User talk:Kg13la/ourSANDBOX

Congratulations. --LynnMcCleary (talk) 21:38, 9 September 2014 (UTC)[reply]

Initial ideas and critique

Dg13gq's initial ideas

Good Afternoon Everyone!

To start off, at the top of the Nurse-client relationship page is a warning listing the multiple issues our article has. It states that the article is like a personal reflection or opinion essay, that the introduction does not adequately summarize the contents of the article and that it includes inline citations that are not properly formatted. After critically reviewing the article to my best judgment in regards to the good article criteria, I have identified all of the following as some things that we can do to improve the article.

This article has horrible grammar. Anything that we decide to keep from the original article has to be attentively edited. Sentences are missing periods, quotations are not formatted properly and words that need to be capitalized are not. This article is unclear and confusing and visually unappealing which may be turning people away from reading it. We need to correct the formatting of the article so that it meets the manual of style guidelines and is easier to comprehend.
As stated in the warning box, we need to properly format any citations we keep in the article. Additionally, opinionated statements made within the article are not verified. For example, “Humour is important in developing a lasting relationship”, is stated but not verified. Like it stated in the warning box, we need to retrieve expert’s opinions and reference them.
The original editor of this page seems to have backed up her personal view with experimental evidence. We have to work to make the article unbiased. To do this we need to retrieve a wider variety of information on the topic so that we can give different viewpoints evidence.
The introduction is a summary of only the “Peplau's theory” section of the article, this needs to be changed to a brief summary of all the information that we eventually included in the article.
Is possible we should upload a picture to the page that somehow helps people understand what an aspect of a good Nurse-Client relationship may look like.
In order to achieve the “Stable” aspect of the good article criteria, we need to make sure our article is properly balanced so that once we are finished editing it does not does not raise an ongoing dispute and does not change from day to day.

We will do awesome! Have a great day everyone ! Dg13gq (talk) 18:28, 15 September 2014 (UTC)[reply]

Not sure how I forgot this, but we also need to incorporate a section on how communication, as stated in our textbook, "is the relationship itself". It's not possible to have a nurse-client relationship without it! I don't think that the article goes into enough detail about that! Incorporating that will be very important! Dg13gq (talk) 16:06, 16 September 2014 (UTC)[reply]

You've identified a lot of issues. Your group has a great opportunity to make a good contribution to improving this page. Getting it to good article status in the confines of this course isn't expected - but you will make a good start and improve it. You'll need to keep yourself focused. I'd be happy if you made a contribution to the elements section (you might need to rename it).LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

Kristen's initial ideas

Hi there, this is Kristen speaking!

After reading the Nurse-Client Relationship article thoroughly, I definitely agree with Dana’s response and suggestions. As mentioned, Wikipedia has stated that the article is written like a personal reflection with the editor’s own opinions, leaving it extremely biased. After addressing Wikipedia’s “Good Article Criteria”, I realize that it is important to edit this article to contain the opinions of experts and proven research to ensure that the article is neutral and no longer considered biased.

Relating to Dana’s first point, the grammar in the article is very poor. Periods are missing, commas are inaccurately placed, and there are many run-on sentences that would need to be rewritten/restated. Also, quotations and citations need to be properly formatted to meet the proper guidelines.

The introduction of this article is based solely on “Peplau's theory”. We need to incorporate a summary of all aspects of the article into the introduction to establish stability. Along with rewriting the introduction, I believe we need to make changes to the article so it incorporates the therapeutic nurse behaviors.

To further improve this article to meet good article criteria, illustrations should be added! Only relevant images should be added to the article with suitable, informative captions.

To achieve a successful article we need to make the changes that will allow this article to be considered: well written, verifiable, broad in it’s coverage, neutral, stable, and illustrated properly.

Thanks! Kg13la (talk) 16:11, 16 September 2014 (UTC)[reply]

I agree with you about the grammar and need for editing. Just be careful, you don't want to waste your time on editing something that doesn't meet the criteria of being from a secondary source. In this case, you would either find a secondary source or delete. LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

Sarah's Initial Ideas

Dana, I just have to say that you did a wonderful job discussing the problems with our page. In fact I thought up until your signature that Lynn had made some suggestions for us. So, great job!

I do not want to restate the problems that both Dana and Kristen have addressed therefore I will instead talk about some specific issues that I noticed right away. Both of you have done a great job summarizing all of the extensive issues with this page. We definitely have our hands full to meeting the "Good Article Criteria" (well written, verifiable, broad in it’s coverage, neutral, stable, and illustrated properly).

The format of this page is terrible and looks very unprofessional at a glance. I would not trust this site for reliable information from appearance alone, it has a title with improper capitalization and no pictures to attract my interest. Reading this article just reinforces this fact by having a completely biased voice and having a multitude of grammatical errors. Overall the old editor for this page has not arranged the information in a way that is both concise and informative to the reader. Due to the formatting I think it would be difficult to digest/ learn anything from it. As well, it seems as though the information had momentum in the beginning and died at the end; example the "Practice of the Nurse–Client Relationship" section, we have a whole chapter on this in our Communications textbook.

Hopefully by the end of this project we will have revamped this page into a informative page for Nurses to use.

It was great putting names to faces today in Lab!

Sg13bc (talk) — Preceding undated comment added 00:24, 17 September 2014 (UTC)[reply]

Jane's initial ideas

Hello everyone this is Jane,

I apologize for the late response as I had mistakenly posted it on the wrong page. I read through all of your suggestions/responses and I agree with everything that’s been mentioned.

-The introduction does not summarize each subcategory of the article (putting a lot of emphasis just on Peplau’s theory and failing to mention the parts of the article) -poor grammar all throughout -the article certainly is biased as it appears to contain personal opinion, and also failing to cite sources -desperately requiring an image that illustrates the nurse-client relationship etc.

I am pleased that we are all on the same page, agreeing upon what requires altering and parts we’d like to keep. I do believe that if we split up the work evenly, and use our critical thinking skills we can recreate a wonderful, unbiased, and easy to understand article. I believe the next step within this project requires us to do further research and find alternative sources (other than our text book, which is a great one). Jg11pv (talk) 02:27, 23 September 2014 (UTC)[reply]

We'll talk about images later in the course. There is a video tutorial on images in the student resources (linked from the top of our course webpage).LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

Moving forward

Dg13gq's ideas

I think that we have done a great job pointing out all the flaws and areas that need improvement in our article! This is the step by step plan I have come up with to make our article spectacular:

Gather and organize all information from the “Practice of the Nurse-Client Relationship” section in our textbook that we think is worthy of being placed in the article!
Find Credible Sources that focus on:

How communication affects nurse-client relationships (in addition to our textbook)
Peplau’s Theory
A client’s perspective towards the topic
Importance of Building Trust
Significance of Humour
Ways one can improve relationships

However Lynn did tell us that we do not need to edit the whole article and that we can focus on one particular section. This particular section would be the one that focus’s on the importance of communication (we have to create it). I think though that if we spilt up this work evenly we can improve the whole article without doing a ton of work, considering also that we have so much time to complete this project. Our main focus should be sorting the information from our textbook and finding sources about communication but by putting a little bit of work into the other sections and the overall look of the article will probably really improve our mark. Something we have to talk about is how we are going to split up the work so that each of us is not doing more than needed. I think this can be very easy if we do it right.

Do what we did for the section in our textbook for each source we found. A.k.a. Gather all the information from our sources that we think is worthy of being placed in the article.
Compare what we have found with what is in the article and decided what we should add, delete or keep. It would probably be best to do this one section at a time.
Find a related picture.
GRAMMAR! Go through each section on by one correcting grammar. As well as making sure that everything is citied correctly.
Properly format our picture.
Take the time to format our article in a way that looks beautiful and is easy to understand.
Look at our article and smile because we did an awesome job.

Let me know if you guys think we should add, remove or improve a step, or if you have an idea about how we can split up the work! All the best Dana (talk) 18:49, 22 September 2014

Sarah's Ideas

I really like your action plan! I think it is important to stick to it and focus on the tasks we have been asked to accomplish. Practice of the Nurse–Client Relationship is the section that we have specifically been asked to improve, well write in this case. Therefore I think that before we get too involved in the other aspects of our page that we should get a good handle or finish the communication section before moving on. We have some great information in our textbook for us to use, so I definitely agree that it should be our first task to organize that information together. We should ask Lynn if all of us are allowed to use the textbook as one of our sources or if each individual needs three different sources to contribute. Finding a wide variety of sources is very important to us writing a reliable, informative section. We need to ensure that this new and improved section has properly cited sources and has a neutral view, which can only be accomplished with multiple sources. This section absolutely needs some colour. Depending upon how this goes we might want more than one picture. As a suggestion I’m throwing out here that we could all find applicable pictures and then have a vote to see which ones we want to use. This way everyone is contributing to this aspect of our page. I think it is important to remember that we are suppose to work on this project actively and collectively, no real dividing of tasks.

