CPNRE® Comprehensive Review Series: Part 6





Today’s post from the CPNRE® Comprehensive Review eBook is a follow up of yesterday’s post about mistrust.  Today we’re talking about how we should and shouldn’t treat people – especially the folks who are most different from us.  Here’s part 1, part 2, part 3, part 4 and part 5

Nurse-client interactions: Respect

Like trust, we know respect when we feel respected or feel respect for someone else, but it’s hard to put into words what it is.

I believe that respect is a feeling of appreciation about someone based on his or her behaviours, decisions or achievements. It’s a feeling we experience when we believe someone is worthy of admiration.

For example, many of us feel respected when someone holds the door for us, listens to us or thanks us for something we’ve done. We feel respect for someone when they’ve accomplished a goal or survived a traumatic event, or when they’ve been courageous. We also might feel respect for authority figures like teachers or police officers, or older adults like elders and grandparents.

In some cultures, respect is earned over time by helping others, but in other cultures, people believe that others are automatically worthy of respect unless they act in ways that are deemed unworthy. Regardless of how it is established and communicated, respect boils down to accepting people for who they are, and treating people with the same attention, honour, and care no matter who they are or where they come from.

In nursing, respect is one of the first things we can offer clients. But it’s often one of the first things to go – especially when we’re working with clients who are most different from us.

One way to understand respect is for us to be aware of what leads to disrespect. According to research, one of the most common reasons we feel disrespected, or act disrespectfully towards others is because of stereotyping or labelling. Stereotyping is defined as “a generalized and rigid definition of group characteristics that are assigned to people based on their membership in a group”.

Sometimes we use stereotypes to give a quick picture about someone:

  • “She’s your classic grandma. Kind and sweet”.
  • “Watch your back. He’s schizophrenic”.
  • “Don’t tell the doctor what to do. He’s a typical man”.
  • “She’s a classic teenager”
  • “Be sure you don’t get manipulated. She’s crazy”.

While these might seem harmless, they are a slippery slope to things like:

  • “She’s obese – clearly she needs to stop eating McDonald’s”.
  • “All women are bad drivers, that’s why we only see women in the ER after car accidents”
  • “He’s probably gay – only gay men get HIV”.
  • “She’s lying – all teens lie”.
  • “She’s Muslim – they’re usually abused”
  • “He’s your typical ICU nurse – rude and thinks he’s better than everyone else”

Regardless if they’re used in a positive or negative way, we need to realize that stereotyping is disrespectful and harmful. Whether we stereotype to give people a quick picture of who someone is, or whether we do it to ridicule someone, we’re effectively reducing people to a narrow category that might not be true. Stereotyping leads us to blame people for their problems, and it gives us permission to believe they are unworthy of our respect.

When we blame people for their problems we basically say “I don’t have a lot of respect for your behaviour or your choices and I don’t need to have empathy for you because you put yourself in this situation”.

When working with clients who are different from us in terms of values, beliefs, appearances and behaviours, we have to be careful not to disrespect them by making generalizations or false assumptions about who they are. When we interact with others based on our assumptions, we are quick to blame them for their problems and excuse ourselves from our responsibility to build trust and communicate respect.

Combining trust and respect

Magic happens when nurses are trusted and respectful. When we put clients at the centre of the team, when we help clients feel in control, when we listen to clients’ preferences, and when we work hard to provide privacy and dignity, clients are healthier for it.

The best way we can demonstrate respect is by treating clients as if they are an admired family member, friend or colleague.

We can be respectful by:

  • Asking clients about their opinions, values, beliefs, concerns and preferences
  • Being friendly and speaking in a relaxed, calm manner
  • Saying thank you or smiling in response to a friendly gesture
  • Involving clients in planning their care
  • Acknowledge the individuality and uniqueness of every person
  • Encouraging clients to evaluate their care and give feedback
  • Sitting beside rather than standing over people
  • Closing doors during private conversations
  • Explaining procedures and obtaining consent before doing them
  • Warning clients before entering their physical or personal space
  • Avoiding eye contact during personal care
  • Establishing and maintaining boundaries
  • Advocating for clients to get the care they need

Exam tactic

Keep these examples in mind when you’re answering questions on the CPNRE®. You may see a question explicitly asking ‘how can the practical nurse show respect’. Other questions, particularly those involving communication, will implicitly ask you to choose answers that convey respect.

Respect always wins.