Interpersonal Relationship Essay

Introduction Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. American Nurses Association (ANA) An interpersonal relationship is an association between two or more people that may range from fleeting to enduring. (http://en.wikipedia.org/wiki/Interpersonal_relationship). Seemingly to Hildegard Peplau, nursing is an interpersonal process because it involves interaction between two or more individuals with a common goal. Peplau, emphasized the nurse-client relationship as the foundation of nursing practice. A therapeutic nurse-patient relationship is defined as a helping relationship that’s based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient’s physical, emotional, and spiritual needs through your knowledge and skill. This caring relationship develops when you and your patient come together in the moment, which results in harmony and healing. Effective verbal and nonverbal communication is an important part of the nurse-patient interaction, as well as providing care in a manner that enables your patient to be an equal partner in achieving wellness. (Pullen & Mathias 2010) Patient-centered communication is a basic component of nursing which facilitates the development of a positive nurse-patient relationship and along with other organizational factors, results in the delivery of quality nursing care. In most instances, a nurse plays an essential role in the life of a patient. The concerns and cares they give to their patients is a big factor that uplifts each one’s spirit, therefore the goal of the nurses of Olivarez College BSN IV is to create a harmonious relationship between their patients through a well organize and meaningful interactions. The study of the relationship between patient and nurse is important to see how efficient a patient recovers, to understand his illness fully; whether there’s a chance of recovery or nothing to expect at all. Moreover, the role of the nurse is to lessen the emotional and physical pain of every patient. In dealing with these, a need for better communication strategies and methods should be applied. There may be some existing practices exercised by hospitals for their nurses and patients, but a thorough study to improve it better is an advantage. (Cruz, JA 2010) One good way of communicating with a patient is by merely listening to them. Letting them express their thoughts and anxieties may help them feel better. Furthermore, an understanding smile, a good sense of humor, a compassionate outlook and friendly gestures can alleviate their pain and anxiety. The focus of this research is the patient’s perception of an effective nurse-patient relationship. The most common method of interaction is communication. Communication is the sending of ones information to another and may be done verbally or non-verbally. Background of the Study An internal problem of nurses is common. There are so many things to adjust especially working with people that they knew for the 1st time. An interpersonal problem not only occurs with co-workers, it can also be applied with nurse-patient relationship. Everyday different types of patient are being encountered by the nurses. This study gives interest to the researchers to develop and enhanced interpersonal skills and confidence during nurse-patient interaction in the area. Mostly, nurses do not practice good communication skills because of low-self esteem to deal with the patient, resulting to the insufficient gathering of important details and information on the patient’s data. Nursing students should practice well on developing nurse-patient relationship to be an effective and a qualified nurse. Nurse has important role enhancing communication skills. Nurses play an important role in health communication. They are the ones who are always in close contact with the patients. Having effective communication skills and being able to employ them in communicating to the patients is very essential for every nurse. A nurse must be able to communicate effectively to the patient, its family and their co-workers, as well. It is important for health care personnel to understand the doubts, fears and the anxieties of the patients who come to them for treatment. It is equally important to talk in an understanding tone to those who have not voiced their fears but are obviously scared. Patience is also essential in dealing with hard headed and unbeliever patients especially when the patient is suffering and in pain during medication and they tend to refuse taking medicines anymore. Nurses feel a sense of accomplishment when they give a positive influence on their client’s health status. Learning experiences with simulation offer the nursing student an opportunity to further develop knowledge, skills and critical thinking abilities prior to practicing in the clinical setting. Role play, as well as manikin use, can enhance the nursing student’s ability to respond to a variety of patient care scenarios before actually encountering them in the clinical setting (Billings & Halstead, 2005). Active learning with immediate feedback reinforces the nursing student’s performance and confidence in relating to patients and other professionals in the healthcare setting (Billings & Halstead, 2005). A student nurse can easily relate to the situation of their patients in terms of their know-how and further sturdy of their illnesses. This study aims to know how patients can perceive and cooperate for the fulfilment of their rehabilitation. Cutcliffe and McKenna (2005) reported that during treatment, hospital and community patients interact more with nurses than with any other health professional in the multidisciplinary team. These authors also highlighted that nurses are continuing to expand their role into medical and even surgical practice. Nursing proves as difficult to define as ‘care’, which means that the role of the nurse and how it is differentiated from other health professions is often misunderstood. Perhaps nurses provide care and doctors provide tre atment, but (McMahon 2007) argues