Once we are finished working collaboratively on the communication section I think it is a wonderful intention to fix up the rest of the page. This part would be better to divide up and work on individually. 20:29, 23 September 2014 (UTC)Sarah (talk)

Jane's ideas

Sarah, I fully agree with your point, stating the need to focus primarily on specific aspects of the article without overwhelming ourselves with repairing the article as a whole. I spoke with Lynn earlier today as she mentioned the two main categories she would like us to pay particular attention to (the introduction, as well as the elements section). Evidently, the introduction paragraph is in rough shape, requiring thorough editing, repairing as well as excluding components that are irrelevant to the nurse-client relationship topic. We need to recreate it and also highlight points emphasizing the true essence of the nurse client relationship. As for the elements section, she said if we prefer, we can focus on all of it (contract-setting, boundaries, confidentiality and therapeutic nurse behaviors) or choose just one such as the therapeutic nurse behaviors, and elaborate on the subcategories. I would prefer assigning each group member to a specific one since there are four categories as well as four group members. Lynn also mentioned that we are all required to obtain three different sources each. I believe we are heading towards the right direction thus far. Let me know what you all think.Jg11pv (talk) 04:55, 24 September 2014 (UTC)[reply]

This makes a lot of sense! It was great that you talked to her! Dana (talk) 17:28, 29 September 2014 (UTC)[reply]

Kristen's ideas

Hi everyone!

I just want to acknowledge everyone’s thoughts, good job! Dana, you made an excellent list of work we need to split up and complete. I agree with Sarah and Jane, we really need to focus on getting information about communication relating to the nurse-client relationship. To make things fair, everyone should contribute to this article heading. We should all do our own research to contribute to the communication aspect; it is important that we all start looking for reliable sources ASAP (I have found a few good ones besides the textbook). After we have all contributed to this important topic, we should then split up the other tasks, ex: correcting grammar, adding photos, etc. (as Dana has already listed).

It is clear that we all have come to the agreement that our first priority will be working on the communication aspect of the Nurse-Client Relationship. The only thing left to do is decide whether we are strictly focusing on the therapeutic nurse behaviors, or if we are going to focus on all aspects, as Jane mentioned. Kg13la (talk) 15:45, 24 September 2014 (UTC)[reply]

Lynn's initial comments

Great start with your critique, everyone. You need to come to a consensus on your goals for your editing and where you want to focus your time and energy. I added a few comments and suggestions above. Please feel free to talk to me about your plans. LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

Please use the signature tilde symbols (4 ~)to sign your posts when you're logged in. I need that information to track your contributions and grade. You can sign by typing the symbols or clicking the short cuts (at the bottom of the editing window or the pencil symbol at the top of the editing window). LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

I added some headings. Change them as works for you. I think you'll find you need some headings and subheadings to organize information as it grows on your talk page. LynnMcCleary (talk) 19:03, 23 September 2014 (UTC)[reply]

One more thing. I love your enthusiasm. As you continue your discussion and eventually make suggestions on the main article talk page, please be careful about how your criticism might be perceived by other editors who might be attached to their work and contributions (you will all soon be attached to what you contribute). Just remind yourself what learned about Wikipedia etiquette and what you already know about communicating through text and email. --LynnMcCleary (talk) 19:10, 23 September 2014 (UTC)[reply]

Credible Sources

Sarah's Sources

Hey there ladies! The section of our page that we are supposed to focus on is pretty vague and doesn't really provide us with a good starting point. The other sections used studies to explain them however, this section isn’t really a theory but a practice; way of doing things, which is why I think the last editor had difficulties finding information. We also need to think about what subheadings we want to add because there is just so much information. My sources are: 1. Communications in Nursing (book)

Erickson, M., & Blazer-Riley, J. (2012). The Client-Nurse Relationship: A Helping Relationship. In Communications in Nursing (Seventh ed., pp. 16-31). St.Louis, Missouri: Elsevier Mosby. (hope this is properly cited)

This source has information about the purpose of the Client-Nurse relationship, identifies characteristics of a successful of a Client- Nurse relationship, identifies therapeutic communication techniques, lists what to do and what not to do in this type of relationship, and discusses the dynamics of the relationship.

2. Interpersonal Relationships (book)

Arnold, E., & Underman-Boggs, K. (2011). Interpersonal Relationships: Professional Communication Skills for Nurses (sixth edition). St.Louis, Missouri: Elsevier Saunders

Half of this book is dedicated to the nurse-client relationship and therapeutic communication, so it is definitely going to be useful!

3. Nursing: Communication Skills in Practice (book)

Webb, L., & Holland, K. (Eds.). (2011). Nursing: Communication Skills In Practice. Oxford: Oxford University Press.

This book has a great chapter on the nurse-client relationship and talks about communication throughout. It is designed to help practice the skills taught in the book, which will be helpful in our understanding. Will provide a great insight to the relationship. --Sarah Greer 16:37, 29 September 2014 (UTC)

Kristen's Sources

Hey guys! Here are my sources:

1. Culture, Communication, and Nursing (Book) This book has a section devoted to communication skills that are client/patient centred and listening centred. We can definitely use this information!

Burnard, P., & Gill, P. (2008). Culture, Communication, and Nursing. Harlow, Essex: Pearson Education Limited.

2. Establishing Therapeutic Relationships (RNAO Book) This book is entirely related to establishing therapeutic relationships. It talks about phases, difficulties, interactions.

Virani, T., & Tait, A., & McConnell, H., & Scott, C., & Gergolas, E. (2002). Establishing Therapeutic Relationships. Toronto, ON.

-I'm sorry that citation is missing the publication location. I couldn't find it...

3. CNO Standard Therapeutic Nurse-Client Relationship (Practice Standard) I realize we were just assigned this reading for our lab but it relates completely to our topic! This standard discusses the Therapeutic Nurse Client relationship which is what our wikipedia page is about! This is a perfect resource to use.

Link: http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf

Therapeutic Nurse-Client Relationship, Revised 2006. (1999, March 1). June 1, 2009, Retrieved from http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf

Kg13la (talk) 17:47, 29 September 2014 (UTC)[reply]

Jane's Sources

Hello all, The reason I didn't give too much information about my three sources is because each of them have the same content only phrased differently. They all include information about empathy, boundaries, therapeutic nurse behaviours etc. All three are very similar, but some explain the material better than the others. Hope that makes sense. — Preceding unsigned comment added by 139.57.204.155 (talk) 00:36, 30 September 2014 (UTC)[reply]

1. Patient-provider communications: This book includes detail about empathy and boundaries

A. Hart, V. (2007). Personal and Professional Relationships and Communication. In Patient-Provider Communications (pp. 99-102). Sudbury, Massachusetts: Jones and Bartlett.

2. Nurse client relationship: This book includes a section about cultural competence and self-awareness

Antai-Otong, D. (2007). Perspectives and Principles of Therapeutic Communication. In Nurse-Client Communication (1st ed., pp. 16-17). Sudbury, Massachusetts: Jones and Bartlett.

3. Therapeutic Interaction in Nursing: this section talks about empathy

L. Williams, C. (2008). Using the Self to Promote Health. In Therapeutic Interaction in Nursing (2nd ed., pp. 18-19). Sudbury, Massachusetts: Jones and Bartlett. Jane (talk) 03:01, 23 October 2014 (UTC)[reply]

Dana's Sources

Hi everyone, I’m so happy about how organized our talk page is!

My 3 sources are:

BOOK: Newer dimensions of patient care, Part 1: The use of the physical and social environment of the general hospital for therapeutic purposes.

This book focuses on what a client desires. It talks about how to show interest in and sympathetic understanding of a client’s difficulties so that they feel comfortable, pleased and satisfied. We could use little pieces form each chapter, it’s not a long book.

