The Importance Of Therapeutic Relationships
Relationships are very important in our everyday life; they connect people with one another. These relationships do not happen overnight but they take a lot of time. It is important that in order for a relationship to be healthy it should be based on trust, respect, honesty and integrity (Ezine Articles 2010).
As stated by McCormack (1997), the therapeutic relationship between the nurse and the patient is the core of the nursing profession. Therapeutic relationships are different from social and intimate relationships because they focus more on what the patient needs, on the experiences that the patients passed through and also on the patient’s feelings and ideas. These relationships between the nurse and their patients are goal oriented because …show more content…
by the means of these relationships the patients get better quickly. It is really important that this relationship should be based on trust, empathy and respect. If the nurses show more respect to the patients, these will open more on how they are feeling and on some other problems that they might have.
From my very own experience, I really agree with the therapeutic relationships and I wish that this type of relationship will be practiced more often by all the registered nurses in hospitals and in other health care entities.
When I was admitted as a patient in hospital, I could notice the difference between one nurse and another. I was more rigid and kind of unfriendly to the nurses that used to come near me angry and not smiling to me. On the other hand, I was more open to the other nurses that used to come and sit down near me and with a friendly smile ask me if they can help me with something.
O’Brien (2001), points out that the origins of the therapeutic relationships go back to the beginning of the institutional care. Yet, as MaCabe and Priebe in 2004 stated; more efforts are being put lately in consideration of these …show more content…
relationships.
The therapeutic relationship is a very important ingredient in successful therapy (Singer Jr). As Singer Jr points out, nurses and doctors sometimes seek to cure their patients with different types of theories and medicines but if they show more respect, strong willingness and trust to their patients, these will recover more quickly because they know that someone is there to actually help them to get better. Sometimes the patients don’t need medicines and therapy, they just need someone’s attention, someone to help them and there to talk to when needed. This caring relationship between the nurse and the patients develop when they have some time to talk together in privacy and this will result in tranquility, happiness and also their healing (Pullen 2010).
A therapeutic relationship is an acknowledged, mutual engagement which is developed within a clinical practice setting; that is the hospital or other health care institutions.
Throughout this relationship the nurse and the patient work together in order to accomplish health related targets (Arnold & Underman Boggs, 2011). Each therapeutic relationship is different, it can take only few hours or minutes a day or it can be extended over a span of weeks and months. Whether this relationship is in the beginning, middle or at the end, it should be really substantial and purposeful (Arnold & Underman Boggs, 2011; Registered Nurses Association of Ontario (RNAO), 2006). In a research that was carried out by the Registered Nurses Association of Ontario (RNAO) in 2006, documented that the therapeutic relationships have a really optimistic influence on the patient’s health outcomes and
fulfillment.
It is very important that nurses fully understand the meaning of therapeutic relationships. They should be very careful in order to maintain this relationship within the therapeutic boundaries. A therapeutic relation is very different from a personal relationship with a friend. Therefore, nurses should be able to keep professional boundaries between them and the patient taking also in consideration the cultural and spiritual differences between them (College of Nurses of Ontario 2004). If the nurse crosses his/her boundaries and limits, this will result in the relationship changing from professional to personal and unprofessional. In order for a nurse to maintain boundaries, one has to reflect daily on his/her practice and also a plan of the care being giving should be planned from before. Patient’s wishes and needs should always be nurse’s priorities (College of Nurses of Ontario 2004).
Despite, all nurses know the great importance of the therapeutic relationships when they are asked to say what this relationship entitles everyone finds it really hard in stating exactly what it really is (Welch, 2005). A study carried out with six psychiatric nurses was reported by Welch in 2005. This study was carried out to analyze crucial moments during therapeutic relationships. These nurses were asked to reflect on the qualities of their relationships with their patients. The major topics that are of great importance in the relationships that were obtained from the results were trust, power, empathy, mutuality and self-revelation.
These nurses found that their patients trusted them with intimate experiences. One of the interviewed nurses even stated that he was really pleased and happy that the patient communicated his problems with him. If trust is infringed it is really hard to restore.
Empathy is the ability “…to perceive the internal frame of reference of another with accuracy and with emotional components and meanings…as if one were the person” (Rogers, 1959; pp. 210-211). Empathy is of great importance when helping patients. The nurse should be capable of discerning the patient’s worries in order to help them get better and recuperate quickly as possible (Reynolds, 1999).
