Differences In The Therapeutic Relationship Between Nurses And Their Patients, Essay.

What Is The Differences In The Therapeutic Relationship Between Nurses And Their Patients?

Components of Therapeutic Relationships

A therapeutic relationship is an alliance between the caregiver and the patient. The client and the caregiver should engage one another in a manner that benefits the client (Haydon, van der Reit, & Browne, 2015). The case study talks about Michael, a registered nurse (RN) who fails to maintain a therapeutic interaction with the female Aboriginal patient. The RN goes ahead to conduct vaginal tests on the patient without seeking the consent of the patient. The action of the nurse prompts the family of the patient to complain about the caregiver. Michael does not respect the personal and cultural beliefs of the patient when providing medical care. This essay will explore the components and benefits of the therapeutic relationship about the case study. The paper will also use NMBA standards to judge the conduct of the nurse. Finally, the write-up will discuss the concepts of paternalism and cultural safety.

Power is the first component of a nurse-client relationship. The patient and the nurse have unequal power when in a clinical set-up. The nurses are more potent than the patient due to their positions and authorities in the health facilities (Kornhaber, Walsh, Duff, & Walker, 2016). Michael uses his adverse knowledge and positional advantage to conduct virginal examination on the aboriginal woman. The power that Michael possesses has made the patient vulnerable; hence she has no option but to undergo the test despite the comfort concerns.

Trust is necessary for the nurse-patient interaction to be a success. Patients expect caregivers to possess relevant skills and knowledge of providing safe medical care (Kornhaber et al., 2016). Additionally, patients expect nurses to showcase caring behaviors and attitudes towards them. The aboriginal patient trusts the expertise of Nurse Michael; thus allows him to conduct the test. The patient believes that the test is beneficial to her regardless of the concerns of discomfort.

Respect towards the uniqueness, rights, worth, and dignity of the patient is essential in the provision of quality health care. The RN should acknowledge and consider the patient’s culture when issuing care (Kornhaber et al., 2016). Michael fails to respect the cultural beliefs of the aboriginals since the patient is uncomfortable with the vaginal examination. The RN should ask the patient whether she is comfortable with the tests or otherwise.

Professional intimacy ensures that the client is comfortable with the nurse and the methods of treatment. The intimacy is a collective term for activities that caregivers perform together with the patient to create private and personal closeness. Professional intimacy includes spiritual, emotional, and physical elements (Richardson, Percy, & Hughes, 2015). Michael fails to create intimacy with the patient as he does not ask about whether the patient is comfortable or otherwise. The nurse's lack of professionalism prompts the patient's relatives to complain.

Benefits of Therapeutic Relationship

Empathy is the last component of a therapeutic relationship. The component requires the RN to understand and validate the condition of the patient (Richardson, Percy, & Hughes, 2015). Michael did not attempt to understand the fact that the female patient would be uncomfortable with a male nurse conducting a vaginal examination. However, nurses should maintain an emotional distance between the patients and themselves to create objectivity. A professional response comes into play when the nurses empathize with the clinical situation of the patient.

Therapeutic relationship promotes positive interaction between the nurse and the patient. A proper partnership between the two parties allows the clients to reveal their top secrets and emotional tendencies. Therefore, the nurse can now select the most appropriate mode of treatment that suits the needs of the patient (Sandhu, Arcidiacono, Aguglia, & Priebe, 2015). RN Michael fails to develop a therapeutic relationship with the patient; hence leading to a unidirectional conversation. The nurse explains the benefits of virginal examination of the female client but fails to seek her opinions on the concerns of comfort. The nurse should have a nonjudgmental attitude to enable the patient air honest opinion about the methods of health care delivery. Additionally, the RN should respect and empathize with the patient to improve their professional partnership. Therefore, positive interaction is possible after the development of a therapeutic relationship.

