and reflect feelings back to the individual
Speak calmly and slowly and avoid technical language
Maintain professional boundaries
Touch Point
Clear attention to the individual and a genuine interest will help to establish a rapport.
Figure 3.2 The OARS model of motivational interviewing.
Take Note
Maintaining Professional Boundaries
Maintaining professional boundaries is essential in the nurse–patient relationship. The lines of professional behaviour can be easily blurred. Crossing professional boundaries can be subtle and not easily recognised. Care is so varied, and the nursing associate will at some point perform intimate tasks or procedures on patients, spending time to develop trust and a therapeutic relationship. The nursing associate must always consider the boundaries of a professional and therapeutic relationship in terms of being underinvolved or overinvolved with their patient’s care. The nursing associate must recognise if they are building a personal relationship with a patient and should understand the implications of doing so. The nursing associate must always ensure their patient’s care, treatment and needs, which are paramount. Should the nursing associate find it difficult to maintain a therapeutic and professional relationship, they must request help and support and step away from the situation. The following are examples to assist the nursing associate in understanding if they are at risk of breaching a professional boundary:
Agreeing to contact or meet a patient out of the working environment
Discussing other colleagues or your working environment negatively
Engaging in discussions regarding your personal life in detail
Giving one patient more time than another unnecessarily
Agreeing to keep secrets with a patient
Accepting a friend request on social media
Receiving gifts (Nursing and Midwifery Council 2018b)
The 6Cs
Healthcare and social care in the United Kingdom are constantly changing and evolving. Government policy, technological advancement, demographics, patterns of disease and life expectancy all play a part in the everchanging demands on healthcare and social care. These demands are faced by the professionals who support individuals and groups in healthcare and social care settings. What is constant amongst all this change is the commitment to always deliver excellent care.
Yellow Flag Beliefs and values
Source: National Health Service (2016). Public Domain
The 6Cs of nursing arose out of a need to ensure that high standards of care were consistently delivered. This was in the wake of damming reports of care from the Frances Report (Mid Staffordshire NHS Foundation Trust 2013) and the Cavendish Review in the same year, which highlighted failings in the delivery of care and the subsequent lack of public confidence in the services (Department of Health 2013). The Chief Nursing Officer for England and the Director of Nursing for the Department of Health, Public Health England, identified the core values that underpin nursing care:
Care
Compassion
Competence
Communication
Courage
Commitment
Each value is equal, not one is more important than the other. They focus on putting the person being cared for at the heart of the care they are given. Figure 3.2 shows the person at the heart of the 6Cs. Nurses have been praised for their application and leadership in applying the 6Cs in their everyday encounters with patients, and the inherent values have been rolled out to all staff who engage in healthcare and social care. Figure 3.3 highlights the person at the heart of the 6Cs.
Supporting Evidence Clinical Leaders Network 2014
The 6Cs belong to everyone working in the healthcare and social care services. They belong to all health and care staff from nurses, midwives, doctors, porters, care staff, physiotherapists, dieticians and managers, both clinical and non‐clinical, to executive Boards and commissioning Board.)
Source: http://www.cln.nhs.uk/6csforeveryone/ (accessed September 2019
Figure 3.3 The person is at the heart of the 6Cs.
Care
Often described as the core activity in healthcare and social care, the concept of care can be difficult to pinpoint. When asked to define what nurses do, for example, the response is often that they care for people. While this is true, it is a very narrow idea of what caring is. In this text, there is a unit which focuses on the ‘care and support with hygiene and the maintenance of skin integrity’. This implies that caring is related to physical aspect of hands‐on support; however, if one acknowledges the therapeutic nature of care, as described earlier in this chapter, there is a suggestion of the unique bond that nurses and individuals have in the delivery of care. Indeed, when supporting hygiene and skin integrity needs, the nurse is delivering support within all the domains of health: physical, psychological, social, spiritual, mental, sexual and societal health. Care is overarching in this sense and cannot work in isolation without input from the other Cs. People should be able to trust in the care that is delivered, and care should be timely, respectful, and competently delivered, with the person at the core of all interactions.
Orange Flag