Читать книгу The Nursing Associate's Handbook of Clinical Skills - Группа авторов - Страница 30

Health Education England have developed a Cultural Competence e‐learning package to support health professionals in developing cultural competence https://www.e‐lfh.org.uk/programmes/cultural‐competence/

The three models of communication (transmission, interactive and transactional) while relevant to the role of the nursing associate, as they apply to all forms of human interaction, were developed to describe communication in general. The nurse‐patient relationship is, by its very nature, embedded in interpersonal communication. There are a number of communication theories that have been developed in nursing to help explain and guide interactions between nurses and patients (Bylund et al. 2012). One such theory is Peplau’s interpersonal relations theory (1997) which focuses on the nurse‐patient relationship and the therapeutic process that takes place. Although the focus is on the nurse‐patient relationship, it is similar to the transactional model in that communication that occurs in this context involves complex factors such as environment, attitudes and beliefs and culture. Peplau’s interpersonal relations theory defines four stages of the relationship that achieve a common goal:

 Orientation phase: This is the initial stage of the relationship where the nursing associate demonstrates patient‐centred care that enables the patient to ask questions and develop trust in the nursing associate. First impressions of the nursing associate and the healthcare provision begin to evolve. This phase sets the stage for a more trusting relationship and is where the nursing associate would introduce themselves (Granger 2014), collect information about the patient’s needs, potential, interests and the patient’s susceptibility to experience fear or anxiety (Fawcett 2010).

 Identification phase: This is when the nursing associate and patient begin to work collaboratively to enable the patient to become an active recipient of treatment. The nursing associate uses knowledge, skills, attitudes and values while consistently providing compassionate, non‐judgemental care and empathy. This is an important stage during which the power shifts from the nursing associate to the patient as the patient becomes more independent. The nursing associate uses their communication skills as an educator and a leader to enable better patient outcomes.

 Exploitation phase: The patient maximises wider opportunities, exploiting the nurse‐patient relationship to address treatment goals. The patient feels like an integral part of the relationship and may make requests to the nursing associate to gain a greater understanding of their own health and social care needs.

 Resolution phase: As a product of effective communication, patient issues are resolved, and they become independent. The patient no longer relies on the nursing associate’s support, and the relationship ends. The skills here are for the nursing associate to enhance the patient’s ability to become more self‐reliant in leading a productive and healthier life (Fawcett 2010).