• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

Discuss the Care of one patient from a participating placement area that demonstrates establishing a therapeutic relationship in the short term setting including advocacy and the use of clinical science knowledge.

Extracts from this document...


Discuss the Care of one patient from a participating placement area that demonstrates establishing a therapeutic relationship in the short term setting including advocacy and the use of clinical science knowledge. This assignment will revolve around a single episode of care provided to Mr. A, a recently diagnosed Human Immunodeficiency Virus (HIV) positive gentleman. As part of his ongoing care, he attends a Genito-Urinary Medicine department as an outpatient every 3 months in order to ascertain the progression of his disease. As part of this assessment, he undergoes a series of blood tests, including a count of his T-helper cells (colloquially known as a "CD4 count"). At the time, Mr. A was a Clinical Stage 1 asymptomatic patient, according to the World Health Organisation (WHO) HIV staging criteria (WHO, 2005), meaning that he was not currently receiving Highly Active Antiretroviral Therapy (HAART). The assignment will cover the pathophysiology of HIV, focusing specifically on the relationship of the CD4 count to disease progression. Communication strategies relating specifically to the short-term professional and therapeutic relationships developed with Mr. A will also be discussed. In line with guidelines published by the Nursing and Midwifery Council (NMC), specific names and places have been amended to retain anonymity for all concerned, and consent has been obtained from the patient (NMC, 2008). ...read more.


A, the communication employed seemed appropriate at the time. On his arrival at the clinic, I greeted Mr. A and introduced myself, as I was waiting for him to arrive. Nolan and Ellis (2008) advocate that the therapeutic relationship begins as soon as the patient and practitioner meet: thus the adage about first impressions being everything. Smiling and offering my hand to Mr. A seemed to relax considerably: he had seemed initially quite lost and tense. This initial introduction already seemed to soften the perceptions that most have of the Genitourinary setting. In fact, Bilney and D'Ardenne (2001) found that patients visiting GU clinics can have a decidedly 'warped' view, mainly relating to confidentiality and shame issues, and can therefore be quite hostile and withdrawn: thoroughly non-productive within any healthcare setting. In this particular outpatient setting, the power balance between patient and nurse can be difficult to maintain. From the patient's perspective, the nurse holds most of the power: patients are asked to divulge deeply personal information to a complete stranger and then potentially undress and submit to an extremely intimate examination. With Mr. A, the nursing staff were possibly the only people aware of is HIV diagnosis, and because of this, could have held all of the perceived power. ...read more.


This was handled in an informal manner: a jovial suggestion rather than an edict. Culley (1991) suggests that such behaviour can help to empower patients: getting them to share responsibility and progress, rather than being static. Through this means, not only could Mr. A progress personally, but he could also feel better connected to the service, and by extension more comfortable. In conclusion, it appears that developing a genuine therapeutic relationship is not only vital to the success of outpatient care, but also a cornerstone of good nursing practice. Although many outpatient encounters are single episodes of care with sometimes no follow up, it is still vital the strategies such as those outlined above are employed to ensure that patients receive the best possible care. With respect to GU medicine, it is intrinsic to the nature of the work that a trusting, productive relationship is built with patients: due to the intimate nature of the exchange, trust is vital to provide an accurate and useful service to patients. I feel that in this circumstance, I displayed and employed several effective strategies to build the initial patient relationship, but with the benefit of hindsight, I think that there is still more work that I can do to develop my practice and ensure that patients feel comfortable and by extension engaged with the service that I am offering. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Nursing section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Nursing essays

  1. The aim of this essay is to critically evaluate the bio-psycho-social perspectives and influences ...

    A bone fracture medically abbreviated as FX F or # is described as a break in the bones continuity (McRae and Esser 2002; Martini and Nath 2009). Regardless of individual belief there is no medically distinction between the term fracture and break (McRae and Esser 2002).

  2. Discussing a patient with type 2 Diabetes Mellitus.

    Epidemiology, Policies and Health Promotion The World Health Organisation (WHO) found that in 2000 some 1804943 people in the UK suffered from diabetes, while the Grampian Health Board find that currently there are 11000 sufferers in Grampian, (World Health Organisation, 2003)

  1. Nursing case study. The aspect selected is pressure area care and nursing models, knowledge, ...

    The environment affects the individual's health and the way the care is delivered. The ward has a ward manager, ward sister and a team mixed skills nurses and HCAs. Each bay has its own nursing team which includes a named registered nurse and health care assistants.

  2. Reflection on a clinical skill

    I was very conscious that I didn't want the patient to think I was unsure at any point about the treatment I was giving her. I referred to my mentor regularly throughout the process to ensure I was conducting the procedure correctly and appropriately.

  1. Case study. This assignment will present a holistic profile and discuss the plan of ...

    After that she enjoyed traveling to Australia every year to be with her son until her health gave up on her. Joy describes herself as outdoor person. Her favorite pastimes include: gardening, playing with grandchildren and cooking. Joy also has the love of tapestry and looks forward to go back

  2. HOSPITAL CASE ANALYSIS. This case study takes place at a hospital and is based ...

    - Get rid of Smith No Team Work - Job enlargement - Casual Fridays - Departmentalization - Regular group meeting- discussing negatives, positives, and improvements - Have group meeting - Training workshops/ retreats - Let staff members choose what floor they want to work on - Self directing work teams

  1. A Critical Appraisal of a Published Piece of Research Related to Practice. ...

    The twenty-six registered nurses and healthcare assistants were observed in practice thirteen of which were interviewed following observation. Six senior nurses were purposely selected for interview. There were also twelve patients that had stayed on the ward for at least two days who were interviewed following discharge.

  2. Pain Assessment. The implementation and rationale for using pain assessment tools is focused ...

    due to a change in her environment, alongside her continued anxious state. Therefore her care encompassed different issues when trying to achieve optimum pain management. The need to develop effective communication was vital, thus ensuring that Mrs Green could express her pain and anxieties openly.

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work