The Therapeutic Nurse-Patient Relationship - ppt download
The nurse–client relationship is an interaction aimed to enhance the well-being of a "client," which may be an individual, a family, a group, or a community. A therapeutic nurse-patient relationship is a supportive interaction that moves a patient toward wellness. It's based on trust, respect, interest. A therapeutic nurse-patient relationship is defined as a helping relationship that's based on mutual trust and respect, the nurturing of faith and hope, being.
This means a composition of knowledge, clinical work and interpersonal communication 1.
Communication and the Nurse-Patient Relationship
Communication is a vital element in Nursing in all areas of activity and in all its interventions such as prevention, treatment, therapy, rehabilitation, education and health promotion 2.
The nursing process moreover as a scientific method of exercise and implementation of Nursing, is achieved through dialogue, through interpersonal environment and with specific skills of verbal communication 3.
As communication we can define the exchange of information, thoughts and feelings among people using speech or other means. Therapeutic practice involves the oral communication of public health officials and nurses on the one hand and the patient or his relatives on the other.
It is a two way process. The patient conveys their fears and concerns to their nurse and helps them make a correct nursing diagnosis.
The nurse takes the information and in turn transmits other information to the patient with discretion and delicacy as to the nature of the disease and advises with treatment and a rehabilitation plan for health promotion 4. Effective communication requires an understanding of the patient and the experiences they express. It requires skills and simultaneously the sincere intention of the nurse to understand what concerns the patient.
It is a reflection of the knowledge of the participants, the way they think and feel and their capabilities 5. In order for the nurses to be successful in their work they have to study communication and interpersonal relations in their education with special courses and internships.
They need to learn the various aspects and applications of communication in various fields of nursing 6. In this context it is understood that emphasis must be placed on the importance of communication between nurse and patient and nursing education must focus on communication skills of nurses. The entire process occurs in a context consisting of physical space, cultural and social values and psychological conditions 7.
Communication assists in the performance of accurate, consistent and easy nursing work, ensuring both the satisfaction of the patient and the protection of the health professional. When health professionals are not trained in communication skills, they face more difficulties separating work from their personal life, tending to transfer problems from one side to the other 8. Communication is an intrinsic characteristic of human nature.
Communication has content and value. The contents regards to what was said, whilst the relationship regards as to how it was said. The nature of the relationship depends on how the two parties understand the communication sequence 9.
Communication is never unidirectional. It is an interaction in which each sender becomes receiver and vice versa. The failure to recognize the two-way communication capability, quite often leads to negative conclusions and attitudes Moreover, the message sent is not the same as the message received.
The decoding of the messages is based on individual factors and subjective perceptions.
This fact, in conjunction with the process of feedback makes communication. We interpret something that we heard not according to what the sender actually said but according to our own code Particular attention should be given by the caregivers to use technical terms and medical terminology during their contact with the ill, because it is often found that the patient ascribes different interpretations to what he hears or even more cannot understand what is meant exactly, mainly by the therapist, thus increasing mental stress, a fact which makes it more difficult to communicate with the patient Communication happens without words.
It is an ongoing process. This non-verbal communication is expressed by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor It is important that there is an agreement between verbal and nonverbal communication.
Particularly under stressful conditions where it is difficult to see the changes in the non-verbal messages of the patients with whom we mostly communicate Moreover, each patient has his own specific characteristics that influence not only behavior in the process of communication, but also if and how to cooperate with nursing services and how they will undertake self-management of health Listening is important in communication.
It is responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and non-verbal messages emitted by each patient.
Good personal relationships are described as the ability of the nurse to ask questions with kindness and provide information in a way that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society The therapeutic relationship is an important prerequisite to effective communication between health professionals and patients in order not only to transmit information, but also to effectively address mental processes which are activated by it.
The communication between health professionals and patients include the ability to express sincere concern for the care of the patient and the patient becomes a partaker of this interest 9. This will happen if the conversation is held in appropriate conditions. Even though it seems obvious, it should be noted that courtesy and kindness on part of the nurse is required 4 A key element is the need for a peaceful environment with no external distractions, which will ensure appropriate confidentiality of the dialogue.
Frequently we see the phenomenon of serious discussions taking place in the middle of the corridor of the outpatient department or the nursing department, clinic, or in some office of the hospital, in which third parties unrelated to the care of the individual patient are coming in and out In such an environment the patients are ashamed to express themselves freely Unfortunately, the concept of privacy is pretty much unknown to the Greek hospital system.
Skilled nursing operations for the patients are made in chambers without screens or in hallways, in front of others. Patients and visitors of hospitals move without restriction in all the areas of the nursing and clinical departments. However, it is up to us to teach our colleagues and especially the new nurses and their patients setting the right example, in order for things to slowly change for the better Even more than the comfort of space, communication with the patient requires ample time.
Each patient has his own way and pace to reveal his problem, but it takes some time to get to know the nurses and feel the confidence necessary to face them.
The patient should have the feeling that the time-whether it is five minutes or an hour-is entirely his. The patient who has the undivided attention of the nurse reveals his problem sooner, with the satisfaction that the nurse has listened and observed him The language he uses for this purpose is very important. Often the patient is bombarded with big words with little or no significance for him Once again the nurse may be directed to the ill in an incomprehensible way.
Patients that are ashamed of their ignorance or are hesitant, avoid seeking an explanation, and as a result the consultation is inadequate and does not lead to the right outcome for the patient. The language of communication should therefore be at the level of the listener, who is not able to assess our scientific knowledge, but has to understand what we are telling him 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.
Nurses must intervene and report any abusive situations observed that might be seen as violent, threatening, or intended to inflict harm.
Communication in Nursing Practice
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.
Therapeutic Nurse-Client Relationship
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. 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. 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.
Letters were chosen from 13 chronically ill clients from Finland. The clients were also interviewed in addition to their letters. The interviews reported that humour played an important role in health. A paralyzed woman said, "Well you have to have a sense of humour if you want to live and survive. You have to keep it up no matter how much it hurts". One participant stated, " A participant said, "For male patients humour is also a way of concealing their feelings. It's extremely hard for them to admit they're afraid".
Interpersonal Relations in Nursing. Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E.
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- Presentation on theme: "Communication and the Nurse-Patient Relationship"— Presentation transcript:
Springer Publishing Company, Journal of Nursing Administration, 35 1 Professional Communication Skills for Nurses sixth edition. In Communications in Nursing Seventh ed. Newer dimensions of patient care, Part 1: The use of the physical and social environment of the general hospital for therapeutic purposes.
Culture, Communication, and Nursing. Using the Self to Promote Health. In Therapeutic Interaction in Nursing 2nd ed. Perspectives and Principles of Therapeutic Communication. In Nurse-Client Communication 1st ed. International Journal of Mental Health Nursing.
International Journal of Caring Sciences. Retrieved 30 June