CPNRE® Comprehensive Review Series: Part 4





We’re getting to the heart of nursing in our series of the CPNRE® Comprehensive Review eBook. In case you missed them, here’s part 1, part 2 and part 3.

Nurse-client interactions: Trust

We know trust when we feel it about something or someone, but what does it actually mean?

Charles Feltman defines trust as “choosing to risk making something you value vulnerable to another person’s actions”.

Here are some examples:

  • When I leave my daughter in the care of a babysitter, I am making my daughter’s wellbeing vulnerable to the babysitter’s actions.
  • When I make a transaction with a bank teller, I am making my finances vulnerable to the bank teller’s actions.
  • When I share personal information with my physician, I’m choosing to make my privacy vulnerable to my physician’s actions.

Trust is feeling comfortable with sharing personal information with someone and believing that it’s safe with them. It’s believing someone when they say they’re going to meet us at a certain time and place.

When we trust someone, we make our money, our job, our goals, our beliefs, our reputation, our health and many other things at risk to another person’s actions. We believe that their actions will support or help what we’re making vulnerable, and not harm it.

When it comes to the work of nursing, our interactions with clients are also built on a feeling of mutual trust. Trust comes from what we say, how we act and how we communicate. It’s a feeling of comfort and safety, and it’s what allows clients to be open and vulnerable about their problems with us.

When clients allow us to provide their care, they are making their health vulnerable to our actions; they trust that we’ll do what we say when it comes to their health and their care.

From the first time we meet a client, they’re judging whether we’re trustworthy. That is, whether we are:

  • Accountable: that we’re responsible for our behaviours and will own our mistakes and failures
  • Reliable: that we’ll do what we say we’re going to do, when we’re going to do it and keep our promises
  • Competent: that we have the knowledge, skill, judgment and resources to do what we say we’re going to do or propose to do
  • Caring: that we have their best interests in mind when we act and make decisions
  • Authentic: that our actions and words align with how we feel and what we believe and who we want to be
  • Non-judgmental: that we don’t think less of them because of who they are
  • Honest: that we’re telling the truth
  • Boundaried: that we’re clear about what is and what isn’t okay
  • Empathetic: that we’re able to see things from their perspective

We build and demonstrate and maintain trust by:

  • Being honest
  • Setting and maintaining boundaries about what is and what isn’t okay
  • Keeping promises and following through with what we say we’re going to do
  • Being loyal and showing clients our willingness to protect and understand them
  • Being consistent in how we speak and act over time
  • Allowing for clients’ preferences
  • Being respectful of clients’ uniqueness and cultural differences
  • Maintaining privacy and confidentiality
  • Assuming people are doing the best they can with what they have
  • Trying to understand the feelings, thoughts and experiences of others

Exam Tactic

Throughout the CPNRE®, you can expect to be tested about your understanding of trust. Even though questions may not explicitly mention the word trust, it’s important to be aware of the fact that because our interactions with clients are built on trust, correct answers will always reflect an attribute of trust listed above.

If you see a question asking ‘how can the practical nurse establish trust’, try to think about the above ways in which nurses build trust as you look at the answer options.