Rana Awdish, MD, was wrapping up her fellowship training back in 2008 when a tumor ruptured in her liver. The medical emergency led to multisystem organ failure, a miscarriage, and — over the next 2 years — a growing understanding that she had so much more to learn about being a health care provider.
As did much of her health care team, she realized.
Despite the highly skilled, expert care she received, she couldn’t help but notice something key was missing: empathy and connection. Lying in a hospital bed, she could immediately identify what she’d been blind to as a busy, efficient clinician.
“There were disturbing deficits in communication, dis-coordinated care, occasionally an apparently complete absence of empathy,” Dr. Awdish said. “I recognized myself in many of those failures.”
The young physician used the hard-earned wisdom to champion a shift in culture to emphasize compassionate communication at Henry Ford Health System in Detroit, where she now works as a critical care medicine physician and director of Henry Ford Hospital’s pulmonary hypertension program.
Her career-changing take-home lesson?
“Everything matters, always,” she said. “Every person, every time.”
Nurses are trained to value a patient’s story. But, if we’re being honest, a principle taught in the classroom can turn into a slippery slope in real-world practice, where schedules are hectic, patience is tried, and bodies are overtaxed.
That doesn’t change the reality, though, that the way nurses communicate with patients is important. Commit to a few simple strategies, and you can make a big difference in your patient’s day.
Greet the patient a warm “hello” or a polite “excuse me” if visitors are present. Close the door or curtain to ensure privacy. Sit at eye-level if you are going to be talking with the patient for some time, and silence the TV. Introduce other team members as necessary, and ask open-ended questions.
Demonstrating basic courtesies like these helped boost Hospital Consumer Assessment of Healthcare Provider Systems (HCAHPS) survey scores at one major academic medical center. The results of the hospital-wide communication training program were reported in the American Journal of Medical Quality earlier this year.
"A major strength of this study,” the authors wrote, “is its generalizability to other institutions … as establishing specific communication standards is neither costly nor time intensive.”
When patients talk, listen. Don’t interrupt. Don’t correct. Take a deep breath if necessary, let them air their views, and use the opportunity to learn about their concerns, preferences, and expectations.
According to the National Committee for Quality Assurance (NCQA) Blog, health care providers interrupt patients after just 17 seconds, on average. When patients talk uninterrupted, however, their comments usually last only about 90 seconds. During that time, a clinician can glean a lot of information that may aid in their care.
What’s more, the patient will feel heard, which is priceless medicine in a situation where feelings of helplessness and loss of control are common.
As you talk to the patient, avoid jargon, technical terms, and too much information. Use everyday language to explain things in a way the patient can understand. As the NCQA blog explains, if you leave the room and the patient is confused, the encounter was counterproductive.
“Allow a pause, creating a strategic silence. This gives time for the patient to think and information to sink in,” coached Michael Ho, MD, of Anesthesiology Consultants, in the piece. “Ask questions to assess patient understanding, repeat explanations as needed, and encourage questions.”
Skilled patient communication is worth the investment. It affects the quality of care provided, patient satisfaction scores, and, thus, even Medicare reimbursement. Plus, communicating empathetically is the right thing to do.
You don’t want to have to spend time in a hospital bed to learn that lesson.
Still need additional help with enhancing nurse-patient communication? Let Lippincott Advisor help! Our leading clinical decision support resource provides instant, one-click access to over 17,000 evidence-based monographs and customizable patient teaching handouts. To further support patient-centered care, Lippincott Advisor also includes program sets that instruct bedside clinicians on how to teach patients, and provide culturally sensitive care guidelines for patients of diverse ethnic and geographic backgrounds.