...The Nurse-Patient Relationship In this essay, I plan to explore the concepts of the “nurse-patient relationship” using the necessary literature to back up my findings. I have chosen to study this concept because I am interested in discovering what makes a successful, or indeed, an unsuccessful nurse-patient relationship, as I believe the relationship between nurse and patient to be an integral part of nursing. The main focus of my essay will be around the works of Hildegard Peplau, but I plan to incorporate other theorists, such as Carl Rogers and Abraham Maslow, comparing and contrasting their approaches as well as drawing on my own practical experiences out on placement. Before beginning, it is important to understand what a “concept” is. This is so as to fully understand what the essay question is asking. According to Arnold and Underman Boggs (1999), a concept is a series of:- “Broad comprehensive ideas that serve as building blocks to present key ideas that make up models in a logical and focused manner” (p552). Concepts are very important in nursing and it is important that we understand why in order to integrate them into our practice. Nursing is now considered to be an “evidence-based” profession and one that changes constantly as new and fresh ideas are embraced. These ideas are formed through theories which, in turn, are formed through concepts. A fundamental part of the nurse’s role is to maintain confidentiality, and student nurses are no different...
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...Nurse-patient relationship According Cutliffe and McKenna (2005), research, theoretical and educational literature on interpersonal relations between nurses and patients has proliferated since the 1960s. This has generated a range of divergent accounts of what the nurse-patient relationship (NPR) ought to be, how this should be achieved, and how the NPR is constituted in practice. I have chosen the concept of nurse-patient relationship because this relationship is viewed as the essence of nursing practice (Moyle 2003). This essay’s aim is to demonstrate my understanding of the concept of the nurse-patient relationship through utilising relevant literature and relating this to a specific incident in my practice-experience. I will briefly explain an incident which I was involved in prior to identifying and discussing the significant aspect of the incident. Peplau‘s (1953) interpersonal relationship model and Rogers’ (1951) model of Self-Concept in mental health nursing will be used. I will then reflect on my learning and how this will impact on me as a registered mental health nurse. According to Julia and George (2002) a concept is an idea, thought, or notion conceived in the mind. These ideas or thoughts may be experimental or actual, depending on their ability to be observed in the real world. Meleis (2007), on the other hand, defined a concept as a term used to describe a phenomenon or a group of phenomenon. Nursing theories have been defined as reservoirs in which findings...
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...Nurse Patient Relationship ------------------------------------------------- The nurse patient relationship is a central to patient satisfaction. Nurses spend most of the time with patient. Therefore nurses attitude toward their work, co-workers and hospital influences patients’ opinion and experience about the hospital. It is imperative to have positive nurse patient relationship to establish rapport and achieve healing. Patients and families count on nurses to keep them informed, to connect them to their physicians and other caregivers, to listen to them, to ease their anxiety, and to protect and watch over them during their healthcare experience. Because of these high expectations of nurses, it’s no wonder that nursing performance, and more specifically, the nurse patient relationship, is so central to patient satisfaction and a quality patient experience. ------------------------------------------------- ------------------------------------------------- It is a nurse’s job to care for a patient’s medical needs. However, caring for their emotional well-being can have just as beneficial an impact on patient care. The relationship between nurse and patient requires trust, as well as understanding. For a patient to disclose private or embarrassing details about their physical or mental condition, they need to first trust that their nurse will treat them with dignity and respect. Furthermore, patients will only follow the advice of their nurse if they trust in his or...
