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Rhône
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For other uses, see Rhône (disambiguation).
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Rhône (French: Le Rhône)
German: Rhone
River
View over the Rhône flowing from Valais into Lake Geneva
Countries
Switzerland, France
Source
Rhône Glacier
- elevation 2,208 m (7,244 ft)
Mouth
Mediterranean Sea
- elevation 0 m (0 ft)
- coordinates 43°19′51″N 4°50′44″E / 43.33083°N 4.84556°E / 43.33083; 4.84556Coordinates: 43°19′51″N 4°50′44″E / 43.33083°N 4.84556°E / 43.33083; 4.84556
Length
813 km (505 mi)
Basin
98,000 km2 (37,838 sq mi)
Discharge
- average 1,710 m3/s (60,388 cu ft/s)
- max 13,000 m3/s (459,091 cu ft/s)
- min 360 m3/s (12,713 cu ft/s)
The Rhône (/ˈroʊn/; French: Le Rhône [ʁon]; German: Rhone [ˈroːnə]; Walliser German: Rotten [ˈrotən]; Italian: Rodano [ˈrɔːdano]; Arpitan: Rôno [ˈʁono]; Occitan: Ròse [ˈrɔze]) is one of the major rivers of Europe and has twice the average discharge of the Loire (which is the longest French river), rising in the Rhône Glacier in the Swiss Alps at the far eastern end of the Swiss canton of Valais, passing through Lake Geneva and running through southeastern France. At Arles, near its mouth on the Mediterranean Sea, the river divides into two branches, known as the Great Rhône (French: Le Grand Rhône) and the Little Rhône (Le Petit Rhône). The resulting delta constitutes the Camargue region.
Contents
[hide]
1 Name
2 Navigation
3 Course
4 History
5 Post-World War II development
6 Along the Rhône
6.1 Switzerland
6.2 France
7 See also
8 References and notes
9 Further reading
10 External links
Name[edit]
Mouth of the Rhône
The name Rhône continues the name Rhodanus (Greek Ῥοδανός Rhodanos) in Greco-Roman geography. The Gaulish name of the river was *Rodonos or *Rotonos (from a PIE root *ret- "to run, roll" frequently found in river names).
The Greco-Roman as well as the reconstructed Gaulish name is masculine, as is French le Rhône. This form survives in the Spanish/Portuguese and Italian namesakes, el/o Ródano and il Rodano, respectively. German has adopted the French name but given it the feminine gender, die Rhone. The original German adoption of the Latin name was also masculine, der Rotten; it survives only in the Upper Valais (dialectal Rottu).
In French, the adjective derived from the river is rhodanien, as in le sillon rhodanien (literally "the furrow of the Rhône"), which is the name of the long, straight Saône and Rhône river valleys, a deep cleft running due south to the Mediterranean and separating the Alps from the Massif Central.
Navigation[edit]
Before railroads and highways were developed, the Rhône was an important inland trade and transportation route, connecting the cities of Arles, Avignon, Valence, Vienne and Lyon to the Mediterranean ports of Fos-sur-Mer, Marseille and Sète. Travelling down the Rhône by barge would take three weeks. By motorized vessel, the trip now takes only three days. The Rhône is classified as a Class V waterway from the mouth of the Saône to the sea. The Saône, which is also canalized, connects the Rhône ports to the cities of Villefranche-sur-Saône, Mâcon and Chalon-sur-Saône. Smaller vessels (up to CEMT class I) can travel further northwest, north and northeast via the Centre-Loire-Briare and Loing Canals to the Seine, via the Canal de la Marne à la Saône (recently often called the "Canal entre Champagne et Bourgogne") to the Marne, via the Canal des Vosges (formerly called the "Canal de l'Est – Branche Sud") to the Moselle and via the Canal du Rhône au Rhin to the Rhine.
The Rhône is infamous for its strong current when the river carries large quantities of water: current speeds up to 10 kilometres per hour (6 mph) are sometimes reached, particularly in the stretch below the last lock at Vallabrègues and in the relatively narrow first diversion canal south of Lyon. The 12 locks are operated daily from 5:00 a.m. until 9:00 p.m. All operation is centrally controlled from one control centre at Châteauneuf. Commercial barges may navigate during the night hours by authorisation.[1]
Course[edit]
The Rhône Glacier above Oberwald, Switzerland is the source of the river.
The Rhône flowing through the valleys of the Swiss Alps and arriving into Lake Geneva, in Switzerland.
The Rhône rises as an effluent of the Rhône Glacier in the Valais, in the Swiss Alps, at an altitude of approximately 2,208 metres (7,244 ft).[2] From there it flows south through Gletsch and the Goms, the uppermost, valley region of the Valais before Brig. Shortly before reaching Brig, it receives the waters of the Massa from the Aletsch Glacier. It flows onward through the valley which bears its name and runs initially in a westerly direction about thirty kilometers to Leuk, then southwest about fifty kilometers to Martigny .
Down as far as Brig, the Rhône is a torrent; it then becomes a great mountain river running southwest through a glacier valley. Between Brig and Martigny, it collects waters mostly from the valleys of the Pennine Alps to the south, whose rivers originate from the large glaciers of the massifs of Monte Rosa, Dom, and Grand Combin.
At Martigny, where it receives the waters of la Drance on its left bank, the Rhône makes a strong turn towards the north. Heading toward Lake Geneva, the valley narrows, a feature that has long given the Rhône valley strategic importance for the control of the Alpine passes. The Rhône then marks the boundary between the cantons of Valais (left bank) and Vaud (right bank), separating the Valais Chablais and Chablais Vaudois. It enters Lake Geneva near Le Bouveret.
On a portion of its extent Lake Geneva marks the border between France and Switzerland. On the left bank of Lake Geneva the river receives the Morge River. This river marks the border between France (Haute-Savoie) and Switzerland (Valais). The Morge enters Lake Geneva at Saint-Gingolph, a village on both sides of the border. On the right bank of the lake the Rhône receives the Venoge (river) and the Morges River.
