Therapeutic Relationships In Nursing

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Therapeutic Relationships in Nursing


Therapeutic relationship is a professional relationship that has been structured based on theoretical props. This relationship is a complicated, wide and unique relationship which develops between two people, where both sides' personality and attitudes inevitably interfere. Nursing-patient relationship experienced through transference and counter transference, especially in psychodynamic approaches, is accepted as the main aspect of the therapeutic process. However, the approaches without dynamic tendency also take nurse-patient relationship into account seriously and stress the uniqueness of interaction between two people. Being a person and a human naturally sometimes may negatively influence the relationship between the nurse and patient. (Baxter, 2000, 305)

The therapeutic nurse-client relationship is one of the building blocks on which nursing practice is built. Registered nurses are expected to behave, interact and communicate in a professional manner and demonstrate professional presence at all times. Boundaries are the defining lines which separate the therapeutic behavior of any behavior which, well intentioned or not, could reduce the benefit of nursing care to clients. Boundaries give each person a sense of legitimate control in the therapeutic nurse-client relationship. It is the nurse's responsibility to determine when actions or behaviors deviate from established boundaries and shift the nurse-client relationship from being therapeutic, to being non-therapeutic or non-professional in nature.

Historical development

The nurse-patient relationship is a foundation of nursing practice because patients experience improved care when their needs are fully considered. The nurse-patient relationship involves functioning within the limitations of the purpose of the relationship, therapeutic behaviors, recognition of the roles of the participants, and appreciation of patient confidentiality and the right to privacy. The nurse-patient relationship involves communicating effectively with patients to provide information, but it also requires that the nurse listen well to understand the patient's needs and concerns, discern what information is most influential and useful to the patient, and provide information in a way that is understandable to the patient. The nurse-patient relationship occurs in all settings in which nurses' care for patients, including inpatient, outpatient, and homecare settings. All healthcare professionals can practice communication skills that can establish a positive relationship with the patient, and these skills can be used by assistive nursing staff as well. Confidentiality is always a concern in nurse-patient relationships, therefore the patient and nurse must determine if it is appropriate for family members and other caretakers to be present during discussions. (Bordin, 2001, 252)

It is necessary to promote patient- nurse relationship, which can decrease the patient's anxiety and improve patient communication and adherence to the plan of care. Promoting clear communication between the nurse and patient can result in more effective patient teaching and help patient's voice concerns and questions about their care. Improved communication promotes more effective patient care, potentially reducing patient complications and conserving hospital resources. Clear post-discharge care instructions promote successful home care, which can improve patient outcomes and reduce the rate of hospital readmission.

Important characteristics of a strong therapeutic relationship include:

Trust - the patient needs to trust the nurse, and the nurse ...
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