The nurse–client relationship is an interaction aimed to enhance the well-being of a "client," . an individual's culture and ensuring open-mindedness is being incorporated all throughout the relationship up until the termination phase. Nurse – Patient Relationship The Nurses and attendants staff we provide . Phases of the nurse-patient relationship Pre-interaction phase. PHASES OF A THERAPEUTIC NURSE- CLIENT RELATIONSHIP (CONT'D) Working phase Maintain trust and rapport Promote client ' s insight and perception.
These behaviours are effective for communication skills, and are useful for thinking about how to listen to another person. Empathy Having the ability to enter the perceptual world of the other person and understanding how they experience the situation is empathy. This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences.
Patients are expecting a nurse who will show interest, sympathy, and an understanding of their difficulties. When receiving care patients tend to be looking for more than the treatment of their disease or disability, they want to receive psychological consideration. During hard times, clients are looking for a therapeutic relationship that will make their treatment as less challenging as possible.
Many patients are aware that a solution to their problems may not be available but expect to have support through them and that this is what defines a positive or negative experience. Past experiences can help the clinician can better understand issues in order to provide better intervention and treatment.
The goal of the nurse is to develop a body of knowledge that allows them to provide cultural specific care. This begins with an open mind and accepting attitude. Cultural competence is a viewpoint that increases respect and awareness for patients from cultures different from the nurse's own.
Cultural sensitivity is putting aside our own perspective to understand another person's perceptive. Caring and culture are described as being intricately linked. It is important to assess language needs and request for a translation service if needed and provide written material in the patient's language.
As well as, trying to mimic the patient's style of communication e. Another obstacle is stereotyping, a patient's background is often multifaceted encompassing many ethic and cultural traditions. In order to individualize communication and provide culturally sensitive care it is important to understand the complexity of social, ethnic, cultural and economic. This involves overcoming certain attitudes and offering consistent, non-judgemental care to all patients.
Accepting the person for who they are regardless of diverse backgrounds and circumstances or differences in morals or beliefs.Orientation Phase of the therapeutic nurse-patient relationship
By exhibiting these attributes trust can grow between patient and nurse. It includes nurses working with the client to create goals directed at improving their health status. A partnership is formed between nurse and client. The nurse empowers patient and families to get involved in their health. To make this process successful the nurse must value, respect and listen to clients as individuals. Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health.
It is stated that it is the nurse's job to report abuse of their client to ensure that their client is safe from harm.
Nurse–client relationship - Wikipedia
Nurses must intervene and report any abusive situations observed that might be seen as violent, threatening, or intended to inflict harm. Nurses must also report any health care provider's behaviors or remarks towards clients that are perceived as romantic, or sexually abusive. Interviews were done with participants from Southern Ontario, ten had been hospitalized for a psychiatric illness and four had experiences with nurses from community-based organizations, but were never hospitalized.
The participants were asked about experiences at different stages of the relationship. The research described two relationships that formed the "bright side" and the "dark side".
The "bright" relationship involved nurses who validated clients and their feelings. For example, one client tested his trust of the nurse by becoming angry with her and revealing his negative thoughts related to the hospitalization. The client stated, "she's trying to be quite nice to me For example, one client stated, "The nurses' general feeling was when someone asks for help, they're being manipulative and attention seeking ".
One patient reported, "the nurses all stayed in their central station.
They didn't mix with the patients The only interaction you have with them is medication time". One participant stated, "no one cares. It's just, they don't want to hear it. They don't want to know it; they don't want to listen". These findings bring awareness about the importance of the nurse—client relationship. Building trust[ edit ] Building trust is beneficial to how the relationship progresses. Wiesman used interviews with 15 participants who spent at least three days in intensive care to investigate the factors that helped develop trust in the nurse—client relationship.
Patients said nurses promoted trust through attentiveness, competence, comfort measures, personality traits, and provision of information. Every participant stated the attentiveness of the nurse was important to develop trust. One said the nurses "are with you all the time.
Whenever anything comes up, they're in there caring for you". They took time to do little things and made sure they were done right and proper," stated one participant. One client stated, "they were there for the smallest need.
