Polishing up the right tools for relationship building

Apr 22nd, 2014

Marcia Porter

Polishing up the right tools for relationship building

Dr. Caroline Porr is determined that her PhD research isn't going to collect dust on a shelf in her office.

So the assistant professor at Memorial's School of Nursing has put it into a toolbox of sorts...one she can easily carry to workshops, or professional development sessions.

On closer inspection you'll notice that the tools inside aren't really suitable for hammering nails or sawing wood...they're made of construction paper, but they are tough enough for what Dr. Porr has in mind when she meets with groups of public health nurses (PHN).

"My workshops with PHNs validate the tremendous contributions of PHNs, and I love praising their relational practice efforts," said Dr. Porr. "They have high levels of social intelligence competencies!"

Skills need to be practiced and refined, though, and sometimes new approaches need to be learned. That's a message she doesn't need to hammer home with PHNs, who actively participate in her sessions.

"The PHNs work with clients from all walks of life, for example, the young, single mother who is worried, fearful and distraught, and is scheduled with the PHN for child vaccinations," she said. "This young mother may not readily open up with the PHN, and opportunity is lost to focus on the mother's worries and fears."

The PHN has a very narrow window of opportunity to establish therapeutic rapport so that this young mother will vent emotions and discuss heartfelt concerns. The quality relationship between the PHN and the young mother has been shown to influence the quality of relationship she in turn has with her child.

"I think it is important that I translate my research findings by publicly engaging with the frontline practitioners," said Dr. Porr who really enjoys working with the PHNs. "Workshops are a perfect forum, and we need to actively engage as faculty of the School of Nursing with frontline health care professionals to ensure our research project findings are well disseminated, so that research goals are filling practice gaps, in this case advancing practitioner competencies."

As a PhD student at the University of Alberta, she focused her research on developing a model of relationship-building that she calls, Targeting Essence. It's a way of connecting with people that gets to the essence, the essential concern foremost in the heart and mind. That becomes the basis of the therapeutic relationship.

"My own nursing experiences include working with individuals and families from lower income communities," said Dr. Porr, "So I have always been interested in how we engage them, how we work with them in ways that are non-threatening, and that optimize their innate strengths and capacities to promote health and well-being."

One of her full-day workshops involved simulated nurse-client interactions with standardized patients from the Standardized Patient (SP) Program at Memorial University's Faculty of Medicine who took on the roles of single mothers. Dr. Porr brought in the babies - baby mannequins - from the nursing skills lab in the School of Nursing.

"The PHNs were astounded by the simulation experience, and gave comments like, 'Wow, I really believed that the standardized patient was a young mother who was on the defensive, and was angry. That was extremely challenging,'" said Dr. Porr.

Other comments included..."It (the workshop) has given better insight into my own actions, approaches and attitudes and helps me be more aware of how to better interact with clients..."It's helped me see things from their perspective and the many challenges they may be facing and made me realize that they evaluate me to."

To help create that realistic interaction for PHNs, Dr. Porr worked with Karen Mitchell, a standardized patient educator in the SP Program.

"The standardized patients are so engaging, it's amazing how quickly you get caught up in the realism," said Ms. Mitchell who sees her program involved, increasingly, with interprofessional education and with community.

Dr. Porr has held five relationship-building workshops already with Eastern Health PHNs, including one she gave at Cordage Place in St. John's with the standardized patients and baby mannequins.

Later this June she'll take to the road again, holding sessions with PHNs in Holyrood and Clarenville.