Therapeutic Relationships and Involuntary Treatment †Free Samples

Question: Discuss about the Therapeutic Relationships and Involuntary Treatment. Answer: Introduction: Professional nursing has stressed more on thinking critically as one of the substantial skills in the nursing career for many years. Critical thinking can be defined as self-regulatory, purposeful determination that utilizes the cognitive tools like assessment, interpretation, inference, and explanations.These tools help nurses to achieve and evaluate their way of reasoning considering the ethical view underlying on the basis of evidence and clinical thinking. The nursing exercises have significant roles and effective when assessing, evaluating or implementing because they contribute to meeting certain goals and better results (Levett 2011). The competency of nursing professionals is constituted by the four domains that include, critical thinking, analysis, coordination and therapeutic relationship practices. In this section, I will outline some of the experiences while at the placement at the Acute medical ward La Mcwin hospital. During my nursing placement at La Mcwin hospital, I was able to implement all the nursing procedures to achieve the best of nursing practice qualities and to procure best outcomes. The main objective of the nursing placement was to gain the relevant professional hands-on skills and to offer the best excellence healthcare. I was doing my nursing place at the acute medical ward. Pain assessment was one of role before the patient was transferred to the next ward or even discharged. Appropriate pain assessment can decrease morbidity and period of hospital admission (Abrami et al 2015). Pain management control involved an increased comfort of the patient, pleasure cardiac and pulmonary complication. The information gathered during postoperative assessments training during the nursing placement supported my healthcare plan using nursing practice evidence. If the pain is not controlled can cause physiological impacts like stress whose response could be the production of cortisol hormones and the glucagon. The outcome of the hormones is the resistance of the insulin (Bulman et al 2012). While in the acute medical ward I was attending to a patient who had the different culture. Therefore, I had to develop adequate interpersonal evaluating skills in order to note any reflex aching behavior. For example, I was to identify stomach pain in the patient by observing the facial expressions. The patient was moving the upper part of his face. The blood pressure of the patient was not normal. It had increased due to the onset of the pain which would have stimulated the nervous process (Perry et al 2013). I went ahead to test his temperature using the clinical thermometer. The temperature had increased significantly. I made assurance of the understanding of the procedure application with the registered nurse. I also consulted the RN who was my mentor on how to manage the patient's stomach pain through the use of a painful procedure as stipulated by the acute medical ward. Fentanyl is the opioid that was used to ease the patient from the pain. With respect to this technique, the patient needed supervision after every few minutes. The reason for monitoring the patient is because the opioid's side effect is the depression of the respiratory system. As a nurse, I had to perform other interventions under the guidelines of the mentor and acute medical ward protocols. Implementation of these interventions would surpass the complications associated with the mobility and the circulatory system (Chan, 2013). The interventions were the following. I encouraged the patient the patient to engage his legs in exercises which facilitated the contraction and relaxation of body muscles hence proper circulation of the blood. I applied foot pumps as directed by the doctor (Popil,2011). The doctor gave the advice to administer the small dosage of anticoagulant. I ensured the patient maintained the right posture on the bed and while seated on the chair. The right posture wo uld prevent any interruption of the blood flow. Lastly, I helped the patient to walk steadily by his side. Lastly respecting patient's is an important value that every nurse profession should uphold. The rationale for this helped to decrease disparities in the healthcare. This facilitated to improve the quality of the services in the nursing profession. That means all the nurse professionals should respond to the demographic change of the patient to offer sensitive healthcare (Yildirim Ozkahraman,2011). As a nurse in the acute medical ward, I had to understand the culture of my patient and minded on how I interacted with the family members. I respected his culture to avoid to prevent upset that would compromise his health improvement. Engages in therapeutic and professional relationship Within the nursing profession, the people related to the patient and the patient acknowledge the nurse as one of the people who can be highly trusted. That means communication is one of the most vital things that determine the quality of caring service and the relationship with the patient's family. The main role of the nurse is to explain to the patient the complexity of the healthcare organization. Lack of the appropriate communication abilities can result in very critical errors that can cost lives of the patients (Yildirim Ozkahraman,2011). Appropriate communication ability is not directed to the patients alone but also among the healthcare professions. Communication ability is constituted by the knowledge and the interpersonal relationship. In the nursing profession, communication is a very vital aspect especially when administering therapy and promoting the health of a patient. Good communication can be achieved via the dialogue and through verbal communication (Hatlevik, 2012 ) For example, I applied these communication