Therapeutic nurse-patient relationship is the relationship between the nurse and the patient where the patient opens up to his nurse about his problems what is bothering him or private stuff because he feels secure and trusts the nurse. The nurse must show the patient that she is trustworthy and that she keeps promises. By this the patient gains trust towards the nurse and also respect to her for helping him in need when he is in his most weak moment. There must be good communication between the nurses and the patients for a rewarding outcome of each patient in a nursing care. However, to achieve a successful outcome, the nurses must understand and help their patients with kindness, sincerity and also demonstrating courtesy. Nurses should dedicate time to the patient so they talk to them with the required confidentiality and also they should not forget the people that are surrounded by the sick person for example the family of the patient. The nurses must keep in mind that when she talks she uses the language that is understood by the ones involved and not using medical words that are used in the wards between the professionals. Physical abilities of the nurses is not enough for good communication, but a good communication must be also based on education and experience that the nurse has.
Therapeutic nurse-patient relationship
A therapeutic nurse-patient relationship is characterised as a relationship where there is helping involved and that is based on trust and respect which is reciprocal between the nurse and also the patient being in care. There must be also the nurturing of faith and hope, being sensitive to yourself and also to others. With your knowledge and skill that you have, you assist your patient’s spiritual, physical and emotional needs graphically. As a result in harmony and healing, this relationship of caring expands and develops when your patient and yourself come together in the moment. A very important and essential part of the nurse-patient interaction is effective verbal and nonverbal communication. In the achievement of wellness, there must be the contribution care in a way that facilitates your patient to be an equal partner.
The therapeutic nurse-patient relationship is based on 5 important factors which are; respect, power, trust, professional intimacy and empathy. A good way of gaining your patient’s trust you must first introduce yourself to your patient, by a handshake and also with a smile, when you talking with your patient it is important to use her name. Trust is a critical factor especially when it comes to nurse-patient relationship, this is because the patient is in a weak situation in his life. When a nurse makes a promise with the patient that he must trust her when he tells her something, the nurse must keep her promise because trust is important in this moment for the patient. If the nurse fails in trust and does not keep her promise that she made with her patient, it will be difficult for the patient to trust the nurse again. A nurse should respect all of her patients equally, regardless their, socio-economic status, health problems, personal character and race because each and every patient is unique and has dignity and worth just like everyone else. Professional intimacy is the caring and the services that a nurse give to the patient. This includes the physical activities, helping the patient to take a bath or giving the patient a bath yourself as a nurse, it also includes psychological, spiritual and social elements that characterised in the care plan. The nurse has the access to the patient’s personal information, this is also added to professional intimacy. To understand your patients, a nurse should empathise with them to show them that she is understanding them and understanding what they are going through at that time. Empathy in nursing also include the right emotional distance from the patient to protect objectivity and the right professional feedback. In the nurse-patient relationship, the nurse is the most powerful even though the nurse do not realise instantly. Also the nurse rules and has an influence in the health care system, because she has more know-how and she has the access for certain information that the patient does not have. The power that is used here in this relationship is the use of power in a caring way, by facilitating the nurse to meet the patient’s needs. When we say meet the patient needs we mean that the patient has all the basic needs and we make sure that our patient is comfortable and in no pain If the power of the nurse is used in a bad way this is no longer called power but it will be abuse on the patient.
Characteristics of therapeutic nurse-patient relationship
There are certain goals of a therapeutic relationship that are directed towards the achievement of the patient’s optimal growth that include these following dimensions:
Patient accept their self, increase in their genuine self-respect and self-realisation.
It is important that the patient knows himself and has an improved level of his personal integration.
A patient must be able to form intimate, interdependent, interpersonal relationships with a capacity to give and also receive love.
They must have the ability to satisfy their own personal needs and achieve realistic personal goals.
Different aspects of the patient’s life experiences are explored to achieve these goals. In the therapeutic nurse-patient relationship, the nurse lets the patient to express his thoughts and feelings and also relates them to the behaviours that she observes and that are also reported and analyse area of conflict and anxiety. The nurse analyse and maximise her patient’s ego strengths and encourages so there will be socialisation and family relatedness. The patient and the nurse, hand in hand they correct communication problems and adapt behaviour patterns, this is done by testing new patterns of behaviour and more adaptive coping systems. In conflict with values are respected in the nurse-patient relationship. Both the nurse and the patient communicate together through a dialogue or in the form of a discussion, confirming the patient’s reality and worth and allowing the patient more fully characterised identity ego.
Phases of Therapeutic nurse-patient relationship
The therapeutic nurse-patient relationship is divided into four important phases which are;
Pre interaction phase; it is the phase where the nurse goes through before the definite interaction with the patient. The start of this phase is when the nurse is appointed with a patient to start developing therapeutic relationship with him until she goes to the patient for interaction.
