Nursing: Clinical Reflection on Nurse and Patient Relationship

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In order to develop a therapeutic professional relationship with patients, trust must be promoted and kept throughout. The Nursing and Midwifery Council (2015) states that us as nurses must uphold and respect our patient’s dignity and to do this, patients must be cared for with compassion, respect and benevolence. By treating patients with such care this will allow a therapeutic professional relationship to develop, this will allow patients to feel safe under our care but will also allow effective care and treatment as a trusting, meaningful relationship will be formed. The Nursing and Midwifery Council (2015) further states that professionalism must be promoted, this should be done by acting honestly with integrity at all times, treating people without discrimination. This would further add to a strong therapeutic professional relationship as the patient would be able to receive the care they are entitled to without judgement and discrimination.

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Cahill, Paley and Hardy (2013) state how therapeutic relationships are still very much important and relevant in care and nursing practice. They suggested that often nurses will spend more time on administrating medication and treating their patients rather than implementing an important therapeutic relationship. This means that time that is spent with a patient it is rarely focussed on building a therapeutic relationship and more focussed on the treatment and medication of the patient. This could be due to many different factors, the main factor being lack of time and resources for nurses to spend more time with each of their patients. Forchuck and Reynolds (2001) suggest that in mental health nursing in particular, nurses often face a divided identity, one side being the ‘therapeutic relationship’ side that mainly focusses on the relationship aspect and the other being the ‘biology’ side which largely centres on the biological factors of mental health illnesses. In order to develop a professional therapeutic relationship with the people I will look after on placement, it is important to ensure I talk with and communicate with my patients in order to gain a sense of trust, as it is the basis of a therapeutic relationship. Although time might be limited it is crucial to ensure my patients feel listened to and that way a therapeutic relationship will become stronger.

Hobson (2019) discusses Carl Rogers person centred theory. This theory was applied to psychotherapy and counselling and states that person centred care is where the care is centred around the patient and they are the main focus of their own care. Hobson (2019) also states that this theory was brought about to make patients feel empowered and involved in their own care. By having a person-centred approach when delivering care to my patients, it will allow them to feel in control to a certain extent of their care. This approach will allow patients to keep their independence and therefore promote recovery and empowerment. Hayes (2013) states how important person-centred care is, even at the end of life. She suggests that it is crucial to have a person-centred assessment in order to provide effective care for every patient. Wright et al. (2008) states that he found that end of life care planning enhances the quality of life for both the individual and their carer. This is also seen to reduce the anxiety and depression of family members after bereavement. This clearly shows how important person-centred care is for the individual and their family members at a difficult time in their lives, by having person centred care, the individual remains involved throughout the process. I will deliver person centred care by ensuring a person-centred care plan is in place and ensuring my patients needs are met at all times during their care.

Arabiat et al. (2018) states that family centred care is the main focus of Pediatric care today, it recognises the family’s part and also their involvement when care is being delivered. Shields (2010) states that family-centred care is based around caring for a child but also their families, it is not just planned around the individual. Everyone involved with the patient is also recognised as care recipients. This is very important in care, especially when a child is involved as it allows the family to be able to remain involved and feel in control to a certain extent with their child’s care. Th family are also able to be kept up to date and know exactly what is going on and what is to be expected of care in the future. Arabiat et al. (2018 p.39) also states that after a recent study, ‘’85% of parents reported positive experiences of receiving family-centred care practice from nurses.’’ This clearly shows the impact of family-centred care and how effective and meaningful it can be to a family when they are involved in their family members care. I will deliver family-centred care to the best of my ability to my patients by ensuring family is involved throughout the process. I will deliver this by understanding how their family will aid the patient’s recovery and use this to further support the patient.

Biegler (2011) states that the term ‘autonomy’ relates to the Greek language meaning ‘self’ and ‘rule’, suggesting how the term autonomy relates to the patient having control while receiving care, and to be able to have a say in the care they receive. This will allow the patient to remain as independent as possible by giving them some control and involvement in their own care. Biegler (2011) also states how much of a positive effect autonomy has on patients as it allows them to feel liberated and feel self-determination. This is important in care as patients should feel encouraged and determined in recovery and by having the ethical principle of autonomy this will be the main focus in their care. However, Smith (2017) states that in mental health nursing in particular there are many ethical dilemmas, one of them being locking doors. This is usually done to keep the patient from harming themselves and others, however this is seen as being very unethical and takes away the ethical principle of autonomy. Furthermore, Moe, et al. (2012) states that often in mental health nursing, patients experiencing psychosis may become unable to make their own sufficient choices for their care. This may result in medical professionals making care decisions for an individual, making this a complicated situation in terms of ethics, especially autonomy. I will apply autonomy in my practice by treating every situation as they come, rather than having a set way to deal with them all. I will also apply this by listening to my patients and how they wish to be treated and cared for. this will allow my patients to feel powered and allow them to feel as though their autonomy is respected.

Noriko and Khe Foon (2008) state how much healthcare practice is continuously evolving. Thus, meaning that the need for healthcare professionals such as nurses to develop and maintain clinical knowledge (Forbes et al., 2006; Spencer, 2006). Continuous professional development is key to maintaining clinical knowledge that is up-to-date and relevant (Heron and Hammond 2001).

Jasper, Rosser and Mooney (2013) state that reflection on practice is the way that nurses learn from and develop form their own experience and their practice. This suggests that reflecting on their work can enable nurses to continually develop throughout their career by being able to reflect each experience of their own, allowing them to progress.  

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