Lake Geneva ends in Geneva, where the lake level is maintained by the Seujet dam. The average discharge from Lake Geneva is 251 cubic metres per second (8,900 cu ft/s).[3] In Geneva, the Rhône receives the waters of the Arve from the Mont Blanc. After a course of 290 kilometres (180 mi) the Rhône leaves Switzerland and enters the southern Jura Mountains. It then turns toward the south past the Bourget Lake which it is connected by the Savières channel. At Lyon, which is the biggest city along its course, the Rhône meets its biggest tributary, the Saône. The Saône carries 400 cubic metres per second (14,000 cu ft/s) and the Rhône itself 600 cubic metres per second (21,000 cu ft/s). From the confluence, the Rhône follows the southbound direction of the Saône. Along the Rhône Valley, it is joined on the right (western) bank by the rivers Eyrieux, Ardèche, Cèze, and Gardon coming from the Cévennes mountains; and on the left bank by the rivers Isère, with an average discharge of 350 cubic metres per second (12,000 cu ft/s), Drôme, Ouvèze, and Durance at 188 cubic metres per second (6,600 cu ft/s) from the Alps.
From Lyon, it flows south, between the Alps and the Massif Central. At Arles, the Rhône divides into two major arms forming the Camargue delta, both branches flowing into the Mediterranean Sea, the delta being termed the Rhône Fan. The larger arm is called the "Grand Rhône", the smaller the "Petit Rhône". The average annual discharge at Arles is 1,710 cubic metres per second (60,000 cu ft/s).[3]
History[edit]
Personification of the Rhône by Pierre Puvis de Chavannes, 1883-1886, National Museum in Warsaw, a study for decoration of the stairwell in the new wing of the Palace of Fine Arts in Lyon, a city at the confluence of the Saône and Rhône rivers
The Rhône has been an important highway since the times of the Greeks and Romans. It was the main trade route from the Mediterranean to east-central Gaul.[4] As such, it helped convey Greek cultural influences to the western Hallstatt and the later La Tène cultures.[4] Celtic tribes living near the Rhône included the Seduni, Sequani, Segobriges, Allobroges, Segusiavi, Helvetii, Vocontii and Volcae Arecomici.[4]
Navigation was difficult, as the river suffered from fierce currents, shallows, floods in spring and early summer when the ice was melting, and droughts in late summer. Until the 19th century, passengers travelled in coches d'eau (water coaches) drawn by men or horses, or under sail. Most travelled with a painted cross covered with religious symbols as protection against the hazards of the journey.[5]
Trade on the upper river used barques du Rhône, sailing barges, 30 by 3.5 metres (98 by 11 ft), with a 75-tonne (165,000 lb) capacity. As many as 50 to 80 horses were employed to haul trains of five to seven craft upstream. Goods would be transshipped at Arles into 23-metre (75 ft) sailing barges called allèges d'Arles for the final run down to the Mediterranean.
The first experimental steam boat was built at Lyon by Jouffroy d'Abbans in 1783. Regular services were not started until 1829 and they continued until 1952. Steam passenger vessels 80 to 100 metres (260–330 ft) long made up to 20 kilometres per hour (12 mph) and could do the downstream run from Lyon to Arles in a day. Cargo was hauled in bateau-anguilles, boats 157 by 6.35 metres (515.1 by 20.8 ft) with paddle wheels amidships, and bateaux crabes, a huge toothed 'claw' wheel 6.5 metres (21 ft) across to grip the river bed in the shallows to supplement the paddle wheels. In the 20th century, powerful motor barges propelled by diesel engines were introduced, carrying 1,500 tonnes (3,300,000 lb).
In 1933, the Compagnie Nationale du Rhône (CNR) was established to improve navigation and generate electricity, also to develop irrigated agriculture and to protect the riverside towns and land from flooding. Some progress was made in deepening the navigation channel and constructing scouring walls, but World War II brought such work to a halt. In 1942, following the collapse of Vichy France, Italian military forces occupied southeastern France up to the eastern banks of the Rhône, as part of the Italian Fascist regime's expansionist agenda.
Post-World War II development[edit]
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In 1948, the government started construction of a series of dams and diversion canals, with a navigation lock beside the hydroelectric power plant on each of these canals. The locks were up to 23 metres (75 ft) deep. After building the Génissiat dam on the Upper Rhône (with no lock) in 1948, designed to meet the electricity needs of Paris, twelve hydroelectric plants and locks were built between 1964 and 1980. With a total head of 162 m, they produce 13 GWh of electricity annually, or 16% of the country’s total hydroelectric production (20% if the Upper Rhône schemes are added). There have been significant benefits for agriculture throughout the Rhône valley.
With the Lower Rhône project completed, CNR turned its attention to the Haut-Rhône (Upper Rhône), and built four hydropower dams in the 1980s: Sault-Brénaz, Brégnier-Cordon, Belley-Brens and Chautagne. It also drew up plans for the high-capacity Rhine-Rhône Waterway, along the route of the existing Canal du Rhône au Rhin, but this project was abandoned in 1997. In the period 2005-2010, navigation locks of small barge dimensions (40 by 6 m) were built to bypass the last two, forming a navigable waterway network with Lake Bourget, through the Canal de Savières.
