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Assignment on nurse-patient relationship
Factors affecting the nurse-patient relationship
The nurse patient relationship
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In the nursing profession unfortunately, there are multiple phenomena of concern for the nurses. One of the major phenomena of concern for a nurse that works in the hospital setting is the readmission of elderly patients. Another one of these phenomena of concern that is specific to the emergency room and inpatient psychiatric units is psychiatric patients that are boarding in the emergency room waiting for a psychiatric bed to become available and the patient not having a therapeutic environment. This continues to be a topic of concern all over the world with the increase in patients with mental health illness and not enough psychiatric hospitals and beds for all these patients. In my practice, I have attempted to solve both of these phenomena …show more content…
One of the major concern for anyone that is working in the hospital or an acute care setting is readmission of the elderly patients. This is something that can be solved with better discharge teaching and instruction and also longer stays in the hospital so that the patient can fully recover from his or her illness. Another phenomena of concern that is specific to the emergency room is that psychiatric patients that are boarding in the emergency room waiting for a psychiatric bed to become available that are not in a therapeutic environment. Both of these phenomena of concerns can integrate Hildegard Peplau’s theory of nurse to patient relationship (McEwen & Wills, 2014, p. 30). In order to solve these phenomena of concern it is important for the nurse to have a good rapport with the patient he or she is taking care of. The topic of the psychiatric patient boarding is the phenomena of concern I want to use for my final project, this is a topic that I am passionate about. I know I went into nursing to help people and by helping to solve some of the phenomena of concern that nurses have in the health care field I am able to help the patient receive better quality
In the nurse-patient relationship, there are three phases that help the relationship develop. Craven and Hirnle (2009) describe the first phase, orientation, “consists of introductions and agreement between nurse and client about their mutual roles and responsibilities” (p. 329). It is in this orientation phase that first impressions are made a...
Never has it been more critical to provide high quality care in the hospital while being cost effective. The American Association of Colleges of Nursing (American Association of Colleges of Nursing [AACN], 2005) has created the Clinical Nurse Leader (CNL) role to introduce lateral integration of care for specified groups by creatively and intentionally using a variety of health care resources (AACN, 2005). The CNL’s purpose is to aid in various departments of the health care system including the psychiatric department. Although there is continuous tension between medical care and psychiatric care and choosing which is more important for a patient, the Clinical Nurse Leader is intended to bridge the gap between the two.
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
Rather than preparing graduates in education or consulting as previous graduate nursing programs had done, this program educated psychiatric-mental health nurses as therapists with the ability to assess and diagnose mental health issues as well as psychiatric disorders and treat them via individual, group, and family therapy (ANA, 2014). Thus, the Psychiatric Mental Health Clinical Nurse Specialist (PMH-CNS), one of the initial advanced practice nursing roles (Schmidt, 2013), was born. After Community Mental Health Centers Act of 1963 led to deinstitutionalization of individuals with mental illness, PMH-CNSs played a crucial role in reintegrating formerly institutionalized individuals back into community life (ANA, 2014). PMH-CNSs have been providing care in a wide range of setting and obtaining third-party reimbursement since the late 1960’s. In 1974 a national certification for PMH-CNSs was created (APNA, 2010). Subsequently, PMH-CNSs began to be granted prescriptive privileges in the Pacific Northwest in the late 1970s, that practice has now spread to 37 states and the District of Columbia (APNA,
This article was written by several well educated professionals in the nursing field. The article appears in a peer reviewed nursing journal that covers topics in psychiatric and mental health nursing that has a 37-year history. The sources history, along with the use of various references from other professional sources establish the journal entries
The nursing theories that are currently being implemented in the psychiatric area of the emergency room should continue to be implemented along with other nursing theories. With the nursing theories that are currently being implemented it is not solving the problem of a non-therapeutic environment for the pscyharitic patients that are boarding in the emergency room waiting for an inpatient bed to become available, there needs to be other nursing theories implemented in order to solve this problem. The policies and procedures that are put into place in this part of the department should be evidence based and should allow the patient to have a therapeutic environment so the patient is able to start the healing and recovery process while the patient is boarding in the emergency
Mental health nurses are exposed, due a lack of community support, low staffing levels, stigma and client pressures including the risk of violence, The increasing number of mental health patient compare to the decreasing number of beds and capable staff, means that mental health nurses are spending less time per patient and potentially providing a minimum quality of care level , Moreover, mental health nurses are dealing with caring for patients in inappropriate settings, with a reduced level of ,all factors leading to an increase in stress and burnout (Barling, 2001, p. 252; MHCA, 2005, p. 3)
During her early career she has practiced as a psychiatric nurse in acute care and in community settings. She is faculty member in department of Nursing at the California State University at Los Angeles, professor
Therapeutic relationship is an essential part of nursing; it is the foundation of nursing (CNO, 2009). The National Competency Standard for Registered Nurses state that nurses are responsible for “establishing, sustaining and concluding professional relationship with individuals/groups.” Throughout this essay the importance of forming a therapeutic relationships will be explained. The process of building a therapeutic relationship begins from prior to time of contact with a patient, the interpersonal skills of the nurse; then the process includes skills required by the nurse to communicate effectively, including respect, trust, non-judgment and empathy. The way to portray these skills can be via verbal or non-verbal cues that are important to understand how they influence a person. The process and skills listed below are all relevant to nurses working in the contemporary hospital environment today.