The therapeutic interactions also create accountability on the part of the client. The RN should train the patients about their conditions and the relevant modes of treatment. The training impacts the clients with knowledge about their circumstances. The nurse should understand the weaknesses of the patients and suggest methods that can help the clients to overcome their limitations (Sandhu et al., 2015). However, the caregiver should not force the nurse in any medical direction. An RN that insist on his ways and fail to work with the client can experience resistance which lowers the quality of health care. Michael compels the female Aboriginal patient to undergo the vaginal test against her wishes. The act reduces the reputation of the nurse as the family of the patient complains about the caregiver’s conduct to the hospital authorities.

The therapeutic partnership allows for openness between the nurse and the patient. The nurse should encourage the patient to be sincere and share any information about her condition. Open communication lines enable the patients to disclose hidden details of their requirements. Honest information from the patient allows the caregiver to relook at the methods of treatment (Bentley, Stirling, Robinson, & Minstrell, 2016). Additionally, the nurse can change the mode of care to suit the needs of the patient. Therapeutic interactions also allow the client to make critical medical decisions such as the gender of the nurse that should attend to them. The lack of a professional relationship between Michael and the patient restrict the aboriginal client from expressing her sincere feelings.

NMBA Codes on Therapeutic Relationships

Therapeutic Relationships form the second standards in the NMBA standards of practice for Australian nurses. The registered nurse should between personal and professional relationship during the delivery of healthcare (Cashin et al., 2017). The nurse should maintain a professional interaction with the patient to ensure quality health care. Michael fails to create an interactive platform with the female patient; hence forcing the patient into the virginal tests.

Sub-section 2.2 of the codes requires caregivers to carry out an active communication with the patient. The RN should respect the rights, beliefs, values, culture, and dignity of the patient (NMBA, 2018). Michael fails to recognize the dignity of the female patient by conducting the virginal test despite the gender differences and the discomfort of the patient.

The nurse should recognize the fact that the patient knows everything about her condition according to subsection 2.3 (Cashin et al., 2017). Therefore, the nurses should allow the client to disclose the details of her situation. The caregivers have the duty of educating the patient on the available methods of treatment and allowing the patient to make an informed choice.

Caregivers should support the patients to make proper health-related decisions. Additionally, the nurses should avail relevant resources to help in the decision-making process by the client. Michael only explained the importance of the vaginal tests to the female client. However, he did not support the client to decide on the nurse to attend to her. The action of the nurse jeopardized the quality of care.

Sub-section 2.5 requires the nurses to fight for the rights of the patients. The clients have the right to decide on the methods of medication and the caregiver who should attend to them. Additionally, the nurse should respect the autonomy of the patient. Michael fails to allow the patient to express her discomfort due to the virginal tests; thus disrespecting the client.

Sub-section 2.6 acknowledges the essence of consultation, supervision, coordination, and delegation in medical care (Cashin et al., 2017). Nurses should also refer cases that are beyond their understanding of the other colleagues. In the case study, Michael should have referred the female patient to a female aboriginal nurse. However, the RN should have consulted the patient to understand her concerns before the referral. Therefore, nursing coordination improves the quality of health care.

Nurses should share knowledge with their colleagues towards enhancing person-centered care according to sub-section 2.7. The caregivers should ensure that medical attention respects the culture of the patients (Heidke, Howie, & Ferdous, 2018). The action of Michael to conduct the vaginal tests is contrary to the cultural beliefs of the Aboriginals. Michael should have involved his colleagues in the care and ask them about the appropriate method to use in the prevailing situation.

The process of care provision should be a collaborative exercise between the caregiver, the patient, and the family members of the patient. RN Michael fails to consult the female patient or her family before conducting the vaginal examination. The action of the nurse makes the client uncomfortable during the period of the test. The family members also feel that the nurse disrespected the patient’s cultural beliefs.

A registered nurse should report the undesirable conduct of colleagues to the hospital administration (Heidke, Howie, & Ferdous, 2018). Michael's cause of action is wrong, and the other nurses should report him to the authorities for therapeutic training. The family of the client goes ahead to complain about the quality of care that Michael rendered to the patient. Therefore, caregivers have the duty of providing care that respects the culture of the patients.