Along the Rhône[edit]
Cities and towns along the Rhône include:
The Rhône through Geneva, Switzerland
The Rhône (left) meeting the river Arve in Geneva
Switzerland[edit]
Oberwald (Valais)
Brig (Valais)
Visp (Valais)
Leuk (Valais)
Sierre (Valais)
Sion (Valais)
Martigny (Valais)
St. Maurice (Valais)
see Lake Geneva for a list of Swiss and French towns around the lake
Geneva (Geneva)
France[edit]
The Rhône in Lyon under the old Boucle's Bridge
The Rhône at Avignon
Lyon, (Rhône (département))
Vienne (Isère)
Tournon-sur-Rhône (Ardèche) opposite Tain-l'Hermitage (Drôme)
Valence (Drôme) opposite Saint-Péray and Guilherand-Granges (Ardèche)
Montélimar (Drôme) opposite Le Teil and Rochemaure (Ardèche)
Viviers (Ardèche)
Bourg-Saint-Andéol (Ardèche)
Pont-Saint-Esprit (Gard)
Roquemaure (Gard) opposite Châteauneuf-du-Pape (Vaucluse)
Avignon (Vaucluse) opposite Villeneuve-lès-Avignon (Gard)
Beaucaire (Gard) opposite Tarascon (Bouches-du-Rhône)
Vallabrègues (Gard)
Arles (Bouches-du-Rhône)
See also[edit]
Almost all affluents of more than 36 km length. → This map in 20% projection – 749 x 1114 px
Berges du Rhône
Rhône (département)
Rhône (wine region)
Witenwasserenstock (triple watershed: Rhône-Rhine-Po)
References and notes[edit]
Jump up ^ Edwards-May, David (2010). Inland Waterways of France. St Ives, Cambs., UK: Imray. pp. 210–220. ISBN 978-1-846230-14-1.
Jump up ^ "255 Sustenpass" (Map). Rhône source (online map) (2015 ed.). 1:50 000. National Map 1:50 000 – 78 sheets and 25 composites (in German). Cartography by Swiss Federal Office for Topography, swisstopo. Berne, Switzerland: Swiss Federal Office for Topography, swisstopo. 2013. ISBN 978-3-302-00255-2. Retrieved 2015-10-18.
^ Jump up to: a b "Le Rhône" (in French). Geneva, Switzerland: La fédération Genevoise des Sociétés de Pêche. March 2001. Retrieved 2015-10-18.
^ Jump up to: a b c Freeman, Philip. John T. Koch, ed. Celtic Culture: A Historical Encyclopedia. I. ABC-CLIO. p. 901. ISBN 1-85109-440-7.
Jump up ^ McKnight, Hugh (September 2005). Cruising French Waterways (4th ed.). Sheridan House. ISBN 978-1-57409-210-3.
Further reading[edit]
Champion, Maurice (1858–1864), Les inondations en France depuis le VIe siècle jusqu'a nos jours (6 Volumes) (in French), Paris: V. Dalmont Scans: Volume 3 (1861) (Bassin du Rhône starts at page 185), Volume 4 (1862).
Pardé, Maurice (1925), "Le régime du Rhône", Revue de géographie alpine (in French), 13 (13-3): 459–547 .
Pritchard, Sara B. (2011), Confluence: The Nature of Technology and the Remaking of the Rhône, Cambridge, Mass: Harvard University Press, ISBN 978-0-674-04965-9 A social, environmental, and technological history of the transformation of the river since 1945.
External links[edit]
Wikimedia Commons has media related to Rhône River.
InfoRhone Navigation and river conditions
CNR The Rhône Authority
Rhône, Petit-Rhône, and Haut-Rhône guides, with maps, detailed plans and information on places, moorings and facilities by the author of Inland Waterways of France, Imray
Navigation details for 80 French rivers and canals (French waterways website section)
The Rhône-Mediterranean page of EauFrance
Waterways in France
Authority control
WorldCat Identities
VIAF: 124711308
GND: 4103774-1
SUDOC: 027242692
HDS: 8769
NDL: 00629450
Retrieved from "https://en.wikipedia.org/w/index.php?title=Rhône&oldid=797731891"
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text:
Dave Pelzer
From Wikipedia, the free encyclopedia
Jump to: navigation, search
David Pelzer
Pelzer speaking to Airmen while visiting troops in Southwest Asia.
Born
(1960-12-29) December 29, 1960 (age 57)
Daly City, California
Occupation
Autobiographer, motivational speaker
Nationality
American
Notable works
A Child Called "It", Help Yourself
Website
www.davepelzer.com
David James "Dave" Pelzer (born December 29, 1960 in San Francisco, California)[1] is an American author, of several autobiographical and self-help books.[2] He is best known for his 1995 memoir of childhood abuse, A Child Called "It".
Contents
[hide]
1 Biography
2 Abuse
3 Books
3.1 Reception of A Child Called It
4 Controversy
5 Current life
6 Work
7 See also
8 References
9 External links
Biography
Pelzer was born in San Francisco, California the second of five boys. He grew up in Daly City, California.[3] He is the son of Catherine Roerva Christen Pelzer (1929-1992) and San Francisco fireman Stephen Joseph Pelzer (1923-1980). Pelzer's books describe the abuse he suffered for several years of childhood, including continual mistreatment and beatings by his mother, who he said thought of it as a game. His teachers stepped in on March 5, 1973, when 12-year-old Pelzer was placed in foster care. At age 18 he joined the U.S. Air Force in 1979 and served in the Gulf War.[4][5] In the 1980s Pelzer married his first wife Patsy (a pseudonym), with whom he had a son. In 1996 he carried a torch in the 1996 Summer Olympics torch relay.[6] Pelzer and Patsy divorced and many years later he married his second wife, Marsha, who was his editor.[7]
Abuse
His book A Child called "It" describes from his viewpoint the severe abuse he suffered as a child. He writes how his mother was physically and emotionally abusive towards him from ages 4 to 12. He describes how his mom starved him, forced him to drink ammonia, stabbed him in the stomach, burned his arm on a gas stove, and forced him to eat his own vomit. He mentioned that his father was not active in resolving or stopping the conflicts between Pelzer and his alcoholic mother. He was sent to a foster family at age 12 in 1973. In the book he refers to his relatives by pseudonyms.