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... The nurse demonstrates her unprofessional behavior and poor communication skills during the first patient interaction scenario when she speaks to the pregnant women. She asks about the patients insurance even before being concerned about if the possibility of active labor. She informs the patient that she needs the patient’s husband’s number so she can call him about her being in the hospital. The nurse should have asked if there was anyone the patient wanted contacted, and she should only ask that after the patient has been sent back to the examination room. The nurse also makes a snap judgment about the laboring women when she finds out that she isn’t married. The nurse decides that the status of the child is such that the religious hospital won’t see her. The federal government enacted several laws that the nurse in this video has ignored. The First law is the Emergency Medical Treatment and Labor Act that says that a Medicare-accepting hospital has to take patients in emergency situation, including active labor, regardless of their ability to pay. They have to stabilize these patients before they can be discharged or transferred. By asking about her insurance while the women was in active labor she broke this law. She also was going to violate the HIPPA law by contacting the women’s husband without getting her express permission to do so. The HIPPA law prohibits releasing medical information to anyone without written permission of the patient. Besides the...
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...Importance of Patient-Centered Care It has been a goal of many healthcare providers to achieve patient-centered care in their facilities. At the Cleveland Clinic, they have come up with a program that will help create better communication between the physician, nurse and patient. Rimmerman (2013) said that their hopes are to eliminate misunderstandings, create a better environment for the patient and their families to ask questions and to achieve a plan of care that will fit to the patient’s needs. Why is a patient-centered program important? At many facilities, patients often spend about 30 minutes or less a day with their physician during their stay. According to Rimmerman (2013), the nurse devotes their time with the patient and their family more than any other staff member. The relationship that nurse develops with the patient is a vital component to the patient’s care. This allows the nurse to create an environment for the patient and their family to ask questions or state any concerns they may have. According to the Rimmerman (2013), “In many respects, they know the patient better by virtue of their time spent and reflect an in valuable source of clinical information with respect to, patient progress, personal needs, skin wounds, IV status, activity level, nutritional status, independent ambulation, emotional concerns and family dynamics. Nursing is in a position of strength by virtue of its continuity of care.” That statement sums up why it is an important key for...
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...administrative issue? Explain the managerial responsibilities related to administrative ethical issues. If none were stated, what should have been done? Identify any proposed solutions. When a nurse becomes overwhelmed, they may turn to narcotics like in this case. The nurse was putting the patient’s health at risk to help her get her drugs. She would chart the patient was given the drug but in turn she was giving them saline and was taking the drugs herself. It was a flexible nurse so she didn’t have certain rooms with specific patients. The pharmacist was the one who actually figured out there was an increasing amount of narcotics signed out and the signatures were questionable. Confidentiality became an issue in this situation. Since two nurses knew of the situation and confronted the nurse about getting help. But one nurse stated all the nurse had to do was complete rehabilitation during her leave. The other nurse supervisor wanted to have a meeting with other members to discuss how it needed to be handled, let the other staff members know what had gone on and see if they know anything but didn’t say anything. Also reassuring the staff that a problem had been found and it was taken care of. To show that administration was committed to taking care of their employees and patients also run a safe practice. In certain cases such as the one, there may be circumstances that maintain the confidentiality Act places legal protection on some information. The supervisors need...
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...Clearly, this patient has no idea how bad her illness really is. Not only does she have the doctor lying to her, but she also has two daughters who are in on it all too. Her primary nurse, must decide if she will go along with them as she was asked to do, or if she will go against them and possibly lose her job. We also must decide if lying to the patient is morally justified. After just going through a painful divorce, one could say that it is in the best interest of the patient to not know how serious her illness is. With her not knowing the truth it may have been what was best for her mental health, which means the lies her justified. That would mean that the medical staff handled the situation to the best of their ability. However, one...
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...experienced an incident that I would like to reflect upon. I was assigned to a female patient with diagnose of third stage breast cancer. After taking her interview, I came to know that patient and even their family member didn’t know any thing about the patient prognosis and they were too worried to know about. For that reason, I went to doctor and inquired that whether doctor had told them about the patient prognosis or not. In response to my question, doctor got irritated and replied in a very rude manner. He said, “you want me to tell patient that when he would gone to die? Or how much life is remaining for him… six month or less then that?” why should I be bothered? Let the family deal with it. I have other number of tasks. On hearing that comment, I got astonished and remained silent in front of him. After some time, he again probe that we don’t get enough time to explain each and every patient about their diagnosis and prognosis and if we take such type of tension related to patient’s health status, one day we get burst out. After coming across this situation, several kinds of feelings came in my mind. First of all, I felt very strange on hearing that discourteous response of doctor. I thought that being a professional, how he could talk in such a pathetic manner? Not only as a professional but also as a human being, he must have understanding and empathy towards terminally ill patients. Secondly, I got confused because after looking at the apprehensive behavior of doctor...
