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Reflective essays on therapeutic relationship in psychiatry

Related Introduction This is a reflective essay based on an episode of care that I was directly involved in managing during a community placement.

  1. Providing something outside of patient expectations, such as going for coffee, or helping with practical tasks, helped to create reciprocal obligations, similar to findings by Laugharne et al. At that time particularly difficult clients were transferred to other, more secure facilities.
  2. Implications for the therapeutic relationship in mental health nursing.
  3. So care plans, tended to be either a team treatment plan, a client's list of goals, a list of things to do, or an impersonal entity borrowed heavily from the text books available on the ward with vague, non-specific interventions. Interesting to note for this review is that, in the possibilities and presuppositions theme, participants spoke about real acknowledgement, rather than acknowledgement as a formal claim.
  4. The clients as they were now called were somewhat different too, in that they tended to come from the community, and did not have a long history of containment in large institutions. Occupational therapists and social workers now fill the roll of keyworker along side nurses in some areas.
  5. Namely, ACT was considered coercive in that it was intimidating and overwhelming, whereas experiences of coercion in other services were related to lack of autonomy, lack of alliance with staff and lack of influence on treatment.

This episode of care will be analysed using up to date references, health care policies and relevant models. Issues and theories relating to leadership qualities and management styles will also be explored, taking into consideration any legal, ethical and political factors that may have impacted on patient care.

Therapeutic Relationship Reflective Essay

Care delivery, delegation and prioritisation will be examined along with team working, risk assessment and patient safety. I will also take into consideration my role as a supervised student nurse and analyse the roles and responsibilities of those supervising me and what influence this has on my practice.

  • The question "What differentiates the practice of psychiatric nurses from other disciplines working in mental health settings?
  • The nursing staff cared for patients twenty four hours a day;
  • Themes and perspectives in nursing.

During my extended practice placement there were many opportunities to develop these skills and manage my own caseload of patients and arrange many complex aspects of their care. During this placement an 88 year old patient, to be known as Mrs A, was due to be discharged from a rehab centre following recurrent falls, issues with safety at home, and self neglect, the referral had been made by a concerned General Practitioner. Mrs A had spent the last 6 weeks receiving holistic multidisciplinary care, including; intensive physiotherapy, occupational therapy and nursing care.

Mrs A had made much improvement and was able to safely administer her own medication.

Therapeutic Relationship Reflective Essay

One of the Physiotherapists called Ken, had commented during handover, that Mrs A had seemed confused during their session together, and asked if the nurses would go in and review her. Upon visiting Mrs A it was clearly evident that she was not herself, and seemed confused.

Following discussion with my mentor I felt that Mrs A was not safe to administer her own medication. I recommended to the patient to let the rehabilitation staff administer her medication. Mrs A consented to this, thus reducing a great risk of Mrs A causing her-self harm. I delegated to the support workers to obtain a urine sample which was tested and confirmed that Mrs A had a urinary tract infection, antibiotics were prescribed by her GP.

This episode of care was managed effectively as the underlying cause of the patients confusion was discovered and treated, a risk assessment was completed and a referral was promptly made to medicine management and a dossett box was supplied to Mrs A, to help her manage her own medications safely.

All members of the multi-disciplinary team were fully committed to the team approach to care delivery and this facilitated efficient and organised care delivery.

The care delivered was patient-centred and teamwork was integral to providing this care.

  • Essentials of nursing research;
  • What we write or record may begin in an arbitrary fashion, but as questions emerge we may begin to focus on specific incidents for a more detailed analysis;
  • They acknowledge that, while participants found it difficult to engage with the concept of power, two overarching themes emerged;
  • Due to these tremors she was unable to walk unassisted and was unable to feed herself;
  • It is a relationship in which the patient feels accepted as a person of worth, free to engage in self-expression without fear of rejection;
  • The distinctiveness of nursing knowledge.

First will be a discussion on the importance of self awareness and how this awareness enabled a more assertive and confidant approach to be made to managing patient care. Self awareness must be considered as the foundation for management and is a vital skill and quality needed in leadership. If you wish to provide care that is of a high standard and improve your own performance as a skilled health care professional you need to manage the cognitive, affective and behavioural self in order to engage effectively in therapeutic relationships.

Without being self aware, recognising personal and cultural beliefs, and understanding interpersonal strengths and limitations, it is impossible to establish and maintain good relationship with co-workers and patients. This relates to the need to maximise potential and achieve a sense of personal fulfilment, competence, and accomplishment Maslow, 1954.

It is important as a student nurse to be completely aware of strengths and weaknesses, and to be conscious of any limitations, self-awareness helps to exploit strengths and cope with weaknesses Walshe and Smith2006.

To understand nursing management it is crucial to understand what nursing management is and the theory behind it. Another definition of management is a process by which organisational goals are met through the application of skills and the use of resources Huber, 1996.

Prentice Hall Gopee, N. Sage Publishers Huber, D. B Saunders Company Maslow, A. Pearson Education Limited WalsheK.

  • Trust, choice and power in mental health care;
  • The clients as they were now called were somewhat different too, in that they tended to come from the community, and did not have a long history of containment in large institutions;
  • In situation like this the patient may take time to trust the nurse to tell the truth but the nurse has to be patient to let them take their time in order to form a trusting relationship;
  • Measures of the therapeutic relationship in severe psychotic illness:

And SmithJ. Open University Press Related.