One of Dave's brothers, Richard B. Pelzer, published his own autobiography, A Brother's Journey, that detailed his experiences. A Brother's Journey.[8] Paraphrased, Pelzer said in the afterword of his book that his objectives for his story was to show how a parent can become abusive and how the human spirit can triumph and survive.[9]
This section needs expansion. You can help by adding to it. (January 2014)
Books
Pelzer's first book, A Child Called "It" was published in 1995 and describes the abuse Pelzer suffered in his childhood. His second book, The Lost Boy: A Foster Child's Search for the Love of a Family was published shortly after in 1997. The book covered Pelzer's teen years. The third book in his series, A Man Named Dave: A Story of Triumph and Forgiveness[10] was about Pelzer's experiences as an adult and how he forgave his father. In 2001 he wrote Help Yourself: Finding Hope, Courage, And Happiness which was a self-help book. When discussing his seventh book Moving Forward he said, "My message has always been about resilience". [11]
Reception of A Child Called It
His first book, A Child Called It, was successful and garnered interest.[12] It was listed on the New York Times Bestseller List for several years and in 5 years had sold at least 1.6 million copies.[13][14] Pelzer was invited to television shows such as Montel Williams and The Oprah Winfrey Show to give interviews after the book was published.
In a 2001 news article Orion UK Publishing's Trevor Dolby said, "We get 10 letters a day from people saying the first book mirrors their own childhood, which is very depressing." [12] One reader was quoted: "(The book) made me see that I wasn't the only one out there...that had this...in their life. That there's people who do understand."[15]
Writer David Plotz criticized Pelzer in an article he wrote for Slate. In the article Plotz says that because Pelzer's parents are dead it is hard to question them.[14]
This section needs expansion. You can help by adding to it. (January 2014)
Controversy
The assertions in his memoirs have led to some skeptical commentary.[16] In a 2002 New York Times article by Pat Jordan the author questioned the reliability of Pelzer's recollections. He said that "Pelzer has an exquisite recall of his abuse, but almost no recall of anything that would authenticate that abuse", such as any details about his mother.[2] Two members of his family, his maternal grandmother and brother, have disputed his book. One of his younger brothers, Stephen, denies that any abuse took place, and says that he thinks David was placed in foster care because "he started a fire and was caught shoplifting".[2] However, his other brother Richard Pelzer is author of the book A Brother's Journey, which confirms much of what David has said and describes his own abuse when David was finally removed from the home. In regard to this, Dave has said that Stephen had affection towards his mother and that "he misses her terribly because she protected him".[7] Due to the criticism from the New York Times article Dave does not give interviews often.[7]
In an article in The Boston Globe Pelzer's grandmother said she believed Dave had been abused but not as severely as he described. She also said she didn't believe his brother Richard was abused. It was revealed, however, that Pelzer's grandmother did not live in the same state as his brothers and family and was not in contact with them when the abuse happened.[17]
An article in The Guardian notes that gaps in the background narrative "makes the foreground harder to trust".[13] The author writes, "My own hunch is that, substantially, he's telling the truth ... But there is a definite feeling of exaggeration in the later two books..." The author then states the same feeling Plotz also covered in his article, that she feels Pelzer is profiting from his abuse and minimizing the seriousness of the crime by making the writing "entertaining".[13]
Current life
Pelzer spends his time giving lectures across the country. He is also a volunteer.[7][18]
Work
A Child Called It (1995)
The Lost Boy: A Foster Child's Search for the Love of a Family (1997)
A Man Named Dave: A Story of Triumph and Forgiveness (2000)
Help Yourself (2001)
The Privilege of Youth (2004)
Help Yourself for Teens (2005)
Moving Forward (2009)
See also
Richard B. Pelzer
References
Jump up ^ "California Birth Index", www.ancestry.com : "David J Pelzer, December 29, 1960, San Francisco County, mother's maiden name Christa"
^ Jump up to: a b c Jordan, Pat (July 28, 2002). "Dysfunction For Dollars". New York Times.
Jump up ^ de Bertodano, Helena (29 March 2005). "Memories of a family at war". Sydney Morning Herald. Retrieved 5 January 2014.
Jump up ^ Dave Pelzer website bio
Jump up ^ PR Web news article
Jump up ^ Canfield, Jack (1997). A 4th Course of Chicken Soup for the Soul. HCI. p. 343. ISBN 978-1558744592.
^ Jump up to: a b c d Kellaway, Kate (February 14, 2004). "No pain, no gain". The Guardian. Retrieved 5 January 2014.
Jump up ^ [1]
Jump up ^ Pelzer, Dave (1995). A Child Called It: One Child's Courage to Survive. HCI. p. 52. ISBN 978-1558743663.
Jump up ^ Pelzer, Dave (1999) "A Man Named Dave: A Story of Triumph and Forgiveness" Published by Penguin Group; 1999, New York. ISBN 0-525-94521-0 (hc.), ISBN 0-452-28190-3 (pbk. 339 pp).
Jump up ^ Jardine, Cassandra (June 20, 2008). "Dave Pelzer: 'You don't get over it, just accept it'". Telegraph. Retrieved 5 January 2014.
^ Jump up to: a b "Dave Pelzer: Dave who?". BBC. January 27, 2001. Retrieved 5 January 2014.
^ Jump up to: a b c Bedell, Geraldine (1 September 2001). "Child abuse as entertainment". The Guardian. Retrieved 29 March 2013.
^ Jump up to: a b Plotz, David (September 29, 2000). "Dave Pelzer The child-abuse entrepreneur". Slate. Retrieved 29 March 2013.
Jump up ^ Coffel, Cynthia (2010). Thinking Themselves Free: Research on the Literacy of Teen Mothers. Peter Lang Publishing. p. 52. ISBN 978-1433109720.
Jump up ^ "Is He Making "It" All Up?". The Mail on Sunday.
Jump up ^ English, Bella (26 April 2006). "Family Feud". Boston Globe. Retrieved 5 January 2014.
