Reflection Paper on the Collaborative Nurse-Client Relationship
Introduction

The collaborative nurse-client relationship (CNCR) is vitally important in achieving high quality of care in the field of nursing. However, as Feo, Rasmussen, Wiechula, Conroy and Kitson (2017) point out, developing these type of therapeutic relationship is not without its challenges. Putting the patient at the center of the care process and working with the patient so that the client takes ownership of his or her own care process and is involved in the decision-making process is the best way to ensure optimal care. Collaboration is a crucial concept in nursing (Trautman, 2017), and when it comes to developing the nurse-client relationship it is no less vital than it is when it comes to collaborating with other health care professionals. As Burger (2018) puts it, “Nurses must get buy-in from patients when it comes to their care. As any nurse will tell you, it’s nearly impossible to work with a non-compliant patient. Little to no improvement is made. Encouraging participation and educating patients is paramount.” This paper will reflect on the nature of the collaborative (therapeutic) nurse-client treatment relationship, show what it is, what it should look like, why it is advantageous, when it might be disadvantageous, how it is established, and whether there are any barriers to this type of care approach.

What is CNCR?

Pullen and Mathias (2010) state that the therapeutic nurse-patient relationship is defined as “a helping relationship based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient’s physical, emotional, and spiritual needs through your knowledge and skill” (p. 4). As every patient and client is going to be different, the nurse should be aware of the personal tastes and needs of the client-patient. The nurse may ask questions to identify likes and dislikes, but should do so in a way that is respectful rather than pushy. The nurse should not come across as invasive but should use empathy, emotional and social intelligence skills, and communication tools to evaluate the patient’s preferences before engaging the patient in a manner that may not align with the client’s particular values. For instance, some patients may prefer to be comforted through words, touch or the sharing of information. Others may prefer time to think in silence, reflect in private, or talk to others in their support system. All of these are acceptable in CNCR, but the nurse must recognize which is preferred by the client at the time because that is how trust and respect are developed—through nurse awareness of patient preferences.

Pros and Cons of CNCR

Pros

The benefits of CNCR are that it allows the nurse to get to the heart of patient-centered care, which Chiaramonte et al. (2018) note are very helpful in building trust and empowerment among clients. CNCR focuses on putting the patient’s needs first and foremost in care providing process. It means that the patient is likely to have questions, cultural inputs, unique wants and ideas about what care means to him or her. By collaborating with the patient to develop a unique and personalized care approach, the nurse can empower the patient and make the patient feel that he or she is truly part of the decision making process. The aim, here, is to get the patient involved in taking care of his or her own health in such a way and to such an extent that the patient becomes empowered to do more, know more, and be healthier all...…process, specifically because the patient is either totally unwilling to cooperate or is completely unable to cooperate. A patient’s wishes should always be respected, and a patient who cannot make decisions on his or her own should always be treated according to the best practice guidelines that apply.

Barriers

Barriers to CNCR include a lack of training on the part of nurses, a lack of communication skills, a lack of social and emotional intelligence, a lack of cultural understanding, and a lack of education on the part of the patient. Most patients fail to take part in the decision making process and in the ownership process of care because they lack education. Sometimes this failure occurs because they lack support. The nurse must be able to provide both of these consistently and selflessly so that the patient is involved, informed and included in the care process. Communication barriers occur when nurses lack a grounded approach to patient-centered care (Mulder, Lokhorst, Rutten & van Woerkum, 2015)—so training nurses in how to acquire this approach is important in overcoming barriers to CNCR.

Conclusion

The collaborative nurse-client relationship is helpful in providing client-patients with the quality of care they require through the care process. Nurses can use CNCR to give the patients support, information, education, and ownership in the care process itself by including them in decision-making. This approach can be especially helpful in cases on non-compliance, but it is not effective with every population—particularly those patients who are incapable of engaging or interacting with the nurse because of incapacitation. Barriers to CNCR include a nurse’s lack of training, lack of emotional or social intelligence, lack of cultural competency, and the patient’s lack of education. Focusing on overcoming these barriers can help to enhance quality of care.

…