ISSUES AND INNOVATIONS IN NURSING PRACTICE Nurse–patient relationships in palliative care

Correspondence: Esther Mok, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. E-mail: [email protected] MOK E. & CHIU P.C. (2004) Journal of Advanced Nursing 48(5), 475–483 Nurse–patient relationships in palliative care Aim. The aim of this paper is to report a study exploring aspects of nurse–patient relationships in the context of palliative care. Background. Although there are numerous studies addressing nurse–patient relationships, little research has focused on these in the context of palliative are. Furthermore, no previous study has examined the relationship in the Chinese context. Methods. Qualitative data were collected from 10 hospice nurses and 10 terminally ill patients by means of open ended unstructured interviews. Respondents were asked to reflect on practices and incidents that would allow an understanding of the meaning of nurse–patient relationships in palliative care. Results. Four major categories emerged from the perspectives of patients and nurses: (1) forming a relationship of trust; (2) being part of the family; (3) refilling with fuel along the journey of living and dying; and (4) enriched experiences. Responses revealed that a relationship of trust is formed, and that nurses are not only regarded as health professionals, but also become part of the family or a good friend. Nurses who develop trusting relationships demonstrate a holistic approach to caring, show their understanding of patients’ suffering, are aware of their unvoiced needs, provide comfort without actually being asked, and are reliable, proficient, competent and dedicated in their care. Conclusion. Trust, the achievement of the goals of patients and nurses, caring and reciprocity are important elements of nurse–patient relationships in palliative care. Such relationships not only improve patients’ physical and emotional state, but also facilitate their adjustment to their illness, ease pain and can ultimately lead to a good death experience. It is nurses’ personal qualities and skills, which are embedded in these relationships, that constitute excellence in nursing care. Nurses also derive satisfaction and are enriched through the relationships.