Nurse Tony should first discuss terminating nurse-client relationship with a client during :

Correct Answer: C. Orientation phase when a contract is established.

When the nurse and client agree to work together, a contract should be established, the length of the relationship should be discussed in terms of its ultimate termination. Termination of a meaningful nurse-client relationship should be final in any setting. To provide the client with even a hint that the relationship will continue is inappropriate, unprofessional, and unethical; for example, the LPN informs the client that he/she may contact the client on social media to check on their condition after discharge.

• Option A: Termination occurs when the care provided by the nurse is no longer required for the context of care; for example, a client who was hospitalized for pneumonia has recovered and no longer requires nursing care is now discharged home. In this phase, the nurse and client evaluate the client’s response to treatment and explore the meaning of the relationship and what goals have been achieved. Discussing the achievements, how the client and nurse feel about concluding the relationship, and plans for the future are an important part of the termination phase.
• Option B: The problem-solving phase of the relationship, paralleling the planning and implementation phases of the nursing process. Within this phase, relevant treatment goals are established to guide nursing interventions and client actions, and the conversation in the working phase turns to active problem solving related to assessed needs. Clients can more deeply disclose concerns/issues that they are having.
• Option D: The nurse begins to build a sense of trust by providing the client with basic information (name, professional status, and essential information about the purpose and nature of the relationship). Introductions are important even when the client is confused, aphasic, unresponsive, or unable to respond. Nonverbal supportive communication such as a handshake, eye contact, a smile, and appropriate body language reinforce spoken words.