Therapeutic Relationship And Case Study

Professional Identity
Student's Name:
Student's ID:
Subject:

1
Introduction
The fundamental aim of the paper is to identify the elements related to therapeutic relationship
that is appropriate for the case study. It will discuss the benefits of building a therapeutic
relationship and applying person-centred care for delivering quality care to the patients in
residential aged care. The paper will analyze the effectiveness of the NMBA code of conduct for
nurses and Registered nurse standards for practice that will help Mary and her peers to deal with
the situation in residential aged care. Such nursing standards will help Mary along with her
colleagues to avoid professional misconduct as well as unlawful behaviour and deliver quality
and safe care to the clients.
Thesis Statement
It is significant for the registered nurses to adhere to NMBA Code of Conduct along with
Registered Nurse Standards for Practice to assure delivery of quality and safe care to the patients
in residential age care.
Section A
From the given study it is observed that Mary is not meeting the NMBA standards as her conduct
towards the patients within the residential care deteriorates the standards and fails to meet the
performance plan. Her conduct highly affects patient safety in the residential aged care that is
against NMBA standards. As a registered nurse (RN), Mary fails to apply evidence-based and
person-centred decision making to assure the delivery of quality and safe care. It is significant
for the nurses to practice as per the broader health system and professional standards set by
NMBA standards and Australian Aged Care Quality Agency Standards for residential aged care

2
(Birks, Davis, Smithson & Cant, 2016). Mary does not possess leadership qualities to understand
her professional responsibility to safeguard patients and comply with the rules and regulations.
Based on the evidence in the case study, it is believed that Mary has not formed person-centred
and therapeutic relationships with her clients. It can be seen that Mary did not attend the
residents those who were allocated to her for providing quality care, rather she spent time at the
nurse's station. This states that she is not interested and fails to build person-centred and
therapeutic relationships with the patients. In a therapeutic relationship, RN is highly sensitive
towards the client's condition and decisively involves with the client by using skills and
knowledge in kindness, compassion and respect (Scanlon, Cashin, Bryce, Kelly & Buckely,
2016). In this particular relationship, client's dignity and rights are acknowledged and given
respect. However, it has been noticed that Mary did not follow these standards of practice to
understand the client's situation by building strong and positive relationships with them.
To do so, Mary must comply with NMBA standards for nurses as it will help her to understand
the patient's situation, get appropriate solutions to deliver quality and safe care (Halcomb,
Stephens, Bryce, Foley & Ashley, 2017). It is significant for Mary to apply Principle 2 and
Principle 4 associated with the code in practice to improve her conduct at work.
Principle 2: Person-centered practice
The principle states that nurses must apply evidence-based decision making and person-centred
care for providing quality and safe care.

3
Principle 4: Professional behaviour
The principle states that nurses must address lack of care and disrespect, disengagement,
omission and indifference to individuals that indicate under-engagement involving escaping from
the issue to assure patient's safety (Gardner, Duffield, Doubrovsky & Adams, 2016).
By adhering to principle two implements a person-centred approach to managing patient's
concerns and care by focusing on the client's preferences and values. She must make informed
decisions by considering her shared responsibility to contribute to effective nursing practice. It is
significant for Mary to take relevant steps to facilitate quality and care to the patients in
residential aged care as it will be beneficial for her to handle patients with care (Cashin et al.,
2017). To develop a therapeutic relationship with patients, it is essential for nurses to avoid
unlawful behaviour and professional misconduct. Thus, Mary must adopt lawful behavior while
nursing practice as it will help in strengthening therapeutic relationships with her clients.
Mary must focus on understanding professional boundaries while engaging with the residents in
residential aged care. While doing so, she must address the lack of disrespect and care towards
the patient. This can be done by implementing effective communication strategies with aged care
patients (Trollor et al., 2018). By following this particular principle, she will gain the benefit of
engaging with the patients and understanding the problems faced by them.
Section B
Yes, it is reasonable for Mary's peers to report the incident to the manager as the unprofessional
or unlawful behaviour, and professional misconduct of Mary may affect the safety of the patients
in residential aged care. However, this will help the manager to raise the issue and discuss it with

4
Mary and other colleagues to get a relevant solution. It is also reasonable as per principle three
that is cultural practice and respectful relationships, which states that nurses must develop
culturally safe and positive work environment (Pickles, Lacey & King, 2019). As a result, it is
significant for Mary to generate a safe work environment by supporting safety, dignity and rights
of others and role modelling involving peers and client. Therefore, according to the standards,
the nurses or peers must report the incident to the upper-level management to avoid such
professional misconduct in the future.
NMBA Code of Conduct for nurses (2018) will help in guiding Mary and her peers to manage
the critical situation by complying with the seven principles.
Principle 1: Legal Compliance
This will guide Mary and her peers to adhere and respect to their professional regulations under
the General Law and adhere to the appropriate laws.
Principle 2: Person-centered practice
This principle will guide Mary and the colleagues to follow evidence-based, person-centred and
care practice for the wellbeing of the patients in residential aged care (Nagle et al., 2017).
Principle 3: Cultural practice and respectful relationships
This will support them to involve with clients in residential aged care in a culturally humble and
safe manner to facilitate truthful and exposed professional relationships.

