Nurses who are committed to patient engagement and advocacy now have one more evidence-based tool to add to their arsenal. Research published this past April in the Patient Experience Journal demonstrates that patients rate the quality of nursing higher when nurses sit down at the bedside to talk with them. The researchers developed a strategy they call the “Commit to Sit” initiative and studied it as it was applied to a cardiac care unit (CCU).
When nurses pull up a chair and sit while discussing patient concerns or explaining medication usage, they are literally on the same level as the patient. They can more easily make eye contact, demonstrate active listening skills, and engage in undistracted communication. In the study, nurses committed at least five minutes per shift in the CCU to sit and talk with patients and family members—resulting in the patients’ perception that the nurses were more empathetic and overall better communicators. Patients also perceived that the nurses spent more at the bedside than they actually did, largely because the quality of the communication was enhanced. When the initiative was implemented in a radiology department, the results were similarly positive.
There are good reasons to improve the quality of nurse-patient communication. Research demonstrates that better communication can improve outcomes, increase medication compliance, and improve patient satisfaction. When patients feel free to discuss their spiritual needs and express feelings of fear, anxiety, or discomfort, they can form a therapeutic bond with nurses and truly feel they are in a healing environment—rather than in a cold, sterile, and impersonal hospital. The study found the impact was increased when nurses directly asked the patients, “Do you mind if I sit and talk with you?” This simple question can communicate respect for patient choice, a key element in delivering patient-centric care.
Patient satisfaction is now linked to a hospital’s financial incentives as well, through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Since 2012, it’s been of Medicare’s value-based purchasing program, which is an effort to shift to reimbursement models that pay for high-quality care, rather than a high quantity of care. HCAHPS itself is a survey instrument that aims to measure patient satisfaction with the entire hospital experience. Recently discharged patients are asked to answer 27 questions, in seven key topic areas that include responsiveness of hospital staff, nursing communication skills, physician communication skills, pain management, quietness and cleanliness, explanations about medications, and discharge instructions. Nurses make up the largest group of healthcare workers, and they are the “face” of the daily care that patients receive. So it’s no surprise that the HCAHPS survey section on nurses’ communication has been found to have the greatest impact on overall patient satisfaction and likelihood to recommend the hospital to family and friends.
Active listening can allow nurses to learn something about patients on an individual level, provide comfort, and communicate health education in a way patients can understand. Time and inadequate staffing are probably the biggest barriers nurses face when it comes to active listening and committing to sit. When you’re rushed, it’s harder to remember to take the time to address each patient as an individual. Burnout may also hamper your efforts to be an effective patient advocate. It takes professional knowledge, dedication, and a clear ethical vision to see each and every patient as another human being, and to strive to improve patient communication and the overall patient experience.
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