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8 Tips From a Psychiatric Emergency Nurse


We are all patients. The golden rule of treating others as you would like to be treated can help patients and healthcare providers build more trusting relationships.

All healthcare providers encounter patients in varying degrees of acute, chronic, and preventative levels of care. Often, time is of the essence either due to acuity or workload. However, establishing trust and rapport with patients is also of paramount importance.


Below are eight tips fo establishing trust that I’ve gathered in my experience as a psychiatric emergency nurse. After any stabilization regarding safety, the following techniques can be helpful in establishing trust between the patient and provider:


1.) Actively listen to your patient.

Look at your patient. Observe their nonverbal cues. Even if they are not giving you eye contact, you looking at them shows you are listening. If you want to write something down or type something in a computer, tell them that. For example, you can say, “I am listening to what you are saying. I just want to write a few things down if we need to refer to it later ….”


2.) Accept and meet your patient where they are.

Setting aside judgement is crucial in establishing rapport. Patterns of speech, dialect, slang, cursing (or not), and volume levels are unique to each patient. Gauge your length of response and words and terms used based on how receptive they are to what you are saying. Be ready to rephrase what you are saying or asking your patient.


3.) Assess whether or not it would be helpful to get closer to their physical level.

It may or may not be safe to do so. Depending upon the patient, it may be helpful to lean in so that they feel you are listening more closely. Sometimes sitting next to them allows them to feel like you are less intimidating or “standing over” them.

Your body language will convey your level of ease with them, which can in turn help patients feel more comfortable. If you casually lean against the wall while talking, it can come across as less threatening. Offering reassuring or therapeutic touch, such as placing your hand on the patient’s arm gently may or may not be helpful. Again, paying attention to the patient’s behavior and body language can help guide that.


4.) Be honest.

Answer questions to the best of your knowledge. Try to provide as much information about the treatment process as they can tolerate. Sometimes it is best to give little bits of info at a time; other patients want to know as much as they can right up front. It is often helpful to update the patient as often as you can so that they know you haven’t “forgotten about them.” Be flexible.

If you don’t know an answer, say so.

If you feel you need additional support giving information to a patient that may upset them, alert other staff to the situation so that they are aware. Be prepared with a plan ahead of time if you think the patient may react poorly to whatever information you give.


5.) Ask questions if you don’t understand exactly what your patient is saying.

Respectfully asking for clarification shows that you are listening and want to connect and understand your patient’s concerns.


6.) Gauge if your patient would do better speaking with another staff member.

A patient may have a preconceived mistrust (or would trust more easily) of certain people due to specific characteristics like gender or culture. Consider a patient’s known history and nature of why you are with the patient. For instance, a female patient with a history of trauma may feel more comfortable with another female staff member.


7.) Respect each patient as an individual.

One size does not fit all. Different patients require different approaches. Being genuine in accepting the patient as an individual is important. Each patient has their own individual stories and life experiences, and being able to adapt with your own demeanor is often very helpful.


8.) Validate your patient’s experience.

Often, in acute psychiatric crisis, trying to “reorient” a patient that a delusion or their hallucination is not real may be counterproductive in the moment and further escalate a patient to crisis. Using a neutral phrase like, “I hear what you are saying. I believe that you are seeing that / that you believe that / that you hear that. Let’s see what we can do to help,” can be calming.


We are all patients. The simple golden rule of treating others as you would like to be treated always helps patients and healthcare providers build a trusting relationship.