What is the importance of nurse-patient relationship?

The therapeutic nurse-patient relationship is at the core of nursing practice. When established properly, the relationship contributes to a patient’s health and well-being.

For this reason, nurses are accountable for establishing and maintaining therapeutic relationships with their patients, including maintaining appropriate professional boundaries.

It is also important to know that the relationship lasts as long as the patient needs nursing care. This means that no matter how short or long the time span, a therapeutic nurse-patient relationship is formed.

To make sure the patient’s needs are prioritized, nurses must understand that the following five components are always present in a therapeutic nurse-patient relationship:

Trust:

Trust is critical to the therapeutic relationship. It may be fragile at first, and you need continual effort to maintain it.

Respect:

To respect is to recognize that every individual has inherent dignity, worth and uniqueness, regardless of socio-economic status, personal attributes and the nature of their health problem.

Professional Intimacy:

When nurses provide intimate care activities to their patients, such as bathing, it creates professional closeness. Professional intimacy can also involve being privy to psychological, spiritual and social elements that are identified in patients’ plans of care.

Empathy:

A nurse shows empathy by understanding, validating and confirming what the health care experience means to the patient. Nurses must ensure that they maintain appropriate emotional distance from the patient to ensure objectivity and an appropriate professional response.

Power:

The nurse-patient relationship is one of unequal power. The nurse has more authority and influence in the health care system, access to confidential information and the ability to advocate for the patient. If a nurse misuses this power, it is considered abuse.

Nurses’ responsibility to establish and maintain the therapeutic nurse-patient relationship also includes maintaining proper boundaries. This means that nurses must not engage in any behaviour or activity that could be perceived as violating a boundary. Violating a boundary means a nurse is misusing their power and trust in the relationship to meet personal needs or is behaving in an unprofessional manner with the patient.

Page 11 of the Therapeutic Nurse-Client Relationship practice standard has a decision tree which helps to determine whether an activity or behaviour is appropriate within the context of the nurse-patient relationship and meets a therapeutic purpose. For more information about nurses’ accountabilities to their patients, read the Code of Conduct.

It is also important to be aware of the differences between professional and social relationships. Nurses must make sure they set appropriate boundaries that prevent a professional relationship from becoming a social one. For more information, read the Ask Practice FAQ: Professional versus social relationships.

Resource Articles //

We often think of medical care as a series of treatments and medications. But good care is about more than addressing physical conditions. It’s about connecting with patients in ways that help them embrace their recovery.

The best nurses know that forming a strong relationship with their patients is an integral part of succeeding as a nurse. If you’re considering starting a nursing career—or if you’re considering advancing your career by becoming a nurse practitioner—the nurse-patient relationship is of great value.

What Are the Benefits of a Good Nurse-Patient Relationship?

Research indicates that the relationship between a healthcare provider and a patient impacts healthcare outcomes.* That means, how you interact with your patients—outside of simply providing medical care—influences their recovery.

This is true in a wide variety of settings. For example, a strong clinician-patient relationship improves recovery from mental illness,† compassionate nursing leads to fewer pressure ulcers and falls among hospitalized patients,‡ and patients whose healthcare providers help them feel optimistic about a medical procedure experience less pain and recover more quickly than patients who feel pessimistic.§

The connection between good nurse-patient relationships and higher quality of care is so strong that the Institute of Medicine recommends all nurses follow the patient-centered method of care, which the Institute of Medicine defines as “providing care that is respectful of, and responsive to, individual patient preferences, needs, and values.”** Clearly, if you want to excel as a nurse, you’ll need to take your relationship with patients seriously.

How Do You Build a Good Nurse-Patient Relationship?

