Defining A Therapeutic Relationship Between Patient And Nurse Nursing Essay

Defining A Therapeutic Relationship Between Patient And Nurse Nursing Essay In this assignment the author is going to explore what is a therapeutic relationship, by defining it and describing what elements and skills are necessary to uphold an efficient therapeutic relationship with a patient. The assignment shall explore how Multi disciplinary teams contribute to achieving a therapeutic relationship. It further will explore what governs a therapeutic relationship according to the code of practice set by the nursing governing body, the Nursing and Midwifery Council (NMC), putting into consideration what is expected from nurses as health professionals. Being Self aware is a crucial attribute in order to maintain a therapeutic relationship, so the writer shall give a brief definition of what self awareness is ,and explain the significance of being self aware within a therapeutic relations and relate it to an incident that happened in practice that made them more self aware. The therapeutic relationship is fundamental to the care of a patient and was described in the 1950s by famous psychotherapist Carl Rodgers .Rogers defines it as a helping relationship, A relationship in which one of the participants intends that there should come about, in one or both parties, more appreciation of, more expression of, more functional use of the latent inner resources of the individual (Rodgers 1961). Other authors have come up with various definitions but they are all closely linked to that of Rodgers, Jane Stein-Parbury (2000) suggests it is unilateral because the nurse maintains most control and it is usually short or average duration, with the patient facing a non threatening situation. However (Stuart 2001) defined a therapeutic relationship As a mutual learning experience and a corrective, emotional experience for the patient (cited in Cutliffe and Mckenna 2005.P.304) For a therapeutic relationship to work effectively, certain elements need to be upheld and followed, such as showing warmth towards your patient, being respectful by showing the patient that they are individual and a unique being. Dignity of the patient puts the patient at ease and they feel more valued and may in turn open up more to the nurse which aids their treatment. Demonstrating professionalism assures the patient that they are in capable hands and will effectively build trust about your capabilities. Carl Rodgers highlighted that the three core components of a therapeutic relationship are empathy, which is defined as: a continuing process whereby the counsellor lay aside her own way of experiencing and perceiving reality, preferring to sense and respond to the experience and perceptions of her client. (Mearns and Thorne, 2005, p.41) Where there is lack of empathy expression, patients may be left with a sense of isolation, which have an effect on their treatment plan. The sec ond crucial element that was highlighted by Rodgers as being essential is having unconditional positive regard towards patients or client which is a label given to the fundamental attitude of the person-centred counsellor towards her client. The counsellor who holds this attitude provides care for the individual irrespective of what beliefs and values the individual (patient) may hold. (Mearns and Thorne,2005 p 64). In other words unconditional positive regards is being non judgmental towards a patient regardless of what the care provider believes or values themselves. Unconditional positive regard should ideally commence on the onset the relationship between patient and nurse. Other elements that constitute a therapeutic relationship include, maintaining confidentiality, and treating people as individuals at all time, good record keeping (NMC 2008). For Therapeutic relationships to be successfully applied and implemented, nurses have to acquire certain skills to achieve this. To instate a strong therapeutic relationship a practitioner should consider their interpersonal communication skills with the patient. There are two forms of interpersonal communication skills, which are non-verbal and verbal communication. Non-verbal communication skills are a very effective way to convey a message, empathy and active listening. Egan formulated a communication tool which aids to effective non-verbal communication skill, the skills are summarized by the acronym SOLER, meaning sitting squarely with an open posture, leaning forward to show your interest maintaining eye contact at all times showing that you are relaxed, not fidgeting nervously. Argyle (1994) suggested the main forms of non-verbal communication as, facial expression, gaze, body movement, gesture, partial behaviour, clothing and behaviour. (Cited by Rana, Upton, 2009, ). Verbal skills are too, an essential part of interpersonal communication, these include techniques such as paraphrasing; this is where by a nurse rephrases what has been stated by the patient into their own words, i.e. by saying in other words. (Jane Stein -Parbury). Other methods of active listening are to parrot what the patient has said; this shows you have clearly heard what they have said. Practitioners should also be able to know when to use open and closed questions in the appropriate manner and time, for this skill can easily perceived as uncaring and unprofessional when not adopted carefully. In conclusion to what has been talked about, nurse and patient should reflect on what they said. Heron (2001) stated that a there are six tools of a clients needs. Herons model has two basic categories, authoritative and facilitative. These two categories further breakdown into a total six categories to describe how people intervene when helping. Authoritative Interventions are Prescriptive, which is giving advice, Informative where you provide information to guide the other person, Confronting- you challenge the other persons behaviour in an unaggressive attitude. Facilitative Interventions include: Cathartic-you help the other person to express and overcome thoughts