Peplau's Theory - A Nurse/Patient Collaboration - Ausmed
I remember one time where they repositioned me maybe five or six times in a matter of an hour". One said, "they were all friendly, and they make you feel like they've known you for a long time" Receiving adequate information was important to four participants.
One participant said, "they explained things. They followed it through, step by step". Emotional support[ edit ] Emotional Support is giving and receiving reassurance and encouragement done through understanding. Yamashita, Forchuk, and Mound conducted a study to examine the process of nurse case management involving clients with mental illness. Nurses in inpatient, transitional, and community settings in four cities in Ontario Canada were interviewed.
The interviews show the importance of providing emotional support to the patients. One nurse stated that if the client knows "Somebody really cares enough to see how they are doing once a week To them it means the world". A nurse stated that "We're with the families. We can be with them as oppositional and overly involved and somewhere else in between, and we're in contact with them as much as they want".
The study reaffirmed the importance of emotional support in the relationship.
Peplau’s Theory – A Nurse/Patient Collaboration
Humour[ edit ] Humour is important in developing a lasting relationship. Astedt-Kurki, Isola, Tammentie, and Kervinen asked readers to write about experiences with humour while in the hospital through a patient organization newsletter.
In this phase, the nurse The subjects ranged in age from 18 to 91 years, with and client come to know each other as persons and to the mean age being Approximately two-thirds of understand the role that each is expected to assume. The most common psychi- Consistency and clarity is essential on the part of the atric diagnoses included schizophrenia and depres- nurse, if the therapeutic relationship is to be forged.
Subjects generally had numerous psychosocial client will test the parameters of the relationship in order deficits. There were only six dropouts from the pro- to establish that the nurse is a trustworthy person. The gram during the initial two-year period.
Variables orientation phase is completed when the client identifies studied within the sample included: Findings indicated that 15 subjects were still This research studied the length of the orientation in orientation after a year. The length of orientation phase in a selected sample of clients and nurses. The ranged from one to 23 months, with the mean being 5. The charting included regular documenta- orientation; b months in orientation; or, c 11 or tion on the progression of the nurse-client relationships.
The breakdown is summa- Since the program was new, a relatively large number rized in Table 1. Subjects who anticipated a change in nurses over months 2 months or less 32 44 e. On the other hand, in cases where a nurse left with only two weeks notice and subjects reverted to the orientation phases, they generally stayed there longer with the new nurse than during their initial orientation. Four of the eight subjects had not completed the orienta- The only variables that were statistically significant tion phase with the new nurse.
Those subjects with the longest period in the orien- tation phase of the relationship had more and longer hospitalizations, as indicated in Table 2. A similar pat- Those subjects with the longest period in tern was noted with 30 clients who had reverted to the orientation phase after moving to the working phase.
It is interesting to note that all three subjects with personality disorders returned to orientation at least once. With the remaining 13 subjects, the precipitating fac- tors appeared related to signs that their psychiatric ill- nesses were worsening, such as increasing paranoia or depression.
These returns to orientation were very brief, and were all resolved within two months, even when the Table 2. Time in Orientation Compared to psychiatric symptoms persisted.
Hospitalization Pattern Discussion Time in No. For example, the author anticipated that sub- jects with schizophrenia might take longer in orientation months 4. Not only was this assumption not true, months 5.
For example, each of the three 11months or more 5. Perspectivesin Psychiatric Care Vol. S d a r l yit might be presumed that the inhvidual with that lengthy hospitalizationpatterns are related to lengthy a chronic mental illness seeking counseling for a specific orientationphases. If the nurse-client relationslup is indeed issue, lke parenting, might move to the problem identifica- the crux of psychiatric nursing Peplau,the study of tion phase more quickly than an individual admitted for the nurse-client relationship is essential to mental-health lifelong case management.
Again, the data did not bear out nursing. Indeed, such findings raise more questions than answers. Do any of our readers have thoughts about a possible explanation for these fmdings? Let us henr from you. Does a h t o r y of longer hospitaliza- References tions in some way increase the time required for the orien- tation phase? Concepts and their relations.