The eBook for this book can be found using this link when signed into the Brock Library: http://books2.scholarsportal.info.proxy.library.brocku.ca/viewdoc.html?id=/ebooks/ebooks0/apa/2014-03-13/1/201343261

Brown, E. L. (1961). Newer dimensions of patient care, Part 1: The use of the physical and social environment of the general hospital for therapeutic purposes. New York. Russell Sage Foundation

BOOK: Professional boundaries and the nurse-client relationship: keeping it safe and therapeutic: guidelines for registered nurses.

It seems that we already have found a lot of information on communication so I found this book in case we explore the element Jane mentioned. This book talks about crossing boundaries, and recognizing signs that you are getting over-involved. It presents a decision-making framework that helps nurses identify when they are doing something beyond their job.

The link for this book can be found at: http://www.crnns.ca/documents/ProfessionalBoundaries2012.pdf

College of Registered Nurses of Nova Scotia. (2012) Professional boundaries and the nurse-client relationship: keeping it safe and therapeutic : guidelines for registered nurses. Retrieved from http://www.crnns.ca/documents/ProfessionalBoundaries2012.pdf

BOOK: Communication for nurses : talking with patients

This book offers valuable methods to effective communication. In particular, I think that chapter 13 of this book, “Communicating with Different Age Groups and Families” can give us insight on how age and circumstances affect the type of nurse-client relationship built. This could help people reading our article relate.

Sheldon, L. K. (2009) Communicating with Different Age Groups and Families.Communication for nurses : talking with patients. (pp. 149-159) Sudbury, Mass: Jones and Bartlett Pub.

All the best Dana (talk) 23:26, 29 September 2014 (UTC)[reply]

Lynn's comments about your sources

You have relevant sources. With all of these books, you have a lot of information. Assuming you don't want to get overwhelmed, my advice is to be clear on what your focus is. You can't each summarize three entire books. You'll need to read sections that are most important for your editing goals. LynnMcCleary (talk) 01:59, 8 October 2014 (UTC)[reply]

Summaries and Discussion of Sources

Sarah's Summaries

Hey guys, so I went back and looked at the original email from Professor Lynn describing to us what our focus is for this project. It said to specifically focus on the Therapeutic Nurse Behaviours section, which located in the section labeled Elements; Therapeutic nurse behaviors: a.) self-awareness; b.) genuine, warm and respectful; c.) empathy; d.)cultural sensitivity; e.) collaborative goal setting; f.) responsible, ethical practice. I apologize because I have been looking at the completely wrong section of our page. I know it was quite confusing for you guys. Now that I’m on the right page, I completely agree with Professor Lynn about becoming overwhelmed. Here are my summaries. I mainly looked at things that specifically described therapeutic nursing and a lot of what I read corresponded with the points made in our section, they just were an expanded version.

Number One: This source is Chapter 2 in Miller, E., & Nambiar-Greenwood, G. (2011). The nurse-patient relationship. In Nursing: Communication Skills in Practice (pp. 20-32). Oxford: Oxford University Press.

According to this chapter, the Nurse-patient relationship has three phases, a beginning (first time contact/introduction), a middle (develop a relationship to deliver care) and an end (the patient is no longer dependant on the nurse). To make this process successful the nurse must value, respect and listen to clients as individuals. Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health. This is a communication based relationship, therefore, a responsibility to interact, educate, and share information genuinely is placed upon the nurse. Foundations of therapeutic relationships are self-awareness, empathy, trust, non-judgemental, genuine and boundaries. Until an individual can fully understand themselves then they cannot understand others. Nurses need self-awareness in this relationship to be able to relate to the patients experiences to develop empathy. Having the ability to enter the perceptual world of the other person and understanding how they experience the situation is empathy. This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences. Offering consistent, non-judgemental care to all patients and accepting the person for who they are regardless of diverse backgrounds and circumstances or differences in morals or beliefs. By exhibiting these attributes trust can grow between patient and nurse. The patient should feel comfortable disclosing personal information and be able to ask questions. Patient needs to be able to trust that the nurse will keep this information confidential. Nurses carry the responsibility of maintaining appropriate boundaries, which aim to be good for the patient and enable nursing care.

This information is very similar to both of my other sources (Communications in Nursing and Interpersonal Relationships). One theme I noticed was that focused on specifically was the importance of focusing on the patient’s needs. Another was the interrelation of all of the aspects to a therapeutic relationship. You cannot efficiently use one aspect without the other, they are all connected and work together to create a successful relationship. This source and Interpersonal Relationships book both shared the theme of self-awareness, they both shared the view that you first need to understand yourself before you can help someone else. --Sarah Greer 21:28, 13 October 2014 (UTC)

I am so impressed by this summary! It is awesome! It has details that cover: self-awareness, genuineness, empathy and cultural sensitivity! You also touched on confidentiality and boundaries! We definitely have to incorporate a lot of your lines from this summary in the article. In particular, in the last paragraph which includes you talking about talking about how everything is connected I believe is a great point that we could finish off the therapeutic section with. Dana (talk) 19:29, 17 October 2014 (UTC)[reply]

Number Two: This source is Chapter 5 in Arnold, E., & Underman-Boggs, K. (2011). The nurse-client relationship. In Interpersonal Relationships: Professional Communication Skills for Nurses (sixth ed., pp. 83-102). St. Louis, Missouri: Elsevier Saunders

Phases of the therapeutic nurse client relationship include orientation (engagement and assessment, gathering information), working (planning, giving feedback) and termination (evaluation and validation). Relationship is centered around clients values beliefs and needs. A partnership is formed between nurse and client. The nurse empowers patient and families to get involved in their health. This is accomplished by revealing your whole self and being genuine with clients. Self-awareness allows you to fully engage with a client and presence; being with the client in the moment, allows the nurse to know when to provide help and when to stand back. Nurses have a responsibility for maintaining appropriate boundaries. The boundaries have a specific purpose and health goal, and the relationship terminates when identified goal is met. During the relationship self-disclosure is limited for the nurse but encouraged for the client. “Professional boundaries represent invisible structures imposed by legal, ethical and professional standards of nursing that respect nurse and clients rights” (Arnold & Underman-Boggs, 2011, pp 85). This makes the relationship safe and establishes trust because the client needs to be able to trust the nurse with their personal information.

This is similar to Communications in Nursing and Nursing: Communication Skills in Practice. They share themes of client focused sessions. Also the nurses have a responsibility to not cross boundaries for this would break trust. I think we can somehow integrate the quote that I have included in my summary into our edits. It shows the nurses legal obligations to keep the clients information confidential, not just having to trust that the nurse will do so. As well it describes presence which I didn’t really notice in any other text but I think it is an important therapeutic behaviour; to be with the client in the moment. --Sarah Greer 23:09, 13 October 2014 (UTC)

In this paragraph you touch a little bit on genuineness and self-awareness, we could add this information to the information in your first paragraph! As well as your information about boundaries and the important aspect of self-disclosure! You have found great information that we can tie together! You also made good points about health promotion and trust. I think that the point you made on being present with clients can be tied into the aspect of respect under b.). Lastly is the quote, I agree that it should be incorporated. That is something I don't think many people are aware of and it proves the point. Dana (talk) 19:43, 17 October 2014 (UTC)[reply]

Number Three: This source is Chapter 2 in Erickson, M., & Blazer-Riley, J. (2012). The Client-Nurse Relationship: A Helping Relationship. In Communications in Nursing (Seventh ed., pp. 16-31). St.Louis, Missouri: Elsevier Mosby.

Each Therapeutic encounter is comprised of a series of phases; beginning (initiation), middle (maintenance) and end (termination). This relationship is established for the benefit of the client and with goals directed at growth. Nurses must make their client feel confident that they will be treated courteously and that their nurses show genuine interest in them. The client should trust the confidentiality of any personal information will be respected. The connections between clients and nurses are made by presence, touch and listening (olthuis et al, 206). Nurses work with their clients to improve their health status. Behaving therapeutically may mean remaining silent to show acceptance, making open ended comments to allow the client control of the conversation and encouragement to continue, reducing distance to demonstrate your desire to be involved, restating and reflecting to validate the nurses interpretation of the clients message, directing the conversation towards important topics by focusing in on them, seeking clarification to demonstrate your want to understand and summarizing to help aid the client in separating the relevant information from the irrelevant information. In addition a nurse must establish the guidelines of the relationship so that the client can know what is expected of them. Showing respect for a client by being polite and punctual is a must. As well as remembering to be patient, understanding and to praise and encourage the client for their attempts to take better care of their health.

