HLTH 3621: Relational Practice
Instructions Assignment 2:
Communication to Support Professional Nursing Relationships (20%)
Introduction
This assignment is completed in three parts. In Part A you will review a case study that
that focuses on therapeutic communication and behaviours that contribute to an effective nurse client interaction. Next, in Part B, you will then examine appropriate professional boundaries in
the context of therapeutic nurse-client relationships and learn about strategies that contribute to
appropriate, professional nursing relationships. Part C is the marked component of the
assignment where you apply information you learned in Part A and Part B to address
professional boundaries and the effective use of therapeutic communication in an inappropriate
nurse-client relationship.
By completing the assignment, you will apply your own practical and theoretical
experience to the information you have learned about therapeutic communication and standards
of practice. You will also have the opportunity to evaluate your previous professional practice
against the standards set by the British Columbia College of Nurses and Midwives (BCCNM). In
particular, the practice standard boundaries in the nurse-client relationship (BCCNM, 2018).
This practice standard is one of 17 BCCNM practice standards (BCCNM, 2022). Learning about
the other standards provides you with a broad understanding of the standards for practice
required of nurses in BC.
The assignment ties back to the course and learning through the following learning
objectives:
• Analyze the contribution of nursing stereotypes to power and empowerment in
nursing relationships.
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 2
• Understand the relevance of advocacy and social justice to nursing as caring,
relational practice.
• Identify and describe ways in which nurses are leaders when working with clients
as individuals, families, groups or communities.
• Review the key principles and processes of communication and therapeutic
communication in nursing.
• Assess and reflect on your preferred communication style.
Future assignments build off this assignment through improved writing skills and the
ability to communicate and understand better. Your memory and ability to think critically are
developed (e.g., enhanced cognitive and analytical abilities). Research traits such as using
the library, websites, and finding credible reference material are enhanced. Completing
assignments builds study habits like methods of study, hours of study and location of study.
Time management, planning, and organizational skills are learned along with personal
responsibility.
The assignment benefits your learning through such means as awareness and knowledge
about the topic, reinforcing skills, concepts and information, and because application of real life
examples improves learning. Writing deepens thinking and increases engagement with the
course material. Furthermore, the process of writing assignments can operate to improve your
online discussions. While doing assignments can be stressful, look at them as the opportunity to
learn useful skills that will help you in future.
Part A: Case Study, Analysis of Communication Behaviors
Background
Part A prepares you for Part C of the assignment. Part C is the marked component of
the assignment. Part A is not submitted or marked by the course OLFM.
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 3
In Module 2 Topic 1: Communication in Nursing you watched Bevel Up – Drugs, Users
and Outreach Nursing (BC Center for Disease Control and National Film Board of Canada,
2007). For this part of the assignment you will analyze communication behaviors (thinking,
feeling, and acting) of the street nurses in the film. The resource is “an award winning
documentary and learning resource to help healthcare workers deliver compassionate care to
people who use drugs” (Government of Canada, 2019). You can read more about the resource
on the Government of Canada website. To access the video, go to the National Film Board of
Canada (NFB) website and search for Bevel Up – Drugs, Users and Outreach Nursing. You will
need to become a member of the NFB, although membership is free.
Instructions
1. Communicating in difficult settings. Review Chapter 2 – Wheels & Barry of Bevel Up –
Drugs, Users and Outreach Nursing. This chapter looks at the difficulty street nurses
have with doing their job in the context of hotels, parks, alleys, etc. The two scenarios
showcase the communication skills the nurses used to obtain a blood sample.
2. Client targeted communication. Choose either the Wheels or Barry scenario. Think about
the approach of the nurse in terms of her choice of words and verbal and non-verbal
behaviour.
3. Communicating with aggressive clients. Imagine, if you were the nurse seeking the
blood sample, what would you do if the client behaved aggressively. Describe what
being aggressive would look and sound like, and what you would do in terms of selected
words, and your verbal and non-verbal behaviour in response. Record your responses in
your personal notebook. You are encouraged to refer to the various sources of
information provided, to date.
4. Communicating with passive clients. Imagine, if you were the nurse seeking the blood
sample, what would you do if the client behaved passively and ignores your request.
Describe what this response would look and sound like, and what you would do in terms
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 4
of language, verbal and non-verbal behaviour in response. Record your responses in
your personal notebook. You are encouraged to refer to the various sources of
information provided, to date.
Part B: Understanding Appropriate Use of Professional Boundaries
Background
Part B prepares you for Part C of the assignment. Part C is the marked component of
the assignment. Part A is not submitted or marked by the course OLFM.
The nurse-client relationship is often referred to as the foundation of nursing practice.
This part of the assignment helps you to understand what boundaries are in the nurse-client
relationship and how to set and maintain boundaries. As well, by reflecting on your practice, you
can identify areas that have been done well and areas that could be improved on.
Instructions
1. Therapeutic communication and boundaries. Watch the webcast on the practice
standard of professional boundaries developed by the College of Nurses of Ontario
(2007). Focus on therapeutic communication and maintaining boundaries. Record your
reflections on the nurse-client therapeutic communication and professional boundaries
with clients in your personal notebook.
2. Professional relationships. Review the resources on the BCCNP (2022) website on
nurse-client relationships. Record your reflections on professional boundaries with
clients in your personal notebook.
