NURS1006 Introduction To Professional Practice

A nurse-patient relationship is based on an interaction that helps nurses to improve the health status and enhance the wellbeing of their patients. An important aspect of this kind of relationship is that both the clients and the nurses gain knowledge and maturity over the course of their relationship. The present case scenario depicts a good therapeutic relationship. Both the involved person agrees on the tasks that are needed to be accomplished in order to achieve the goals that would benefit the client. This relationship is based on the act of helping the client by developing a mutual respect and trust, nurturing hope, building a good rapport and showing empathy towards the patient (Benbenishty & Hannink 2015, p.77). Furthermore, nurses also exhibit a sensitive behavior towards their clients and acknowledge the latter’s physical, spiritual and emotional needs through clinical expertise (Atkins et al. 2017, p. 10). Therefore, improving this interpersonal relationship helps in the progress and recovery of the client, thereby providing good health outcomes and patient satisfaction.

While nurse-patient relationship is regulated by professional standards and codes of ethics that are framed by the Nursing and Midwifery Board of Australia personal relationships are guided by beliefs and personal values (NMBA 2010). Furthermore, a nurse follows an already established care plan to meet the demands of the client. On the other hand, personal relationships are often interest directed and based on pleasure experiences. The National Law (section 39) has formulated certain guidelines for good medical practice that nurses need to follow for good medical practice (Medical Board of Australia, p.1). The NMBA code of ethics also mentions that it is the duty of nurses to value the diversity of clients, informed decision making process, show respect and kindness, give importance to ethical information management and provide quality nursing care to all patients (NMBA 2010, p.3). These codes differentiate this relationship from a personal relationship.

2.Power operation

Power refers to the presence of dominance, authority or control. Thus, proper use of power is inherent in the establishment of the relationship. The nurse-client relationship shows unequal power. The nurse has more influence and authority owing to specialized skills, knowledge, and access to information, and capability for patient advocacy (Gilmour & Huntington 2017, p.183). Specialized clinical knowledge makes the client trust the nurses for gaining health benefits (Dinç & Gastmans 2013, p.510). They generally utilize this power, in a caring way, which in turn enables them to foster partnership and meet client needs. They also use this power to interact with the patients by influencing the latter to ask questions and by providing professional support. However, misuse of such power results in abuse (Ters & Yima 2014, p.17). Power imbalance can lead to violation of sexual boundaries. The NMBA standards control occurrence of such power imbalance by imposing codes of ethics that direct nurses to refrain from using confidential information or their power to create disadvantages for the patients (NMBA 2010, p.6). The National Law also considers such power imbalance as a notifiable conduct (Medical Board of Australia, p.2).

3.Importance of boundaries

According to the NMBA standards, professional boundaries help in reducing the gap between client vulnerability and misuse of power. These standards state that it is the role of nurses to provide holistic care to their clients by adopting a kind behavior, preserving client dignity and recognizing the powerlessness and vulnerability of the clients (NMBA 2010, p.1). These boundaries protect the space between power and vulnerability of the nurse and the client respectively. Thus, they help in marking edges between a therapeutic relationship and personal relationship in care settings. The major issues that can arise is loss of trust due to sexual misconduct. While the section 1.4 of the National Law states that patient safety should be the primary concern for doctors and they should display qualities of truthfulness, integrity, compassion and dependability for establishing a good working relationship. In addition, the section 8.2 mentions that professional boundaries are also integral to such relationship (Medical Board of Australia, p.1).

4.Immediate actions

I consider it inappropriate to accept the gift from Mr. White and would politely refuse him stating that acceptance of the gift violated my professional standards. I understand that involving in any financial transactions or receiving any gifts will compromise my professional relationship. Although the board accepts gifts such as flowers or chocolates, I will adhere to the organization policy to understand the official declaration of acceptance of gifts (NMBA 2010, p.5).  Furthermore, I will seek the assistance of my supervisor to determine whether it would be good to accept the gift from Mr. White. Furthermore, I would also not want to hurt his feelings while refusing the gift. Thus, I consider it essential to abide by the NBMA professional standards and follow my supervisor’s opinion in this context.

References

Atkins, K., De Lacey, S., Britton, B. & Ripperger, R., 2017. Ethics and law for Australian nurses. Cambridge University Press, Australia, pp.8-31.

Benbenishty, J. & Hannink, J.R., 2015. Building a Nurse-Patient Relationship for Optimal Outcomes. International Journal for Human Caring, 19(4), p.77.

Dinç, L. & Gastmans, C., 2013. Trust in nurse–patient relationships: A literature review. Nursing Ethics, 20(5), pp.501-516.

Gilmour, J. & Huntington, A., 2017. Power and politics in the practice of nursing. Contexts of Nursing: An Introduction, p.183.

Medical Board of Australia 2011, Sexual Boundaries: Guidelines for doctors, viewed 7 December, 2017.

Nursing and Midwifery Board of Australia 2010, A nurse’s guide to professional boundaries, viewed 7 December, 2017.

Nursing and Midwifery Board of Australia 2010, Code of Professional Conduct for Nurses in Australia, viewed 7 December, 2017.

Ters, A. & Yima, T., 2014. Power imbalance prevents shared decision making. BMJ, 348, p.17.