Building Trust In The Nurse-Patient Therapeutic Relationship

Importance of Trust in the Nurse-Patient Therapeutic Relationship

I believe enabling trust within a clinical setting is extremely important. I found an article which spoke about the importance in trust within a clinical placement of an aged care facility. Trust can be built when nurses meet the relational needs of older people (Muntinga et al. 2016). This statement explains that it is possible for older patients to form a trusting relationship with future nurses such as ourselves, even if we are of different nationality and especially age, we just need to understand what it is the patient wants from us. If we take the time to explore the older patient’s values and life stories, we can develop a strong focus on the needs of the elderly (Muntinga et al. 2016). It is also important for nurses to careful to ensure a patient, in this case and older patient knows and understand the difference between what that patience really wants and want the nurse wants the patient to want (Atkins et al. 2017).

When working as a nurse, it is important to form relationships with patients that are built on trust, because without trust the patients care and recovery may be affected (Atkins, De Lacey, Ripperger & Britton, 2017, p. 201). Whether or a not a patient decides to share information with nurses and other health professionals is directly related to their trust towards that person (Atkins, De Lacey, Ripperger & Britton, 2017, p. 203). Trust is formed upon entering into a therapeutic nurse-patient relationship, usually during the introductory phase when the nurse is learning about the patient, and to trust another person involves risk, and with the outcome of an individual’s health in the hands of a medical professional it can be easy to form mistrust (Levett-Jones, 2018, p. 500). It is not expected as a nurse to do everything that the patient is asking of, but through compassion, knowledge, integrity and professional self-respect this trust can easily be formed (Atkins, De Lacey, Ripperger & Britton, 2017, p. 219). As a nurse, it is in the duty of care to provide health care that is directly related to the patient’s condition, and if there is treatment or therapies recommended that they believe will cause harm to the patient then the nurse may refuse to comply. 

Reflecting on the above statement i acme to an understanding that trust is the most basic relation between a nurse and a patient in a therapeutic relationship as patients are vulnerable to the nurses, they can't do things which they can do before and now they need help of the nurse or any other health practitioner (Atkins,et.al. 2017). Nurses actively preserve the dignity of the patient and respect their vulnerability and powerlessness in their care to establish a sense of trust in patients that their physical, psychological, emotional, social and cultural well-being will be protected when receiving care. According to Atkins et al. (2017) trust can be categorised by four essential features which are an element of uncertainty as you never know what the trusted person will do, an element of risk and vulnerability as it makes us vulnerable to another person's competence and goodwill, an element of discretionary judgement as it gives nurse to heal and harm the patient, and asymmetry of power in trusting relationship as the power imbalance in short term allows the patient to have more control over their lives in the long term.

Hi Caitlin, your discussion post has highlighted few key factors that come into play with respect to the therapeutic relationship. I agree with the fact that the establishment of trust among the patients help the nurses to develop better care plans and achieve care outcomes. With the emphasis of trust in the therapeutic relationship will help develop a sense of comfort in the patient and allow the patient to share their preferences and grievances to the nurses effectively (Murray & McCrone, 2015). In my opinion, this will not only help in enhancing the patient centeredness of the care planning, however, it will also help the nurses to enhance the level of patient satisfaction rate. I would like to congratulate you on highlighting a very important aspect with respect to my post that the future nurses can take into consideration is lived experiences of the patients, especially for the elderly or aging patients.  Hence, the discussion post undoubtedly mentioned the impact of patients trusting their care providers, however, you missed out on providing information on how the nurses can help patients trust wisely.

Hi Chelsea, your post has taken into consideration the challenges that one may encounter while developing a trusting relationship with the patients. The derivation of this issue from the content of post and the school of thought it illustrated is appreciable. I agree to your reply post that the introductory phase of a nurse with the patients is undoubtedly one of the most crucial phases of the interaction. You have clearly identified the dilemma of the patients in trusting the nurse regarding their health on the nurses who are practically a stranger to them. As discussed by Wiechula et al. (2016), the impact of compassion, empathy, respect and integrity can be of excellent help to the nurses in gaining the initial trust of the patients, which you have highlighted effectively as well.

