The Nurse Patient Relationship Is
Central to Patient Satisfaction
The nurse patient relationship, according to research by Press Ganey Associates Inc., sets the tone of the care experience and has a powerful impact on patient satisfaction. Nurses spend the most time with patients. Patients see nurses’ interactions with others on the care team and draw conclusions about the hospital based on their observations. Also, nurses’ attitudes toward their work, their coworkers and the organization affect patient and family judgments of all the things they don’t see behind the scenes.
Without a positive nurse patient relationship, there cannot be patient and family satisfaction. And there cannot be an environment that supports anxiety reduction and healing.
By analyzing and understanding the factors that have the greatest impact on overall patient satisfaction, you can AIM. You can focus your efforts and resources on improvements with the greatest potential to enhance the patient experience.
On the CAHPS survey, there are two global items: “Overall rating of hospital” and “likelihood of recommending hospital.” Based on 2007 CAHPS and Press Ganey Survey data, Press Ganey identified “Nurse Communication” as the factor with the greatest impact on patients’ overall ratings of their hospital experience.
that focus on the nurse patient relationship drive patient ratings of their overall experience. Quality of communication in nursing also has the highest impact on patients’ likelihood to recommend the hospital.
To hear Wendy speak about Communicating with Empathy, click the play button below.
Patients and families want much more from nurses than competent clinical care.
Patients and families count on nurses to keep them informed, to connect them to their physicians and other caregivers, to listen to them, to ease their anxiety, and to protect and watch over them during their healthcare experience. Because of these high expectations of nurses, it’s no wonder that nursing performance, and more specifically, the nurse patient relationship, is so central to patient satisfaction and a quality patient experience.
for a poster that makes this point.
Yet, in strategies to achieve service excellence, while some nurses are enthusiastic, committed and supportive, many express concerns and resistance.
There’s more than one grain of truth in each of these sentiments.
- Some nurses feel insulted. They think, “I’m a nursing professional! I’m with people when they’re sick and dying, and now I’m being told to smile more?!?” Or they feel judged, “How dare anyone imply that I don’t care!?!”
- Some nurses feel resentful. They think, “When this organization removes the obstacles that make my life difficult, I’ll smile more!”
- And other nurses feel cynical. They think, “This IS important, but it won’t stick. This too shall pass like other things we’ve tried to do here.”
See Wendy Leebov’s
in American Nurse Today that makes the case and defines a much more relevant goal for nurses –a goal that reduces possible resistance significantly. We need to help nurses communicate expertly and connect at a personal and emotional level in ways that do not take more of their time—time that they don’t have.
- Often service improvement strategies in health care have emphasized cosmetic aspects of the service relationships. Nurses are keenly aware of working with people who are emotionally drained and emotionally charged, and facing traumatic life circumstances. Making them happy hardly seems like a relevant goal, and nurses perceive it as superficial and discounting of the important work they do.
- Resistance to raised service standards is also understandable when nurses perceive leaders as doing too little to remove obstacles to provide excellent care and service. Broken equipment, linen shortages, short staffing, inadequate support in the face of disrespectful doctors – all of these and more obstacles cause nurses to say, “Don’t pin patient dissatisfaction on us! We don’t have the support we need to provide the care we WANT to provide.”
- Cynical nurses who are very dedicated to patients and families sound their frustration over past initiatives that raised their hopes but then fizzled due to lack of follow-through by the organization’s leaders.
Leaders also need to run interference. They need to remove the barriers and create the conditions that make it possible for nurses to serve their patients and families with diligent and compassionate care.
And finally, to engage nurses’ hearts and minds in strengthening their communication with patients and families, leaders need to ensure follow-up and follow-through. Quick fix approaches might be compelling but not sustainable. Strengthening nurses’ skills and the hard work of supporting APPLICATION of these skills to the nurse patient relationship in their everyday work requires a long-term investment of time and energy… or cynicism is the predictable result.
Help Nurses Make Their Caring Felt
Nurses care, but patients and families may not FEEL their caring.
Nurses are so swamped. Their multiple responsibilities breed task-orientation, not people-orientation. Then, seeing nurses focus on the tasks and activities of their jobs, patients and families wonder, “Where has all the caring gone?”
The caring is still there, but it might as well not be if patients and families don’t see or feel it. That’s why there’s a crying need today to help nurses speak the language of caring so that their caring reaches the people they serve. In everyday routines, there are so many opportunities to make their caring felt and ease their patients’ anxiety. For instance, when one nurse’s shift is ending and another nurse is taking over the patient’s care, the first nurse can ease the transition for the patient by speaking the language of caring during
this important handoff.
|Caring Framework for Nursing Practice|
Dr. Jean Watson in “The Theory of Transpersonal Caring” said,
- Caring is central to the nursing role and its mission as a distinct profession.
- Caring is often the measure by which patients evaluate their “cure-dominated” experience.
Highlight the Meaning in the Nurse’s Work
Dr. Jean Watson also said, “Caring is transpersonal in nature, involving the one caring as well as the one being cared for.” With nurses so fraught with multiple demands and pressures, many lose touch with their caring mission. This is a sad shame. It leads to fatigue and disillusionment. Some remain in the job and these effects show in their relationships (or lack of relationships) with patients, families and coworkers. Others leave in a cloud of cynicism and grief that may be personally damaging to the nurse and also discouraging to future prospects for nursing careers.
Nurse Managers (also fraught with an overload of responsibilities) need to adopt as a central priority helping their nurses rekindle and sustain their passion for the work…. Ask these
Three Appreciative Questions
to focus your nurses on their contributions.
Services That Enhance the Nurse Patient Relationship by Wendy Leebov and Associates will help your nurses:
Workshops for Nurses
- Renew their sense of caring mission and help them sustain their passion for the work
- Speak the language of caring in the full range of emotionally demanding situations they handle daily
- Score highly on patient satisfaction survey items that focus on communication in the nurse patient relationship and correlate highly with patient ratings of their overall experience with your organization.
Peer Coach Training
to discuss services that enhance the nurse patient relationship tailored to your unique needs and priorities.
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