Nursing as Relational Practice – A Formal Essay

Nursing as Relational Practice – A Formal Essay

 

Nursing as Relational Practice – a Formal Essay

Part A: Formal Essay Outline Instructions

The purpose of the outline is to clearly indicate the content that will be included in each section of your proposed essay and to assist you in organizing your thoughts and ideas about the essay topic. The outline is divided into four sections; content should be logically linked together to support the development of your ideas and information about the role of leadership in engaging in caring relations in the context of nursing as relational practice.

The outline sections are:

  1. Introduction. Introductory paragraph setting out what you will do or say in your paper.
  2. Case study.
  3. a) A case study for the purposes of this assignment is: A research method involving an examination of a particular case to gain a better understanding of a subject or process. The case study should be presented in an efficient, narrative form using full sentences. Use a chronological approach with a beginning, middle, and an end. Incorporating direct quotes is a great way to tell your or your client’s own story.
  4. b) Include the following information
  • Client characteristics—age? developmental stage? health-related needs?
  • Situation characteristics—what is unique about this situation?
  • Your role as the nurse—why are you involved? What contributes to a caring relation here? Are there any advocacy or social justice issues?
  • Based on the described situation, what kind of nursing leadership will be used to further engage in caring relations with your identified client?
  1. c) Review the points below before creating the case study so that you can be sure to include information that allows you to answer the questions. As case studies vary widely in terms of style, tone and format, there is no one way to write the case study for this assignment.
  2. Body.

Main points to support the ways in which you will lead and engage in a caring, nurse-client relationship are outlined, barriers and enablers to building a trusting, caring relationship are considered. Strategies to promote health are also indicated. Include ideas about what you will reflect on to identify lessons learned from doing this paper about nursing as relational practice.

 

  1. Conclusion.

Summarize main points that were examined or discussed in the paper. NOTE: Although Part A is not worth marks you must submit this as an Appendix to Part B.

 

Part B: Formal Essay Instructions

 There are four components on which your essay will be graded as follows.

  1. Case study.
  2. a) Create a case study Describe the practice situation or case study you have chosen and include the following information:
  • Client characteristics—age? developmental stage? health-related needs?
  • Situation characteristics—what is unique about this situation?
  • Your role as the nurse—why are you involved? What contributes to a caring relation here? Are there any advocacy or social justice issues?
  • Based on the described situation, what kind of nursing leadership will be used to further engage in caring relations with your identified client?

2) Body.

  1. a) Describe the leadership role, your selected leadership style, and communication strategies to enhance trust building with your selected client. Support with theory.
  2. b) Describe challenges and enablers that support nursing as relational practice by focusing on leadership and engaging in caring relations. Include strategies (what you will do) to enhance even more caring relations between you and your identified client (e.g., consider teaching principles, role of empowerment, advocacy, social justice and the ethic of caring in nursing). Support with theory.
  3. c) Reflect on what you propose to do. Is it realistic that you will be able to maintain or enhance caring relations with your identified client? What are three lessons you have learned about the role of leadership in enhancing caring relations and facilitating nursing as relational practice? Support your reflections with theory.
  4. Formatting, Introduction, Conclusion, Citations, and References. Follows formatting, introduction, conclusion, citations, and references conventions.

For example:

  1. Portrait orientation with 1” margins on all four sides of the page.
  2. PDF file.
  3. Continuous text. That is, there should be no blank part blank pages.
  4. Double spaced.
  5. Avoid tables (unless noted in the instructions), bullets and lists. f. Introductory and concluding paragraphs.
  6. In-text citations according to the 7th edition of APA style (APA, 2021).
  7. Reference list according to the 7th edition of APA style (APA, 2021).

Marking

Assignment 4 is marked according to the HLTH 3621 Assignment 4 Marking Guide. Only numeric grades are given. The case study is worth 20%, body 60% and formatting, introduction, conclusion, citations and references 10%.

Length Limitations

Assignments that go over the length set-out in the Assignment are returned without review. They will need to be rewritten to meet the length limitation of the assignment and then resubmitted. Five percent of the final mark will be deducted for assignments being returned for resubmission due to being over the length specified in the assignment directions.

Length specifications are as follows.

