Relational Nursing Practice and Leadership

The provided document discusses the importance of relational nursing in delivering effective care, including behavioral communication, person-centered approach, accountability, and transformational leadership. The assignment highlights the significance of relational practice as a reflexive and respectful approach for inquiry into patient's life experiences and healthcare needs. It also emphasizes the need for nurse leaders to prioritize patient-centered care and engage nurses in real-world strategies for improving the patient experience.

Running head: RELATIONAL NURSING
Relational Nursing
Name of the student
University name
Author’s note

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Table of Contents
Introduction................................................................................................................................2
Client characteristics..................................................................................................................2
Analysis of the situation.............................................................................................................3
Discussion of the nursing practices............................................................................................4
Nursing leadership used to engage in caring relationship with client........................................5
Conclusion..................................................................................................................................6
References..................................................................................................................................7

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Introduction
The current assignment focuses on the concept of relational nursing. Applying the
concepts of relational needs helps the nurses in understanding the complex health care needs
of a client. Some of the contextual factors which are taken into consideration over here are –
gender, age, ability, cultural and geographical aspects. In this respect, a number of personal,
social, interpersonal factors have been seen to affect the life of a person.
Client characteristics
The current assignment focuses on the aspect of the provision of relational nursing
care for a 58 year old man who had been admitted to hospital with a sharp chest pain. On
further diagnosis it was found that the man had a blockage in the heart and required an
immediate angioplasty.
The assignment focuses on the pathophysiology of heart blockage where a delay or
interruption in the passage of electric signals occurs from the top to the bottom of the heart.
The sinoauricuclar node (SA node) is responsible for sending the electric signals across the
heart. The SA node cans often dysfunction due to age related and neurological disorders. In
the current situation the patient was admitted to the hospital with a sharp chest pain (or
angina). There are several risk factors to heart attack which should be accessed in the patient
accordingly. A prior assessment helps in the administration of the right treatment and
medication patterns. Some of the common factors which normally trigger heart disorder in a
patient are prior incidents of heart failure, abnormalities within the heart valve, congenital
heart diseases ageing and exposure to harmful substances. The progression through the
treatment is done based upon the stage of the heart attack. For understanding the
developmental stages we need to understand the pathophysiology of the condition. The heart

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block could be divided into first, second and third degree heart block. The first degree heart
attack happens when the electrical impulses are slowed down across the conduction system.
In second degree heart attack an electrical impulse fails to reach the ventricle entirely due to
an extended delay. As mentioned by Keyko (2014), very often such delays are caused due to
psychologic stress or otherwise. The progression through this condition requires medical
intervention and often may be more serious than expected. It is at the second stage of heart
attack that the installation of pacemakers is suggested to normalise the process of impulse
transmission of the heart (Freeney & Fellenz, 2013).
Analysis of the situation
In the current case study John is a 58 year old man who had been admitted to the
hospital with second degree heart attack. On further diagnosis it was found out that the man
had a cardiac history and already had a cardiac attack in the past. Mr. John was asked to
undergo further test after giving him the preliminary medications and therapy. From the test it
was confirmed that Mr. John had a blockage in few of the veins supplying blood to the heart.
On further investigations it was found that Mr. John had other co-morbidities such as
hypertension and elevated levels of blood cholesterol. Hence, reflecting upon the present
condition of the patient it was decided that further detailed follow up will be conducted for
the patient.
Mr. John was also suggested an angioplasty depending upon his current condition.
However, lack of knowledge and fear of the process developed further anxiety within the
patient. Therefore, as a nurse looking after the patient I had to ensure that the patient feels
less perplexed or stressed out. As commented by Dewar & Nolan (2013), using the
therapeutic communication skills could be a useful method over here. In this respect, the
nursing professional needs to ensure care services provided over here are person-centered

