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Tools to aid development of nurse patient relationship (Patient…
Tools to aid development of nurse patient relationship
Knowing the patient
Case knowledge
Generalised and objective, includes matters such as anatomy, physiology, physical disease processes and pharmacology.
Based upon statistics and probabilities of the situation.
Patient knowledge
Knowledge of how individual patients are responding to their clinical situations.
Based upon understanding what individual patients are experiencing and therefore requires adequate interaction between patient and nurse.
Enables nurses to negotiate care plans for patients in correlation with the healthcare system and MDT members.
Person knowledge
Identified by Liaschenko and Fisher involved an understanding of the unique individuality of the patients, knowing the patient's personal and private biography and understanding how that person's action make sense for them.
This concepts refers to a process whereby nurses are able to treat a patient as an individual person person because they know something about them.
This holistic approach is central to caring and associated with expert clinical nursing practice where the nurse is able to know the patient by observing their responses to nursing actions.
Why are interpersonal skills important?
In order to demonstrate a profesional nursing role, the nurse needs to demonstrate social competence in order to gather relevant and useful data for clinical assessment.
Nurses who identify close cooperation and demonstrate ways of getting to know their patients closely facilitates to patient participation.
Understanding the theoretical construct of caring is essential to understanding nursing itself.
Five levels of caring
1). The capacity to care - compassion, empathy, knowledge, positive outlook.
2). Values and beliefs about connecting and building rapport with patients.
3). Conditions - personal, organisational and patient-relate affecting the capacity to care.
4). Caring actions - i.e: behaviours associated with therapeutic interventions.
5). The consequences of caring, both positive and negative (if absence of caring).
These five levels of caring are hierarchal in sense that conditions of each preceding level are to be met before the next level is possible.
A concept analysis of the meaning of caring in nursing revealed the core demensions of caring:
Action
- voluntary action such as physical care and presence.
Attitude
- involves genuine concern and regard for patients.
Acceptance
- of the patient includes recognising the intrinsic value and worth of each patient.
Variability
- indicates that caring is fluid and ever-changing in response to the context.
Overall this evidence indicates that patients want to interact with nurses who are genuine, available, organised, and not hurried while are accessible, approachable, and willing to talk.
Patient perspectives of caring behaviours
Mutuality in problem solving - assisting patients in understand and dealing with illness.
Attentive reassurance in relation to being available and interested.
Respect and hope
Encouragement and support
Involving family in care
Meeting basic needs such as food and sleep.
Mutual understand and collaboration
Communication competence
Involves two types of skills: A skilled competent communicator will competently balance both assertive and responsive skills in their interpersonal interactions.
1). those of being responsive, able to listen and understand what others are saying.
2). Those of being assertive, able to state their own point of view and express their needs.
Emotional intelligence
Competent communicators comprehend that emotional intelligence refers to the ability to carry out accurate reasoning focused on emotions and ability to use emotional knowledge to enhance thoughts.
Internal qualities such as:
Resilience
Initiative
Optimism
Adaptability.
Acknowledge significance of human feelings and are able to use head and heart when deciding of response or actions.
Conceptualised in nursing as:
Manage emotional responses
understand emotions and their meaning
assess emotions in situations
Identify and recognise emotions in other people
Use emotions for reasoning.
Five hierarchal dimensions of emotional intelligence
1). Self-awareness: accurate assessment of self, along with self-confidence.
2). Self regulation: control over one's emotions and being trustworthy.
3). Motivation: includes commitment, initiative and optimism.
4). Empathy: a central dimension; includes not only understanding other people, but also maintaining a service orientation towards others.
5). Social skills: including conflict management, cooperation and collaboration - all necessary for emotional intelligence.