Establishing A Therapeutic Relationship: A Structured Reflection

1724 words - 7 pages

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Establishing a Therapeutic Relationship: A Structured ReflectionA purposeful and goal-directed therapeutic relationship between a nurse and client is grounded in an interpersonal process that strives for advancing the best interests and outcomes for the client (Registered Nurses' Association of Ontario, 2002). Building a trusting relationship is based on "being with," and not "doing to,"' the client in the most caring way possible. Communicating with care is a holistic approach requiring the recognition of the client as a person and not a mere body requiring nursing interventions (Balzer Riley, 2008, p.12). This reflection will examine the relational abilities in establishing a therapeutic relationship within a pre-taped clinical scenario. Through structured reflection, the nurse's image of nursing as portrayed within her therapeutic relational behaviors will be discussed as well as the meaning for both parties involved.In the video scenario a young adult male is sitting on an examination table awaiting the arrival of Dr. Smith. The presented scenario demonstrated a lack of professionalism and caring attitudes from the attending female nurse. Without knocking on the door, her entrance was intrusive, unannounced and careless as the door slammed against the wall. Without introducing herself, the client expressed immediate concern stating, "I came here to see Dr. Smith" and her response was, "yeah, yeah he's coming." With the door open and no discussion or eye contact, she immediately instructed the male client to take his shirt off for a blood pressure check. She explained she was taking his blood pressure and the client continued to ask pertinent questions such as, "Do you know if I'll have to go in the hospital? I need at least a doctor's note" and she parroted "yeah, yeah." She overinflated the ill-fitting cuff until it blew off and she stated "ugh, the cuff's not quite big enough for your little arm." Her task-oriented nature was overpowering the client's needs to heard and validated. The client describes his symptoms of pain in the abdomen, headaches, nausea and an upset stomach that seem to be authenticated by his actions of being stooped over in pain with his arms clenching his stomach. The nurse continues her assessment and becomes overly focused on the client's alcohol use and she gives her personal opinion, "You still drinkin'? Yeah well maybe if you wouldn't drink, it would be helpful eh? It's the drinking eh?" The client is noticeably uncomfortable as she asks him repeatedly why he is at the clinic. Upon finding out he is a cigarette smoker the nurse snidely says under her breath, "Just havin' a good time eh?" When he makes reference to his stomach she rudely remarks "well you got lots of it anyway." She asks him what medications he takes and she exits the room in a rush while still speaking to him. Particular issues that are significant to pay attention to are: the lack of a proper introduction or connection, not listening,...

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