Hi Vishwajeet, your reply post for this topic although has attempted to discover the impact of the trust on the nurse-patient relationship, although the content and the direction of the post of the patient and nurse is unclear and I could not interpret it. You have discussed the definition of trust and the different components of trust, however, have not reflected adequately on the original argument of the post. Although, you have rightfully mentioned the importance of actively preserving the dignity of the patient and respecting their vulnerability and powerlessness while establishing the therapeutic relationship with the patient, although there is not enough information illustrated on the content of my post (Rørtveit et al., 2015).

Meeting Relational Needs of Patients

Hi Jade, in response to my discussion post on the therapeutic relationship among the nurse and the patient, your reply post has commendably summarized the key points of my discussion and has also illustrated on the importance of the therapeutic relationship of the patients with the nurses. On a more elaborative note, you have described not just the meaning of therapeutic relationship in the context of patient care. Moreover, it has illustrated the main goals of therapeutic relationship establishment of the patients as well. I have gathered a wealth of knowledge on the patient care relationships and how to maximize the component of effective communication in order to develop a compassionate and effective therapeutic relationship and helps in enhancing the recovery of the patients as well (Arnold & Boggs, 2015). Hence, it had been a great wealth of knowledge that I have gained on how to develop therapeutic relationship and the content you provided has also excellently aligned to the discussion post done by me.

Hi Adau, you have discussed in the reply post regarding the relation of the power and the moral responsibility of the nurses that are caring for the patients. In this post, with respect to my post, you have also discussed the power of decision making and trust that the patients have placed on the care provider with respect to care planning and implementation. I agree with your opinion that the nurses have the power of influencing the care by having the clinical knowledge that the nurses haver and the patients lack. In my belief, this power should be utilized positively by the nurses on the care decision making and planning allowing the patients have the priority to decide in the therapeutic relationship they have with the patients (Engel, Prentice & Taplay, 2017).

Hi Braeden, you mentioned in your reply that the therapeutic relationship is the beneficial and healing component in the care delivery system, to which I absolutely agree to. Here, here you have highlighted the need of the therapeutic relationship to be patient centered which is a very important aspect of recovery oriented care. Another two crucial aspects of the therapeutic relationship between a nurse and a patient, trust and rapport has been excellently discussed. You stated as soon as the nurse is able to achieve the trust and rapport of the patient, the therapeutic relationship can be considered successfully developed, I would like to differ with you on this school of thought. Although, trust and rapport are two very important aspect of the relationship, compassion, empathy and shared decision making are also very important aspects of this relationship. The nurses will also have to consider whether the patient is actively participating and communicating with the nurse regarding the grievances in order to ensure the therapeutic relationship is flawless (Richardson, Percy & Hughes, 2015).

References:

Arnold, E. C., & Boggs, K. U. (2015). Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Engel, J., Prentice, D., & Taplay, K. (2017). A power experience: a phenomenological study of interprofessional education. Journal of Professional Nursing, 33(3), 204-211.

Murray, B., & McCrone, S. (2015). An integrative review of promoting trust in the patient–primary care provider relationship. Journal of Advanced Nursing, 71(1), 3-23.

Richardson, C., Percy, M., & Hughes, J. (2015). Nursing therapeutics: teaching student nurses care, compassion and empathy. Nurse Education Today, 35(5), e1-e5.

Rørtveit, K., Hansen, B., Leiknes, I., Joa, I., Testad, I., & Severinsson, E. (2015). Patients' experiences of trust in the patient-nurse relationship-a systematic review of qualitative studies.

Wiechula, R., Conroy, T., Kitson, A.L., Marshall, R.J., Whitaker, N. and Rasmussen, P., 2016. Umbrella review of the evidence: what factors influence the caring relationship between a nurse and patient?. Journal of advanced nursing, 72(4), pp.723-734.