NR 510 Week 2: Theory and APN Role Discussion Part Two

NR 510 Week 2: Theory and APN Role Discussion Part Two

NR 510 Week 2: Theory and APN Role Discussion Part Two

As a future CNP, Karen will establish relationships with patients and colleagues. She is a primary care provider who will deal with patients of all ages. Karen will be trained to individually assess health problems and risk factors and to develop treatment plans. She may decide to collaborate with other health providers and colleagues to identify patients’ health problems and implement the appropriate interventions. Karen’s overall goal is to improve the health of the individual and family. To foster a strong relationship between herself, her patients, and other healthcare providers on her patients’ healthcare teams, Karen must master the art of interpersonal communication. This is the process that allows people to exchange information and feelings through verbal and non-verbal messages (Lee & Doran, 2017). Interpersonal communication is face-to-face communication that determines how well patients and CNPs understand each other and work together to reach health goals (Lee & Doran, 2017).

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Psychiatric nursing pioneer, Hildegard Peplau’s Theory of Interpersonal Relations model points out four sequential phases, the primary areas of communication essential to the nurse/patient relationship: orientation, identification, exploitation, and resolution (Nursingtheory.org, 2016). These frameworks help nurses understand their behavior in relation to listening to patients describe their health problems and working with other health providers. Peplau describes nursing as a “therapeutic, healing art” that becomes an interpersonal process because of the interaction between the NP, patient, and other healthcare providers (Arora, 2015). Interpersonal communication guides the way NPs create treatment plans and set health goals for patients and their families. Positive, open, and respectful interpersonal communication help the nurse and patient work together to become mature, knowledgeable partners in the care process (Arora, 2015). In my experience, patients often feel nervous and anxious around medical personnel. Many patients become defensive, passive-aggressive, shy, or uncomfortable all because they do not want to be perceived as uneducated about their health or the diagnosis/treatment information being relayed. Patients feel nurses and doctors talk at them instead of with them. I have heard patients complain that nurses are rude just because the patient did not understand what the nurse said about a diagnosis or treatment. Karen can use Peplau’s theory to engage in better ways to communicate with patients and help them feel valued. Undergraduate nursing school taught me best practices in creating a solid patient-nurse relationship. In Peplau’s model, this begins with the orientation stage. First, I should introduce myself to the patient then state my credentials and the role I will play. I should ask the patient his or her preferred name. I want to relieve the patient’s anxiety, so I ask the patient if there are any recent health changes he or she would like to discuss with me. I want to normalize the situation, so I may even ask about family life, hobbies, talk about the news, etc. There are so many ways for me to help the patient feel comfortable talking to me. The point is to let the patient know through verbal and non-verbal communication that I am here to help.

References

Arora, S. (2015). Integration of nursing theories in practice. International Journal of Nursing Science Practice and Research, 1(1), 8-12. Retrieved from https://www.researchgate.net/publication/283319003_Integration_of_Nursing_Theories_in_Practice

Lee, C. T., & Doran, D. M. (2017). The role of interpersonal relations in healthcare team communication and patient safety: A proposed model of interpersonal process in teamwork. Canadian Journal of Nursing Research, 49(2), 75-93. Retrieved from https://doi.org/10.1177/0844562117699349 Nursingtheory.org. (2016). Hildegard Peplau Theory. Retrieved from http://www.nursing-theory.org/theories-and-models/peplau-theory-of-interpersonal-relations.php

I truly believe the concept of care or caregiving is central to the role of the FNP. I agree with your point that nursing theories provide a foundation for nurses to refer to in regard to improving patient outcomes and carrying out treatment plans. Care and compassion go hand-in-hand. Nurses are obligated and have a duty of care to apply these elements when serving patient populations, but nurses should also remember to apply the concepts of care and compassion to themselves.  I sometimes feel nurses are expected to be perfect, which is unrealistic. Brandford and Reed (2016) state nurses suffer from depression more than other professionals due to job stress. There is a shortage of nurses because they do not feel valued or respected. When nurses continue to work through their depression caused by a lack of compassion and empathy from patients, colleagues, and other medical professionals, nurses make mistakes due to trouble concentrating (Brandford & Reed, 2016). Nurses then begin to show less compassion to patients and colleagues. It is also important for nurses to receive emotional and professional support.

Reference Brandford, A. A. (2016). Depression in registered nurses: A state of the science. Workplace Health and Safety, 64(10), 488-511. Retrieved from https://doi.org/10.1177/2165079916653415

Communication is an important aspect of nursing practice. Quality communication is essential with patients as well as with other health care providers. We need to make sure that we aware of our non-verbal communication as well, our actions can sometimes speaker louder than our words. The article you referenced discussed motivational interviewing (MI) to help patients make changes to their behaviors. Bishop and Jackson (2013) define MI as “a patient-centered counseling method that uses principles of interpersonal communication skills to elicit behavior change when internal motivation is lacking…it is based on the premise that patients have ambivalence toward a particular behavior and a low readiness to change” (p. 106). Their literature review found that using MI with patient with one or more chronic illness was effective in the areas of diet and exercise, 2 of the main lifestyles changes to improve symptoms of chronic conditions such as heart failure, diabetes, obesity, etc.

Thanks for sharing,

References:

Bishop, C. & Jackson, J. (2013). Motivational interviewing: how advanced practice nurses can impact the rise of chronic disease. The Journal for Nurse Practitioner, 105-109.

Ronan, C. (2016). Group family nurse partnership: effective communication to support learning, adaptation and change within an intensive group family nurse partnership parenting programme. International Journal of Birth & Parent Education, 3(4), 29-34.