‘Partnership’: a co‐operative inquiry between Community Mental Health Nurses and their clients. 2. The nurse–client relationship

Abstract

This paper describes the output of a co-operative enquiry between Community Mental Health Nurses and their clients. Two nurses and two clients volunteered to participate as co-researchers and co-subjects with two facilitators in a co-operative inquiry group. The subject of the inquiry, agreed by the group, was the relationship between the nurse and client. The description of the nurse-client relationship and the influences on it is extremely rich and potentially useful with implications for clinical and managerial practice. Despite the limitations of the study, co-operative inquiry appears to be a useful vehicle for contributing to an increased understanding of the nurse-client relationship with potential for further research and development. Unsurprisingly, when both the relationship characteristics and the health care context are appropriate there seems to be more positive outcomes for both nurse and client. Within the current health policy context there are increased external demands with the potential to disrupt this relationship. Nurses need to be aware of the potential effects of these so that the relationship and the client do not suffer and health service managers need to be aware of the contribution their behaviour may have on the nurse-client relationship.

To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings

“…If nurses lack patience and understanding in such situations, patients adjust their behaviour in order to gain benefits (Hörberg et al 2012) and hide their suffering for fear of misunderstanding and rejection (Hostick & McClelland 2002). Not being able to express suffering verbally also contributes to the development of destructive emotions (Carlén & Bengtsson 2007) and to a perception of the nurse as a guard rather than a caregiver (Hörberg et al 2004).…”

Patient-Nurse Collaboration in Nursing Practice: A Korean Study

“…There are indications that patients' involvement and participation in health care decision making have a positive influence on patient satisfaction, goal attainment, and experiences with care (Alexy, 1985;Langer & Rodin, 1976;Mahler & Kulik, 1990;Robert & Krouse, 1989). A study described the co-operative enquiry between community mental health nurses and their clients in which they involved work as co-researchers and co-subjects would have the potential effects on personal growth and development of both the clients and nurses, referencing to the results by analyzing summary paper content produced from the group enquiry meeting (Hostick & McClelland, 2002).…”

Therapeutic Alliance in Mental Health Nursing: An Evolutionary Concept Analysis

“…An effective nursing alliance involves such a process and unity (Callery & Milnes, 2012;Cole, 2006;Doherty, 2009;Gardner, 2010;Madden, 1990;Shattell, Starr, & Thomas, 2007 & Wood, 2010). The term 'partnership' symbolises the process and unity of a therapeutic alliance, representing equality, mutual agreement, collaboration and interpersonal engagement (Conway, 1998;Hostick & McClelland, 2002;Shanley & Jubb-Shanley, 2007;Shanley & Jubb-Shanley, 2012;Surtees, 2007). This partnership continues throughout the course of care, and the nurse dynamically adjusts the course of the partnership to the consumer's health situation and needs.…”

“…Throughout the literature, certain qualities and characteristics of interactions and relationships are emphasised as necessary for a therapeutic alliance; qualities such as: rapport, understanding, a non-judgemental attitude, friendliness, compassion, acceptance, trust, respect, empathy, honesty, warmth and hope, are frequently cited components of a therapeutic alliance or an effective nursing relationship (Anderson & Funnell, 2008;Bennett, 2012;Brown & Wissow, 2012;Callery & Milnes, 2012;Cravener, 1992;Doherty, 2009Doherty, , 2010Gardner, 2010;Hewitt & Coffey, 2005;Hosking, 1993;Hostick & McClelland, 2002;Madden, 1990;Shattell et al, 2007;Spiers & Wood, 2010). Relationships rich in these characteristics are foundational to facilitating therapeutic change (Anderson & Funnell, 2008;Hosking, 1993), and a nurse's awareness and mastery of the mechanisms of therapeutic interaction is necessary (Hewitt & Coffey, 2005;Hosking, 1993;van Meijel et al, 2009).…”

“…A recurrent theme in the literature regarding contextual requirements is that therapeutic alliance develops over a considerable length of time or in care contexts which involve sustained nurse-consumer contact (de Leeuw, Van Meijel, Grypdonck, & Kroon, 2012;Encinares & Lorbergs, 2001;Hewitt & Coffey, 2005;Hostick & McClelland, 2002;Shattell et al, 2007), such as in the context of long-term community nursing (Gardner, 2010) or such as that in primary nurse or 'keyworker' models (Thurston, 2003). Therefore, whether in the in-patient or out-patient setting, nurses must be supported with staffing routines and procedures that maintain consistency in relationships with consumers (Madden, 1990;Ramjan, 2004;Spiers & Wood, 2010).…”