Topics: Nursing, Health care, Patient Pages: 8 (2921 words) Published: November 26, 2013
A STRUCTURED REFLECTION ON THE DEVELOPMENT OF A THERAPEUTIC RELATIONSHIP WITH A CLIENT In this essay, I am going to give a structured reflective account on the development of a therapeutic relationship with a client on one of my clinical placements as part of my training as a student nurse. I will be using a reflective model which explores the processes involved in developing and maintaining such relationships bearing in mind theoretical knowledge and how it applies to this clinical experience. Jasper (2003) describes reflective practice as one of the ways that professionals learn from experience in order to understand and develop their practice. As a trainee health care professional, I have learnt the importance of reflection in practice as a platform for judging one’s progress, strengths and weaknesses and also as a tool for appraising what went well during an intervention and what needs to be improved upon. Reflective practice is an important factor for nurses when building a therapeutic relationship with clients. Though this is essential in all nursing practices, it cannot be over emphasised in Mental Health nursing as this is based on quite a lot of understanding and trust between nurses and client. It is also now a respected and required learning and assessment method in many nursing programmes worldwide. The Nursing and Midwifery Council (NMC, 2008) requires nurses to keep knowledge and skills up to date throughout their working life. Considering the importance of clinical competence in the nursing profession, then it will suffice to say that reflection is an important tool in the nurse’s range of skills which aids the achievement and maintenance of clinical competence and performance (Mattews, 2004). I have chosen to use the Gibb’s, (1988) reflective cycle as a model of reflection to help me systematically analyse the experience better for the purpose of this essay and for future practice. This model is made up of six stages depicted as a cycle which supports the notion that learning is a continuous process as through reflection; we are able to continuously learn from our experiences and thereby improve our nursing practice in future. This cycle is made up of description of the event, the feelings that was experienced, an evaluation of that event, an analysis to make sense of the experience, a conclusion drawn about the experience and finally an action plan put in place in preparation of a future reoccurrence. Siviter, (2004) sees reflection as a way of gaining self confidence, identifying when to improve, the ability to learn from own mistakes and behaviour, looking at issues from the perspective of others and becoming self aware to improve the future by learning from the past. My client whose relationship I will be discussing is a seventy-two year old lady with a diagnosis of Dementia called Trisha. This is a pseudonym to protect her identity as necessitated by the code of conducts of the Nursing and Midwifery Council (NMC, 2004a). The clinical setting was a specialist care unit for older adults with Dementia, the incident involved issues around compliance with prescribed medication and the dilemma that ensued over what was an appropriate course of action to take as well as the effect it had on my relationship with Trisha. The therapeutic relationship that exists between a nurse and their client is built on a series of interactions which is developed over a period of time. Although not all interactions develop into a relationship they may still be therapeutic. This relationship is usually for the benefit of the client only and differs from social relationships as the Nursing and Midwifery Council (2004b) expects that at all times nursing staff must maintain appropriate professional boundaries in the relationships they have with patients and clients. It is time limited, goal oriented and in phases (Arnold & Boggs, 2003). Peplau (1952) describes the nurse – client relationship as the foundation of nursing...

References: Arnold E., & Boggs K.U (2003) Interpersonal Relationships: Professional Communication Skills for Nurses. (4th ed.) Missouri: Saunders Elsevier.
Boyd E. & Fales A. (1983) Reflective learning: key to learning from experience. Journal of Humanistic Psychology 23(2), 99–117.
Carper B. (1978) Fundamental patterns of knowing in nursing. Advances in nursing science, 1(1), 13-24.
Chambers M. (1998) Interpersonal mental health nursing: research issues and challenges. Journal of psychiatric and mental health nursing 5: 203-211.
Gibbs G. (1998) Learning by Doing: A Guide to Teaching and Learning. London: FEU.
Gould E. & Mitty E. (2010) Mediation adherence is a partnership, medication compliance is not. Geriatric nursing 31 (4): 290-298
Jasper M
Johns C. (1995) Framing learning through reflection within Carper’s fundamental ways of knowing in nursing. Journal of Advance Nursing, 22(2): 226-234.
Matthews G., Roberts R. D., & Zeidner M. (2004) " Seven Myths About Emotional Intelligence". Psychological Inquiry, 15(3), 179-196.
McCabe C. (2004) Nurse–patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing, 13: 41–49.
McHugh S
Mental Capacity Act (2005): Code of Practice.
National Institute for Health and Clinical Excellence (2009). NICE Clinical Guideline 76: Medicines adherence. Available at : (Assessed: 20 November, 2012).
Nursing and Midwifery Council (2002) An NMC guide for students of nursing and midwifery. London
Nursing and Midwifery Council (2004a) The NMC code of professional conduct: standards for conduct, performance and ethics
Nursing and Midwifery Council (2004b) The NMC code of professional conduct: standards for conduct, performance and ethics. London.
Nursing and Midwifery Council (2008) Guidiance on professional conduct.
Peplau H. (1952). Interpersonal relations in nursing. New York: Putnam.
Peplau H. (1992). Interpersonal relations: A theoretical framework for application in nursing practice. Nursing Science Quarterly, 5(1): 13-18.
Siviter B. (2004) The Student Nurse Handbook. USA: Baillere Tindall.
Continue Reading

Please join StudyMode to read the full document

You May Also Find These Documents Helpful

  • Essay on Ways of Maintaining the Therapeutic Relationship
  • Write an Essay on Confidentiality and the Boundaries of a Helping Relationship
  • Describe the Transference/Counter-Transference Element of the Therapeutic Relationship Essay
  • Discuss the ways in which counsellor qualities such as Empathy, Genuineness and Unconditional positive regard are important in the...
  • Essay about “Compare and Contrast the Different Ways the Person-Centred and Cognitive- Behavioural Approaches to Counselling Understand and...
  • The therapy is the relationship Essay
  • the importance of theraputic relationship between client and therapist Essay

Become a StudyMode Member

Sign Up - It's Free