Again a large theme between all three texts was the importance of the client’s needs. Focus should be put on this. This text was similar to interpersonal relationships for its theme of presence. All three texts mentioned authenticity/ genuineness, trust, respect, that therapeutic relationships are a three step process and the nurse’s responsibility to uphold boundaries. Once everyone has submitted their summaries we can narrow down on what exactly we want to put in this section. I’m not sure if the three step process information is necessary to our section, but I thought I would include it just in case. Therapeutic nurse behaviours – empathy, trust, upholding boundaries, self-awareness, presence, genuineness, non-judgemental, listening and focus on the client’s needs, values, beliefs, etc. We could add from this summary some tips for exhibiting these behaviours. --Sarah Greer 23:56, 13 October 2014 (UTC) — Preceding unsigned comment added by Sg13bc (talk • contribs)

Lynn is definitely right that we are going to have a lot of information! Going through and organizing it all will be a big a step for us. I think that we should maybe keep the aspects lettered, this will keep it more organized, what do you all think? The clients needs is something we will probably have to touch on a bit in every section because the theme reoccurs so much. From your information is looks like we will for sure be able to add some information about the other elements ; boundaries and confidentiality. In paragraph 2, sentence 5 has very good points on behaviours we should not forget to incorporate. The 3 phases of the relationship could maybe be touched upon in the aspect of "collaborative goal setting" ? I will try to make my summaries focus on different aspects different than yours! Dana (talk) 19:58, 17 October 2014 (UTC)[reply]

Im not to sure what you mean by lettered? But I'm sure it is a great organization tool. Once we have all added our summaries then we can decide what headings we want or divide into sections. Can't wait to see what you guys have to add!--Sarah Greer 23:26, 18 October 2014 (UTC) — Preceding unsigned comment added by Sg13bc (talk • contribs)

Sorry about that! What I mean is how all the aspects (ex. genuine, self-awareness) are lettered already, like this "Therapeutic nurse behaviors: a.) self-awareness; b.) genuine, warm and respectful; c.) empathy; d.)cultural sensitivity; e.) collaborative goal setting; f.) responsible, ethical practice.", to keep it separated like this and do paragraphs within each (: Dana (talk) 03:17, 19 October 2014 (UTC)[reply]

Dana’s Summaries

Hi Everyone! I tried my best to focus on specific things from my sources that Sarah had not already touch on a lot since I read hers prior to doing mine.

Summary 1

This source is Chapter 4 (called Cultural Diversity: Awareness and Respect) in Sheldon, L. K. (2009) Cultural Diversity: Awareness and Respect (pp. 41-48) Sudbury, Mass: Jones and Bartlett Pub. I originally thought that I would focus on chapter 13 of this book (Communicating with Different Age Groups and Families) but chapter 4 is more related to therapeutic nurse behaviours.

Healthcare is a multicultural environment and nurses have to expect that they will care for patients from many different culture and ethical backgrounds. Cultural backgrounds effect people’s perceptions of life and health. Cultural competence is a viewpoint that increases respect and awareness for patients from cultures different from our own. Cultural sensitivity is putting aside our own perspective to understand another person’s perceptive. Culture and caring are described as being intricately linked. This is believed because there can be no cure without caring and caring involves knowing the different values and behaviours of a person’s culture. The goal of the nurse is to develop a body of knowledge that allows them to provide cultural specific care. This begins with an open mind and accepting attitude. It is important to assess language needs and request for a translation service if needed and provide written material in the patient’s language. As well as, trying to mimic the patient’s style of communication (e.g. little direct eye contact, slow, quiet). A major obstacle to cultural sensitivity and good communication is ethnocentrism, which is the belief that ones ethical group is superior to another; this causes prejudice and stops a nurse for fully understanding the patient. Another obstacle is stereotyping, a patient’s background is often multifaceted encompassing many ethic and cultural traditions. In order to individualize communication and provide culturally sensitive care it is important to understand the complexity of social, ethnic, cultural and economic.

The information I found here is similar to Chapter 4 (Understanding Each Other: Communication and Culture) in our textbooks (Riley, J. B. (2012). Communication in Nursing (7th ed.). St. Louis, MO: Elsevier Mosby.). There is a common theme of overcoming certain attitudes. This information can be used under the aspect of Cultural Sensitivity. I think that this information also has to do with having respect for a patient. Dana (talk) 03:17, 19 October 2014 (UTC)[reply]

Summary 2

This source is found under the section titled “Boundary Crossings and Violations” on pages 3-9 in College of Registered Nurses of Nova Scotia. (2012) Professional boundaries and the nurse-client relationship: keeping it safe and therapeutic: guidelines for registered nurses. Retrieved from http://www.crnns.ca/documents/ProfessionalBoundaries2012.pdf

Any action or behaviour in a nurse-client relationship that personally benefits the nurse at the expense of the client is a boundary violation. Some examples of boundary violations are engaging in a romantic or sexual relationship with a current client, extensive non-beneficial disclosure to the client and receiving a gift of money from the client. Abuse and neglect are extreme examples. They involve the betrayal of respect and trust. This includes withholding communication from a client because it is considered to be an example of neglect. It is the nurse’s job to be aware of signs that professional boundaries may be crossed or have been crossed. Warning signs of boundary crossing that may lead to boundary violations include frequently thinking of a client in a personal way, keeping secrets with a specific client, favoring one client’s care at the expense of another’s and telling a client personal things about yourself in order to make an impression. Anything that could comprise the client’s well-being if the relationship with a registered nurse is continued or discontinued can be considered a warning sign. Boundary violations are never acceptable and it is the nurse’s job to handle any situation with any regards to it professionally and therapeutically regardless of who initiated it.

I think that the information from this source takes an intense approach to the boundary aspect of the nurse-client relationship. I don’t recall having talked about neglect or abuse yet and I don’t think it is something we need to elaborate on in our article with regards to what our focus is. However, always acting in the best interest of the patient; a relationship that is strictly with all intent to only benefit the client is the theme that seems to be reoccurring as Sarah has stated. Dana (talk) 03:17, 19 October 2014 (UTC)[reply]

Summary 3

This source is Chapter 2 called (Patients’ Perceptions and Expectations) in Brown, E. L. (1961). Newer dimensions of patient care, Part 1: The use of the physical and social environment of the general hospital for therapeutic purposes. New York. Russell Sage Foundation.

A client to a nurse, in a general sense, is seeking help. Patients are expecting a nurse who will show interest, sympathy, and an understanding of their difficulties. When receiving care patients tend to be looking for more than the treatment of their disease or disability, they want to receive psychological consideration. This happens through good communication, communication with clients is the foundation of care. During hard times, clients are looking for a therapeutic relationship that will make their treatment as less challenging as possible. Many patients are aware that a solution to their problems may not be available but expect to have support through them and that this is what defines a positive or negative experience.

The theme that arises from this text is ‘patient care beyond the treatment of disease and disability’ which I think is exactly the point of a therapeutic relationship. This relates to basically all of Part 2 (Building Relationships) in our textbook (Riley, J. B. (2012). Communication in Nursing(7th ed.). St. Louis, MO: Elsevier Mosby.) The source also talks about how extensive research and clinical observation has shown that the body, mind and emotions are in unity. Therefore in order to help another, one must consider all these aspects, this means not neglecting the person and strictly just treating the illness. I think this text looks at the therapeutic relationship in a bigger picture and that this information would be good to conclude with and tie together all the aspects of a therapeutic relationship we talk about. Dana (talk) 03:17, 19 October 2014 (UTC)[reply]

Dana, we touch upon a few of the same topics which is a good thing! This way, instead of having a lot of topics and a small range of information, we will be able to incorporate both of our findings to have a broad range of information on an appropriate amount of topics. This relates back to what Lynn said about getting overwhelmed by the amount of topics. If we decide on an appropriate amount of topics under the Therapeutic Nurse Behaviour, we should be able to stay on task and provide good information. A few of the same topics we touch on are: boundaries, and culture.

Kg13la (talk) 21:36, 19 October 2014 (UTC)[reply]

Yes, that makes sense! Perfect (: Dana (talk) 01:50, 20 October 2014 (UTC)[reply]

Kristen’s Summary

1. This source is found in chapter 3: Communication Skills, of Culture, Communication, and Nursing. Burnard, P., & Gill, P. (2008). Culture, Communication, and Nursing. Harlow, Essex: Pearson Education Limited.

