The Exploration and Advancement of the Concept of Trust in Nursing - Research Paper Example

? The Exploration and Advancement of the Concept of Trust Nursing: Research Paper [Pick the Trust is an essential part of our lives and it has an ascendant role in our society. Study was conducted which aimed at exploring trust from the nurse’s perception and experiences. Three areas are covered: What nurses think of and perceive of the relationship, what they experienced in this relationship and what process influenced and led towards fostering trust in nurse-patient relationship. Graduate nurses were employed in this research. A graduate nurse is a nurse working for first year after completion of their degree program and they are on a house job. The method incorporated included qualitative description. Seven nurses took part in the research. The criterion was currently working nurses, practicing their house jobs in Melbourne hospital and registered as division of nursing branch. Purposeful sampling strategy was used. The purposeful sampling focuses on selecting a population who will illuminate the question under studies. The finding was that they had no experience after their graduation of the trust and faced problems treating their patients. What led to develop a confidence in their patient was described in four steps which fostered their relation like building a rapport, focusing on improved communication skills and time taken in building of successful trust (Belcher and Jones, 2009). The Concept of “Trust” “You will get better with this medicine”, “consult a doctor”, “look for a psychiatrist he better knows your problems” etc. these statements show a part of the trust we share with the public around us. Trust is a person’s ability to predict what others will do next or what circumstance can come next. However, the scope of trust is being neglected in the circle of science for long as it relates to spiritual concept having no particular strategy to weigh down its crucibles in professional fields such as healthcare (Mok and Pui, 2004). Scientific study for the concept was mandatory to highlight the importance and hence, improve the relationships among the people at workplace or a highly trust dependent field of healthcare, sociology, physiology etc. In health care, three actors play a crucial role in the ‘trust’ play. They are the state, the healthcare practitioner and the patient and other disciplines are likewise. For better service, trust is both a virtue and an obligation; hence it is a crucial factor in therapeutic relationship. There has been a lot said and discussed about the concept, but the gravity of ‘trust” ideology remains unrecognized. For this purpose, instead of more and more verbal war and never-ending discussions, a scientific approach to test the ‘trust’ hypothesis is established, to negate the skeptics related to the social issue in field of science and, to offer a concrete ground for the hypothesis to stand upon in healthcare sciences. The concept is researched by the way of social sciences research strategy as it is a complicated research to test the concepts. The methods chosen consisted of four basic phases. First is the analysis of the concepts by collected data then concept advancement is made by making principles based on initial analysis. The concept is then examined in the light of the principles. Finally, reviewing the researched data, therapeutic definitions are made. In the first step the concept is developed and analyzed by using review of the specific literature (Hupcey, et. al., 2002). Methods of concept analysis were undertaken to develop the concept of trust; like analytic questioning was employed which lead to the emergence of such issued that could help in determining the level of maturity of the concept of trust. Other than employing analytic questioning, congruence is searched for across the fields to look for common theoretical basis or ‘linkages’ in the literature of nursing, medicine, psychology and sociology (Hupcey, et. al., 2002). The analysis generated results that in a lay man’s language trust is used interchangeably with other words but when resorting to specific disciplines the concept gains versatility and specificity to the field In nursing trust was more a representative of the relationship that exists between the nurse and the patient dependant on time for maturity (Hupcey, et. al., 2002). In nursing, trust is explored as a concept that develops over the time. In medicine, trust depended on certain parameters for the successful trust building between the two parties. The parameters included and depended on whether the patient’s interest is given priority, the patient’s individual experience is credited or not, the experience of care, providing treatment and the time the result of treatment. In Medicine this trust was a hall mark of the patient and physician relationship and could result in the refusal of treatment once broken (Hupcey, et. al., 2002). In psychology trust is more interpersonally defined, and is the expectation of an individual from others that their word is true, and also that society is largely dependent on it to function properly (Hupcey, et. al., 2002). The patient puts himself to risk, when discussing explicitly the problems related to him in his personal life and it was found that this relation builds slowly with different parameters like trust can be supported by verbal communication, carefully chosen words, promise attitude of the psychiatrist (Hupcey, et. al., 2002). In sociology, two types of systems were identified to examine the concept; one examined it as a whole with the view of society perspective, while the other one pointed towards the individual perspective of the concept. Hupcey et al (2001) distinguish three types of trust: cognitive, emotional and behavioral. Context can also tend to play a significant role in the development of the concept of trust. To assess the level of maturity of the concept the four approaches yielded the following results. In the Epistemological parameter the studies of different disciplines had many things in common about trust concept; and that was, it is highly commendable in all fields to recognize the need