that neither addresses the skills and knowledge needed in modern nursing to provide good-quality care, nor explains why students take three years to train before they become qualified nurses. Since Florence Nightingale’s time, nursing could be seen as having moved from a task-oriented practice towards a therapeutic process that encompasses a wide range of nursing roles, focused on the individual patient and his or her health and well-being. (McMahon 2007) attempts to define therapeutic nursing abilities as being characterized by six skills: developing the nurse-patient relationship; caring and comforting; using evidence-based physical interventions; teaching; manipulating the environment; adopting complementary health practices. These are all the skills developed by nurses during their pre-registration education; all of them demand good communication skills for effectiveness. It appears that this argument supports the notion that ‘nursing’, in addition to the applied knowledge and attitude, is underpinned essentially by communication skills. Review of Related Literature and Studies FOREIGN The relationship between the nurse and the patient is often seen as a therapeutic relationship in itself that is based on partnership, intimacy, and reciprocity (McMahon, 2007). Its purpose is different from a social relationship in that it has a focus on the patient’s well-being as a priority, and the nurse and the patient do not need to have anything in common or even like each other (Arnold and Boggs, 2006). This relationship can last only five minutes in an accident and emergency department or primary care practice, or can continue and develop for months or years during chronic illness management. It can be intensely personal when breaking bad news, or quite superficial such as when directing a patient to the appropriate clinic room. However, all of these scenarios are nurse-patient encounters that impart to the patient something of the support and meaningfulness of their engagement with health care. They tell the patient whether they are viewed as important and valued, and whether they will be listed to or discriminated against. Since Florence Nightingale’s time, nursing could be seen as having moved from a task-oriented practice towards a therapeutic process that encompasses a wide range of nursing roles, focused on the individual patient and his or her health and well-being. (McManhon 2007) attempts to define therapeutic nursing abilities as being characterized by six skills: developing the nurse-patient relationship; caring and comforting; using evidence-based physical interventions; teaching; manipulating the environment; adopting complementary health practices. These skills are developed by nurses during their pre-registration education; all of them demand good communication skills for effectiveness. It appears that this argument supports the notion that ‘nursing’, in addition to the applied knowledge and attitude, is underpinned essentially by communication skills. For instance, reticence from the others may prompt encouraging remarks of prompt questioning timing of social responses: This requires the communicator to know when to speak, when to listen, when to interrupt or prompt, or when to take the lead or be led. Self-presentation: A good communicator has self-awareness and is able to use this self-knowledge to present themselves to the other. This gives the other feedback about who the communicator is and therefore how to interpret and respond to them. For instance, sitting in a forward-leaning position assures the other that they are being listened to. Rewardingness: This is the ability to engage the other in the communication and know how to reward communication behaviour. For instance, using nods, smiles, and eye contact encourages someone to talk about themselves. For instance, if they realize that being dressed formally is off putting to a young teenager, they can respond by removing a tie or rolling up their sleeves. Argyle breaks communication skills down into behavioural skills rather than skills of insight, understanding, and cognition. Another definition of good communication comes from (Becker et al.) who suggest that skilful communicator ‘must be able to identify the emotions or intent expressed by the other person and make sophisticated judgements about the form and timing of the appropriate response ‘. In this definition, the skilled communicator uses accurate perception and good judgement to understand the interactions and know how to make appropriate judgements. It may be that all of these factors are part of the skills of a good communicator–that skills are made up of a good sense of reality, awareness of self and others, accurate reading of situations, good timing, and ability to use the self to facilitate meaningful and positive communication. Many of these skills can be learnt and developed through the practice and through personal development by improving self-awareness, and awareness and understanding of other people and heir cognitive and emotional states. Related Studies Patients’ Perceptions of Interpersonal Continuity of Care by Nancy Pandhi, MD and John W. Saultz, MD (2005) this is the qualitative and quantitative study of Interpersonal continuity of care is important to a majority of patients, particularly those from vulnerable groups. Patients value the relationship with their physician, their physician’s knowledge about them, and the ability to communicate their concerns. Over time, contact with a physician seems to lead to the development of trust and confidence. However, continuity of care is not valued by all patients or across all settings. Nurse-patient relationship: analysis of problems Encountered by the nursing students of Olivarez College (2010). In this study the purpose of descriptive studies is to observe, describe and document aspects of a situation as it naturally occurs and sometimes to observe as a starting point for the hypothesis be it as general or theory development. The survey analyzed the data of the faculty needs of