Part C: Therapeutic Responses to Inappropriate Nurse-client Relationships
Background
Part C is the component assignment two that is marked by the course OLFM. In Part C,
you will create a case story, examine therapeutic responses to inappropriate nurse-client
relationship.
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 5
Students will examine two types of inappropriate nurse-client relationships: boundary
crossings and boundary violations. According to BCCNM, nurses can violate boundaries in 10
different ways related to their behavior (2018). The ways are as follows.
• Favouritism
• Physical contact
• Friendship
• Socializing
• Gifts
• Dating
• Intimacy
• Disclosure
• Chastising
• Coercion
Instructions
1. Assigned boundary. Go to the A#2 Assigned Boundaries document to locate your
assigned boundary type e.g., boundary crossing gifts: Virginia.
2. Reflection. Reflect on a past nurse-client relationship (preferably although can be
potential) that involved your assigned boundary. This relationship should be described
from your position as the nurse involved in the inappropriate nurse-client relationship
and not as an observer of a colleague in an inappropriate nurse-client professional
relationship.
3. Case study (15 marks).
a. Create a case study around your assigned boundary by including information that
contributed to the problem of an inappropriate relationship. A case study for the
purposes of this assignment is: A research method involving an examination of a
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 6
particular case to gain a better understanding of a subject or process. The case
study should be presented in an efficient, narrative form using full sentences. Use a
chronological approach with a beginning, middle, and an end. Incorporating direct
quotes is a great way to tell your or your client’s own story.
b. Review the points below before creating the case study so that you can include
information that allows you to answer the questions.
As case studies vary widely in terms of style, tone and format, there is no one way to
write the case study for this assignment.
Include, for instance, in your description:
a. The care situation (include relevant contextual factors).
b. Characteristics and behaviour of the nurse (you are the nurse in the case study).
c. Characteristics and behaviour of the client.
4. Analysis of case study: Communication CNO and BCCNM (20 marks).
a. Examine your communication in terms of the components of the therapeutic
relationship according to the CNO (2011) resource. Clearly identify the components.
b. Examine your communication in terms of the components of the nurse-client
relationship. Clearly identify the components.
c. Identify and discuss a cue in the case study that related to Boundaries in the Nurse Client Relationship Practice Standard Principle 2.
2. Nurses are responsible for beginning, maintaining and ending a relationship with a client in a
way that ensures the client’s needs are first.
5. Analysis of case study: Communication boundary infraction (20 marks).
a. Identify the verbal/non-verbal communication strategy or behavior that violated or
crossed the boundary. Examine how the violation could have harmed both the nurse client relationship and the client.
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 7
b. Identify and discuss a verbal/non-verbal communication strategy or behavior to 5a.
that would have helped avoid the boundary violation or crossing. Provide reasons or
rationale to support your choice.
c. Identify the most appropriate therapeutic communication strategy that you could
have used to repair or resolve the boundary violation or crossing. Provide reasons or
rationale to support your choice.
6. Analysis of case study: Intervention (20 marks).
a. Determine whether the best intervention was to maintain, re-establish, or terminate
the nurse-client relationship. Provide reasons or rationale to support your decision.
For example, given the described circumstances, answer the question: What would
have been the best action in the interest of preventing harm or wrongdoing to the
client?
7. Analysis of case study: Lessons Learned (10 marks) .
Self-reflect on the work you did for the assignment.
a. Identify and discuss three best lessons learned about using therapeutic
communication when nursing is a relational practice of engaging in caring,
responsible nurse-client relationships.
8. Formatting, Introduction, Conclusion, Citations, and References (15 marks).
Follows formatting, introduction, conclusion, citations, and referencing conventions. For
example:
a. Portrait orientation with 1” margins on all four sides of the page.
b. PDF file.
c. Continuous text. That is, there should be no blank part blank pages.
d. Double spaced.
e. Avoid tables (unless noted in the instructions), bullets and lists.
f. Introductory and concluding paragraphs.
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 8
g. In-text citations according to the 7th edition of APA style (APA, 2022).
h. Reference list according to the 7th edition of APA style (APA, 2022).
Marking
Assignment 2 is marked according to the HLTH 3621 Assignment 2 Marking Guide. Only
numeric grades are given. The case study is worth 15 marks, the analysis of the case study 60
marks, reflection 10 marks, and formatting, introduction, conclusion, citations and references 15
marks. Comments are given on work although kept to a reasonable amount so that students
can receive their work back in a timely fashion. I welcome you to contact me to talk with you
about your ideas and improving your learning process.
Length Limitations
Assignments that go over the length set-out in the Assignment are returned without
review. They will need to be rewritten to meet the length limitation of the assignment and then
resubmitted. Five percent of the final mark will be deducted for assignments being returned for
resubmission due to being over the length specified in the assignment directions.
Length specifications are as follows.
Title Page Page 1
Introductory paragraph First paragraph page 2
Case story Begins page 2
Analysis of case study Begins page 3 and ends page 7
Conclusion Page 7
Reference list Pages 8/9
The maximum word count from page 2 to 7 is 1,500 words. The word count should
be indicated at the end of the body of your work as the last line e.g., Word Count: 1445
(following conclusion).
Submission
HLTH 3621 A#2 Instructions by Virginia Jacklin 6 September 2022 9
Submit your Assignment to your Open Learning Faculty Member for Assessment. You have
now completed Assignment 4.
Due Date
See the HLTH 3621 Study Schedule for dates.

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