NRSG139 Ax3: Analyzing Nurse-Patient Relationship Using Gibb's Model

This essay provides a reflective analysis of a nursing practitioner's application of the second standard of the Australian Nursing and Midwifery Board, focusing on therapeutic and professional relationships with patients. Using Gibb's reflective framework, the essay examines a video vignette (NRSG139 Ax3 TPR) to understand how the practitioner establishes trust, communicates effectively, and respects patient dignity, values, and rights. The reflection covers the practitioner's actions, feelings, and evaluations, highlighting the importance of communication skills in building rapport and ensuring patient participation in the care process. The essay concludes with an action plan for improving communication skills and understanding patient behavior to enhance clinical outcomes. Desklib offers a platform for students to access similar solved assignments and study tools.

Running head: NURSING REFLECTION
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Nursing Reflection
Student’s Name
University

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Nursing Reflection
The Australian Nursing and Midwifery Board has a set of seven standards that guide the way
practitioners need to engage with patients. Since registered nurses work with individual, families
and communities, they meet patients from different demographic backgrounds that present an
array of challenges for the practitioner (The Nursing & Midwifery Board Australia, 2018). The
role of these standards is to establish a common ground that practitioner use to approach
healthcare issues, address the challenges that they face and at the same time remain accountable
to the license that they hold. This essay analyses the NRSG139 Ax3 TPR Vignette video with the
Gibb’s reflective framework to understand how the practitioner applied the second standard in
the care process.
Description
From the case, the practitioner engages with the second standard through the therapeutic and
professional relationship that he forms with the patient. When the practitioner enters the room,
the first thing is to greet the patient while calling him by name to establish a professional bond
with the patient. Lidia (2013) suggests that the practitioner can create professional bonds through
building trust, use of communication skills, caring and showing respect. The fact that the
practitioner calls the patient by name makes the patient feel appreciated since the practitioner has
personal knowledge of him. This leads to opening up of the patient since there is mutual trust
between the two. The practitioner engages the patient by forming a relationship that defines the
boundaries that exist between the two (Leonard, 2017). The patient is comfortable with this
setting since it allows him to take the sick role so that he can be assisted by professionals.
Further, the practitioner is seen applying the requirements of the standard by communicating

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effectively with the patient while observing his dignity, values and rights. Perera (2015) adds
that the role of the practitioner is to achieve the best out of any clinical process by applying
professional skills. In this case, the practitioner recognises the diversity and uniqueness that
patients have and thus approaches the assessment process from this perspective. By recognising
this, the practitioner carefully communicated with the patient by asking questions that relate to
his well being without necessarily penetrating into the personal space of the patient. The
outcome is a satisfied patient who follows up the care process and ensures that the participation
of the patient is achieved. The practitioner also uses effective communication to interact with the
patient and gather the required information for the whole assessment period.
Feelings
From the beginning of the video, anyone will want to know how the practitioner will engage the
patient to achieve the required clinical outcomes. This is seen in trying to understand
communication patterns that the researcher will use to approach the patient and handle any issues
that revolve around the care process. In most cases practitioners have difficulty initiating contact
with patients and building rapport for clinical outcomes. The challenge here is establishing
therapeutic and professional boundaries that yield the expected outcomes. Each patient is unique
and presents personal challenges that the practitioner deals with (Keea, Khoob, Limb, & Koh,
2018). However, through proper communication skills, the practitioner navigated these barriers
and ensured that the patient responds to all clinical obligations required of him. From the video,
the practitioner was informed of the requirements of the second standard thus making it easy for
him to navigate through the whole process.
Evaluations

