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1.Establishing a person centred, therapeutic relationship is essential in the provision of nursing care. Identify the purpose and benefits of the therapeutic relationship for both the nurse and the patient.

2.Taking into account Jason’s situation, what would you identify as potential barriers to communication with Jason in this setting?

Please write your answer here

3.Define and explain two verbal and two non-verbal communication techniques you would use when communicating with Jason to encourage open and honest communication.

Jason’s parents leave the room for a moment, when they do, he turns to you and says;

‘I feel so crap, I think I have really blown it this time, my parents are really angry with me and Ashley will probably never talk to me again’

Consider this (above) comment and answer the following;

4.a)  Define and explain what is meant by the term ‘empathy’.

  1. b) Describe how you would respond to Jason in an empathetic manner. Include in your answer a description of your non-verbal actions AND a verbal response. When discussing the verbal response include a suggested verbal response as a quote, in quotation marks.  

Please write your answer here

5.Eleven functional health patterns are considered as part of Gordon’s functional health assessment (1982).

a)Outline the purpose of this model of data collection

b)Review the information in the case scenario and identify TWO (2) functional health patterns that you consider to be lacking information. For each of the functional health patterns you identified, present TWO (2) further questions you would ask Jason.

6.Taking into account the information provided in Jason’s case, identify THREE (3) nursing focused actual or potential health problems that Jason may be at risk of.  Provide a brief explanation for each and identify (from the subjective and objective data in Jason’s case scenario) why he may be at risk of the health problem.

7.Identify TWO (2) of the Australian and Midwifery Board of Australia (2016) Registered nurse standards for practice that you have met by caring for Jason (in this case study) and briefly explain how you have met each standard.

Purpose and benefits of therapeutic relationship

Answer:

  1. Purpose and Benefits of Therapeutic relationships

Therapeutic relationship between the nurse and patient is a partnership that relies on mutual respect and trust between the two (Weber, & Farrell, 2016). The ties instil optimism and belief in a patient that their will recover from their infections. Therapeutic relationships enable the nurse to treat themselves and the patient with dignity (Weber, & Farrell, 2016). Furthermore, it makes the physician help the patient to overcome emotions and pain when they are sick (Weber, & Farrell, 2016). The nurse can use the clinical experience to calm down an anxious patient.

The nurses’ assistance help patiens in the recovery process. The quick recovery of the patient is the primary purpose of clinical therapy. A proper therapeutic relationship provides the patient with a platform to explain their conditions to the health practitioners. The specialist should be free and avoid judging the thoughts and opinions of the patients. For the therapy to be a success, the clinician should be genuine and provide the necessary assistance to the patient.

A proper therapeutic process enables a critically ill patient to recover faster from their conditions. For the therapy to be a success, the patient should have no doubts about the ability of the physician. Moreover, the therapist should keep the conversation with the patient as a secret. The patient should reveal all information to the clinician and trust that the physician cannot tell anyone about their discussions.  

  1. Communication barriers between Patients and Physicians

Jason has many issues bothering him after the accident. The problems preoccupying his mind are likely to disrupt the communication between him and the nurse. Firstly, he is a frustrated boy following the argument that he and his girlfriend had at the club. Jason terms the confrontations as silly and unnecessary. Secondly, he feels that he has disappointed the parents with his actions.  Jason worries that the relationship with Ashley is over. The combination of all these problems must hamper the communication between the boy and the nurse in several ways.

A mentally disturbed Jason is likely to talk in a low tone when explaining his worries to the nurse. His problems are numerous and private. Hence he would like to have a private conversation. Due to the low tone that Jason prefers, the nurse has to listen carefully. In case the nurse does not understand the English Language, then effective communication with Jason can fail (Adams et al., 2016).  The noisy health facility environment hampers the conversation between Jason and the nurse due to the low tone by Jason.