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...nursing are ‘necessary for achieving mastery in the discipline’. I believe that implementing those four patterns of knowing into daily nursing care is vital in order to provide best quality care for each patient. Nursing care should be implemented in flexible, thoughtful manner and should be carefully executed in unique situation with unique patients. Empirical Way of Knowing Empirical way of thinking is defined in article as a ‘factual, descriptive…exemplary, discursively formulated and publically verifiable which is ultimately aimed at developing abstract and theoretical explanation’ (Carper: 15). This way of thinking is executed using Evidence Based Practice. I have been a nurse for the past 10 years and I believe that empirical way of knowing is most familiar to me. For example, my facility is using Congestive Heart Failure protocol (policy created by facility based on clinical practice guidelines CPG) for patients admitted to hospital with either new onset of CHF or exacerbation of the disease. Each patient with CHF has comprehensive assessments, symptoms management, appropriate use of medications (ACE inhibitors), daily weight monitoring, resident and family education throughout the hospital stay. This is achieved by using multidisciplinary approach for patient care and by following Evidence Based Practice. Personal Way of Knowing Personal way of knowing is probably easiest for me to understand. As quoted in article this...
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... however, her situation could worsen. Fetal distress is not currently critical, but it has been increasing gradually, as has RB’s own distress and fear. We have been keeping a close eye on her. I'm not sure her parents understand how dangerous her situation could get because RB and the baby may be moving toward irreversible medical danger if some intervention is not made. Ethical Issue #2 Presented During my Shift One of our ICU's patients, AT, has been unconscious for nearly a day and as yet no definitive diagnosis has been reached by doctors. AT was brought to the hospital by his domestic partner, YM, who was with him while he was in the ER, but was prevented from visiting him in the ICU by CB, the shift supervisor for the day shift. Hospital policy states that domestic partners are to be treated as married couples, for the purposes of access and, most importantly, when it must be determined who can make medical decisions for a patient unable to give their own consent. How can I best to assure the access for gay partners of Seva's patients on equal footing with straight couples? Decision-making...
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... : Dr katuna Working ours : Maximum 5 hours per day Patients per day : Maximum 16 patients per day Numbers of patients we observed : 4 patients We went to MCN clinical centre, which it is situated in vazha pshavela.It is a primary health care centre, Beause its medical facility that mainly focuses on the initial treatment of medical ailments. During our clinical sessions we observed that most of patients came there for just medical consultations. Structure of the MCN: General consultation service Diagnostics and medications General medical test services (Urine tests, ECG...etc) Dental surgery unit Patients of the clinic: During our session we noticed that most of are adults, age up to year 35. Most of them were equipped with their own insurance schemes. Therefore they going to paid with their insurance cards. Further diagnostic with special clinics: We unable to find out that our Doctor going to transfer their patient to special clinics. but she told that MCN can act as a facilitator for patients transfer to the upper level of clinics for their further examinations. On the other hand MCN doesn’t equipped with a surgical facilities, if it patient required to any surgical approach to overcome his or her disorder, he or...
