According Cutliffe and McKenna (2005), research, theoretical and educational literature on interpersonal relations between nurses and patients has proliferated since the 1960s. This has generated a range of divergent accounts of what the nurse-patient relationship (NPR) ought to be, how this should be achieved, and how the NPR is constituted in practice. I have chosen the concept of nurse-patient relationship because this relationship is viewed as the essence of nursing practice (Moyle 2003). This essay’s aim is to demonstrate my understanding of the concept of the nurse-patient relationship through utilising relevant literature and relating this to a specific incident in my practice-experience. I will briefly explain an incident which I was involved in prior to identifying and discussing the significant aspect of the incident. Peplau‘s (1953) interpersonal relationship model and Rogers’ (1951) model of Self-Concept in mental health nursing will be used. I will then reflect on my learning and how this will impact on me as a registered mental health nurse.
According to Julia and George (2002) a concept is an idea, thought, or notion conceived in the mind. These ideas or thoughts may be experimental or actual, depending on their ability to be observed in the real world. Meleis (2007), on the other hand, defined a concept as a term used to describe a phenomenon or a group of phenomenon. Nursing theories have been defined as reservoirs in which findings that are related to nursing concepts ,such as comfort, healing ,recovering, mobility rest caring enabling fatigue, and family care are stored ( Pearson 2005 ).
I have used the pseudonym, Anna, when referring to the patient in order to protect her confidentiality in accordance with the Nursing and Midwifery Council’s Code of Professional Conduct and Ethics (NMC, 2008). I will start on her mental health background, problems, needs and events that led to her admission.
Anna was a forty-four year old white female who was admitted as a formal patient to an acute ward where I was on placement. Formal patients are those patients who are not a section, they come to hospital voluntarily. Anna was married with four children .Her problems started when her husband died and as a result she could not cope with grieving for the husband and looking after the children. Anna started to drink alcohol excessively consequently her mental state and physical well-being deteriorated. Anna’s children were, unfortunately, taken away by the Social Services because of Anna’s alcohol related behaviour. She had several seizures due to alcohol and, also experienced panic attacks, and headaches. On admission, Anna came with her relatives who had been exposed to considerable strain. She was subjected to comments, criticism and reproach by the family. The family had delayed bringing Anna to hospital because they felt guilty about psychiatric hospitals.
I identified depressive illness, excessive alcohol intake and ailing physical health as Anna’s three most significant problems, all of which are interrelated. Anna’s loss of a husband caused her to feel depressed, she then started to drink excessively, which led her to lose her children to Social Services and also contributed to her ailing physical health. All these contributed to Anna’s mental state. According to Rogers (1951) self-concept contributes to, and is greatly affected by experience, the greater the incongruence between the organisimic experience and the self as experienced in the world, the more likely it is for the person to experience tension.
Pepalu (1953) stated that a patient’s expectations and preconceptions about people are based on the feelings they have had in their relationship with people who were significant earlier in their life. To the psychiatric patient, nurses symbolise, or are an illusionary reminder of these earlier figures. It was of paramount importance...