Enhancing Therapeutic Relationships in Nursing Essay (Critical Writing)

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Introduction

The relations between a patient and the nurse have been described as crucial to achieving better health. Nurses are advised to adopt unconditional positive regard because it enhances respect. The perspective ensures that the healthcare provider is cognizant of the impact of viewing patients as human beings. Acceptance and respect for all sick people are essential in enhancing therapeutic relationships. Self-awareness is another aspect that can enhance the development of a nurse. The ability to be aware of how to respond to situations creates increased possibilities for effective service. This paper will evaluate the concepts of therapeutic relationships, unconditional positive regard, containment, self-awareness, and emotional intelligence.

Therapeutic Relationships

A therapeutic relationship can be defined as a purposeful, goal-oriented relationship that is focused on achieving the best outcome for the patient. They are viewed as the foundation of the nursing practice (McKinnon, 2016). This is because the relationship between client and nurse can become the primary intervention that can aid awareness and help work through difficulties. In areas such as the intensive care unit, therapeutic relationships may manifest in the form of the provision of comfort, support, and care to patients (Böhmer and Krüger, 2019). One of the components of therapeutic relationships is professional intimacy, which can involve the psychological, spiritual, and social aspects identified in the plan of care (McKinnon, 2016). Activities such as access to the patient’s personal information and bathing a patient contribute to the development of professional intimacy.

Another significant component is respect, which means the need to recognize the dignity, worth, and uniqueness of every individual during the process of care. Nurses should not be affected by socioeconomic status, personal attributes, and the nature of the patient’s problem when reacting to all situations (McKinnon, 2016). Trust is the other significant aspect as it may be difficult to re-establish trust once it has been broken. Nurses need to ensure that they follow through when they promise to help a patient (McCance, McCormack, and Dewing, 2011). Empathy refers to understanding the healthcare experience from the perspective of the client. This can be expressed in the form of maintaining objectivity when responding to the patient (Norcross and Lambert, 2018). The last component is power which addresses the aspect of authority and influence in the client-nurse relationship. The healthcare provider has more power than the patient and should ensure that it is utilized for the benefit of the client.

Unconditional Positive Regard

Unconditional positive regard can be defined as caring for the client as a separate person, with permission to have their feelings and experiences. Rogers viewed unconditional positive regard as an attitude that nurses, therapists, and counselors needed to develop (Rogers and Freiberg, 2005). This is because unconditional positive regard ensures the creation of trust between the client and the healthcare provider. The idea does not involve the nurse or therapist agreeing to and accepting everything the patient has done (Farber, Suzuki, and Lynch, 2018). The concept involves respecting the patient as a human being who possesses their own free will and operates under the inclination that they are doing the best they can (Rogers and Freiberg, 2005). Unconditional positive regard from a nurse or therapist can be a substitute for the regard that the client did not receive during their childhood.

The concept is based on the assumption that when a nurse or therapist respects the client’s need for self-determination and adopts a similar attitude, the client is likely to move towards socially constructive behavior. Nurses and therapists have to lay aside their views and values and approach the patient without prejudice (Murphy et al., 2020). Unconditional positive regard requires the practitioner to be self-aware because it is possible to adopt the perspective of the patient. The concept was developed for therapists and counselors but has been applied in different fields. This is because it enhances respect and empathy when dealing with people.

Containment

Containment can be viewed as a pattern of communicating mental experiences. Individuals undergo difficult and traumatic experiences that result in overwhelming emotions (Gibson, Till, and Adshead, 2019). The inability to contain these feelings can result in challenges in integrating with people. containment is a concept that arises from early childhood in the relationship between the child and the mother. The child is taught to handle difficult emotions by the mother through different actions and experiences. Containment is also present during therapy and occurs when the therapist listens to the distressing inner experiences of the patient and provides feedback that fosters growth and understanding.

The process of containment starts with the patient sharing their experiences with the practitioner. This sets the stage for the therapist to listen and generate appropriate feedback for the client. The emphasis is on empathy because it enhances respect and trust between the client and therapist. Most people still hold the fantasy that difficult feelings can only be dealt with using avoidance (Casement, 2014). For containment to occur the individual must accept the unmanageable feelings (Adimando, 2018). This allows the patient to share with the practitioner, which enhances the recovery process. Therapists should ensure that they have insight into the issues that are being re-enacted with them during the process.

Self-Awareness

Self-awareness is a crucial aspect for all healthcare providers. The concept can be described as the cognitive exploration of own thoughts, beliefs, feelings, values, and feedback from others. The Johari window was developed in the 50s and can be used to develop self-awareness. The system focuses on four forms of the self, which are the public self, the private hidden self, the blind self, and the undiscovered self (Rasheed, 2015). The goal of therapy is to increase the size of the open area (public self) by reducing the blind space. This is because the blind self represents what is known about a person by others but is unknown by the individual.