or emotions that they have not previously confronted. Catalytic- You help the other person reflect, and they become more self-directed in making decisions. Supportive- You build up the confidence of the other person by focusing on their competences, qualities and achievements. A multi disciplinary team (MDTs) is important in the care of a patient. A multi disciplinary team is a group of professionals from different disciplines, who have a role in contributing to an assessment of an individuals needs. This should include two health professionals, i.e. nurse, clinician or therapist, as well as a representative from social care services, i.e. a social worker (NHS 2010). Chan (2004) argued that the main mechanism is to ensure truly holistic care for patients and a seamless service for patients throughout their disease trajectory and across the boundaries of primary, secondary and tertiary care. Multi disciplinary teams ensure a continuum in patients care and can be 24 hours. Different professions bring different type of care to the patient. MDTs can however come to conflict, if they demonstrate allegiance to their profession. Junor, Hole Gillis (1994) states that multidisciplinary team working is known to maximise clinical effectiveness, Multi disciplinary teams have enabled health professionals to adopt the clinical care pathways where different teams within the organization outline anticipated care, place an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes. In a multi disciplinary team within a healthcare setting, one may expect to work with doctors, social workers, psychologists, occupational therapists, health care assistants (HCAs) and other related professions. A therapeutic relationship within nursing follows the code of professional code of practice which was set by Nursing and Midwifery Council [NMC], which acts as the governing body for nurses and midwives in the United Kingdom which was formed in 2002 by parliament. Its main objective is to safeguard the health and wellbeing of the public,(NMC 2008).The NMC outlines that Nurses should always uphold the patients respect at all times, it states that nurses should always treat people as individuals and respect their dignity. Nurses should respect patient confidentiality, and uphold it at all times, breach of confidentiality can lead to serious consequences for health professionals (NMC 2008) including disciplinary actions such as suspension or being struck off the NMC register. Consent is very important in patient care; its the opening avenue for any care that follows. NMC states the every adult must be presumed to have the mental capacity to consent or refuse treatment. Patient care is a lways going through different multi disciplinary teams therefore accurately record keeping is crucial, it should be factual ,not falsified, and clearly legible (NMC 2010), these are some of the factors that insure accurate information is passed on to different care givers to maximise effective care for the patient. Nurses endure different feelings and emotions when interacting or treating patients, which calls for them to be more self aware, Duval and Wuckland defines self awareness as a state in which one is aware of oneself as an object, much as one might be aware of a tree or another person (cited by Rana and Upton 2009. p142).For a nurse to be self aware they need to treat each patient as individuals and present themselves appropriately. Patients have a plethora of beliefs and values, which always come into play in any given care setting. Beliefs can be associated with patients religion and culture, such as that of Muslims, to only eat halaal meat, a nurse has to be aware of this dietary requirement and honour it. Equally beliefs also play a vital role in the treatment of a patient, so a provision to fulfil this should be met at all time, i.e. providing a chapel in the hospital. Values of a patient are crucial when in care. Downie, R. S. 1990 stated that values are preferences based on beliefs about objects, persons, or situations and are accompanied by feelings of approval or disapproval. Patients of a different culture will most certainly have different values based on what they were brought up on. On any given care setting, the way in which nurses present themselves to patients is of utmost importance, their body posture is a critical aid to supplement being self aware, and nurses can use SOLER (Egan 2001) to ensure they achieve this. In practice, the author recalls an incident when a 92 year old lady was referred to their practice for assessment on every Wednesday of the week. On arrival the lady would engage in social activities with fellow patients. The staff provide the lady with a menu relevant to her culture of West Indian background, The staff fulfilled their role in being self aware on her values and diversity, During the meal, staff began to talk about a holiday abroad and how the food made their bowel move rapidly, and how they really found the food disgusting. The lady did initially try to express her frustration of the conversations the staff were having whilst she was trying to enjoy. She eventually stopped having her meal as she found it not appetizing anymore, staff recorded that the patient had poor dietary at dinner time, and they were not self aware that they were the catalyst for the poor intake of her food. Had the staff been more self aware of their presentations, they would have considered that different cultures have different table manners. In conclusion an effective therapeutic relationship is accomplished by good verbal and non verbal communication. Respecting individuality, beliefs, values, this promotes good recovery and openness between nurse and patient. A therapeutic relationship is not just between a patients and nurse but can, and often extends to other multi disciplinary teams. The therapeutic relationship can never be stated as fully complete, but can be made more effective, because different patients have different opinions i.e. different experiences in previous care, and different values and beliefs.

