| Recommendation 1 | The nurse must acquire the necessary knowledge to participate effectively in therapeutic relationships. |
| Recommendation 2 | Establishment of a therapeutic relationship requires reflective practice. This concept includes the required capacities of: selfawareness, self-knowledge, empathy, awareness of boundaries and limits of the professional role. |
| Recommendation 3 | The nurse needs to understand the process of a therapeutic relationship and be able to recognize the current phase of his/her relationship with the client. |
| Recommendation 4 | All entry-level nursing programs must include in-depth learning about the therapeutic process, including both theoretical content and supervised practice. |
| Recommendation 5 | Organizations will consider the therapeutic relationship as the basis of nursing practice and, over time, will integrate a variety of professional development opportunities to support nurses in effectively developing these relationships. Opportunities must include nursing consultation, clinical supervision and coaching. |
| Recommendation 6 | Health care agencies will implement a model of care that promotes consistency of the nurse-client assignment, such as primary nursing. |
| Recommendation 7 | Agencies will ensure that at minimum, 70 per cent of their nurses are working on a permanent, full-time basis. |
| Recommendation 8 | Agencies will ensure that nurses’ workload is maintained at levels conducive to developing therapeutic relationships. |
| Recommendation 9 | Staffing decisions must consider client acuity, complexity level, complexity of work environment, and the availability of expert resources. |
| Recommendation 10 | Organizations will consider the nurse’s well-being as vital to the development of therapeutic nurse-client relationships and support the nurse as necessary. |
| Recommendation 11 | Organizations will assist in advancing knowledge about therapeutic relationships by disseminating nursing research, supporting the nurse in using these findings, and supporting his/her participation in the research process. |
| Recommendation 12 | Agencies will have a highly visible nursing leadership that establishes and maintains mechanisms to promote open conversation between nurses and all levels of management, including senior management. |
| Recommendation 13 | Resources must be allocated to support clinical supervision and coaching processes to ensure that all nurses have clinical supervision and coaching on a regular basis. |
| Recommendation 14 | Organizations are encouraged to include the development of nursing best practice guidelines in their annual review of performance indicators/quality improvement, and accreditation bodies are also encouraged to incorporate nursing best practice guidelines into their standards. |
Foundational
Establishing Therapeutic Relationship
Practice Recommendations