Caring and Nursing Nurse Patient Relationship Caring

Caring and Nursing

Nurse patient relationship caring relationship Boundaries maintenance relationship Nursing practice standards Research paper, primary source House Arrest Ellen Meeropol (2011) Need a good introduction a good conclusion Do a reference page text citation a refer illustrative House arrest. ID

The nurse-patient relationship as caring, professional relationship

One of the primary reasons that nurses embark upon the profession of nursing is their desire to give care to others. However, caring in the sense of 'nursing' is different than the type of caring that a person gives to a friend. Nursing is a specific discipline that dispenses a specific kind of care. There must be preservation of professional barriers when dispensing that care. Yet although a nurse is not a friend, a nurse must also be a good listener and dispense care that shows sensitivity to the individual patient's needs.

Trust is at the heart of showing caring in nursing. "The concept of trust is of particular interest to nursing as it has been identified as an important element in the nurse-patient relationship; however, the concept is loosely used in everyday discourse with confusion apparent and the true meaning of the concept of trust unclear. Patients' trust in the nursing profession cannot be taken for granted simply due to a requirement for nursing care" (Bell & Duffy 2009: 46). Trust may be compromised because patients perceive a power imbalance in nursing. The nurse may feel that she knows what is best based upon his or her framework of knowledge, while the patient intuitively feels that he or she knows what is best for his or her health. This intuition may differ from the nurse's perception.

Surveys of nurses show that one of the most significant impediments to creating a relationship of trust and open communication between nurses and patients are nurses' sense that they know best, regardless of patient input. "With the exception of a few, the majority of nurses were unwilling to share their decision-making powers. This created a situation of power imbalance with subsequent little patient input. Factors identified included nurses' beliefs that they 'know best,' the view that patients lacked medical knowledge and the perceived need for nurses to hold onto their power and maintain control" (Henderson 2003).

However, this sense of knowing best can mean that nurses are not able to adequately assess the patient's social and cultural context. While professionalism is a core component of almost every model of nursing, it is not the only component of patient care. The patient's individual needs, the patient's environment and social context, and a definition of health that is mutually acceptable for both patient and nurse must be arrived at, for care to be effective. In general, the wider the power differential between two adults, the lower the sense of automatic trust. The nurse must understand why patients may be mistrustful of the nursing relationship, initially. One way to 'shut down' communication is to get angry at a patient if he or she expresses reservations about a treatment or questions if a procedure is necessary. The nurse perceives this as an affront to his or her competence. However, a truly effective use of the nursing paradigm is to see the world from the patient's perspective, and address reservations with an eye based on the patient's experiences, level of education, and personal definition of health. Only then can a bridge be created between the nurse's experience and the patient's experience.

For example, in the novel House arrest by Ellen Meeropol, a nurse is forced to care for a pregnant woman whose membership in a cult resulted in the death of the woman's teenage daughter the previous year. Although it would be easy to adopt a judgmental attitude towards Pippa, the nurse Emily also has a duty as a caregiver to see the world from Pippa's perspective and to understand Pippa's articulated needs and perspective. Ultimately the novel suggests that passing judgment on patient's health choices does not result in better health outcomes, either from the perspective of the medical profession or the patient.