Critical Reflection on Dialogues Essay

My journey to nursing began with my personal healthcare experience, and has continued to evolve since entering the nursing program at State University. My personal philosophy of nursing is related my life experience and my personal philosophy of life. Using reflection-on-action, I have begun to understand the influences that have lead me to nursing. I discovered client and family centered care to be an important quality when I look at the influential nurses in my life. To develop a positive therapeutic nurse-client relationship, nurses must integrate all 5 dimensions of the therapeutic nurse-client relationship into their practice (CNO, 2006). When it comes to providing client-centered care, the dimensions of trust, empathy

Communication involves information being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a number of communication skills; which in a nursing context generally focuses on listening and giving information to patients (Weller 2002). This process of sending and receiving messages has been described as both simple and complex (Rosengren 2000 in McCabe 2006, p.4). It is a process which is continually utilised by nurses to convey and receive information from the patient, co-workers, others they come into contact with and the patient’s family.

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

This assignment will explore and critically evaluate the role of the registered nurse in the development of a plan of care that is patient centred. This will involve examining and critically analysing the chosen nursing model in a holistic assessment of the patient and the use of the nursing framework ASPIRE (Barrett, Wilson and Wollands, 2012).

Therapeutic communication is seen as a complex skill that involves much subtlety and requires a range of different approaches (Jones, 2009). The importance of therapeutic communication and professional relationships with patients as a prime means of attaining healthcare treatment found to be the underlying theme in interpersonal relationships ( Arnold and Boggs, 2011). Therapeutic communication can create a nurse-patient relationship that enhances choice and responsibility, improves patient input and cooperation and thereby maximizes care outcomes (Rosenberg and Gallo-Silver, 2011). By integrating knowledge with compassion, the skill of therapeutic communication is regarded as the nurse’s greatest asset in reducing stresses and establishing a bond (Rosenberg and Gallo-Silver, 2011). Therefore, person-centred communication is regarded as the mandatory fundamentals in health professions (O’Toole, 2012). Attaining person-centred communication is often challenging and it is essentially required in health professions (O’Toole, 2012). One of the important basis for patient-centred communication is the effective listening (O’Toole, 2012). This essay briefly explains the various components of active listening skills that enhance therapeutic communication. Finally this essay concludes with a self-assessment of the current knowledge and skills that the author possess, followed by a development plan that shows the goals and strategies that can be used to improve author’s active

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

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.

The objective of therapeutic communication in family nursing is to provide the family with guidance and support. Effective communication between the nurse and family is vital because it will help the nurse to develop trust from the family, as this is one of the most important and influential factors (Wright, & Leahey, 2013). Therefore, nurses should be aware that the family and/or patient must feel respected and confident

Health facilities aim to achieve client satisfaction of care through every health profession worker despite directly providing care or not. As the patient, subjective experience will define the patient perception across the continuum care. Consequently, person centered care technique through communication enables the nurse to give more effective nursing care to patients. As everyone in the healthcare service works in partnership, to deliver care responsive to the patient’s individual abilities, needs, preferences and goals.

Develop an alliance by using caring gestures to the family. Asking caring, sensitive and perceptive questions convey sincere concern for the patient and will help develop trust with the family

In any practice of care, nurses must be able to provide care that is holistic and centred to the individual client. According to the World Health Organisation (WHO), to care for a patient ‘holistically’ is to look beyond their illness or disability and care for them as individuals considering not just physical but also their mental, emotional and spiritual well-being (ref). Whilst, person-centred care is to deliver care moulded to the patients’ personal preferences, treating them with value and respect, ensuring that the care provided is appropriate for their needs (Goodrich and Cornwall, 2008).

Today, Eli and I decided to try and invent something, ''to help people working in fields to be able to pick seeds out of cotton easier,'' said Eli I have been his assistant for years now.

Effective communication in the healthcare setting improves recovery rates and reduces pain and complication rates. (Wilkinson et al, 2003). Many complaints to the NHS are attributed to poor communication. Effective communication is reliant on the nurse working in partnership with the patient. It is essential that the nurse establishes a rapport and most of this will be achieved through the use of facial expressions. In my practice, it is important that develop a therapeutic relationship with the patients so that they can be able to put their trust in me. The therapeutic relationship is solely to meet the needs of the patient. In this relationship, there is a rapport established from a sense of mutual understanding and trust. To build a good nurse-patient relationship, I would have to show qualities of empathy, caring, sincerity and trustworthiness. During practice, if I am approaching a patient and the patient looks anxious, I should approach with empathy.

“Family-centered care” is a term heard often in healthcare settings and in nursing practice. Family-centered care has been recognized as being an integral part to patient health, satisfaction and health care quality (Kuo, et al, 2012). Family-centered care is implemented with the goal to increase partnerships between, families, patients and providers; and has been prioritized as a core-concept of quality healthcare (Gallo, Hill, Hoagwood & Olin, 2016) Many professionals, however, would be hard-pressed to state what the term “family-centered care” actually means and how it applies to nursing practice. They would be at a loss for how to implement family-centered care and what is absolutely necessary to have in order for family-centered care to be successful. Advanced practice nurses are faced with the challenge of adhering to family-centered care in their practice. Illness, both chronic and acute, and health does not just affect the patient involved in care. Illness and health affect the patient, their children, their spouses, their parents, their brothers, their sisters, their grandparents and anyone else involved in their life. Research by Davidson (2009) supports the idea that the perceived effectiveness of communication between healthcare providers and the patient’s family is related to the overall satisfaction of care. Advance

Therapeutic Communication has a huge impact on patients, whether, we, as nurses, see it or not. It is very important for a nurse to gain a patient’s trust. Many patients are already filled with sadness, nervousness and unsure thoughts of their current situation. Such thoughts may make a person scared to trust or open up to a nurse or doctor. Developing a close rapport with a patient can help to create a safe, warming environment, resulting in a positive experience throughout their time in the hospital or even nursing home. In “Therapeutic Communication”, Anna Lauria opens saying, “What we say or do not say can influence whether a client is able to quiet his mind, relax his body and initiate a healing response” (Lauria). Being a nurse, we automatically have the opportunity to create a strong influence on patients’ lives during, and even after, their hospital experience.