Identify Four Therapeutic Communication and/or Professional Boundary
Introduction
Attending to patients can be rewarding as well as fulfilling, nonetheless, in some cases, it becomes emotionally and physically exhausting. Nurses take care of patients while at the same time doing customer service. Upholding a professional, well-mannered interactive relationship may be a bit challenging. However, this is critical in a patient’s general health and well-being. Creating a healthy nurse-patient relationship is significant, in the sense that it allows the nurse to closely monitor the patient, encourage and to also offer the best services to the patient. In most cases, patients lose hope, thus it takes the effort of the nurse to encourage the patient hence bringing the patient’s hope back to life. In as much as nurses are supposed to create a close professional relationship with patients, it is necessary to understand the personal boundaries, because some patients have a preference for not being touched. For that reason, this paper will address poor nursing practice, professional boundaries, and how they may affect patient safety and patent-nurse relationship.
Errors the Impact on Patient Safety
- The nurse has not put a scrub and a cap thus exposing her hair.
- Poor Communication Skills by the Nurse
Impact of the Errors on Patient Safety
The nurse as seen in the video has not put on proper dressing for her job. As a professional nurse, one is supposed to put on a lab coat, or a scrub, and a nursing cap. In Sandra’s case, the nurse was not wearing a cap, even though she had long hair which made her turn her head from time to time (UTS Health, 2018). While entering the ward, the nurse had not properly kept her hair, prompting the patient to ask her questions concerning her safety. Similarly, the patient seemed irritated by the fact that the nurse was not wearing a cap, and when asked about it she did not seem to care. Leaving the hair exposed can carry germs, as well as dust which may not be healthy for the patient. The patient was also asthmatic, and small particles of hair or even dust coming from the nurse’s hair could affect the patient’s health.
As seen in the video, the nurse shook her head, before tying her hair by so doing, some pieces of hair could have easily fallen from her head, and they may have entered the patient’s body while she was breathing. The nurse should have consequently worn a cap, to avoid negatively affecting the patients’ health. On the other hand, while testing the patient’s blood pressure, the nurse openly tells the patient she does not remember how to use the sphygmomanometer (UTS Health, 2018). The nurse then goes ahead to tell the patient that the measurement does not have to be accurate, thus she gives her an estimated measurement. As a professional nurse, one is supposed to communicate professionally, thus enabling the patient to feel secure while at the hand of the caregiver (Ulutasdemir, 2018). In this case, the nurse did not follow these guidelines but instead decided to do things differently. Likewise, taking an estimated measurement of a client’s blood pressure is detrimental to the patient’s health, for the reason that the patient was suffering from PV bleeding. Presenting false or a measurement that is not appropriate could easily put the patient’s health at risk because the treatment administered would be based on the patient’s blood pressure (Perry, Potter & Ostendorf, 2016). If the patient’s blood pressure higher than the recorded measurement, then the drug administered may not work properly, or else the wrong drug may be administered hence negatively affecting the patient’s health.
Errors Impacting Nurse/Patient Relationship
- The Nurse did not put the Patient First, in that the Patient was not her Main Priority.
- The Nurse exceeded social Limits
Impact of Errors on Patient/Nurse Relationship
When it comes to a patient-nurse relationship, the nurse did not use proper language while communicating with the patient. Also, the patient did not put the patient first, and she would even check her phone while addressing the patient. More so, to be close to the patient, the nurse would regularly move closer to the patient. Nurses are required to be active listeners, to understand the intent, feelings, and the contents of the patient. This was not, however, the case with the nurse, as she kept on talking from the moment she entered the ward, to the moment she left. She did not seem to care about the patient’s feelings, because she did not ask the patient basic questions as it required of a nurse (Perry, Potter & Ostendorf, 2016). Furthermore, the patient was not given the chance to express herself, how she felt, and how she was fairing on. In this situation, the patient was not comfortable at all with the nurse, and she would have preferred not to disclose significant information to the nurse. Besides, the nurse would also tell the patient information about her fiancée, to the point where she would show her the pictures in her phone. In so doing, the nurse breached the requirements of a nurse which is to focus on the patient’s needs rather than sharing personal information (Finkelman, 2009).
