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The interpersonal engagement or relational connection between the clinician and the patient and/or family.

In this Chapter

  • Suspending judgment

  • Giving patients hope

  • Respecting cultural needs

  • Confronting mistrust

  • Having the wisdom of curiosity


The theme of clinician–patient relationship was the first theme that was evident in the narratives that members of the Professional Development Committee reviewed. This was not surprising because central to the work of all clinicians in Patient Care Services is the care of patients and families. It is through the direct care of patients that clinicians gain a greater understanding of the following:

  • Who the patient is

  • Their unique needs and concerns

  • Their lives beyond the walls of the institution

  • The values and beliefs that give their lives meaning

This understanding allows the clinician to enter the patient’s world and allows care to take place.

Narratives—Entry Level of Practice

At the Entry level of practice, the newly licensed clinician is learning how to establish a therapeutic relationship with patients and families. At this level clinicians are recognizing the differences among individuals in their response to illness and incorporating those differences in how they care and interact with the patient and family.

Narratives—Clinician Level of Practice

At the Clinician level of practice, the clinician is able to personalize the care of each patient and advocate for the patient and family. At this level the clinicians are able to incorporate individual and family needs into their interventions and plan of care.

Narratives—Advanced Clinician Level of Practice

At the Advanced Clinician level of practice, the clinicians have a deep understanding of patient/family dynamics and is able to incorporate complex factors into the plan of care. They advocate for the needs of patients and families and for the unit-based systems that support and influence care delivery.

Narratives—Clinical Scholar Level of Practice

At the Clinical Scholar level of practice, the Clinical Scholar advocates and empowers patients and families to maximize their participation in decision-making. The Clinical Scholar’s influence moves beyond the unit/department and is felt organizationally.

Developing a therapeutic relationship is not innate; it is a skill that requires practice, experience, and reflection. For the newer clinician, building this skill begins by gaining confidence and comfort in working with patients and learning how to develop open, nonjudgmental behaviors with patients who have cultures and values different from the clinician’s. The ability to understand and then incorporate those unique elements of the patient’s life into his or her care, treatment, and planning is a key developmental milestone for the clinician. Continued experience and reflection allows the clinician to individualize his or her care and interactions based ...

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