Nurse –client relationship
In real examination of CPNRE,
They include many questions on the basis of nurse client relationship. They want nurses to build the boundaries beyond the nurse-client relationship. CNO likes to test students on this particular topic.
It is important for nurses to be aware when a professional relationship is slipping into the non-professional realm and to take immediate action. Nurses do not enter into a friendship or a romantic or sexual relationship with clients. Nurses are cautious in socializing with clients and/or former clients, especially when the client or former client is vulnerable and may require ongoing care. Nurses are responsible for maintaining a professional nurse-client relationship regardless of how the client behaves.
I found some lists of “yellow lights” that may serve as a caution in journal of British Columbia.
Yellow Lights: Warning Signals of Nurse Behavior
- Frequently thinking of the client when away from work.
- Frequently planning other client’s care around the client’s needs.
- Seeking social contact or spending free time with the client.
- Sharing personal information or work concerns with the client.
- Feeling worried about the client’s or family’s view of the nurse as a person if their expectations are not met.
- Feeling so strongly about the client’s goals that colleagues’ comments or client’s/family’s wishes are disregarded.
- Feeling responsible for the client’s limited progress.
- Feeling unusual irritation if someone or something in the system creates a barrier or delay in the client’s progress.
- Hiding aspects of the relationship with the client from others.
- Having more physical touching than is appropriate or required for the situation.
- Introducing sexual content in conversation with the client.
- Feeling a sense of excitement or longing related to the client.
- Making special exceptions for the client because s/he is appealing, impressive or well connected.
- Using the client to meet personal needs for status, social support or financial gain.
- Receiving feedback from others that behavior with the client is overly familiar or intrusive.
- Having romantic or sexual thoughts about the client.
Differences between Professional and Personal Relationships
|Characteristic||Professional Relationship (nurse-client)||Personal Relationship (casual, friendship, romantic, sexual|
|behavior||Regulated by a code of ethics and||professional standards.Guided by personal values and beliefs|
|Remuneration||Nurses are paid to provide care to the client||No payment for being in therelationship.|
|Length of relationship||Time-limited for the length of the client’s need for nursing care..||May last a lifetime|
|Location of relationship||Place defined and limited to where nursing care is provided.||Place unlimited; often undefined|
|Purpose of relationship||Goal-directed to provide care to client.||Pleasure, interest-directed.|
|Structure ofrelationship||Nurse provides care to client.||Spontaneous, unstructured.|
|Power of balance||Unequal: nurse has more power due to authority, knowledge, influence and access to privileged information about client.||Relatively equal.|
There are five components to the nurse-client relationship: trust, respect, professional intimacy, empathy and power.
Regardless of the context, length of interaction and whether a nurse is the primary or secondary care provider, these components are always present.
Trust is critical in the nurse-client relationship because the client is in a vulnerable position. Initially, trust in a relationship is fragile, so it’s especially important that a nurse keep promises to a client. If trust is breached, it becomes difficult to re-establish.
Respect is the recognition of the inherent dignity, worth and uniqueness of every individual, regardless of socio-economic status, personal attributes and the nature of the health problem.
3. Professional intimacy.
Professional intimacy is inherent in the type of care and services that nurses provide. It may relate to the physical activities, such as bathing, that nurses perform for, and with, the client that creates closeness. Professional intimacy can also involve psychological, spiritual and social elements that are identified in the plan of care. Access to the client’s personal information also contributes to professional intimacy.
Empathy is the expression of understanding, validating and resonating with the meaning that the health care experience holds for the client. In nursing, empathy includes appropriate emotional distance from the client to ensure objectivity and an appropriate professional response.
The nurse-client relationship is one of unequal power. Although the nurse may not immediately perceive it, the nurse has more power than the client. The nurse has more authority and influence in the health care system, specialized knowledge, access to privileged information, and the ability to advocate for the client and the client’s significant others. The appropriate use of power, in a caring manner, enables the nurse to partner with the client to meet the client’s needs.