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Therapeutic relations decision making: the Rainbow Framework

L G McAliley, S A Lambert, M D Ashenberg

    Pediatric Nursing
    |May 1, 1996
    PubMed
    Summary
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    Pediatric nurses face challenges in maintaining therapeutic relationships due to boundary issues. A new framework aids nurses in conscious decision-making and reviewing interactions to improve patient care.

    Area of Science:

    • Pediatric Nursing
    • Bioethics
    • Healthcare Relationship Dynamics

    Background:

    • Therapeutic relationships are crucial in pediatric tertiary care.
    • Issues like gift-giving and boundary-crossing complicate nurse-patient interactions.
    • A Midwest pediatric facility identified the need to analyze these complexities.

    Purpose of the Study:

    • To develop a decision-making framework for nurse-patient interactions.
    • To foster conscious deliberation in therapeutic relationships.
    • To provide a mechanism for reviewing non-therapeutic relationships.

    Main Methods:

    • A multidisciplinary group created a framework based on act utilitarianism.
    • The framework guides proactive decision-making in nursing care.
    Keywords:
    Professional Patient RelationshipRainbow Babies and Children's Hospital (Cleveland, OH)

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  • It offers a non-threatening method for retrospective review.

    • Main Results:

    • The framework promotes clarification of personal philosophy and values.
    • It supports deliberate, consistent, and confident nursing care delivery.
    • It serves as a basis for new patient and family care initiatives.

    Conclusions:

    • The developed framework enhances the promotion and maintenance of therapeutic relationships.
    • It empowers nurses with a structured approach to ethical decision-making.
    • This initiative can lead to improved patient and family care strategies.