When it Comes to Patient Care, Mother Knows Best

In my last post I worote about my latest experience in medicine. It wasn't as a nurse practitioner, but rather as a patient. And, it didn't go that well. As medical providers it's difficult to offer a positive patient experience under the pressure to bill, a packed schedule, the increasing amount of red tape in healthcare, and the disillusionment that can develop over the course of a career. Despite these pressures, it's time to get back to the basics when it comes to how we treat people. 

There will always be patients who are 'difficult', unpleasant, 'noncompliant', or otherwise unhappy. But, most people don't operate on this level. Most people are looking to go about their daily lives with a positive attitude and respond well to basic courtesies. Unfortunately, manners and the basics of treating people respectfully are missing from many of our nation's clinics and hospitals. We treat people as "patients" rather than individuals. 

Policymakers are looking to legislation to help fix our healthcare system, but I can't help but think that if healthcare providers got back down to the basics more than a few positive developments would result as well. My employer has suggested that NPs, PAs, and MD's working in the emergency department increase their focus on customer service in past months. And, guess what? As a medical provider I'm happier, my patients are happier, and I leave work feeling good about my day and not quite so mentally exhausted when I apply these principles. 

It's time we get back to the basic manners we learned from our mothers in our day to day as nurse practitioners. Here are a few places to start. 

1. Make eye contact, shake hands, and introduce yourself

I'm not a hand shaker. I think it's gross. Especially at work. But, my interactions with patients and their families start off on a positive note when I extend a hand, so, I do. Make eye contact and shake hands with everyone in the room while introducing yourself. A proper introduction starts a visit off with a foundation upon which respect and trust can be built. 

If you can't get past the threat of contracting c. diff as a result of shaking someone's hand, then at least make a point of making eye contact and introducing yourself to everyone in the room. Don't forget to ask friends and family members their names as well.

2. Ask "Did I do an OK job of explaining that?"

I explain what seems like the same set of advice, instructions, and medical knowledge to patients all day long. This makes it easy to rush through important information. Often I also misjudge a patient's level of education or background knowledge of their disease. Perhaps the language I used in my explanation was too technical in nature, or perhaps the patient was highly educated and looking for more. The question "did I do an OK job of explaining that?" puts the responsibility back on you as the medical provider if the information was lacking rather than the patient. Questions like "does that make sense?" can make the person on the receiving end feel stupid if they didn't comprehend the information.

3. Don't interrupt

I'm always in a hurry at work. Some days it seems I literally jog around the halls of the emergency department trying to make it from room 30 to room 18 (I hate having front hall and back hall patients at the same time- such a sprint!) with ultimate efficiency. I type information into medical charts at insane speeds, my fingers somehow remembering the keyboard patterns of the words I most commonly use. It can be hard to quell this "faster, faster, faster" mentality when I enter a patient's room. When talking to patients, pause, take a deep breath, and have a real conversation- without interruption. Otherwise, you dismiss patient's concerns and come across as rude. 

Studies show that providers, on average, interrupt patients within 12 to 18 seconds of their opening statements. Imagine if you interrupted your family members that often- what would your relationships look like? Stick with your mom's teachings on this one an let patients finish their sentences. 

4. Say "Thank You"

Too many times patients are treated as a bother or a nuisance rather than what they are- paying customers. This fact is often lost in a maze of medical billing intricacies. Yes, your patients are likely paying Blue Cross rather than you directly, but somehow you are being compensated for the care you provide. Even if you see Medicaid patients (I'll be the first to admit the system is seriously flawed) your patient has selected you as their provider and are taking their benefits through the doors of your clinic rather than a competitor's. So, thanking your patients for using your services is in order. 

5. Remember the Golden Rule

The "do unto others" concept pervades time, culture, and religion. Your mother probably told you to treat others as you would want to be treated and she didn't mean only in your personal life. It's time that as medical providers we approach treating our patients as we would treating our family members. What would you want your family member to know in a certain medical situation? How would you act toward them? The Golden Rule should be our ultimate reality check when it comes to how we provide patient care. 

How would you rate the way patients are treated in your workplace? What areas could use improvement?

 

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Comments

I work in corrections, so my patients have no choice in who they see, but I still follow the above rules. As for #4, I still say thanks for having the faith in me as a provider and sharing their healthcare concerns with me and giving me the opportunity to help them. They are charged a copay that sounds small to those of us on the outside ($5), but its the equivalent of about 15 -20 hours of work, so they are paying quite a large some of money every time they ask to see me and I try hard to give them their money's worth.

Charlie

Thanks for the encouraging words! Would love to hear what kind of changes you see in the practice :)

Erin Tolbert

I love this article. I am currently graduating from NP school, but already work as the administrator of my husband's very busy private practice. I plan to read this at our next staff meeting. Thank you.

Stacy

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