skills to provide the patient with good and a conducive environment. I had also to explain the procedures and the importance of pain assessment to the patient in order to prevent any circulation and blood circulation complications. As a professional nurse, to establish a relationship between the patient and the nurse main objective and the goal is to set standards and some social boundaries (Efstathiou et al 2011). Setting these boundaries is very important. The boundaries enable the nurse to establish his or her role. Thus, the therapeutic relationship revolves around the needs of the patient. Its main idea is to facilitate the assessment of the patient's requirement and offering competent profession healthcare. Being the assertive nurse, I must use empathy when approaching my patient and I should avoid being emotion. This because the emotional approach would compromise my judgment towards the patient care. That means the nurse and the pati ent must understand each other very well to avoid any error (Gabr Mohamed,2011) For instance, the patient I was attending to was from a different culture. The parent faced a lot of problems to explain any health concern. When the doctor came to assess his painful stomach, he could not ask any question. The family members also faced difficulties when they came to check on him especially the patient's history because of the language barrier. That forced me to ensure the wellbeing of the client was well catered for and maintained his healthcare. Communication incorporated a vast range line of things. I had to include these things in my daily routines. These things were such as playing, touching gently his painful body. I maintained my primarily physical senses as it was a way of giving attention to the patient. Therefore, touch was a non-verbal behavior and could express different things like affectionate. While La Mcwin hospital, I spent some time with the patient especially when he was upset. As some nurse practitioners, I would hold and hug him by taking a care of his individual boundaries (Applin et al 2011). I supported that nursing staff members must all times keep felicitous professional boundaries during interactions with the patients. Hatlevik (2012) require the nurse practitioners to respect and acknowledge the roles of the clients as one of their partners in healthcare. The patients or clients contributes greatly to our success. The contribution was through Peplau's model of identification in the nurse-client or patient connection. Peplau model looks at the nurse-patient interactions as connected to four cycles. The phases include resolution, orientation, exploitation, and identification. Identification is all about the patients seeking the rationale for the healthcare and people to depend upon, especially for assistance. My patient had severe abdominal pain and that meant I gave him the first priority. I applied the touching method to help the patient relieve the pain.I did not need any consent from the clients or discuss the personal issues for the patients. However, the confiden ce is one of the keys to assure the accuracy and substantial to inform the validity of the patients. This is because some clients want to keep their healthcare a secret. Efstathiou et al (2011) implied that the therapeutic relationships circulate around disclosing patient's individual feelings to the nurse at a range calculated temperamental distance with the objective of much help. I regarded trust as the two sides of the coin in the sense that patient would wish for big trust from the nurses' relationship. Therapeutic relationship results are not seen immediately. Confidence between patients and nursing practitioners is weighty for the establishment of the relationship (Wyder et al 20150. The service consumers must accept to support the nurses and both to work collectively in order to develop a better relationship. Clients themselves will treasure a therapeutic relationship that provides healthcare trust and respect. Provides safe, appropriate and responsive quality nursing practice In LA Mcwin hospital I ensured the appropriate safety to the patient by ensuring there are no or few human errors that would lead to harmful outcomes to the patients. These errors could result in adverse consequences and risky effects on the patient. It was my responsibility to note any error and ensure a correction is made. Latent factors like random distribution of services and accidents do occur throughout the health center. It was my role to protect the patient from these latent factors and accidents which could cause external injuries to the patient. (Moran et al, 2016) The safety of the patient was improved in LA Mcwin hospital through proper coordination of systems, redesigning and producing mitigate the effect on several human factors. The overall supervisor of the health center formulated a routine guide for nurses to ensure the best is offered to the patients. During my shift as a nurse, I recorded every information clearly and dated them accordingly in the nurse's routing guide. It helped the next nurse have an easy time in providing services to the patient. It also helped the doctor to take the appropriate action on the patient's diagnosis. Keeping one's disease records and information private and confidential was very important. It gave respect to the patient's culture, ethnicity and beliefs. The main aim of good record keeping and documentation system was to facilitate and give the flow of quality, continuous and safety nurse care. Incorrect way record keeping and documentation could result in discontinuity and wrong medication to the patie nt. The hospital developed a program for improving pain assessment to cater for those who were experiencing acute, chronic and other risky pain situations. The plan included an interdisciplinary approach to control acute pain. The program involved the family of the patient. The