Relationship of Nurse and Patient Assessment 2022

Assessment
Topic: Relationship of Nurse and the Patient
Student Name:
Student ID:

Relationship of Nurse and Patient 2
Criteria 1
Topic- “Relationship of Nurse and Patients”. The topic addresses the patient safety AND a
healthy workplace.
Criteria 2
A therapeutic nurse-patient relationship is helping in nature based on mutual respect and trust,
infusing hope and faith and being sensitive to the spiritual, emotional and physical needs of the
patients (Health Workforce Australia, 2014). Effective relationship ensures psychosocial and
physical safety while providing optimal patient care. Effective communication (verbal and non
verbal) is an essential part of nursing care enabling the equal partnership of the patient in getting
well (Institute of Medicine of the National Academies, 2004).
Nurse Patient Relationship as a problem
Nurse patient relationship is often influenced by the work environment factors like high stress,
increased workload, extended working hours and mandatory overtime which leads to fatigue
(Richard and Tabatha, 2010).
Maintaining effective Nurse Patient Relationship is a problem because workplace and
environmental issues result into high rate of medical errors and preventable adverse events.
Higher staff turnover rate results into poor quality of care, shortage of staff and low morale of the
staff which adversely affects the nurse patient relationship and patient safety (Nejati, Shepley
and Rodiek, 2016). Fatigue results into impaired physical and mental health which adversely
affects the patient safety and treatment outcomes. The nurses spend most of the time in
performing housekeeping work, transporting the patients and supplying the medical equipments.
These activities interrupt their primary care duties. It consistently threatens the patient safety.
Therefore, it is important to address these latent conditions at the work environment of nurses as
they affect the relationships at the care setting and the productivity
What is currently being done about it?

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To facilitate right nurse patient relationship and effective work environment for nurses, the IOM
recommended major changes in the way healthcare is structured. The changes were proposed in
Workforce deployment, management and leadership, organizational cultures and work processes.
The American Association for Critical Care Nurses (AACCN) established certain standards to
sustain the professional relationships like True collaboration, effective communication and
decision making, right staffing, reliable leadership and recognition of staff values (Hughes,
2008). The six major aims of healthcare as illustrated by the healthcare organizations like IOM,
CMS, The Joint Commission and AHRQ are: patient centered care, effective, equitable, timely,
efficient and safe care (Nejati et al., 2016). Emphasis is being given on Patient centered care,
evidence based practice and safety culture. These factors contribute in positive nurse patient
relationship.
Why it is a significant issue to Contemporary Nursing Practice?
Maintaining and developing effective Nurse patient relationship is a significant issue to the
contemporary nursing practice, as the nurses are primarily accountable for setting the purpose
and structure of relationship. Unsuccessful relationship of nurse and Patients may directly lead to
stressful working environment, as well as physical and mental health of the Nurse. The nurses
should use patient cantered care to satisfy the requirements of the patients and thus to develop
the relationship. The nurses have to work under professional, legal, ethical and personal
confinements to respect the unique attributes of every patient to understand their response to
care.
How effective leadership may mitigate the problem?
I think that effective leadership can ensure standard operating procedures, fair organization
climate, equal distribution of resources and adequate training of staff. Through transformative
leadership, the change can be taken as an opportunity to adapt, learn and improve. Strong
leadership provides strategic decision making authority to implement the teamwork, empowering
and engaging the employees towards improvements in all the spheres. The encouragement may
be used as a leadership technique to transform the perceptions about safety and developing
relationship.

