSIST THE PATIENT BY OPENLY ELICITING HIS THOUGHTS AND FEELINGS ABOUT TERMINATION•SUPERVISOR CAN ASSIST THE NURSE IN MAKING DISCHARGE PLAN OF THE PATIENT.

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