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 inmates distrust almost everyone. Having spent their lives using deceit and manipulation to order their world, they easily assume others are doing the same. 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 with inmates.

Respect

Quickly develop rapport with a patient by showing respect for them as an individual. Respect is defined as unconditional positive regard. It is a rare commodity in most correctional settings. As nurses we show respect for our patients by being genuine, accepting, and nonjudgmental about what they say and do. In addition, don’t treat your patient as an object, a number, or a condition. Patients can feel when they are being depersonalized. They also feel disrespected when a nurse is condescending. Automatically treating a patient like he is uneducated, unimportant, or uninteresting is disrespectful and will not build needed trust. Feeling emotionally and physically safe in the relationship is also important.

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. Although we have two ears and one mouth, in a time-pressed situation we tend to speak more than listen. Just like with honesty, our patients can tell when we are paying attention. 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.

• Giving attention to the speaker
• Interpreting the meaning of their words
• Observing both verbal and nonverbal messages

Follow Through

Building a trust relationship involves credibility. A patient needs to see that you follow-through on what you commit to do. 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, pull out the paperwork and enter their name on the form. If you say you will make a referral to the mental health provider, call their service while the patient is with you. Of course, keep in mind security rules of confidentiality such as not disclosing dates and times of outside appointments or providing any forms or contact numbers directly to the patient.

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