Question

In our text discusses the importance of establishing a therapeutic relationship as part of the assessment process. All of you are practicing nurses, how do you establish a therapeutic relationship? A positive environment for an initial assessment? Any differences for an assessment of an infant that you would make?

Answer 1

A therapeutic relationship is relationship that exist between the patient and the health care provider during a therapy. The main use of the therapeutic relationship in a therapy is to bring changes in their life for better outcomes. The initial step when a nurse and patient interacts for the first time is developing a healthy interpersonal communication which will develop a sense of trust and safety among the patients. The maintainence of a therapeutic relationship is important as it help to begin the initial step of nursing process i.e assessments. The patient should be given a safe, open and non judgemental atmosphere so that they can share their thoughts, beliefs, emotions and concerns regarding an issue. This will help the therapist to understand the patient better and therefore to plan treatment which will be effective for patient's condition.

In order to establish a therapeutic relationship,

• firstly greet the patient and introduce yourself. Tell him that you will be taking care of the patient today.
• Secondly ask him how is he doing today, how is he feeling about his health.
• Orient the patient to his surroundings like toilet facilities, lighting, call bells etc.
• Provide the patient with pamphelets that will describe the mission and vision of hospital and will give an overview of the hospital services.
• Ask him what is reason for seeking a medical help.
• While assessing, provide a calm and quiet environment.
• Be patient and a active listerner.
• Allow him to convey all his concerns, symptoms experienced by him.
• Donot interupt him neither pass any judgemental answers on them.
• Have a pleasant face and a gesture that will show that you are there to help them.
• Be clear in your language and use phrases and statement that can be clearly understood by the patient.
• Give respect to the patient's identity, cultural and religious differences.
• Maintain the privacy of patient will assessing especially if a female patient.
• Keep the data confidential and do not disclose any information without patient's concern.
• Assessment the female patients's by female nurses will be highly appreciated and accompany the patient if a male doctor is attending them.

All these are the keypoints that will foster a positive environment for initial assessment.

In case of dealing with infant, the nurse needs to establish a therapeutic relationship not with the child but also their family. Nurses should priortize the child's need and empower the family. Care, compassion, commitment,competence,communication, courage and patience is very important in maintaing time pressures and disturbed family expectations. The major difference while assessing an infant will be the use of nonverbal communications methods.