Barriers to the development of interpersonal relationship – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.

Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.

Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.

Table of Contents

Barriers to the development of interpersonal relationship:

1. Anxiety
2. Stereotyping and Bias
3. Space violence.

A. Anxiety: Anxiety is a vague, persistent, and uncomfortable feeling of impending doom. A mild level of anxiety heightens ones awareness of the surrounding environment, fostering both learning and decision making. Higher level of anxiety decrease perceptual ability. The nurse needs to use anxiety and stress reduction strategies when clients demonstrate moderate anxiety levels. Severe sustained levels of anxiety and untreated panic are incompatible with life.

B. Stereotyping & Bias: Stereotypes are generalizations representing an unsubstantiated belief that all individuals of a particular social group, race, or religion share the same characteristics. No allowance is made for individual differences within a sub group. Developing a non-judgmental, neutral attitude toward a client helps the nurse reduce clinical bias in nursing practice.

C. Personal space violence: Personal space defined as an invisible boundary around the individual is another individual is another conceptual variable worthy of attention in the nurse client relationship. The emotional boundary needed for interpersonal comfort changes with different conditions. It is defined by past experiences and culture. Proxemics is the term given to the study of human’s use of space. To minimize a decreased sense of personal space, the nurse needs to demonstrate a high regard for the clients dignity and privacy.

Reduce of Barriers in Nurse Client Relationship:

Recognition of barriers is the first step in eliminating them and thus enhancing the process of developing a therapeutic professional relationship. Practice with exercise should help recognition of possible barriers.

Nursing Strategies to Reduce Client’s Anxiety

1. Active listening to show acceptance

2. Honesty, answering all questions at the clients level of understanding.

3. Clearly explaining procedures, surgery etc.

4. Acting in a calm, unhurried manner.

5. Speaking clearly but not loudly.

6. Giving information regarding lab tests, medication, treatments etc. Setting reasonable limits and providing structure.

7. Encouraging clients to explore reasons for anxiety.

8. Encouraging self-affirmations through positive statement, such as “I will”, “I can”.

9. For children use play therapy.

10. Using touch, giving warm baths, back rub.

11. Initiating recreational activities such as physical exercise, music etc.

12. Teaching- breathing and relaxation exercises.

13. Drawing for young clients.

14. Initiating recreational activities such as physical exercise, music, card games, board games, crafts, reading.

15. Using guided imagery.

Respect for Personal Space:

Before providing care the nurse needs to access the client personal space needs. A comprehensive assessment includes cultural and developmental factors affecting the client’s perceptions of spaces. How the clients reacts to instructions, how the client defends personal space, and non-verbal behaviors that may indicate loss of territory. To increase the client sense of personal space, you can decrease close direct eye contact. Instead, sit beside the client or position the chairs at angles for counseling or health teaching.

Clients in intensive care unit, where there are many intrusive procedure, benefit from decrease eye contact during, certain time such as when being bathed or during suction, wound care and changing of dressing. At the same time, it is important for the nurse to talk gently with client during such procedure and to elicit the client feedback if appropriate.

To minimize the loss of sense of personal space and associated behaviors the nurse demonstrates a high regard for the clients dignity and privacy. Closed doors privet rest and periods of uninterrupted relaxation are respected. Personal belongings are arrange and treated with care, particularly with very old and very young clients for whom personal items may be highly significant as a link with a more familiar environment.

Elderly clients can become profoundly disoriented in unfamiliar environments because their internal sensory skill in a processing new information is often reduced. Encouraging persons in long term facilities to bring pictures, clothing, and favorite mementoes is an important nursing intervention with
such clients.

Respect for Personal Space in Hospital Situations:

Obviously, there is a discrepancy between the minimum amount of space an individual needs and tit amount of space hospitals are able to provide in multiple-occupancy rooms. Therefore, the nurse must recognize individual needs for privacy and implement actions to increase the sense of personal space. Respect for the client personal space can be accomplished by the following:

Providing privacy when disturbing matters are to be discussed.
Explaining procedures before implementing them.
Entering another person’s personal space with warning (e.g. knocking or calling his name) and preferably, waiting for permission to enter.
Providing an identified space for personal belongings.
Encouraging the inclusion of personal and familiar objects on the client’s nightstand.
Decreasing direct eye contact during hands-on care.
Minimizing bodily exposure during care.
Using only the necessary number of people during any procedure.
Using touch appropriately.

Nursing Strategies to Reduce Stereotyping and Bias:

Use neutral terms.
Strive for a balanced representation of various groups in diverse roles
Use standard, formal language. Avoid slang, idioms and colloquialisms.
Also avoid obscure language ambiguous acronyms unless they are standard, recognized terms with regards to the subject matter of r assessment.
Be wary of using a condescending tone. For example, this could be a tone that implies that a person with differing abilities is incapable of caring for himself or herself, or that a person of lower socio-economic status is not as intelligent as someone from a higher status.
Avoid references to race, ethnicity, gender, age, etc. unless they specifically apply to the question. Include positive depictions of individuals in non-traditional roles. For example, don’t assume that all nurses are female and all doctors are male.
Make sure your items are reviewed by a diverse group of subject matter experts.
Present people with disabilities in active, capable and independent positions.
Avoid common racial/ethnic stereotyping.
Do not portray either sex as submissive or having an inferior status.
Do not demean the elderly by portraying them as feeble, lonely or dependent.

Nursing Strategies to Reduce Client’s Anxiety.