Nurse – Patient Relationship

Nurse – Patient Relationship
د.عبدالمهدي عبدالرضا حسن
Ph.D., Pediatric & Mental Health Nursing

What is interpersonal relationship?

“ the relationships between persons

Components of interpersonal relationship
Scientific principles
Specific communication skills and strategies
Creative application of self
(Boggs, 1989)
What is nurse-patient relationship?
What is the purpose of nurse – patient relationship?
Requisites for nurse-patient relationship
Careful thinking
Sensitiveness
Energy
time
Nurses’ roles in nurse-patient relationship
Care giver
Counselor
Educator
Consultant
researcher
Characteristics of good nurse-patient relationship
Relationship is therapeutic
Exist until patent have fulfilled the health care needs
Nurses’ work is to attain, maintain, and restore the patients’ health
Patients are satisfied
Based on nurses’ competent care derived from skills and knowledge
Characteristics of good nurse-patient relationship Cont….
Provide holistic care
Patient/client is an active participant
Nurse uses patients’ knowledge, attitudes, values, and thoughts to plan interventions
Reciprocal relationship influenced by professional and personal characteristics of both parties
Phases of the nurse-patient relationship
Pre-interaction phase
Engagement phase
Active intervention phase
Termination phase
(Arnold & Boggs, 1989)
Pre-interaction phase
During this phase
Nurse assess the environment in which the nurse meet with patient
Explain the professional goals and set priorities
Both parties enter to the relationship with expectations
Patients develop uncertainties and hesitate to comply with care and treatments
Patient and nurse become oriented to overall needs and expectations from the relationship


Engagement phase

Begin to develop the relationship
Nurse create a supportive environment
Establish a therapeutic contact with patients
Nurse introduce herself and the role functions
Trust and empathy are basic qualities here
Develop strong bond and feel less anxiety
Nurse plays the key role with expertise on illness
Nurse act as a coordinator
Engagement phase Cont….


Nurse observe and assess patients
Develop an impression and validate with patients
Patients come to know their health issues and feel fear, discomfort, or insecure feelings and expect help
Nurses realize patients through their body languages and help them
Therapeutic relationship is well established




Active intervention phase

The sense of mutuality is developed between nurse and patient
Discuss conflicting situations deeply
Nurse and patient work with commitment
Nurse sort out problems and solve them
Collaboration and equal participation is seen
Aware of the differences of rights, roles, and responsibilities
Active intervention phase Cont….

Nurse acknowledge the patients’ feelings, show the genuine interest, and honesty
Nurse should be congruent
Nurse convince the patient of equal right to make decision
Nobody will play dominant or submissive role
No violation of patients’ rights
Patients become independent decision makers

Termination phase

Start at the time of explaining plans & goals
Patient should be informed of this phase at the beginning
Otherwise patients develop strong feeling of separation at this phase
Nurse work on education, health advices preparing discharge plan
Nurse-professional relationship

why?

To get advice

To educational support

To work related achievements

To self support

Nurse-professional relationship Co…
How?

Collaboratively

Cooperatively

With acceptance and self worth

With appreciation

With respect
Barriers for effective professional relationship

Role stress

Lack of inter professional understanding

Autonomy struggle

(Northouse & Northouse, 1992)

Role stress

The stress arises from role conflict or role confusion
Role conflict is a situation that you happen to play a role different from what you expected to play
Role stress occur when you are expected to do than what you can do
Result in stress and communication is disturbed





How to prevent role stress?
Prevention of role stress
Experienced persons are responsible

Understand individual capabilities

Identify the individual weaknesses

Assign tasks accordingly

Kindly and duly respond against inexperienced behaviors or faults



What are the disadvantages of role conflicts?
Autonomy struggles
What is autonomy?
autonomy is one’s ability to be one’s own person directed by own desires, not imposed by others.

When this ability is threatened by others autonomy struggles are arose.

People with higher level of autonomy underestimate others bringing struggles.

Nurse – family relationship
Who is the nurse?

What is the family?

The group of individuals related by blood, marriage or adopting, and sharing the same space, resources with a common human bond while having common goals.


Why do nurses need a relationship with the family?