Discuss the challenges of a student nurse in establishing therapeutic engagement with service users; using clinical examples and theoretical frameworks to illustrate points of discussion.
Throughout this essay I will refer to myself as the Student nurse. The clinical
example that shall be used, will be based from experiences within a
community mental health setting for adults, where a care programme
approach was applied. It will describe the settings and the importance
of therapeutic engagement of the service user and the student- nurse.
The intention of this essay will be to describe the main features of the
therapeutic relationship in terms of the experience between the student-nurse
and the service user. The essay will present a progressive picture of
therapeutic interaction, in the varying stages of the service user’s illness.
There will be shared thoughts and feelings about working with clients with
mental health problems.
It will relate the theoretical framework to the actual hands on experience
in a community setting, drawing out the main advantages and disadvanges in
relation to practice. The student-nurse will discuss the different stages
throughout their developing relationship with the service user. They will also
share their thoughts and feelings about their experience and aspects of the
service users Illness. There will also be theoretical nursing model applied to
the care of the service user. These models include Carl Roger’s
person centred counselling(1902-1987), Hildegard Palau’s developmental
stages of the Nurse-client relationship (1909 -1999), and also Phil Barker’s
Hildagard Peplau (1998) defines the therapeutic relationship as the
foundation of nursing practice in addition to people who are experiencing
threats to their mental health. The therapeutic nurse-patient relationship
evolves from. She introduced an interpersonal relations paradigm for the
study and practice of nursing that was grounded in clinical experiences of
herself and her graduates students (Peplau,H. 1998 in Phil Barker 2003).
For the reasons of autonomy and patient confidentiality the patients name will
be chosen at random. (Nursing and midwifery council,2004). I will refer to
the patient as Stuart. Stuart is a thirty-two African-Caribbean year old male
with a diagnosis of paranoid schizophrenia. He lives on his own and is
currently unemployed. He was first admitted to hospital nearly five years ago.
He has a history of suffering from depression and delusions involving the
pope plotting against him. On a daily basis he is prescribed an oral medication
of Flupenthixol (Nice,2006). By now the student-nurse had met Stuart on
several occasions through ward rounds and home visits with CPN’s of the
community, which the stuart-nurse was based on. As time went on and into
the third week of the student- nurse’s nine week placement, her
mentor decided to give her the opportunity to take Stuart as one of their
case loads. During this placement my aim was to achieve an engagement of
an therapeutic relationship with Student within a nine week placement . This I
personally felt this was going to be quite challenging because of the time
factor and also because of my status as a student nurse i.e. Stuart found it
hard to accept me. As he stated to me, I was another in a long line of student
nurses and what was the point of opening up to me.
Supervision begins and end with a relationship (P, Barker,1992).
A therapeutic relationship had gradually developed between the student-nurse
and Stuart. The student -nurse now began to feel as though Stuart
understood the purpose of their therapeutic interventions on a weekly basis.
Peplau (1994) states that the most therapeutic potential is
when a nurse and a...
Please join StudyMode to read the full document