Madonna: Successfully Incorporating Sexuality Into Music Essay

Madonna Madonna has been a very influential female "popstar" over the last 20 years: to sell her music she has publicised herself through the media, and through this media she has stuck to the concept that "sex does sell". Madonna was born on the 16th of August 1958 as Louise Veronica Ciccone, in Bay City, Michigan. She began her journey into the most influential industry and medium by moving to New York to become a ballerina. From this young age she was very aware of the human body and the way it is perceived. She knew that the body needed to be sold in some way, to 'make it' in these types of industries. At this stage of her life she became anorexic in an attempt to become the "stereotypical" ballerina figure. Louise eventually left her ballerina days, and turned to music. She was part of the Patrick Hernandez Revel, The Breakfast club and Emmy: dance and pop groups that didn't make it to the top. It was through these small groups that she was scouted as a solo artist and in 1982 Louise was signed to Sire Records, under the performance name "Madonna". By the end of 1982 she released her debut single "Everybody", which became an instant hit. This was the start of Madonna's influential music career. Madonna debuted as a young, innocent, Christian girl, with strong morals and values. However, this changed as she began to transform herself and her image to attract a larger audience. She began her career with the stage name Madonna, which she has kept throughout her long career. The word "Madonna" is from the bible, a biblical name for the mother of Jesus (or Virgin Mary), and is a biblical character that is associat... ...le erotic and packaged as a giant condom. Erotica: uncut featured graphic nudity and overt depiction of sex acts In 1998 she seemed to change her style and reinvented herself once again with the release of ray of light: seemed to show a change in perspective and her songs were now bout motherhood and the lose of her mother. Released her record music coinciding in the same year she married Guy Ritchie and her cow-boy image American life was a flop dealt with more contempory issues such as the war and September 11, Sex does sell, she learnt that by incorporating sexuality and sex into her music - so she could sell her album, she performed this by her kiss with Brittany spears last year in which boosted her back into the media and outraged critics but still boosted her otherwise but flopping album sales.

The Dutch Oven

The Dutch Oven is a old version of a frying pan or roasting pan. The dutch Ovens started production in the 1700's. Dutch ovens are still used for many things, like cobblers and roasts. Dutch ovens were made of brass in the first couple of years that they were made. Then a man by the name of Abraham Darby visited the Netherlands and wanted to watch the the production of the Dutch Oven. When he figured out how to make the oven he traveled back to England. When he returned home he was trying to find a way to make a cheaper version of the oven. His creation was made of a more economical metal of cast iron. The Americans found out about these dutch ovens and they brought them into their colonies. The famous patriot Paul Revere was credited with adding the peg legs on the pots and the flat top lid with a rack that would hold the coals. All of the settlers and the colonists that have moved to america used these pot because of their durability and there versatility. When Lewis and Clark set out on there expositions they took a Dutch Oven with them all the way through the american west. The Dutch oven was one of the many things that Lewis and Clark brought home with them at the end of there exposition. In the year of 1896 a man by the name of Joseph Lodge founded a company that would make and sell Dutch ovens. This company was located in the state of Tennessee. The name of this company is called Lodge the owner named it after himself. Today the company is sells more dutch ovens than any of the other company's in the world. There was also another company that was founded it was called Le Creuset. Le Creuset was built and constructed in the French town of Fresnoy-le-Grand. This company made Dutch Ovens and cooking supplies like Lodge did. Le Creuset is famous for the really good quality of its iron and for the really good quality of their enamel coatings. Even though the Dutch oven is a older style of pot it is still used today to cook food.

5 Interesting Facts About the Medici Coat of Arms

The Medici have long been associated with balls. Their family emblem — five red balls and one blue on a gold shield — is prominently displayed on buildings all over Florence and Tuscany which have Medicean connections or which were financed with Medici money. Some examples of where you can see them outside of Florence are Piazza Grande in Montepulciano and Piazza del Campo in Siena. In fact, the coat of arms was so widespread that one outraged contemporary of Cosimo il Vecchio declared, He has emblazoned even the monks privies with his balls. To prepare you for your trip to Tuscany (or just to add some historical fodder to your next conversation in Italian), here are five cocktail party facts about the Medici coat of arms. Five Facts About the Medici Coat of Arms 1.) One origin story for the coat of arms comes from a giant named Mugello. The Medici family crest has long been the object of much historical speculation. The most romantic (and far-fetched) explanation of the origin of the palle is that the balls are actually dents in a shield, inflicted by the fearsome giant Mugello on one of Charlemagnes knights, Averardo (from whom, legend claims, the family were descended). The knight eventually vanquished the giant and, to mark his victory, Charlemagne permitted Averardo to use the image of the battered shield as his coat of arms. 2.) Other origin stories for the coat of arms represent pills  and money. Others say the balls had less exalted origins: that they were pawnbrokers coins or medicinal pills (or cupping glasses) that recalled the familys origins as doctors (medici) or apothecaries. Others say they are bezants, Byzantine coins, inspired by the arms of the Arte del Cambio (or the Guild of Moneychangers, the bankers organization to which the Medici belonged). I’ve also read that the balls are meant to represent gold bars, again  representing their profession as bankers,  as many frescoes and works of art in Florence depict gold bars as originally being formed as balls. 3.) If you were a supporter of the Medici family, you might be seen enthusiastically yelling â€Å"Palle! Palle! Palle!† In times of danger, Medicean supporters were rallied with cries of Palle! Palle! Palle!, a reference to the balls (palle) on their armorial bearings. 4.) The number of balls on the shield changed over the years. Originally there were 12 balls. In Cosimo dà © Medicis time, it was seven, the ceiling of San Lorenzos Sagrestia Vecchi has eight, Cosimo Is tomb in the Cappelle Medicee has five, and Ferdinando Is coat of arms in the Forte di Belvedere has six. The number six remained stable after 1465. 5.) The blue ball has the symbol of the kings of France on it - three golden lilies. It’s said that Louis XI had a debt with the Medici family and in order to reduce his debts, he allowed the bank to use his symbol, giving the Medici bank more clout among the people.