By Richard Freedberg, RN, MSN, MPA

Have you ever had one of those days? You introduce yourself to the patient assigned to you in clinical, “Hi, I’m Rick, your student nurse,” and he or she responds, “Great, another rookie! I feel like a guinea pig! Why don’t you just go practice somewhere else?”  Your experience seems to plummet from there. What went wrong? How can you establish a relationship? How can you find your nursing voice? Remember, we all have some control over our lives. We can’t necessarily determine what situations we are presented with, but we can decide how we are going prepare and try to respond. Let’s talk about a few solid steps you can take to establish fruitful nurse-patient partnerships.

A little self-examination on your part is the all-important first step. You are bringing your ‘I’ to the interaction and you must have self-awareness. If your patient is an elderly, crotchety male and he reminds you of the grandpa you never really liked, how are you going to deal with that? Are you disgusted by substance abuse problems or sexually transmitted diseases? You need to set those feelings aside or they will sabotage any efforts you make to communicate with your patient who has them. Be aware of your biases, values, and concerns. For example, is completing your clinical paperwork and meeting course objectives your chief desire? Understanding ourselves prepares us for the next step.

Secondly, and this is the easiest to say but hardest to do, be real. Really care about what happens to your patients. Accept them. This doesn’t mean that you approve of everything they’ve ever done (or even like them), but genuinely accept them as fellow humans who need your care. Do this with everyone in your life, not just patients. If you nurture this genuineness, people sense it and respond. Simply put, they know you care, feel gratified by it, and will accept your efforts. That brings us to the next step.

Third, it sounds silly to say, but it needs to be said: Your patient did not get sick in order to help you get your degree. Most patients were engaged in that daily struggle we call life with all of its joys and challenges when suddenly an injury or illness shattered their world. Understand that. Don’t just feel sorry or sympathetic, but, instead, try to cultivate empathy. Empathy is a learned skill that comes with practice. It allows us to, on some level, recognize, understand, and vicariously feel someone else’s pain and distress. Don’t wallow in it but always remember, no matter how demanding or rude or irritating a patient is to staff, it is always worse to be the patient! Understand they are doing the best they can given the circumstances. Understand their fears and coping skills.

The final step is to actually be helpful. You are not an observer; you are a member of the healthcare team. Let your patients know you are actually giving them extra attention that is not afforded to patients without students. Along with administering medications and treatments, check frequently with your patients to see if there is anything else they need. Also, be sure you give their families support and care. Being professional doesn’t mean you can’t be nice!

So, to recap our discussion: The first step we need to take prior to clinical interactions is to examine our own feelings and prejudices. Second, we need to be genuine and accepting with everyone we encounter. Third, we must be empathetic instead of sympathetic. Finally, we need to be useful and actually make a difference in the life of our patients. Practice this stuff and your patients will appreciate you (which is always a nice way to spend a shift!).

Editor’s note: Freedberg is a professor of mental health nursing at Lansing (MI) Community College and the author of Stressed Out About Pharmacology. Email your questions to him at editor@stressedoutnurses.com.