Title Page Page 1

Introductory paragraph First paragraph page 2

Case story Begins page 2

Body -Page 2-6

Conclusion – Page 6

Peer review Page 7-8;

Reference list Pages 9-10

The maximum word count for Part B is 1,250 words. The word count should be indicated at the end of the conclusion e.g., Word Count = 1250.

 

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Solution

 Nursing as a Relational Practice – A Formal Essay

Relational nursing practice is an understanding of patients’ health care needs within complicated contexts, in which patients experience health care and nurses deliver nursing care (Zou, 2016). This paper will explore the different elements of nursing as a relational practice, including how nurses develop a therapeutic nurse-client relationship, the different leadership roles that support nursing as a relational practice, different leadership styles that support nursing as a relational practice, various communication strategies that support nursing as a relational practice and the challenges and enablers of nursing as a relational practice.

Case Story

Mr. Smith, a retired 67-year-old male who has no support from family, was admitted to the Acute Medical Ward. He lives in a small house alone. Cecilia, the nurse, assigned, reviewed Mr. Smith’s assessment upon admission. He was rushed to the Emergency Unit due to drowsiness, excessive thirst, and warm, dry skin. The patient has a history of hypertension for six months and diabetes for a year, on oral medications but is non-compliant. The nurse went to assess Mr. Smith, who has regained strength already after being treated in the ER. She introduced herself and asked if he is feeling better. Mr. Smith said that he feels fine and looking forward to going home. The nurse explained that the reason for the admission to the hospital is because he is not taking his medications regularly. The nurse also said that the doctor has added an Insulin injection for him and will teach him how to inject it into himself before discharge. She asked, ”Can you tell me the reason for your non-compliance with medications?”. Mr. Smith claimed that he forgets to take his medications most of the time because he does not feel anything unusual for a long time. He also expressed to the nurse that he wants to live his life to the fullest without taking all his medications and ready to die if that will be his fate. The nurse responded, “Taking your medications will help manage your diabetes that can prevent the recurrence of the signs and symptoms you had experienced. The nurse just listened and acknowledged Mr. Smith’s responses. In the nursing profession, advocacy means preserving human dignity, promoting patient equality, and providing freedom from suffering. It’s also about ensuring that patients have the right to make decisions about their own health (Gerber, 2018).

Developing Therapeutic Nurse-Client Relationship

The nurse meets the standard of therapeutic communication by introducing herself as the primary nurse and that she will be looking after him and will be involved in his care until discharge. Cecilia needs to initially assess Mr. Smith’s awareness and knowledge about his illness and how it can affect his overall health. The therapeutic relationship must be established by the nurse by fostering and utilizing nursing knowledge, skills, and clinical judgment to ensure the provision of nursing services that support patient’s health (Feo et al., 2017). Secondly, the nurse needs to educate the client once the reasons for non-adherence to prescribed treatment are identified. This education includes how to self-inject the insulin prior to discharge. The nurse must give the client time, opportunity, and ability to explain himself and listen to the client with the intent to understand and without diminishing the client’s feelings or immediately giving advice (CNO, 2006).

Leadership Role that Supports Nursing as a Relational Practice

Nursing clinical leadership skills focus on clients and healthcare teams such as those advocating for patients, communicating with the healthcare team, patients, and their families; compared to individuals reporting to and working with a nurse in a formal leadership position. (AL-Dossary, 2017). With regard to the case story, the RN should collaborate with other interdisciplinary team members starting from the physician, who can further explain the disease process, its complications, and how medications can help in managing and treating the disease. The nurse should also collaborate with the home health nurse for the continuity of care provided at home and to support health care needs (Larsson & Sahlsten, 2016). The CHN can liaise with the social worker to conduct an assessment of the patient’s living situation to determine needs and goals. The next member of the team to get involved would be the dietitian to develop a personalized food plan and modify Mr. Smith’s eating habits to manage his blood sugar level. Nurses in their role at the bedside demonstrate clinical leadership skills by providing, facilitating, and promoting the best possible care for their patients (AL-Dossary, 2017).

