The Importance Of Engaging In Therapeutic And Professional Relationships And Conducting Comprehensive Assessments In Nursing

This assessment requires you to reflect on two of the AHPRA Registered Nurse Standard of Practice. Provide a structured response describing the relevance and importance of the standards they choose reflecting on experiences from your undergraduate nursing clinical practice experiences and your imminent role registered nurse.

Benefits of NMBA Registered Nurse Standards

Nurses play a key role in the health sector (Louisiana State University at Alexandria, 2016). The practice and behaviour of nurses are defined by the professional standards guiding them (Warwick, 2015). The Nursing and Midwifery board of Australia (2017) provided seven registered nurse standards for practice. As provided by the standards, a registered nurse on practice: engages in therapeutic and professional relationships and comprehensively conducts assessments among other standards (NMBA, 2017). Each standard has a criteria on how it should be demonstrated. The criteria is interpreted in the context of practice. The nurses support these standards by adhering the thus promoting their professional identity (Terry, Stirling, Bull & Fassett, 2015).

This paper focuses on two of the standards provided. The standards are: engages in therapeutic and professional relationships and comprehensively conducts assessments. The paper further analyses the relevance between the standards and future nursing practice and identifies the professional issues inherent in the standards.

In an article, Cashin et al (2016) acknowledged that the benefits of the registered nurse standards of practice is that they are not restricted to only some roles performed by a nurse but rather they accommodate all the possible roles of a registered nurse on practice (Cashin, et al., 2016).The scholars also state that another advantage of the standards is that they are interrelated and can therefore facilitate the regular changes of the roles of registered nurse practice.

Therapeutic relationships are described as a ‘primary component of all health care interactions’ (Kornhaber, Walsh, Duff &Walker, 2016).The relations facilitate the improvement of a patient. The registered nurse on practice is required to listen and respond to the patient. This way the patient's emotional health is catered for. These kind of relationships promote patient centeredness and this will lead to improvement of health (Kornhaber, et al, 2016). All the questions, anxieties and doubts of not only the patient but also their families are acknowledged and in this way the medical practitioners can identify the unmet needs and unclear issues that needs to be handled. During these interactions, it is the duty of the nurses to guide the patient’s in the right direction as they make decisions that will have an impact on their health.  A challenge that faces the relationships is that it can be viewed as a task and thus not done effectively by the nurse (Kornhaber, et al, 2016)

In order to improve the therapeutic relationships, hospitals should come up with a system of nurse leader rounds (Morton, Brekhus, Reynolds & Dykes, 2014). It is a system which allows the nurses to go round talking to patient’s in the hospital so as to get their feedback. However, it is important for the nurses to keep in mind the professional relationships amidst their friendliness with the patient (NMBA, 2017).The nurses also ought to respect the patient’s on the grounds of culture, values, beliefs, autonomy and also their rights. The registered nurses on practice are expected to work in collaboration with other health care practitioners to promote the patient centred care.

Positive Therapeutic Relationships

According to Cashin et al (2016), there is a need for clear standards to ‘override’ the regular views of nursing such as limitation of nurses in their helper roles. The scholars argue that this type of view imposes a future risk of lack of proper nurse representation in planning situations.

I have worked in a mental health facility within Australia and have greatly incorporated the criteria of this standard in my practice. The mental health department is a sensitive one that requires facilitating relationships based on mutually exclusive trust and respect. In order to give hope and empowerment to my patients, I knew I had to work in collaboration with my care colleagues in the gratification of my patient’s mental, spiritual, emotional as well as physical needs. I was sensitive to culture and personal beliefs of the patient and that way, they were subjective to care and consequently achieved better improved care outcomes towards recovery.

It is the duty of the registered nurses to conduct satisfactory assessments which are systematically and comprehensive. There are different types of assessments done by nurses according to the Royal Children's Hospital Melbourne (2017). These include: admission assessment which entails knowing the patient's medical history and checking his or her vital signs, shift assessments which entails checking the condition of an admitted patient at different times and focused assessment which is carried out on a specific body system depending on the patient's health status. It is very important for the nurses to record correct data which will be later assessed. A registered nurse is required to conducts assessments that are holistic as well as culturally appropriate (NMBA, 2017). None of the patient’s condition should not be assumed. The registered nurse should ensure that the well-being of the patient is considered.

