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Discuss about the Relational Practice, Optimum relational practice, as stated by Keyko et al., (2016), forms the cornerstone of deliverance of high quality medical treatment in the clinical setting.

Optimum Characteristics of Relational Practice

Nurses are required to exhibit relational practice during their interactions with the patient. For successful relational practice, nurses must takes into consideration, numerous emotional and interpersonal characteristics of the patient. He or she must also treat the patient’s family, with respect, trust, dignity and empathy (Lawson et al., 2017). This essay, aims to shed light on the concept of relational practice in nursing, against a case study where the concerned patient as well as her husband, are suffering from the physiological and psychological complications of extreme sleep deprivation. Optimum relational practice, as stated by Keyko et al., (2016), forms the cornerstone of deliverance of high quality medical treatment in the clinical setting. Prospecting nurses must engage in adequate criticism and analysis of their existing relational behaviors. This will help to improve future professional practice in nurse-patient relationships.

The optimum characteristics of the relational practice include includes a clear understanding of the complicated needs of the patient in a clinical scenario, along with identifying the patient’s social and financial background, gender, medical history and demographic features (Zou et al., 2015). The student nurse attempted to accomplish significant understanding of the complex requirements of the patient – where he recognized the role of external hospital sounds in her state of sleep deprivation, followed by assuring her and her husband concerning the possibilities of shifting to a quieter, isolated room. Despite the absence of inquiring her geographical, financial conditions, the student nurse attempted to consider her gender-oriented social obligations of motherhood, and assured her of the wellbeing of her children at home in order to mitigate her existing anxiety and concern. Upon critical analysis concerning the identification of my relational practice, the student nurse also attempted to accomplish consideration of her medical history concern of depression, alcoholism and substance abuse, along with prioritizing her family needs, as evident in the recording where he considered the concerns of her husband. The student nurse engaged in a therapeutic nature of practice with the concerned patient. Therapeutic nursing involves communicating with the patient face-to-face, along with usage of adequate empathetic interactions with the purpose of improving the emotional, psychological and physiological well-being of the patient (White, 2014). He engaged in adequate therapeutic practice by interacting closely with the patient, along with repeatedly consoling her to relax and allow me to undertake the necessary changes for the provision of sleep-appropriate surroundings. For the purpose of successful professional relational practice, there is a need to adopt the theoretical principles of therapeutic communication skills as stated by Noome et al., (2016). This will include being authentic in the presentation of symptoms, initiative in the provision of required treatment practice, adequate synchronizing of patient needs and hospital workforce activities, reimaging and relating to the unique patient condition with due consideration of ambiguous patient needs, and most importantly, being adequately responsive to the needs of the patient (Noome et al., 2016). The student nurse was responsive to the needs of the patient, as evident from my expression of concerned considering her sleep deprivation. Through the provision of a separate, noise-free room for the patient, he also tried to synchronize the needs of the patient along with the availability of the hospital services. The student nurse also empathetically related to the patient and her husband’s concern about her family and well-being. However, according to Davidson et al., (2017), patient’s often express ambiguity or confusion in their interests. In this scenario, there was no ambiguity as the patient and her husband clearly stated their concern of her lack of sleep which was hindering her recovery.