This chapter focuses on the communication skills in nursing. It touches upon the elements of empathy, cultural sensitivity, responsible, ethical practice, and genuine, warm and respectfulness of the therapeutic nurse behaviours. The book explains that in previous research it was found that effective communication in nursing entails being empathic, non-judgmental, understanding, approachable, sympathetic, caring, and having safe and ethical qualities. The chapter then discusses the listening behaviours identified as S.O.L.E.R; S-sit squarely in relation to client, O-maintain an open position and do not cross arms or legs, L-lean slightly towards the client, E-maintain reasonable and comfortable eye contact, R-relax. It explains how these behaviours are effective for communication skills, and how they are useful for thinking about how to listen to another person. In terms of cultural sensitivity, this chapter discusses the Six Category Intervention Analysis: a Cultural Perspective; three of these aspects are relevant. “Informative” explains that in most cultures, information given by the health-care professional is assumed to be correct, and that in certain cultures, Nurse Educators are the ones who have the accurate answers to everything and that the student must seek answers from them. “Catalytic” explains that sharing your problems is not a universal view and certain cultures see this as impolite. Finally, “Supportive” explains that although most cultures encourage support for others, sometimes the amount of support offered will depend on a person’s status in society.

2. This source is found under Practice Recommendations in Establishing Therapeutic Relationships – RNAO. Virani, T., & Tait, A., & McConnell, H., & Scott, C., & Gergolas, E. (2002). Establishing Therapeutic Relationships. Toronto, ON.

This source states that a nurse must have the appropriate knowledge to effectively maintain a therapeutic relationship. The necessary knowledge aspects that are needed are: background knowledge, knowledge of interpersonal and development theory, knowledge of diversity influences and determinants, knowledge of person, knowledge of health/illness, knowledge of the broad influences on health care and health care policy, and knowledge of systems. Background knowledge is the nurse’s education, and her life experience. Knowledge of interpersonal and development theory is the knowledge of theories of the sense of self and self influence on others. The specific theories are: The Interpersonal Theory, Object relation theory, Developmental theory, and Gender/developmental theory. Knowledge of diversity influences and determinants explains that nurses need to know the outcome of social, cultural, and racial differences, and how they can affect the therapeutic relationship. Knowledge of person explains that nurses must take the time to understand the client, and their world; what is meaningful to them, and their history. Knowledge of Health and Illness is the knowledge that the nurse must attain about their client’s health issue. Knowledge of the broad influences on health care and health care policy explains that nurses need to be aware of the influences of the client’s care; social/political forces, expectations of health-care system, and changes in accessibility, and resources. Knowledge of Systems explains that the nurse needs to know about the health-care system so they can help their clients access services.

Kristen, you’ve done a great job with all of these paragraphs. You’ve touched upon the importance of knowledge and how it can influence the nurse client relationship. “Knowledge of diversity influences and determinants explains that nurses need to know the outcome of social, cultural, and racial differences, and how they can affect the therapeutic relationship”. I really liked this sentence and we should use it in the cultural competence/sensitivity section. Keep up the good work.Jane (talk) 02:18, 22 October 2014 (UTC)[reply]

3. This source is found under the standard statement of Therapeutic Communication in the CNO Therapeutic Nurse-Client Relationship Standard. Therapeutic Nurse-Client Relationship, Revised 2006. (1999, March 1). June 1, 2009, Retrieved from http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf This source identifies the four standard statements that describe the nurse’s role in a nurse-client relationship. The first statement is Therapeutic Communication, which explains that a nurse should apply her communication and interpersonal skills to create, maintain, and terminate a nurse-client relationship. The Second statement, Client-centered Care, explains that nurses must ensure that their client’s needs are met while being professional. The third statement, Maintaining Boundaries, explains that it is the nurse’s responsibility to establish the boundaries and limits of the relationship between the nurse and client. The final statement, Protecting Client from Abuse, states that it is the nurse’s job to report abuse of their client to ensure that their client is safe from harm.

All of these sources state the therapeutic relationships of nurses, and their required knowledge and responsibilities in their Nurse-Client relationships.

Kg13la (talk) 21:27, 19 October 2014 (UTC)[reply]

Jane's Summary

Hey guys, sorry for waiting this long to post my summaries, but here they are.

1. This source is found in Chapter 3 of Patient-provider communications: This book includes detail about empathy and boundaries Hart, V. (2007). Personal and Professional Relationships and Communication. In Patient-Provider Communications (pp. 99-102). Sudbury, Massachusetts: Jones and Bartlett.

Within Patient-Provider Communications it expands on and goes further into detail about empathy and boundaries. There is no universal definition of empathy. “Many perceive it as an emotional state of sharing feelings with another person”. Empathy is used as a tool to enhance the communication between the nurse and client. Another way of understanding empathy is to differentiate it with sympathy or pity, which don’t facilitate the intervention and final goal for the client. It is of high priority to keep personal feelings separate from those of the patient as they are our primary focus, it is important that we don’t get caught up in our own problems. “Becoming empathetic is a matter of imagining the experience of another and when imagining what the patient of the family is experiencing, the clinician uses their experience to better understand the issues in order to provide intervention and treatment. This is also referred to as participant observation. This textbook also goes into detail about boundaries, stating boundaries are rules of behavior and are a way to describe the limits of the professional relationship. The list of boundary violations is continues involving certain aspects such as, duration of clinical home visits, accepting gifts from patients, altering our appearance for a certain patient, keeping secrets from colleagues about the patient, and giving special treatment to one client compared to the others under your care.

2. Nurse client relationship: This book includes a section about cultural sensitivity and self-awareness (chapters 3, 5) Antai-Otong, D. (2007). Perspectives and Principles of Therapeutic Communication. In Nurse-Client Communication (1st ed., pp. 16-17). Sudbury, Massachusetts: Jones and Bartlett.

This specific source goes into detail about Cultural sensitivity and self-awareness. It states that cultural sensitivity and competence must be an integral part of nursing. Furth explaining that “a failure to respond to red flags and acknowledge the needs of diverse cultures and ethnicities will damage the nurse client-relationship, staff morals interpersonal relationships among staff, and client’s clinical outcomes”( Antai-Otong, 2007). Nurses need to acknowledge the impact of culture on health practices, beliefs and values and responses to illness and health helps the nurse integrate client needs into practice. Being and effective health care provider involves learning about the diversity of alternative cultures. For example, you may be involved with clients who practice eastern medicine, instead of looking down on their practices, you could be knowledgeable and ask how you can help them and work collaboratively to achieve optimal health. “Self-awareness is an internal evaluation of self and one’s reactions to emotionally charged situations, people and places. It affords an opportunity to recognize how our attitudes, perceptions, past and present experiences, and relationships frame or distort interactions with others”( Antai-Otong, 2007). An example of self-awareness would be acknowledging that showing anger is not a sign of weakness, because there were emotions outside of your comfort level. Self-awareness involves learning about ourselves. We must possess self-knowledge in order to effectively help patients. If we aren’t emotionally content then how can we be expected to help others?

 3. Therapeutic Interaction in Nursing: (chapter 2) L. Williams, C. (2008). Using the Self to Promote Health. In Therapeutic Interaction in Nursing (2nd ed., pp. 18-19). Sudbury, Massachusetts: Jones and Bartlett

The primary role of nurses in terms of therapeutic behavior is knowing how effectively communicate with clients. This requires translating medical jargon into understandable terms for our clients. It is crucial to be an effective listener and communicator. Nurses assist clients to achieve their health related goals including improving their relationship with others. “The help that nurses offer to their clients is much more than technical expertise. The relationship between nurse and client is a powerful healing force by itself”. If the client experiences a collaborative relationship with the nurse then this will lead to personal growth and development. The client will then become stronger and know how to deal with similar situations in the future if it arises. Nurses are continues health promoters, as this is our main priority. With this body of knowledge we possess it is our duty to inform our clients and ensure they understand the consequences. Jane (talk) 01:43, 22 October 2014 (UTC)[reply]

Professor suggestions re: summaries and collaboration

Dg13gq, Kg13la , Sg13bc, and Jg11pv , as I said, you’ve got some great sources. I think you have the potential to get overwhelmed by the amount of information you have or take on more than is necessary for this assignment. I have some suggestions for you for your next steps – to help you keep your work manageable and within the scope of this assignment. Keep your expectations of yourselves reasonable. Thinking about the communication model we learned about the first week of class might be helpful – but maybe not as much for your group as for other groups. Beware of being sidetracked.