Jump up ^ Sullivan, Olive (June 17, 2011). "Author Dave Pelzer visits Joplin to help aid recovery". GateHouse News Service. Retrieved 5 January 2014.
External links
Dave Pelzer's Official Website
An interview with Dave Pelzer
Audio interview with Dave Pelzer at Oprah.com
Authority control
WorldCat Identities
VIAF: 27944449
LCCN: n94079943
ISNI: 0000 0000 6317 9010
GND: 122082389
SELIBR: 243145
SUDOC: 084273097
BNF: cb144028421 (data)
NDL: 00714813
Retrieved from "https://en.wikipedia.org/w/index.php?title=Dave_Pelzer&oldid=826654266"
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Nurse–client relationship
From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
Nurse explaining information in a brochure with a client. Picture was taken by Bill Branson (Photographer).
The nurse–client relationship is an interaction aimed to enhance the well-being of a "client," which may be an individual, a family, a group, or a community. Peplau's theory is of high relevance to the nurse-client relationship, with one of its major aspects being that both the nurse and the client become more knowledgeable and mature over the course of their relationship.[1] Peplau believed that the relationship depended on the interaction of the thoughts, feelings, and actions of each person and that the patient will experience better health when all their specific needs are fully considered in the relationship.[1] The nurse-patient relationship enables nurses to spend more time, to connect, to interact with their patients as well as to understand their patient’s needs. It assists nurses to establish a unique perspective regarding the meaning of the patient’s illness, beliefs, and preferences of patients/families. Thus, the patients/families feel that they are being cared for and they feel more motivated to open up to the nurses as well as working together to achieve better outcomes/satisfaction.[2]
Contents
1 Elements
1.1 Boundaries
1.2 Confidentiality
2 Therapeutic nurse behaviours
2.1 Self-awareness
2.2 Genuine, warm and respectful
2.3 Empathy
2.4 Cultural sensitivity
2.5 Collaborative goal setting
2.6 Responsible, ethical practice
3 Clients' perspectives
4 Building trust
5 Emotional support
6 Humour
7 References
Elements[edit]
The nurse-client relationship is composed of several elements.
Boundaries[edit]
Main article: Professional boundaries
Boundaries are an integral part of the nurse-client relationship. They represent invisible structures imposed by legal, ethical, and professional standards of nursing that respect the rights of nurses and clients.[3] These boundaries ensure that the focus of the relationship remains on the client’s needs, not only by word but also by law. The College of Nurses of Ontario (CNO) Standards identifies that it is the nurse’s responsibility to establish the boundaries and limits of the relationship between the nurse and client.[4] The boundaries have a specific purpose and health goal, and the relationship terminates when identified goal is met.[3]
Any action or behaviour in a nurse-client relationship that personally benefits the nurse at the expense of the client is a boundary violation. Some examples of boundary violations are engaging in a romantic or sexual relationship with a current client, extensive non-beneficial disclosure to the client and receiving a gift of money from the client. Abuse and neglect are extreme examples. They involve the betrayal of respect and trust within the relationship. This includes withholding communication from a client because it is considered to be an example of neglect.[5]
It is the nurse’s job to be aware of signs that professional boundaries may be crossed or have been crossed. Warning signs of boundary crossing that may lead to boundary violations include frequently thinking of a client in a personal way, keeping secrets with a specific client, favouring one client’s care at the expense of another’s and telling a client personal things about yourself in order to make an impression. Anything that could comprise the client’s well-being if the relationship with a registered nurse is continued or discontinued can be considered a warning sign.[5] Boundary violations are never acceptable and it is the nurse’s job to handle any situation with any regards to it professionally and therapeutically regardless of who initiated it.
Confidentiality[edit]
This makes the relationship safe and establishes trust.[3] The patient should feel comfortable disclosing personal information and asking questions.[6] The nurse is to share information only with professional staff that needs to know and obtain the client's written permission to share information with others outside the treatment team.[7]
Therapeutic nurse behaviours[edit]
Nurse takes a client's blood pressure. This photo was taken by Bill Branson (Photographer).
Nurses are expected to always act in the best interests of the patient to maintain a relationship that is strictly with all intent to only benefit the client.[4] The nurse must ensure that their client’s needs are met while being professional.[4] Extensive research and clinical observation has shown that the body, mind and emotions are in unity. Therefore, in order to help another person, one must consider all these aspects; this means not neglecting the person and strictly just treating the illness. Caring for patients is beyond the treatment of disease and disability.[8]
The necessary knowledge aspects that are needed to maintain a therapeutic nurse-client relationship are: background knowledge, knowledge of interpersonal and development theory, knowledge of diversity influences and determinants, knowledge of person, knowledge of health/illness, knowledge of the broad influences on health care and health care policy, and knowledge of systems.
