I’m pleased and honored to host the Nurse Blog Carnival for the very first time. Wow!
My professional passion is people skills: better ways to build rapport, coöperation, and treatment adherence quicker and easier. Providers benefit by saving time and energy, and having more friendly patients. It turns out nursing CAN be fun!
Such a project requires improved empathy: learning about the other’s point of view as accurately as possible, respecting that point of view, and tailoring treatment accordingly. In short, patient-centered care!
People use words to communicate. Unfortunately, sometimes people abuse words to decieve.
Abused words sound nice but offer illusions. When corporations take over health care, we see an explosion of them:
Ever read Dilbert? Often you see word abuse: people taking up space and avoiding the risk of actually saying anything real. In health care today, we see too much word abuse, including, sadly, “patient-centered care.” I’ve seen this phrase used honestly, but also abused as an empty slogan to make facilities sound better without actually improving anything. A marketing mirage.
Patients need the real deal, of course, not empty words! Thankfully, nurses are on the case.
In Nicole’s Med Surg Wedding: Patient Centered Care, Beth Hawkes describes how she and her colleagues used two of my favorite words in nursing, “Why not?” Patient-centered care – the real deal – involves meeting patients as equals, listening, meeting their needs, finding a way and getting it done. Not always easy, it remains very much the heart and soul of nursing.
Elizabeth Scala asks Who is the Most Important Person in the Patient-Centered Care Model, and wisely points out that to properly care for others, we must also care for ourselves. She offers practical tips. Burnt out, tired, distracted nurses can’t do their best work. If we neglect crucial self-mantainence, soon enough we’ll become like dull saw blades. Increasingly we’ll generate friction and frustration instead of getting the job done. Self-care isn’t selfish: it’s mandatory for any sustained caregiver. (Also check out her book, listed at the link above!)
In Holding Their Hands through Life – 3 Ways Nurses Deliver Patient-Centered Care, David Greene, RN describes some of the struggles involved and the wonderful results, going back to Florence Nightingale’s experiences in the Crimean War saving many wounded soldiers’ lives. He also provides his own experiences as a hospice nurse. Like Beth Hawkes, he uses “Why not?” reasoning to get it done for his patients.
In Are You a Task Or Relationship Oriented Nurse? Joyce Fiodembo, RN offers advice based on Maya Angelou’s wisdom:
People will Forget what you did,
People will Forget what you said, but
People will never Forget how you Made them feel.
Joyce describes a patient experience of her own. In patient care, what goes around comes around that much quicker, harder, and often. You’re far better off if what comes back around is pleasant!
April Tenhunfeld MSN, FNP-C APRN speaks about an ominous experience as a patient in Medical Mistakes: Have you been a victim? Hospitals are often dangerous places for patients. I worry about surgeons who take on too much, too fast, increasing both revenues AND errors. Nurses offer patients so much protection every day, yet… there are limits. We need to do our best to see that everyone in health care accepts this fact. There are limits. We are all human. What’s more patient centered than avoiding harm?
Joyce Harrell, RN, OCN offers Patient Centered Nursing Care Model & Pets: useful resources and a touching story. A cat and dog visit the unit where I work, once a week. Seriously ill and difficult patients blossom, relax, engage. It’s the most popular, peaceful, and HAPPY activity I’ve seen in many years on any psychiatric unit. It addresses people, not illnesses.
As Kathy Quan RN BSN PHN discusses in Renewed Interest in Patient-Centered Care, it’s hardly a new idea. The problem, as Kathy points out, is that profit-driven institutions seem to place value in this idea as – remember? – a buzz phrase: fake words for ads and press releases. If they were honest… we’d likely hear about billing gambits, staffing cuts and profits instead. It’s a serious problem nurses must face, lest it run us over. Kathy discusses one option: how hospice and home-care nursing have allowed her to live up to up to her values. We must all do what we can. No one will do it for us.
Nicole Deziel brings a student perspective. In Patient Centered Care- Nursing Student Style, she raises an excellent point: given lighter patient loads, student nurses have a fantastic opportunity to tailor care empathically. I can remember meeting a few goals in clinicals that experienced nurses hadn’t achieved, simply because I had the time. One patient had a truly awful medical situation, was horribly depressed and refusing to eat. I achieved treatment adherence, for a shift anyway, partly by taking him to the cafeteria for a milk shake. It was time-consuming, unorthodox and it WORKED! Such small victories you never forget. Thanks, Nicole, for bringing back pleasant memories!
Marsha Battee, RN offers training in entrepreneurial startups. In her post she asks: why not make patient – centered care your professional focus? In Guiding Patient-Centered Care: An Alternative to the Bedside, Marsha tells us all about becoming a Care Navigator / Care Guide. It sounds promising to me – both the navigator role and the startup training!
In How Examining Our Own Motivation Can Help Us Provide Patient-Centered Care!, Beth Boynton, RN, MS makes an interesting and important point. Professional helpers are usually people who like to help. Our want to feel useful and important can lead us to unwittingly encourage patient dependence on us. We see this kind of dynamic in psychiatric nursing often, as certain patients tend to encourage it. It’s great to feel important: in fact many experts over the years have described it as one of the deepest needs for all human beings. We need to take care to serve our patients, not ourselves.
In The Patient Centered Medical Home, Rachel Silva DNP, APN, NP-C, FNP-BC explains the Medical Home concept, proposed by the Agency for Healthcare Research and Quality (AHRQ) to improve care quality and coördination. It sounds like a building, but it’s not! It offers ambitious, worthy goals and interesting ideas, although it remains to be seen if it will happen in practice, and how. I see a risk for word abuse, true of all new ideas.
Finally, in I Am Not The Nut Job Lady In Room 13, Let’s Focus on Our Human Patients, Leslie Block, RN describes just how we can dehumanize our patients: view them as problems, categories or jokes instead of human beings. She also describes her experience as a family member of a patient – her husband. Unless we treat patients as people, they often make us pay for it. I see it often: staff suffer in ways they could have easily avoided. We’re far better off finding ways to do better, easier, than we are with more of the same. AND we become better, happier nurses that way too.
By the way: the one time I had to stand up for my wife in an ER, I calmly told that entire staff – nurses, docs, all of them – unpleasant things they definitely didn’t enjoy hearing, and they definitely agreed were fair. They offered no reply except stunned silence, the ‘stare at the floor’ thing, and meeting my requests. The sad thing was they lost time trying to save it: so common! Oh, and I’ve gotten nothing but VIP treatment from that hospital ever since, across the board. I guess I made an impression…
Final lesson for today:
When you mess with a family member, they just might be a psych nurse! 😉
Thanks so much to all our contributors this month, and to the most important folks in this project: all you readers.
Have any ideas or stories of your own? I’d love to hear them! Let’s start a conversation, pool resources…
Thanks again – Greg