A therapeutic relationship with a patient demands patience from the nurse. This is because, the client’s needs come first in this instance. The nurse needs to listen more and understand the experience the patient may be going through. This means that a patient like Alice needs a female nurse who understands that Alice is in denial. (Varcarous) Alice may be in in denial and Mike is likely to have been an emotional abuser. This is because he is later able to make Alice doubt her memory and even believes that Mike must have had a reason to beat her. This is a very difficult situation to deal with but the period of hospitalization for Alice will work in her favor. With this information in mind, as a nurse, it is important to gradually earn the trust of Alice. This can be achieved by being a good listener and gradually introducing the idea of therapy. As a nurse, it is important to realize that Alice being in denial may later fall into depression or even suffer a mental breakdown. Developing a relationship means that as a nurse, empathy and compassion have to be constantly present. This will mean that the nurse and Alice talk about her state regularly and gradually Alice will be convinced that she needs help. Once she acknowledges that she has a problem and needs help, she will accept therapy. This is an important phase of Alice’ treatment seeing that her failure to find fault with Mike almost cost her life.
As a nurse, Alice’ physical recovery is of utmost importance. This is because with damaged kidneys, Alice is weak and needs close attention. (Joint Commission Panel for Mental Health) In addition to physical recovery, mental recovery is also important. She needs to process her physical injury so that she can clearly understand why she needs therapy. The nurse should always try to see whether Alice believed Mike more than her own memory or not. In the case where she believes Mike’s story, the nurse can systematically explain the injuries and how Mike’s version of the story does not explain what happened. This will make Alice realize that she needs to get physically well and then continue on therapy. The problem discussion with Alice should result in Alice taking active part in discussing the solutions. In order to restore Alice to her normal routine, she will needs to implement the solutions suggested by the burse with her approval. The first thing should be to report Mike and file a restraining order against him. This is because, being the manipulator he is, he will lure her back into his grip and she may not survive the next attack. Developing a normal routine will mean that she will have to attend therapy regularly at the beginning. This is to ensure that her desire to seek help does not fade in the process.
The nurse can have an explanation of the character of Mike for Alice. Discussing Mike’s character and probably a disorder will mean that Alice understands that Mike is manipulating her. Once she gets that Mike may have a psychotic problem, she will most likely understand that he may not have done it willingly and it is something she cannot control. This will make her stop blaming herself for getting injured/ as a nurse empathy and being non-judgmental is very important. This will make it easy for Alice to open up and gradually realize that indeed she needs help and is getting it from the right person. This kind of intervention will restore Alice to a daily routine that she can easily work with.
Treatment Plan according to the guidelines below:
Identified Problem # 1: Alice is at risk for physical and emotional abuse.
Behavioral Definition: Alice is in denial due to emotional manipulation by Mike.
1. The first long term goal is to restore Alice’ independence. This will mean Alice being able to live her life without relying on a man for anything.
2. Alice also needs therapy to restore her self- esteem. This is because, if she had it, she would have realized that Mike was not a good person when he reacted as he did in prior to attacking her
Joint Commission Panel for Mental Health. (n.d.). Therapeutic Interventions. Retrieved from Joint Commission Panel for Mental Health: www.jcpmh.info/commissioning-tools/cases-for-change/mild-to-moerate-problems/what-works/therapeutic-interventions/
Psychology Today. (2017). Therapeutic Intervention. Retrieved from Psychology Today: www,psychologytoday.com/therapy-types/therapeutic-intervention
Varcarous, E. M. (n.d.). Developing Therapeutic Relationships. In E. M. Varcarous, Psychosocial Nursing tools (pp. 155- 168). http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.456.8724&rep=rep1&type=pdf.
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