HME712 Healthcare Operations

Nurse-Patient Therapeutic Relationship

The high mortality and mobility cases in Australia are being associated with heart failure as it is said to be responsible for many hospital admissions in the country, taking a total of 30 percent of the total hospital admissions per month. The North Australian territory registers more than 30 percent of the indigenous population suffering from heart failure. Together with the rural areas, the northern territory of Australia are faced with poor access and availability of resources. The aboriginals, on the other hand are economically, language, socially and culturally challenged. They have a poor discharge services uptake and also their access to preventive care presents a big challenge to hem (Iyngkara et al. 2013). This has of course raised questions of why the lag in such a developed nation. Iyngkara and his colleagues think that this has been brought about by lack of well devolved medical structure and strategies to the rural areas.

Regardless of this, there is need for a health relationship between the patients and the health providers. According to Thornbury Community Services (2016), the informal environment in the health care set up can be a challenge in fostering a therapeutic relationship between a client and the clinician. Four types of mutual relationships may develop, which include therapeutic, clinical, over involved and a connected relationship, depending on the patient’s needs, ability of the patient to trust the nurse, time of contact between the health provider and the patient and the nurse commitment with the patient. In case the nurse in uncooperative, the patient may try using their manipulative behaviours so as to gain the nurse’s attention, a relationship called unilateral relationship (Milton. 2016). According to Milton’s argument, I think than nurse-person relationship is the true nature of a professional nursing activity. A healthy nurse-patient relationship is based on four aspects; empathy, respect, intimacy and trust. When making decisions for the patient I would apply a high level of maturity and wisdom, with more considerations on the cultural needs of the patient. As the nurse, I would also put into consideration spiritual, physical and psychological effects that the decision may have on the patient (Thornbury Community Services (2016).

To establish and maintain a health nurse-patient therapeutic relationship with Mrs. Windbarra, I would require both effective and efficient verbal and non-verbal communication. It is healthy to introduce myself to her and use her name when addressing her. To establish respect and respect with a patient, a handshake would be good at the initial meeting with the patient (Pullen and Mathias, 2010). Establish trust between a health care professional and a patient is elementary considering the risk and uncertainty of the vulnerable patient who is dependent on the intentions and competence of the nurse. Trusting the nurse helps the patient accept and adhere to the treatment administered to them. A patient would be free to open up and share any information concerning their illness to a health provider they trust (Allinson and Char, 2016). The only way to prove to a person that one is competent in their field of profession is by ensuring that one’s skills and knowledge are relevant to his professional roles and responsibilities. Mrs. Windbara must therefore see that I know what I am doing by offering effective services and meeting the safety standards of my career. Health care providers win the patient’s trust by being knowledgeable in their practice and career.

Whenever a patient detects any level of dishonest with a nurse, they definitely lose their credibility and respect. Therefore, I would uphold a high degree of integrity and honesty so as to maintain my trust and reputation.  In most cases, when the confidentiality of a patient is not safeguarded, it breaches the trust the patient has on that health care provider and also any other nurse the patient may have trusted. Respecting Mrs. Windbara’s privacy and dignity would help build trust between us. In cases where I have to disclose her confidential information, I must obtain consent from my patient and also ensure that the legal requirements governing confidentiality are not breached (Allinson and Char, 2016). As a nurse I should respect the cultural diversity and beliefs of every patient. Nurse-patient boundaries have to be kept intact always because whenever they are abused, there is no more trust between them.

According to Berg (2010), the aboriginal population feels neglected when it comes to health care. Just like any other person in the community, they need to feel worthy, accepted and part of the society. They are patronized and treated like children. It would be my duty to show Mrs. Wikndbarra that she is my equal and that she is my responsibility. The Aboriginals and Torres Strait Islander patients are faced with mistreatment, poor and harsh communication and racism in hospitals which makes them more likely distrust clinicians and hospitals. Making Mrs. Windbarra’s stay in the hospital culturally conducive would make her content with my services (The Heart Foundation, 2018). So that my patient feels culturally secure I should show equity and equality, unity and cultural acceptance and also prove to her that her race is just like that of mine.

These could not be achieved without creating a good communication scheme with my patient. A study made by Jagosh et al. (2011) prove that when I maintain a good communication with my patient, her healing is enhanced. I should therefore employ high quality communication skills (Kornhaber et al. 2016). Every professional health care provider is obliged to effectively communicate with patients and should also adopt a communication style accepted by the General Pharmaceutical Council (GphC) (Allinson and Chaar, 2016). I should understand her communication both verbal and non-verbal. Listening to patients, respecting their views and not judging them, enriches the relationship between the nurse and the patient. Maintaining an eye contact with as she talks and also ensuring I understand her concerns are important to ensure a good relationship. I should ensure that the eye contact is not too much as it could be intimidation. I should use words and language she is able to understand without difficulties and respond to her calmly.

References

Pullen, R. and Mathias, T. (2010). Fostering Therapeutic Nurse-Patient Relationships. The Journal of Nursing, Vol. 8, No. 3, pp. 3-4. Doi: 10.1097/01.NME.0000371036.87494.11

Milton, C. L. (2016). Boundaries: Ethical Implications for what it Means to be Therapeutic in the Nurse-Person Relationship. Sage Journals, Vol. 21, No. 1. Doi: 10.1177/0894318407310755

The Thornbury Community Services. (2016). Therapeutic relationships between nurse and client: the importance of striking a balance. Retrieved from: https://www.thornburycommunityservices.co.uk/blog/therapeuticrelationships-between-nurse-and-client-the-importance-of-striking-a-balanceblog-61321115581

Allinson, m. and Char, B. (2016). How to build and maintain trust with patients. Retrieved from: https://www.pharmaceutical-journal.com/pharmacy-learning-centre/how-to-build-and-maintain-trust-with-patients/20201862.article?firstPass=false

Kornhaber, R., Walsh, K., Dufff, J. and Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. Journal of Multidisplinary Healthcare, Vol. 9, pp. 537-546. Doi: 10.2147/JMDH.S116957

Berg, R. (2010). Cultural safety in health for Aboriginal people: will it work in Australia? The Medical Journal of Australia, Vol. 193, No. 3. Retrieved from: https://www.mja.com.au/journal/2010/193/3/cultural-safety-health-aboriginal-people-will-it-work-australia

Heart Foundation. (2018). Recognising the historic experience of Aboriginal and Torres Strait Islander patients is key to reconciliation. Retrieved from: https://www.heartfoundation.org.au/news/recognising-the-historic-experience-of-aboriginal-and-torres-strait-islander-patients-is-key-to-reconciliation

Jagosh J., Boudreau, J., Steinert, Y., MacDonald, M. and Ingram L. (2011). The importance of physician listening from the patients’ perspective: enhancing diagnosis, healing, and the doctor–patient relationship. Patient Educ. Couns.; Vol. 85, No. 3, pp. 369–374

Inngkaran, P., Harris, M., Ilton, M., Kangaharan, N., Battersby, M. and Stewart, S. (2014). Implementing  Guideline  Based  Heart Failure  Care  in  the  Northern  Territory: Challenges  and  Solutions. Heart, Lung and Circulation Journal, Vol. 23, pp. 391-406. Doi: 10.1016/j.hlc.2013.12.005