of patient-nurse, patient-psychologist relationship and likewise for other disciplines of life as well (Hupcey et al, 2001). But in sociology the definitions of trust vary greatly and share no common features. On the pragmatical parameter, the results yielded that trust does not have a sound base of the concepts development. The concept has been related to the patient and nurse without any sound research backing and evidence. Medicine only focuses on enhancing the trust of the patient. Psychology has focused on the intrapersonal vs. the global trust whereas sociology has completely left the paper blank (Hupcey, et. al., 2002). The Linguistic parameter relates that nursing has focused consistently and appropriately towards the concept of the nurse-patient relationship but has been unable to clearly define the meaning. Medicine fails to generate significant results due to lack of relevant literature but psychology and medicine have enough literature that applies the term in a personal and global context (Hupcey, et. al., 2002). The final parameter is logical which studies if the concept maintains its individuality when used in conjunction with other concepts and fields. Nursing showed overlapping with respect; in medicine overlapping occurs with truth, distrust and competence; psychology theoretically integrates it with faith, trustworthiness and trusting behavior (Hupcey, et. al., 2002). Evaluation for the maturity of the concept showed the concept of trust to be immature, significant literature showed that there was a lack of consensus when it came to meaning across the disciplines (Hupcey, et. al., 2002). Concept advancement was carried out by analytic questions which relayed the common grounds for the concept across the different fields. The data showed promising results of a higher level of conceptualization across the fields (Hupcey, et. al., 2002). The technique of concept development through analysis of concerned literature allows the authors to derive common concepts about trust across the four disciplines which might lead to the deriving of an interdisciplinary concept that can be utilized around all the disciplines (Hupcey, et. al., 2002). In research, mentioned in the abstract (Belcher and Jones, 2009) nurses are chosen to understand the problems they faced in building up a strong relationship with their patients, as they were raw and had no experience; so, the problems could be openly studied and the result of the lack of trust could be studied well, as in contrast to an experienced nurse. The research solely emphasized upon the communication skills of a nurse playing role in the relation. Findings of the research were that all the nurses found it difficult to define trust accurately and precisely. In fact, they were unable to decide that the feeling they were trying to cover up, for improvement of their relation, was the concept of trust. When a concept is unrecognized, how can it be improved to make betterment in relation? For analysis, the data rapport building was implemented. It describes that the patient and nurse must feel comfort with and confide in each other until a comfortable level of trust is achieved, to begin the treatment. To build a rapport, communication process, issue of language, professionalism, will of trust and confidence in the other is mandatory. Professionalism includes a good nurse’s personality and communication skills along with personal issues left behind. A healthy, astound and happy nurse only, can take better care of the patient. Also it is a bilateral relation. It can develop instantly if both parties are willing. The attributes mentioned by Hupcey, et. al. (2001) of trust are that they need to be dependent on another individual for basic needs, require confidence in the person being depended upon; also expecting need to be fulfilled by the person looked forward and finally having a free will to take the risk of dependency. Similarly trust could be vulnerable, as shown in research, if it does not flourish, the reasons may be that the individual failed to have a will or lacks confidence on the staff for some reason, it may be environmental like some unhealthy politics being played within. He will feel unsecure too when he is not treated and had not taken care of properly, or he experiences pain where he thinks he could have escaped it with guidance and nurse’s care (Hupcey et al, 2001). For example if a youngster is afraid of receiving a shot and thinks that he will develop an infection. The nurse of the care giver needs to develop trust with the patient that the nurse will take all necessary precautions before administering the shot and will not let any infection be developed. The nurse will have to communicate how necessary the shot is for the youngster and not getting it will increases the chances of an infection and disease. Only after the youngster will trust the nurse, will he be able to take the shot. The nurse should also provide an atmosphere of trustworthiness by allowing the youngster to view someone taking the shot; this will increase the chances of being trusted. Conclusion: From the research, it is found that trust is a fragile fragment of person’s hope in the other, that is highly vulnerable and largely depends upon responses and it develops with the passage of time. Study of trust in different disciplines showed similarities about the concept of trust. For developing trust, a family like environment has to be made to make the patient’s journey towards healing more pleasant and quick with maximum comfort; by making them believe that their confidence will in no way be smashed at any cost. Hence, for health regain a healthy environment is only possible with the building up of nurse-patient relationship. References: Belcher, M., & Jones, L. K. (2009). Graduate nurses experiences of developing trust in the nurse-patient relationship. Contemporary Nurse, 31(2), 142-152. Mok, E. and Pui, C. C. "Nurse–patient relationships in palliative care."Journal of advanced Nursing 48.5 (2004): 475-483. Hupcey, J. E., Penrod, J., Morse, J. M., & Mitcham, C. (2002). An exploration and advancement of the concept of trust. Journal of Advanced Nursing, 36(2), 282-293. Read More