Abuse in the therapeutic relationship
A therapeutic relationship is a relationship that allows for meeting nursing needs to the mutual satisfaction of the nurse and patient.
Attributes for a therapeutic relationship include respect/consideration, communication, competence, co-operation, flexibility to changes.
Relationships between nurses and patients will vary from patient to patient. The NMC recognise this and states nurses must maintain appropriate boundaries in professional relationships, this includes patient’s families and carers.
Some recommendations have been made to help nurses to maintain professional boundaries, these include:
* Keep personal information minimal
* Maintain adequate appointment system
* Offer the choice of a chaperone
* Refrain form familiarity
* Exercise caution in accepting gifts
* Be aware of patient’s vulnerability
Vulnerable adults are the most ‘at risk’ group to be abused. Those with learning disabilities, physical disabilities, hearing or sight loss, mental health problems, severe illness, old age and frailty, dementia and confusion are considered vulnerable.
Types of abuse
Physical - “any physical contact which harms clients or is likely to cause them unnecessary and avoidable pain & distress”
Psychological - “any verbal or non-verbal behaviour which demonstrates disrespect for the client.”
Verbal- “ any remark made to or about a client which may be reasonably perceived to be demeaning, disrespectful, humiliating, intimidating, racist sexist, homophobic, ageist or blasphemous”
Sexual - “forcing, inducing or attempting to induce the client to engage in any form of sexual activity”
Financial/Material - “illegal acts … also the inappropriate use of a client’s funds or resources”
Neglect - “the refusal or failure on the part of the registered nurse to meet the essential care needs of a client”
If you suspect abuse because you have general concern about someone’s well being, you see or hear...