Nurse Patient Relationship in Heath Care

Heath Care and Nurse Patient Relationship

Nurse Patient Relationship,Challenges in Relationships,Factor Affecting Nurse Patient Relationship,Complexities of Nurse Patient Relationship.

Nurse Patient Relationship

     The interpersonal relationship between nurses and patients has become an important subject of discussion, theorizing, and research since Peplau and Orlando introduced the concept of the nurse-patient relationship as an essential component of nursing practice. 

    Recognition of the need for individualized nursing care, the introduction of new approaches to care delivery (eg, primary nursing), increasing concerns about dehumanization related to advances in technology, and the emergence of theories delineating caring as a pivotal concept in nursing have reinforced the centrality of the nurse-patient relationship in contemporary practice. 

    The nurse patient relationship is now viewed as essential content in nursing curricula, and clinicians value the development of therapeutic relationships with patients as a significant part of their work. 

    Yet despite the overwhelming endorsement of the importance of the nurse patient relationship, the practical difficulties associated with developing relationships remain unresolved. Of importance are issues related to balancing personal involvement and professional detachment. 

    Other important issues concern building relationships in contexts where the organization of nurses' work limits involvement or where reporting practices undermine the development of trust. 

Challenges in Relationships

    Issues also arise from challenges related to renegotiating relationships in response to changes in patient dependency and vulnerability. Nurses have attempted to identify the unique characteristics of the nurse patient relationship through their conceptualizations, although to date there is little evidence to support this assumption. 

    The nurse-patient relationship has been described as a therapeutic instrument with levels or types of involvement and as an interactive process requiring the active participation of both patients and nurses. 

    Important components of the nurse patient relationship include concepts such as empathy, trust, respect, knowing the patient, commitment, advocacy, and social control. Nursing writers critiquing current conceptualizations of the nurse-patient relationship have pointed out the failure to consider the collective nature of nursing work and other realities of everyday practice such as the provision of bodily comforts. 

    Theorists such as Sally Gadow and Jean Watson have attempted to explain the nature of the links between nurse patient relationships and positive health care outcomes, and there is some empirical evidence that supports these assertions.

Factor Affecting Nurse Patient Relationship 

    Although researchers have begun to explore the complex dynamics involved in nurse-patient interactions and their therapeutic potential, there is relatively little empirical data related to what takes place in everyday clinical settings to support current conceptualizations of the nurse-patient relationship. 

    Early investigations of nurse-patient relationships were influenced by definitions from the social sciences and the traditions of logical positivism. However, explanations of the relationship proved difficult to quantify. 

    With increasing acceptance of qualitative research methods in nursing, researchers have turned to a variety of new approaches to examine patterns of relationships in nursing, including grounded theory and narrative analysis.     

    These studies have revealed important new information about nurse-patient relationships, some of which has contradicted professional rhetoric surrounding the development of these relationships.

Complexities of Nurse Patient Relationship

    The complexities inherent in the nurse patient relationship demand that the research agenda be augmented by micro-level approaches (such as sociolinguistics, ethno methodology, and in depth videotape analysis).

    Advances in interpretive methodology (eg, using a feminist perspective), and triangulation (eg, triangulating conversational analysis with data from ethnographic research), as well as by taking advantage of constructionist, critical, and postmodern theory to understand the dynamics of nurse patient relationships. 

    For example, observational studies of the development of nurse-patient relationships as they occur in everyday clinical settings would augment nurses' narratives of memorable relationships. 

    Some researchers are exploring the potential value of using video recorders to capture the development of relationships over time. Detailed analysis of videotaped patient and nurse behaviors at the interaction level have produced some encouraging results.

    For the most part, researchers have focused on the affective dimensions of nurse-patient relationships by interviewing nurses, particularly those who were able to provide exemplary cases. 

    Other dimensions of the nurse patient relationship should be examined, as well as outcomes, as they relate to different phases and types of relationships. Attention must be given to the patient's perspective and role in shaping relationships.