Beware of claiming to know your patient best

Can we really say nurses build a closer rapport than other multidisciplinary team members?

Can we really say nurses build a closer rapport than other multidisciplinary team members?

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It is often said that, in the acute sector, the nurse spends more time with patients than any other member of the healthcare team, so is the one who hears their concerns, fears and hopes. A variation on this theme is that the nurse is with the patient 24 hours a day – a claim that should be challenged.

The suggestion is that any nurse is closer to the patient and knows them better than other members of the team. In reality this is not always the case.

Take, for example, a ward where patients receive care from several nurses. Some patients may require a relatively large proportion of nurses’ time and others less. Perhaps none of the patients have a lot of time with a single nurse who gets to know them well.

Listening and communicating

Even with one-to-one nursing, as in critical care, shift patterns and days off can mean that many nurses see one patient and at least some of them may not know them well.

Getting to know a patient is about communication, listening to them and developing a rapport. We need to recognise that other healthcare colleagues also achieve this. A patient may be in hospital for a short stay but may have seen their consultant as an outpatient over several years for management of a long-term condition.

That doctor may have a great understanding of the patient’s hopes and fears and a close rapport.

Ability to build relationships

Another example is physiotherapists and occupational therapists involved in the recovery and rehabilitation of a patient following a stroke – might they not know the patient better than the nurse who looks after them during a ward admission? Then there is the speech and language therapist who helps a child recover and works with them over a long period of time.

The assumption that a nurse spends the most time with the patient may be correct in the short term, but not always so. And even when it is true, it does not ensure that the nurse really gets to know the patient.

Nurses are brilliant, compassionate and caring, but as a profession we should be careful when claiming to know the patient best.

For in that assumption we fail to acknowledge that the ability to build a relationship with a patient, to know the person, and the humanity that goes with it, also applies to other members of the multidisciplinary team.

Caroline Shuldham is chair of the RCNi editorial advisory board. A former nursing director, she is an independent adviser on research, teaching and mentoring

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