Correctional nurses must quickly develop a trust relationship with their patients in order to collect accurate data and effectively evaluate symptoms and requests. Yet, many incarcerated persons distrust almost everyone. They may have spent their lives using deceit and coercion to order their world, and so assume others do the same thing. As staff in a correctional facility, nurses are often seen as aligned with the motivations of the officers. Patients are concerned that nurses will use disclosed information against them. Therefore, the characteristics of a trust relationship must be rapidly developed when a nurse is working with an incarcerated patient. Here are four key elements to develop for better nurse-patient relationships in the correctional environment.

Respect

Quickly develop rapport with a patient by showing respect for them as an individual. Respect means that you accept someone for who they are, even when they are different from you or you don’t agree with them. As nurses we show respect for our patients by being genuine, accepting, and nonjudgmental about what they say and do. In addition, respect means you don’t treat your patient as an object, a number, or a condition. Patients know when they are being depersonalized, and they feel disrespected when a nurse is condescending. Automatically treating a patient like he is uneducated, unimportant, or uninteresting is disrespectful and will not build the needed trust.

Honesty

According to psychologist Daniel Goleman, we are wired to detect honesty in human relationship. Studies cited in his book, Social Intelligence, show how individuals are clued in to insincerity even when they don’t understand why they feel that way. Goleman suggests that we have neural circuitry for detecting deceit.

So, while we, as correctional nurses, are trying to objectively determine what is going on with our patient, the patient is determining our sincerity as a health care provider.

Honesty is shown by

• maintaining a direct and forthright manner
• providing adequate information
• communicating respectfully

Listening

A patient will trust a listening nurse. Sometimes when in a time-pressed situation, we tend to speak more than listen. Just as with honesty, our patients can tell when we are paying attention and when we are not. Body language is important. Here are some ways we physically show attention.

• Facing the patient
• Making eye contact
• Nodding or smiling
• Keeping arms relaxed and uncrossed

Active listening involves several other elements, including attending to the speaker; interpreting the meaning of their words and observing both verbal and non-verbal messages from the patient.

Follow Through

Building a trust relationship involves credibility. I have asked many, many incarcerated individuals how correctional nurses show they care, and 100% of the time, the answer was “they do what they say they will do.” We follow-through! An easy way to show follow-through is to initiate the action in front of the patient. If you say you will make a diet change for them during a nursing sick call encounter, pull out the paperwork and enter their name on the form. If you say that you will let the patient know why the medication wasn’t on the cart, go back to the med room, find out and then return to the unit to let her know. Sometimes, it is difficult to do with our workload, but credibility is of the upmost importance in building trust with our patients.

How about you? How do you quickly build trust with your patients? Share your thoughts in the comments section of this post.