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Care Delivery System – Department of Nursing

Relationship-Based Care is our care delivery system. Human connection is at the heart of relationship-based care, and its four key relationships are the relationship with patients, families and communities, the relationship with self, the relationship with colleagues and the relationship with our diverse communities and worlds.

Relationship with patients, families and communities

This relationship is at the center of all we do as BWH nurses. The nurse-patient relationship is central to practice as it is through this relationship that we learn about patients' unique response to illness, what’s most important to them and how to keep them engaged in the healing process. This guides our clinical judgment and is respectful of their human dignity and concerns. To to do this well, we must stay attuned to the other key relationships.

Relationship with self

This is a crucial relationship in relationship-based care. Relationship with self is nurtured by self-knowing and self-care. Self-knowing is a prerequisite for emotional maturity, healthy interpersonal relationships and the capacity for empathy (Goleman, 1997). Effective self-care means that we possess the skills and knowledge to manage our own stress, articulate personal needs and values, and balance the demands of our work with physical (body), mind (emotional) and spirit(spiritual). (Koloroutis)

The clinical narrative is one tool we use at BWH for self reflection and practice development. Through narratives, nurses are able to reflect on how they make a difference to patients and families and share their learnings with their nursing community.

Relationship with colleagues

Effective teams operate with respect and trust, connecting with one another and valuing the contributions of each member ... recognizing that everyone counts! Our teams include patients and their families as integral members.

Relationship with our diverse communities and worlds

This relationship involves how we are informed by evolving science and how we bring what we are learning at Brigham and Women's to the broader nursing community.

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