Task: Write a reflective report describing 3 incidences of therapeutic relationship in nursing and how it helped your career.
Case 1: This specific event is the scenario that demonstrates how I succeeded in establishing a curing and a therapeutic relationship in nursing with one of my patients. The patient could not speak since a stroke that she had experienced several years ago. During my fourth semester, I had been in the psychiatric ward with a 3-week hospital assignment in mental healthcare. Patients in the hospital were allowed to move out of the ward during the mealtime to a nearby cafeteria. I found at lunch time that a patient who was 77-year-old at the time and was diagnosed with schizophrenia sits on the bed and does not go out of her ward. She had constant spasms and in her legs and could not control her movements. Such spasms are generally a side effect of the anti-psychotic medication that was administered to her. She had been unable to comprehend this because of her mental condition and became irritated. I introduced myself at first and greeted her in order to establish a therapeutic relationship in nursing her. I told her if she'd like to have lunch or not. She could not move without any assistance because of these spasms and was not able to eat by herself. I searched for her nutrition chart and brought her lunch from the cafeteria to her room. I came to know from her chart that she was on a softer diet because she's having trouble swallowing. I took her approval to feed her thereafter, but she stared at me as if she couldn't understand. I envisioned myself in her state out of sympathy and thought that she might be having impaired hearing because of her age. I rubbed her hand and lifted my voice while making expressions to feed her She acknowledged and nodded to my actions saying yes.. Fortunately, non-verbal interaction in the form of expressions and movements helped me communicate my thoughts to her. When feeding her, I made eye contact with her to demonstrate that I was concerned about her. She ate the food comfortably and loved the meal. I made the correct choice in my assessment to meet the patient and feed her. I utilized my communication abilities to create a relationship of mutual trust and confidence. When a nurse and a patient have a level of trust, it develops a bond that increases self-esteem for the patient. It makes the patient connect well with the caregiver and it was achieved through gestures and behaviour in this situation. Being compassionate, sensitive, and having sensitivity is critical for a nurse. It also involved postures, movements, and facial expressions because our interaction was not verbal. Because she was not able to move and support herself, I visited the patient to express my concern for her. It was my responsibility to look after her. The role of a nurse must not thus be confined to chore-cantered interaction, but effective patient-cantered contact should also be included.
Case 2: I was posted for 3 weeks and was instructed to take care for patients with multiple diseases. One of the patients was a 70-year-old male who was suffering from hyperlipidaemia, gall bladder gangrene, diabetes Mellitus, and hypertension and was at the final stage of renal disease. I found he was alone and didn't mix with rest of the patients He was not visited by any members of the family. I began to understand while talking with him that because of his multiple medical problems he feels he is a burden on his family. Rather than dealing with so many ailments, he wanted to die instead. He also informed me that nobody was concerned about him, cared for and loved him. He stated many times all through our discussions that he didn't want to live. I had sat and listened to him politely, however, at the same moment, there were also signs of suicidal tendencies. I told the doctor in charge of what he had shared with me about his condition and state of depression. I continued to spend more time with him and tried to explain that dying wasn't going to solve his issues. The team began to pay more concern to him and offered him suggestions. I was using the technique of diversion with him and brought him to communicate with everyone. As he announced his wish to die, I felt uneasy, and I empathized with him. His thoughts of suicidal ideation were clear in his speech, and I chose not to dismiss them. He seemed to have a fear of physical dependency that can be resolved by compassionate contact with him. I was quite vigilant towards him as well as polite and respectful. The professional life of nurse must be vigilant, compassionate and gentle with the patients in circumstances like this. Upon discovering their desire to die time after time, we can't express our frustration or scream out to the patient Only when he trusted me, he was able to confide in me about his negative thoughts. I began to build a strong therapeutic relationship in nursing with the patient which allowed me to provide him with the necessary guidance to improve his journey. It really was crucial in his situation to maintain interaction with other individuals as it would provide him with a supportive environment to improve through such an encounter, by consciously communicating with the patient and sympathizing with him, I was able to understand practical therapy skills. With some expressions of compassion and support, an elderly patient is turned into a relaxed and friendly individual from a depressed person. He was normally in a relaxed and happy mood when engaging with me and the hospital staff. He praised me as well as the team members for our caring and moral support on the day he was released.
Case 3: This is an overview of my role in the treatment of a 14-year-old girl, which I believe is an excellent example of good nursing care. I had the opportunity to witness the public health nurse who interacted with a 14-year-old who had been physically abused. First of all, I was very pleased with the manner in which the nurse spoke to the girl. She claimed that she had slipped and got a "black eye" as we evaluated and spoke to the child. Because of this, she could hardly see. I found on her arms and face she had numerous cuts and bruises. She was reluctant to discuss what happened and retreated. As she spoke with the child, I found that the nurse was supportive in her voice. As she interviewed the girl, she was quite compassionate and very kindly inquired if she had any problems at home. The girl answered "No" plainly, however, the nurse didn't push the child for a different response. I noted how the nurse was cautious with the girl and non-threatening. After which, once the girl left, the nurse discussed her views with me. She spent time to help me recognise a lot of details I had forgotten and examine them. I discovered how well the nurse, along with her knowledge, was using her interviewing and examining abilities to understand the actual situation even when the girl told her something else. Only after she had thoroughly examined the circumstance and the information presented to her did she draw conclusions. She didn't reach any judgments and realized she would have to formulate a brief-term plan because she still had insufficient information. Her analytical skills and communicating with me taught me a lot, which is something I would certainly like to master. I have discovered in my training that a therapeutic relationship in nursing is about effective communication, understanding the patient and being a listener who is non-threatening. I witnessed a supportive interaction between a professional and a patient through this case. I've discovered how important it is to look above what the patient tells you, as it is about interpreting the signs before you. It's about letting the patient respect you by calmly speaking to them even though you recognize that opening up to you might require the patient some time. In such a case, the patient may take some time to confide in the nurse to tell the whole truth, but the nurse must be careful in letting them take that time to establish a trusting relationship. The easiest method of expressing compassion is via reflection because you can do it in several forms as a nurse. We have to realize that clinicians have their own problems and therefore should view the information posed to us by the patient. As nurses, we need to understand that distress interaction isn't always going to be oral, but can be in the form of sounds and actions.
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