5
Principle 4: Professional behaviour
By adhering to this principle, they will be able to exemplify kindness, admiration, morality and
truthfulness while delivering quality and safe care to the patients.
Principle 5: Teaching, supervising and assessing
As per this principle, Mary, along with other nurses, must commit themselves to assess,
supervise and teach others to enhance the nursing workforce (Casey et al., 2017).
Principle 6: Research in health
According to this principle, Mary and her peers must execute extensive research regarding policy
development and quality healthcare.
Principle 7: Health and Wellbeing
This will help them to promote wellbeing and health of the patients in residential aged care to
avoid health inequalities.
Moreover, the Registered Nurses Standards for Practice (2016) will also help Mary and her peers
to manage the situation by following the seven standards given below:
Standard 1: Think critically and analyzes nursing practice
This will help them in using evidence and multiple thinking strategies to provide quality care.

6
Standard 2: Engages in therapeutic and professional relationships
This will help in communicating with patients in residential aged care effectively to understand
their situation and gain mutual respect and trust (Anderson, Moxham & Broadbent, 2016).
Standard 3: Maintains the capability for practice
With the help of this standard, they can use a wide range of valuation tools to execute informed
practice and care to the aged care patients.
Standard 4: Comprehensively conducts assessments
The standard will support them to work together to analyze the data to identify the factors that
harm the well-being and health of the patients in residential aged care (Fairbrother, Cashin,
Conway, Symes & Graham, 2016).
Standard 5: Develops a plan for nursing practice
This will allow Mary and her peers to create an agreed plan by developing a partnership among
them.
Standard 6: Provides safe, appropriate and responsive quality nursing practice
Through this standard, they will be able to enhance nursing practices by following the nursing
and health guidelines (Hildingsson et al., 2016).

7
Standard 7: Evaluates outcomes to inform nursing practice
It will help them to assess practice related to approve plans, targets and significances to offer
quality care to the clients.
Conclusion
The paper demonstrated an understanding of the components related to nursing standards that
will help Mary to provide person-centred care to the residents in residential aged care. It is
observed that Mary has been involved in a lack of care and professional misconduct that may
create a negative impact on the patient's safety. It is seen that to enhance therapeutic and person-
centred relationships with patients; Mary must follow NBMA code for nursing practice. It will
help Mary and her peers to strengthen the relationship with the patient and make informed
decisions. The paper stated that it is important for Mary's peer to report the incident of
professional misconduct to the manager to avoid the occurrence of such issues in the future. The
paper also analyzed the effectiveness of Registered Standards for nursing practise will help her in
using effective strategies along with tools and techniques to understand the situation of the
patients.

8
References
Anderson, C., Moxham, L., & Broadbent, M. (2016). Providing support to nursing students in
the clinical environment: a nursing standard requirement. Contemporary nurse, 52(5),
636-642.
Birks, M., Davis, J., Smithson, J., & Cant, R. (2016). Registered nurse scope of practice in
Australia: an integrative review of the literature. Contemporary Nurse, 52(5), 522-543.
Casey, M., Cooney, A., O'Connell, R., Hegarty, J. M., Brady, A. M., O'Reilly, P., ... &
O'Connor, L. (2017). Nurses', midwives' and key stakeholders' experiences and
perceptions on requirements to demonstrate the maintenance of professional
competence. Journal of advanced nursing, 73(3), 653-664.
Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., ... & Fisher, M. (2017).
Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.
Fairbrother, G., Cashin, A., Conway, M. R., Symes, M. A., & Graham, I. (2016). Evidence based
nursing and midwifery practice in a regional Australian healthcare setting: Behaviours,
skills and barriers. Collegian, 23(1), 29-37.
Gardner, G., Duffield, C., Doubrovsky, A., & Adams, M. (2016). Identifying advanced practice:
A national survey of a nursing workforce. International Journal of Nursing Studies, 55,
60-70.

9
Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2017). The development of
professional practice standards for Australian general practice nurses. Journal of
Advanced Nursing, 73(8), 1958-1969.
Hildingsson, I., Gamble, J., Sidebotham, M., Creedy, D. K., Guilliland, K., Dixon, L., ... &
Fenwick, J. (2016). Midwifery empowerment: National surveys of midwives from
Australia, New Zealand and Sweden. Midwifery, 40, 62-69.
Nagle, C., Heartfield, M., McDonald, S., Morrow, J., Kruger, G., Bryce, J., ... & Hartney, N.
(2017). A necessary practice parameter: Nursing and Midwifery Board of Australia
Midwife standards for practice. Women and Birth, 30, 10-11.
Pickles, D., Lacey, S. D., & King, L. (2019). Conflict between nursing student’s personal beliefs
and professional nursing values. Nursing ethics, 26(4), 1087-1100.
Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of
defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1),
129-142.
Trollor, J. N., Eagleson, C., Turner, B., Salomon, C., Cashin, A., Iacono, T., ... & Lennox, N.
(2018). Intellectual disability content within pre-registration nursing curriculum: How is
it taught?. Nurse education today, 69, 48-52.