  1.  Verbal and non-verbal communication techniques

Barriers to communication

Jason is a mentally disturbed patient. I have to maintain proper communication to enable him to open up to me before I can administer diagnosis and treatment. Verbal communication majorly entails conversation and a bit of the written forms (De Giacomo et al., 2016). When talking to Jason about his condition, I would avoid using complicated medical terms. When asking him about how he feels after the accident, I would use Standard English language in communication. I would appropriately use written and oral types of verbal communications.

When explaining the suggestions of the modes of treatment available, I would write complicated medical terms to Jason. Diagnostic terms are purely scientific, and a nurse should write down the spelling to enable the patient to understand them. When I ask about what happened the night before the accident, he might be afraid to reveal all the details. I would provide him with a piece of paper for him to write to me precisely what transpired. I would also write down the dosage for him on a paper.

Oral communication is the other type of communication that I would use. When advising on how to handle the relationship with Ashley, I would look directly into his eyes. I would convince him to reveal all the issues bothering him to me. Non-verbal communication involves body movements to make a point (Burgoon, Guerrero, & Floyd, 2016). I would maintain eye contact with Jason when asking him about his health conditions. Maintenance of eye contact helps him to focus and reveal all the information that I need to diagnose him. Secondly, I would wear a smiling and an encouraging facial expression to encourage him to be free and reveal all the information.

4 (a) Empathy

In clinical setups, empathy is a technique of keenly gauging the speech of the patient (Halpern, 2014). Moreover, empathy requires that the clinician develops a feeling for the conditions of the patient (Halpern, 2014). Consequently, the physician should express their opinions to the patient. Medical empathy improves the relationship between the patient and the doctor. A proper empathy involves two issues. Firstly, the nurse should resonate with the feelings of the patient and tie the conditions to the current world. Secondly, the physician should suggest treatment modes that the patient approves.

(b) Jason's statement is as follows, "I feel so crap. I think I have blown it this time around. My parents are hungry with me. Ashley will probably never talk to me again". I would use appropriate verbal and non-verbal techniques to respond to this statement. I would nod my head in objection to show him that his situation is not that bad.  I would hold him and tell him that such situations are common in the current world. Furthermore, I would encourage him that Ashley will soon talk to him. My statement would read: "Do not worry Jason, such situations are common, I also passed through them when I was at your age. Your parents perfectly understand your situation. Ashley will also understand you and get back to you soon".

Verbal and non-verbal communication techniques

5 (a) the purpose of Gordon’s functional Healthcare Patterns

The goal of this pattern is to give nurses an assessment platform that they can use to attend to patients (Gordon, 2014). The nurse should present the modes of treatment and ask the patient to choose one. The clinician should examine the types of food that the patient eats (Moorhead, Johnson, Maas, & Swanson, 2014). Furthermore, the physician should advise on the foods that suit the medical condition of the patient. The nurse can ask whether the patient has issues while releasing waste. The Gordon’s functional patterns are eleven in number. Nurses find them useful in examining the conditions of the patients.

(b)  When Jason visits the hospital, the doctor accesses him on various issues. His medical conditions, previous illness, immunization history, and allergies are some of the questions that he answers. Additionally, Jason honestly answers questions on the nature of family support and relationship status. Moreover, the doctor accesses his travelling history. However, the doctor does not ask him about his future missions and visions. Furthermore, the physician's report is silent on looking at Jason's past three years.

In response to the two issues that are lacking in Jason's medical card, I would ask him two critical questions. "What are your visions and missions for the future?" "Which is the worst health condition that u have experienced in the past three years?" A proper vision ensures that Jason avoids such club confrontations in the future. Jason should learn from the worst experience.

  1.  Potential Health Problems

From a nursing point of view, Jason risks suffering from an array of health issues due to his lifestyle. Jason's medical card indicates that he drinks alcohol. Additionally, he occasionally smokes. The allergies section suggests that Jason does not eat shellfish. Cigarette smoking leads to lung cancer (Reid et al., 2017). Additionally, constant smoking addition leads to consistent addiction. Jason also drinks alcohol during the weekends. Alcohol addiction causes lung hepatitis (W.H.O, and W.H.O, 2014). Excessive consumption causes liver cirrhosis (W.H.O, & W.H.O, 2014).

