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Trusts must bolster trust in nurses

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VOL: 98, ISSUE: 09, PAGE NO: 31

Janet Gillan MSc, RGN, NDN Cert, DPSN

It is worrying that the word 'trust' appears to have lost its meaning. Trust used to mean something you could rely on in the health service. It sounded reassuring, yet is now being undermined.

It is worrying that the word 'trust' appears to have lost its meaning. Trust used to mean something you could rely on in the health service. It sounded reassuring, yet is now being undermined.

There are still signs that patients can trust nurses, and the will is still there to support and help patients in their time of need. But nurses are reluctant to talk about those nursing incidents which illustrate that trust can develop between themselves and their patients.

Mark Radcliffe (Last Word, February 7, p200) described an experience where he and his family trusted a nurse. It resulted in them being reassured and helped.

Despite all that is happening in the health service, we have to build on incidents such as these. Then at least patients will feel that they can trust nurses.

I have recently been reading the reflective accounts of some nursing students. They describe incidents similar to the one involving Mark Radcliffe and his family. Perhaps they were not as significant, but they were important to patients.

Some of those nursing students made a difference to people's experience of health care and underlined the importance of 'trust' in the nurse-patient relationship.

So it is sad to read a report from the Picker Institute (Coulter and Cleary, 2001) that shows Britons rate some aspects of their health care lower than their counterparts in Switzerland, Germany, Sweden and the USA.

The UK patients told the researchers that they were often kept in the dark about their treatment and did not feel they were the focus of attention.

The research was also damning about NHS care in areas such as physical comfort, emotional support, respect for preferences and the involvement of family and friends.

In my experience, many nurses do what they can to enable patients to trust them so that they can help them. And trusts need to be seen to support nurses in their endeavours to rebuild trust.

At the moment we have the spectre of management consultants being brought in to manage those trusts that have been identified as 'troublesome'.

I would like to sound a note of caution. I was working in clinical practice when the first wave of management consultants was brought in to help set up trusts and witnessed the start of this so-called cultural change.

My experience of management consultants was that they alternated a patronising style with one of criticism and cynicism. This is worrying given the lack of evidence to support their usefulness in the NHS.

Cultural change values everyone involved, and has to come from the top. My experiences, and Mark Radcliffe's, show that nurses' are still quietly working to build their patients' trust.

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