Random Thoughts About The Nurse-Patient Relationship
Therapeutic nurse-patient relationships are based on mutual trust, nurturing, and sensitivity to the patient's needs. However, does the modern day healthcare system really allow nurses to foster this type of relationship with each and every patient?
According to Pullen and Mathias (2010), a therapeutic nurse-patient relationship is defined as a helping relationship that's based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient's physical, emotional, and spiritual needs through your knowledge and skill. In other words, a therapeutic nurse-patient relationship focuses mainly on the patient.
I have come to believe that the modern day nurse-patient relationship is undergoing some serious strain due to several factors, including short staffing, high nurse-patient ratios, and time constraints combined with sicker patients who are actually requiring more of our time with each passing year. The nurse must spend an inordinate amount of time completing redundant documentation in several different places, hunting for supplies, wearing multiple hats, and performing other tasks.
For instance, if the need for a cleanup arises and the housekeeping staff has left for the day, nursing staff must address it. If the remote control is not functioning properly and maintenance staff is nowhere to be found, the nurse is usually the person who must try to resolve the issue.
Essential ingredients of the nurse-patient relationship, such as mutual trust, confidence, and regard for one another, simply take some time to build and maintain. This bond is something that cannot be fostered within a matter of a couple of minutes.
It takes time.
However, today's harried healthcare system does not realistically allocate enough time in each shift to foster the most solid nurse-patient relationships possible. I honestly believe that the vast majority of nurses display caring and compassion as much as humanly possible during each interaction, but some caregivers do not always have the time to communicate their concern effectively to all patients and their families. As a result, some patients and family members who do not sense this concern might feel displeased and be more prone to file complaints or pursue legal action for poor outcomes.
Past studies have shown that patients and families are more likely to refrain from submitting complaints or filing lawsuits if they experienced therapeutic nurse-patient relationships and perceived that their caregivers actually cared about them. Therefore, I feel that it is in the best interests of all healthcare facilities to increase staffing, decrease the outrageous nurse-patient ratios, and basically allocate more time to allow nursing staff to foster solid nurse-patient relationships. After all, it will save facilities a great deal of money later on down the line.Last edit by Joe V on Jan 10, '15
TheCommuter is a moderator of allnurses.com and has varied experiences upon which to draw for her articles. She was an LPN/LVN for more than four years prior to becoming a registered nurse.
TheCommuter has '9' year(s) of experience and specializes in 'acute rehabilitation (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 34 Years Old; Joined Feb '05; Posts: 29,899; Likes: 46,519.
Must Read Topics2Aug 13, '12 by kabfighter, ASN, RNThis article hits the nail right on the head. I'm not a super touchy-feely guy, but I hate the days during which I'm unable to spend a few minutes chit-chatting with my patients. It's hard to develop a trusting relationship when you're running in and out of rooms trying to race the clock from the moment you get report to when you report off to the next shift. It certainly doesn't make the patients feel like you are giving them the attention they deserve. I hope it doesn't get to the point where patients start dying in droves for staffing changes to take place. My employer is accredited by a 'prestigious' organization...I would bet my favorite set of scrubs that if they stopped dumping money into meaningless accreditations (about which the patients know nothing) and instead staff appropriately with the money saved, patients would be happier and have far better outcomes.
Humbug1Aug 14, '12 by TheCommuter, BSN, RN Senior ModeratorI'm not an extremely touchy-feely person either, but I get the sense that patients and families would feel more secure and confident in nursing staff if only we had the time to establish a halfway decent nurse/patient relationship.
Sorry, but pretty hospital lobbies that are decorated to look like five-star hotels and flat panel televisions with complete cable packages will not prevent patient demise and other sentinel events. Facilities need to stop spending money on the 'niceties' and put those funds toward causes that will produce better patient outcomes.
Good outcomes = Zero lawsuits1Aug 14, '12 by kabfighter, ASN, RNQuote from TheCommuterSorry, but pretty hospital lobbies that are decorated to look like five-star hotels and flat panel televisions with complete cable packages will not prevent patient demise and other sentinel events. Facilities need to stop spending money on the 'niceties' and put those funds toward causes that will produce better patient outcomes.
That reminds me of a radio advertisement for a local car dealership. They point out that they don't have fancy new carpet and a glitzy showroom because the price to maintain those would get tacked on to the vehicles they sell (a dig at the bigger dealerships with nice showrooms)
One of my patients' wives today said: "We like you, you talk to us. Nobody else talks to us." This couple had a sad story regarding two of their (adult) children, which made them suspicious of the entire medical establishment. I made sure that I explained everything very thoroughly and encouraged them to ask questions, and they were much happier for it. You can't check that off on the MAR.
When I'm not busy trolling the religion forum, I'm actually a very nice person and a conscientious nurse.