Background knowledge is the nurse’s education, and her life experience. Knowledge of interpersonal and development theory is the knowledge of theories of the sense of self and self influence on others. The specific theories are: The Interpersonal Theory, Object relation theory, Developmental theory, and Gender/developmental theory. Knowledge of person explains that nurses must take the time to understand the client, and their world; what is meaningful to them, and their history. Knowledge of Health and Illness is the knowledge that the nurse must attain about their client’s health issue. Knowledge of the broad influences on health care and health care policy explains that nurses need to be aware of the influences of the client’s care; social/political forces, expectations of health-care system, and changes in accessibility, and resources. Knowledge of Systems explains that the nurse needs to know about the health-care system so they can help their clients access services.[9] Effective communication in nursing entails being empathic, non-judgmental, understanding, approachable, sympathetic, caring, and having safe and ethical qualities.[10] The first statement of the CNO Standard is Therapeutic Communication, which explains that a nurse should apply communication and interpersonal skills to create, maintain, and terminate a nurse-client relationship.[4]
All of the aspects to a therapeutic relationship are interrelated. You cannot efficiently use one aspect without the other; they are all connected and work together to create a successful relationship. Nurses assist clients to achieve their health related goals including improving their relationship with others. "The help that nurses offer to their clients is much more than technical expertise. The relationship between nurse and client is a powerful healing force by itself.[11]
Self-awareness[edit]
Main article: Self-awareness
Self-awareness is an internal evaluation of one self and of one’s reactions to emotionally charged situations, people and places. It offers an opportunity to recognize how our attitudes, perceptions, past and present experiences, and relationships frame or distort interactions with others. An example of self-awareness would be acknowledging that showing anger is not a sign of weakness, because there were emotions outside of your control.[12] Self-awareness allows you to fully engage with a client and presence; being with the client in the moment, allows the nurse to know when to provide help and when to stand back.[3] Until individuals can fully understand themselves they cannot understand others. Nurses need self-awareness in this relationship to be able to relate to the patient’s experiences to develop empathy.[6][13] Self awareness may be the nurses's most important facet of their professional practice[14]
Genuine, warm and respectful[edit]
Highly skilled, experienced nurses must possessed certain attributes or skills to successfully establish a nurse client relationship. Attributes such as being genuine, warm and respectful are a few to mention. An aspect of respect is respecting an individual’s culture and ensuring open-mindedness is being incorporated all throughout the relationship up until the termination phase.[8] The nurse works to empower the client along with their family to get more engaged in learning about their health and ways in which it can be improved. It is highly beneficial for the client to incorporate their family, as they may be the most effective support system. Revealing your whole self and being genuine with clients will accomplish the desired nurse client relationship.[3]
Behaving therapeutically may require remaining silent at times to display acceptance, incorporating open ended questions to allow the client control of the conversation and encouragement to continue. In addition, the nurse may also reduce distance to demonstrate their desire in being involved, restating and reflecting to validate the nurse’s interpretation of the client’s message, directing the conversation towards important topics by focusing in on them. Furthermore, being polite and punctual displays respect for the client in addition to remembering to be patient, understanding, also to praise and encourage the client for their attempts to take better care of their health.[15] A primary factor in establishing a nurse client relationship is the non-verbal message or behaviours you send out unconsciously, resulting in a negative perception and may distort your attempts in effectively assisting the client to achieve optimal health. One of the non-verbal factors is listening. Listening behaviours are identified as S.O.L.E.R; S-sit squarely in relation to client, O-maintain an open position and do not cross arms or legs, L-lean slightly towards the client, E-maintain reasonable and comfortable eye contact, R-relax. These behaviours are effective for communication skills, and are useful for thinking about how to listen to another person.[10]
Empathy[edit]
Main article: Empathy
Having the ability to enter the perceptual world of the other person and understanding how they experience the situation is empathy. This is an important therapeutic nurse behaviour essential to convey support, understanding and share experiences.[6] A client to a nurse in a general sense is seeking help. Patients are expecting a nurse who will show interest, sympathy, and an understanding of their difficulties. When receiving care patients tend to be looking for more than the treatment of their disease or disability, they want to receive psychological consideration. this happens through good communication, communication with clients is the foundation of care.
During hard times, clients are looking for a therapeutic relationship that will make their treatment as less challenging as possible. Many patients are aware that a solution to their problems may not be available but expect to have support through them and that this is what defines a positive or negative experience.[16] Empathy is used as a tool to enhance the communication between the nurse and client. Past experiences can help the clinician can better understand issues in order to provide better intervention and treatment.[17]
Cultural sensitivity[edit]
Healthcare is a multicultural environment and nurses have to expect that they will care for patients from many different culture and ethical backgrounds.[8] Cultural backgrounds effect people’s perceptions of life and health. The goal of the nurse is to develop a body of knowledge that allows them to provide cultural specific care. This begins with an open mind and accepting attitude.
Cultural competence is a viewpoint that increases respect and awareness for patients from cultures different from the nurse's own. Cultural sensitivity is putting aside our own perspective to understand another person’s perceptive. Caring and culture are described as being intricately linked.[8] This is believed because there can be no cure without caring and caring involves knowing the different values and behaviours of a person’s culture. It is important to assess language needs and request for a translation service if needed and provide written material in the patient’s language. As well as, trying to mimic the patient’s style of communication (e.g. little direct eye contact, slow, quiet).[8]
A major obstacle to cultural sensitivity and good communication is ethnocentrism, which is the belief that ones ethical group is superior to another; this causes prejudice and stops a nurse for fully understanding the patient. Another obstacle is stereotyping, a patient’s background is often multifaceted encompassing many ethic and cultural traditions. In order to individualize communication and provide culturally sensitive care it is important to understand the complexity of social, ethnic, cultural and economic. This involves overcoming certain attitudes and offering consistent, non-judgemental care to all patients. Accepting the person for who they are regardless of diverse backgrounds and circumstances or differences in morals or beliefs. By exhibiting these attributes trust can grow between patient and nurse.[6][8] Nurses need to know the outcome of social, cultural, and racial differences, and how they can affect the therapeutic relationship.[9] Nurses need to acknowledge the impact of culture in order to practice health in a way that respects a person’s beliefs and values.[12]
Collaborative goal setting[edit]
A therapeutic nurse-client relationship is established for the benefit of the client. It includes nurses working with the client to create goals directed at improving their health status.[6] Goals are centered on the client’s values, beliefs and needs. A partnership is formed between nurse and client. The nurse empowers patient and families to get involved in their health.[6] This relationship has three phases, a beginning (first time contact/introduction), a middle (develop a relationship to deliver care) and an end (the patient is no longer dependant on the nurse). To make this process successful the nurse must value, respect and listen to clients as individuals. Focus should be on the feelings, priorities, challenges, and ideas of the patient, with progressive aim of enhancing optimum physical, spiritual, and mental health.[6]
Responsible, ethical practice[edit]
This is a communication-based relationship, therefore, a responsibility to interact, educate, and share information genuinely is placed upon the nurse.[18] The fourth statement of the CNO Standard is, Protecting Clients from Abuse. It is stated that it is the nurse’s job to report abuse of their client to ensure that their client is safe from harm. Nurses must intervene and report any abusive situations observed that might be seen as violent, threatening, or intended to inflict harm. Nurses must also report any health care provider’s behaviors or remarks towards clients that are perceived as romantic, or sexually abusive.[4]
Clients' perspectives[edit]
Coatsworth-Puspoky, Forchuk, and Ward-Griffin conducted a study on clients' perspectives in the nurse–client relationship. Interviews were done with participants from Southern Ontario, ten had been hospitalized for a psychiatric illness and four had experiences with nurses from community-based organizations, but were never hospitalized. The participants were asked about experiences at different stages of the relationship. The research described two relationships that formed the "bright side" and the "dark side".