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Criteria 3
Background of Patient Nurse Relationship Concept
In our general life, the friends make the life feel safe and fine. Good friends maintain our secrets
and respect our privacy. Through their words and actions the friends give us support to reach our
goals and help us during setbacks. In many ways, the relationship between a Nurse and Patient
relates to friendship. This professional relationship involves a caring interaction that assists the
patients in transition from one phase of treatment to the other. An effective Nurse Patient
relationship is based on respect and trust. One of the essential skills of nurses involves how to
establish therapeutic relationships.
Responsibilities of New Graduate Nurse
As a new Graduate nurse, I need to practice essential skills to create effective relationship with
the patients. I should use good communication skills to focus on the needs of the patient. I should
consider several factors in practice like the physical and emotional state of the patient, his
readiness to engage in communication, values, cultural preferences and the timing of
communication. I should learn to exhibit respect, genuineness, empathy, trust and confidentiality
during the interaction. I should follow the instructions of Registered Nurses. I need to respect the
differences in personalities and cultures of different patients and show real interest in the life and
condition of the patient. It may be accompanied with building rapport with patient, actively
listening to them and fostering empathy. I also need to master certain components like introduce
myself to the patient, refer to the patient by his name, maintain an eye contact with the patient
and respect the boundaries of the patient.
My responsibilities while educating my peers, patients and families
While educating the patients, peers and families, I need to identify their needs. The education can
be provided informally as well, such as explaining about the medications, responding to the
requests, educating about the medical interventions, preparing them for diagnostic procedures or

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discharge planning (Fakhr-Movahedi, Rahnavard, Salsali and Negarandeh, 2016). I may educate
the patients and their families during the care procedures. I need to express polite and respectful
behavior with patience while listening to them and responding back. My behavior during
education delivery should infuse trust in them. I need to comply with the nursing models and
treatment prescriptions. Through care, attention, inducing the calmness and getting trust I can
increase the patient safety
I should respect the boundary between therapeutic and non professional relationship with
patients. Patient’s Autonomy, privacy and dignity should be maintained during relationship. The
patients having speech problems, impaired cognition, anxiety and depression may find difficult
to interact. We should be able to detect such co morbidities.
.
Evidences I found and their integration with Presentation
I found that effective relationship building skills cannot be imposed over anyone. The changes in
behavior require development of additional skills like multidisciplinary collaboration, teamwork,
knowledge and adequate exposure. These skills are not acquired easily but can be developed
through collaborative programs such as NNLI (Novice Nurse Leadership Initiative) implemented
in South Florida in 2006 (Dyess and Sherman, 2011). Being a new Graduate nurse I need to be
awareness of Evidence Based Practice (EBP) and its implementation in my clinical practice.
I need to have entry level competencies and should practice under the guidance of Registered
Nurse (Birks, 2016). I should provide competent, safer and ethical care in different practice
settings as per the Nursing standards, legislation, code of conduct and employer policies. It will
help in developing safe environment for patients.
While following the ethical standards I should respect the patients, protecting their rights
maintaining the dignity. I should safeguard the privacy of the patients, and should establish an
environment of mutual trust with the patient. I should provide equable and fair treatment to all
the patients irrespective of age, disability, sexual orientation, economic status and citizenship
(LSU of Alexandria, 2017).

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How to put this information together?
I would distinguish the boundary between professional-therapeutic behavior with Non
professional- Non therapeutic relationships in nursing care. I can emphasize on the harms of
violating the boundaries. The violation may be in terms of socializing, disclosure, intimacy, gifts,
physical contact or coercion (British Columbia College of Nursing Professionals, 2019). There
are Nursing Principles to guide us in building relationships with patients. When the boundaries
are unclear and issues are complex, I recommend discussing them with trusted and
knowledgeable colleagues. As Nurses, we need to use professional judgment to understand the
boundaries related to therapeutic relationships with patients (Sheldon, 2018).
Criteria 4
Contemporary Research Policies
There are different policies, position statements and guidelines delivered by Australian Nursing
& Midwifery Federation, to safeguard the Nurse patient relationship, effective work environment
for the Nurses and delivery of safe patient care. For example: There are policies for bullying at
workplace, professional development, education, health and the environment, equal opportunity
at the workplace, occupational health and safety and many more (Australian Nursing and
midwifery Federation, 2014). I can understand those policies to implement them in my practice.
When the patients have positive experience of provided care, it provides a healthy work
environment for nurses. We are able to meet the organisational goals as well as achieve increased
satisfaction. According to American Nurses Credentialing Center (ANCC), patient safety can be
increased by developing healthy relationship between patients and nurses (Kieft, Brouwer,
Francke and Delnoij, 2014). The hospitals having better working environment give more positive
outcomes.
How am I going to Communicate?
I am going to communicate the information through presentation in a way, easier to understand
and recognize. The aim of the presentation is to sum up the main points about how improving the

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Nurse Patient relationship improves the patient safety. The presentation uses attractive images
and simple sentences to make it understandable.
How my presentation supported the peer, my role as leader?
I think that my presentation would have answered all the doubts related to therapeutic nurse
patient relationship which may influence the working environment and can affect patient safety.
The information is presented in an informative, logical and interesting way easier to follow for
the audience.

