Importance of the Nurse Patient relationship in delivering care

Importance of the Nurse Patient relationship in delivering care The nurse-patient relationship is essential to the delivery of care. By use of verbal and non-verbal communication skills, nurses can offer the three core conditions of all therapeutic relationships to patients, empathy, genuineness and unconditional positive regard. It is the intention of this essay to discuss in depth the nature of one of the core conditions associated with effective helping skills. In relation to communication and an effective nurse-patient relationship the application of the core condition will also be examined The first core condition that is associated with effective helping skills is empathy. This is the beginnings of a helping relationship, the ability to enter into and understand the world of the other person and being able to communicate this understanding to them (Egan 2002). The second core condition is genuineness which Rogers (1994) defined as a personal quality or relationship characterised by open and honest communication where professionals do not hide behind their role. Unconditional positive regard often described as acceptance is the third core condition and this involves taking a non-judgemental attitude towards the client accepting and respecting them for who and what they are (Freshwater 2010). According to Rogers (2003) the core conditions are the necessary and sufficient tools needed to achieve a positive outcome in therapy. The core condition that has been chosen to be discussed in this essay and is associated with effective helping skills is unconditional positive reg ard. Unconditional positive regard is a very difficult skill to learn but also a very important one as nurses and patients beliefs and values may conflict altogether. It is important to note that no single core condition stands in isolation from the others and that the three conditions are automatically brought into the natural communication style (Wickman and Campbell 2003). Unconditional positive regard is often defined as acceptance. According to Rogers (2003) it is when one person is completely accepting towards another person. This is not just a show of acceptance but it is an attitude that is then demonstrated through behaviour. The patient should be able to feel as if they can freely express their emotions without fear of being rejected by the nurse. Hough (2007), says the patients need to feel valued unconditionally even when what they bring to the nurse may not be positive à ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬ in fact it may be frightening or upsetting. This may be particularly true of patients who have been abused who may feel embarrassed and ashamed and could also be anxious as to what the nurse will think of them. The nurse must therefore own the necessary skills to put aside any personal prejudices and provide a safe and accepting environment for the patient. Hough (2007) is careful to point out that whilst this does not necessarily mean that the nurse must li ke or approve of everything the patients says or does, it is important for the nurse to be able to separate their own views from that of the patient. Hough (2007) suggests that the whole philosophy behind unconditional positive regard is to allow the patient to feel accepted, therefore the patient is more likely to accept themselves and be confident in their own abilities. Unconditional positive regard is the necessary and sufficient condition to allow the patient to change in a constructive manner (Wilkins and Bozarth 2001). There are a number of key components that put together unconditional positive regard, and according to Aengel (2010), these include respect, nurturing and caring for the other person, and being compassionate and understanding to a persons personal struggle with issues and problems. Unconditional positive regard might be difficult because of the manner or style of the matter or something about the patient might conflict with our own personal values. Nurses must put aside any pre-judgements and opinions, accept the patient at face-value and to try to treat the issue that they are currently presented with. Nurses cannot let any judgements affect the relationship with the patient because it might affect the care and treatment they receive. The counsellors guide (2009) emphasises that unconditional positive regard as being one of the most difficult counselling skills to learn because people are very skilled at being able to accept people for who they are, without considering whether they really are who they claim to be. This prevents them from allowing stereotypes and personal opinions affect their judgements. As for unconditional positive regard it may be possible that the nurse may come to like or even love the patient with whom they may at first have not felt much connection (Tschudin 1995). According to The Nursing and Midwifery Council (2008) Code of Conduct nurses are required to treat people as individuals and respect their dignity. They should not discriminate in any way, recognise diversity and respect and value beliefs of others. Thus part of valuing the other person is to accept them for who they are. Carl Rogers (1994) called acceptance unconditional positive regard. It implies that there should be respect for the other person irrespective of what he or she may do or has done. Acceptance of another person involves an non-judgemental attitude as Ruddick (2010) suggests, as this creates a safe environment in which the patient can explore their most sensitive thoughts and feelings. The nurse must recognise that being non-judgemental is not always possible and if the nurse lays judgement on the patient then they will compromise their relationship with them and because they feel judged then they may become defensive rather than opening up and exploring their issues (Geldard and Geldard 2003). Geldard and Geldard (2003) also suggest that the opposite of being accepting is to be critical. Being critical of someone will make them become fixed in their thinking and their behaviours and they will generally resist changing. When they are accepted they feel good about themselves and they can get in touch with their personality and positive parts and learn to move forward. Collins (2009) argues that judgemental attitudes can