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You are a school nurse. A student comes into your office and is hesitant to share his thoughts with you. What could you say or do to develop a therapeutic alliance?
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It’s a challenge when it comes to opening up to someone and say out your thoughts and emotions. It is usually as a result of trauma, fear of judgment, discomfort in the therapeutic environment and cultural or religious norms. It is normally the duty of the therapist or the nurse performing the therapy to eliminate any viable condition that may bring discomfort to the patient and cause him/her not to open up and be reluctant in seeking help.
As a nurse, to ensure that the student will feel safe and supported (Pihlaja et al., 2018). One way is by making the student feel more welcomed by ensuring the surrounding environment is calm and provides a sense of protection and most importantly, provides privacy. Build up a bond with the student. After creating a strong bond with the patient, ensure keeping a strong bond by not judging the client and retain yourself from exposing your own emotions as this will make the student get insecure about himself/herself.
Get to know what the student is hoping to achieve at the end of the therapy. This will provide you with a goal and a plan on how to handle your patient. Questions to the patient should vary and make the communication feel less of an interrogation and more of an interview with an interested person. Lastly, focus on the client’s needs and ensure that the client feels accepted and not rejected as this will hinder the patient from opening up and maybe even lead to creating a bigger problem for the patient. It’s also important to refer the student to another therapist if you find out you won’t be able to help out with the problem (Leonard et al., 2018).
Reply 2 Brittany:
This discussion is right up my ally because I have been a pediatric nurse for five years and a school nurse for two years. I encounter this very situation often,especially when working in schools with higher poverty rates, a higher amountof students who have more emotional and intellectual needs and students who have experienced trauma or a destructive homelife. It is never an easy situation to address but my ultimate goal is to help that student to the absolute best of my ability. I start by ensuring them that they are in a safe place and letting them know I am trustworthy and responsible for their care. I try to relate to them and make them feel like they are being herd and their thoughts and feelins are valued. I am also honest with them,for example if a student indicates the intent for self harm I calmly listen, allow them to express their feelings, ensure them that I am here for them and they are safe and with that I also inform them for their safety we have to report these thoughts.to better assist their wellbeing. I build my theraputic alliance with all my students simply by trust, empathy, honesty and ensuring their safety. When working as a school nurse this can be challenging becasue their are many factors you have to consider in order to build a good relationship, developmental stages being a huge consideration when attempting to care for children at different ages and with different needs. Pediatrics is my specialty, I have always practiced with innocence, nuturing, compassion and kindness and I believe these personal traits are why I do best working in pediatrics. I also believe children are the most vulnerable popualtion of our society and they need good advocates who can stand up and fight for them when they dont have the capabilty to do it for them selves. As I have two children of my own, one with developmental and emotional needs I can also perspanlly relate from a parenting standpoint which I feel also helps me to have the ability to work and relate to children successfully.
It is stated by the family institute of behavioral health “Dr. Edward Bordin, defined a good therapeutic relationship as consisting of three essential qualities: an emotional bond of trust, caring, and respect; agreement on the goals of therapy; and collaboration on the “work” or tasks of the treatment.” What this means to me is as providers it is our responsibility to treat our patients with a holistic approach in order to build a solid patient-provider relationship and achieve the best possible outcomes for our patients. Providers need to see the patient as a whole, not just the physical aspects that appear in front of them in the moment. All components of a patient’s well being have to be considered and respected when it comes to providing good quality care. This includes taking into consideration the patients physical,emotional,social, psychological and cultural needs. Good providers must also listen to their patients and demonstrate empathy in their care. If these needs are not met and the patient senses disconnect or unimportance with the provider, the patient-provider relationship will fail which could lead to gaps in care, poor communication, non compliance and even medical errors.