(1961) described respect in terms of unconditional positive regard. This approach to respecting another relies on the ability to accept an individual’s personal beliefs despite one’s own feelings. Rogers’ approach recognises the abundance of experiences and exposures individuals have experienced in their lifetime, making their beliefs and behaviours unique. Acceptance does not imply approval or agreement, rather a non‐judging approach to the person as an individual.
Touch Point
Respect implies a recognition of the individual as they are, engaging in an open and non‐judgemental attitude to those in your care.
Genuineness
Being oneself within the context of a professional healthcare role is referred to as genuineness. Rogers (1961) describes this approach as congruence, where the carer does not hide behind a professional veneer but rather promotes an open and genuine contact. In a nurse–patient relationship, the nursing associates’ perceptions are underpinned by their values and beliefs and their own culture; these inevitably play a role in how they facilitate genuineness (Van den Heever et al. 2015).
It can be difficult to adapt our behaviours to be genuine within the context of the care setting; we are taught to be polite, pleasing, socially and professionally appropriate which can detract from a true demonstration of genuineness. Consider the approach of the nurse in the two scenarios in the Blue flag example, in the sexual health clinic below:
Blue Flag Brief patient encounter. Sexual Health Clinic
Patient: ‘this is really embarrassing, last night I had unprotected sex and I don’t really know what to do, what if I am pregnant’
Nursing associate: ‘OK, (smiles) I need to first take some details, then I’ll get the clinic doctor to come and sort you out. Please wait there’
Scenario 2
Patient: ‘this is really embarrassing, last night I had unprotected sex and I don’t really know what to do, what if I am pregnant’
Nursing associate: ‘I am glad that you have come today, please, don’t feel embarrassed. I can tell that you are anxious, and that’s perfectly understandable. Let’s just take some time to find out a little more about your experiences yesterday. Are you comfortable to share this with me?’
(Patient nods and shares her experience.)
Nursing associate: ‘Thank you for sharing what happened with me, I understand how difficult this can be. OK, there are several options that we can explore together, and you need to know that at some point, the clinic doctor will be here to see you. I hope that you will feel comfortable enough to ask me anything along the way that you are unsure of…’
Red Flag
Empathy
Empathy 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
