Establishing nurse-family relationships is important, particularly in situations where a patient is unresponsive or unable to fully take care of themselves and make independent decisions. The relationship is a bond where both sides work together for the benefit of the patient. However, there are potential challenges and barriers to forming a healthy relationship that may inhibit care. In the context of professional practice, family involvement may not be welcome, as some units such as the ICU may experience significant disruption if the family is present. Careful assessment should be given towards family involvement in such cases. Furthermore, it requires additional nursing resources in terms of time as family members expect to be kept updated and want to participate in every aspect of treatment. While some level of family engagement and education is expected from nurses, often in nurse-family relationships, the family begins to demand greater nurse involvement in the care of their loved ones rather than a fair distribution of resources and time.
Communication is the key aspect to good nurse-family interaction, and that may often break down leading to barriers in the relationship. One common aspect is a misunderstanding about treatment needs which stems from differences in health beliefs or perceptions of unfair treatment. Confrontations about the treatment which nurses may not have any input on (physicians prescribe the treatment) or non-observance of basic rules such as visitation hours or badgering of nursing staff are some commonplace instances of communication barriers. Furthermore, the relationship between nurses and families is dependent somewhat on the balance of power. Nurses may be in a more powerful position of control over the patient’s treatment, which may lead to wrongful perceptions or expectations from the family. At the same time, families want the best treatment and outcome for their loved ones, and if these are not met, the nurse may be blamed. Overall, the nurse-family bond should be formed but maintained at a professional level and it is critical to ensure neither side violates certain barriers.