Paternalism is an activity that limits the autonomy of the other individual (McConnell, & Moroney, 2015). However, paternalism aims to improve the well-being of the individuals who feel that their independence is under threat. In a majority of scenarios, the paternalists are superior to their others. In the case study, the RN is superior to the female Aboriginal woman. Additionally, Michael feels that the vaginal test improves the health status of the patient regardless of her comfort issues. Paternalism is applicable in the case study if there is no female aboriginal nurse in the health facility to attend to the patient.

Philosophers justify soft paternalism if the victim has adequate knowledge about her condition and volunteers to allow for a restrictive action (McConnell, & Moroney, 2015). Michael explains the essence of vaginal examination to the patient and goes ahead to conduct the tests. Therefore, the RN is assuming that the patient is knowledgeable about her condition and that it is right to proceed with the care.  Hard paternalists argue that it is essential to prevent harm towards people even if the prevention is against the wish of the victim. Therefore, Michael is right to conduct the tests as the examination benefits the patient.

Pure paternalism refers to restricting the liberty of an individual to assist them (McConnell, & Moroney, 2015). Michael prevents the patient from expressing her opinion to treat the vaginal infection. Impure paternalism restricts the idea of individuals who are indirectly affected by a given action. Michael applies impure paternalism to the family members of the female Aboriginal patient. He does not seek the consent of the family before conducting the vaginal examination. Moral paternalism protects the well-being of individuals regardless of their welfare. Michael concentrates on the test and ignores the comfort of the patient.

Cultural safety requires caregivers to ensure. Aboriginal patients receive treatment that respects the culture of the indigenous people (Brown, Middleton, Fereday, & Pincombe, 2016). The nurse should learn about the culture of the patients by engaging in healthy interaction with the patient or the patient's family members. The components of culture include sexual orientations, gender, and religious beliefs. Additional components are occupation, disabilities, generation, and age. The concerns of the patient's family indicate that Aboriginals are comfortable with treatment that respects sexual orientation. Therefore, male caregivers should attend to male patients, and the female care providers should care for female clients. Thus, Michael went against the cultural beliefs of the patient due to the gender differences.

The primary aim of social safety is to improve the well-being and health status of the Aboriginals and the Torres Islanders (Brown et al., 2016). Medical attention should insist on the positive gains by the patient. In the case study, the patient benefits from the care but disrespectfully. Nurses should honor the differing practices and beliefs of the patients. Additionally, the caregivers should allow the patients to give opinions on the methods of treatment. Michael disregards the first principle of social safety; since he does not seek the view of the female patient before the examination.

Caregivers should understand the impact of their treatment actions on the attitude, history, and culture of the patients. Additionally, the nurses should relook at the methods of treatment and realign them towards cultural safety (Bryce, Foley, & Reeves, 2018). The nurses should balance the power of decision making with the patients and their families. In the case study, Michael does not allow the patient or the family members to have a say on the care. The actions of the RN make the relatives of the female patient to report the cultural disrespect.

Conclusion

The therapeutic relationship is the nurse-client interaction that improves the quality of health care. In the case study, Michael fails to develop an alliance with the patient; hence making the client uncomfortable with the vaginal examination. The components of the therapeutic relationship include respect, empathy, professional intimacy, trust, and power. The nurse should respect the cultural beliefs of the patient before conducting treatment. The patients trust a majority of caregivers with their lives due to the knowledge of the nurses. Therapeutic relationship promotes openness; hence the patient can disclose hidden information about the symptoms of her condition. The nurse-client interaction also supports patient accountability due to the information that caregivers impact on them. A proper nurse-patient alliance creates a health interaction; hence, improving the quality of care. The NMBA Codes also support a therapeutic relationship between patients and caregivers. The concepts of paternalism and cultural safety are also relevant to the case study.

References

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