The nurse-patient relationship is the foundation of clinical nursing practice. It requires trust, advocacy, and a patient-centered approach. But the reality is, many nurse-patient relationships may last for only a single shift, and some for less than an hour. As a nurse, how can you build a relationship when you don’t have much time — and you’re likely being pulled in a hundred different directions?
Nursing is a relational profession, and the relationship between a nurse and a patient is a unique one. The connections you have with patients are generally not emotional, but detachment isn’t the goal either. Instead, the therapeutic relationship relies on social ties, and many scholars agree that this relationship is the basis for ethical care.
As a nurse, you strive to give the best care possible to your patients. So let’s explore the unique relationships you enter into as a nurse and how you can build strong relationships in your practice.
Basic Requirements for a Positive Nurse-Patient Relationship
What are the emotional elements that need to exist for positive relationships to thrive? While these skills might not be ones you practiced in the lab during nursing school, they’re critical for building healthy patient relationships. Consider the following factors:
- Trust: Patients need to have trust that their providers will act in their best interests. Trust can be nurtured by providing dignity, as well as through verbal and nonverbal communication.
- Communication: For a relationship to meet care goals, both parties need to communicate clearly with one another. For nurses, this means introducing yourself, establishing expectations, and offering education.
- Empathy: Being able to respect a patient’s unique perspective is critical for high-quality care. This includes using cultural competency, offering support, and respecting a patient’s wishes even if they differ from your own.
Phases of the Nurse-Patient Relationship
Another way to approach your understanding of this relationship is in phases. Theorist Hildegard Peplau codified connections between nurses and patients into four distinct steps. We’ve included the steps and an example for each below:
- Orientation: The nurse and patient meet as strangers and are introduced within the context of the care environment.
Example: Good evening, I’m Hayden, and I’ll be your nurse for the night.
- Identification: The patient understands the nurse's role, learning how the nurse may assist with their needs.
Example: If you need to go to the bathroom, press the call bell and either the tech or I will be in to assist you as soon as possible.
- Exploitation: The nurse acts as teacher, counselor, and leader for the patient, while the patient relies on the nurse.
Example: This medication will make you need to urinate frequently, which can put you at higher risk for a fall if you’re getting up. If you’d like to stay in bed, we can use a device to collect your urine instead.
- Resolution: When care is terminated, the relationship between the patient and nurse ends.
Example: You’re being discharged today, so let’s go through your medications and when you’ll take each one, as well as symptoms to watch out for.
Building Strong Patient Relationships: 6 Tips for Nurses
Whether you’re a new graduate or a seasoned professional, there might still be ways you can work on building better relationships with patients. Nurses in acute care, outpatient medicine, procedural areas, and other patient-facing specialties can use the following tips to build stronger patient connections.
1. Focus on Clinical Competence
The best thing you can do for your patient relationships is bring strong nursing skills — that includes physical skills like placing IVs and foleys, as well as mental skills like critical thinking. Being a competent professional allows you to practice with confidence and offer the best outcomes possible to each patient.
What are some ways you can improve competency and confidence as a nurse? Consider the tips below.
- Once you meet qualifications, pursue a certification or additional training.
- Look up diagnoses and medications you don’t know.
- Ask questions when you don’t fully understand something at work.
- Listen to medical or nursing podcasts.
- Complete continuing education requirements on topics relevant to your specialty.
2. Be an Active Listener
When patients bring a complaint, a new symptom, or a question, you can encourage that communication by using active listening cues. This helps patients feel comfortable enough to share more and shows that you’re prioritizing them in their moment of need.
You can show patients you’re listening to them by doing the following:
- Nodding
- Using verbal affirmations, like, Yes, go on
- Asking them to say more
- Asking investigatory questions, such as “could you describe your pain?”
- Sitting down with them to be at eye-level (if you have time)
- Not interrupting or rushing
- Not offering judgments that have not been requested
3. Be a Leader
Even as a new nurse, remember that you hold institutional power in the relationship. You have knowledge, skills, and resources that vulnerable patients need in order to get better. You are present to do a job, while patients may be fearing for their own well-being. You’ll need to recognize this power — and understand its implications — in order to put patients at ease in your care.
Here’s what this might look like:
- Asking patients repeatedly whether they have questions, because they may not ask the first time
- Advocating for patients when they cannot do so for themselves
- Explaining to each patient that they have a right to refuse care
- Getting permission before sharing medical information in front of family or visitors
- Not asking prying questions or seeking information that isn’t pertinent to care
4. Make a Strong First Impression
Finally, first impressions are a key part of every relationship. When you introduce yourself, make eye contact and smile. Be sure your scrubs or uniform aren’t rumpled, and adhere to your facility’s dress code policy. Showing that you have yourself put together communicates to patients that you can be trusted with their care.
5. Try Not to Take Things Personally
Nurses might interact with patients during some of the most stressful, painful, and chaotic times in their lives, and sometimes this leads to words said in anger. Plus, many patients with cognitive or personality problems might not be fully responsible for their actions. While you deserve to be treated with courtesy and respect, it’s not always delivered. It’s your job to carry on a healthy nurse-patient relationship, even if you’re the only one carrying it.
6. Be Human
As a nurse, you don’t always have the time to build a meaningful relationship with each patient, but you can attempt to make small connections when it’s appropriate. You might prepare a few nurse jokes for moments like this or tell stories to get a patient’s mind off of a procedure. Ask them about their shirt or something else in the room. You can also talk about your own interests — if you like music, ask about what they’re listening to. If you have time to sit down, that can be a great way to show that you have the time to connect.
Build Your Career With Credenza
If you’re looking for a new setting to build your next nurse-patient relationship, we can help. Credenza gives you access to open roles at facilities in your area. Plus, with tailored job notifications, we can send great-fit roles straight to your inbox. Learn more today.