Other Titles
Relational Safety in Nursing: Creating Safe, Connected Care [Title Slide]
Abstract
Psychological safety is central to patient-centered care and effective nurse-patient relationships. When relational safety is present, patients report better experiences, outcomes, and trust, and nurses benefit from strengthened confidence and teamwork. However, the relational processes through which psychological safety is co-created in acute care remain insufficiently described.
This study examined the emotional, cognitive, and social processes that shape psychological safety within nurse-patient relationships and explored how relational safety emerges and influences care experiences. The study sought to generate theoretical insights explaining how relational safety emerges, is negotiated, and influences care experiences in acute care environments.
Using a constructivist grounded theory approach, maximum variation purposive and non-linear snowball sampling were used to recruit participants across acute care settings. Data came from semi-structured interviews, observations, and researcher memos. Analysis involved initial, focused, and theoretical coding with constant comparison and co-construction with participants to illuminate how relational safety develops.
Findings showed that psychological safety is co-constructed through emotional attunement, mutual vulnerability, clear communication, and role negotiation. Workload, uncertainty, and environmental pressures influenced whether safety was strengthened or disrupted. The resulting framework identifies relational mechanisms that shape trust, engagement, and therapeutic connection in acute care encounters.
The study clarifies how relational safety functions in nurse-patient interactions. It identifies relational behaviors that strengthen therapeutic engagement, highlights competencies relevant for nursing education and simulation, informs care delivery models that support patient-centered interactions, and points to organizational conditions that promote psychologically safe clinical environments. Together, these insights enhance understanding of how nurses and patients co-create meaningful therapeutic relationships.
Notes
References:
Allande-Cussó, R., Fernández-García, E., & Porcel-Gálvez, A. M. (2022). Defining and characterising the nurse–patient relationship: A concept analysis. Nursing Ethics, 29(2), 454–467. https://doi.org/10.1177/09697330211046651
Cho, H., Steege, L. M., & Arsenault Knudsen, É. N. (2023). Psychological safety, communication openness, nurse job outcomes, and patient safety in hospital nurses. Research in Nursing & Health, 46(4), 445–453. https://doi.org/10.1002/nur.22327
Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. https://www.doi.org/10.2307/2666999
Grailey, K., Murray, E., & Reader, T. (2021). The presence and potential impact of psychological safety in the healthcare setting: An evidence synthesis. BMC Health Services Research, 21, 773. https://doi.org/10.1186/s12913-021-06740-6
O’Donovan, R., & McAuliffe, E. (2020b). A systematic review of factors that enable psychological safety in healthcare teams. International Journal for Quality in Health Care, 32(4), 240–250. https://doi.org/10.1093/intqhc/mzaa025
Peplau, H. E. (1952). Interpersonal relations in nursing. G.P. Putnam’s Sons.
Shaban, M., Mohammed, H. H., Gomaa Mohamed Amer, F., & Elsayed, M. (2024). Exploring the nurse-patient relationship in caring for the health priorities of older adults: Qualitative study. BMC Nursing, 23, Article 480. https://doi.org/10.1186/s12912-024-02099-1
Sigma Membership
Rho Theta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Grounded Theory
Research Approach
Qualitative Research
Keywords:
Acute Care, Nurse-Patient Relationships, Psychological Safety, Patient Safety, Nursing Practice
Recommended Citation
Benton-Lee, Jitana P., "Relational Safety in Practice: Examining How Nurses and Patients Co-Create Safe Clinical Encounters" (2026). International Nursing Research Congress (INRC). 299.
https://www.sigmarepository.org/inrc/2026/presentations_2026/299
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-25
Relational Safety in Practice: Examining How Nurses and Patients Co-Create Safe Clinical Encounters
Toronto, Ontario, Canada
Psychological safety is central to patient-centered care and effective nurse-patient relationships. When relational safety is present, patients report better experiences, outcomes, and trust, and nurses benefit from strengthened confidence and teamwork. However, the relational processes through which psychological safety is co-created in acute care remain insufficiently described.
This study examined the emotional, cognitive, and social processes that shape psychological safety within nurse-patient relationships and explored how relational safety emerges and influences care experiences. The study sought to generate theoretical insights explaining how relational safety emerges, is negotiated, and influences care experiences in acute care environments.
Using a constructivist grounded theory approach, maximum variation purposive and non-linear snowball sampling were used to recruit participants across acute care settings. Data came from semi-structured interviews, observations, and researcher memos. Analysis involved initial, focused, and theoretical coding with constant comparison and co-construction with participants to illuminate how relational safety develops.
Findings showed that psychological safety is co-constructed through emotional attunement, mutual vulnerability, clear communication, and role negotiation. Workload, uncertainty, and environmental pressures influenced whether safety was strengthened or disrupted. The resulting framework identifies relational mechanisms that shape trust, engagement, and therapeutic connection in acute care encounters.
The study clarifies how relational safety functions in nurse-patient interactions. It identifies relational behaviors that strengthen therapeutic engagement, highlights competencies relevant for nursing education and simulation, informs care delivery models that support patient-centered interactions, and points to organizational conditions that promote psychologically safe clinical environments. Together, these insights enhance understanding of how nurses and patients co-create meaningful therapeutic relationships.
Description
Relational safety emerges through a set of emotional, cognitive, and communication processes that shape how nurses and patients build psychological safety in acute care. Through interviews, observations, and comparative analysis, this work identifies the conditions that strengthen or disrupt trust and connection and offers a practical framework that clarifies how meaningful therapeutic relationships develop and how clinical environments can better support them.