In nursing education, the quality of the nurse-patient relationship is stressed as an important aspect of care. While clinical nursing is indeed often largely task-based, the nurse-patient relationship can be critical to quality of care, patient satisfaction and successful outcomes.
Medicare's patient satisfaction scores (HCAHPS) have struck fear into the hearts of hospital bureaucrats. The realization that quality of care can be directly impacted by how patients are treated and how they feel about their care is readily apparent, but tying such measurements to reimbursement truly touches the bottom line.
If nurses are given the time and space to develop positive nurse-patient relationships, the benefits and reverberations of such relationships are far-reaching.
Nurses in touch with patients
In the acute care setting, nurses carry out physician orders, administer treatments and medications, coordinate multidisciplinary care, and use the nursing process and scope of practice on behalf of the plan of care.
For physicians and surgeons, precious little time is generally spent at the bedside. Patient visits during medical rounds can at times be as little as several minutes of limited conversation and examination, with no time for small talk or deeper inquiry.
Since nurses spend more time with patients than other acute care providers, reason leads us to rightly believe that the establishment of highly therapeutic relationships is largely the purview of the nurse. Likewise, home health and hospice nurses also have the luxury of being able to dig deeper with patients and their families through therapeutic relationships and communication aimed at expanding trust.
Not just touchy-feely
While some may negate the establishment of trust and therapeutic nurse-patient relationships as so-called "soft skills" that are more "touchy-feely" than scientific, there is a plethora of evidence supporting the assertion that emotional intelligence, relational intelligence and highly developed communication skills are central to the delivery of high-level medical care.
Just as infants devoid of skin-to-skin human touch will fail to thrive, adult patients treated without kindness, empathy or compassion can also experience the negative results of impersonal medical care.
Nursing education often focuses on the psychosocial and cultural needs of patients and their families, and it is here that the nurse-patient relationship takes hold. Nursing students learn the power of touch, eye contact, compassionate communication and motivational interviewing. The positive rapport between a nurse and a patient can be key to the delivery of successful care, and such touchy-feely practices can be the factors that spell the difference in outcomes.
Patients remember good care — they also remember when they've felt more like a number than a human being. Taking the time to hold a patient's hand, look them in the eye or address a fear or concern are therapeutic interventions with significant value, not touchy-feely extras with little to no impact.
Making room for relationship
Thoughtfully managed healthcare facilities understand the value of the nurse-patient relationship, and they create environments wherein nurses have the time and wherewithal to establish such connections.
Patients want to be seen as individuals, and truly individualized care can only be successfully delivered if patients' humanity is duly recognized and celebrated.
Nurses with untenable patient loads and little time for anything more than cursory communication lose myriad golden opportunities to connect on a deeper level with patients, and both the nurse and the patient suffer the consequences in such unfortunate circumstances.
When we make room for relationship and connection, we make room for greater satisfaction for both providers and patients alike. Nursing care is indeed rooted in science — including the science of therapeutic communication — and allowing nurses to practice the establishment and nurturing of powerful nurse-patient relationships makes sense on every level.
Satisfied, nurtured patients are likely to share more readily, open up about their fears and concerns, ask questions and benefit more greatly from medical and nursing interventions.
When patients are more engaged in their care through the benefit of positive nurse-patient relationships, everyone wins. And when everyone wins within the calculus of healthcare, the positive repercussions are immeasurable.