electronic systems for monitoring pain were updated. It alerted the clinician in case of a pain that exceeded the set threshold. A severe pain in a patient who is experiencing acute pain reads 4 and above on a zero to ten scale. Through the creation of close interaction and good communication I was able to discover an arising pain and called the doctor. If I could take care of it I just took the action accordingly. I was very careful in observing and recording any pain alteration on the pain indicator scale and informed the doctor on the same so as to improve the treatment pattern. As a student nurse, I assisted the doctor in reassessing and adjusting the plan for the pain management. In case of changing the patient's position either in the bed or in need of support to stand or walk, I preferred working with other nurses to help the patient. This was to avoid causing extra pain or any harm. It was useful to understand the language of the patient where possible in order to evaluate his/her requirements better. For example, I came across a patient who could speak my mother language and he asked me to accompany him to the other assessment department in order to translate and to explain the answers correctly to the doctors. Miscommunication between the patient and service providers may lead to wrong medication and this would delay patient's discharge time from the hospital(Davis, A., 2014.) Monitoring the process and results of pain management was a good step in the improvement of the patients care. During postsurgical pain control, I ensured that the patient took the recommended dose to control the severe pain. The institution provided nurses with a good and conducive environment to allow them to make their decisions on how to improve the pain management. (Twigg et al 2014). I made this possible by regularly analyzing, administering and also by providing a multimodal approach which included other extra strategies of pain control like giving anti-inflammatory drugs, opioids and non-pharmacological interventions. To facilitate proper functioning and improve the safety and quality wellbeing of the patient was achieved by increasing the degree of pain control and prevention. As a nurse, I made sure that before undertaking any change in pain control method, the patient was early informed and had adequate knowledge about it. I continuously analyzed patient pain satisfaction data and used it together with the other indicators to ensure pain reliever. This data was also used for doctor's programmed review of the patient. Many institutions have been known to use the commercial patient survey to check patient satisfaction. I conducted some surveys by asking one or more questions concerning pain experiences. The guideline of the institution gave definitions of pain on clear directions for treatment and assessment with both non-pharmacological and pharmacological interventions to patients, staff and to the family members. Evaluates outcomes to inform practice The process of evaluating and interpreting the results of the evidence related is the core thing in the evaluation process. The measure of the outcome may be psychosocial or physiological. Psychosocial has to deal with patient perception care, quality of life and the reduction anxiety and depressive symptoms. Physiological deals with reducing the complications and improving people's health. The evaluation of the result may be done through audit, self-reflection or peer assessment. It is possible to do some comparison of the outcomes depending on the type of results achieved. (Lichtner, et al 2014) In the recent years, pain has been recognized and regarded a vital sign in relation to health care. It became acceptable that like any other core signs pain is a sensational objective rather than subjective. As a student nurse, I was trained to assess pain in order to cater for a large number of patients who undergo an agony of pain daily. A systematic and precise pain assessment was a requirement to make the most suitable diagnosis and help in determining the most efficacious treatment to be used for patients experiencing pain (Pijl et al 2014.). The hospital's pain management policies stipulated that a nurse must conduct a pain assessment at least once in every four hours. All the pain assessments that I did were based on evidence. A valid pain scale was well documented in every nursing shift. Doing this facilitated evidence-based pain assessment being examined through the evaluation of the pain documentation. The pain was assessed using a number of dimensions like the quality, severity, chronicity associated factors etc. chronic pain takes a little bit longer to be resolved.it may take several months or even years to deal with it. As a practicing nurse, knowing the genesis of the pain was really important in determining the best possible way to deal with it. I found out that chronic and acute pains are very common among the elderly. I opted the use pain movement because it gives room for effective mobilization. Depression contributes to the pain that the elderly experience and the medication used may cause severe side effects. I took some time to take care of their needs and speak to them in order to help them relax (Hadjistavropoulos, et al 2014.). In case the selecting of pain assessment tool was needed I made sure that decision was made in the consent of the patients. I did this to ensure the patients were familiar with the scale that was used. As a student nurse, I considered the emotional, physical and cognitive status as well as the age of the patient. The chosen tool was regularly used to assess the pain and the impact of the intervention (Bourdel, et al 2014.). The assessment I did was always time efficient while at the same time very comprehensive. I repeatedly emphasized the need for assessing pain relief, some aspects of functioning and the side effects. The success of the pain management entirely depended on how I motivated the patient to be responsible for active involvement in the care (Cooper Lesser,2014) The seriousness with which they took their medication was an important aspect of their responsibility inactive health care. A good and effective pain management efforts must start with the appropriately noting and analyzing the proper detailed history of the patient. The alleviating and the aggravating factors and the effects they cause on psychosocial being were noted and documented. I used a set of formulated questions below to help me analyze the condition of the patient. This was the first step in every assessment (Breimaier et al 2015). 