Building up a therapeutic relationship with his patient enabled nursing student Gareth Taylor to get to the heart of what was causing the patient’s distress, and help find a solution to the problem

In my first year of training I was on placement on a neurology surgical ward where I helped to care for a patient who I will call George.

George was in his 50s and married with two daughters. He had been admitted with progressively worsening migraines, and after an MRI scan a mass on his brain was discovered.

As a first-year student, I had more time to spend interacting with patients than the qualified staff, so would often sit and chat to George, who told me that his daughter was getting married in a few days.

Personality change

I noticed that George seemed very withdrawn, and wanted to know what was troubling him. I assumed it was the test results he was waiting for, but soon discovered that the consultant had told George he could not be discharged until after his results were back. This meant he might miss his daughter’s wedding.

George didn't want to cause any problems for the staff, but it was clear this was having a detrimental effect on his well-being. When I told my mentor she informed the consultant, who was then able to fast-track the test results.

Once the results had been evaluated, it was decided that George could be discharged in time for his daughter’s wedding, and that delaying his treatment would not adversely affect his prognosis.

I was allowed to give George the good news, and when I told him that the plans for his daughter’s wedding would not be disrupted, his personality changed immediately – he was so happy and relieved, and thanked me for speaking up on his behalf.

Underlying issue

This experience made me realise the power of effective communication. By building up a therapeutic relationship with George I was able to get to the bottom of what was troubling him and was able to help him.

It also taught me not to assume anything, especially what may be causing patients distress. There may well be an underlying issue that is more important to the patient than the condition they are being treated for, but if we don’t ask we won’t know.

I have been taught extensively about the holistic approach to nursing care, and this experience really identified how important external factors are to the well-being of patients. Effective communication is essential in helping us to understand our patients, and what factors play a major part in their lives.

Many qualities are needed to be a good nurse, but the ability to communicate effectively is probably one of the greatest skills we can possess, and one that can be developed throughout our nursing careers. 

Gareth Taylor is a second-year nursing student at the University of the West of England