There are a number of ways you can help ensure strong relationships with your patients. These include:

• Listening. Maybe you’ve heard the saying “Don’t just hear, listen.” It’s good advice when you’re dealing with patients. Active listening—paying close attention to the meaning and subtext of what someone is saying—can help you better understand patient needs, fears, and complaints. And that, in turn, can help you provide better, more attentive care.
• Being Present. Nursing is a busy job and it’s easy to get into a rush. But whenever you enter an exam room or patient room, take a breath and give the patient your full attention. Eye contact is especially important, as are facial expressions that communicate your compassion and your concern for the patient’s well-being.
• Staying Positive. If you’re having a bad day, don’t reveal that to your patients. You want them to believe in you and in the efficacy of their treatment. A negative attitude on your part can undermine otherwise effective therapies.
• Showing Respect. When patients are discussing their medical problems or are hooked up to medical equipment, they can feel vulnerable, embarrassed, or even demeaned. Take that into consideration when relating to your patients, and go out of your way to show them respect. This includes making sure they have privacy when they want privacy. The more you make your patient feel like a full and valuable person, the better your relationship with them will be.
• Paying Attention. Your patients are unlikely to communicate all their needs verbally. In some cases, they may be hurting, depressed, upset, or confused and yet unwilling to say so. To counteract this, you need to pay close attention to nonverbal clues like body language, eating habits, and other behaviors. This can help you determine what your patients really need from you.

How Can You Improve Your Nursing Skills?

There are two primary ways to improve your skills: experience and education. Experience comes with time, but education can come whenever you choose. If you’re interested in advancing your nursing skills—or want to learn the skills that can help you start a nursing career—you should consider earning a Master of Science in Nursing (MSN) degree.

Not only can a master’s in nursing program help you gain advanced skills, it can help you qualify for many of the best nursing jobs and highest nursing salaries. Best of all, thanks to online education, you don’t have to take a break from your current job in order to earn a master’s of science in nursing. When you enroll in an online MSN program, you can complete the majority of your coursework from home. Plus, a master’s in nursing online program will allow you to attend classes at whatever time of day works best for your schedule, giving you the flexibility to continue working full time while you earn your degree.

When it comes to choosing which online nursing school to attend, you should look for MSN programs that are CCNE accredited, employ faculty that is doctorally prepared, provide plenty of student resources, and offer a variety of master’s degree in nursing specializations. One nursing school that has all of that and more is Walden University. Walden even offers an RN to MSN online program that allows you to move directly from your RN to MSN without having to earn your bachelor’s degree first.

Given all it offers, it’s no surprise Walden is number one in Master of Science in Nursing graduates in the U.S.†† It’s a great place to earn your MSN degree and improve your nursing skills.

Walden University is an accredited institution offering a Master of Science in Nursing degree program online. Expand your career options and earn your degree in a convenient, flexible format that fits your busy life.

*J. Kelley, et. al., The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, PLoS One, on the internet at www.ncbi.nlm.nih.gov/pmc/articles/PMC3981763.

†C. Green, et. al., Understanding How Clinician-Patient Relationships and Relational Continuity of Care Affect Recovery From Serious Mental Illness: STARS Study Results, Psychiatric Rehabilitation Journal, on the internet at www.ncbi.nlm.nih.gov/pmc/articles/PMC2573468.

‡Loyola University Health System, Emphasizing Compassion in Nursing Orientation Leads to Fewer Pressure Ulcers, Falls, Science Daily, on the internet at www.sciencedaily.com/releases/2014/07/140723105949.htm.

§ABC News, Positive Thinking, Faster Recovery, on the internet at http://abcnews.go.com/Health/story?id=117317&page=1.

**Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century, The National Academics Press, available for purchase on the internet at www.nap.edu/catalog/10027/crossing-the-quality-chasm-a-new-health-system-for-the?gclid=Cj0KCQjwybvPBRDBARIsAA7T2kgYQheZ1wq7lomD7t9W9H9OOyYu5g5NJpWfWZVwhptT-aYq6CzMsoIaAlwyEALw_wcB.

††Source: National Center for Education Statistics (NCES) IPEDS database. Retrieved July 2017, using CIP code 51.3801 (Registered Nursing/Registered Nurse). Includes 2016 preliminary data.

Walden University is accredited by The Higher Learning Commission, www.hlcommission.org.