1 Does the patient ask for pain medication frequently? 2 For how long has the patient taken the drug? 3 Are there any signs of pain like such as grimacing and crying? 4 Does the patient continually request for medication? 5 Is there any notable change in behavior and mood in case they don't get medication at a particular time? 6 What may social factors be affecting the patient? 7 How many types of medication is the person on? 8 Is the patient asking for medication because they want to sleep or because they are in pain? 9 Does the patient ask for more or less medication as the time goes on? In case a patient was continuously asking for the increase of the DDA drugs prescription, I reported to the registered nurse because student nurses are not allowed handle them (Schreiber et al2014.). The patient may be getting addicted to the medication prescribed to them. I followed the senior registered nurse to learn the kind of prescription he made and how to deal with different issues of healthcare different cases References Abrami, P.C., Bernard, R.M., Borokhovski, E., Waddington, D.I., Wade, C.A. and Persson, T., 2015. Strategies for teaching students to think critically: A meta-analysis. Review of Educational Research, 85(2), pp.275-314. Applin, H., Williams, B., Day, R. and Buro, K., 2011. A comparison of competencies between problem-based learning and non-problem-based graduate nurses. Nurse Education Today, 31(2), pp.129-134. Bulman, C., Lathlean, J. and Gobbi, M., 2012. The concept of reflection in nursing: Qualitative findings on student and teacher perspectives. Nurse education today, 32(5), pp.e8-e13. Bourdel, N., Alves, J., Pickering, G., Ramilo, I., Roman, H. and Canis, M., 2014. The systematic review of endometriosis pain assessment: how to choose a scale?. Human reproduction update, 21(1), pp.136-152. Butcher, H.K., Bulechek, G.M., Dochterman, J.M.M. and Wagner, C., 2018. Nursing Interventions Classification (NIC)-E-Book. Elsevier Health Sciences. Breimaier, H.E., Heckemann, B., Halfens, R.J. and Lohrmann, C., 2015. The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nursing, 14(1), p.43. Cooper, M. and Lesser, J.G., 2014. Clinical social work practice: An integrated approach. Pearson. Davis, A., 2014. Core Communication Competencies in. Efstathiou, G., Papastavrou, E., Raftopoulos, V. and Merkouris, A., 2011. Factors influencing nurses' compliance with Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study. BMC nursing, 10(1), p.1. Gabr, H. and Mohamed, N., 2011. EFFECT OF PROBLEM-BASED LEARNING ON UNDERGRADUATE NURSING STUDENTS ENROLLED IN NURSING ADMINISTRATION COURSE. International Journal of Academic Research, 3(1). Hadjistavropoulos, T., Herr, K., Prkachin, K.M., Craig, K.D., Gibson, S.J., Lukas, A. and Smith, J.H., 2014. Pain assessment in elderly adults with dementia. The Lancet Neurology, 13(12), pp.1216-122 Hatlevik, I.K.R., 2012. The theory?practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of advanced nursing, 68(4), pp.868-877. Hoe, J. and Hoare, Z., 2012. Understanding quantitative research: Part 1. Nursing Standard (through 2013), 27(15-17), p.52. Levett-Jones, T., Gersbach, J., Arthur, C. and Roche, J., 2011. Implementing a clinical competency assessment model that promotes critical reflection and ensures nursing graduates readiness for professional practice. Nurse Education in Practice, 11(1), pp.64-69. Lichtner, V., Dowding, D., Esterhuizen, P., Closs, S.J., Long, A.F., Corbett, A. and Briggs, M., 2014. Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools. BMC Geriatrics, 14(1), p.138. Moran, K.J., Burson, R. and Conrad, D., 2016. The doctor of the nursing practice scholarly project. Jones Bartlett Publishers. Perry, A.G., Potter, P.A. and Ostendorf, W., 2013. Clinical Nursing Skills and Techniques8: Clinical Nursing Skills and Techniques. Elsevier Health Sciences. Pijl-Zieber, E.M., Barton, S., Konkin, J., Awosoga, O. and Caine, V., 2014. Competence and competency-based nursing education: finding our way through the issues. Nurse Education Today, 34(5), pp.676-678. Popil, I., 2011. Promotion of critical thinking by using case studies as teaching method. Nurse education today, 31(2), pp.204-207. Raymond-Seniuk, C. and Profetto-McGrath, J., 2011. Can one learn to think critically?a philosophical exploration. The open nursing journal, 5, p.45. Schreiber, J.A., Cantrell, D., Moe, K.A., Hench, J., McKinney, E., Lewis, C.P., Weir, A. and Brockopp, D., 2014. Improving knowledge, assessment, and attitudes related to pain management: evaluation of an intervention. Pain management nursing, 15(2), pp.474-481. Twigg, D. and McCullough, K., 2014. Nurse retention: a review of strategies to create and enhance positive practice environments in clinical settings. International journal of nursing studies, 51(1), pp.85-92. Wyder, M., Bland, R., Blythe, A., Matarasso, B. and Crompton, D., 2015. Therapeutic relationships and involuntary treatment orders: Service users' interactions with health?care professionals on the ward. International journal of mental health nursing, 24(2), pp.181-189. Yildirim, B. and Ozkahraman, S., 2011. Critical thinking in nursing process and education. International journal of humanities and social science, 1(13), pp.257-262.