Self-awareness is essential because it enables nurses to create an environment that fosters therapeutic relationships with patients. This is beneficial because these relations can aid the recovery process. Another advantage is that self-awareness helps nurses engage in healthy behaviors, which results in better client care (Taylor, LeBlanc, and Nosik, 2019). Enhancing self-awareness can also help nurses to improve their communication with patients (Howe, 2011). The nurses can direct the message toward the needs of the patient, which can create a therapeutic environment (Carpenter et al., 2017). The use of a reflective diary can ensure the development of self-awareness. This is because reflections provide the opportunity to look back and analyze the events for growth and development (Reljić, Pajnkihar, and Fekonja, 2019). Therefore, self-awareness is important in ensuring that patients receive the best care.

Emotional Intelligence

Emotional intelligence can be described as the ability of an individual to understand and manage their emotions and recognize the feelings of others. In the nursing practice, emotional intelligence is required because of the different situations that happen (Raeissi et al., 2022). One of the first components of emotional intelligence is self-awareness, which indicates the ability to recognize own emotions and feelings. This is considered integral because the emotions of nurses can impact their delivery of care. Another important component is self-regulation, which is the ability to manage emotions and behaviors that result from them. People have to develop self-awareness first before understanding how to regulate their feelings (Raghubir, 2018). Nurses should not be affected by feelings such as anger when dealing with patients.

Motivation is another crucial aspect and involves the processes that stimulate and direct someone toward achieving their objectives. Motivation is crucial in healthcare because it allows the practitioner sot persevere during challenging times (White and Grason, 2019). Healthcare providers who are motivated can enhance the client relationship by focusing on person-centered care (McCance and McCormack, 2017). Empathy is another essential component, which focuses on understanding the feelings of other people. Identifying the feelings of patients without asking them can foster trust and respect, which can enhance the therapeutic relationship (Strachan, 2017). The last aspect is social skills, which deals with the ability to relate to others. Nurses need enhanced social skills because the delivery of care involves interacting with other people.

Conclusion

In summary, therapeutic relationships between the client and the healthcare provider are essential as they foster recovery. Nurses and therapists can adopt the unconditional positive regard model to create trust and respect with patients. Developing self-awareness and emotional intelligence can enhance the delivery of care. Healthcare practitioners can also benefit through better and more effective communication with clients.

Reference List

Adimando, A. (2018) ‘’, Journal of Holistic Nursing, 36(4), pp. 304-317. Web.

Böhmer, M.W. and Krüger, C. (2019) ‘’, South African Journal of Psychiatry, 25(1), pp. 1-7. Web.

Carpenter, B., Geddes, H., Nash, P., Cahill, J., Satchwell-Hirst, M., de Thierry, B., Wilson, P., Rose, J., Gus, L., Wood, F. and Clifford, T. (2017) Attachment and emotional development in the classroom: Theory and practice. Jessica Kingsley Publishers.

Casement, P. (2014) On learning from the patient. Routledge.

Farber, B.A., Suzuki, J.Y. and Lynch, D.A. (2018) ‘Positive regard and psychotherapy outcome: A meta-analytic review.’ Psychotherapy, 55(4), p. 411.

Gibson, R., Till, A. and Adshead, G. (2019) ‘’, BJPsych Advances, 25(2), pp. 133-141. Web.

Howe, D. (2011) Attachment across the lifecourse: A brief introduction. Bloomsbury Publishing.

McCance, T. and McCormack, B. eds. (2017) Person-centered practice in nursing and health care: theory and practice. John Wiley & Sons.

McCance, T., McCormack, B., and Dewing, J. (2011) ‘’, Online Journal of Issues in Nursing, 16(2). p. 1. Web.

McKinnon, J. (2016) Reflection for nursing life: principles, process, and practice. Routledge.

Murphy, D., Joseph, S., Demetriou, E. and Karimi-Mofrad, P. (2020) ‘,’ Journal of Humanistic Psychology, 60(2), pp. 258-279. Web.

Norcross, J.C. and Lambert, M.J. (2018) ‘’, Psychotherapy, 55(4), p. 303. Web.

Raeissi, P., Zandian, H., Mirzarahimy, T., Delavari, S., Moghadam, T.Z. and Rahimi, G. (2022) ‘Relationship between communication skills and emotional intelligence among nurses’, Nursing Management, 29(4), p. 1.

Raghubir, A.E. (2018) ‘’, International Journal of Nursing sciences, 5(2), pp. 126-130. Web.

Rasheed, S.P. (2015) ‘Self-awareness as a therapeutic tool for nurse/client relationship’, International Journal of Caring Sciences, 8(1), p. 1.

Reljić, N.M., Pajnkihar, M. and Fekonja, Z. (2019) ‘’, Nurse Education Today, 72, pp. 61-66. Web.

Rogers, C.R. and Freiberg, H.J. (2005) Freedom to learn. Columbus, OH: Charles Merrill.

Strachan, J. (2017) ‘Psychological ideas in palliative care: attachment theory’, European Journal of Palliative Care, 24(1), pp. 24-27.

Taylor, B.A., LeBlanc, L.A. and Nosik, M.R. (2019) ‘’, Behavior Analysis in Practice, 12(3), pp. 654-666. Web.

White, D.E. and Grason, S. (2019) ‘’, Journal of Comprehensive Nursing Research and Care, 4(152), pp. 1-3. Web.

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