Therapeutic Communication Skills

One of the major reasons which motivated the student nurse to engage in a relational practice is the presence of complexity in present healthcare scenario. As stated by Démeh and Rosengren, (2015), since traditional times the role and obligations of nurses have always been limited to eradication of the physiological conditions of the patient. At present, nurses are required to undertake a variety of roles concerning leadership and delegation, considering the need for hospitals to provide high quality treatment which is highly dependent on the cooperative functioning of the clinical workforce. Hence, considering the complex needs of the patient in a situation of high noise settings due to ongoing treatments of other patients, engaging in a relational practice will provide the student nurse with the opportunity to exhibit skills of leadership and delegation (Bjornsdottir, 2018). Hence, for the provision of a new room for the patient to sleep peacefully, the student nurse will be required to instruct the medical staff to shift the patient and her associated equipment safely. He just also delegate the assistant and enrolled nurses for strictly monitoring and maintaining a noise-free environment. As a relational inquirer of the patient, the student nurse was obliged to exhibit an interpersonal relationship. For successful interpersonal relational inquiry as stated by  Wright, Brajtman and Macdonald (2018), the nurse must listen carefully to the needs of the patient, adequately engage in clear verbal communication and most importantly, display considerable assertive behavior for the purpose of solving problems, taking decisions and negotiating peacefully with the patient’s family. The student nurse patiently listened as well as acknowledged the concerns of the patient and her husband, along with promptly taking the concern to the management to further shift her into a new room and effectively communicating the same with the patient. However, the student nurse lacked considerable assertiveness which was evident in the inability to immediately execute this decision concerning changing the room of the patient or undertaking steps to reduce the associated noise. Further, the obligations as a nurse also reflected the context of the patient surrounding and the complexity of her problems. Adequate sleep is required for the patient for her timely and adequate recovery and recuperation, and reduction of noise forms a cornerstone for its fulfillment (Ashworth et al., 2015). Without my usage of appropriate relational practice, there would have been little consideration given to the role of patient surroundings in rest and treatment, even after discharge. Hence, the relational inquiry obligations clearly emphasized on the nurses’ and hospital’s perspective of considering the importance of patient’s surroundings for recovery. It also considered the importance of providing a stress-free, silent environment for the patient at home. This will aid in her quick recovery and continued sustenance of well-being.

For the optimum conductance of relational practice, the student nurse was obliged to engage in adequate compassion and commitment to the needs of the patient (Bikker et al., 2015). The requirements of adhering to these obligations were determined by the outlines stated in the Code of Ethics of the Canadian Nurses Association, 2017 Edition. Nurses are required to undertake a role of considerable autonomy, emphasizing on the need to exhibit a therapeutic role for the purpose of bringing about positive emotional and behavioral changes in the patient (Blomberg et al., 2016).For fulfilling nursing obligations, the student nurse intended to adhere to the salient features of the ‘Need Theory’ by Viginia Henderson, who has been known as ‘the Nightingale of Modern Nursing’. In accordance to this theory as stated by Fernandes et al., (2016), nurses must undertake a patient-centered approach and allow the patient to engage actively in his or her treatment procedures, in order to regain their independence to live a normal life.  The student nurse actively discussed the plan of changing rooms to the patient and her husband, along with actively listening to their needs and showing concern for her deteriorating condition. However, if viewed critically, he should have engaged in such relational inquiry earlier, as the patient’s husband complained of feeling unattended considering their problems. Further, he should have involved the patient and her husband more in uncovering an appropriate solution to her problem. Despite taking the concern of changing rooms to the management, the student lacked enough assertiveness for guaranteeing this success of its implementation.

Complexity in Present Healthcare Scenario

In accordance to the Standards of Nurse-Client Therapeutic relationships outlined by the College of Nurses of Ontario, the key components required for usage of appropriate therapeutic communication skills are professional intimacy, trust, respect and power (College of Nurses of Ontario, 2017). With respect to the video during my communication with the patient, the three communication skills which the student nurse actively exhibited were empathy, professional intimacy and power. However, he was unable to gain the trust of the patient’s husband, as he clearly stated that previously, their complaints were not adhered to. However, in order to mitigate this shortcoming, he treated the patient with respect, by recognizing her unique needs. He also empathized adequately with her sleep deprivation, as evident by my efforts to change her behavior. The student nurse engaged in professional intimacy by exhibiting patience and concern to her problems. However, the nurse always holds greater power in any clinical relationship, which he was unable to exercise effectively, as evident in my difficulty to guarantee an immediate shift in her room.