stand in the way of getting to know your pat ient and that labels attached to individuals such as demented can act as a language barrier. Effective nursing requires us to be assertive, responsible and to help our patients achieve the best possible health status (Balzer Riley 2008). Effective communication is more than delivering high quality patient-centred care. It also allows patients to feel involved in their care, which can make a significant difference to their outlook on their treatment (Collins 2009). The personal qualities of a nurse should include compassion, respect and a non-judgemental approach, according to The Royal College of Nursing (2003). The nurse must provide holistic care for patients and the goal is to listen to the whole person and provide them with empathetic understanding. Another key point is that the nurse must be non judgemental no matter what the patients circumstances are and be keen to develop a therapeutic relationship as they learn to accept people for who they are as each of us have had different experiences throughout life and these experiences make us who we are. Wilkins (2010) is keen to point out that there is not much difference between the nurses attempt to communicate unconditional positive regard and empathic understanding and the patients awareness of them. What the nurse communicates is not always understood and perhaps with respect to simplifying the understanding of unconditional positive regard, it may be necessary to have patience, consiste ncy and genuineness of acceptance (Wilkins 2010). According to Dunne (2005) it is important that nurses develop their communication skills so that they can become more skilled in their interpersonal contact with their patients. The beginning of any nurse-patient relationship are needs which should be based on some fundamental aspects. Rogers(2003) described these as the core conditions, because the aforementioned argued that for a positive outcome to the therapeutic nurse-patient relationship, the nurse must display these core conditions. The nurse-patient relationship does not exist without the core conditions or at least it will not have a positive outcome. It is important to build up a good working relationship with any patient trust, respect and good communication skills are all essential but the counselling relationship has to go that bit further because it tends to deal with deeper issues (The Counsellors Guide 2009). Nurses work with a diverse variety of people from a wide range of social circumstances, with difference beliefs and values around health. This could be related to sexual health, alcohol consumption, smoking and so on. Freshwater (2010) suggests that many patients continue with their dangerous health behaviours despite having information about the adverse and potentially damaging aspects of their actions. This makes it difficult for the nurse to engage in any health promotion activities whilst continuing to value and respect the patient and in fact it may be that the patients and nurses beliefs may cause conflict on the whole (Freshwater 2010). The nurse-patient relationship is a professionally close and private one and in order for it to be effective it needs to reflect trust, caring, hope and autonomy (Brooker and Nicol 2003). By demonstrating this core condition of unconditional positive regard the nurse is offering support to others. Brooker and Nicol (2003) suggest that active li stening skills are essential in any therapeutic relationship and the nurse needs to explore how they can use communication skills; verbal and non-verbal to develop the relationship. The nurse-patient relationship is a series of interactions between the nurse and the patient in which the nurse assists the patient to reach a positive communicative change. The skills of active listening, open questioning and reflection promote better communication and the evidence suggests the need for nurses and other health professionals to develop their communication skills so that they can simplify the process of communication with the patient (Dunne 2005). It is in the therapeutic relationship that true person-centred care is the product of genuine engagement with the patient whose fears are being uncovered according to Ruddick (2010) A therapeutic relationship cannot be maintained with the expression of unconditional positive regard and before the patient can understand themselves they must be able to accept themselves (Dexter and Wash 2001). The core condition of unconditional positive regard is a very difficult skill to learn and probably one of the hardest things a nurse has been asked to do. According to Dexter and Wash (2001) the nurse is asked to accept an individual without any kind of judgement and without criticism. The nurse is not only being asked to accept the patient but respect them too even though the nurse may not know what the patients previous behaviour has been. To be an effective counsellor, the nurse is asked to dissolve their own values, beliefs, prejudices and stereotypes and must try to understand the patients values, beliefs, prejudices and stereotypes even though they are totally opposed to their own (Dexter and Wash 2001). In conclusion, this essay has briefly discussed all three of the core conditions, which are, empathy, genuineness and unconditional positive regard. It has explained the rationale for choosing unconditional positive regard to discuss in this essay. Unconditional positive regard is often defined as acceptance and this is often demonstrated through behaviour. The key point that has been examined in this essay is that of how the nurse must put aside their own feelings and views and accept the patient for who and what they are. The essay has included how the core condition is used in relation to communication and an effective nurse-patient relationship. Another key point is that active listening skills are essential in any therapeutic relationship and the essay has explored how the nurse can use different communication skills to help to develop the relationship with the patient. Finally, the essay has discussed how unconditional positive regard is a very difficult skill to learn. It is p robably one of the hardest conditions associated with effective helping skills because the beliefs and values of the nurse and patient may conflict together. 1989 words

