Relational Practice Beyond Introductions and Interviewing

study-guide.pdf

Relational Practice

Beyond Introductions and Interviewing

hese modules are intended to support the continuing education of Alberta’s Licensed Practical Nurses.

This course is a refresher and is not a substitute for accreditation or training. Always follow your

employer’s policies and procedures.

© College of Licensed Practical Nurses of Alberta 2018

Summary

Relational practice is a philosophical approach

to engaging clients in their health journey

whether in regard to wellness or acute or chronic

illness. Through partnering, both the nurse and

client gain insight into coping, adaptation, beliefs

and the client’s personal, subjective experiences

with health, illness and the health care system.

Relational practice occurs within the nurse-client

dyad as well as with the entire care team. The

client and client issues are always the focus. 

Chapter 2: Review of Core Relational Practice Skills

Overview

This chapter helps LPNs become even more

familiar with the concepts of the relational

practice approach. As you work through it, you’ll

begin to notice how your knowledge is being

enhanced; it is being improved by gaining new

knowledge beyond the foundational knowledge

you already have.

Topics in this Chapter:

1) Relational Practice

2) Posing Questions

3) Rapport

Topic #1: Relational Practice

The concept of relational practice has gradually

been introduced to nursing practice over the

years. It is a fresh approach to engaging with

clients and others in the LPNs work world.

Relational practice is not just about

communication, but about being with clients

authentically and fully as they experience their

health in wellness or in illness. It is based in the

context of the client’s life and experiences with

health (Doane, G.H.and Varcoe, C., 2007). In other

words, relational practice is about how the LPN

gains an appreciation of the whole client in his or

her health experience. (Jonsdottir, H., Litchfield,

M. and Pharris, MD, 2004). Furthermore, the

nurse is ‘in relation’ with all members of the

client’s care team.

Relational practice takes a participatory stance

(Jonsdottir et al., 2004). This means the LPN will

be working with the client and the team as a

participant in the client’s journey to health.

Partnership with clients includes a fuller sense of

mutuality in the relationship. The client is able to

share concerns not always directly related to care

in the here and now, but to aspects of his or her

Being ‘in relation’ to and with the entire team brings

satisfaction and cohesion.

life that impinge upon it. LPNs appreciate that

clients often come with chaotic or complex

backgrounds and needs. Through relational

practice, the nurse actively wants to know more

about this. Why? Because optimal client

outcomes requires awareness and consideration

of all factors that can positively or negatively

impact recovery, rehabilitation or maintenance of

health. Through relational practice, client insight

can be improved. Most professional, interpersonal relationships theories identify and value

partnering but the end goal is not as extensive or

far-reaching as this.

One important element of relational practice is

nursing presence – the nurse’s availability and

openness to partnering with the client on his/her

health journey. Being fully present is a term

(nursing jargon) that means the nurse puts aside

all other matters and tasks when engaging the

client. This is not an easy thing to do. Attentivelistening and genuine caring necessitates it! Being

fully present and available, communicates the

value the LPN puts on him or her. The relationship

is enhanced.

All nurses work with intentionality: they have

intent for most of their interactions with clients.

They know what they want to learn or do prior to

engagement. However, relational practice

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CLPNA Relational Practice – P a g e | 7

requires the LPN to spend more time with the

client, rather than just interacting over tasks or

procedures. This nurse has the intention of

coming to know the client more holistically; more

deeply in the context of his/her life. To clarify, an

interaction from this perspective advances

beyond those interpersonal skills used for

interviewing, checking in and having brief

conversations (although these remains in the

nurse’s repertoire).