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References
Australian Nursing and midwifery Federation. 2014. ANMF policies, position statements and
guidelines. Viewed on 17 August 2019 < http://anmf.org.au/pages/anmf-policies>
Birks,M., Davis,J., Smithson,J. & Cant,R. 2016. ‘Registered nurse scope of practice in
Australia: an integrative review of the literature’, Contemporary Nurse, Vol 52. No. 5. pp. 522-
543, DOI: 10.1080/10376178.2016.1238773
British Columbia College of Nursing Professionals. 2019. Boundaries in the nurse Client
Relationship. Viewed on 17 August 2019.
<https://www.bccnp.ca/Standards/RN_NP/PracticeStandards/Pages/boundaries.aspx>
Chappel,K.B., and Richards,K.C., 2015. New Graduate Nurses, New Graduate Nurse Transition
Programs, and Clinical Leadership Skill. Viewed on 17 August 2019.
<https://nursing.ceconnection.com/ovidfiles/01709760-201505000-00002.pdf>
Dyess, S. and Sherman, R. 2011. ‘Developing the Leadership Skills of New Graduates to
Influence Practice Environments’. Nursing administration quarterly. Vol 35. pp.313-22.
Doi:10.1097/NAQ.0b013e31822ed1d9.
Fakhr-Movahedi, A., Rahnavard, Z., Salsali, M., & Negarandeh, R. 2016. ‘Exploring Nurse's
Communicative Role in Nurse-Patient Relations: A Qualitative Study’. Journal of caring
sciences, Vol 5. Issue 4., pp 267–276. doi:10.15171/jcs.2016.028
Health Workforce Australia 2014. Nursing Workforce Sustainability: Improving Nurse Retention
and Productivity. Viewed on 17 August 2019
<https://www1.health.gov.au/internet/main/publishing.Nsf/content/29418ba17e67abc0ca257d9b
00757d08/$file/nursing%20workforce%20sustainability%20-%20improving%20nurse
%20retention%20and%20productivity%20report.Pdf>
Hughes RG.2008. Nurses at the “Sharp End” of Patient Care. Patient Safety and Quality: An
Evidence-Based Handbook for Nurses. Chapter 2. Viewed on 17 August
2019.<https://www.ncbi.nlm.nih.gov/books/NBK2672/>
Institute of Medicine of the National Academies 2004. Keeping Patients Safe. Chapter 1.
Nursing: Inseparably linked to Patient Safety. Washington: National Academies Press.
Kesselring,V. 2015. The privilege of Nurse Patient Relationship. Viewed on 17 August 2019
<https://www.excemed.org/resources/privilege-nurse-patient-relationship>

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Kieft,R., Brouwer,B., Francke,A. and Delnoij,D. 2014. ‘How nurses and their work environment
affect patient experiences of the quality of care: a qualitative study’. BMJ health Services
Research. Vol. 14. Issue 1. Article No. 249. DOI: 10.1186/1472-6963-14-249
LSU of Alexandria. 2017. Importance of ethics in Nursing. Viewed on 17 August 2019
<https://online.lsua.edu/articles/healthcare/importance-of-ethics-in-nursing.aspx>
Nejati,A., Shepley,M.,and Rodiek,S.2016. ‘A Review of Design and Policy Interventions to
Promote Nurses’ Restorative Breaks in Health Care Workplaces’. Workplace Health and Safety.
Vol 64. Issue 2. pp 70-77. DOI: 10.1177/2165079915612097
Richard,P. and Tabatha,M. 2010. Fostering therapeutic nurse-patient relationships. Open Access.
Nursing Made Incredibly Easy!: Vol 8 Issue 3. pp. 4-10. doi:
10.1097/01.NME.0000371036.87494.11
Sheldon,L.K. 2018. Establishing a therapeutic relationship. Viewed on 17 August 2019
<http://samples.jbpub.com/9781449691776/9781449691776_CH05_Pass2.pdf>