Assessment 3: VIDEO STIMULUS
Name: Vu Kieu Trang Nguyen Student number: 12843684
Error number 1
Sitting on the patient’s bed without permission is pointed out as an error because it trespasses respected personal space, which is against the professional boundaries that separates the nurse-patient therapeutic relationship from any behaviour that could lessen benefits of care (Ginsburg ; Levinson 2016). Berman et al (2017) picture the personal space is preferred distance between the person and others during a conversation. When realizing that the personal space is threated by unexpected events or actions occurring around, the person tends to be defensive, which decreases the communication’s effective. To avoid this error, the student registered nurse (RN) should create a space that is acceptable for the connection between the nurse and the patient during the conversation (Jeffs et al 2014). It improves the nurse – patient therapeutic relationship as well as protect and advance the human dignity through the fulfillment and contentment of patient privacy which contains significant meanings in the healthcare provided community ( Hasan Tehrani et al 2018). On the contrary, the nurse student should ask for the patient’s permission to approach the patient’s safety zone, which shows the respect of the nurse for the patient’s perspective (Feo et al 2017).
Error number 2
The second error performed on the video is related to professional boundaries, the nurse shares personal problems with the patient as which is one of the warning of the boundaries crossing as an example of a prospective boundary violation, ‘excessive self-disclosure’ (Nursing and Midwifery Board of Australia 2010). On the video, the nurse talks about her personal sexual attraction of males whom she met the night before within using individual device during the shift for personal purpose, specific mobile phone used. This action is negative for the professional relationship contribution between the nurse and the person who she cares, as well as showing a disadvantage for patient safety (Levett-Jones 2016). To avoid this error, the nursing student should limit using smartphone for personal purposes rather than for the purpose of improving knowledge and understanding of the information related to the process of patient care or internal communication, understand and implement regulations on the use of personal electronics in clinical practice (Cho ; Lee 2015). Moreover, instead of contributing a friend-friend relationship with patient, the nurse should focus on the therapeutic relationship, for example, behaviour control , time and mind investing in professional patient-based treatment and caring, exploiting information related to the treatment process to complement and adjust the patient’s active and appropriate treatment plan in the future. The nurse should concentrate on the patient and giving them your full focus, without being diverted as well as connect with and deliberate on the individual and considering their self-mind needs from their point of view are basic abilities (Feo et all 2017).
Error number 3
As being recognized from the video, the student RN discusses about the patient’s relationship situation (asking if the patient used to date the male called Brad) and gives comments (‘small world’, ‘funny’), which is not relevant to the treatment process. It is understood as a professional boundary crossing. In this case, the nurse student is failure in communicating with the person as well as documenting the non-related information (the nurse points out the person’s previous relationship situation and document it), which is crossing to boundary violations zone understood as the ‘over involvement’ zone (Manfrin-Ledet, Porche & Eymard 2015). According to Nursing and Midwifery Board of Australia (2018), the limits in the expert association of the nurse with the person getting care and the essential communicating area is set up and kept up by the nurse. In this case, having a little chat about the person’s private information is not an essential communiqué method recommended using to provide, maintain and improve the therapeutic relationship. The RN student should focus on the person’s experience with medication or pain management, as well as the individual’s feeling, needs and preference (Ashton 2016). Furthermore, medical attendants treat individual data got in an expert limit as classified without utilizing private data or their situation of energy to advantage themselves in any capacity (Nursing and Midwifery Board of Australia 2010). As being seen, the student RN might know the male called, however, using that information as an advantage to grow the closer relationship is off track. To avoid the boundaries crossing, the student RN should keep focusing on the care relationship instead of personal relationship with the patient, for example, the nurse might ask open ending question if the patient is willing to share their thought, feeling and lifestyle which contributes the treatment processing (Ashton 2016).
Error number 4.
The other error recorded on the video is language used one which is cross therapeutic communication. As can be seen, the student uses unprofessional language instead of nursing language to communicate with the patient, she shows passive listening side of therapeutic communication (Bermand et al 2017). Specifically, she doesn’t let the patient finishes sentences, talking too fast with high tone of voice, misdiagnosis of patient and failure to explain vital signs, which reduces the patient’s trust, making the person more defensive and unwilling to share information. This error directly affects patient safety due to it breaks the special nurse-patient connection based on belief (Kelley et al 2015). To avoid repeating this mistake, the student RN should build this relationship by creating affinity to empower the patient to feel comprehended, esteemed and upheld empowering a situation that amplifies exact and proficient start, data social affair and clarification and arranging, empowering steady advising as an end in itself, including the patient so she comprehends and is relaxed with partaking during the time spent, diminishing potential clash amongst specialist and patient (Silverman et al 2013). Also, empowering inquiries and data illumination and being primed to rehash clarification is an approach to enhance the correspondence (PCC4U 2018). In addition, the uses of a sense of humour to create a sense of security and comfort in the exchange of information is a suggested idea to increase the interactivity between these factors of the therapeutic relationship (Kelley et al 2015).
Ashton, K. 2016, ‘Teaching nursing students about terminating professional relationships, boundaries, and social media’, Nurse Education Today, vol. 37,pp. 170-72.
Berman, A, Snyder, S., Kozier, B. ; Erb, G. (eds) 2017, Kozier ; Erb’s fundamentals of Nursing: Concepts, process and practice, 8th edn, New Jersey, Pearson Prentice Hall.
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Ginsburg, S. & Levinson, W. 2016, ‘Professional Boundaries’, JAMA, vol. 316,no. 16, p.1706.
Hasan Tehrani, T., Seyed Bagher Maddah, S., Fallahi-Khoshknab, M., Ebadi, A., Mohammadi Shahboulaghi, F. & Gillespie, M. 2018, ‘Respecting the privacy of hospitalized patients: An integrative review’, Nursing Ethics, p.096973301875983.
Jeffs, L., Beswick, S., Acott, A., Simpson, E., Cardoso, R., Campbell, H. & Irwin, T. 2014, ‘Patients? Views on Bedside Nursing Handover’, Journal of Nursing Care Quality, vol. 29,no. 2,pp. 149-54.
Kelley, M., James, C., Alessi Kraft, S., Korngiebel, D., Wijangco, I., Rosenthal, E., Joffe, S., Cho, M., Wilfond, B. & Lee, S. 2015, ‘Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making’, The American Journal of Bioethics, vol. 15, no. 9, pp.4-17.
Levett-Jones, T. 2016 (ed), Critical Conversations for Patient Safety eBook, Pearson Australia Pty Ltd.
Manfrin-Ledet, L., Porche, D. & Eymard, A. 2015, ‘Professional Boundary Violations’, Home Healthcare Now, vol. 33,no. 6,pp. 326-32.
Nursing and Midwifery Board of Australia 2010, A nurse’s guide to professional boundaries, Melbourne.
Silverman, J. Kurtz, S. ; Draper, J. 2013 (eds), Skills for Communicating with Patient, 3rd edn, Boca Raton, CRC Press.
The PCC4U Project 2018, Activity 3: Communication principles, Australian Government Innitiative.