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Department: ADVICE P.R.N.

‘Authenticity’ in nursing care

Richmond, Misty M. PhD, PMHNP-BC

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doi: 10.1097/01.NURSE.0000827192.85337.76
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I keep hearing about the need to be authentic. Is this something that would help in the care of my patients?–GK, Calif.

Authenticity has become a buzzword in recent years and is not always used clearly. In the realm of mental health nursing, authenticity is related to a specific form of psychotherapy.1 In a more general sense, being authentic is a useful approach when providing holistic, evidence-based care. Authentic behavior can have a positive effect on patients, in nurses' advocacy, and on nurses' moral behavior and well-being.2

What is authenticity?

Authenticity is generally defined as being true or reality-based. Dictionary definitions emphasize having authority and being genuine.3,4 These are essential traits in nursing that patients appreciate.2

Regarding mental health, the concept of authenticity is derived from existential philosophy and emphasizes honesty and empathy toward the human condition in therapeutic relationships. Nurses' ability to listen to patients in a nonjudgmental way makes patients feel understood.1 Such understanding and acceptance can reduce anxiety in patients.

Radical authenticity

In nursing practice, the concept of radical authenticity can be viewed as an aspect of authentic leadership. It is a way of being that disrupts existing beliefs.5

Imagine this situation: An inpatient surgical unit has been short-staffed due to chronic nurse turnover. The nurse manager is working with the staff to address problems and seems to be sincerely trying to improve the work environment. She commends the nurses for continuing to provide what she believes is excellent care—when in reality, patient care is suffering. In this situation, a radically authentic clinical nurse is one who disrupts the nurse manager's belief and speaks up about how patient care is suffering from the staffing shortage. This is a radical step because the opinion of the person in a position of power is being questioned. It is an authentic act because the nurse is expressing sincere concern about patient welfare. An authentic nurse leader will listen to these concerns.

Authenticity in the workplace

Authenticity is also known to be a strong predictor of positive outcomes in the workplace, including psychological well-being and job performance.6 Individuals who perceive themselves as behaving morally in the workplace (not being wasteful or mismanaging organizational resources) feel more authentic. That is, they feel more rational and consistent with their true moral self. This increased sense of authenticity leads to more positive feelings in their personal and professional lives.6


Nurses can utilize authenticity in various ways to benefit their patients, their work environment, and their well-being. By taking the time to truly listen and respond to patients while being caring, honest, and realistic, nurses can promote authentic interactions.


1. Temple M, Gall TL. Working through existential anxiety toward authenticity: a spiritual journey of meaning making. J Humanistic Psychol. 2018;58(2):168–193. doi:10.1177/0022167816629968.
2. Starr SS. Authenticity: a concept analysis. Nurs Forum. 2008;43(2):55–62. doi:10.1111/j.1744-6198.2008.00096.x.
3. Authenticity. Cambridge English Dictionary.
4. Whitehall H. Webster's New Twentieth Century Dictionary of the English Language, Unabridged. New York, NY: Standard Reference Works Publishing Company; 1956.
5. Shattell M. Radical authenticity. J Psychosoc Nurs Ment Health Serv. 2018;56(6):3–4. doi:10.3928/02793695-20180521-01.
6. Zhang H, Chen K, Schlegel R, et al. The authentic moral self: dynamic interplay between perceived authenticity and moral behaviors in the workplace. Collabra: Psychology. 2019;5(1):1–17. doi:10.1525/collabra.260.
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