When Jason continues to drink alcoholic drinks, he is likely to suffer from an array of cancers. Mouth and Pancreatic cancer are examples that Jason risk due to his drinking habits. Alcohol interferes with the normal functioning of the liver.  Alcoholism is a significant cause of Throat cancer (W.H.O, & W.H.O, 2014). Shellfish is a vital source of proteins and vitamins (Domingo, 2016). Additionally, Shellfish is a source Iodine (Domingo, 2016). Therefore, Jason risks contacting goiter due to a potential lack of sufficient iodine in his system. If Jason continues to drink alcohol and smoke cigarette and at the same time avoiding eating shellfish, he risks contacting the diseases discussed above.

  1.  Australian Registered Nurses Standards

Understanding empathy

The standards that I have met while caring for Jason are two. Firstly is standard (2), which is, "Engages in a Therapeutic and Professional relationship” (Carney, 2016). Secondly is the standard (4), which is, “Comprehensively conducts assessments” (Halcomb et al., 2016).

I have built a healthy therapeutic relationship with Jason. I have encouraged him to be free and share everything that affects him with me. Furthermore, I have assured him of confidentiality of our conversation. The relaxed atmosphere that I have created has enabled him to share his health issues. Moreover, I have given him the chance to choose the best mode of treatment that suits his preference.

I have used Gordon’s assessment model to check on his health status. I asked him about his missions and visions for the future. Additionally, I enquired about his past worst experiences in the last three years.

References

Adams, A. S., Parker, M. M., Moffet, H. H., Jaffe, M., Schillinger, D., Callaghan, B., ... & Karter, A. J. (2016). Communication barriers and the clinical recognition of diabetic peripheral neuropathy in a diverse cohort of adults: the DISTANCE study. Journal of health communication, 21(5), 544-553.

Burgoon, J. K., Guerrero, L. K., & Floyd, K. (2016). Nonverbal communication. Routledge.

Carney, M., (2016). Regulation of advanced nurse practice: its existence and regulatory dimensions from an international perspective. Journal of nursing management, 24(1), pp.105-114.

De Giacomo, A., Craig, F., Terenzio, V., Coppola, A., Campa, M.G. & Passeri, G., (2016). Aggressive behaviors and verbal communication skills in autism spectrum disorders. Global pediatric health, 3, p.2333794X16644360.

Domingo, J.L., (2016). Nutrients and chemical pollutants in fish and shellfish. Balancing health benefits and risks of regular fish consumption. Critical reviews in food science and nutrition, 56(6), pp.979-988.

Gordon, M. (2014). Manual of nursing diagnosis. Jones & Bartlett Publishers.

Halcomb, E., Stephens, M., Bryce, J., Foley, E. & Ashley, C., (2016). Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-10), pp.1193-1205.

Halpern, J., (2014). From idealized clinical empathy to empathic communication in medical care. Medicine, Health Care and Philosophy, 17(2), pp.301-311.

Moorhead, S., Johnson, M., Maas, M.L. & Swanson, E., (2014). Nursing Outcomes Classification (NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health Sciences.

Reid, J.L., Mutti-Packer, S., Gupta, P.C., Li, Q., Yuan, J., Nargis, N., Hussain, A.K.M.  & Hammond, D., (2017). Influence of health warnings on beliefs about the health effects of cigarette smoking, in the context of an experimental study in four Asian countries. International journal of environmental research and public health, 14(8), p.868.

Weber, K. & Farrell, T., (2016). Developing therapeutic communication skills: Integration of standardized client simulation in an associate degree nursing program.

World Health Organization & World Health Organization. Management of Substance Abuse Unit, 2014. Global status report on alcohol and health, (2014). World Health Organization.

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