...This assignment will focus on a short communication between myself and a mother (Caroline) whom I had met three times before, at the antenatal, birth, and six-to-eight week contacts. I had cancelled a three-to-four month visit with her that day on the advice of my mentor. Caroline was an experienced mum and the visit had been mainly to aid my development (Appendix One). She had sounded fine on the phone and had told me she was coming into clinic. Borton’s (1970) reflective model will be used to guide this essay, and I will analyse how the experience has improved my skills in building therapeutic relationships, while recognising areas that require work in order to fulfil my role. All names have been changed to protect confidentiality, as is the responsibility of any registered nurse (NMC 2008). Mental and emotional wellbeing in all family members is intrinsic to the wellbeing of children. The “Healthy Child Programme” (DH 2009) identifies the assessment and promotion of this area as a core part of the health visitor’s role. A common mental health problem that impacts on children is post-natal depression, affecting 10-15% of women (Royal College of Psychiatrists n.d.). Infants whose mothers have post-natal depression often have less positive life outcomes, as discussed in Every Child Matters (HM Treasury 2003). It can impact negatively on emotional, social and mental development, often demonstrated through behavioural problems (Wrate et al., 1985), and neurological problems (Dale...
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...acknowledging your own biases may be helpful when working with clients. As a future mental health professional being in the position of a client, that is seeing a therapist whose background is different from mine whether by ethnicity, linguistics or even sexuality I would crave for them to be understanding, non-judgmental and respectful of my beliefs and values. In reflecting an understanding attitude, it would be very important for me that the therapist displays keen listening skills; as these attitudes of listening can either assist in promoting a free flowing dialogue between myself and the therapist or build a wall which may prevent me from expressing my feelings on the challenges and issues I am currently facing. In the therapeutic relationship, it is important that the client feels that the therapist is not critical and judgmental towards them and displays a high level of "caring and compassion toward the client even if they have confessed their deepest secrets and hidden desires" (Brew and Kottler, 2008; p.115). Another aspect of being understanding on the part of the therapist is the therapist's body language. Especially with the therapist's cultural differences certain actions in relation to body language may have differing meaning and thus depending on the action may be construed as being offensive. With body language being so important Ivey, Ivey and Zalaquett (2010) noted that if the therapist faces the client squarely, leans forward slightly, has a positively...
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...contributing factors (MDA, 1998). In the hospital where this audit was carried out, syringe drivers are used to administer drugs to patients with cancer during the palliative phase of illness. The purpose of this clinical audit was to establish the standard of current practice in wards where syringe drivers were being used. A retrospective study of 13 cases of syringe driver use is presented. The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of drugs and doses prescribed, evaluation of treatment responses and review of treatment regimens were also areas of concern. Guidelines for the use of syringe drivers in non-specialist hospitals are put forward. Therapeutic regimens Diamorphine and hydromorphine as analgesics for opioid-responsive pain are the opioids of choice for continuous subcutaneous infusion simply on the grounds of...
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...Therapeutics Essay: Understanding Behaviour In psychology there are many theories of cognitive behaviour each with their own origins and aims. Within this text two psychological theories that will be discussed and how they can be effective within a health care setting with an introduction as to what psychology is. The two psychological theories that will be discussed are the Social Learning Theory as developed by Albert Bandura and the Humanistic Theory or also known as the Humanistic Approach developed by Carl Rogers, Abraham Maslow and George Kelly. Psychology is known as the scientific study of the mind One of the theories that will be discussed within this text is the Social Learning Theory which was developed by Albert Bandura in 1977 after evaluating previous theories which had already been attempted by other psychologists. He also used Julian Rotter’s learning theory and incorporated these theories together. His theory states “that observational learning can occur in relation to three models” these models are; live model which is when a person is demonstrating a desired behaviour for example a child behaving well because they know that they will be rewarded by their parent for this type of behaviour. Verbal instruction which is when an individual describes in detail the desired behaviour and also instructs the person verbally on how to engage in the instructed behaviour, an example of this would be when a lecturer is discussing the appropriate behaviour that...
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...communicate the ways in which a nurse must effectively establish and maintain a therapeutic relationship with their patient through not only treatment and caring, but throughout communication towards a selected client from the City of Horizon online Hospital. The selected client to focus on throughout this assignment is Tai Cam. In this assignment, therapeutic relationships will be discussed, assessing the guidelines and boundaries whilst being compared to the national competency standards which must be followed by nurses. A therapeutic relationship is a relationship between the nurse and the patient, however this relationship is on a personal but professional level. Nurses need to ensure they are not coming...