See the course page for information about your tasks due October 22.

Your summaries should be between 250 and at most 400 words for each source. Try not to make them long. If there aren’t 250 words worth of information in your source, don't blather on to fill space. I am looking for summaries I can understand and that are logical and coherent. You'll need to really focus in on the heart of the relevant findings. You should be aiming to tell your group members what the key messages are in your sources and how you think the information fits or doesn't fit with the article (it's okay if you logically determine that it wouldn't add to the article). If there is repetition within your sources, you should note that. Hopefully there is. Each summary should have a citation that is acceptable for Wikipedia and that has the information needed for a reader to verify your interpretation by finding your source. Links that only work within the university aren’t user friendly for me or your group members. If there is information that you can’t paraphrase, indicate quotes with quotation marks and page numbers.

When you've got your summaries done, hopefully there will be some themes and repetition among your summaries. Your job then is to collaboratively decide on what deserves to be suggested as an edit for the article and craft summaries of what your group found that could be incorporated in the article. That might be citations for information that is already there or new information. Discuss why your new information is relevant to the article.

I can copy your article over to your sandbox so you can practice editing before you make any suggestions to the editors of the relationships article. If you want me to do that, let me know by email or by using my user name in a response to this post. As always, I'm available to guide you.

Don't forget to sign your posts. I look up your contributions by user name for grading. If you don't sign your posts, you won't get credit for them when I'm grading.LynnMcCleary (talk) 00:53, 10 October 2014 (UTC)[reply]

How We Can Organize Our Information and Delete Repeated Information

Hi everyone! I thought of an idea on how we can discuss the information we have found (organize it and delete repeated information) in a way that is time efficient because I know that everyone is busy studying!

Its not super brilliant but I think it will allow us to organize and delete a lot easier! Everyone put the relevant information they found into the specific category:

Ps. Finish a point with ex. (1), (2), (3) so we can remember what source we got it from, and your signature so we know who's information it was.

Let me know if you like this idea. Dana (talk) 14:42, 21 October 2014 (UTC)[reply]

Therapeutic Nurse Behaviours:

Always acting in the best interest of the patient; a relationship that is strictly with all intent to only benefit the client. (2) Dana (talk) 14:29, 21 October 2014 (UTC)[reply]

‘patient care beyond the treatment of disease and disability’ (3)Dana (talk) 14:40, 21 October 2014 (UTC)[reply]

Extensive research and clinical observation has shown that the body, mind and emotions are in unity. Therefore in order to help another, one must consider all these aspects, this means not neglecting the person and strictly just treating the illness. (3)Dana (talk) 14:40, 21 October 2014 (UTC)[reply]

The necessary knowledge aspects that are needed to maintain a therapeutic nurse-client relationship are: background knowledge, knowledge of interpersonal and development theory, knowledge of diversity influences and determinants, knowledge of person, knowledge of health/illness, knowledge of the broad influences on health care and health care policy, and knowledge of systems. Background knowledge is the nurse’s education, and her life experience. Knowledge of interpersonal and development theory is the knowledge of theories of the sense of self and self influence on others. The specific theories are: The Interpersonal Theory, Object relation theory, Developmental theory, and Gender/developmental theory. Knowledge of person explains that nurses must take the time to understand the client, and their world; what is meaningful to them, and their history. Knowledge of Health and Illness is the knowledge that the nurse must attain about their client’s health issue. Knowledge of the broad influences on health care and health care policy explains that nurses need to be aware of the influences of the client’s care; social/political forces, expectations of health-care system, and changes in accessibility, and resources. Knowledge of Systems explains that the nurse needs to know about the health-care system so they can help their clients access services. (2) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

Effective communication in nursing entails being empathic, non-judgmental, understanding, approachable, sympathetic, caring, and having safe and ethical qualities. (1) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

The first statement of the CNO Standard is Therapeutic Communication, which explains that a nurse should apply her communication and interpersonal skills to create, maintain, and terminate a nurse-client relationship. (3) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

The Second statement of the CNO Standard under Therapeutic Communication states that, Client-centered Care explains that nurses must ensure that their client’s needs are met while being professional. (3) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

All of the aspects to a therapeutic relationship are interrelated. You cannot efficiently use one aspect without the other, they are all connected and work together to create a successful relationship. (me in my reflection of the sources, a theme, observation. I want to use this but I don’t know how to properly incorporate it) Sg13bc (talk)--Sarah Greer 04:21, 29 October 2014 (UTC)[reply]

Relationship is centered around clients values beliefs and needs. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Nurses assist clients to achieve their health related goals including improving their relationship with others. “The help that nurses offer to their clients is much more than technical expertise. The relationship between nurse and client is a powerful healing force by itself”(3) (Williams, 2008). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

a.) Self-Awareness

Until an individual can fully understand themselves then they cannot understand others. Nurses need self-awareness in this relationship to be able to relate to the patients experiences to develop empathy. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Self-awareness allows you to fully engage with a client and presence; being with the client in the moment, allows the nurse to know when to provide help and when to stand back. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

“Self-awareness is an internal evaluation of self and one’s reactions to emotionally charged situations, people and places. It affords an opportunity to recognize how our attitudes, perceptions, past and present experiences, and relationships frame or distort interactions with others” (2) ( Antai-Otong, 2007). Jane (talk) 21:58, 29 October 2014 (UTC)[reply]

An example of self-awareness would be acknowledging that showing anger is not a sign of weakness, because there were emotions outside of your comfort level (2) (Antai-Otong, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

b.) Genuine, Warm and Respectful

An aspect of respect is respecting a person's culture. (1) Dana (talk)

Listening behaviours are identified as S.O.L.E.R; S-sit squarely in relation to client, O-maintain an open position and do not cross arms or legs, L-lean slightly towards the client, E-maintain reasonable and comfortable eye contact, R-relax. Tthese behaviours are effective for communication skills, and are useful for thinking about how to listen to another person.(1) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

The nurse empowers patient and families to get involved in their health. This is accomplished by revealing your whole self and being genuine with clients. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Being with the client in the moment. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Nurses must make their client feel confident that they will be treated courteously and that their nurses show genuine interest in them. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

The connections between clients and nurses are made by presence, touch and listening (olthuis et al, 206). (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

Behaving therapeutically may mean remaining silent to show acceptance, making open ended comments to allow the client control of the conversation and encouragement to continue, reducing distance to demonstrate your desire to be involved, restating and reflecting to validate the nurses interpretation of the clients message, directing the conversation towards important topics by focusing in on them, seeking clarification to demonstrate your want to understand and summarizing to help aid the client in separating the relevant information from the irrelevant information. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

Showing respect for a client by being polite and punctual is a must. As well as remembering to be patient, understanding and to praise and encourage the client for their attempts to take better care of their health. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

c.) Empathy

A client to a nurse, in a general sense, is seeking help. Patients are expecting a nurse who will show interest, sympathy, and an understanding of their difficulties. (3) Dana (talk) 14:40, 21 October 2014 (UTC)[reply]

When receiving care patients tend to be looking for more than the treatment of their disease or disability, they want to receive psychological consideration. This happens through good communication, communication with clients is the foundation of care. During hard times, clients are looking for a therapeutic relationship that will make their treatment as less challenging as possible. (3) Dana (talk) 14:40, 21 October 2014 (UTC)[reply]

Many patients are aware that a solution to their problems may not be available but expect to have support through them and that this is what defines a positive or negative experience. (3) Dana (talk) 14:40, 21 October 2014 (UTC)[reply]

Having the ability to enter the perceptual world of the other person and understanding how they experience the situation is empathy. This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Empathy is used as a tool to enhance the communication between the nurse and client (1) (Hart, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

“Becoming empathetic is a matter of imagining the experience of another and when imagining what the patient of the family is experiencing, the clinician uses their experience to better understand the issues in order to provide intervention and treatment. This is also referred to as participant observation” (1) (Hart, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

d.) Cultural Sensitivity

Healthcare is a multicultural environment and nurses have to expect that they will care for patients from many different culture and ethical backgrounds. (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

Cultural backgrounds effect people’s perceptions of life and health. (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

Cultural competence is a viewpoint that increases respect and awareness for patients from cultures different from our own. (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

