This essay aims to identify, explore and discuss the therapeutic goals of working with a patient I encountered during past clinical practice, and the challenges associated in meeting the goals and needs of the patient; this is achieved through reflection and the consideration of the behaviour of the patient, the responses of the nursing team, and a plethora of other factors inherent within the healthcare service itself.
Table of Contents
1. NT3 – The Management of Therapeutic Challenges
Objectives & Topics
This essay explores the complexities of building and maintaining a therapeutic nurse-patient relationship within an acute mental health setting. It examines the impact of clinical challenges, such as aggressive behaviour and non-concordance, on both the patient’s recovery and the healthcare professional’s practice.
- The importance of the therapeutic relationship as a cornerstone of nursing care.
- Challenges in establishing rapport with patients exhibiting psychosis and paranoia.
- The impact of authoritative interventions, such as physical restraint, on the therapeutic bond.
- Strategies for managing staff stress, burnout, and negative labelling of patients.
- The critical role of clinical supervision in maintaining high-quality patient care.
Excerpt from the Book
NT3 – The Management of Therapeutic Challenges
The following assignment aims to identify, explore and discuss the therapeutic goals of working with a patient I have encountered during past clinical practice, and the challenges associated in meeting the goals and needs of the patient; this will be achieved through reflection and the consideration of the behaviour of the patient, the responses of the nursing team, and a plethora of other factors inherent within the healthcare service itself. This is important, as Shafer (1997) highlights that although the field of mental health nursing is an “exciting” arena in which to work, it also presents nurses with a wealth of challenges. The interpersonal exchanges and communication processes that occurred between the nursing team and the patient will be analysed, with the hope of recognising interactions and interventions which were effective, as well as identifying those which were ineffective (Caris-Verhallen et al, 1999). This is significant, as Miller (2002) reports that good communication facilitates the development of good interpersonal relationships, and is also considered to be a critical factor in the growth of a “positive nurse-patient relationship” (McCabe, 2004).
The seminal work of Peplau (1952) asserts the importance of an effective and successful ‘therapeutic relationship’ between nurse and patient in the delivery of holistic, high quality, patient-centred care; accrediting this interpersonal phenomenon with the ability to improve outcomes for both nurse and patient. Such relationships between patients and those caring for them can be argued to provide the “backbone upon which all other care is delivered” (Forchuk, 2002); and significantly, Graham (2001), Hewitt and Coffey (2005), Lauder et al (2002) and Welch (2005) all concur that the therapeutic relationship forms the “cornerstone” of good nursing practice. The establishment of such a relationship is a “pivotal factor in the treatment and recovery of patients” (Ramjan, 2004); and is, according to Davis and Lysaker (2007), Hewitt and Coffey (2005), Horvath and Symonds (1991) and Martin et al (2000) highly conducive to the improvement of outcomes for patients.
Summary of Chapters
1. NT3 – The Management of Therapeutic Challenges: This section introduces the core theme of the therapeutic relationship in mental health nursing and outlines the clinical scenario involving the patient, Jemaine, while grounding the discussion in established nursing theory.
Keywords
Therapeutic relationship, Mental health nursing, Psychosis, Clinical practice, Patient-centred care, Communication, Physical restraint, Clinical supervision, Trust, Therapeutic goals, Reflective practice, Professional conduct, Mental Health Act, Nurse-patient interaction, Patient advocacy.
Frequently Asked Questions
What is the primary focus of this assignment?
The assignment focuses on identifying and discussing the therapeutic goals and clinical challenges associated with caring for a patient within an acute mental health inpatient setting.
What are the central themes discussed in the text?
The central themes include the significance of the therapeutic relationship, the impact of patient behaviour on nursing practice, the use of authoritative interventions like restraint, and the prevention of staff burnout through clinical supervision.
What is the core research objective?
The core objective is to reflect on the effectiveness of nursing interactions and interventions in the face of challenging patient behaviours, aiming to improve future nursing practice and patient outcomes.
Which scientific methodology is employed?
The work utilizes a reflective approach, analysing personal clinical experience in conjunction with established academic literature and psychological theories regarding nurse-patient interactions.
What is covered in the main body of the work?
The main body examines the specific case of the patient 'Jemaine,' discusses the barriers to building rapport, evaluates the necessity of physical restraint, and addresses the dangers of labelling patients in healthcare settings.
Which keywords best characterize this work?
Key terms include therapeutic relationship, mental health nursing, psychosis, clinical supervision, patient-centred care, and reflective practice.
How does the author address the issue of patient confidentiality?
The author adheres to the Nursing and Midwifery Council (2004) code of conduct by using the pseudonym 'Jemaine' to protect the patient's identity throughout the essay.
What role does clinical supervision play in this context?
Clinical supervision acts as a vital forum for staff to discuss their feelings of inadequacy or resentment, ensuring that personal stress does not negatively impact the care provided to patients.
How does the author view the use of physical restraint?
The author acknowledges physical restraint as a highly distressing and traumatic intervention, arguing that while sometimes necessary, it can cause significant damage to the therapeutic relationship if not handled with empathy and communication.
What are the consequences of labelling patients?
Labelling leads to 'malignant alienation,' where healthcare professionals begin to view patients as unreasonable or troublesome, which may ultimately result in a withdrawal of care and support.
- Quote paper
- Timothy John Whittard (Author), 2008, Therapeutic goals and challenges of meeting the unmet care needs of a patient, Munich, GRIN Verlag, https://www.grin.com/document/470793