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...Connecting with Patients J. Scott Joslyn, PharmD, MBA ABSTRACT Electronically connecting with patients is a challenging frontier at which technical hurdles are probably exceeded by political, legal, and other barriers. The rise of consumerism, however, compels a response focused more on revenue and strategic advantage than on pure cost savings. Among the difficulties faced by providers is choosing among various models of connectivity and component function. Emerging models include “freefloating” personal medical records largely independent of the office-based physician, systems with compatible and intertwined physician and consumer relationships using an application services provider office practice system, and systems that connect patients and providers through e-mail, office triage, prescription refills, scheduling, and so on. This article discusses these and other combinations of technology that significantly overcome the barriers involved and that may be woven together to provide solutions uniquely suited to various competitive situations. KEYWORDS • Consumerism • Patient-provider relationship • Data ownership • Application service providers • Time and cost savings The Internet has created both opportunities and threats that providers of all stripes must eventually confront to remain viable businesses in the new economy. Although business-to-business (B2B) innovations offer great hope in reducing costs and providing other efficiencies, electronically connecting with patients is a particularly...
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...choose to organize patient files and how loose papers are handled. Regardless of the size of the medical facility; each facility prefers to have all of the patient’s paper work to be anchored securely in each patient’s chart. By having all of the patients paperwork secured in the patient file, this will eliminate the possibility of losing or misplacing paperwork. This also allows for each patient record to be neatly organized and can be easily viewed by all medical staff. Medical facilities file patient records differently. Depending on the size of each facility there are a few different ways to file patient records. Some facilities use the patient’s last name, and others may choose to file by patient number. Facilities may also organize patient files differently; again, depending on the size of the medical facility medical records can be organized in the following ways. A patient’s chart can be organized by visit with the most recent visit filed on top (or first). Other facilities may choose to file patient charts by report type, and or by categories. Large facilities such as a hospital may choose to file patient charts by categories or report type instead of by each patient’s visit. You may see in a patient’s chart that is organized by categories or report type, headings such as, lab reports, physician notes, and physician orders. Even though there are many similarities and differences on how medical records are organized and file patient records, it is up to...
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...communicate with the patients/consumers. Electronic medical records is fairly new and very beneficial to not only the organization but for the patients as well. Benefits The electronic medical records is much more efficient over having paper charts because they are easier to access as well as share with others that are involved in the patients care. With this being said if a patient has a sudden emergency where they are required to go to the hospital then those records can be sent and shared with that ER staff as well so that it may help with any complications the patient may encounter. With such catastrophic events in our nations past like 9/11, and the tornadoes that have been plaguing our heart lands this comes in handy so that information is easier to share with other medical personnel. Safety In today’s crazy world we patient’s privacy is very important because there has been such rapid identity theft with the electronic medical records system in place it will help to eliminate that for the most part. There are no perfect systems out there but it does help to cut down on this. There are laws in place to help with stiff laws and penalties for not protecting patients could be very costly to the organization. No practice should give out any patient information without for getting the okay from that very patient. Organization must also make sure that the laws are clearly spelled out and displayed for all to read and understand and if that patient asks for a copy they...
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...specifically deal one on one with patients, so I am going to go back to when I worked in a Physician’s office where I was handling patient information on a daily basis. As a medical biller at that time, we were trained regarding what HIPPA regulations were all about and how to stay within those regulations and not accidently or on purpose expose any personal information regarding our patients. We had volunteers, as well as interns that would come and go. And they as well had to be trained to follow the HIPPA laws, some were not aware of what HIPPA even stood for so it was imperative that they be trained immediately so that no personal information was released to unauthorized entities. There was strict communication within our facility as far as when and where we could discuss any patient information while the office was open, we were instructed to talk in hushed tones and behind closed doors. Even after hours we were instructed not to shout across the hall any personnel information on any patient, the physicians frowned upon that highly. “The dramatic changes in health care delivery and administration over the past several decades have resulted in increased consumer concerns about privacy (Applebaum, 2002; Gostin, 2001).” There is a huge impact when it comes to dealing with different ethnic groups among the co-workers, patients, caregivers, managers and families. There had to be Spanish speaking personnel on staff at all times, so any patient that did not speak English we...
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