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Get to know your patients to improve care

Posted Sep 30 2013 5:04pm

by Doug Della Pietra

"Tell me something new or something you didn't already know about your patients," the nurse manager asked her team.

Silence--awkward silence; the kind of silence most of us would want to fill with just about anything.

"Come on, you just worked a 12-hour shift," she said. "No one has learned anything new about their patients?"

Silence prevailed that day and the next and the next.

Undeterred, Clare kept asking the question at daily huddles. "They were doing the work," she said, "but weren't talking to the patient. You don't always have to do something for the patient like give meds. You can just go in and talk."

It took about a week of asking her team what they'd learned about their patients when finally someone spoke up.

"My patient has the same birthday as I do," she said.

"How did that come up," Clare asked.

"Doing the two patient IDs," the nurse explained.

It's important to note the purpose of learning something new about patients wasn't to have a story to tell. Rather, it was the empathy borne in the team after reflecting on questions like "How do you think he/she feels?" and "What can we do?" posed by Clare and others.

For example, one of the unit's patients was admitted with chest pain. Without going into all of the details, one of the patient's nurses for only a few hours was Michele--a nurse of 25 years, experienced, dedicated, by the book, direct and "here for all of the right reasons," as Clare put it.

The patient was overweight, drank alcohol regularly, worked extreme hours in a high stress job and had other risk factors for cardiac disease. In addition, the patient was stoic and not likely to express the fear of the upcoming procedure.

In the course of the morning, the patient and spouse poked fun with Michele, who jumped right in and used the opportunities to educate her patient on different diet choices that would fit the patient's life style. Michele also talked about the procedure and what to expect.

Following the angiogram and later that evening, right before Michele was about to leave, she got a phone call. It was the patient: "I just wanted to call and let you know that everything went great with my procedure today and wanted to say thank you for the care and service that you gave me. You're more than just a nurse; you're a real person who gets to know her patients. Thank you."

Clare connected the dots: “Taking just a little time to talk to your patients, getting to know a little something about them often means more to a patient than anything else. Michele was able to make that connection with her patient in the course of a morning. It's not the quantity of time spent with your patients, but the quality. The patient clearly was touched by her efforts.”

As the weeks passed, more and more of Clare's team started sharing. In fact, one day when Clare forgot to ask, someone spoke up and said, "Hey, I learned something about one of my patients today."

Clare suggests three simple steps to get your team to know their patients better:

  1. Ask the question of everyone on your team--nurses, techs, secretaries, housekeepers, etc.
  2. Allow awkward silence; it's insightful, especially if no one can tell you something new they've learned about their patients.
  3. Connect the dots and make meaning for the team: "Why is it important that you learned that about your patient?"

Doug Della Pietra is the director of Customer Services and Volunteers for Rochester General Hospital in New York, where he directs an intentionally-designed patient- and family-centered volunteer program , oversees the front-line valet and guest services teams, and leads the service excellence element of the Patient Experience Initiative while co-chairing the hospital's Patient Experience Team. Follow Doug @DougDellaPietra on Twitter.

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