All Unhappy Patients Are Not Alike

illustration by the author illustration by the author

The first sentence from Leo Tolstoy’s novel Anna Karenina is one of the most famous in literature:

“All happy families are alike; each unhappy family is unhappy in its own way.”

It can easily be applied to patients. Happy patients tend to love their doctors, feel they received the best possible care, and consider their nurses invaluable.

Unhappy patients are unhappy in their own way. The challenge for busy nurses is resisting the temptation to turn a deaf ear or feign listening, in effect reducing patients’ concerns to “waa, waa, waa.”

A common thread among unhappy patients is unmet expectations.

Sometimes the patient’s expectations are unrealistic because they’re based on incorrect assumptions—but they do not know this. Responding requires a willingness to listen and the patience to tease out why a patient is unhappy with their care. Let patients tell their stories. Most bedside nurses have limited time; it’s okay to enlist help from a case manager, social worker, or nurse navigator if necessary. However, investing time up front to improve communication with a patient may pay off in dividends by smoothing the rest of your shift.

Begin by listening. Sometimes, I’ll take a seat, and write what the patient says while they talk. This simple act […]

2016-11-21T13:00:58-05:00September 6th, 2016|Nursing, nursing perspective, patient engagement|0 Comments
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Daniel

jen promesJennifer L. Promes is a gerontological clinical nurse specialist and Magnet Program director in Omaha, Nebraska. In this post, she describes an experience she had early in her career while working as a certified nursing assistant in a nursing home’s memory support unit.

Daniel had a kind, mild-mannered disposition, but because of his advanced dementia he would sometimes become agitated and belligerent, especially at night. Most of the staff didn’t want to help him prepare for bed. I knew Daniel was much more cooperative if you distracted him by talking about his past, so one night I volunteered to help him with his personal care.

All of the residents had just finished their evening meal and were waiting patiently at their tables to be assisted back to their rooms for the night. As I approached Daniel–a short, stocky bald man in his late 80’s with thick-rimmed glasses, always dressed in a button-up flannel shirt, polyester slacks, and square-toed, diabetic shoes—I could tell he was “working on something.” He had a table knife in his hand and was prying at the seam between the two leaves of the table. He was quietly muttering something under his breath as he worked, his head nodding as he grew more tired.

Daniel would “fix” anything he could get his […]

2016-11-21T13:01:06-05:00July 12th, 2016|narratives, Nursing, nursing perspective, patient engagement|1 Comment
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The View from the Other Side: When the Daughter is a Nurse

I knew where we were heading and it scared me. I didn’t want to have to think about decisions that would have to be made in the not so distant future. I didn’t want to be a nurse; I just wanted to be the daughter.

Flowers_in_the_field_(5832054482)I knew Marie was special the moment I met her. Her home was one where all were welcome, the coffee always hot and fresh, the house filled with family and friends, and everyone left with a full belly. She freely shared her opinion, whether or not a person sought out her advice.

I knew Marie for nearly 30 years. She was my mother-in-law. She was also my cheerleader, proud that I had come so far in my nursing career. She told everyone I was a nurse and often referred to me as her daughter rather than specifying that I was her daughter-in-law.

Fiercely loyal and loving of her large family, she always put their needs before hers. I worried about her because she smoked and rarely visited a doctor. With regard to health, she believed in the notion that if it ain’t broke, don’t fix it. But slowly, health problems began cropping up. After a hospitalization for heart failure, she was diagnosed with COPD and hypertension.

Still, […]

2016-11-21T13:01:07-05:00June 30th, 2016|narratives, Nursing, nursing perspective, patient engagement|1 Comment
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A Strong Case for the Professional Introduction in Nursing

nametagDo you always introduce yourself by name to your patients? Or do you simply say, “Hi, I’ll be your nurse today?”

In their Viewpoint essay in the June issue of AJN, Raeann LeBlanc and two colleagues at the University of Massachusetts Amherst College of Nursing make a strong case for the professional introduction, in which “a nurse states her or his full name and role in the patient’s care.”

The authors argue that professional introductions are “a powerful way to make clear the centrality of the nurse’s role in the care of the patient.” When nurses use professional introductions, we make our knowledge and expertise more visible and help patients better understand just what it is that nurses do.

The authors also address potential safety concerns nurses may have about disclosing their full name to a patient, and they offer some reasons why the importance of professional introductions may not be taught in nursing school.

[…]

2016-11-21T13:01:07-05:00June 28th, 2016|Nursing, nursing perspective, patient engagement, patient experience|5 Comments
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Food is Medicine: An Oncology Nurse’s Lunch Break Walk

IMG_3900 (002)On a beautiful spring day I took a walk during my lunch break through the urban neighborhood surrounding the hospital, wishing for a convenient place to buy a piece of fruit.

I discovered, as if conjured, a vintage trolley tucked in a driveway between medical office buildings. A table laden with apples, carrots, potatoes, and leafy greens leaned against it, creating the ambience of an open-air market. Charmed, and curious about its purpose, I climbed the two steps into the trolley.

Inside, a refrigerated case contained meats and dairy products. The walls were lined with shelves containing packaged goods such as bulgur, brown rice, beans, and more fresh fruits and vegetables. I plucked an orange, noticing it was priced by the piece, not by the pound.

I had multiple questions for the clerk as I handed her a quarter to pay for the orange.

A food prescription program.

The trolley, it turned out, is a mobile grocery store in partnership with the hospital, piloting a “food prescription” program. It arrives weekly, traveling to other sites the rest of the week. Cash, cards, and food stamps are accepted. Outside, a caseworker seated on a camp chair gave food vouchers to qualified customers below a specific income level. A dietician also provided budgeting assistance, with tips on healthy food choices and […]

2017-07-17T14:20:55-04:00June 17th, 2016|Nursing, nursing perspective, patient engagement, Public health|2 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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