The "bright" relationship involved nurses who validated clients and their feelings. For example, one client tested his trust of the nurse by becoming angry with her and revealing his negative thoughts related to the hospitalization. The client stated, "she's trying to be quite nice to me ... if she's able to tolerate this occasional venomous attack, which she has done quite well right up to now, it will probably be a very beneficial relationship".[19]
The "dark" side of the relationship resulted in the nurse and client moving away from each other. For example, one client stated, "The nurses' general feeling was when someone asks for help, they're being manipulative and attention seeking".[19] The nurse didn't recognize the client who has an illness with needs therefore; the clients avoided the nurse and perceived the nurse as avoiding them. One patient reported, "the nurses all stayed in their central station. They didn't mix with the patients ... The only interaction you have with them is medication time".[19] Neither trust nor caring was exchanged so perceptions of mutual avoiding and ignoring resulted. One participant stated, "no one cares. It doesn't matter. It's just, they don't want to hear it. They don't want to know it; they don't want to listen".[19] The relationship that developed depended on the nurse's personality and attitude. These findings bring awareness about the importance of the nurse–client relationship.
Building trust[edit]
Building trust is beneficial to how the relationship progresses. Wiesman used interviews with 15 participants who spent at least three days in intensive care to investigate the factors that helped develop trust in the nurse–client relationship. Patients said nurses promoted trust through attentiveness, competence, comfort measures, personality traits, and provision of information. Every participant stated the attentiveness of the nurse was important to develop trust. One said the nurses "are with you all the time. Whenever anything comes up, they're in there caring for you".[7] Competence was seen by seven participants as being important in the development of trust. "I trusted the nurses because I could see them doing their job. They took time to do little things and made sure they were done right and proper," stated one participant.[7] The relief of pain was seen by five participants as promoting trust.
One client stated, "they were there for the smallest need. I remember one time where they repositioned me maybe five or six times in a matter of an hour".[7] A good personality was stated by five participants as important. One said, "they were all friendly, and they make you feel like they've known you for a long time" (61). Receiving adequate information was important to four participants. One participant said, "they explained things. They followed it through, step by step".[7] The findings of this study show how trust is beneficial to a lasting relationship.
Emotional support[edit]
Emotional Support is giving and receiving reassurance and encouragement done through understanding. Yamashita, Forchuk, and Mound conducted a study to examine the process of nurse case management involving clients with mental illness. Nurses in inpatient, transitional, and community settings in four cities in Ontario Canada were interviewed. The interviews show the importance of providing emotional support to the patients. One nurse stated that if the client knows "Somebody really cares enough to see how they are doing once a week ... by going shopping with them or to a doctor's appointment. To them it means the world".[20]
The interviews showed it was crucial to include the family as therapeutic allies. A nurse stated that "We're with the families. We can be with them as oppositional and overly involved and somewhere else in between, and we're in contact with them as much as they want".[20] With frequent contact the nurse was able to discuss possibilities with the family. The study reaffirmed the importance of emotional support in the relationship.
Humour[edit]
Humour is important in developing a lasting relationship. Astedt-Kurki, Isola, Tammentie, and Kervinen asked readers to write about experiences with humour while in the hospital through a patient organization newsletter. Letters were chosen from 13 chronically ill clients from Finland. The clients were also interviewed in addition to their letters. The interviews reported that humour played an important role in health. A paralyzed woman said, "Well you have to have a sense of humour if you want to live and survive. You have to keep it up no matter how much it hurts".[21]
Humour helped clients accept what happened by finding a positive outlook. One participant stated, "... when you're sick as you can be and do nothing but lie down and another person does everything in her power to help, humour really makes you feel good".[21] Humour also serves as a defence mechanism, especially in men. A participant said, "For male patients humour is also a way of concealing their feelings. It's extremely hard for them to admit they're afraid".[21] The patient finds it easier to discuss difficult matters when a nurse has a sense of humour. "A nurse who has a sense of humour, ... that's the sort of nurse you can talk to, that's the sort of nurse you can turn to and ask for help ..." reported a participant.[21] This study lends support that if humour is generally important to people, then in times of change it will remain important.
References[edit]
^ Jump up to: a b Peplau, Hildegard E. Interpersonal Relations in Nursing. New York: G.P. Putnam's Sons, 1952. Interpersonal Theory in Nursing Practice: Selected Works of Hildegard E. Peplau. New York: Springer Publishing Company, 1989.
Jump up ^ Duffy, J. R. (2005). Implementing the Quality‐Caring model in acute care. Journal of Nursing Administration, 35(1), 4-6.
^ Jump up to: a b c d e Arnold, E., & Underman-Boggs, K. (2011). Interpersonal Relationships: Professional Communication Skills for Nurses (sixth edition). St.Louis, Missouri: Elsevier Saunders
^ Jump up to: a b c d e Therapeutic Nurse-Client Relationship, Revised 2006. (1 March 1999). 1 June 2009, Retrieved from http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
^ Jump up to: a b College of Registered Nurses of Nova Scotia. (2012) Professional boundaries and the nurse-client relationship: keeping it safe and therapeutic: guidelines for registered nurses. Retrieved from http://www.crnns.ca/documents/ProfessionalBoundaries2012.pdfIt
^ Jump up to: a b c d e f g Erickson, M., & Blazer-Riley, J. (2012). The Client-Nurse Relationship: A Helping Relationship. In Communications in Nursing (Seventh ed., pp. 16-31). St.Louis, Missouri: Elsevier Mosby.