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Agarwal & Sharma (2017) argue that patient-practitioner relationships form the quality of care
that the patient receives. The role of therapeutic and professional relationships is to build a
supportive environment that meets the needs of the patient and the practitioner. The video
provides the way in which the second standard is applied in care processes to yield the required
outcomes. When engaging with the patient, the nurse starts by building rapport and a culture of
trust through proper communication skills. However, he is keen on maintaining a professional
boundary to ensure that the rights and values of the patient are respected and at the same time
ensuring that the practitioner meets the needs of the profession. Communication skills have been
used well in the process thus leading to increased outcomes and ensuring that active participation
of the patient is gained. According to Flannery, Glew, Brewster, & Christie (2018) the
practitioner uses communication skills to involve the patient in the care process through asking
assessment related questions that measure the wellbeing of the patient. This leads to culture of
trust that makes the patient active in the whole process by participating in seeking clarifications
on what seems different to increase his understanding of the whole process.
Analysis
From the case, therapeutic and professional relationships are integral elements of any care
process. Practitioners need to equip themselves with communication skills for establishing bonds
with patients to improve clinical outcomes. In the video communication is a clinical tool that the
practitioner uses to engage the patient and gather the required clinical information. This leads to
patient participation which is seen in informed consent to all the clinical assessments that need to
be done. Since the practitioner had established a therapeutic and professional bond with the
patient. The nurse understands the effect of practitioner superiority and thus uses his

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communication skills to explain to the patient the demands of the situation and the requirements
of the patient. From an ethical perspective, the professional needs to assist the patient to
understand the obligations that they have in the assessment process and allow them autonomy to
make the decision. This is seen where the patient is informed of the assessments that needs to be
done and consents to them.
Conclusion
From the case, nursing experience becomes easy when the patient understands the requirements
of the care process and applies the required standards towards the process. By using the second
standard requirements, the practitioner achieved the required assessment information that was to
be gathered from the patient. However, the nursing profession like any other field is evolving
requiring the practitioners to equip themselves with clinical tools and strategies designed for the
modern profession (Stahlke, Rawson, & Pituski, 2017). This required regular training and
updating of skills to meet the requirements of the professional and therapeutic standards.
Action plan
To improve clinical outcomes and application of the second standard, I need to work on my
communication skills for easy interaction with patients and other colleagues. The role of
communication in the second standard is to necessitate formation of professional and therapeutic
boundaries that yield the required clinical outcomes (Hoff & Collinson, 2016). One area that I
need to work on is understanding of patient behaviour within clinical settings. Patients display
different behaviours that the practitioner is forced to control and manage to achieve the intended
clinical outcomes. The communication skills that I require in this case are the ones that will be
used to manage different patient behaviours during assessment. Since the second standard

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recognizes the uniqueness of patients and the need to approach each of them differently,
communication skills will inform the way to deal with patient situations and improve my
relationship and rapport building skills (Kutzleb, et al.). This will make me a better professional
who can overcome the challenges that patients present in clinical situations. With these skills, I
will achieve the best care process when working different patient profiles and segments.

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References
Agarwal, A. K., & Sharma, A. (2017). Patient-Physician Relationship; A keystone of Care in
Emerging Health Care System. Psychology and Behavioural Science, 2(2).
Flannery, H., Glew, S., Brewster, A., & Christie, D. (2018). Measuring Outcomes of
PsychologicalWell-Being within Paediatric Health Settings. Healthcare, 6(1).
Hoff, T., & Collinson, G. E. (2016). How Do We Talk About the Physician–Patient
Relationship? What the Nonempirical Literature Tells Us. Medical Care Research and
Review, 74(3).
Keea, J. W., Khoob, H. S., Limb, I., & Koh, M. Y. (2018). Communication Skills in Patient-
Doctor Interactions: Learning from Patient Complaints. Health Professions Education,
4(2), 97-106.
Kutzleb, J., Reilly, M., Rigolosi, R., Shaftic, A. M., Fruhschien, A., Duran, D., & Flynn, D.
(n.d.). Nurse Practitioner Care Model: Meeting the Health Care Challenges With a
Collaborative Team. Nursing Economics, 33(6), 297-304.
Leonard, P. (2017). Exploring ways to manage healthcare professional—patient communication
issues. Supportive Care in Cancer, 25(1).
Lidia, S. (2013). The Essential Elements of a Therapeutic Presence. Cancer, 1706-1713.
Perera, J. (2015). Effective Communication Skills for Medical Practice. Journal ofthe
Postgraduate Institute of Medicine, 2, 1-7.
Stahlke, S., Rawson, K., & Pituski, E. (2017). Patient Perspectives on Nurse Practitioner Care in
Oncology in Canada. Journal of Nursing Scholarship, 49(5), 487-494.

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TheNursing&MidwiferyBoardAustralia. (2018). Registered nurse standards for practice.
Retrieved from Nursing and Midwifery Board Australia:
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards/registered-nurse-standards-for-practice.aspx