The Quality of Nurses’ Relationships with Patients and their Relatives in the Emergency Department of a Tertiary Hospital in Nigeria: A Qualitative Study

Abstract

Nurses, patients and patients‟ relatives engage in a continuous interaction in the hospital setting. Such interaction is expected
to be supportive, educative and therapeutic. The extent to which the nurse communicates with patients and their relatives
should lead to transaction, goal attainment, effective nursing care, and satisfaction. Anchored on the Peplau’s Interpersonal
theory, this study explored the views of nurses, patients, and patients‟ relatives on the level of nurse-patient and nurse-patient
relatives‟ relationships, and the level of satisfaction with the nursing care and its associated factors at an Accident and
Emergency (A&E) Unit of a Teaching Hospital in North-Central Nigeria. Using a cross-sectional survey design, an in-depth
interview guide was used to collect data from 17 purposively selected participants (seven nurses of different ranks, five
patients, and the one relative each of these patients). Interviews were audio recorded. Following transcription, data were
analyzed thematically. Levels and satisfaction with nurse-patient relationship were rated differently: below average by the
nurses, but relatively more satisfactory by most patients. However, both nurses and patients‟ relatives described nurse-patient
relatives‟ relationship as dissatisfactory, with its potential and actual effects on patient care. Communication barriers, poor
interpersonal skills, poor nursing staff: ratio shortage and the nature of Emergency Room are factors affecting interpersonal
relationship of nurses with patients and their relatives. Improved communication, nurse-patient ratio, quality of care,
interpersonal relationship skills training for nurses and orientation of patients and relatives are recommended to enhance
therapeutic relationships.