Introductory / orientation phase; this phase starts when the nurse goes to the patient she is assigned to and she introduces herself and get to know about her patient, the nurse and the patient get informed about each other. The introductory / orientation phase ends when the patient and also the nurse accept each other as a unique human being.
Working phase; this phase starts when both the patient and the nurse are able to overcome the barriers of the phase of before, the orientation phase and introductory phase. In the working phase the patient and the nurse work on meeting the goals which they have had established during the orientation phase. In this phase the nurse overcomes anxiety and the patient decreases his fear.
Termination phase; in this phase the nurse discusses the phase with the patient and encourages him to identify the progress that he has made and also explores the necessity of any referral that can be beneficial for him. In this phase the patient may exhibit regressive behaviour, demonstrates hostility or experience sadness as the separation will happen. The patient may ask to pro long the relationship with the nurse because of the symptoms of anxiety but in the end he still has to be terminated.
Effective communication is an important skill in any profession but in nursing profession they can mean the difference between life and death of a person. Nurses in their profession must be capable of helping her patients to understand their medical issues and give them steps how to take care of themselves in the best way possible. Nurses must also explain to the patient the condition they have in simpler language that the doctor had used when they talk to them. It is very important that the nurses use language that their patients can understand so there will be no misunderstanding and the patient knows better how to take care of himself because he understands. When nurses are giving out orders, reading or reporting test results, it is important that they confirm the information before they keep going, especially with verbal communication either in person or on the phone. When nurses take information over the phone it is important that they repeat what they heard so they put in the right information because it is easy to misunderstand words on the phone. By this that nurses make it a point that they make sure that they understood the information correctly and put it in correctly for each patient, reduce the risk of miscommunications and errors. When nurses are administering treatments and medications, they should always explain to the patient what they are giving them. Often nurses have more contact on a daily basis with the patient than the doctors during the recovery process, so it is important and the nurse duty that they help the patient to understand their diagnosis and prognosis and teach them how to help themselves during the recovery. When nurses come across patients who are children or elderly people with dementia, they will have more difficulty grasping her situation. In addition to this, nurses must be skilled in listening to the patients and understanding them especially regarding their symptoms and or also their concerns. Nurses come in contact with different people, from different countries with different cultures, religions and also different skin colour, sometimes they also do not speak English. Nurses should always look at each patient as an individual with feelings and dignity. Nurses should respect each patient with their own believes and cultures and treat them all in the same way. Body language is an important role in effective communication because the way you react shows if you are interested in what the other person is telling you or not. For example if there is a patient or a co-worker that is talking to you and you look at the watch or do very little eye-contact with the person, that shows that you are not interested in what the person is telling you. On the other hand If you make eye-contact and ask questions about what the person is telling you, you show that you are listening and you are taking notice of what they are telling you. When you do not show interest in what a patient is tell you or your co-workers that is a sign of disrespect and make a negative impact on you. Nurses should take in consideration non-verbal cues, make eye-contact with the person, smile and stop what they are doing and focus the attention on what the the patient or co-worker is saying.
Principles of communication
A transaction and message creation is a definition of communication. The whole process takes place in a context that is consisted of cultural and social values, psychological conditions and also physical space. When nurses are not trained in communication skills, they face difficulties when it comes to separate work from their personal live, because they tend to transfer problems from one side to the other and this creates a problem on both sides. Every human on earth has to communicate with each other, it is an intrinsic characteristic of human nature, communication includes content and value. The relationship regards as to how it was said and the contents regards to what was said. Communication is always directional, it is in corporation which each sender becomes the receiver and vice versa. Communication alone is nothing, but listening to your patient is everything and it very important. Nurses can assess the situation and the problems that their patients have by listening, they boost up their patient’s self esteem and assimilate both the nursing diagnosis and also the process of care at all levels.
Barriers of Effective Communication
Nurses that are conscious of the barriers that are common to effective communication, will be capable to assume and react properly to any roadblocks. Nurses can be of help ensured optimal communication and patient care with this focus. Barriers that effect the patient include environmental features such as; noises, poor privacy and poor control over who is there present, being afraid and also anxiety because they are afraid that they will be judged and also being afraid of being weak and emotional. Other barriers can be that the patient does not be able to explain his feelings and they try to be as strong as possible for the benefit of someone else. On the other hand the health care professionals also can have barriers that include environmental items such as poor time or lack of support, conflicts between the staff and a lot of work to be done, fear and anxiety linked to the patient that causes the patient to be distressed by responding to questions or by talking. Also other barriers that the health care professionals can have are poor skills or lack of planning for handling with the difficult reactions, questions or emotions.