Clinical placements

Never give up trying to form therapeutic relationships with patients

Caring for an older patient with Alzheimer’s disease taught Georgina Mercy the value of perseverance in the nurse-patient relationship.
dominos

Caring for an older patient with Alzheimers disease taught Georgina Mercy the value of perseverance in the nurse-patient relationship

I was working on a medical ward for older people in my first year of training when a patient, who I will call Joyce, was admitted following a fall.

Joyce had a fracture of the distal radius and acute and chronic confusion. She was in the early stages of Alzheimers disease and would become agitated, wandering around the ward searching for scissors to remove her plaster cast, or wanting to go outside.

Joyce required observation, so I was asked to watch her. But this seemed to make her agitation worse, and she kept asking me why I was following her around and why I could not provide her with

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Caring for an older patient with Alzheimer’s disease taught Georgina Mercy the value of perseverance in the nurse-patient relationship


A game of dominoes proved instrumental in forming a relationship with a patient. Picture: iStock 

I was working on a medical ward for older people in my first year of training when a patient, who I will call Joyce, was admitted following a fall.

Joyce had a fracture of the distal radius and acute and chronic confusion. She was in the early stages of Alzheimer’s disease and would become agitated, wandering around the ward searching for scissors to remove her plaster cast, or wanting to go outside.

Joyce required observation, so I was asked to watch her. But this seemed to make her agitation worse, and she kept asking me why I was ‘following her around’ and why I could not provide her with scissors.

I listened to Joyce and tried to be understanding, using verbal and non-verbal communication, but after 3 hours I started to burn out. 

Sensory stimulation 

The ability to build up effective therapeutic relationships with patients is a core nursing skill. Joyce behaved negatively towards me, and I was becoming frustrated by the emotional barrier between us. 

But I persevered, and on one occasion managed to persuade Joyce to sit down in the day room and play a game of dominoes with me. At first she struggled to remember how to play, but then it slowly came back to her and she was playing well. 

Through interacting in this way we started to form a more connected relationship, and eventually started to view each other as professional friends. Joyce told me how she had lost two husbands, but had remained independent. She said ‘you just have to get up and go to work and get on with it, even though life can be cruel’. 

Through the use of sensory stimulation and distraction, Joyce became much calmer, even laughing with me as we played the game. I was also aware of how my thoughts and feelings towards her changed for the better.

Beyond theory

This experience taught me the value of never giving up when trying to form therapeutic relationships with patients, and always doing your best to communicate.  

By listening to and communicating with Joyce as well as attending to her mental and physical needs, I practised compassionate and holistic care, which helped build a trusting interpersonal relationship between us. I empathised with her feelings, practised resilience in actively listening to her distress, and used self-awareness to empower her and help relieve her anxieties. 

Although my interpersonal skills had deteriorated when I started to become frustrated with Joyce’s behaviour, self-awareness enabled me to challenge these negative emotions and form a therapeutic relationship with her. 

I realised that learning about therapeutic techniques in university is not enough. You have to put them into practice, no matter how difficult it may be at times, to provide high quality care. 


Georgina Mercy is a second-year nursing student at the University of Brighton 

 

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