Nurse–client relationship
It assists nurses to establish a unique perspective regarding the meaning of the patient's illness, beliefs, and preferences of patients/families.
[3] Any action or behaviour in a nurse-client relationship that personally benefits the nurse at the expense of the client is a boundary violation.
Anything that could comprise the client's well-being if the relationship with a registered nurse is continued or discontinued can be considered a warning sign.
[5] Boundary violations are never acceptable and it is the nurse's job to handle any situation with any regards to it professionally and therapeutically regardless of who initiated it.
[7] Nurses are expected to always act in the best interests of the patient to maintain a relationship that is strictly with all intent to only benefit the client.
Knowledge of person explains that nurses must take the time to understand the client, and their world; what is meaningful to them, and their history.
[9] Effective communication in nursing entails being empathic, non-judgmental, understanding, approachable, sympathetic, caring, and having safe and ethical qualities.
Nurses assist clients to achieve their health related goals including improving their relationship with others.
As mentioned, compassion fatigue hinders the nurses ability to form a therapeutic relationship with the patient.
It offers an opportunity to recognise how our attitudes, perceptions, past and present experiences, and relationships frame or distort interactions with others.
[8] The nurse works to empower the client along with their family to get more engaged in learning about their health and ways in which it can be improved.
[3] Behaving therapeutically may require remaining silent at times to display acceptance, incorporating open ended questions to allow the client control of the conversation and encouragement to continue.
This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences.
[8] A major obstacle to cultural sensitivity and good communication is ethnocentrism, which is the belief that one's ethnic group is superior to another; this causes prejudice and stops a nurse from fully understanding the patient.
[6][8] Nurses need to know the outcome of social, cultural, and racial differences, and how they can affect the therapeutic relationship.
[9] Nurses need to acknowledge the impact of culture in order to practice health in a way that respects a person's beliefs and values.
It includes nurses working with the client to create goals directed at improving their health status.
Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health.
[6] This is a communication-based relationship, therefore, a responsibility to interact, educate, and share information genuinely is placed upon the nurse.
Nurses must intervene and report any abusive situations observed that might be seen as violent, threatening, or intended to inflict harm.
Nurses must also report any health care provider's behaviors or remarks towards clients that are perceived as romantic, or sexually abusive.
For example, one client tested his trust of the nurse by becoming angry with her and revealing his negative thoughts related to the hospitalisation.
The client stated, "she's trying to be quite nice to me ... if she's able to tolerate this occasional venomous attack, which she has done quite well right up to now, it will probably be a very beneficial relationship".
For example, one client stated, "The nurses' general feeling was when someone asks for help, they're being manipulative and attention seeking".
Wiesman used interviews with 15 participants who spent at least three days in intensive care to investigate the factors that helped develop trust in the nurse–client relationship.
Patients said nurses promoted trust through attentiveness, competence, comfort measures, personality traits, and provision of information.
Yamashita, Forchuk, and Mound conducted a study to examine the process of nurse case management involving clients with mental illness.
Astedt-Kurki, Isola, Tammentie, and Kervinen asked readers to write about experiences with humour while in the hospital through a patient organisation newsletter.
One participant stated, "... when you're sick as you can be and do nothing but lie down and another person does everything in her power to help, humour really makes you feel good".
It's extremely hard for them to admit they're afraid".The patient finds it easier to discuss difficult matters when a nurse has a sense of humour.
