Therapeutic Relationship in Healthcare
Competent professional nursing depends on appropriate therapeutic relationships between nurses and their clients. A therapeutic relationship refers to the mode of interaction between a nurse and a client, as well as, the underlying perception that drives hope and positive change on the client. As per the provisions of the national competency standards for registered nurses, collaborative and therapeutic practice is a primary domain in nursing. Professional healthcare service delivery starts with the establishment of an in-depth understanding of the client. As a result, confidence, reliability, and consistency are developed, but within appropriate and defined boundaries. A therapeutic relationship eliminates emotional discomfort and low self-esteem that may exist during the nursing care process. In this essay, I have selected Vincent Romero from the Health Professional Horizon Community as my client. I intend to establish, maintain, and conclude a therapeutic relationship with him. Based on the National Competency Standards for the Registered Nurse Standard 9 entitled “Establishes, maintains, and appropriately concludes therapeutic relationships”, I have selected the professional attribute known as “demonstrates empathy, trust, respect for dignity and potential of individual or group.” I will utilize the aforementioned professional aspect in establishing, maintaining, and concluding a therapeutic relationship with my client. The essay also discusses why the professional attribute is important to my role as a future registered nurse in establishing, maintaining, and concluding a therapeutic relationship with my chosen client.
Importance of Therapeutic Relationships in Nursing
The National Institute of Mental Health Treatment indicates that development of therapeutic relationships between patients and the nurses has always made nursing care a success. Conversely, successful nursing interventions are unattainable when the nurse and the client do not create a therapeutic relationship, despite the healthcare efforts by nurses since such situations are full of frustrations. The ability to empathize with clients is positively correlated with the capacity to create therapeutic relationships. It has been asserted by various studies that empathetic nurses are highly valued by clients. Therefore, a nurse should seek to demonstrate empathy, trust, and respect for dignity and potential of clients.
Empathy, Trust, and Respect for Dignity and Potential of Clients in Nursing
As a nurse, I will have to be compassionate and ensure ethical care as a fundamental tenet for the development of a rewarding relationship with my client. It enhances understanding, demonstration of empathy, and maintenance of appropriate emotional distance. It will help me to stay focused and objective-oriented. Empathy, trust, and respect will allow me to demonstrate professionalism when responding to the needs of the client. I will still be able to make him feel that he is within an accommodative zone. My first reaction will be to empathize with Romero as he is old and widowed. Moreover, Romero has pneumonia, chronic bronchitis, and is always on oxygen therapy. I will try to understand these problems as if I were Romero. Though it is impossible feel for others, I will assure Romero that I understand what he is going through. I will actively listen to him to ensure that he opens up and narrates his problems, fears, and feeling to me. Consequently, I will be able to offer the appropriate nursing attention needed by Romero to restore his hope and possibly, persuade him to develop a positive attitude towards the nursing care that he is yet to receive. Thus, I will be able to create a confidence-building relationship between me and Romero. I expect that my client will trust me after showing him compassion and assuring him that I will be able to attend to his health care needs.
Therapeutic communication is an important tool that will enhance the care plan set by the doctor for Mr. Romero. Empathy, trust, and respect will prepare a ground that makes Romero feel free to engage in effective communication. For instance, if he wants to be assisted in moving around, he can freely request for my help now that he has built confidence in me. Once there is open communication between us, I will be able to maintain Romero’s respiratory care plan effectively. He will be free to request for change of medical apparatus from me. For instance, I will be able to change Romero’s inner tubes during tracheostomy care. I will be able to assess and monitor Romero’s condition after I build a strong therapeutic relationship with him. It is imperative to accept and acknowledge the ideas and feelings of the client in order to respond professionally without tampering with interactions.
Respect for dignity and potential of the client creates a collaborative and therapeutic relationship in nursing practice. Despite a client’s socioeconomic status, health condition, personal attributes, and gender, a nurse should recognize their uniqueness, worth, and dignity. Thus, it is possible to develop a therapeutic relationship with the client. The patient has his or her rights that deserve respect from the nurse. Respect for dignity and potential for an individual or group is demonstrated when a nurse observes the set professional boundaries. Each relationship should be nurtured for the benefit of the client. In a care plan, respect for boundaries will enhance realistic expectations between the nurse and the patient. Thus, the objectivity of nursing practice is not undermined. In my case, despite Romero’s medical history of a chronic obstructive pulmonary disease and permanent tracheotomy, I will have to respect his dignity as this will strengthen our relationship.
If trust is lost, either the client or the nurse may be frustrated. In some cases, both the nurse and the nurse may be frustrated. It will be difficult for the nurse to achieve the intended objective care plan as the client may regard the nurse as a betrayer. Since trust is very fragile, it is recommended that the nurse keeps all the promises made to the client during the initial stages of their encounter. If trust is violated, it is extremely difficult to re-establish. Clients should trust that a registered nurse has the skills, abilities, and the knowledge to enhance competent care. Trust creates confidence since the client is convinced that the nurse will protect patient information. Patient information should only be utilized for professional use. Professionalism in nursing entails safeguarding of client information. Success in nursing practice is solely based on the strength of the therapeutic relationship created. Therefore, in establishing, maintaining and concluding a therapeutic relationship, Empathy, trust, and respect is important. Therefore, the aspects of empathy, respect and trust are the primary steps involved in building a therapeutic relationship.
