This essay aims to discuss and explore the impact of diversity between nurse and patient within the confines of the therapeutic relationship; this is achieved through reflecting upon an interaction which occurred between a patient and myself during clinical practice.
Peplau (1952) considers the therapeutic relationship to be the central focus of all nursing practice. Furthermore, Graham (2001), Lauder et al (2002) and Hewitt and Coffey (2005) all describe the therapeutic relationship as forming the “cornerstone” of modern nursing practice. Egan (1994) illustrates the ‘skilled helper model’ of counseling, which is reported by Sloan (1999) to promote warmth and genuineness during interactions with patients; this model focuses on the patient (Egan, 1994), and can be described as a “humanistic” approach to helping (Jones, 1998). It is for these reasons that I have elected to apply the use of this model to the interactions, which occurred between the patient and myself.
Explicit consent was obtained from the patient in question for the material which was obtained during these interactions to be used within this assignment; and in order to conform to the code of conduct detailed by the Nursing and Midwifery Council, and to maintain the confidentiality of the patient, throughout this essay they will be referred to as Howard.
Howard is a 38-year-old man, who had been unemployed and living in ‘bed and breakfast’ accommodation for the six months preceding his admission to hospital, following the breakdown of his marriage. It appeared that the stress, which culminated with the separation from his wife and their pending divorce, had led to a progressive deterioration in his mental state and mood, which had made it difficult for him to work.
Table of Contents
1. Introduction to the therapeutic nurse-patient relationship
2. Theoretical models of nursing intervention
2.1 The Skilled Helper Model
2.2 Six-Category Intervention Analysis
3. Practical application and case study: Howard
4. Factors of diversity in nursing practice
4.1 Addressing age-related differences
4.2 Cultural background considerations
4.3 Gender and boundary management
5. Professional boundaries and power dynamics
6. Conclusion and reflective synthesis
Objectives and Research Focus
This assignment explores the complexities of the therapeutic relationship between nurse and patient, specifically examining how personal and professional diversity influences interaction quality and patient outcomes. Through the lens of a clinical case study, the work investigates how communication strategies and structural models can mitigate barriers to care.
- Analysis of the 'skilled helper model' in mental health nursing.
- Evaluation of the impact of diversity factors, including age, culture, and gender.
- Discussion on maintaining professional boundaries and addressing power imbalances.
- Application of 'six-category intervention analysis' to clinical encounters.
- Reflective practice on student nurse interactions with patients.
Excerpt from the Book
The Skilled Helper Model in Clinical Practice
Egan (1994) illustrates the ‘skilled helper model’ of counseling, which is reported by Sloan (1999) to promote warmth and genuineness during interactions with patients; this model focuses on the patient (Egan, 1994), and can be described as a “humanistic” approach to helping (Jones, 1998). It is for these reasons that I have elected to apply the use of this model to the interactions, which occurred between the patient and myself.
The model as outlined by Egan (1994, p.22) details three stages to the helping process, which “overlap and interact with one another”; the first stage aims to help the patient “identify, explore, and clarify their problem situations”. Jones (1998) states that this initial stage promotes and facilitates the “exploration and identification” of problems which are faced by the patient. Egan (1994, p.23) reports that the second stage intends to help the patient highlight “goals and objectives”, and recognise different options and choices available in overcoming their problems. The third stage of the model is involved in “identifying strategies for movement from the present to the preferred scenario” (Jones, 1998); Egan (1994, p.24) states that the purpose of this stage is to help the patient determine “ways of achieving results”. Cutcliffe (1997) suggests that this model empowers the patients, by requiring them to actively participate, which helps them to “gain a critical understanding of their problems” and also offers responsibility. Such empowerment can help the patient to feel more in control (Gibson, 1991), perpetuate feelings of hope (Miller, 1989) and improve the patient experience (Downie et al, 1990).
Summary of Chapters
Introduction to the therapeutic nurse-patient relationship: Defines the therapeutic relationship as the cornerstone of modern nursing practice, citing key definitions from nursing theorists.
Theoretical models of nursing intervention: Introduces the 'skilled helper model' and 'six-category intervention analysis' as frameworks for managing patient interactions.
Practical application and case study: Howard: Details the specific case of Howard, an unemployed patient struggling with stress and mental health, to demonstrate real-world application of nursing theory.
Factors of diversity in nursing practice: Examines how age, culture, and gender differences affect the therapeutic alliance and the necessity of avoiding stereotypes.
Professional boundaries and power dynamics: Discusses the inherent power imbalance in nursing and the crucial role of boundaries in fostering safety and professional integrity.
Conclusion and reflective synthesis: Summarizes the importance of reflection on diversity and theoretical models to improve patient care outcomes.
Keywords
Therapeutic relationship, Nurse-patient interaction, Skilled helper model, Six-category intervention analysis, Mental health nursing, Professional boundaries, Diversity, Patient empowerment, Clinical placement, Holistic care, Communication skills, Power imbalance, Reflective practice, Healthcare ethics, Patient-centred care.
Frequently Asked Questions
What is the fundamental focus of this assignment?
The assignment explores the impact of diversity between nurses and patients and how these factors influence the development and effectiveness of the therapeutic relationship.
What are the primary thematic areas covered?
The core themes include nursing communication models, the influence of personal diversity (age, gender, culture), the management of professional boundaries, and the dynamics of power in care.
What is the central research aim?
The aim is to evaluate how applying specific helping models and maintaining professional sensitivity can improve outcomes for patients in mental health nursing.
Which scientific models are utilized in this work?
The author primarily applies Egan’s ‘skilled helper model’ and Heron’s ‘six-category intervention analysis’ to evaluate the interactions with a specific patient.
What topics are discussed in the main body of the text?
The main body covers the theoretical basis of therapeutic alliances, specific case reflections, the challenges posed by diversity, and the importance of maintaining professional boundaries.
Which keywords best characterize this work?
Key terms include therapeutic relationship, nursing communication, mental health nursing, professional boundaries, and patient empowerment.
How does the author maintain patient confidentiality during the case study?
The patient is referred to as "Howard" throughout the essay, and explicit consent was obtained to use his case data in accordance with the Nursing and Midwifery Council's code of conduct.
What specific challenge regarding diversity did the author face with "Howard"?
The author identifies an age gap of eighteen years as a significant factor of diversity, which Howard initially perceived as a lack of life experience, leading to him being dismissive of the author's input.
- Quote paper
- Timothy John Whittard (Author), 2007, Nursing Therapeutics. The impact of diversity between nurse and patient within the confines of the therapeutic relationship, Munich, GRIN Verlag, https://www.grin.com/document/470792
