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The goal of this ward is to assist elderly patients in adapting to their functional capacities and lifestyle abilities, in order that they can achieve the maximum possible degree of quality of life in the community setting following discharge (Routasalo et al., 2004).Consequently, numerous health professionals provide an input into the care pathway, including physiotherapists, occupational therapists and physicians, in addition to nursing staff (Hershkovitz et al., 2007).Mc Klindon & Barnsteiner (1999) suggest that the therapeutic relationship needs to be a two-way, reciprocal relationship at all times, involving nursing staff, the patient and their family, where appropriate.
These elements may be more profoundly encountered by nursing staff on hospital wards due to their prolonged exposure to specific patients and their in-depth interactions in the patient care journey, when compared to other members of staff who may have less face-to-face time with individuals (Pelzang, 2010).
Within the setting of the elderly rehabilitation ward, many patients are transitioning from an acute or chronic care scenario to community care and require additional, specialist assistance in doing so (Mc Cormack, 2003).
Hence, the relationship between a nurse and patient should fit into the patient-centred model of care, where patients are not only listened to within a clinical decision-making context, but are actively encouraged to participate in their own care pathway (Mc Cormack & Mc Cance, 2006).
The therapeutic relationship encompasses three important domains of care: physical, psychological and emotional care (Pelzang, 2010).
Communicating effectively with patients in the elderly rehabilitation setting was a massive responsibility and challenge for the author, as this was their first encounter with such patients in this setting.
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The expectation of knowledge in this setting was high and it could be frustrating to patients who want answers from a junior or inexperienced practitioner (Mc Cormack, 2003; Leach, 2005).
Consequently, nursing staff in this ward are exposed to patients for extended periods of time and need to consider the holistic aspects of care in order to achieve successful rehabilitation (Cott, 2004).
Therefore, the therapeutic relationship in this context involves establishing the capabilities of the patient, working with the patient to achieve set goals, and ensuring that the psychological and emotional aspects of chronic illness or disability can be managed effectively in the long term (Mc Cormack & Mc Cance, 2006).
In light of the definition of the therapeutic relationship within the context of rehabilitation, the remaining sections of this paper will evaluate the core aspects involved in maintaining a therapeutic relationship, with this section focusing on communication between nurse and patient.
The specific clinical scenario the author has struggled with in the rehabilitation placement is when a patient has higher expectations than they should in terms of their ability to perform tasks or live independently following discharge.