NURSE-PATIENT
RELATIONSHIP

What is nurse-patient
relationship?
• Series of interaction between the
nurse and the patient in which the
nurse assist the patient to attain
positive behavioral change

What are the
characteristics of the
nurse-patient relationship?
• It is goal directed, focused on the
needs of the patient, planned, time
limited and professional.

What are the basic
elements of a therapeutic
nurse-patient relationship?
• Trust
• Rapport
• Unconditional positive regard
• Setting limits
• Therapeutic communication

Phases of NPR:
A. Pre-interaction phase
• Begins when the nurse is assigned to a patient
• Major task of nurse: to develop self-awareness
• Data gathering, planning for first interaction

B. Orientation Phase
• Begins when the nurse and the patient
interacts for the first time
• Parameters of the relationship are laid
• Major task of the nurse: Establish
rapport, develop trust, assessment

C. Working phase
• The longest and most productive
phase of the NPR
• Major task: identification and
resolution of the patient’s problems

D. Termination Phase
• Major task: to assist the patient to review
what he has learned and transfer his
learning to his relationship with others
• Evaluation

When to terminate NPR?
• When goals have been accomplished
• When the patient is emotionally
stable
• When the patient exhibits greater
independence
• When the patient is able to cope with
anxiety, separation, fear and loss

How to terminate?
• Gradually decrease interaction time
• Focus on future oriented topics
• Encourage expression of feelings
• Make the necessary referral

Common Problems
Affecting NPR
• Transference – the development of an
emotional attitude of the patient either
positive or negative towards the nurse
• Countertranference – transference as
experienced by the nurse
• Resistance – development of ambivalent
feelings towards self-exploration