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In order to fully appreciate the need for a therapeutic relationship it is important to define this relationship in a practice context.The term is often used within the context of psychiatric or psychological therapy distribution in modern literature, although the aim of this paper is to consider the term as a more general way in which nurses communicate and interact with patients to establish a clear clinical outcome (Bulmer Smith et al., 2009).
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.
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).
The model in this case will be that devised by Gibbs (1988), which has been validated as a useful tool for personal practice development and goal-setting in the clinical domain (Foster & Hawkins, 2005).
This model emphasises a step-wise approach to reflection, encompassing: description, feelings, evaluation, analysis, conclusion and action plan formulation (Gibbs, 1988).
The opposite is also true, whereby overly expressive patients may limit the nurse-led component of the communication episode; both parties need to be good at communication for a perfect mutual appreciation of ideas to occur (Sheldon et al., 2006).
In practice this may be difficult to achieve, but the obligations of the nurse to facilitate this process are a core component of the therapeutic relationship.
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.
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).