^ Jump up to: a b c d e Wiesman, Shirley A. "A Development of Trust in the Nurse–Client Relationship." Diss. UW-Eau Claire, 1992.
^ Jump up to: a b c d e f Brown, E. L. (1961). Newer dimensions of patient care, Part 1: The use of the physical and social environment of the general hospital for therapeutic purposes. New York. Russell Sage Foundation.
^ Jump up to: a b RNAO. Virani, T., & Tait, A., & McConnell, H., & Scott, C., & Gergolas, E. (2002). Establishing Therapeutic Relationships. Toronto, ON.
^ Jump up to: a b Burnard, P., & Gill, P. 2008/> Burnard, P., & Gill, P. (2008). Culture, Communication, and Nursing. Harlow, Essex: Pearson Education Limited.
Jump up ^ L. Williams, C. (2008). Using the Self to Promote Health. In Therapeutic Interaction in Nursing (2nd ed., pp. 18-19). Sudbury, Massachusetts: Jones and Bartlett
^ Jump up to: a b Antai-Otong, D. (2007). Perspectives and Principles of Therapeutic Communication. In Nurse-Client Communication (1st ed., pp. 16-17). Sudbury, Massachusetts: Jones and Bartlett.
Jump up ^ Gerace, A.; Oster, C.; O'Kane, D.; Hayman, C. L.; Muir-Cochrane, E. (2018). "Empathic processes during nurse-consumer conflict situations in psychiatric inpatient units: A qualitative study". International Journal of Mental Health Nursing. 27 (1): 92–105. doi:10.1111/inm.12298.
Jump up ^ Rasheed, Subia (2015). "Self-Awareness as a Therapeutic Tool for Nurse/Client Relationship" (PDF). International Journal of Caring Sciences. 8 (1): 213. Retrieved 30 June 2017.
Jump up ^ Webb, L., & Holland, K. (Eds.). (2011). Nursing: Communication Skills In Practice. Oxford: Oxford University Press.
Jump up ^ Sheldon, L. K. (2009) Communicating with Different Age Groups and Families.Communication for nurses : talking with patients. (pp. 149-159) Sudbury, Mass: Jones and Bartlett Pub.
Jump up ^ A. Hart, V. (2007). Personal and Professional Relationships and Communication. In Patient-Provider Communications (pp. 99-102). Sudbury, Massachusetts: Jones and Bartlet.
Jump up ^ Miller, E., & Nambiar-Greenwood, G. (2011). The nurse-patient relationship. In Nursing: Communication Skills in Practice (pp. 20-32). Oxford: Oxford University Press.
^ Jump up to: a b c d Coatsworth-Puspoky, R., C. Forchuk, and C. Ward-Griffin. "Nurse–client processes in mental health: recipient's perspectives." Journal of Psychiatric and Mental Health Nursing 13 (2006): 347–355. EBSCOHost. McIntyre Lib., UW-Eau Claire. 12 November 2006.
^ Jump up to: a b Yamashita, Mineko, Cheryl Forchuk, and Bronwyn Mound. "Nurse Case Management: Negotiating Care Together Within a Developing Relationship." Perspectives in Psychiatric Care 41.2 (2005): 62–70. EBSCOHost. McIntyre Lib., UW- Eau Claire. 14 November 2006.
^ Jump up to: a b c d Päivi Astedt-Kurki, Arja Isola, Tarja Tammentie, and Ulla Kervinen. "Importance of humour to client–nurse relationships and clients' well being." International Journal of Nursing Practice 7 (2001): 119–125. EBSCOHost. McIntyre Lib., UW-Eau Claire. 14 November 2006.
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2006 Jama Masjid bombings
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Jama Masjid in Old Delhi
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On June 06 2006, two explosions occurred in the courtyard of Jama Masjid, a 17th-century mosque in Old Delhi (India). The first blast took place at 17:26 local time right in the middle of the courtyard next to Wazoo Khana which comprises a pond where worshipers wash their hands and feet before offering prayers, and the second a few meters away seven minutes later. At least thirteen people were injured in the blasts. The blasts took place just before the time of Azaan. The explosives were reportedly carried in plastic bags. There were around 1000 people in the mosque at the time of blasts as the day happened to be Friday, considered holy by the Muslims as well as being the first Friday after Milad un Nabi, Prophet Muhammad's birthday. The explosions did not cause any damage to the mosque. The Delhi government announced an ex gratia compensation of Rs. 50,000 to those with serious injuries and Rs. 25,000 to those with minor injuries.[1]
Some sources claim that the mosque was almost empty with only 100–150 people in the premises when the blast took place. The first blast occurred near Gate No. 1, a place where people wash their hands before offering prayers. It was the first attack of its kind on the historic mosque.[2] It is being speculated that these blasts might be linked with coincidental six grenade attacks in Srinagar, that took place the same day.[3]
According to Delhi police, these were "low-intensity blasts" triggered by crude explosives. The police have not ruled out terrorist involvement. As of 07 June 2006, no terrorist group had claimed the responsibility of the blasts. The Delhi police have arrested four people and are questioning them for the blasts.
Another school of thought suggests that the explosions could be the handiwork of some office bearers of the mosque due to internal rivalry.[4]
References[edit]
Jump up ^ "Report on CNN IBNLive".
Jump up ^ "Twin blasts rock Jama". Rediff.com. 2006-04-14.
Jump up ^ "Series of explosions injures 27 in India". Irish Examiner. 2006-04-14.
Jump up ^ "Column by B Raman". Rediff.com. 2007-05-18.
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