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...Asian Americans are more likely to responsd to counseling and intervention when there is a therapeutic relationship (Paniagua, 2005). Therapeutic relationship includes the therapist to be honest, open, sincere and sensitive, show empathy and inquires concerns; minimize racial and ethnic barriers and have cultural compatibility with the client (Paniagua, 2005). The therapist can also be mindful of who the patient is and to have family treatment goals (Sue & Sue, 2013). When speaking to Asian Americans a silence response and lack of eye contact is a sign of respect and should not be taken as incompetence or not understanding (Sue & Sue, 2013). The children’s academic and career success are important for the parents, however, the children may suffer from isolation, depression, and anxiousness, thus have parent acknowledge other positive behaviors and skills that...
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...Therapeutic Relationship Patients [pic] Translate This Page [pic] Powered by [pic]Translate [pic][pic] Download PDF Free Essay Quote This piece of reflection will focus on my experiences whilst on practice placement; I will be using the (Gibbs 1988, cited in Jasper 2003, p.77) model of reflection. Gibbs cycle is set out in order of categories made up of different headings. (See appendix 1). By using this cycle it allows me to reflect in structured and effective way. The subject of this final piece of reflection will cover the development and utilisation of interpersonal skills in order to establish and maintain therapeutic relationships. Neal (2003, p100) states a therapeutic relationship can be described as being between nurse and patient and is based on patients needs for care assistance and guidance. It is a relationship that is established solely to meet the patient’s needs and therefore, is therapeutic in nature. Chambers et al (2005, p303) suggest interpersonal and therapeutic relationships are at the centre of nursing work, the relationship that exists between nurse and patient can often provide the energy and be the catalyst, the motivation and the source of strength to continue with treatment or face difficult sometimes life threatening situations. I felt the need to develop therapeutic relationships with the patient’s so that they could feel they could put their trust in me, also that I was there to listen and talk to them not just care for them. There...
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...was at KinderHafen and I enjoyed my experience. I loved working with all the kids, and I picked MC as my patient; who was a very sweet 13-year-old. I also interacted with VG often and I enjoyed her a lot. I thought she was a hilarious, sassy 17-year-old and her and I got along great. Because I took the time to ask her questions and got to know her, it helped me build a therapeutic relationship. I was better able to understand the whole picture, she got in an accident and therefore, is now dependent on all her care. She is the oldest and only patient that can talk in KH, hence, making it understandable for why she behaves the way she does. I think some people may misunderstand her as being rude, but I think some of it is her just joking and some of it may be because she is upset...
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...The Therapeutic Relationship Between Client and Clinician The Importance of Profile Clients for Specific Clinicians The relationship between the clinician and the client is a crutial aspect for the therapeutic outcome. Having a connection between the client and therapist can have many determining factors that lead to a positive evaluation and outcome of the therapy. There are many components and attributes a therapist must be aware of and contain to have a good helping relationship with their client. A client wants to have a positive experience when receiving help and if there is no relationship or positive understanding between each the outcome could be negative or the client could stop therapy early. The concept that was thought of in the early 1900’s to profile clients and match them with a clinician that would possibly have a more successful outcome with therapy should be used in a lot of therapeutic helping relationships, and goes along with the importance of having a good clinician-client relationship. Being able to profile a client to find out which therapist would be a good fit for them, would help the initial alliance between the therapist and client. A client’s relationship with their therapist is very important in helping have a positive outcome at the end of therapy. According to the article “Relationships Among Client-Therapist Personality Congruence, Working Alliance, and Therapeutic Outcome” both client and therapist have their own ways of thinking, morals...
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...We are diverse in many ways and often times these different identities often raises complications in the working relationship with clients. The challenge that are often face when trying to establish a therapeutic relationship with clients may stem from differences in sexual orientation, gender, age, ethnic background, economic class, experiences, illnesses etc. At my job, they sometimes try to match the clients to a worker base on these differences, but often time this is not possible. Dealing with racial issues can often be a challenge when working in this profession, especially in cases when the client and the social worker are racially different. Fears often arise in cases where the client may misinterpret what is said or I may appear insensitive...
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...Technique Identifier Aphasic Technique 1 Selected Option/ Result Nontherapeutic Result: Correct Rationale Dismissive behavior is an ineffective style of interpersonal communication because the nurse indicates that another person’s opinions or presence is not wanted or needed. Technique 2 Selected Option/ Result Therapeutic Result: Correct Rationale Displaying a caring attitude supports the establishment of a therapeutic relationship by conveying genuine concern and a feeling of emotional closeness, which results in the nurse’s ability to achieve a greater level of communication and understanding with the client. Technique 3 Selected Option/ Result Therapeutic Result: Correct Rationale Clarifying is a therapeutic communication technique because it allows the nurse to validate the message received to ensure that both the nurse and client have a mutual interpretation of the message. Page 1 of 3 Report Created on: 10/19/2015 06:47 PM EDT REP_NTIndv_CommModuleReport_1_0 Technique 4 Selected Option/ Result Therapeutic Result: Correct Rationale Focused questions are a therapeutic communication technique because they allow the nurse to clarify a message, collect data, encourage feedback, and confirm the client’s ideas and beliefs. Technique 5 Selected Option/ Result Nontherapeutic Result: Correct Rationale Shaming is an ineffective style of interpersonal communication because the nurse mistreats...
