Remembering the Nurse-Patient Relationship
A therapeutic nurse-patient relationship revolves around the unique needs of the patient and is built upon essential ingredients such as assistance, trust, respect, sensitivity, and nurturance of the client's physiological and emotional needs. However, nurse-patient relationships are under tremendous strain in today's hastily fast-paced healthcare settings.
The nurse-patient relationship carries great significance because it is the ultimate foundation upon which all nursing care is provided, regardless of the patient population, specialty, practice setting, or the circumstances that brought the patient and clinician together. Therapeutic nurse-patient relationships are professional bonds between nurses and their patients that are formulated on basic ingredients such as knowledge, trust, respect, assistance, sensitivity, confidence, rapport, and careful nurturance of the client's physiological and psychosocial needs.
A truly beneficial nurse-patient relationship revolves around the specific, unique needs of the patient.
In today's increasingly complex healthcare environment, nurse-patient relationships are developing noticeable foundation cracks due to multiple issues such as unsafe nurse/patient ratios, under-staffing, and perpetual time constraints while dealing with sicker patients who demand larger chunks of the caregiver's time than ever before.
It is normal for nurses to spend a ridiculously long time charting the same information in several different places, looking for supplies that might have run out, juggling various roles, and completing assorted tasks that were traditionally not within the realm of the nursing department.
For example, if a visitor spills soda on the hallway floor near the nurses station, nursing staff must mop it up when members of housekeeping staff have gone home for the day. If the toilet in the patient's room is not working properly and maintenance staff is unavailable, the nurse must try to resolve the issue and perhaps attempt to work wonders with the plunger. If the 2000 calorie diabetic diet tastes bland and unappealing, the nurse is usually the first person to deal with the onslaught of food complaints.
Basic components of the nurse-patient relationship, such as trust, rapport, confidence, and positive regard for each other, often require a little time to develop. This professional bond is not one of those things that can be created and nurtured within the span of a few minutes.
On the other hand, today's rushed healthcare settings don't offer nearly enough time per shift to reinforce strong nurse-patient relationships. Many nurses who work in direct care settings display professionalism during every interaction, but some overworked members of nursing staff do not always have the time to effectively communicate their concern to all patients and their families.
Consequently, there are patients and family members who may not pick up on this heartfelt concern. These are the same people who end up dissatisfied and more apt to conjure up complaints or consider seeking legal action for outcomes that are less than ideal.
Previous research and anecdotal evidence reveals that patients and families are less likely to file formal complaints or lawsuits if they enjoyed the benefits of a therapeutic nurse-patient relationship and perceived their caregivers genuinely cared about their outcomes. Hence, it is in the best long-term interests of all healthcare facilities to increase numbers of staff, reduce the insanely high nurse/patient ratios, and provide more time to enable nurses to establish therapeutic nurse-patient relationships.Last edit by Joe V on Jan 10, '15
About TheCommuter, BSN, RN Senior Moderator
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 '10' year(s) of experience and specializes in 'Case mgmt., rehab, (CRRN), LTC & psych'. From 'Fort Worth, Texas, USA'; 35 Years Old; Joined Feb '05; Posts: 36,172; Likes: 64,428.Jan 25, '14 by jadelpn, LPN, EMT-B GuideAnd to stop the ridiculous scripting. And to stop the practice of "discharge 'teaching' involves a little handout in a lovely folder" for the patient to take home with them. Because a nurse doesn't usually have time to explain it, and the computer records that you gave it, so wa-la, done.
If we don't start stressing communication and critical thinking skills I sincerely fear for the future of our occupation.Jan 26, '14 by Wise Woman RNThat nail has been hit squarely on the head... Well-written, indeed.Jan 29, '14 by jgamomVery well written and spot on! I, too, have been struggling a lot lately with watching the demise of nurse/patient relationships due to all of the changes in staffing, etc. Its ironic that in a time that hospital reimbursement is directly tied to patient satisfaction, that nurses would be put in the position where they are not able to establish good relationships. And to top it off, if you do take the extra time to give proper care to your very sick patients and put off the charting until later, you get in trouble for going into overtime. This appears to be a no win situation.Jan 29, '14 by lizbit120"Its ironic that in a time that hospital reimbursement is directly tied to patient satisfaction, that nurses would be put in the position where they are not able to establish good relationships. And to top it off, if you do take the extra time to give proper care to your very sick patients and put off the charting until later, you get in trouble for going into overtime. This appears to be a no win situation."
Jgamom, you are so on point with this! You would think that hospitals would prioritize financial security, aka hospital reimbursement, aka patient satisfaction and try to find the time/resources to help nursing staff achieve these preferred levels of patient satisfaction. I'm finding that hospitals are expecting nursing staff to perform like super humans. We have to be charting whizzes, be able to create a strong patient-caregiver relationship (through our personality/interactions), finish all of our required tasks, maintain cleanliness of our facility, etc WITHOUT going overtime. But I believe that top management is just too far away from the actual patient care to realize how ridiculous this is. I mean we all work hard, but there is a limit to our capacity to perform various tasks, etc.Jan 29, '14 by jgamomlizbit120,
I know. It's absolutely exhausting. I used to love my job. I still love my patients, but these ratios are just dangerous and I dread going into work every shift. The unit culture is really changing, too. Although the nurses are nice, we have so much turnover because there is no joy in the job anymore.Jan 29, '14 by NextGenI whole heartedly agree that nurses are pressed for time. We need to always always always have excellent time management skills. I am always baffled at the nurses I work with who have time during the shift for playing Candy Crush, updating their Facebook pages, endlessly texting and discussing their personal lives in detail. And then they complain that they do not have enough time to spend with their patients!!
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