Therapeutic Relationship : Mental Health Professionals

With the development of the nurses understanding, the nurse will be able to clearly communication across relevant information. This will promote patient participation (Tobiano, Marshall, Bucknall, & Chaboyer, 2016) and empower the patients voice by actively involving them in the decision-making process. Per the Health and Disability Act (1994, as cited in Medical Council of New Zealand, n.d) patients should have their treatment explained to them, including the benefits, risks, alternatives and costs; as well as having the option to change their mind at any time. This all contributes to the development of a partnership and ensures that the patient will cooperate with tasks at hand. However, the lack of communication with the patient regarding their treatment can cause severe anxiety and ultimately a breakdown in the trust between the patient and the nurse. The successful implementation of this in practice can be seen in an observational study conducted by Tobiano et al. (2016).

The Health Care and Profession Council (HCPC, 2014) states that a patient must first give consent for treatment, effective communication is key in gaining this

In this assignment I will be discussing Adult Nursing and Mental Health Nursing and issues regarding consent. Consent is important within all fields of nursing as it is essential to conduct any medical procedures. The Nursing and Midwifery Council Code of Conduct (NMC,2008) states that all healthcare professionals must presume that all patients have the mental capacity to accept or deny medical treatments after being given all information which may be needed. However there may be some instances where consent cannot be obtained. An example of this is if the patient is in a medical emergency and may be unconscious or if the patient lacks the mental capacity to make a knowledgeable choice. In this situation treatment would be

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

The author cites qualitative research articles and nursing education manuals and training manuals from many different authors and time periods. There were no quantitative studies cited. All research article referenced were relevant to the study, most were greater than seven years old and older. No evaluations of strengths or weaknesses were available for referenced material. The limitations of this study were named as: “data was exploratory, It was not the specific intention to explore the management of the patient who refuses care; the topic came from the inductive data analysis.(Aveyard, 2004, p. 349) It is relevant as this is a previously unexplored area of nursing.(Aveyard, 2004, p. 349) The author builds a logical argument through discussion of nursing education, and the fact that nursing education and the focus of informed consent in nursing education is on the nurse’s role in obtaining consent prior to medical procedures and research procedures, and not prior to nursing care procedures. The author uses the argument that the lack of discussion on informed consent does not negate its importance and it purpose which is to protect a patients autonomy .(Aveyard, 2004, p. 346)

In our day today lives we make complex decisions, continually weighing up the risks and benefits of our actions. However in the hospital environment, the Doctor knows best attitude has prevailed for many years, patients deemed unable to be involved in decisions regarding treatment. Development in law relating to consent has been slow, based on paternalistic approach and therapeutic privilege to decide treatment choice for patients. Whilst health care practice moved towards informed consent, the law lagged behind. In 2015 informed consent has finally been recognised in Law. The author will describe the changing attitude in the law of consent from 1950’s to present day and how these changes affected nurses duty to obtain consent from patients

Which may not always be the case, they could make their decisions solely based on the knowledge base and experience of the physician, or they may not know what is in their best interest due to mental illness, or mental retardation, or any number of other factors. Furthermore, in the cases of mental illness or mental retardation, and appointing a surrogate, how would it even be possible for the surrogate or legally appointed guardian to make decisions based on the patient’s best interest, when they themselves do not, or cannot know what their best interests even are. Informed Consent also assumes that the patient is acting solely based off of their interests, but they could be heavily influenced by social factors such as the parents, spouse or children’s ideas and opinions, and as such the patients view on how best to proceed can be clouded by these social influences. And as such the patient could consent or refuse by going with the wishes of family and friends even if that is against their best

It’s called consent capacity. This is practiced by the nurses who are taking care of the individual. There are four factors within consent capacity: choice, unde4rstanding, appreciation and reasoning. Choice gives the person the right to choose as much as they can, and their choices are documented with a lawyer and a medical professional. This allows the person to make sure that they are able to get what they wish, even when they are unable to remember. The second is understanding, and this deals with treatments and why they are in a facility. It is discussed in as much detail as the patient needs prior to joining a facility, and whenever they wish to understand why they need treatments. This understanding connects with appreciation, and relating the information which shows the reasons and consequences. The last part allows individuals to understand the reasoning, and compare all

There are various systems of attaining valid consent. Nurses can receive either verbal, implied or written consent. Consent is a fundamental requirement in adult nursing to permit any form of treatment. Competent patients are able to withdraw consent at any stage and their decision should be respected. Francis Report was established by Robert Francis due to the failure of an NHS foundation trust.

Anytime we can have a win, win situation in learning new and better ways of helping one another is awesome. I think dialogue is a perfect way to retain trust in conversation and build self-esteem (Benner, 1998, p. 133). It keeps arguments down and it allows questions, which is a great way to learn. Anytime we can broaden our understanding of a topic is a plus. I also believe that in building a relationship is much better. In therapeutic conversation it’s all about relationship’s. In relationships we develop empathy which creates a loving bond as if we were in that problem area ourselves. Like a true Christian should do. It can be a learning experience also for the counselor in which can be related into their life as a learning experience. This

coaching may be aiding as well. Everyone involved in the treatment plan of the client should be

Educate the client’s family on this disorder. – With a better understanding of what their loved one is facing, they can be better able to help.

Family is playing an important part in helping to ensure that patients are fit and following the advice of health care professionals. This is because the family is a foundation of support for everyone. At the same time, members can learn about what is impacting their loved one and what kind of procedures need to be followed. When this happens, there will be higher amounts of compliance as they will ensure that the patient continues to stick with their treatment protocol. (Saleeba, 2009)

Nurses and healthcare providers must uphold a patient’s right to make decisions regarding his or her medical care. Competent, informed patients have the right to choose among treatment options and refuse any unwanted medical interventions (Beauchamp and Childress, 2009, p. 103). By providing informed consent and following Pam’s wishes, healthcare providers demonstrate their respect for the autonomy of their client.