Hence to conclude, the student nurse’s efforts to successfully integrate relational practice  will prove to be beneficial in the future development of nursing professional practice, as well as for the purpose of understanding the needs of the patient. Relational practice is an effective way to exhibit the therapeutic potential of a nurse. However, the usage of this practice continues to be less prevalent in hospitals at present, as evident by the patient and her family’s complaints that their problems were ignored previously. Further, the student nurse exhibited considerable shortcomings in the practice of relational inquiry with the patient. For future improvements in relational practice, he must be more assertive and prompt in undertaking decisions, as well as actively engage the patient while deciding the appropriate care plan. However, he used enough empathy and compassion, along with eagerness to appreciate the complexity of healthcare. It can be concluded that he can further work to improve and enhance his future exploits in relational practice. This will generate beneficial health outcomes in his patients.

References

Ashworth, A., Hill, C. M., Karmiloff-Smith, A., & Dimitriou, D. (2015). The importance of sleep: attentional problems in school-aged children with Down syndrome and Williams syndrome. Behavioral sleep medicine, 13(6), 455-471.

Bikker, A. P., Fitzpatrick, B., Murphy, D., & Mercer, S. W. (2015). Measuring empathic, person-centred communication in primary care nurses: validity and reliability of the Consultation and Relational Empathy (CARE) Measure. BMC family practice, 16(1), 149.

Bjornsdottir, K. (2018). ‘I try to make a net around each patient’: home care nursing as relational practice. Scandinavian journal of caring sciences, 32(1), 177-185.

Blomberg, K., Griffiths, P., Wengström, Y., May, C., & Bridges, J. (2016). Interventions for compassionate nursing care: A systematic review. International Journal of Nursing Studies, 62, 137-155.

College of Nurses of Ontario. (2017). Therapeutic Nurse-Client Relationship, Revised 2006. College of Nurses of Ontario.

Davidson, J. E., Aslakson, R. A., Long, A. C., Puntillo, K. A., Kross, E. K., Hart, J., ... & Netzer, G. (2017). Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Critical care medicine, 45(1), 103-128.

Démeh, W., & Rosengren, K. (2015). The visualisation of clinical leadership in the content of nursing education—a qualitative study of nursing students' experiences. Nurse education today, 35(7), 888-893.

Fernandes, B. K. C., Guedes, M. V. C., da Silva, L. D. F., Borges, C. L., & de Freitas, M. C. (2016). Nursing process based on Virginia Henderson applied for a working elderly. Journal of Nursing UFPE on line-ISSN: 1981-8963, 10(9), 3418-3425.

Keyko, K., Cummings, G. G., Yonge, O., & Wong, C. A. (2016). Work engagement in professional nursing practice: A systematic review. International Journal of Nursing Studies, 61, 142-164.

Lawson, L., Knudson-Martin, C., Hernandez, B. C., Lough, A., Benesh, S., & Douglas, A. (2017). Student Healthcare Clinicians' Illness Narratives: Professional Identity Development and Relational Practice. The American Journal of Family Therapy, 45(3), 149-162.

Noome, M., Beneken genaamd Kolmer, D. M., van Leeuwen, E., Dijkstra, B. M., & Vloet, L. C. (2016). The nursing role during end?of?life care in the intensive care unit related to the interaction between patient, family and professional: an integrative review. Scandinavian journal of caring sciences, 30(4), 645-661.

Spadoni, M., & Sevean, P. (2016). Relational Inquiry—Attending to the spirit of nursing students. Religions, 7(3), 34.

White, L. (2014). Mindfulness in nursing: An evolutionary concept analysis. Journal of Advanced Nursing, 70(2), 282-294.

Wright, D. K., Brajtman, S., & Macdonald, M. E. (2018). Relational ethics of delirium care: Findings from a hospice ethnography. Nursing inquiry, e12234.

Zou, P. (2016). Relational Practice in Nursing: A Case Analysis. NHC, 102, 9-13.

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