Q & A: What was the Inspiration for the RBC Model?

QUESTION:
Hello! I am in graduate school at Kent State University working to become a nurse practitioner. My group chose your nursing theory to present for our peers. We would like to know what was your motivation for developing the Relationship Based Care theory? What was your process used for developing this theory? Also if there is any information that you would like to add regarding the theory? I have recently purchased a couple of your books and your CD, and I love your theory!! I have practiced as a bedside nurse for fourteen years and have been inspired by your writing and stories! I am excited to present your theory to my classmates and also to my coworkers. Thank you in advance for your guidance, and I look forward to hearing from you!

Sincerely,
Lisa Meek, BSN, CMSRN

ANSWER:
Mary-Koloroutis-150x150Hello, Lisa! It is rewarding to know that Relationship-Based Care resonates with you and is helping to inform your practice. Relationship-Based Care has evolved over the past 25 years beginning with the seminal work of Marie Manthey on primary nursing—a care delivery system that puts the patient-nurse relationship central. My motivation for contributing to the development of the RBC Model is very simple, actually. When I entered nursing practice, it was clear to me that safeguarding the humanity of those in our care as well as the humanity of those of us providing care would take intention and awareness as well as leadership (whether at the point of care or leading in a role within the organization). Institutions are where most care is provided and they are, by nature and design, prone to dehumanizing processes. The volume of patients served, the complexity of human caring and the complexity and escalating development in the sciences and technology all take attention and can undermine our core purpose. Holding the person central takes mindfulness, teamwork, and perseverance, along with an established way of doing/way of being within an organization that supports caregivers in keeping patients and families central at all times.

The work I did with Michael Trout on the book and workshop See Me as a Person was motivated by recognizing that while we talked about the nurse-patient therapeutic relationship as the center piece of care in RBC, it was an elusive concept to many in practice.  The “how” of therapeutic relationships had not been fully addressed. Those who excel at establishing and nurturing therapeutic relationships were seen as “simply knowing how to relate” and thus, the knowledge and discipline behind therapeutic relationships and the fact that relational practices can and should be taught was missed. We deconstructed what it looks like when we as caregivers are at our best and in a therapeutic interaction with a person. When authentic connection was established, four things were nearly always happening: We are present and attuned (focused on the person); we are wondering (genuinely interested in the person and what the person has to teach us, so we can provide the best possible care); we are “following,” (remembering and acting on what we have been taught); and we are holding (creating a safe haven for healing by doing what we say we will do; safeguarding the dignity of the people in our care; watching over them, keeping them informed, etc.

I am so pleased that Kent State is integrating this into practice. I remain

Respectfully yours,
Mary Koloroutis

One thought on “Q & A: What was the Inspiration for the RBC Model?

  1. Dear Mary Koloroutis (& Michael Trout),

    I just wanted to say that my group appreciates your timely response and the posting on your website! We were ecstatic to see you posted our question and your response on the website. We are excited to present your theory/model and have included this posting in our PowerPoint. Just wanted to let you know that we appreciate your time, response, and have enjoyed learning about your theory. I also personally plan to incorporate this into my daily practice. On an interesting note, I work at Cleveland Clinic Main Campus and your is theory widely used here in current practice. Have a great day!

    Sincerely,
    Lisa Meek group 5a from Dr. Sheehan’s Theory Class at Kent State University, fall 2014

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