Maintaining eye contact with the patient is a good practice which all nurses are supposed to have, nonetheless, this was not the case with the nurse. Furthermore, the patient should smile, and use a calm and welcoming voice while communicating with the client (Taylor, 2012). The nurse is also required to understand who the patient is through proper communication which enables the patient to feel comfortable and while receiving the care as well as treatment. Through practicing these approaches, the patient easily bonds with the nurse, enabling the nurse to understand changes in the patient’s reaction and response to medication (Webb, 2020). In Sandra’s case, she decided to delve deeper into the patient’s personal life, and would go ahead and ask her about the person she was dating (UTS Health, 2018). The actions of the nurse did not help in creating a bond between the patient and the nurse, but it seemed to break the bond further. This is so because, the patient felt insecure, and would not easily disclose information, due to the fear of getting a negative review from the nurse who did not seem bothered by the patient’s feelings.
In as much as nurses are supposed to be close to patients, they should observe certain limits. For instance, a nurse is not supposed to be too attached to the patient, as this may lead to affection, in a situation where a nurse is a man and the patient is a lady (Ujhely, 2013). This goes against the dictates of professional nurses, thus they should keep distance when it comes to matters relationships. A nurse is required to be clear concerning the boundaries, hence in if a patient indulges the nurse in a close relationship then the nurse has the authority to cut off the communication based on the codes of ethics. In Sandra’s situation, she overstepped her mandate of taking care of the nurse, and instead ended up creating a bad picture of nurses (UTS Health, 2018). The patient would rate all nurses based on how she was treated by a single nurse. On the contrary, sitting too close to the patient was also not right since some patients do not prefer when someone else is too close to them. Patients lack confidence in nurses who move close to them or even touch them, a factor which eventually affects the patient’s response to treatment.
Conclusion
Professional nurses are supposed to maintain a close relationship with their patients in a bid to enhance the care and treatment given to the patient. The nurse should also communicate with the patient clearly and concisely hence winning the patient’s confidence thus making it easier for the patient to tell the nurse about her condition. Moreover, just as discussed in the paper, the nurse is supposed to speak to the patient in a calm and welcoming manner, while at the same time understanding the mood and attitude of the patient. In so doing, the patient can easily create a good relationship with the patient, thus allowing the patient to respond to medication positively. On the other hand, a nurse should not be too attached to the patient as this might lead to the affection which is wrong according to the code of ethics.
References
Alvinius, A. (2017). Contemporary leadership challenges. Rijeka: Croatia in Tech.
Bast, R. C. (2017). Holland-Frei cancer medicine. Shelton Conn: People’s Medical Pub
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011). The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press.
Finkelman, A. (2009). Professional Nursing Concepts: Competencies for Quality Leadership. Jones & Bartlett.
Lowey, S. (2019). Nursing Care at the End of Life: What every clinician should know. (product id 23958320). S.l.: OPEN SUNY.
Perry, A. G., Potter, P. A., & Ostendorf, W. (2016). Nursing interventions & clinical skills. St. Louis, Missouri: Elsevier.
Taylor, E. J. (2012). Religion: A clinical guide for nurses. New York: Oxford University Press.
Ujhely, G. B. (2013). Determinants of the Nurse-Patient Relationship. Berlin, Heidelberg: Springer Berlin / Heidelberg.
Ulutasdemir, N. (2018). Nursing. London: IntechOpen.
UTS Health. (2018). 92431 Patient-Nurse Interaction. Retrieved from: https://www.youtube.com/watch?v=gePTPA0wcag&feature=emb_title
Webb, L. (2020). Communication skills in nursing practice. Open University Press.
