If nurses would only show a little heart when dealing with difficult situations involving patients and families, it is likely that ruffled feathers could quickly be smoothed. The heart to which I’m referring is Respond with H.E.A.R.T., a practical, common sense approach for addressing patients’ frustrations and complaints that is being used at the Cleveland Clinic (the Clinic) in Cleveland, Ohio.
The program, an extension of the Clinic’s commitment to put patients first, is designed for use by any employee at the Clinic, not only nurses. It is quite a basic premise and one that would work in any interpersonal situation: nurse to patient, nurse to coworker, husband to wife, friend to friend.
The beauty of H.E.A.R.T. is that the booklet that outlines the steps involved also offers suggestions for dialogue to be used in a variety of scenarios. The five steps of H.E.A.R.T. are:
H ear: When someone is upset, stop what you are doing, focus on him or her and truly hear their complaint. Don’t interrupt, just listen.
E mpathize: Think about the emotions he or she might be feeling, and verbalize that you can relate. “I can imagine how upsetting this must be for you.”
A pologize: A sincere apology can be powerfully effective in defusing a contentious situation. “I’m sorry that you are so frustrated,” or “I’m sorry that we did not meet your expectations.”
R espond: This is where you solve the problem. Say what you are going to do and what he or she can expect. “I’m going to call your doctor and I’ll be back in 10 minutes to give you an update,” or get the person’s input—“How can I make this better?”
T hank: Dealing with an upset person can be a challenge but be mindful that you are being given an important opportunity to rectify a negative impression. “Thank you for sharing your concerns with me,” or “Thank you for taking the time to make me aware of this.”
These steps can be used in myriad situations, from complaints about waiting for call lights to be answered to delays in meals being delivered, from questioning the need for a procedure to complaints about the attitudes of staff members.
I’m not always a fan of role playing, but in this case I think it would be beneficial. Practicing what to say in given situations puts the appropriate words closer to the tip of the tongue when those situations arise, rather than the easier-to-come-by defensive response.