As a nurse one feels that s/he has a lot of power. The nurse and the patient relationship should be one of an equal power. The nurse should be really conscious on how s/he uses his/her power. It doesn’t mean that if a nurse have the power s/he can impose values and ideas that s/he belief in to the patient. Being in power sometimes means that the nurse should retain her own side of the idea. The sharing of power was observed as being more efficient and forceful than when giving all the control to the patient. Sometimes nurses noticed that patients showed them more appreciation when power is controlled between them two in their relationship (Welch, 2005).
After the study those nurses taking part declared that now they are more confident in establishing new therapeutic relationships and this was because of the observation and thinking done during their experience for the study (Welch, 2005).
Like any other relationships, the therapeutic relationship has a process. This process includes four phases throughout it; the pre-interaction phase, introductory or orientation phase, working phase and termination phase. One should always keep in mind that the care given should be always within the nurse role boundaries.
The pre-interaction phase begins before the nurse meets the patient. Here the nurse starts by doing a self-assessment. S/he will start to examine one’s feelings, fears and anxieties. This is a really important task that should be carried out by all the nurses.
In the introductory or orientation phase, the nurse meets with the patient for the very first time. In this phase, the nurse should find out the reason/s why the patient is in hospital. Slowly trust will start to build. Together, the patient and the nurse should establish a list of specific goals that the patient needs to accomplish by the end of the care. Confidentiality should be discussed. The nurse should give her word to the patient that s/he is going to keep sealed any information given to her/him.
The working phase is the third phase. The bulk of the therapy is carried out here. The nurse should help the patient to examine his/her feelings, perceptions, thoughts and actions. Together, they will establish coping skills. Here most patients show a little bit of distress and discomfort because of the problems that need to be solved and addressed but as the relationship evolves over time the patient will feel more confident about him/herself and then s/he will start to trust the nurse more and so, move forward and overcome resistance behavior.
The last phase of the therapeutic relationship is the termination phase. It is also called the resolution phase. This phase is very difficult and challenging but at the same time, it is also the most meaningful phase of the therapeutic relationship. Termination is where together the patient and the nurse examine the goals accomplished and explore their feelings about the termination of the relationship.
As early as from the 1950’s it has made a lot of sense that the interpersonal relationship between the nurse and her/his patient is fundamental to the growth and improvement of all the psychological, emotional, cognitive and behavioural skills of one self. It is important that all registered nurses form such therapeutic relationships, because the relationship in itself is therapeutic both for the patient and for the nurses giving the care ( McCalman 1950 and Peplau 1952). One can say that these relationships are mutual learning experiences that as a nurse one should be proud to be part of.
As stated by McCormack (1997), the therapeutic relationship between the nurse and the patient is the core of the nursing profession. Therapeutic relationships are different from social and intimate relationships because they focus more on what the patient needs, on the experiences that the patients passed through and also on the patient’s feelings and ideas. These relationships between the nurse and their patients are goal oriented because …show more content…
by the means of these relationships the patients get better quickly. It is really important that this relationship should be based on trust, empathy and respect. If the nurses show more respect to the patients, these will open more on how they are feeling and on some other problems that they might have.
From my very own experience, I really agree with the therapeutic relationships and I wish that this type of relationship will be practiced more often by all the registered nurses in hospitals and in other health care entities.
When I was admitted as a patient in hospital, I could notice the difference between one nurse and another. I was more rigid and kind of unfriendly to the nurses that used to come near me angry and not smiling to me. On the other hand, I was more open to the other nurses that used to come and sit down near me and with a friendly smile ask me if they can help me with something.
O’Brien (2001), points out that the origins of the therapeutic relationships go back to the beginning of the institutional care. Yet, as MaCabe and Priebe in 2004 stated; more efforts are being put lately in consideration of these …show more content…
relationships.
The therapeutic relationship is a very important ingredient in successful therapy (Singer Jr). As Singer Jr points out, nurses and doctors sometimes seek to cure their patients with different types of theories and medicines but if they show more respect, strong willingness and trust to their patients, these will recover more quickly because they know that someone is there to actually help them to get better. Sometimes the patients don’t need medicines and therapy, they just need someone’s attention, someone to help them and there to talk to when needed. This caring relationship between the nurse and the patients develop when they have some time to talk together in privacy and this will result in tranquility, happiness and also their healing (Pullen 2010).
A therapeutic relationship is an acknowledged, mutual engagement which is developed within a clinical practice setting; that is the hospital or other health care institutions.
