NRSG139 Integrating Practice: Therapeutic Relationships Reflection

This essay provides a reflection on therapeutic professional relationships in nursing, utilizing Gibb's Reflective Cycle to analyze a video scenario involving a nurse and a patient. The reflection covers the nurse's communication approach, focusing on the establishment of a therapeutic relationship and adherence to NMBA standards. The essay delves into the description of the scenario, the author's feelings, an evaluation of the interaction, and a detailed analysis of what went well and what could be improved. The conclusion emphasizes the importance of therapeutic communication in nursing practice and outlines an action plan for developing these skills further, stressing the need for practical experience and a comprehensive approach to patient assessment. The document highlights the benefits of therapeutic communication and provides insights on improving interprofessional skills and patient care.

Running head: THERAPEUTIC PROFESSIONAL RELATIONHSIPS
Therapeutic Professional Relationships
Name of the student
University name
Author’s note

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Table of Contents
Introduction............................................................................................................................2
Case background....................................................................................................................2
Gibb’s reflection cycle...........................................................................................................3
Description.................................................................................................................................3
Feelings......................................................................................................................................4
Evaluation..................................................................................................................................4
Analysis......................................................................................................................................5
Conclusion..................................................................................................................................6
Action plan.................................................................................................................................6
Conclusion..................................................................................................................................7
References..............................................................................................................................8

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Introduction
The current assignment focuses upon the aspect of therapeutic communication in
professional relationships. The therapeutic communication approaches belongs to the
standard 2 of the Nursing and Midwifery board of Australia (NMBA). It consists of a number
of sub points such as establishment of therapeutic relationship in a manner which helps to
differentiate between personal and professional boundaries (nursingmidwiferyboard.gov.au,
2018). As per the standard 2 of NMBA, one should communicate in a manner which respects
the dignity, value and culture of a person (Levett-Jones, Gersbach, Arthur & Roche, 2011).
The standard also aims at providing direct support to people to help them with their decision
making process. The implementation of the standard helps in respecting the legal capacity for
a person (Clarke, Ells, Thombs & Clarke, 2017). It helps in fostering a culture of safety and
establishes a person centred care approach. The therapeutic communication also provides one
with the responsibility of reporting notifiable conduct of health professionals and health
workers (Benbenishty & Hannink, 2017).
Case background
In the current study, the aspects of therapeutic communication approaches have been
studied which forms and important component of nursing support and care. In the video, a
conversation between a nurse and a patient has been highlighted. The patient had been
admitted to the ward following which the nurse was sent to the patient to monitor or check
for the vital signs of the patient. Form the video, it was seen that the nurse adopted a very
friendly and cooperative communication approach with the patient. The communication
went from professional to personal such as the point, where the patient enquired the nurse
regarding some of the details such as the time for which the nurse had been working in
the hospital. The patient seemed to be quite easy and free in his communication approaches

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with the nurse which depicted the signs of a healthy and positive therapeutic relationship
(Duarte, J., Pinto-Gouveia, J., & Cruz, 2016).
Therefore, the benefits of the application of therapeutic communication approaches
within a professional setup have been evaluated through the assignment with the help of the
Gibb’s reflection cycle. The use of models such as the Gibb’s reflection cycle helps one to
focus upon professional practice standards.
Gibb’s reflection cycle
The Gibb’s reflective cycle could be divided into a number of basic attributes such as-
description, feelings, evaluation, analysis, and conclusion and action plan. Each of the steps
could be related to the actual clinical scenario to understand the strengths and weaknesses of
professional standards of practice. The different stages of the Gibbs’ reflective cycle could be
related to the actual clinical scenario taken from the course video.
Description
Here, the nurse was sent to collect or gather information regarding the vital signs of
the patient. The patient had been admitted to the hospital ward post a referral from the GP.
Post the admission of the patient the nurse was appointed for monitoring some of the vital
sign of the patient such as temperature and pulse. Therefore, after checking the vital signs of
the patient such as temperature and pulse were found to be normal. Hence, the nurse left the
patient there and asked his permission for reporting the same to the doctor (Wyder, Bland,
Blythe, Matarasso & Crompton, 2015).
In my opinion , over here the nurse had followed the policy pertaining to informed
practice, as per which the nurse will be providing the health details of the patient to the
doctor based upon further treatment plan will be proceeded. However, I think the nurse