Stuart, G. W. (2009). Principles and Practice of Psychiatric Nursing (9th ed. pp 561). St. Louis, MO: Elsevier Mosby.
As a nurse in a psychiatry emergency room, the staff must collaborate for the safety of patients and staff. There is a triage process that must be followed when a patient comes to the Psych ED, security takes any electronic devices, keys, purses, lighters, knives, wallets, etc. A nurse takes a mini-triage, which determines whether a patient needs to go to the medical ED side, if the patient is cleared to go to the Psych ED, the nurse must then decide whether to place the patient in a locked involuntary area or unlocked voluntary area. Any patient that goes into the involuntary waiting area must be searched, and go into a patient gown. Once there the patient must be seen by a nurse, then by a doctor. If a patient is agitated to the point of
I have thoroughly enjoyed nursing to this date, and I see nursing as more of a purpose than a career choice and feel privileged to have been able to succeed in it. However, various events and situations in my career and life have strongly persuaded me that I would be most useful to the community if I were to become a specialist in psychiatric mental health nursing. Before my current practice I would of never considered adopting mental health as a speciality although I enjoyed my psychiatric rotation during training. However, since working in my current practice I have seen that the mental health community is underserved and this is heartbreaking to me. Many patients who need assistant and care
When a nurse is providing patient care, he/she creates a safe environment for the patient and enables the choice to establish a relationship on a human to human interaction or on a transpersonal level. The patient will be acknowledged as a person with the wholeness of their soul despite their illness or number on the bed. The ten carative factors in this theory are used as an education tool for nurses around the world and should be applied to the different care situations in practice. Nurses use the factors to promote growth in themselves and within the patient. A nurse should respect the patient’s decisions and take the time to fully be present in the moments with the patient. A lot of nurses complain about the time limitations they have and do not provide the necessary amount of time to listen and gather the patient’s perspective of the situation. Another way this theory can be applied to practice is by recognizing the caring moment between you and the patient. This will determine how the relationship will
Nursing revolves around a commitment to helping others in need, to become the healthiest they can possibly in all aspects of their being. A nurse needs to know how to care, that means to realize what it is that matters to the patient and how to help them get it, and the basis of my philosophy is that caring is the body of nursing, and nursing is not possible without caring. Caring in a professional sense is to prevent future harm, treat those who are ill, a commitment to learning how to provide the best possible care, and to maintain the patients dignity through all aspects of the care that is being provided. Patient care should always have a holistic root, this opens the door for the patient and nurse to interact in a way that can give the nurse insight into that patients values. Patients who are comfortable in their environment heal better and faster, and one of the best ways to make a person feel comfortable in an unfamiliar place is to establish a therapeutic relationship. A therapeutic relationship is one built with trust on both sides, I think for a nurse to be able to see the situation for the patient’s point of view there needs to be a certain amount of openness in the relationship which will not develop without trust. Nursing should always be focused on what is helping the patient in the most ways, a nurse should always
Many persons go into the healthcare ground because they want to work with people. For these nurses, it is the nurse-patient relationship that is one of the most significant things. By understanding the nurse-patient relationship, nurses can be better furnished to work with their patients and, eventually, deliver superior care for them. Hildegard Peplau's model of nursing emphases on that nurse-patient relationship and recognizes the diverse roles nurses take on when working with patients.