Generally no one wants to be in a hospital, especially in flu season as we surge above 100% occupancy and the emergency department is defined by stretchers lining the halls, the vulnerable patients–elderly folks in acute distress, waiting is the norm and reaching an inpatient unit does not end the reality of waiting.
The patient experience is a focal subject these days as organizations attempt to build and sustain policies and processes that will support individual needs and yet we’re struggling with the need to be efficient and mindful of the increased workload on staff. Operating above the baseline census has become the norm in the unit I work in (currently as the manager, hopefully transitioning to permanent) and the workload, acuity, complexity and patient/family expectations impacts the staff shift to shift and affects their job satisfaction.
The staff includes not only nursing but also allied health, housekeeping, clerical, and physicians. The importance of being in the moment at point of care includes the range of interventions whether a cup of medications, incontinence care, ambulation, or a treatment. At the very least we need to acknowledge the patient by making eye contact, engaging in the skill of small talk, provide a moment of caring through a smile and a dose of empathy. Brene Brown provides an excellent definition of empathy (https://www.youtube.com/watch?v=1Evwgu369Jw) and cross checking standards of nursing this is a key element for a therapeutic relationship. There is always a way to be empathetic and it only takes moments.
A family I met were exemplars for advocating for their loved one, they did not tolerate indifference, they clearly identified their expectations and described their experiences. They asked how nurses could walk past a room that showed a call bell light and not ask or acknowledge there was a need? They described their concern that if they were not there would their loved one receive timely interventions? They asked valid questions why nurses did not help each other, indeed they appeared indifferent that a colleague was “drowning”?
Good questions, I pose you need teamwork, effective workflow, and accountability to enhance staff satisfaction; in turn the staff have the wherewithal to enhance the patient experience by ensuring they use empathy, provide timely interventions, and display accountability, advocacy, caring, and commitment to excellence. Families do not need to be perceived as difficult, indeed one needs to use a lens that a family is difficult for you to manage, remember they did not choose to have their loved one in the hospital. Circumstances of need have brought them to your point of care, if they’re distressed we need to apply our knowledge, skill, and judgement to ease their distress. For we have the responsibility of ensuring the therapeutic relationship is being met by nursing—creating trust, building relationships, being accountable, demonstrating caring, and ensuring teamwork is more than a word. Teamwork is esential to staff satisfaction. Indeed one’s job satisfaction is yours to manage, you own it; as a manager I intend to collaborate, lead the way, inspire, and optimize resources. The capacity of nurses is impressive and the patient experience is inexorably linked to the efforts by staff nurses.