RW: Nature of Therapeutic Relationships Flashcards
Relational work
Involves nurses therapeutically relating to their patients in ways that:
- facilitate client ability to cope
- to understand the meaning
- to take ownership for their own healing and recovery
Therapeutic relationship
Focus is on ministering to the needs of the person receiving care
Characterized by principles of empathy, caring and compassion
Empathy
experience of understanding another person’s condition from their perspective
Compassion
A deep awareness of the suffering of another, coupled with the wish to relieve it
Caring
Genuine kindness and an authentic concern for others, evidenced by qualities of gentleness, warmth, affection and concern
The therapeutic relationship (Koloroutis and Trout, 2012)
“The purpose of the therapeutic relationship is to promote, guide, and support the healing of another person through knowledgeable and authentic connection.”
Healing versus Curing
Cure is contingent on many factors and may or may not be possible
Healing is always possible
Theories of healing (Sidney Jourard)
A person can attain health only insofar as the person is able to be themselves
Why are patients sometimes objectified?
A shield to protect health care providers from patients’ suffering
can lead to disconnection and isolation, conflict and misunderstanding
- cost-cutting
- nurse-client ratio
- bed pressures
- shorter admission times
Theories of healing (Martin Buber and Terry Warner)
I-It (resistant) relationship
- i encounters it, as an object
- relationship of separateness, detachment and objectification
- protects hcp from own vulnerability and control interaction
I-Thou (responsive) relationship
- meet one another in authentic human connection
- relationship of mutuality, reciprocity and shared humanity
- desire to understand the other, curiosity, to be human
Theories of healing (Kristen Swanson)
What clients define as most essential in the caring relationship
Five process to inform therapeutic practice
- maintaining belief
- knowing
- being with
- doing for
- enabling/informing
Theories of healing (Rachel Namoi Remen)
Call for a loving connection
- presence and authenticity
- love makes healing possible
Impact of objectification
Emotional Impact
- fear/anxiety
- anger/frustratrion
- hopelessness
- sense of vulnerability
- difficult making care decisions
- existential pain
Physical Impact
- increase bp, hr, rr, blood sugar
- impaired sleep
- digestion issues
- increased physical pain
- muscle tension
Fear
Emotional difficulty bearing witness to patient’s suffering
- not knowing what to say or saying the wrong thing
Misperceptions about RW
- time consuming
- aspects of RW: how we enter the room, introduce ourselves, way we touch, attention to preferences, language
Presence through attunement
“To be present means to be consciously attuned to the person before you.. it happsn when you see the other, listen to and hear the other, and for the moment, give your undivided attention to the one in your care”
Wondering, following, holding
How does being attuned help?
- notice things
- makes us curious
- rhythmic interaction
- see the impact of our own presence
- helps us align self with others
- allows us to see person as person
- compels us to claim a stake in the welfare of the person we care for
How to practice presence through attunement?
- Begin with ourselves
- reflect on own identity and how these shape our values and beliefs
- think about assumptions that we have
- think about how these assumptions affect the way we act - Practice mindfulness
- practice of becoming more aware and engaged in every moment
- bring attention to present, with curiosity and acceptance
- release worries about future, regrets about past and focus on calm acceptance of present
