NUR 601 Therapeutic Relationship Discussion


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Please construct a peer reply to the two following discussions. Each reply should be 150 words minimum and use at least 1 academic source where relevant.

Case 1: MLM

Therapeutic Relationship

The case involves a nurse practitioner named J.J. who is working in a primary care facility. J.J. identifies fostering therapeutic relationships with clients as the most important aspect of his engagement with community and patients. To foster positive relationship with patients and community, he integrates effective communication approaches. He experiences challenges working with patients who have sensory perception impairment such as deafness and blindness. Therefore, he has to be careful with this category of patients to build a trusting relationship with patients. Respect and humor are other attributes he integrates while interacting with his patients to build trust.

Building trust and commitment to patients is an important practice. According to studies conducted in the past, there are critical factors that influence trust between healthcare professionals and patients (Dawson-Rose, et al., 2018). These studies have identified competence in knowledge, competence in communication skills, confidentiality and caring, honesty, and showing respect (Collado et al., 2017). Competence in knowledge is enhanced through professional development through knowledge acquisition, learning and research. The nurse practitioners must develop competence in their work to ensure safety and quality in all aspects of care. It identifies the training needs that provide an environment for enhanced adherence to quality, safety and standards. The second strategy is communication style adopted by health professionals (Wilkins, 2018). The nurse practitioners must have effective communication strategies that integrate awareness of verbal and non-verbal communication, cross-cultural competence, active listening skills, and respectful and non-judgmental way. Active listening is enhanced through paraphrasing, summarizing, clarifying, reflection. Thirdly, the nurse practitioners must establish trusting relationship with patients through empathy to encourage disclosure from patients for effective diagnostic and assessment of the patients (Allinson & Chaar, 2018). The other strategy is confidentiality and caring engagements with patients. Patients are likely to disclosure their health condition when they feel that the professional cares about their health and wellbeing and is likely to protect their confidentiality (Collado et al., 2017). Honestly in information and engagement is an important determinant of effectiveness in communication among health professionals. Mutual respect is the other strategic approach to building effective relationship with patients to ensure that there is effective engagement during diagnosis, treatment and caring practices.

While working as RN in charge of emergency department, I noticed a colleague was about to giving the wrong dosage to the patient. On this particular day, the nurse provided a medication with a wrong dosage calculations leading to an under-dose of medication. There is a requirement within the facility that any case of medication error should be reported immediately to apply the right strategies for intervention. On the other hand, reporting an error that did not occur since I intervened could demoralize and destroy the teamwork I usually encourage in the department. A week ago, the same nurse was warned about the same issue when a wrong dosage was calculated for a patient leading to an under-dose again that reduced efficacy of the treatment and increase length of stay for patients. This case presented a moral distress on whether to report the incompetence in drug administration. Reporting the nurse could lead to a disciplinary action and failure to report could threaten patients’ safety in the facility. As an intervention, I discussed the issue with the nurse after our handing over, which created an opportunity to the nurse. After our engagement, we made a decision that she must register for a short course on medication administration practices to enhance her competence in medication dosage calculations, which was the only problem the nurse was experiencing. I also encouraged her to develop positive attitude towards mathematical concepts and begin embracing mathematical concepts in properly calculating the dosages for medication. We also agreed that I will always double-check any dosage administration she calculates to ascertain it’s the right dosage. She got so excited over these suggestions and I experienced that she transformed her commitment to dosage calculations.

Considering and identification of ethical issues in health promotion is critical for moral (cultural conceptions and ethical principles) and practice, (producing desired impact), and reasons. Since health promotion is focused on promoting social good to the community, achieving health promotion goals must be aligned to ethical behavior (Wilkins, 2018). Health promotion is founded on moral concerns since behaviors are meant to influence an intimate aspect of the community in areas of culture, relationships, and social values (Dawson-Rose, et al., 2018). For instance, health promotion with require alignment of commitments to health needs of the community and cultural competence. Additionally, health promotion practices must align to moral and ethical practice requirement such as empathy, confidentiality, and trusting relationship with patients.

In my communication ability, I am able to demonstrate strength in active listening skills that allows me to listen to others and draw conclusions based on their assertions. This ability to listen to others exposes me to less talk and more listening, which help to unveil different aspects of life from different engagements I have with people not necessarily patients. Non-verbal communication is another area I flourish during communication since I am able to interpret different body movements and gestures to understand the feelings, perceptions and attitudes of people. However, I am likely to experience challenges in controlling my emotions. When discussing with someone about an emotionally sensitive issue, I usually find myself emotionally drained and disturbed, which expresses that I require my ability to manage stress and emotional control.

Case 2: QA

In order to gain the trust of his patients, J.J. should be open and honest about his aims, respect their autonomy, and make them feel at ease speaking with him. It’s critical to be open and honest about your goals as a healthcare professional. Patients should be aware of your expectations for their care and feel free to ask you any questions they may have. J.J. should, for instance, be upfront with his patients about his expectations for their treatment and encourage them to ask questions if they have any issues. It’s important to always respect the autonomy of your patients. This entails respecting their right to refuse treatment and letting them make their own decisions about their care. J.J. should, for instance, respect his patients’ right to choose not to get treatment if they choose not to take part in a certain intervention and allow them to make their own decisions regarding their care (Johnson et al., 2017). Making ensuring that your patients feel at ease speaking with you is crucial. This entails fostering a welcoming environment where patients feel comfortable expressing their queries and grievances. J.J. might, for instance, make his primary care office a secure and respectful space where patients feel at ease raising issues and asking questions.

There have been times when I had to suggest choices about therapies that I know will be difficult for my patients, it has caused me moral distress in my work. I respect my patient’s autonomy to choose the course of therapy that is appropriate for them in these circumstances and strive to be as open and honest as I can with them about the risks and advantages of the suggested course of treatment (Phillips, 2019). I once had to suggest a course of therapy to a cancer patient, which is only one instance of a situation where I experienced moral difficulty. I was aware that the procedure would be excruciatingly painful and that it might not work. I was aware that the patient had the highest chance of surviving, nevertheless. I explained everything to the patient and respected their choice to receive treatment.

Promoting health is crucial from a moral perspective since it helps people maintain their health and well-being and can avert potential health risks. Health promotion is significant from a utilitarian standpoint since it can reduce suffering and misery (Phillips, 2019). We can shield people from the negative effects of poor health, such as pain, suffering, and incapacity, by encouraging health and well-being. By promoting good eating practices, for instance, we can lower the prevalence of obesity and related health issues, such as heart disease, diabetes, and arthritis.

When a patient is unwilling to cooperate with treatment, it may be challenging to start or end a therapeutic engagement. Establishing a therapeutic relationship may be challenging if a patient is unreceptive to communication or resistant to treatment (Abdolrahimi et al., 2017). Furthermore, if a patient is resistant to therapy, they might not be open to receiving it, which can make it challenging to end the therapeutic alliance. I occasionally struggle to be firm with my patients, especially when they are resistant to treatment. This is one of my shortcomings. This, in my opinion, is a problem because it can make it difficult for me to adequately represent the requirements of my patients. This is crucial, in my opinion, since patients often need someone to speak out for them when they are unable to. I consider listening well to be a strength because it enables me to fully comprehend the wants and worries of my patients. This, in my opinion, is crucial since it enables me to customize my treatment to each patient’s specific needs. 

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