Kashmir Must Gain the Right of Self-determination Essay -- Argumentati

Kashmir Must Gain the Right of Self-Determination The protracted conflict in Kashmir has continually undermined efforts to restore peace and stability to the Indian subcontinent. This South Asian crisis must be resolved so that 'India and Pakistan can devote their resources and energies to the pressing task of advancing the welfare of their people' as espoused by the Simla Accord of 1972. The Simla Accord is the document that states both countries agreed to find peaceful solutions for the promotion of a friendly and harmonious relationship that will restore peace to the subcontinent. The Simla Accord of 1972, however, has not been effectively implemented as the wave of human rights violations committed by both sides has demonstrated over the last decade. Why should Kashmir be granted their right of self-determination? First, the instrument of accession is illegitimate. Second, to stop the atrocities committed by both India and Pakistan that have prevented peaceful relations in South Asia. The need for India to recognize the illegitimacy of the instrument of accession is the starting point toward bilateral and conciliatory discussions between India and Pakistan. This will create an environment in which both countries can work toward establishing an independent Kashmir, the key to peaceful coexistence. Since India is crucial to the initiation of this process, an examination of the instrument of accession signed by the Maharaja Hari Singh and the Indian government on 26 October 1947 immediately follows. India must recognize the underlying weaknesses and the illegitimacy of the instrument of accession. The underlying weaknesses of the signing of the instrument of accession are clear and incontestable. First, the Maharaja l... ...ilitarize and restore peace and security to the Indian subcontinent as already agreed upon in the Simla Accord of 1972, and eventually both sides must work together to decentralize control of Kashmir and allow for the emergence of an independent and sovereign Kashmir. A sovereign Kashmir, free of outside interests and influences, will sustain and maintain ‘peaceful and harmonious’ relations on the Indian subcontinent. Works Cited: Potter, Pitman B. "The Principal Legal and Political Problems Involved in the Kashmir Case." American Journal of International Law, vol. 44, no.2, 1950. Rahman, Mushtaqur. Divided Kashmir: Old Problems, New Opportunities for India, Pakistan, and the Kashmiri People. Lynne Rienner Publishers. Boulder, 1996. Thomas, Raju G.C. et al. Perspectives on Kashmir: The Roots of Conflict in South Asia. Westview Press. Boulder, 1992.

Business Survival in a Recession Essay

The key to business survival in recession is leadership† To what extent do you agree with this view? There are many different ways in which a business can use techniques to survive in a recession and here leadership is the key focus. To explain fully I will be focusing upon such ideas as the type of leadership management used, motivational effects where a business motivates the demoting factors such as ‘cuts’, for example sack employees to reduce costs that may viable save a business, the role of leaders in setting about change and management in bringing about the idea of change/ new instructions. Yet as well as the positives there are the negatives to a leadership styles and how its managed within a recession, so such factors as limited resources from change, an example being the reduction in the workforce size, the role of stake holders that ask the questions whether one leader is enough in a recession in comparison yet the leadership throughout the whole organisation. Particular business example such as ‘British Airways’ and ‘Sainsbury’ case studies and finally the external factors that inhibit a business chances for survival in a recession. Most certainly one of the most relevant points to make about a business trying to survive in a recession is the type of leadership management that is in place. For a success full leader and many styles can be used in times of desperate measures; here I would suggest during a recession that an Autocratic style of leadership needs to be followed, clear expectations for what needs to be done, when it should be done, and how it should be done. Although for the short term this aggressive direct approach needs to be considered to get a business through the hard times it had to face. For example with Margret Thatcher who was in power during the last recession in the 1990’s had to use this style of leadership to get the country out of the problem, yet left certain problems in doing so. If this is not to be the most productive method of leadership during a recession managers may adopt the Democratic leadership style where leaders offer guidance to group members, but they also participate in the group and allow input from other group members. Although the type of leadership is successful in producing high quality it is less productive than that of an Autocratic leadership style. Motivational factors are essential for a business survival in a recession whether it’s for the employees/ staff or the customers who have the purchasing power. Both these groups need to be aimed at by the higher authorities of a business to allow for a good circular flow of income to keep the business stable in hard times such as the recession. Although this motivation may comes in many different ways some being bad and the others being good, for a business such motivational factors as making ‘cuts’ and redundancies of employees to allow for a business to keep up with costs will see demotivation amongst labour workers but may see improvement in the costs in which they have to pay. Reduction of stock and capacity utilisation will see a lower work ethos, as less produce will be produced. By not overstocking and hoping that it will sell a business may have to adopt a ‘JIT’ or just in time method of production to satisfy orders the have at present rather than in the future. So here leaders/ managers must make the decisions to implement whether to make the changes needed to allow the business to survive for the time of the recession or maintain their current workforce and level of stock and hope the business is successful and can still sell their products. The introduction and bringing around of change is in some cases problematic for a business in terms of the employees views of change and valid in times where its essential to keep the business floating. Such examples as General motor’s, IBM, and Sears are ones that need pushing for organizational improvement, whether they are external members of the board, major investors, or top executives; they must deal with cultural and behavioral obstacles to change. Specifically, attempts at organizational change must consider three key features of organizational life: the firm’s culture, the leadership of the change effort, and the existing network of power. Company culture is important because it can make or break a company. Companies with an adaptive culture that is aligned to their business goals routinely outperform their competitors. Company cultures evolve and they change over time. As employee leave the company and replacements are hired the company culture will change. If it is a strong culture, it may not change much. However, since each new employee brings their own values and practices to the group the culture will change, and with this could include different motivational factors and views of other workers; so its vital for a business to include employees and workers in the changes a manager/ leader may wish to implement so such things as strikes and revolts do not occur. The roll of stakeholders in a business is essential as they can decide where a business should go and what should be done during times of recession. Here employees, investors, sharholders, customers and suppliers are all stakeholders that need to be satisfied in order for them to continue to invest within the business to keep it running. Employees should all see where the business is heading, and where it is heading towards otherwise they might see little point in changes in changes that have been made and may become suspicious. It is very important that the changes are explained clearly to employees and that any fear they may have are properly addressed. Investors are important because the business relies on their investment to finance the decisions that it takes. They may become worried that the business has no overall direction and look for other places to put their money. If they are unhappy this could leave the business weakened and prone to take-over. Shareholders are interested in any decision that effects the dividends that they receive is their share of profits. Any decision that will reduce profits, even for a short while, will not be popular with the shareholders. So here the managers of the business would want to avoid this in such poor economic times, so they would have to consider how shareholders will feel about the decisions made. Customers will be concerned if the decisions affect the price, quality, or service of the product they may change their buying habits if the product does not meet their requirements. Suppliers will want to get regular orders with prompt payment, these may be effected by the decisions made by the business. To conclude I do feel that the key to business survival in recession is leadership. For example a business that had a bad leadership style during the recession was British Airways where Willie Walsh’s decisions where poor communication amongst the companies stake holders saw strikes and grounded airlines. With the limited flights due to the poor leadership the business has lost a large amount of profits and the costs the company has to pay in order to compensate customers; the company now and is still in problematic times to regain the motivation and reassurance of the customers.