Leadership Style that Supports Nursing as a Relational Practice

            Transformational leadership is the style that best describes the action of the RN in the case story. According to Sfantou et al. (2017), the transformational leadership style often drives improvements in patient care, personal development among other nurses, and overall organizational improvements. The entire team collaborates and works toward a common goal that is to deliver a safe and ethical quality of care using a holistic approach. This style of leadership improves the efficiency and competence of the healthcare organization. The problem-solving techniques in nursing leadership using the transformational style are excellent because they are always looking for ways to do things better (Ferreira et al., 2020).

Communication Strategies that Support Nursing as a Relational Practice

            Registered nurses are communicators who use a variety of strategies and relevant technologies to create and maintain professional relationships, share information, and foster therapeutic environments (Kwame & Petrucka, 2020). In the case scenario, the primary nurse’s interaction with Mr. Smith has been established with a trusting relationship as the patient had honestly expressed feelings of disinterest in taking his medications promptly. The nurse asked an open-ended question in finding the reason for non-compliance to medications. Cecilia also used an active listening strategy to understand and respond to the client’s concerns. The nurse has incorporated the process of relational practice to adapt to communication skills (Kwame & Petrucka, 2020).

Challenges and Enablers that Support Nursing as a Relational Practice

The central challenges of nursing as a relational of practice include poor communication and a hectic environment in a healthcare setting (Moreno-Poyato et al., 2017). Poor communication can therefore interfere with the nurse-patient relationship. On the other hand, a hectic healthcare setting can create an environment that will interfere with the nurse-patient relationship and tamper with the relational practice of nursing. On the other hand, the main and enablers of nursing as a relational of practice include effective communication skills, empathy, respect, and trust (Zou, 2016). In the case study of the 67 -year old with diabetes and hypertension I would enhance the caring relationship by adopting and seeking to be more empathetic to the patient’s condition and empowering the patients to manage their condition through effective education programs.

Reflection

Taking time to show empathy to the client and educating them on how to manage their diabetes and hypertension through the drug regimen and a healthy lifestyle is realistic and would enhance the caring relationship. Nurses should therefore adopt the right leadership style that will support nursing as a relational practice, such as a transformational leadership style. This leadership style supports collaboration between colleagues and patients. According to Sfantou et al. (2017), transformational leadership is the most effective leadership style to enhance the patient-nurse relationship.

Conclusion

In summary, relational nursing practice entails the understanding of the health care needs of patients, the sophisticated contexts in which the patient will experience health care, and the nurses will deliver such care. Nurses, therefore, have to adopt effective leadership styles such as the transformational leadership style and the right communication approaches to enhance a relational practice.

 

Word Count = 1264

  

References

Al-Dossary, R.N. (2017). Leadership in Nursing, Contemporary Leadership Challenges, Aida

Alvinius, IntechOpen,https; doi10.5772/65308.

College of Nurses of Ontario (CNO)(2006). Therapeutic Nurse-Client Relationship, Revised

  1. Retrieved from: https://www.cno.org/globalassets/docs/prac/41033_therapeutic.pdf on 08/04/21.

Ferreira, V. B, Amestoy, S.C, Silva, G T, Trindade, L.L, Santos, I., AdrianaR., , & Varanda, P.A,

(2020). Transformational leadership in nursing practice: challenges and strategies. Revista Brasileira de Enfermagem, 73(6), e20190364. Epub August 10, 2020.https://doi.org/10.1590/0034-7167-2019-0364.

Feo, R., Rasmussen, P., Wiechula, R., Conroy, T., & Kitson, A. (2017). Developing effective

and caring nurse-patient relationships. Nursing Standard, 31(28), 54–63. doi:10.7748/ns.2017.e10735.

Gerber, L (2018). Understanding the nurse’s role as a patient advocate, Nursing.Vol.48 – Iss 4 – p

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Kwame, A., & Petrucka, P. M. (2020). Communication in nurse-patient interaction in healthcare

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Larsson, I. E., & Sahlsten, M. J. M. (2016). The Staff Nurse Clinical Leader at the Bedside:

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Moreno-Poyato, A.R., Delgado-Hito, P., Suárez-Pérez, R. et al. (2017). Implementation of

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Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou,

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Zou P (2016).Relational Practice in Nursing: A Case Analysis. NHC 102: 9-13. Retrieved from:

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