My clinical practice setting is in various acute care settings at a large teaching hospital in Toronto, where I am part of a nursing resource team. Most of my clinical experience is with oncology patient populations. This week, I was able to interview a family that I have cared for a couple of days as we have created a family-nurse therapeutic relationship, during that time I felt that they would be willing to proceed with the discussion of their illness experience. The patient was a sixty-five year old female woman; her admitting diagnosis is metastasised lung cancer with a poor prognosis, along with dementia as of a month ago. She is widowed for five years, her deceased husband passed away from congestive heart failure.
I found it was very difficult to find the words to start the conversation that would change her life entirely. I found that it was very difficult to make eye contact with the patient and I wish I had done more in order to make the process more personable and comforting. Once I was able to give the information about her diagnosis and potential prognosis, I realized that I was using a lot of medical terminology that may have been difficult to comprehend for the average person. I was able to catch myself early on, and made adjustments accordingly. I also found it was difficult to answer some of her question since they pertained to information that is out of my scope of practice.
The therapist and the client establish clear boundaries, mutual trust and respect. Sperry (2010) The chapter states “effective therapeutic alliance that is sensitive to the client’s needs, expectation, and explanatory model; that engenders trust and hope in the therapist and therapy process; and that engages the client in the treatment process”. Allows the therapist to focus on client treatment and assist the client with developing skills, acceptance of strengths, weakness, developing realistic goals and developing new skills and abilities. The therapist and client have a mutual understanding of the goals which will assist with establishing and developing treatment for client.
I could tell by her expression that the storytelling and reminiscing was making her happy. I then incorporated more closed and open-ended questions about her daily routine and hobbies. 4. Describe your perspective of the patient 's response to the interview.
Additionally, as a counselor, it is important to be genuine with whatever feedbacks one presents to the patient and what one believes regarding the situation of the client. Mrs. Perez believes the more authentic and genuine he is with her patients, the more help he will be able to offer the clients. As a counselor, it is important to have a fine and professional interaction with one 's client but boundaries must be maintained. Through this, a counselor is able to demonstrate their focus on helping the patients by showing the client that they understand their problems. It also through such engagements that counselor is able to use the non-judgmental attention that does not require words for illustration in helping the patient.
The key to establishing a trusting relationship is the integration, usage, and mastery of therapeutic communication skills (Belcher & Jones, 2009).Due to the high importance of effective communication in mental health nursing, it is essential in therapeutic interventions. (Peplau, 1952) states that effective interpersonal skills are central to a mental health nurse’s ability to form a sound therapeutic alliance and to the role of mental health nurses. Excellent interpersonal aptitudes are what every mental health nurse needs to communicate effectively with clients. Active listening is more than just hearing what the client has to say, nurse must be actively engaging with the client, physically, emotionally and mentally. Effective listening is therefore a cognitive, behavioural and an affective process (Arnold and Underman Boggs,
A power imbalance may become an issue when a therapist from a dominant culture such as able-bodied devalues a client with a non-dominant culture like a client with a terminal illness. It is essential for a therapist using CBT with terminal cancer patients to be sensitive and curious about the terminal illness or the client may end up feeling misunderstood. If the therapist is healthy, a client may assume the therapist does not understand what it is like to suffer from a terminal illness. A therapist may feel as if they have the power in the session because they are the counselor and use this power to help the client alter and reduce the negative thoughts they are experiencing. However, a therapist must be careful that they are being sensitive to the client’s emotions surrounding the terminal illness.
The primary purpose of the practices is to help the patients to recover in the best way possible and also bond them together with the patients. The strategies, however, are also specific to certain adjustment problems. Close patient and clinical officer’s relationship can help the patients in this case to bond well and recover from their traumatic experiences. The close patient clinical officer’s relationship that involves effective communication with the patients helps to create an ambient environment for the adjustment (Grol & Grimshaw,
The client could not understand; yet he was feeling uncertain and this interpretation pinpoint the reason why by connecting his past to his future. 4. What do you think was effective about the therapist’s approach in this session? The session was more open and free formed.
The therapist never critiques the client’s work. After a client has finished his or her artwork, the therapist may ask the client to interpret the art, linking it to current issues and events in his or her life. This increases awareness of self and others and promotes personal development and coping
A therapeutic nurse-patient relationship is defined as a helping relationship that's based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient's physical, emotional, and spiritual needs through your knowledge and skill (Pullen & Tabatha, 2010). This caring relationship develops when you and your patient come together in the moment, which results in harmony and healing. The five components of the nurse-client relationship are trust, respect, professional intimacy, empathy and power. To establish a therapeutic nurse-patient relationship, a nurse must master a few key components, including trust and respect. As a nurse, you should introduce yourself to your patients and refer to the patient by name.
The client started his homework with the help of his MT and parents. When the client was done, the MT talked to the client and his parents about the client updated treatment plan. The MT restated the goals of aggression, oppositional defiant disorder, and boundary issues. While reading each goal and the objective, the client and his parents was able to express current and past situations within 3 months for each area and how the client has been showing improvement. After the MT was finish with the client’s treatment plan, the client asked the MT did she want to play a game, in which the MT accepted.
Introduction Motivational interviewing is a collaborative, person-centred form of communication which focuses on the language of change. ‘It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion’ (Miller et al., 2013, p.29). The technique of motivational interviewing was developed by two psychologists, Bill Miller and Steve Rollnick. Motivational interviewing is therapeutic to patients as it is based on a partnership, rather than a nurse-patient relationship (Heckman et al., 2010). There are four processes of motivational interviewing; engaging, focusing, evoking and planning.
He works from an “interpersonal frame of reference” (Yalom, 2001 p. xvi) and tends to work with the terminally ill, bereaved and addiction clients. Interpersonal interaction within the group is vital to effect change and the therapist’s role is to facilitate that experience in the here and now. By members feeling a sense of belonging, hope, safety and awareness they are not alone in their issues, provides a solid foundation. Interpersonal interaction within the group enables members to release previously repressed emotions promoting healing, and the sharing of information can help educate and empower a sense of value by helping others. Members can learn coping strategies from others and interpersonal teaching can help them to develop supportive interpersonal relationships and interpersonal skills, such as empathy and tolerance.
The Process of Reflection The process of reflection is central to clinical supervision. Launer (2003) describes external and internal factors in supervision whereby clinical practice and sharing skills are external and reflection is an ‘internal conversation.’ Brunero & Stein-Parbury (2008) discussed the effects of clinical supervision in nursing staff and argued that self-reflection generates a sense of self-awareness and knowledge to the individual. Supervisees or students may be asked what happened during a clinical event, how they felt, the implications of their actions and what they would do differently if faced with the same situation.