Case study of Boeing Dreamliner - 1560 Words

Title of case: Boeing 787 Dreamliner Critical Facts: Boeing is the world’s largest manufacturer of military and commercial aircraft, which was founded in 1916 by William Boeing and Navy Engineer Conrad Westervelt in the name of Pacific Aero Products Company in Seattle, which after active participation in World war-I was renamed to Boeing Airplane Company (Frederick, 2014). Boeing produced several hundreds of B-17 Flying fortress during World War II which became the U.S Bomber. In 1950’s Boeing faced a tough competition from its opponent McDonnell-Douglas which was good at manufacturing propeller aircraft. Due to the increased reputation of its competitor, Boeing entered into the field of manufacturing commercial Jet-aircrafts in a†¦show more content†¦Because of this tool, Boeing wanted to collaborate its partners planning schedules and progress in work so as to ensure that no delay in manufacturing. But Exostar which opted by Boeing posed problems during its runtime. Also as a part of cultural difference and due to lack of trust on other suppliers some of the vendors involved in 787 design did not input accurate and timely information. As a result of this inaccurate information Boeing had not discovered the problems at the early stages and in a timely fashion (Zhao, 2012). Boeing during 2003 lost its share value to Airbus which is a strong opponent to it (Boeing Corporation, 2014). In order to regain its value in the market Boeing decided to design an aircraft by enhancing its customers. So in the process of designing a new aircraft Boeing decided to use composite carbon fiber instead of regular aluminum to an large extent which had not been implemented in the past. Because of this composite fibers Boeing estimated to decrease the cost of travel for its passengers and to increase fuel efficiency. But this step backfired in getting air bubbles on the skin of fuselage and nose during assembling of aircraft which resulted in delay of 787 Dreamliner (Pearlson Saunders, 2013) Boeing in the process of reduction in time and cost it opted a supply chain process in which it adopted from Toyota. Toyota manufactures its products with short development life cycle with minimal risk and cost. Boeing inShow MoreRelatedBoeing 787 Dreamliner Case Study1755 Words   |  8 Pages (Boeing, 2014) Title – Boeing 787 Dreamliner Case Study Date – 9/29/2014 Name – Pawankumar Sharma CRITICAL FACTS: †¢ Boeing is an American multinational and the world’s largest aerospace corporation that manufactures designs and sells commercial jetliners and defense, space and security systems to clients in 150 countries. (Boeing, 2014) †¢ It was founded by William Boeing on July 15, 1916 and is headquartered at Chicago, Illinois. 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Part (3): Case Study Questions (15 marks in total) Answer each question in the provided space Case Study (3.1): Groupon Groupon, Inc. raised $700 million at its IPO in the fall of 2011, instantly providing a valuation of almost $13 billion for a company that was only 3 years old at the time. Some question