Mr. Vincent Romero’s Scenario
Interpretation of Findings to Mr. Romero
I would courteously respond to Romero by telling him that his condition is not bad and that he will be getting better soon, now that he is under our effective care plan. I will also promise him that he should not worry because he will start undertaking relevant medication processes, immediately the tests are completed. I will tell Romero that he needs sufficient rest, now that I will be around to attend to all his healthcare needs. I will encourage Romero to take any prescribed drugs to enhance improvement of his condition. For instance, I would request him to take the Paracetemol, which he was given at 0600 hours, but he has not taken up to now as it could relief his pain. Thus, he would have felt comfortable to sleep and rest. If he had taken the medication prescribed to him, he would have felt comfortable, slept, and would not be tired by this time. I will let him know this and encourage him to take the medicine because it will still help him feel better and sleep, hence having sufficient rest.
Response to Romero’s Request to go out to call his Brother
Giving Romero an opportunity to express himself and listening to him, without showing despise will be my first action because I seek to develop and maintain a therapeutic relationship with him. My aim is to provide healthcare to Romero with the intention of helping Romero to get well soon. Therefore, I should observe professional boundaries and communicate with my client effectively to help him understand that some requests are beyond the professional limits. Allowing Romero to get out of the hospital room will require removal of the attached medical apparatus. Thus, support for Romero’s respiratory process will be removed and his condition will deteriorate. I will politely tell Romero to relax and let me call his brother for him and assure him that I can be of great help just like his brother.
Nebulizer Medications administered to Mr. Romero
The pneumonax vaccine is used to protect the client from potential pneumococcal infections caused by the bacterium called streptococcus pneumonie, which causes pneumonia and meningitis and can cause permanent brain damage. It is apparent from the past medical report of Mr. Romero that he has been having recurrent pneumonia and chronic bronchitis. His serious coughing and breathing problems are apparent symptoms of pneumococcal infections. Therefore, I will respond to Romero’s brother by telling him that the nebulizers administered to Romero are vaccines against possible pneumococcal infections. The vaccine is administered to the patient using the method of tracheostomy. However, the patient is allowed to breathe during the application. The nebulizer route in the case of Romero will be through the respiratory system. As for the pneumococcal vaccination, the right route will be through intramuscular (1M) injection. However, pneumococcal vaccination has some side effects such as mild fever. Apart from the possibility of allergic reactions, the vaccine does not have any serious side effects. Therefore, pneumococcal vaccination is ideal for Romero.
Preparation for IV Administration
Therapies that are administered to a patient through veins are called intravenous therapy or IV therapy. The Residential Medical Doctor is expected to administer IV to Romero. IV administration is ideal because medication flows through the patient’s veins. The routine is recommended for patients who are unable to take in an adequate dose of medication. The liquid medicine also contains glucose that will give the patient instant energy.
Preparation for IV administration will involve the review of the order of the Residential Medical Doctor to find out the type of solution to be used, the route of administering the drug, the dose to be issued onsite and thereafter, and time of infusion. I will wash my hands and then gather glass containers that are free of cracks, plastic containers that are free of pinholes, venipuncture, and dressing supplies such as gloves, dressing gauze, prepping solution, and catheter. I will check the expiry date of the drug to ensure that it is still appropriate for use. I will also inspect the administering set. I will ensure that I have prepared Romero psychologically for the medication. I will briefly explain the IV procedure to him and lay more emphasis on how the medication will assist him to recover rapidly.
Management of the Abdominal Pain Related to Chronic Constipation
Chronic constipation is common among the elderly. Thus, Romero needs non-pharmacological interventions to manage his situation. Since Romero has undergone IV therapy, it is advisable that he does not take additional drugs. Therefore, it will be appropriate to utilize strategies such as change of diet and bowel habit management. The patient will be encouraged to take sufficient water. Consequently, his stool weight will be altered while his digestive system will be stimulated to transmit waste faster. The patient will be encouraged to take vegetables and fruits, which contain high fiber content that aids bowel elimination. Romero may be subjected to other forms of therapy such as relaxation and behavioral therapy to enhance normal digestion.
Romero has not been eating and drinking adequately. Therefore, it will not be advisable to carry out the urinalysis at the moment. I will advise the patient to rest sufficiently and eat adequately since he can tolerate hospital diet. I will also advise Romero to drink sufficient water so that a urinalysis will be carried out the soonest. Consumption of medicines will have to be reduced before the procedure is completed in order to obtain reliable results. Urinalysis results will hasten the medication program for Romero.
It has been established that healthcare professionals should establish, maintain, and appropriately conclude therapeutic relationships with their clients. Using my selected the professional attribute of demonstration of empathy, trust, respect for dignity and potential of individual or group, I am convinced that I will attend to the needs of my chosen client effectively. For instance, I will be able to persuade Romero to change his attitude and cooperate with medical personnel and explain to him all that he should know. Consequently, a rewarding relationship between me and my client will result that may hasten his healing. Therefore, it is imperative that healthcare professionals demonstrate empathy, trust, respect for dignity and potential of their clients to establish, maintain, and appropriately conclude therapeutic relationships with them.