Patient Connection Increases Nurse Satisfaction and Performance

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By Megan M. Krischke, contributor

June 17, 2011 - Most Americans say that meaningful work is the most important factor that they are looking for in a job, according to Adam Grant, management professor at Wharton Business School. And no doubt many nurses chose their profession because of their desire to make a difference in peoples’ lives. Yet a recent report found that nurses scored the lowest of all hospital workers when it came to their job satisfaction and sense of engagement in the workplace.

In the 2010 Annual Pulse Report by Press Ganey, a consulting firm that partners with health care organizations to create high performing organizations and improve the overall health care experience, the “employee partnership” score of RNs, LPNs/LVNs and nursing assistants ranked the lowest among four divisions of hospital employees.

Because of nurses’ high level of patient contact, it would seem Press Ganey’s findings stand in contrast to Grant’s study, published in the June 2011 issue of Harvard Business Review, which revealed that the more connected employees feel to the end users of their products or services the better they perform.

Nurses, however, rarely see the long-term outcomes of their patients, explained Mary Boustani, MHA, FACHE, former hospital administrator and current managing consultant for Press Ganey.

“The study in the Harvard Business Review focused on sharing written comments or bringing back the end user after the experience to talk about it with the employees. I agree that this is a time when an emotional connection can be made between a patient and the nursing staff,” said Boustani. “This is a time when nurses get to see the outcome of their heroic efforts as clinicians, although some will say they were ‘just doing their job.’ As a hospital administrator, seeing former patients return to visit their nurses always gave me a great feeling. I can only imagine the impact it has on the nursing staff.”

“I believe hospital leaders should do more to read and post comments from patients and to recognize nurses for ‘just doing their job’ or for their truly heroic efforts,” Boustani continued. “Coordinating events to bring back former patients to share their stories is a great way to allow the nursing staff to make an emotional connection to their field and can serve to re-energize them to continue to focus on providing great patient care.”

As part of Grant’s research, he posted signs next to hand washing and sanitizing stations around a hospital. Half of the signs read, “Hand hygiene prevents you from catching diseases.” The second sign replaced “you” with “patients.” While the first sign had no effect on soap and gel use, the sign emphasizing the importance of hand washing for patients’ health increased the use of soap and gel by 33 percent.

“Although many nurses have frequent contact with patients, my research has identified several ways to strengthen nurses’ connections to their impact on patients,” commented Grant.

Grant offers these practical suggestions for increasing the connection of nurses and their supervisors with patients and their families:

Facilitate long-term follow-up. Invite former patients to visit, talk or write about their hospital experiences. This can be powerful given that nurses rarely have the opportunity to see the lasting difference that their work makes in patients’ lives over time.

Personalize the patient interaction. Collect unique information about each patient during the hospitalization (e.g., personal interests or stories about how they met their spouses). This can set the stage for greater identification and empathy, and enable nurses to discover points of similarity that facilitate bonding.

Gather novel information. Gather stories about less familiar ways in which nurses can and do make a difference. For example, stories might describe how nurses have inspired patients to join the health care profession, or how nurses have taken courageous actions to identify and correct errors made by doctors.

Get the patient’s perspective. Enable nurses to see the world from patients’ points of view, such as by spending time in the patient’s role.

Recognize a job well done. Create visible awards for meaningful actions taken to benefit patients.  This is especially memorable if award nominations can be submitted by patients, as well as by co-workers.

Nurses can also be more proactive about increasing their connection to patients. Manoj Jain, M.D., MPH, an infectious-disease specialist in Memphis and an adjunct assistant professor at the Rollins School of Public Health at Emory University in Atlanta, teaches his students how to provide and maintain compassionate care for their patients. He emphasizes what he calls the three Ts: Talk (and listen), Take time, and Touch.

“Nurses do the three Ts more often with the patient compared to doctors because they are more involved in direct care. In this case, I think nurses can go into depth by listening more attentively and following up with a question which tells the patient that they have been heard,” explained Jain. “For example, a nurse may say, ‘You said your grandchildren are in college--are they nearby or far away?’”

“The correlation between patient, employee and physician satisfaction, in my opinion, goes back to the culture and environment of the organization. If I have satisfied and engaged employees who receive effective communication, are involved in decisions, have a relationship with leaders and are recognized and motivated to do their job--the patient wins,” stated Boustani. “They have a nurse who is communicative and involves them in treatment decisions, a nurse who is responsive to their needs, a nurse who makes an emotional connection to them because he or she sits down for a few minutes and looks them in the eye and has a meaningful conversation.”

“The role of a personal connection with patients enables the nurse to reduce anxiety the patient is feeling. Patients feels listened to, involved in their care and they can breathe a sigh of relief knowing they have a someone watching out for their health and well-being,” concluded Boustani.

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