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(Cole, Wellard & Mummery, 2014). This help in taking care of the advocacy issues by
providing sufficient importance to the wishes of the client during dissemination of the care
services. In this respect, following a transformation leadership will help the nursing
professional catering to the health requirements of Mr John. Thus, using this nurse can
develop a bigger picture regarding the future which can positively motivate the patient for
undergoing though the therapy.
Discussion of the nursing practices
The leadership role adopted by me over here was a transformational leadership style.
It helped me in understanding the situation of the patient by taking into consideration the
requirements of the patients. The transformational leadership approach helps in replacing the
old assumptions through intellectual stimulations (Hutchinson & Jackson, 2013). As
commented by Weng, Huang, Chen & Chang (2015), undertaking of the transformational
approaches helps in integrating better care approaches within the health care system. The
transformational leadership could help me in bringing about positive changes within the daily
care routine of the patient (Burman, Robinson & Hart, 2013). It can help the nurse educate
the patient regarding the importance of healthy diet and active lifestyle in reducing the
chances of the recurrence of heart disease. As mentioned by Ross, Fitzpatrick, Click, Krouse
& Clavelle (2014), practising the transformational leadership can allow the nurse adopt a
more holistic approach for the dissemination of the care services.
The communication styles which could be adopted over here is therapeutic
communication approaches. It follows a more patient centered approach by taking into
consideration the emotional aspects of the patient for the delivery of the care and support
services.

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Nursing leadership used to engage in caring relationship with client
There are a number of barriers and facilitators of the nursing practices which have
been discussed over here. The barriers are often faced with regards to dissemination of the
support and care services in line with the ethics and the advocacy issues (Wong &
Laschinger, 2013). The current health condition of Mr. John demands that he be undergone
angioplasty to remove the condition of blockage in his heart. However, fear and anxiety
regarding the can delay the decision of the patient in the favour of the therapy (Pelletier &
Stichler, 2014). As argued by Lievens & Vlerick (2014), under no circumstances the nursing
staffs can force the patient to agree to a particular treatment method. There are additional
amount of barriers provided by some of the nursing advocacies, as per which the nurses need
to follow the safe practise guidelines as stated in the American nurse’s associations (ANA)
foundational documents. Some of the advocacy skills could be practised over here such as
empowering the patient. Thus, empowerment of the patient will help in avoiding any legal
breaches within the health care setup (Dempsey, Reilly & Buhlman, 2014). Additionally, use
of teaching principles for can help in the development of social awareness regarding the
disease (Huber, 2017). Therefore, avoiding the risk factors can reduce the chances of
contraction of the disease.
I think practising as nurse catering to the healthcare requirements of a cardiac patient I
need to develop a caring approach towards my patient. I can do this by following a
therapeutic communication approach with John which will help me in understanding the
anxiety patterns of the patient.Therefore, designing of the care services based upon the
emotional prospects of the patient can help me develop an affirmative relationship with the
patient. Thus, adopting an effective leadership approach can help in developing a bond of
trust between the nurse and the patient (Hibbard & Greene, 2013). Additionally, person

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centered approach and accountability are two other attributes of a perfect leadership
approach.
Conclusion
The relational nursing helps in taking care of all these factors for the designing and
delivery of an effective nursing care. Relational practice is a reflexive and respectful
approach for inquiry into patient’s life experiences and healthcare needs. Some of the
important aspects which had been taken into account over here is behavioural
communication. Therefore, undertaking an effective communication approaches with the
patients can help in understanding their grievances and personalization of the nursing care.

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References
Burman, M. E., Robinson, B., & Hart, A. M. (2013). Linking evidence-based nursing practice
and patient-centered care through patient preferences. Nursing administration
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Cole, C., Wellard, S., & Mummery, J. (2014). Problematising autonomy and advocacy in
nursing. Nursing ethics, 21(5), 576-582.
Dempsey, C., Reilly, B., & Buhlman, N. (2014). Improving the patient experience: real-world
strategies for engaging nurses. Journal of Nursing Administration, 44(3), 142-151.
Dewar, B., & Nolan, M. (2013). Caring about caring: developing a model to implement
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Freeney, Y., & Fellenz, M. R. (2013). Work engagement, job design and the role of the social
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Huber, D. (2017). Leadership and Nursing Care Management-E-Book. NewJersey: Elsevier
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Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: towards a
more critical interpretation. Nursing inquiry, 20(1), 11-22.

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Keyko, K. (2014). Work engagement in nursing practice: A relational ethics
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Ross, E. J., Fitzpatrick, J. J., Click, E. R., Krouse, H. J., & Clavelle, J. T. (2014).
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