Cultural sensitivity is putting aside our own perspective to understand another person’s perceptive. (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

Culture and caring are described as being intricately linked. This is believed because there can be no cure without caring and caring involves knowing the different values and behaviours of a person’s culture. (1)Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

The goal of the nurse is to develop a body of knowledge that allows them to provide cultural specific care. This begins with an open mind and accepting attitude. (1)Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

It is important to assess language needs and request for a translation service if needed and provide written material in the patient’s language. As well as, trying to mimic the patient’s style of communication (e.g. little direct eye contact, slow, quiet). (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

A major obstacle to cultural sensitivity and good communication is ethnocentrism, which is the belief that ones ethical group is superior to another; this causes prejudice and stops a nurse for fully understanding the patient. Another obstacle is stereotyping, a patient’s background is often multifaceted encompassing many ethic and cultural traditions. In order to individualize communication and provide culturally sensitive care it is important to understand the complexity of social, ethnic, cultural and economic. (1) Dana (talk) 14:30, 21 October 2014 (UTC)[reply]

There is a common theme of overcoming certain attitudes. (1) Dana (talk) 14:21, 21 October 2014 (UTC)[reply]

In terms of cultural sensitivity, there is a Six Category Intervention Analysis: a Cultural Perspective; three of these aspects are relevant to the therapeutic nurse behaviour. The “Informative” aspect explains that in most cultures, information given by the health-care professional is assumed to be correct, and that in certain cultures, Nurse Educators are the ones who have the accurate answers to everything. The “Catalytic” aspect explains that sharing your problems is not a universal view and certain cultures see this as impolite. The “Supportive” aspect explains that although most cultures encourage support for others, sometimes the amount of support offered will depend on a person’s status in society. (1) Kg13la (talk) 00:34, 29 October 2014 (UTC)[reply]

Knowledge of diversity influences and determinants explains that nurses need to know the outcome of social, cultural, and racial differences, and how they can affect the therapeutic relationship.(3) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

Offering consistent, non-judgemental care to all patients and accepting the person for who they are regardless of diverse backgrounds and circumstances or differences in morals or beliefs. By exhibiting these attributes trust can grow between patient and nurse. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

“a failure to respond to red flags and acknowledge the needs of diverse cultures and ethnicities will damage the nurse client-relationship, staff morals interpersonal relationships among staff, and client’s clinical outcomes”(2) ( Antai-Otong, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

Nurses need to acknowledge the impact of culture on health practices, beliefs and values and responses to illness and health helps the nurse integrate client needs into practice (2) (Antai-Otong, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

e.) Collaborative Goal setting

The Nurse-patient relationship has three phases, a beginning (first time contact/introduction), a middle (develop a relationship to deliver care) and an end (the patient is no longer dependant on the nurse). To make this process successful the nurse must value, respect and listen to clients as individuals. Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Phases of the therapeutic nurse client relationship include orientation (engagement and assessment, gathering information), working (planning, giving feedback) and termination (evaluation and validation). (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Relationship is centered around clients values beliefs and needs. A partnership is formed between nurse and client. The nurse empowers patient and families to get involved in their health. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Each Therapeutic encounter is comprised of a series of phases; beginning (initiation), middle (maintenance) and end (termination). This relationship is established for the benefit of the client and with goals directed at growth. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

Nurses work with their clients to improve their health status. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

f.) Responsible, Ethical Practice

The fourth statement of the CNO Standard is, Protecting Client from Abuse, which states that it is the nurse’s job to report abuse of their client to ensure that their client is safe from harm. (3) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

This is a communication based relationship, therefore, a responsibility to interact, educate, and share information genuinely is placed upon the nurse. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

Nurses carry the responsibility of maintaining appropriate boundaries, which aim to be good for the patient and enable nursing care. (1) (Miller & Nambiar-Greenwood, 2011) --Sarah Greer 04:21, 29 October 2014 (UTC)

g.) Boundaries

Any action or behaviour in a nurse-client relationship that personally benefits the nurse at the expense of the client is a boundary violation. Some examples of boundary violations are engaging in a romantic or sexual relationship with a current client, extensive non-beneficial disclosure to the client and receiving a gift of money from the client. Abuse and neglect are extreme examples. They involve the betrayal of respect and trust. This includes withholding communication from a client because it is considered to be an example of neglect. (2) Dana (talk)

It is the nurse’s job to be aware of signs that professional boundaries may be crossed or have been crossed. Warning signs of boundary crossing that may lead to boundary violations include frequently thinking of a client in a personal way, keeping secrets with a specific client, favouring one client’s care at the expense of another’s and telling a client personal things about yourself in order to make an impression. Anything that could comprise the client’s well-being if the relationship with a registered nurse is continued or discontinued can be considered a warning sign. (2) Dana (talk) 14:29, 21 October 2014 (UTC)[reply]

Boundary violations are never acceptable and it is the nurse’s job to handle any situation with any regards to it professionally and therapeutically regardless of who initiated it. (2) Dana (talk)

The CNO Standard identifies a standard statement relating to boundaries that describe the nurse’s role in a nurse-client relationship. The statement, Maintaining Boundaries, explains that it is the nurse’s responsibility to establish the boundaries and limits of the relationship between the nurse and client. (3) Kg13la (talk) 00:30, 29 October 2014 (UTC)[reply]

Nurses carry the responsibility of maintaining appropriate boundaries, which aim to be good for the patient and enable nursing care. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

The boundaries have a specific purpose and health goal, and the relationship terminates when identified goal is met. During the relationship self-disclosure is limited for the nurse but encouraged for the client. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

“Professional boundaries represent invisible structures imposed by legal, ethical and professional standards of nursing that respect nurse and clients rights” (2) (Arnold & Underman-Boggs, 2011, pp 85). --Sarah Greer 04:21, 29 October 2014 (UTC)

This makes the relationship safe and establishes trust because the client needs to be able to trust the nurse with their personal information. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

In addition a nurse must establish the guidelines of the relationship so that the client can know what is expected of them. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

The list of boundary violations is continuous involving certain aspects such as, duration of clinical home visits, accepting gifts from patients, altering our appearance for a certain patient, keeping secrets from colleagues about the patient, and giving special treatment to one client compared to the others under your care (1) (Hart, 2007). Jane (talk) 21:56, 29 October 2014 (UTC)[reply]

h.) Confidentiality

The patient should feel comfortable disclosing personal information and be able to ask questions. Patient needs to be able to trust that the nurse will keep this information confidential. (1) (Miller & Nambiar-Greenwood, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

This makes the relationship safe and establishes trust because the client needs to be able to trust the nurse with their personal information. (2) (Arnold & Underman-Boggs, 2011)--Sarah Greer 04:21, 29 October 2014 (UTC)

The client should trust the confidentiality of any personal information will be respected. (3) (Erickson &Blazer-Riley, 2012)--Sarah Greer 04:21, 29 October 2014 (UTC)

Comments on Rought Edits

Dana (talk) 14:12, 21 October 2014 (UTC)[reply]

Dana, I think this is very nicely organized. I was just wondering if what you meant was we should add selective points from our own paragraph to the list you already have here? How should we go about condensing this to its simplest form? Perhaps we could all add a few lines then let each other know if it works or not. Jane (talk) 02:43, 23 October 2014 (UTC)[reply]

Yes, what I'm thinking is for everyone to put the information from their summaries into the sections listed. Then once that is done we can delete repeated information and condense each section into a nice paragraph for our article. This can take place in our sandbox. (:

Ps. Jane your username is red, sign in so that Lynn can see your contributions (: Dana (talk) 18:06, 22 October 2014 (UTC)[reply]

Thats a great idea! Yeah, I am signed in, not quite sure why it's in red. Jane (talk) 03:01, 23 October 2014 (UTC)[reply]

Thank you! and hm that is weird Dana (talk) 17:54, 25 October 2014 (UTC)[reply]

Hi everyone! I added a copy of our article into the sandbox as Lynn requested, along with what we will possibly be adding to the article. Sarah and I thought that maybe each of us could do certain paragraphs. What is everyone thinking? Dana (talk) 01:47, 30 October 2014 (UTC)[reply]

