is the ability to understand and envision another’s experience; to walk in another’s shoes enables us to feel how others go through everyday life.
Supporting Evidence
Empathy and compassion
http://listen.health.org.uk/ Walk in another’s shoes
This website enables you to gain an insight into the experiences of people who engage with healthcare and social care provision. You can choose whose story you wish to engage with. It invites you to ‘walk in another’s shoes’ as a means of empathising with an individual’s experiences of healthcare and social care.
When we empathise, we actively express an awareness of what healthcare and social care feels like from the patient’s perspective. This includes validating those feelings and experiences, communicating that you are aware and do understand and that you ‘connect’ with the individual (Dougherty et al. 2015). In nursing, empathy includes maintaining an appropriate emotional distance from the patient to ensure objectivity. In order to express true empathy, the nursing associates must be able to put aside their own opinions so that these do not influence the perceptions of their patients’ experience (Jones 2019). It also requires that they emotionally distance themselves from others’ experiences; they need to see the world from their patients’ perspective without experiencing the same level of emotional response.
Yellow Flag Beliefs and values
Frances Riley is a ward sister for an acute general medicine ward in John Radcliffe Hospital in Oxford. She is a part of a project working on improving end‐of‐life care on the ward, focused on four areas: earlier recognition that patients are approaching end of life, prioritising comfort, understanding the needs of family members and improving the use of end‐of‐life care medication.
‘I think empathy is closely linked with compassion and dignity and it’s a fundamental part of our job. It’s about seeing each patient as an individual. Patients are not objects, and nurses are not robots – it’s about personal interaction. To be a good nurse, you need to have more than technical skills. There’s got to be empathy there to make it a positive hospital experience for patients and families’.
Source: The Health Foundation (2016). © 2016 The Health Foundation
Touch Point
When we empathise, we actively express an awareness of what healthcare and social care feels like from the patient’s perspective.
Trust
Caring requires nurses to establish trusting relationships with patients and to be trustworthy professionals. Trust is critical in the nurse–patient relationship because, often, the individual is in a vulnerable position. Imagine being totally dependent on another in a healthcare crisis. To give oneself over into the trusting care of another is an enormous act. Trust is overarching in these types of scenarios. Even in routine clinical situations, trust is a cornerstone of the therapeutic relationship. The practice nurse at your local health centre is entrusted with your private information, and you trust that nurse to check the shelf life of your travel vaccines. Patients need to believe that nurses are honest, knowledgeable, can be depended on and will not judge.
Supporting Evidence
Therapeutic relationships in day surgery: A grounded theory study
http://usir.salford.ac.uk/id/eprint/8820/2/Acr3F.pdf
This study interprets the narrative from patients who experience care in a day surgery unit to identify significant therapeutic interventions as perceived by those patients.
‘I got great comfort from the staff. The entire experience (day surgery) is about entrusting your body and well‐being to people whom you have never met before. I think some of the ways in which this trust was engendered in me was, well, by a few things really … explanations of what to expect … general chit chat with the nurses … being in a ward with other people and seeing them go through the same process’.
(Mary, age 42 years)
Source: Mottram (2009)
Touch Point
Trust is critical in the nurse–patient relationship because often the individual is in a vulnerable position.
Rapport
Rapport is an essential component of the nurse–patient relationship and is established from the first encounter with the patient. This can be challenging, to say the least, and some healthcare professionals struggle to relax into an easy rapport on first meeting. All the aspects of the therapeutic relationship discussed in this chapter so far come into play when we develop a rapport with an individual. Clear attention to the individual and a genuine interest will help to establish a rapport. Body language and non‐verbal communication come into their own; smile, calmness, interpersonal warmth, a desire to make the person feel at ease, comfort, privacy and safety all play a role. (More detailed information about non‐verbal communication is available in Chapter 2 of this text.)
Initially, the nursing associate can establish a rapport with the patient through the questions they ask; this helps the nurse to understand the person’s frame of reference, how they are feeling and what they understand about their situation. Both verbal and non‐verbal prompts facilitate the process, alongside open‐ended questioning. Figure 3.2 shows the stages of motivational interviewing identified by Miller & Rollnick (2002). The so‐called OARS model highlights the key skills of motivational interviewing:
O – Open‐ended questioning invites the person to talk freely, for example, ‘how are you today?’
A – Affirmations provide a positive regard for what the person is saying, for example, ‘you have a real insight into why you are here today, and I can help you to understand more about your time in hospital’.
R – Reflective listening conveys through feedback that you are listening and taking note of what is said; often, the discussion will reflect the person’s own words, for example, ‘you say that you are anxious about having an anaesthetic?’
S – Summarising helps to establish that what was said is understood and agreed between you both, bringing together all the points made as a conclusion.
More formal and structured interviews, such as nursing assessment, are built on the initial rapport that you establish in a non‐emergency situation.
Tips for establishing a rapport with your patient:
Introduce yourself, say ‘hello’ and ask the person’s name. Use that name in conversation.
If appropriate, use touch to establish warmth and genuineness.
Employ effective non‐verbals such as maintaining a respectful distance, using eye contact, nod to show you understand, adopt an open stance and sit with the person if they are sitting
Be aware of the environment and privacy
Be aware of distractions such as pain or discomfort
Be culturally sensitive and aware
Actively