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should have also measured some of the other vital signs such as blood pressure which is also
an important health parameter and gives a lot of knowledge regarding the health of the
patient.
Feelings
Therefore, as a nursing student the entire video session was a unique learning
experience for me. I personally felt that it was a very engaging and effective way of learning
nursing care and practices, as it helped the nursing student to analyse and understand the view
presented by both the patient and the nurse.
The event made me understand the aspects of therapeutic communication
approaches. I appreciated the easy exchange of communication and knowledge between the
nurse and the patient. The therapeutic communication approaches fosters a healthy and
effective professional relationship between the healthcare professionals and the patient
(Wyder, Bland, Blythe, Matarasso & Crompton, 2015). In my opinion, the event would have
a positive outcome as use of therapeutic communication approaches would make the patient
feel free with the nursing professional and confide in him regarding any personal or health
issues, which in turn facilitates the entire treatment process (Morera-Balaguer et al., 2018).
Evaluation
I think the entire learning event went well as the video course provided us with much
food for thought as we got to think and elaborate more upon the aspects of therapeutic
communication. I think the entire assessment went well where an effective and friendly care
bond was seen to be established between the patient and the nurse. However, at times I felt
that the nurse was a bit too professional in his approach or he could have tried to engage in
some extra conversation with the patient inquiring him about his past medical history or

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whether the patient was taking any extra medicines. However, excepting the vital signs none
of these extended details were considered by the attending nurse. The nurse also missed
some of the vital other signs such as monitoring the blood pressure of the patient along with
testing important parameters such as pupil dilation which gives a knowledge about the level
of consciousness of the patient (Slatyer, Coventry, Twigg & Davis, 2016). As mentioned by
Blais, Hayes, Kozier and Erb (2015), in the lack of such comprehensive health details, it
becomes difficult for the health professional to follow up the treatment.
Analysis
What went well?
The therapeutic communication session between the nurse and the patient was
addressed well where the nurse was seen to engage effectively with the patient
(McCorquodale & Kinsella, 2015).
What did others do well?
The patient responded proactively to the queries of the nursing professional which
made the gathering and collection of necessary information easier.
What went wrong?
In my opinion, the nurse lacked any extra detail regarding the event as such the entire
length of time or duration for which the patient will be kept in the hospital. Additionally, the
nurse was also not much informed regarding the evidence based approaches which would be
followed up with the patient in due course of time.
What did not turn out the way it was supposed to?

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The nurse attending to the patient over here lacked any further details regarding the
course of treatment or the exact care plan which is to be followed with the patient. Hence, the
nursing professional was not able to provide the relevant details to the patient and left saying
that he will pass o the detail to the doctor. In my opinion, this could lead to a breach the
policy of informed decision making.
Who and what contributed to how things turned out?
Both the nurse and the patient contributed effectively and positively to the entire
situation. I think both the patient and the healthcare professional engaged proactively with
each other which made treatment and follow up easier.
Conclusion
Therefore, going through the video as a part of my nursing curriculum I have
realised that therapeutic communication approaches are one of the most important
objectives in dealing with the patient, as it helps to take into consideration both the physical
and the psychological factors affecting the overall health and well being of the patient.
Therefore, in order to develop my future skills as a nursing professional I need to learn the
aspects of therapeutic communication well.
Action plan
Therefore, in order to develop the skills for therapeutic communication I need to put
myself in more real life situations or practical in-house session, where I can have an effective
one to one conversation with the patient which will enhance my therapeutic communication
skills. Additionally, to make the nursing care service delivery more effective, the detailed

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health status of the patient should be taken into consideration, as in the present case the
nurse missed to check the blood pressure of the patient which could help in monitoring the
orthostatic changes and falls within the vital signs monitoring list.
Therefore, the video learning course helped to understand the strengths and
limitations of the therapeutic communication which could help me in enhancing my inter-
professional skills further. Therefore, advancing in some of the practical clinical skills would
help me in adding more value in my next clinical placement.
Conclusion
The entire learning activities helped me in honing my skills as a nursing professional
and learn the aspect of therapeutic communication better. Additionally, the refection to the
practical scenario also helped me in understanding certain aspects of nursing care such
following a list of vital signs for monitoring the patient along with application of evidence
based approaches which are pivotal to effective handover of the patient.

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References
Benbenishty, J., & Hannink, J. R. (2017). Patient Perspectives on the Influence of Practice of
Nurses Forming Therapeutic Relationships. International Journal for Human
Caring, 21(4), 208-213. Retrieved from : https://doi.org/10.20467/HumanCaring-D-
17-00060
Blais, K., Hayes, J. S., Kozier, B., & Erb, G. L. (2015). Professional nursing practice:
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Clarke, S., Ells, C., Thombs, B. D., & Clarke, D. (2017). Defining elements of patient-
centered care for therapeutic relationships: a literature review of common
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https://doi.org/10.1016/j.ijnurstu.2016.02.015
Levett-Jones, T., Gersbach, J., Arthur, C., & 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), 64-
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McCorquodale, L., & Kinsella, E. A. (2015). Critical reflexivity in client-centred therapeutic
relationships. Scandinavian journal of occupational therapy, 22(4), 311-317.
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Rodríguez-Nogueira, Ó. (2018). Physical therapists’ perceptions and experiences
about barriers and facilitators of therapeutic patient-centred relationships during
outpatient rehabilitation: a qualitative study. Brazilian journal of physical therapy.
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