Throughout this relationship the nurse and the patient work together in order to accomplish health related targets (Arnold & Underman Boggs, 2011). Each therapeutic relationship is different, it can take only few hours or minutes a day or it can be extended over a span of weeks and months. Whether this relationship is in the beginning, middle or at the end, it should be really substantial and purposeful (Arnold & Underman Boggs, 2011; Registered Nurses Association of Ontario (RNAO), 2006). In a research that was carried out by the Registered Nurses Association of Ontario (RNAO) in 2006, documented that the therapeutic relationships have a really optimistic influence on the patient’s health outcomes and
fulfillment.
It is very important that nurses fully understand the meaning of therapeutic relationships. They should be very careful in order to maintain this relationship within the therapeutic boundaries. A therapeutic relation is very different from a personal relationship with a friend. Therefore, nurses should be able to keep professional boundaries between them and the patient taking also in consideration the cultural and spiritual differences between them (College of Nurses of Ontario 2004). If the nurse crosses his/her boundaries and limits, this will result in the relationship changing from professional to personal and unprofessional. In order for a nurse to maintain boundaries, one has to reflect daily on his/her practice and also a plan of the care being giving should be planned from before. Patient’s wishes and needs should always be nurse’s priorities (College of Nurses of Ontario 2004).
Despite, all nurses know the great importance of the therapeutic relationships when they are asked to say what this relationship entitles everyone finds it really hard in stating exactly what it really is (Welch, 2005). A study carried out with six psychiatric nurses was reported by Welch in 2005. This study was carried out to analyze crucial moments during therapeutic relationships. These nurses were asked to reflect on the qualities of their relationships with their patients. The major topics that are of great importance in the relationships that were obtained from the results were trust, power, empathy, mutuality and self-revelation.
These nurses found that their patients trusted them with intimate experiences. One of the interviewed nurses even stated that he was really pleased and happy that the patient communicated his problems with him. If trust is infringed it is really hard to restore.
Empathy is the ability “…to perceive the internal frame of reference of another with accuracy and with emotional components and meanings…as if one were the person” (Rogers, 1959; pp. 210-211). Empathy is of great importance when helping patients. The nurse should be capable of discerning the patient’s worries in order to help them get better and recuperate quickly as possible (Reynolds, 1999).
As a nurse one feels that s/he has a lot of power. The nurse and the patient relationship should be one of an equal power. The nurse should be really conscious on how s/he uses his/her power. It doesn’t mean that if a nurse have the power s/he can impose values and ideas that s/he belief in to the patient. Being in power sometimes means that the nurse should retain her own side of the idea. The sharing of power was observed as being more efficient and forceful than when giving all the control to the patient. Sometimes nurses noticed that patients showed them more appreciation when power is controlled between them two in their relationship (Welch, 2005).
After the study those nurses taking part declared that now they are more confident in establishing new therapeutic relationships and this was because of the observation and thinking done during their experience for the study (Welch, 2005).
Like any other relationships, the therapeutic relationship has a process. This process includes four phases throughout it; the pre-interaction phase, introductory or orientation phase, working phase and termination phase. One should always keep in mind that the care given should be always within the nurse role boundaries.
The pre-interaction phase begins before the nurse meets the patient. Here the nurse starts by doing a self-assessment. S/he will start to examine one’s feelings, fears and anxieties. This is a really important task that should be carried out by all the nurses.
In the introductory or orientation phase, the nurse meets with the patient for the very first time. In this phase, the nurse should find out the reason/s why the patient is in hospital. Slowly trust will start to build. Together, the patient and the nurse should establish a list of specific goals that the patient needs to accomplish by the end of the care. Confidentiality should be discussed. The nurse should give her word to the patient that s/he is going to keep sealed any information given to her/him.
The working phase is the third phase. The bulk of the therapy is carried out here. The nurse should help the patient to examine his/her feelings, perceptions, thoughts and actions. Together, they will establish coping skills. Here most patients show a little bit of distress and discomfort because of the problems that need to be solved and addressed but as the relationship evolves over time the patient will feel more confident about him/herself and then s/he will start to trust the nurse more and so, move forward and overcome resistance behavior.
The last phase of the therapeutic relationship is the termination phase. It is also called the resolution phase. This phase is very difficult and challenging but at the same time, it is also the most meaningful phase of the therapeutic relationship. Termination is where together the patient and the nurse examine the goals accomplished and explore their feelings about the termination of the relationship.
As early as from the 1950’s it has made a lot of sense that the interpersonal relationship between the nurse and her/his patient is fundamental to the growth and improvement of all the psychological, emotional, cognitive and behavioural skills of one self. It is important that all registered nurses form such therapeutic relationships, because the relationship in itself is therapeutic both for the patient and for the nurses giving the care ( McCalman 1950 and Peplau 1952). One can say that these relationships are mutual learning experiences that as a nurse one should be proud to be part of.