We’re finding that the concept of “therapeutic relationships” in terms of the nurse and the patient, is a challenge to define. We’re not therapists, so what is it that we’re supposed to be doing, beyond being caring and nice?
It makes sense that something that eludes quantification and measurement might occasionally seem elusive as a concept—especially when your job is to put it into practice under (usually) less than ideal conditions.
A “therapeutic relationship” is a relationship that heals, and that healing can be physical, mental, emotional, and/or spiritual. Healing sometimes occurs in psychotherapy, but it also occurs when grandma pulls little-you up onto her lap and reminds you that you are the most precious thing on earth. (How did she know you were unsure this was so, just at that moment?) It happens when the TSA agent checking your identity cards in a huge line at the airport takes a moment to make eye contact and asks how your day is going. (How did he know how lost and agitated and lonely you were feeling?) These are examples of some of the elements of a therapeutic relationship.
Healing occurs when engagement happens: when the phlebotomist or the transport person or the dietary worker or the nurse at the bedside reaches through the fog of anonymity or chaos or physical pain, just long enough to connect with you. It doesn’t take more time; it takes different time. The doctor pulls a chair up to the bedside to do the 3-minute rounds she was going to do anyway. The nurse touches a cheek or makes momentary eye contact before beginning a procedure she does 30 times a day—but does at this moment, with you, as if it were the only thing she cared about, as if you were the only thing she cared about. Healing occurs when, in the midst of the pandemonium of health care provision, the nurse focuses on just this one person, for just this one moment, and the patient knows: I am in safe hands today. She sees me.
~ Michael Trout