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Feeling Safe in Medical Settings

Feelings of safety are critical for the disclosure of critical information

Key points

  • A provider's responsibility is to create a safe space through words, actions, and environment.
  • Patients feel safe when their feelings, thoughts, ideas, and perceptions are respected by their provider.
  • Trust is cultivated when the healthcare environment sees the patient as a person, rather than a number.
  • When patients feel safe, they are more compliant and have better healthcare outcomes.
Steele/Adobe, Fizkes, used with permission
Doctor smiling at patient
Source: Steele/Adobe, Fizkes, used with permission

In the therapeutic relationship, the patient must fully disclose their current lifestyle habits, thoughts, feelings, signs, and symptoms for their healthcare provider to be able to assist them. But how does one develop the wherewithal to disclose deep secrets to their provider, especially if their provider has different views from themselves?

In a recent study, those diagnosed with chronic disease expressed vital emotional needs to feel safe enough to discuss healthcare information with their providers. In order to feel safe and honest with their provider, patients wanted to be seen, talked with, understood, and given practical support coupled with knowledge. The top two themes expressed were the need to feel safe and to feel comforted, which motivated the patient to achieve better health. All of these factors generated a feeling of trust in the provider, creating a sense of vulnerability to express themselves authentically.

In another study, researchers found that a primary desire of ICU patients was to feel safe amongst their healthcare team. The safer they felt, the more willing they were to participate in their healthcare by being more compliant.

The perception of safety by patients was influenced by multiple variables, including the behaviors of the ICU staff, their own religious beliefs, and feelings of knowing, regaining control, hoping, and trusting. The beliefs and perceptions must be shared by both the provider and the patient in therapeutic communication for the patient to feel safe to disclose their views authentically. Even if particular personal beliefs are different, respect and open-mindedness must be cultivated to create an environment of comfort and safety.

The presence of staff, including attentiveness, personal care, and respect for the patient's vulnerable emotional and physical state, also creates a feeling of trust. When a provider does not take the patient's health concerns seriously, dismisses them, or is not proactive in understanding their health condition, the patient feels unsafe and unwilling to share themselves authentically.

The lack of safety can be compounded with poor-quality care, marked by medical errors or rushed or impersonal healthcare settings, leaving patients feeling like they are just a number. Lack of quality can be perceived as a potential threat, making patients reluctant to share information as they become self-protective.

Steele/Adobe, Konstantin Yuganov used with permission
Doctor listening to patient
Source: Steele/Adobe, Konstantin Yuganov used with permission

Patients who feel safe in their surroundings and not only feel safe to express themselves they are more satisfied with treatment and more compliant with their provider's recommendations.

Trust is vital for the patient to feel safe to disclose in-depth information without shame or resistance and to allow the provider to help them. Revealing deep secrets can provide clues providers need to determine the root cause of problems.

Providers have a responsibility to create a safe space for patients to express themselves fully, their needs, desires, and health care concerns. Providers must create this space by organizing their practices, structuring their care, and managing their time with the patient to deliver the care they may need.

In addition, patients must have realistic expectations of their providers, be open to education, coaching, and accountability, and be willing to express themselves openly with the provider. While no relationship is perfect, the connection between the doctor and the patient is sacred and created as both people keep an open mind and an open heart in communication to facilitate the healing of the person seeking care.


Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, Werner C, Gerger H. Trust in the health care professional and health outcome: A meta-analysis. PLoS One. 2017 Feb 7;12(2):e0170988. doi: 10.1371/journal.pone.0170988. PMID: 28170443; PMCID: PMC5295692.

Dawson A. Trust, trustworthiness and health. Indian J Med Ethics. 2015 Jul-Sep;12(3):129-30. doi: 10.20529/IJME.2015.040. PMID: 26228044.

Hupcey JE. Feeling safe: the psychosocial needs of ICU patients. J Nurs Scholarsh. 2000;32(4):361-7. doi: 10.1111/j.1547-5069.2000.00361.x. PMID: 11140200.

Kenward L, Whiffin C, Spalek B. Feeling unsafe in the healthcare setting: patients' perspectives. Br J Nurs. 2017 Feb 9;26(3):143-149. doi: 10.12968/bjon.2017.26.3.143. PMID: 28185495.

Leine M, Wahl AK, Borge CR, Hustavenes M, Bondevik H. Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease. J Clin Nurs. 2017 Sep;26(17-18):2755-2764. doi: 10.1111/jocn.13794. Epub 2017 May 17. PMID: 28252816.

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