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...J Clin Epidemiol Vol. 50, No. 12, pp. 1311–1318, 1997 Copyright © 1997 Elsevier Science Inc. 0895-4356/97/$17.00 PII S0895-4356(97)00203-5 The Powerful Placebo Effect: Fact or Fiction? Gunver S. Kienle* and Helmut Kiene ¨ Institut fur Angewandte Erkenntnistheorie und Medizinische Methodologie, D-79112 Freiburg, Germany ABSTRACT. In 1955, Henry K. Beecher published the classic work entitled ‘‘The Powerful Placebo.’’ Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. He claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher’s article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena...
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...Chapter 1 1.1 Introduction By synthesizing the data from various studies and research, this dissertation will aim to systematically review the current literature of evidence for therapeutic hypothermia (TH) post cardiac arrest. The research question is as follows: does therapeutic hypothermia treatment present positive neurological outcomes for post cardiac arrest victims? 1.1a Rationale: Whilst working in the Intensive Care Unit, I had the opportunity to witnessed a patient being cooled (therapeutic hypothermia concept) after experiencing out of hospital post cardiac arrest. I was intrigued to learn more about the concept as I had never heard or seen it done before. This prompted me to research further on the evidence based practice pertinent to TH treatment on post cardiac arrest victims. Patients who have suffered post cardiac arrest are usually cared for in a critical care environment such as the intensive care unit (ICU), and the survival rate for in hospital incidents is considered to be poor (Gwinnut et al 2000). Furthermore, according to Becker (1993) and Rea (2004), approximately 0.04% to 0.19% of out of hospital cardiac arrest incidence occur each year in industrial countries. Around 14% to 40% of these victims regain Return of Spontaneous circulation (Giraud 1996, Finn 2001, Fischer 1997), and only 7% to 30% were able to attain good neurological outcomes on discharge (Jennings 2001, Westfal 1996, Weston 1997). By critically reviewing the literature of evidence...
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...can exacerbate the degree of permanent neurological damage following cardiac arrest. Each degree Celsius higher than 37C can cause cerebral destruction through increased metabolic expenditure, excitatory neurotransmitters resulting in calcium cellular reflux and accumulation of oxygen free radicals (Busto et al., 1987). To improve the outcome of patients who survive cardiac arrest requires not only reducing the ischemic process as quickly as possible, caused by cardiac arrest, but also preventing post resuscitation syndrome caused from reperfusion (Safar, 1993). Cerebral reperfusion after successful resuscitation can trigger harmful chemical cascades such as oxygen free radical production which can result in multifocal brain damage. Therapeutic hypothermia (TH) is considered as an effective method for reducing the deleterious neurological outcomes in patients who have out-of-hospital cardiac arrest. Clinical and animal studies have shown that TH following cardiac arrest reduces both the cerebral metabolic rate and oxygen demand and it is thought to attenuate reperfusion injury, global inflammation and endothelial dysfunction, all consequences of cerebral ischemia. Over the...
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...the nurse to carry out safe medication administration, monitor medication actions, educate patients, and act legally and ethically within the pharmacological parameters. This knowledge is also vital for the nurse practititioner in their role of nurse prescribing. Pharmacology plays a huge part in these roles for the nurse. This essay below will elaborate on the importance of pharmacology for the five reasons of safe medication administration, monitoring of medication actions, patient education, legal and ethical aspects of pharmacology and the nurse practitioner. Firstly, safe medication administration. To administer drugs safely it is the nurse’s responsibility to have knowledge of the prescribed medications as well as their therapeutic and non therapeutic effects. Knowledge of the medications include, knowing its approved drug name and classification, correct dose and route of administration. A medication may have as many as three different names- a chemical name, a generic (proprietary) name and a trade name (Crisp & Taylor, 2011). A chemical name refers to the chemical makeup of a drug, a generic name is the drug name listed in official publications such as the MIMS annual, and the trade name is the name manufacturers have registered the medication as. In a clinical setting medication is normally dispensed using the generic name to avoid confusion, but because medications may come under a number of different names nurses must be able to identify the exact name and spelling so...
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