the nursing college department, the degree on which these needs were met. Synthesis Patients’ Perceptions of Interpersonal Continuity of Care by Nancy Pandhi, MD and John W. Saultz, MD (2005) this is the qualitative and quantitative study of Interpersonal continuity of care is important to a majority of patients, particularly those from vulnerable groups. Patients value the relationship with their physician, their physician’s knowledge about them, and the ability to communicate their concerns. Over time, contact with a physician seems to lead to the development of trust and confidence. However, continuity of care is not valued by all patients or across all settings. The studies utilized results quantitative (19/36), qualitative (16/36), or mixed methods (1/36). The largest number of the studies (15/36) took place in the United States. Several took place in the United Kingdom (8/36), The Netherlands (4/36), and Canada (4/36). The remainder took place in other European countries (2/36), Australia (2/36) or both the United States and England (1/36). All recruited patients from ambulatory settings. A summary of results from these studies regarding our contextual questions is reported below. Nurse-patient relationship: analysis of problems Encountered by the nursing students of Olivarez College (2010). In this study the purpose of descriptive studies is to observe, describe and document aspects of a situation as it naturally occurs and sometimes to observe as a starting point for the hypothesis be it as general or theory development. The survey analyzed the data of the faculty needs of the nursing college department, the degree on which these needs were met. According to researchers, this study is a qualitative phenomological research to a patient-centered communication is a basic component of nursing which facilitates the development of a positive nurse-patient relationship and along with other organizational factors, results in the delivery of quality nursing care. In most instances, a nurse plays an essential role in the life of a patient. The concerns and cares they give to their patients is a big factor that uplifts each one’s spirit, therefore the goal of nurses of Olivarez College BSN IV is to create a harmonious relationship between their patients through a well-organized and meaningful interactions. Theoretical Framework This study is based on Hildegard Peplau’s Theory of Interpersonal Relations. The Theory of Interpersonal Relations is a middle-range descriptive classification theory. It was influenced by Henry Stack Sullivan, Percival Symonds, Abraham Maslow, and Neal Elger Miller. The four components of the theory are: person, which is a developing organism that tries to reduce anxiety caused by needs; environment, which consists of existing forces outside of the person, and put in the context of culture; health, which is a word symbol that implies forward movement of personality and other human processes toward creative, constructive, productive, personal, and community living. The nursing model identifies four sequential phases in the interpersonal relationship: orientation, identification, exploitation, and resolution. The orientation phase defines the problem. It starts when the nurse meets the patient, and the two are strangers. After defining the problem, the orientation phase identifies the type of service needed by the patient. The patient seeks assistance, tells the nurse what he or she needs, asks questions, and shares preconceptions and expectations based on past experiences. Essentially, the orientation phase is the nurse’s assessment of the patient’s health and situation. The identification phase includes the selection of the appropriate assistance by a professional. In this phase, the patient begins to feel as if he or she belongs, and feels capable of dealing with the problem which decreases the feeling of helplessness and hopelessness. The identification phase is the development of a nursing care plan based on the patient’s situation and goals. The exploitation phase uses professional assistance for problem-solving alternatives. The advantages of the professional services used are based on the needs and interests of the patients. In the exploitation phase, the patient feels like an integral part of the helping environment, and may make minor requests or use attention-getting techniques. When communicating with the patient, the nurse should use interview techniques to explore, understand, and adequately deal with the underlying problem. The nurse must also be aware of the various phases of communication since the patient’s independence is likely to fluctuate. The nurse should help the patient exploit all avenues of help as progress is made toward the final phase. This phase is the implementation of the nursing plan, taking actions toward meeting the goals set in the identification phase. The final phase is the resolution phase. It is the termination of the professional relationship since the patient’s needs have been met through the collaboration of patient and nurse. They must sever their relationship and dissolve any ties between them. This can be difficult for both if psychological dependence still exists. The patient drifts away from the nurse and breaks the bond between them. A healthier emotional balance is achieved and both become mature individuals. This is the evaluation of the nursing process. The nurse and patient evaluate the situation based on the goals set and whether or not they were met. The goal of psychodynamic nursing is to help understand one’s own behavior, help others identify felt difficulties, and apply principles of human relations to the problems that come up at all experience levels. Peplau explains that nursing is therapeutic because it is a healing art, assisting a patient who is sick or in need of health care. It is also an interpersonal process because of the interaction between two or more individuals who have a common goal. The nurse and patient work together so both become mature and knowledgeable in the care process.