Relationship Between Nurse And The Nurse

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

In addition to technical support provided to patients, nurses must address the psychosocial challenges and ethical conflicts associated with caring for critically ill patients and their families. More often Nurses are left with dilemmas when it comes to decision making and trying to up holds the ethics of autonomy, who to listen to, the client or the family? Ethically the patient has the right to choose what’s best for self, but is powerlessness when one is brought to hospital in a critical condition.

As nurses we accept the responsibility of caring for the patient therefore, we have to be hold accountable for the care that we provide. It is important for nurses to use their own judgement in accepting responsibility, when to seek consultation and when and what to delegate to others. According to Battie & Steelam (2014), “a prospective nurse should hold themselves accountable for patient advocacy, continuity of care, lifelong learning, to colleagues, the nursing profession, and their organization”.

Relational practice in nursing is critical for developing strong interpersonal relationships that are therapeutic and essential for patient health and well-being. This paper discusses advanced care plans and relevant concepts from Nursing class 260 that contribute to relational practice, which include: Maslow’s hierarchy of needs, health promotion, ethics, collaboration, lifespan, power, culture, communication and interdisciplinary supports. This paper is constructed from a discussion with an individual about their values and beliefs that would influence an advanced care plan, and how the relational concepts can be applied to the conversation and past clinical experiences.

Hildegard Peplau’s middle-range theory, Interpersonal Relations, established in 1948 and highlighted the nurse-patient relationship as the groundwork of nursing practice. Peplau supports each role individually, the nurse and the patient, by ensuring that equal participation is implemented to reach a mutual goal. For example, the role of the patient reflects vulnerability and the expectation to be open to the health care providers throughout care and treatment plan. Subsequently, the nurse is supposed to facilitate a reciprocated relationship by noting the client’s behavior, defining the client’s illness, creating the most proper care for the client, understanding the physician’s treatment plan and confirming it, and intervening when required (Sue Penckofer, 2013).

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.

Challenges to overcome with this issue may be that physicians could feel as though the nurse practitioner (NP) is not adequately equipped as the doctor would be when dealing with patient care. According to the American Medical Association, “physicians have longer and more rigorous training than NPs, nurse practitioners are incapable of providing quality, safe care at the same level of physicians” (Hain & Fleck, 2014). This statement reflects negatively upon nurse practitioners but also coincides with the inability of a nurse practitioner to practice “to the fullest extent of their education and training” (Hain & Fleck, 2014). Only roughly “one-third of the nation has adopted full practice authority licensure and practice laws for NPs” (Hain & Fleck, 2014). This is another dilemma in and of itself within the health care setting and could be one of the reasons as to why NP are not reimbursed one-hundred percent for their

The court of appeal held patients should not be viewed incapable of understanding medical matters, society has change capable adults are able to make autonomous decisions to determine their future. Likewise therapeutic privilege should not be abused in deciding what and how much to tell patients we need to ensure we support patients in their choices. Nurses more than ever need to ensure the duty we owe our patients is fully met the NMC Code Professional Conduct (2015) now specifies a duty of candour to patients. This encourages an open and honest relationship in all matters therefore when patients ask specific questions nurses have a duty to answer within their scope of experience. Following Montgomery (2014) nurses are required to consider what the average patient would want to know about treatment and the material risk, what a reasonable person in a given situation would want to know about any risks involved in treatment or should know. The nurse is required to provide enough information for the patient what significance to give these risks in light of their own values beliefs and desire to determine their own future this can only work if patient and nurse work in close partnership. This goes in hand with NMC code (2015) standard 2 to listen to people respond to concerns

As a professional health care worker, the implication confidentiality breach regarding ethical dilemmas are significant to nurse and patient. The information disclosed can cause problems on a personal and professional level. Breach of confidentiality occurs when the heath care work discloses the patient 's medical or personal information without the patient 's informed written or verbal consent. Confidentiality is needed between the nurse and the patient to maintain a good open and honest relationship between both parties. There are several ethical implications regarding breach of confidentiality, for example,

A nurse-patient relationship is the basic requirements in all practice settings. Its usage is to manage communication between an organization and a public while maintaining boundaries in the therapeutic relationship. Based on Peplau’s interpersonal theory, communication takes place in a nurse-client relationship where therapeutic process occurs involving complex factors such as environment, attitudes, practices, and beliefs in the dominant culture (seu.edu, 2015). The actions of each person in a nurse-patient relationship is measured on the collaboration of their thoughts, feelings, and experiences. Nurse’s work to attain, maintain, and restore the patient’s health until patient have fulfilled the health care needs. Patient must be guided and provided a well-respected environment until a better health and specific needs are fully considered in the relationship. In this kind of setting, nurse’s must create relationship with patients by communicating receptivity, assimilating the concepts of empathy, trust, genuineness, respect, and confidentiality into their interactions.

Within the practice of nursing, situations often arise where nurses are forced to make decisions regardless of their level of experience in the profession. Providing care and following the physician’s orders historically were the nurse’s sole responsibilities. However, social change, changes in health care finances, increasing international perspectives, and demographic population changes, have resulted in a significant evolution of the roles and responsibilities emplaced on today’s nurses (The National Association of Clinical Nurse Specialists (NACNS), 2007). Kelly and Crawford (2013) believe budget cuts, higher client acuity and clients with complex needs, mergers of hospital corporations as well as a general shortage of qualified nurses has made it necessary for nurses to play a role in decision making. Decision making is defined as “cognitive process leading to the selection of a course of action among alternatives” (Kelly & Crawford, 2013, p. 352).

Likewise, Lewis and Soule (2006) point out that autonomy is a valuable ethic in nursing practice, which involves the freedom to be able to make important, non-mandatory decisions that are consistent with ones choice of practice. Most importantly, Lewis and Soule also suggest that autonomy is deemed as most valuable when the nurse has control over the information and knowledge needed for the patient to be able to make decisions, to help the patient chose the correct decision through the specific training and education that nurses provide service users with, so the

In order to create a morally and ethically sound practice and health care environment for every patient, the nurse’s decision-making role is vital and should be treated as such. The nurse’s professional morals and ethics should always be patient oriented to consistently assure the best decisions are being made to support each and every individual appropriately. These morals and ethics should consist of, the willingness to take action on behalf of patient needs and interests, the ability to advocate for the patients care even if that means questioning

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

At a practice level, the importance and guidance of the Code of Conduct, Code of Ethics and NPA are demonstrated on a daily basis with regard to the issues of documentation, informed consent and open disclosure, and confidentiality. With respect to documentation, nurses must be able to document patient assessments and responses in an accurate, comprehensive and confidential manner and record all observations objectively. Informed consent and open disclosure are also major legal issues nurses face daily. It refers to the communication between the patient and health professional that results in the patient's agreement to undergo a specific procedure and requires that the patient has thoroughly understood the procedure, implications and risks prior to giving written consent.