The registered nurse should start by assessing all the available resources at the initial stages of data collection in a case of conducting holistic assessments.  The nurses should use different techniques to collect the data ranging from asking questions, filling questionnaires, observing and using books and other scholarly materials. The data collected will aid not only the nurses but also other medical practitioners in knowing how best to help the patient's. This kind of approach is useful, for example, in a research carried out by a registered nurse to find out how to improve the therapeutic relationships in the hospital so as to promote the patient centeredness health care.

Prerequisites for Positive Therapeutic Relationships

This standard was very crucial in my clinical experience in a hospital in Victoria. I was working as a lead nurse in a surgery department whereby I was supposed to lead in a comprehensive pre-operative assessment of patients. Most of the elderly patients scheduled for surgery could not express themselves so well verbally especially in matters regarding to medical history. In that case, I would coordinate a comprehensive analysis of all factors that would lead to an accurate decision regarding the patient’s health history. This included contacting their close family carers.

Registered nurses are human beings .In as much as they try to remain professional as they carry out their own duties, they can be deeply affected by loss ,heart break and tribulation of not only their personal but also professional lives (Kartz & Johnson, 2016).This can affect the way they perform their duties. They can make decisions according to their own personal views and this will have an impact on the patient's health status.

Conclusion

The NMBA Registered Nurse Standards of practice guide the behaviour and professional conducts of the nurses. The criteria for each standard is provided by the NMBA. These standards are adhered to by all the registered nurses. The standards cover all the areas that a registered nurse may handle .These standards accommodate the evolving nursing practice and will still be valid in the coming years due to this feature. It is the duty of a registered nurse on practice to comprehensively conduct assessments. This aids in the treatment of patients. Data collected for assessment should be accurate and arranged in a clear order. It is the duty of the registered nurse to engage in therapeutic and professional relationships. This promotes a patient cantered approach which can transform the patient's experience and as a result, improve his or her health outcome. The nurses should not be discriminatory in their duties but rather should accept and value the patient's beliefs, culture, race and values. They should also work with and accept the views of other medical practitioners so as to ensure better patient outcome. However, when carrying out their duties, it is important for them to limit the influence of their emotional experience as they advise the patient’s and also their families.

References

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., & Cox, D. et al. (2018). Standards for practice for registered nurses in Australia. Collegian,24 (3), 255-266. Retrieved 16 Sep. 2018 from https://epubs.scu.edu.au/hahs_pubs/2242/ doi:10.1016/j.colegn.2016.03.002

Cousin, G., Mast, M.S., Roter, D.L. and Hall, J.A., 2012. Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient education and counseling, 87(2), pp.193-197 doi: 10.1016/j.pec.2011.08.004.

Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: An integrative review. Journal of Multidisciplinary Healthcare, 9, 537-546. doi:10.2147/jmdh.s116957

Louisiana State University at Alexandria. (2016). What Is the Role of Nurses in Healthcare? | LSUA Online. Retrieved 16 Sep. 2018 from https://online.lsua.edu/articles/healthcare/what-is-the-role-of-nurses-in-healthcare.aspx

Morton, J.C., Brekhus, J., Reynolds, M. and Dykes, A.K., 2014. Improving the patient experience through nurse leader rounds. Patient Experience Journal, 1(2), pp.53-61. 

Nursing and midwifery board of Australia (2017). Registered nurse standards for practice. Retrieved 16 Sep. 2018 from content://com.sec.android.app.sbrowser/readinglist/0915200344.mhtml

Renée S Katz & Johnson, T.A (2016). When professionals weep: Emotional and countertransference responses in palliative and end-of-life care. New York: Routledge.

Royal Children's Hospital Melbourne (2017) Nursing assessments Retrieved 16 Sep. 2018 from content://com.sec.android.app.sbrowser/readinglist/0915233925.mhtml

 Terry, K., Stirling, C., Bull, R., & Fassett, D. (2017). An overview of the ways nurses understand and utilise the existing Australian Competency Standards for Registered Nurses. Collegian, 24(2), 109-116. doi: 10.1016/j.colegn.2015.10.003

Warwick, C. (2015). The NMC Code: Professional standards of practice and behaviour for nurses and midwives | RCM. Retrieved 16 Sep. 2018 from https://www.rcm.org.uk/news-views-and-analysis/views/the-nmc-code-professional-standards-of-practice-and-behaviour-for