Key elements in building interpersonal and therapeutic relationships – 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.
Key elements in building interpersonal and therapeutic relationships
1. Warmth
2. Respect
3. Genuineness
4. Empathy
5. Self-disclosure
6. Questioning
7. Expressing opinion
A. Warmth:
a) Warmth is the glue in the bonding between people and the magnetism that draws us to a closer intimacy with others.
b) Warmth is one of the most difficult interpersonal behaviors in learn. It is the total way of offering oneself to another persona
c) Showing warmth to other means you like to be with them and accept them as they are.
d) Warmth is not communicated in isolation, it must be accompany with other facilitative communication behavior
B. Respect:
a) Respect means accepting others for what they are, not on the condition that they behave in a certain way or possess special characteristics.
b) Receiving respect makes people feel important, cared for and worthwhile. In contrast, when people do not receive respect, they feel hurt and ignored. Respect is displayed principally through acknowledgement, establishing the nature of the contact and establishing a comfortable climate
C. Genuineness:
a) Genuineness or authenticity is a fundamental basis for the best of communication comprising of realness & congruence. The basic feature of genuineness is presenting your true thought s and feelings verbally and none verbally to another person.
b) Genuineness is “what you see is what you get” phenomenon; people receiving your genuineness can trust you because they know you are not sending false signals or hiding something from them. It is this building of trust that is the most important reason for being genuine.
D. Empathy:
a) Empathy is defined as the capacity to see with the eyes of another, to hear with the ears of another, and feel with heart of another without loss of self.
b) It is the act of communicating to a fellow human being that we have understood how he is feeling and what makes him feel that way.
c) A synonym of empathy is communicated understanding. The process of empathy involves the unconditional acceptance of the individual in need of help: judgments and evaluation of feeling are never offered. Another synonym is active listening. Empathy allows the nurses to fully perceive the depth of client’s anger, fear and anxiety without being overwhelmed by it.
E. Self-disclosure:
a) Disclose means to “un” closed or to open up. To self-disclose then means to open up our self to others. When we self-disclosed we reveal our thoughts and feeling and make known to others some of our personal experience.
b) The nurse client relationship demands some special considerations for the employments of self-discloser. It is always established for the benefit of clients. In other words it is a client centered relationship. The intent to self-discloser is to empathic: to show that you really understand because you have walked a similar path.
F. Questioning
a) Adeptness at asking questions is a fundamental requirement of a component and considerate nurse. The more effective the nurse can be in questioning, the more effective the nurse can be in questioning. The interview can be continued successfully at the follow up session.
b) There are six questions the nurse needs to answer to ensure she secures the fact she needs. The following questions are-
- Why- why you need to the information?
- What- What to ask to ensure you are clear in your intension?
- How- How to phrase your question in a way that invites your client to respond?
- When?
- Where- Where to secure a completely secure, private place.
G. Expressing opinion:
a) Expressing opinion is the act of disclosing what the nurse thinks or feels about health care situations affecting her clients or colleagues. It is assertively interactional. That is the opinions are offered as additional information for their problem-solving and decision making process.
b) When to express opinions there are three situations when clients and colleagues seek nursing counsel. These occasions are when they are at a decision point about:
- Whether to provide or withhold information.
- Whether to comply with a treatment plan or resist it
- Which strategies to implement in order to get the desired outcomes
Ways of Displays Respect:
Respect is displayed principally through acknowledgement, establishing the nature of the contact and establishing a comfortable climate.
A. Acknowledging our clients- concrete actions include:
a) Look at your clients.
b) Give your undivided attention.
c) Maintain eye contact
d) Smile is appropriate
e) Move towards the person.
f) Determine how he likes to be addressed
g) Make contact with a handshake or gentle touching (or any other means reinvent to the culture)
B. Establishing the nature of the contact:
There are thinks you can do to convey respect throughout a view or on-going contact for the first time contact.
a) For the first time contact
- Make it clear who we are and what our role is
- Ask what he/she needs.
- Be clear how we recalls his/her situation
- Indicate how we can protect his/her confidentiality
b) For ongoing relationship
- Ensure that he/she recalls who we are and our role is.
- Determine his/her needs at this point
- Indicate we recall his/her situation.
- Review the issue of confidentiality
- Refraining from gossiping about other clients.
- Suggest a referral where appropriate.
C. Establishing a comfortable climate:
a) Indicate time availablemland
b) Arrange to meet at another time if needed.
c) Ensure privacy
d) Arrange the room
e) Ensure comfortable environment
f) Be one time for appointment
g) Explain if there is a change in schedule appointment.
h) Prepare for terminate-allow time and space for the client to talk about the dealings of termination and express our feeling as way showing that our care.
Way to Display Genuineness:
1. Avoid self-disclosure until the client demonstrate a readiness to response positively to such discloser.
2. As trust is establish, the nurses can become more open spontaneous white adhering to the principles of empathy and respect.
3. Avoid using self-disclosure to manipulate, give advice, or influence for the nurses own goals.
Ways to Display Warmth:
1. Attention should be focused largely on the face. Interests and responsiveness will remain during interaction as well as emotional state.
2. Warmth is displayed mostly no-verbally through face, eye contact, month, expression, and attentive, posture-relaxed, comfortable and touching.
3. Touching is another way to affectionately transmit warmth. From the briefest touch on the shoulder to an embracing huge or extended hand one can convey warmth to other. Nurse hands have been called therapeutic tools that can expressed warmth carrying and comfort.
4. Warmth can be conveyed verbally as well as non-verbally the volume of voice is related to warmth soft tune comfortable pitch, pacing, rhythmic-speech, loving soft and non-judgmental words.
Benefit of Empathy for Clients and Colleagues:
1. Increase the feeling of being connected with another human.
2. Contribute to feelings increased self-esteem for those to home me extent it
3. Demonstrate that we accept how or clients and colleagues feel and contribute to their trust.
4. Help them to move on to new feelings s and change their behavior.
5. Help our clients and colleagues to comprehend fully hoe they are reaching
6. Help them inside and expend self-awareness, so that they can decide how to handle the situation
7. Lead to clients listening to themselves more empathically
8. Account for improvement in psychotherapy clients.
Tips of Asking Question:
1. Keep it short and simple (KISS)
2. Be considered offering opportunity to support their ideas, do not jump in and upstage clients.
3. Do not bombard and clients they throwing several questions at a time
4. Avoid medical terminology.
5. Soften the why question because it can always threaten the clients.
6. Use open ended question instead of close ended question.
7. When time is, up, do not suddenly stop the interview but leaving some question for the client to think show the interview can be continued successfully at the follow up sessions.
Ways to Communicate Empathically:
1. Clear our hand of distracting agendas.
2. Remand our self to focus on my speaker.
3. Attend to our clients or colleagues verbal and nonverbal message.
4. Ask myself what does this person wand me to hear?
5. Convey an empathetic response-verbal reflect my feelings and the reason for them, convey the amount of warmth and ensure that the expression is congruent with my attention.
6. Check to see if our empathetic was effective.
Ways to Convey Self-Disclosure in the Helping Relationship:
These are similar to conveying empathy outlines in the previous topic. In sort they are:
1. Listen
2. Reply empathically
3. Self-disclose.
4. Check in out Sells
Self-discloser can be helpful or non-helpful. The nurse should always be aware of what, when and why they should self-disclose with the clients,
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