NSB305 Building Professional Capacity- Therapeutic Relationship
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Using Evidence, discuss the importance of the nurse patient therapeutic relationship in mental health settings when discharge planning, with particular emphasis on development of trust.
Answer
Therapeutic relationship in discharge planning
Therapeutic relationship
This relationship between the nurse and the patient focuses on the patient’s beliefs, feelings, values, ideas, and experiences to enhance patient’s growth. It is an interpersonal relationship. Therapeutic relationship is build from the following components Empathy Rapport Genuineness Warmth
Importance of therapeutic relationship
- Helps patients to communicate distressing feelings and thoughts
- Ensure patient’s trust
- Aid patient with problem solving
- Promotes independence and self care in patient
- Help patient to identify the self defeating behaviour (Farrelly & Lester, 2014)
Therapeutic relationship in mental health setting
Therapeutic relationship is essential in mental setting-
- It’s foundation of the mental health nursing
- Mental health care requires communication, understanding of behaviour and observation
- Helps patient to regain inner resources to grow to the full potential (Fortinash & Worret, 2014 )
Therapeutic relationship is essential in mental setting-
- To respect the autonomy, patient’s dignity, and privacy
- Breach of privacy and confidentiality and omission of informed consent and other unethical behaviour may increase patient’s vulnerability and social violence
- Integrated and collaborative working
Discharge planning
- Discharge planning is discharge of patients from hospital and intermediate care
- It is more than just a process Lack of therapeutic relationship- lack of coordination
- Lack of coordination-unsuccessful discharge
Therapeutic relationship- discharge planning
- Emotionally intelligent response to the client’s needs
- Patient centered care
- Ensure patient trust
- Integrate consumer advocacy, research, clinical practice policy and education
- Collaboration for clinical handover- Referral services (Shepperd et al., 2013)
Evidence
According to Forchuk et al. (2007) when therapeutic relationship was used in transitional discharge model, it provided safety net for discharge of mental health patients. It improved the rate of discharge and reduced the rate of readmission. Effective discharge planning occurs as therapeutic relationship involves staff, peers, care provider, and collaboration with stakeholders.
Strategies for establishing therapeutic relationship
Professional communication skills are important for therapeutic relationship building. These strategies will help in effective discharge planning in mental health setting as it will help patient’s level of functioning, decision making capacity and enhance family support.
References
Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.
Farrelly, S., & Lester, H. (2014). Therapeutic relationships between mental health service users with psychotic disorders and their clinicians: a critical interpretive synthesis. Health & social care in the community, 22(5), 449-460.
Forchuk, C., Reynolds, W., Sharkey, S., Martin, M. L., & Jensen, E. (2007). Transitional discharge based on therapeutic relationships: state of the art. Archives of psychiatric nursing, 21(2), 80-86.
Fortinash, K. M., & Worret, P. A. H. (2014). Psychiatric Mental Health Nursing-E-Book. Elsevier Health Sciences.
Shepperd, S., Lannin, N. A., Clemson, L. M., McCluskey, A., Cameron, I. D., & Barras, S. L. (2013). Discharge planning from hospital to home. Cochrane Database Syst Rev, 1(1).
