A Nurse Patient Relationship Theory

Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.

In my nursing practice I frequently care for long term elderly residents on ventilators and who suffer from stage 3 or 4 pressure ulcers, diabetic, venous ulcers etc. Instead of simply providing pain medications and wound treatment to ease their pain or giving medications to relax them, I wanted to learn ways to enhance the comfort of these residents. This led me to learn more about Katherine Kolcaba’s theory of comfort. I found her theory to be useful in understanding the theory of comfort. Hence as a nurse, it became important for me to analyze, evaluate and research more on its applicability in the world of nursing and also in other health care disciplines.

Carper (1978) defined personal knowing as the candid personal relation between a nurse and his/her patient. She encourages nurses to place themselves in their patients’ shoes so they will have the sensitivity and awareness to address not only physical needs. This author believes that this is very important because nurses need to empathize with patients and their family members as they go through difficult illnesses. It is important to remember that each patient, their illnesses and their situations are different and thereby we should approach them differently. This author also believes that this pattern of knowledge helps build a relationship and trust with the patient. This confidence and trust ultimately lead to patient being more comfortable and

McCabe C. (2004) Nurse-patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing. 13, 41-49.

Conceptual analysis is integral in understanding nursing theory. According to Walker and Avant (1995), concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. It can be used to evaluate a nursing theory and allows for examination of concepts for relevance and fit within the theory. The phenomena of pain will be discussed in this paper and how it relates to the comfort theory.

The relationship of the advanced practice nurse and the patient, with the patient being a single individual or a family unit, is participative with the focus being on meaning as the nurse practitioner assists the patient to select one of the multitudinous possibilities in a given health situation. The nurse practitioner does not prescribe a patient to a set of interventions alone, but instead the FNP intervenes with active presence and listening to help the patient to identify their own desires for change. Instead of finding what is wrong with the patient, the nurse practitioner asks what the patient wishes to discuss during an encounter. Then, the FNP supports the patient and helps improve the patient’s quality of life through perspective, pattern recognition, and change if the patient desires. Together, the FNP and patient collaborate to achieve patient-chosen health goals.

The comfort theory is a nursing theory that was first developed in the 1990s by Katharine Kolcaba. The Theory of Comfort considers patients to be individuals, families, institutions, or communities in need of health care (Petiprin, 2015). The environment in which this theory can be applied is in any aspect of the patient, family, or institutional surroundings that can be controlled by a nurse or a patient’s loved one by means to enhance their comfort. Health is considered to be optimal functioning in the patient, as defined by the patient, group, family, or community (Kolcaba, 2005).

As a nurse, communication is an essential and important factor to building a therapeutic relationship between a nurse and patient as it is the difference between average and excellent nursing care, as it helps maintain a good quality of life and allows nurses’ and patients to interact and provide comfort when needed. The importance of good communication can become apparent with patients especially when they are in the hospital, as it helps the nurses build a positive relationship with patients and helps overcome barriers including physical, psychological and social. A therapeutic relationship is built on many factors which include both verbal and non-verbal communication which helps maintains the relationship and strengthens it due to the positive impact it has not only on the patient’s experience but also the nurse’s.

Series of interaction amongst nurse-patient and researcher-participant stresses the importance of relationship in an interpersonal process. The nurse-patient and researcher-participant are characterized by their own professional relationship including their own unique features in accomplishing goals. In this paper, I will examine their differences and similarities within the context of interrelationship.

This report aims to discuss the communication observed between the Nurse and Patient portrayed in the video. There are two scenarios in which the Nurse addresses the patient’s concerns. The patient’s response is influenced by the Nurse’s approach. In a health care setting, a personal, empathic yet professional approach is most effective in communication from Nurse to Patient. Furthermore this report assesses the therapeutic techniques used by the Nurse to effectively interact with the patient.

The therapeutic nurse-patient relationship is known as a close and consistent connection approaching during patients’

Nursing theory is the backbone of nursing. It is very important in the application of evidence-based practice (EBP). The functions of a theory are to narrow and provide specific information for the analysis of initially confusing behaviors, situations, and events (Fawcett & Madeya 2013). Moreover, nursing theory helps to improve not only the quality of care that we are providing to our patients but, they also help us make better clinical decisions. As a matter of fact, nursing theory gives the nurse a framework for organizing and analyzing information as well as a base for identifying with their patients throughout the nurse-patient relationship (Schick, 2015). I am very much interested in all the theories. The one that I relate to the most is Hildegard Peplau’s theory. It is a middle range theory that focuses on interpersonal relations. This theory teaches us about how to interact with our patients so that they feel more in control of their treatment. In this paper, I will be talking about the importance of nursing, the summary of Peplau's theory, and how as future nurse practitioners, we can apply it.

Within nursing, there is a very delicate balance between a nurse and her patient that must be maintained if the patient is to receive the care that he or she is entitled to receive. The patient must feel comfortable trusting his nurse to hear his needs and respond to them appropriately and in order for this to be the case, the nurse must first provide therapeutic communication effective enough to elicit such a response in her patient. There are both verbal and non-verbal components within the nurse-patient relationship. These components greatly influence how a nurse and patient will relate to each other and, ultimately, greatly influence the care that the patient receives.

This section presents an analysis of Orlando’s theory. The central thesis of the Theory of the Deliberative Nursing Process is finding out and meeting the patient’s immediate need for help. The concepts and propositions of the theory are written at a concrete level of discussion (Fawcett, & Desanto-Madeya, 2013). The theory is classified as a middle-range predicative theory. The theory identifies the effects of a specific interpersonal nursing process on identification of the patient’s immediate need for help.

The nurse reaction to patient behavior is the true beginning of the nursing process discipline. This is when the nurse uses her clinical skills to help recognize both the verbal and non-verbal communication of the patient behavior. This reaction by the nurse, described by George (2011), happens in “…three sequential parts” (p. 166). First, the nurse must be able to recognize the behavior through her senses. Once this behavior is recognized the nurse has an “…automatic thought” (George, 2011, p. 167). The “…automatic thought” then produces a “…automatic feeling” (George, 2011, p. 167). An example given in George’s (2011) writing helps better understand how this works: