Trust: Nursing's Greatest Privilege

Recent polls show that over 80% of Americans have a high level of trust in nurses. Trust in nursing has remained relatively stable over the years, even during periods of significant health care crises. Every year, when the Gallup Most Honest and Ethical Professions Poll announces that nursing remains the most trusted profession, I pause for a moment. Trust is not something we inherit simply because we wear scrubs or hold a nursing license. I still feel, after 40 years of nursing, an overwhelming sense of pride, but I also feel the weight of responsibility that comes with that distinction. It is something we earn every single day, often in quiet moments that no one else ever sees.

Over the years, I have come to believe that patients don’t remember every medication we administered or every laboratory value we monitored. What they remember is how we made them feel. They remember the nurse who sat beside them after hearing the words, “You have cancer.” They remember the reassuring hand before surgery, the gentle explanation when fear clouded their understanding, or the compassionate presence during a sleepless night. They never forget the nurses who moved obstacles so the patient could have the end-of-life setting they desired. Families remember the nurse who answered one more question, made one more phone call, or simply stayed a few extra minutes. These moments rarely appear in a patient’s medical record, yet they are often the moments that define nursing.

These small moments that create trust are especially true in oncology care, where trust is built through repeated acts of presence, honesty, and compassion. Recent literature supports what many nurses have long known from experience: Trust is central to the nurse-patient relationship and is strengthened by caring behaviors that help patients feel safe, respected, and understood (Rajcan et al; Sedighi et al). In oncology, where vulnerability is constant, and uncertainty is often part of every conversation, trust becomes more than a professional value; it becomes a lifeline.

As oncology nurses, we witness people at their most vulnerable. We walk alongside patients through hope, uncertainty, treatment, survivorship, and often the end of life. We celebrate victories that once seemed impossible and grieve losses that never become easier. Through it all, our patients invite us into their lives with extraordinary confidence, believing that we will advocate for them, protect them, and care for them with both competence and compassion. I have never stopped being humbled by that privilege. As a patient living with stage IV breast cancer, I understand this on a very deep level: We need you, we trust you, and we could not do this without you.

The public’s trust in nursing did not happen by accident. It was built over generations by nurses who consistently chose integrity over convenience, compassion over indifference, and service over recognition. Every interaction we have today either strengthens or weakens that legacy. That thought has stayed with me throughout my career.

Health care continues to evolve at an astonishing pace. Technology has transformed the way we deliver care, treatments have become increasingly complex, and documentation often competes for our attention. Yet despite all of these changes, the foundation of nursing has remained remarkably constant. Patients still need someone who will listen. They still need honesty delivered with kindness. They still need an advocate who sees them as a person before seeing them as a diagnosis.

For me, trust remains nursing’s greatest privilege—and its greatest responsibility. It cannot be measured by awards or rankings alone. It is reflected in every conversation, every act of kindness, every difficult decision, and every promise we keep. As nurses, we have the extraordinary opportunity to influence lives in ways that extend far beyond clinical care. My hope is that we never take that privilege for granted and that we continue to earn the trust placed in us, one patient, one family, and one compassionate moment at a time.

I am proud to be an oncology nurse.

Be well, nurses, and continue to love your patients, one patient at a time.

References

1. Brenan M. Nurses continue to lead in honesty and ethics ratings. Gallup. January 12, 2026. Accessed July 27, 2026. https://news.gallup.com/poll/700736/nurses-continue-lead-honesty-ethics-ratings.aspx
2. Rajcan L, Lockhart JS, Goodfellow LM. Generating oncology patient trust in the nurse: an integrative review. West J Nurs Res. 2020;43(1):85-98. doi:10.1177/0193945920930337
3. Sedighi S, Sadeghi A, Roshanaei G, Purfarzad Z. The relationship between nurses' caring behaviors and patient loyalty: trust towards nurses as a mediating role. BMC Nurs. 2025;24(1):568. doi:10.1186/s12912-025-03207-5

Case Study: The Weight and Joy of Trust

JS was 33 years old—a beloved elementary school teacher, the mother of 2 young daughters, and the center of a close-knit family. End-stage cancer had taken away her future, but not her grace. At her bedside stood a husband whose heartbreak was impossible to miss and sisters whose bond remained unbreakable.

One afternoon, JS asked me something no nursing textbook could have prepared me for. She wanted me to tell her when I believed she had only one day left to live. She and her sisters had promised one another to do each other's makeup for life's most important moments. She wanted them to do her makeup one last time, and she trusted me to know when that day had come.

For the next 2 weeks, I made her room my first stop every morning. She would look at me and quietly ask, "Is today the day?" Every time I answered, "No, not today," I felt relieved.

Then came the morning I had been dreading. With tears running down my face, I gently said, "I think today is the day." She simply nodded and asked that her sisters be called.

They spent the day together, laughing through tears, applying makeup to anyone who walked into the room, and sharing memories. There were so many tears, but also laughter and love. That evening, surrounded by the love of her family, JS died peacefully.

Trust takes many forms in nursing. Sometimes it means advocating, educating, or comforting. Sometimes it means being entrusted with a family's most sacred final wish. I still cry when I think about the trust JS placed in me. It remains one of the greatest privileges—and heaviest responsibilities—of my nursing career.