Surveys Aside, One Crucial Precondition for Real Patient Satisfaction

callbellBy Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN. 

During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
1. Never
2. Sometimes
3. Usually
4. Always
5. I never pressed the call button

Everyone is talking about patient satisfaction these days. Purposeful rounding, responsiveness, and customer service are discussed in meetings, on blogs, and in conversations at work. An entire science has been created out of satisfaction, with whole journals devoted to patient experience and paid officers tracking scores and strategies. Since hospital reimbursement is linked to how happy patients are, we’ve suddenly gotten serious about satisfaction.

But behind the sterile questions on the HCAHPS survey, real stories about real people reside. I find myself often forgetting the flesh and blood that’s represented by each checked box, and am learning to realize that, while satisfaction is something to be striven for, dissatisfaction is something to be learned from.

In a series of posts, starting with this one, I’ll share stories of my own missteps—ones that may have caused my patients to answer never instead of always to questions about my care. The events described here helped me realize that, score or no score, responding to call bells actually matters at the human level:

Sarah […]

2016-11-21T13:02:20-05:00June 29th, 2015|Nursing, nursing perspective, patient engagement, Patients|9 Comments
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Nurses Aren’t Just Healers, They’re Teachers Too: A Patient’s View

Illustration by Jennifer Rodgers. All rights reserved. Illustration by Jennifer Rodgers. All rights reserved.

A teeny red bump had mysteriously appeared on my left index finger. It hurt when I pressed on it. I figured it was nothing. . . .

That’s the start of the June Reflections essay in AJN, “Ms. Lisa and Ms. MRSA,” a patient experience narrative by freelance writer Shannon Harris. As luck would have it, the bump on her finger, it turns out, is not nothing. It’s MRSA.

The diagnosis takes a while. Finally the situation worsens, and surgery is needed. The author takes it all in stride, at least in retrospect:

The third physician stood out to me most. He asked to take a picture of my green and black, staph-infected finger with his iPhone. “Sure. Look at it! I thought this only happened to pirates,” I told him as he snapped away. He glanced at the young, button-nosed nurse standing beside him. “Don’t you want a picture? For your records?” he asked.

She shook her head, squinting and gritting her teeth. “I know. Yuck,” I said. I later shared photos of my infection journey online, to the great wonder and disgust of my friends and family. Before that, though, came surgery.

The author’s tone is light, but the […]

2016-11-21T13:02:27-05:00June 3rd, 2015|Nursing, patient engagement, patient experience, Patients|1 Comment
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AJN in June: Gastrostomy Complications, Nursing and Mindfulness, Cultural Competence, More

01AJN0615 CoverAccording to one of the authors of “Cultivating Mindfulness to Enhance Nursing Practice,” the Cultivating Quality article now available in our June issue, mindfulness can be understood as a practice centered around “remembering to pay attention with care and discernment to what is occurring in your immediate experience.” On the cover of our June issue (left), nurses at the Dana-Farber Cancer Institute in Boston practice mindfulness in a spacious garden, as part of a multifaceted program to help nurses manage stress and make the best of opportunities to more fully connect with patients and families. The article discusses the outcome of the program and how nurses in all settings can use mindfulness-based techniques to enhance their well-being and the care of patients.

Also in the June issue, a continuing education (CE) feature article, “Early Percutaneous Endoscopic Gastrostomy Tube Dislodgment,” describes the details of a case study of early percutaneous endoscopic gastrostomy tube dislodgment, attempted replacement, and subsequent sepsis that resulted in the patient’s death. This case is used to better inform nurses about gastrostomy techniques, complications, preventive strategies, and proper tube management. […]

2016-11-21T13:02:28-05:00June 1st, 2015|career, Nursing, nursing perspective, patient engagement, Patients|0 Comments
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The Challenge of Eating Disorders: A Teacher Learns a New Mindfulness Technique

“She’s brought a cup with her. This is not unusual. Clients often bring food or drinks they’re required to finish—but when Mariko reaches inside the cup, I hear the brittle clicking of ice and look closer. There’s no beverage. She pulls out a piece of ice and, without a word, curls up on her side, cradling the cube tenderly in her palm.”

By Jacob Molyneux, senior editor

Illustration by Anne Horst for AJN. Illustration by Anne Horst for AJN.

We hear a lot lately about mindfulness and its benefits in the workplace for dealing with stress, increasing productivity, and the like.

It’s been pointed out lately that mindfulness has become a tool with many uses, some more in keeping with its role in various spiritual traditions than others. Such traditions seem to use meditation practices in order to cultivate compassionate awareness of the varieties of suffering arising from the impermanence of everything from pleasant and unpleasant feelings and the weather to the lives of our loved ones.

This month’s Reflections essay in AJN is by a mindful movement teacher at an eating disorder treatment center. Eating disorders can involve mental and physical suffering that’s unrelenting and self-sustaining. Many clinicians and therapists find patients with eating disorders very challenging to work with. The essay, called “Distress Tolerance,” tells the story of an encounter in which the […]

2016-11-21T13:02:39-05:00April 27th, 2015|Nursing, patient engagement, Patients|0 Comments
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Recent End-of-Life Care Links of Note, by Nurses and Others

nature's own tightrope/marie and alistair knock/flickr creative commons nature’s own tightrope/marie and alistair knock/flickr creative commons

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

End-of-life care and decision making have been getting a lot of attention lately. The Institute of Medicine released a new report earlier this year, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life (available for free download as a PDF).

Nurses who write often write about end-of-life matters. A couple of recent examples:

On the Nurse Manifest Web site, a look at the realities and challenges of futile care in America. Here’s a quote:

“I am currently teaching a thanatology (study of death and dying) course for nurses that I designed . . . to support students to go deeply in their reflective process around death and dying, to explore the holistic needs of the dying, and to delve into the body of evidence around the science and politics of death and dying.”

Or read another nurse blogger’s less abstract take on the tricky emotional territory nurses face when a patient dies.

Elsewhere on the Web
Vox reporter Sarah Kliff collects five strong end-of-life essays that recently appeared in various sources.

And here’s something very practical that might catch on: according to a recent […]

2016-11-21T13:02:42-05:00April 13th, 2015|career, Nursing, nursing perspective, patient engagement|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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