There are nine sections that we have either added information or created, therefore each person can get two sections to work on and if one person wants to do three or if we all want to work on one that is great. Of course we will all be contributing to the entire section but I just thought it would be a bit more manageable if we break it off into chunks. What I was thinking was that with the information posted into a section that the person assigned to that section creates a paragraph. Once all of the paragraphs are created we all go through them and make any suggestions or corrections as needed. Also we should decide what we want to do about pictures. Do we want to add a picture for each section or just a couple at the beginning? Thanks Dana for posting our article into the sandbox!--Sarah Greer 13:56, 30 October 2014 (UTC)

No problem Sarah! I can do three. I'll do confidentiality, cultural sensitivity and empathy! Two of them are smaller so it makes up for doing 3. I think that maybe just one picture for the therapeutic section in general would be good because I don't know how much each picture would differ. Dana (talk) 16:16, 30 October 2014 (UTC)[reply]

Great thanks so much Dana! I definitely agree, the picture would all be pretty similar. Just one should be fine. I will do Collaborative Goal setting and Boundaries. Therefore there is the Therapeutic Nurse Behaviours, Self-awareness, Genuine, Warm and Respectful and Responsible, Ethical practice sections left to be chosen. Dana and I were talking to Lynn yesterday and she wanted us to also remove the primary source data from our page in addition to the material that we have added to the elements section. If we can have our summaries all done and edited by everyone by Sunday that would give us time before Wednesday to do the additional tasks. --Sarah Greer 13:31, 31 October 2014 (UTC) — Preceding unsigned comment added by Sg13bc (talk • contribs)

I will do the Therapeutic Nurse behaviours section, and responsible ethical practice! Jane that means you will be doing Self-awareness, and Genuine, Warmth, and Respectful. Thanks everyone! Kg13la (talk) 18:02, 2 November 2014 (UTC)[reply]

Thanks guys, I'm working on them now and should have it completed for 9 or 10 pm tonightJane (talk) 23:05, 4 November 2014 (UTC)[reply]

Hello everyone, I posted my two summaries. I added a few sentences to make it flow well together, but not too sure if it makes a lot of sense. Let me know what you guys think. Jane (talk) 01:26, 5 November 2014 (UTC)[reply]

Our To Do List For Next Wednesday

As Sarah said, her and I spoke to Lynn and we have quite a bit of work to do before next Wednesday. I thought that having a list would help us organize our thoughts as well as help us get everything done. This is what we have to do, once it is done we can put a strike through it (that always feels good):

~~Summaries~~
- ~~Complete them~~
- ~~Review each others for proper grammar & such~~
- ~~Property Cite them~~
~~Remove the Peplau's Theory Section~~
- ~~make a reference sentence about the theory in our article with a link to the wikipedia page about Peplau's Theory~~
~~Post an explanation of edits on the Articles Talk Page with a link to our Group Talk Page~~
- ~~Include a summary of our edits~~
- ~~Explain why we deleted Peplau's Theory (Based on primary information)~~
- ~~Include the rationale for our edits~~
- ~~Include a summary of further edits that are needed~~
~~Figure out if we are going to add a picture, this would include:~~
- ~~Finding a picture~~
- ~~Property adding and Citing the picture~~ (I researched this extensively to make sure, but no actual citation is required for the photo)--Sarah Greer 01:18, 5 November 2014 (UTC)
~~Make Revisions to Overall Paper~~
- ~~Fix grammar~~
- ~~Proper Citations~~
- ~~Remove Repeated Information (Practice of the Nurse-Client Relationship section)~~
~~Make Sure the Article looks Nice~~
~~Move Edits to Main Wikipedia Article~~

Dana (talk) 19:52, 31 October 2014 (UTC)[reply]

Edits Being Made to Actual Wikipedia Page

Hi guys, correct me if I'm wrong but I believe we are supposed to post the edits we are going to make to the article on this page also. I tried posting my summaries here but I think I might have done the in-text citation incorrect; they are not showing up how they're supposed to. As soon as I figure it out I will post what I will be adding to the actual Wikipedia article. Thanks! Kg13la (talk) 00:01, 4 November 2014 (UTC)[reply]

No you are right :) All the main edits we are going to make I listed in the check list above, if they have been made they are crossed off. Don't worry about doing your citations just post your summary the way Sarah and I posted it and I am going to take care of doing the citations. The original article did not have them done correctly and we need to redo it. The changes we have made include:

Removing Peplau's Theory and Practice of the Nurse-Client relationship
Fixing grammar of the previous articles
Adding brief information about Peplau's theory in the introduction
Sarah found a picture

There is still lots to do but we can not to them until the summary's are done. Dana (talk) 00:34, 4 November 2014 (UTC)[reply]

Dana, will you be posting tonight in the actual page? Thanks! Kg13la (talk) 21:55, 5 November 2014 (UTC)[reply]

Yes, I am reviewing it one last time and posting it (: Dana (talk) 22:52, 5 November 2014 (UTC)[reply]

Summary of What we Edited and Why

The article is not bolded in the sandbox because we made edits to every part of the page
We deleted two previous sections of the article
- One was based on primary data. The section titled: "Peplau's Theory"
- One was based on opinion's. The section titled: "Practice of the Nurse-Client Relationship"
We property added citations to the entire article
We added a picture to the article
We added information to the introduction. This includes a sentence regarding the importance of Peplau's Theory.
We fixed the grammar of all previous sections and added relevant information
We created a section entirely for Therapeutic Nurse Behaviours - all the information in this section came from us
We added new information to the the Boundaries and Confidentiality sections

Yes. We were bold.

Dana (talk) 23:47, 5 November 2014 (UTC)[reply]

This is the Summary of our Edits that Sarah posted in the Article talk page:

As previously posted this page was subject to a Nursing course project intended to improve the quality of this page. We have worked very hard on this project to try and do just that by finding good quality secondary sources and collaboratively deciding what information would be the best to add. If any of the edits added to the page are of any interest or under question please consult our project talk page at this link: https://wiki.riteme.site/wiki/User_talk:Kg13la/ourSANDBOX. This has the whole process for the project and thus for the edits. In our sandbox you can also find our trial runs.

Our focus for this project was to improve the communication aspects of this page, which ended up being the therapeutic nurse behaviour section and the elements section. We attempted to fix up the entire page in addition. We went through and fixed grammar and sentence structure issues in both the original article and our additions. This was necessary to make the article more reliable and professional. The same reasoning was used when we adjusted the formatting and look of the article. We added a photo in the intention of capturing a user’s attention so that they will continue to read the article. This also improved the overall look and feel of the article. One of the last but most significant edit was removing the warning box at the top of the original article. No one wants to read an article that has a specific warning page for invalid information. We also removed the contract setting sections from the elements section because we felt that that information was described within the sections that were added. Sadly we had to remove the entire Peplau’s Theory section because it was solely based on primary information, which is not a part of the Wikipedia good article criteria. But we did add a small explanation of this theory in the introduction of this article. We decided to also remove the section named Practice of the Nurse-patient Relationship because the previous author left it unfinished and after our edits we felt that it had been covered anyway. The places where we added a significant amount of information was the elements section which includes boundaries and confidentiality, as well as the therapeutic nurse behaviors section which includes self-awareness, genuine, warm and respectful, empathy, cultural sensitivity, collaborative gaol setting and responsible, ethical practice. These sections were in the original article however little or no information was provided. We added extensive amounts of well researched secondary source information, which turned this onto the focus of the article. Proper citations were added for all of the new information

Although not everything in this article was fixed we tried our best to improve this page in the time that we had so that users can feel comfortable using the information. Some aspects of this page that require further edits would be the introduction. It remains a bit disconnected from the article and thus isn’t sufficient in providing a true summary of the information that follows. As well the introduction contains information that isn’t a section in the article but is important to the topic. The original section that it referenced had to be removed due to its use of primary information, as mentioned above. The sections client’s perspectives, building trust, emotional support and humor were not edited as extensively as the other sections of this page. Mostly grammar and sentence structure was changed. Due to the improper referencing it was difficult to determine what type of source the information was from. As well the way that the topics are talked about is in a research kind of way instead of a factual/ informational way; however they are very relevant topics to the nurse patient relationship, which is why we decided to leave them a part of this page. The thought was that hopefully someone could aid us in improving these sections, for we were specifically focusing on the communication parts of this page. As mentioned the references that already existed on this page were improperly cited in that they lacked the linkage to the information. This still requires a bit of work. We didn’t want to remove them because they are related to the sections that were also originally on the page. Dana (talk) 23:47, 5 November 2014 (UTC)[reply]