Republic of the Philippines
Notre Dame University
College of Health Sciences
Cotabato City
WRITTEN OUTPUT
NCM 117
A10
Abdul, Andrea
Akmad, Sahida
Anton, Betchiva
Balang, Rayhana
Bayao, Mohamad Alekhine
Bilao, Norhana
Coro, Sittie Aisharein
Deligero, Kirsten Julliane
Gustilo, Julia Mae
Yu, April Chenieren
February 7, 2025
I. DEFINITION
Orientation phase is the initial meeting where the nurse and patient begin to
establish trust, rapport, and communication. This phase is essential in creating a safe and
supportive environment for the patient. During the orientation phase, you will perform
introductions with the patient, establish a rapport, establish boundaries, and explain
patient confidentiality. You will set mutually agreed-upon goals with the patient and
establish the date, time, place and duration of meetings.
IMPORTANCE OF ORIENTATION PHASE
The importance of the orientation phase is crucial in nursing as it lays the foundation
for a strong therapeutic relationship with patients. During this phase, nurses introduce
themselves, establish trust, gather essential information about the patient's needs and
preferences, and create a safe and comfortable environment. By fostering open
communication, understanding the patient's perspective, and establishing clear
expectations, nurses can effectively begin providing individualized care, promoting
patient well-being and achieving positive outcomes.
TASK FOR ORIENTATION PHASE
1. Establishing Contact
The first task is making that initial connection with the patient.
As nurses, we start by introducing ourselves in a calm and professional manner. For
example: ‘Hi, I’m Student Nurse Bayao from Notre Dame University , and I’ll be
working with you today.’
It’s important to use open body language, maintain good eye contact, and show genuine
interest to help the patient feel comfortable and safe.
Active listening is key here when the patient sees that you’re paying attention, it builds
trust.
2. Making Agreements
Next, we focus on creating agreements.
This is where we explain the purpose of the interaction and establish boundaries or
[Link] instance, we might say: ‘During this session, we’ll talk about how
you’ve been feeling and identify areas where I can support you.’
We also clarify the goals and timeframe, ensuring that the patient understands what to
expect. This step sets the tone for a collaborative relationship.
3. Talking with the Patient
Now, moving on to the actual conversation with the patient.
Republic of the Philippines
Notre Dame University
College of Health Sciences
Cotabato City
Using open-ended questions is a good way to start. For example: ‘Can you share with me
how things have been going recently?’
We make sure to validate their feelings and show empathy. For example, if they express
sadness, we might respond with: “It’s okay to feel that way. I’m here to listen and help.”
By doing this, we encourage the patient to open up, which builds trust and understanding.
4. Assessing the Client’s Needs
The final task is gathering detailed information about the patient’s needs. We ask focused
questions like: ‘What’s your main concern right now?’ or ‘What do you think you need
the most help with?’
This step is crucial because it helps us identify their priorities, challenges, and the support
they require moving forward. It’s like laying the groundwork for the care plan, ensuring
it’s centered around their specific concerns.
NURSE-CLIENT CONTRACT
The nurse must outline the responsibilities of the nurse and the client during the
orientation phase. At the outset, both the nurse and the client should agree on these
responsibilities in an informal or a verbal contract. In some instances, a formal or written
contract may be appropriate; examples include if a written contract has been necessary in
the past with the client or if the client “forgets” the agreed-on verbal contract.
The purpose of this is to establish clear professional boundaries and to make sure that the
relationship remains therapeutic, make the client feel safe and respected, and it defines
the roles and responsibilities of both parties during the therapeutic session. For instance,
the nurse's role in the relationship is to listen actively, provide emotional support, ensure
the safety of the client, evaluate the progress and document everything. As for the client,
their responsibility is to participate actively, communicate openly, and follow
agreed-upon interventions.
CONFIDENTIALITY
Confidentiality means respecting the client's right to keep private any information
about his or her mental and physical health and related care. It means allowing only those
dealing with the client's care to have access to the information that the client divulges.
Only under precisely defined conditions can third parties have access to this information;
for example, in many states, the law requires that staff report suspected child and elder
abuse.
SELF-DISCLOSURE
Cultural considerations are another critical aspect of self-disclosure. Different cultures
have varying expectations and comfort levels when it comes to personal information. In
some cultures, self-disclosure may be seen as unprofessional or intrusive, while in others,
it may be welcomed as a way to build connection. Nurses need to be aware of these
cultural differences to ensure that their disclosures are appropriate and well-received.
Self-disclosure in nursing refers to the act of nurses sharing personal information, such as
details about their life, experiences, or feelings, with clients to help foster a trusting and
supportive relationship. This approach has evolved over time. Traditionally, nurses were
advised to keep their personal lives private, sharing only basic information like their name or
general location, to maintain professional boundaries. However, current practices suggest
that, when done thoughtfully and intentionally, self-disclosure can improve the nurse-client
relationship by conveying empathy, building rapport, and reassuring clients that their
emotions are normal.
The goal of self-disclosure is to create an environment where the client feels safe and
supported. By sharing a relevant personal experience or feeling, a nurse can help a client feel
understood and less isolated. For example, a nurse might share a non-specific story about
how they coped with a stressful situation to help a client realize that others face similar
challenges. This can make the client feel more comfortable expressing their own thoughts
and emotions, and reduce anxiety.
SAMPLE QUESTIONS
● " Good morning! I am Shiela Cruz, a student nurse from Notre Dame
University, Cotabato City. I will be coming to the Institution for 2 weeks. I
would like to meet with you each time and I am here to support you as you
work on your treatment goals."
●
- This way, we can build rapport with patients and can reduce their anxiety
considering their condition.
● "Mr/Mrs. Santos we will be meeting every monday from June 1 to June 15 at
11 am in the conference room. We can use the time to work on your feelings
about the loss of your twin sister."
- This provides a sense of control and reduces anxiety.
- It also demonstrates respect for the patient's time and space and helps establish
clear boundaries and expectations for the therapeutic relationship, fostering a
sense of trust and security at the same time.
● "What are your hopes for our time together?"
- Open-ended, shows genuine interest
● " What are some things that make you feel safe and comfortable?"
- Helps identify patient's needs and preferences
● “Mr./Mrs. Santos, it is important that I tell you we should be sharing some of
what we talk about with our instructor, peers, and staff during our clinical
conference. However, we should not be sharing any information with your
Republic of the Philippines
Notre Dame University
College of Health Sciences
Cotabato City
wife or children without your permission. If we feel that any piece of
information might be helpful, we should ask you first if we can share it with
your wife.”
- We should explain the boundaries of confidentiality to the patient. This reassures
the patient that while some of the information shared may be discussed with the
healthcare team for better care, it will always be done with respect for their
privacy.
- We should emphasize that no information will be shared with family members
without the patient’s permission, helping to build trust and ensuring the patient
feels respected.
REFERENCES
Registered Nurses' Association of Ontario (RNAO). (n.d.). Phases of the therapeutic
relationship. Retrieved from [Link] (n.d.).
Nurse-client relationship. In Psychiatric-mental health nursing. Retrieved from
[Link]
Videbeck, S. L. (2020). Psychiatric–mental health nursing (8th ed.). Wolters Kluwer.
ISBN-13: 978-1-975116-37-8.