b u ild in g t ru stw orth y r elation sh ip s w ith c.pdfVIP

AACN Advanced Critical Care Volume 18, Number 1, pp.19–30 © 2007, AACN Building Trustworthy Relationships With Critically Ill Patients and Families Cynda Hylton Rushton, PhD, RN, FAAN Michelle L. Reina, PhD Dennis S. Reina, PhD ABST RACT A difficult case study involving repeated keep agreements, manage expectations, health crises and irreversible organ dys- establish boundaries, and encourage function illust rates the challenges critical mutually serving expectations. The third, care professionals face in caring for patients Communication Trust, or the Trust of Disclo- and their families. In such cases, t rust is es- sure, must be rooted in respect and based pecially fragile, and coexists with its coun- on t ruth-telling. Particularly in life-and- terpart, bet rayal. The Reina Trust Bet rayal death situations, communication requires Model defines 3 types of Transactional honesty and clarity. Each type of t rust Trust. The first, Competence Trust, or the involves specific behaviors that build t rust Trust of Capability, requires that clinicians and can guide critical care professionals practice humility, engage in inquiry, honor as they interact with patients and their the patient’s choices, and express compas- families. sion. The second, Cont ractual Trust, or the Keywords: building t rust, critical care, Trust of C