Page 22 - American Nurse Today January 2008

1. Caring with compassion
Unlike customer service, the term care with compas- sion brings to mind most nurses’ initial calling to a healing profession. The concept “care with compas- sion” doesn’t raise hackles because it’s in harmony with every nurse’s professional goals and self-image. It’s also substantive, not cosmetic. It evokes empathy for the patient’s discomfort and plight and encour- ages emotional generosity and personalized care.
Care with compassion addresses what is unique to health care—patients are sick, scared, and vulnera- ble. They need and depend on nurses. Everything nurses do to be a healing force in their anxiety-ridden experience is a gift.
2. Making sure caring comes across
No wonder nurses are insulted by reminders to be caring. Clearly, nurses care deeply. The question is: Does the caring come across to patients? What a shame when patients don’t
feel the nurse’s caring. Mean- ing well, thinking caring thoughts, or being motivated by good intentions aren’t nec- essarily visible to the patient.
A nurse who calls a pa- tient “honey” may mean well and may be trying to show warmth, but many patients are offended by the term and feel disrespected. A nurse may tell a patient’s daughter, “Visiting hours are over. Don’t worry. Your mother will be fine.” The nurse intends to offer reas- surance. But it backfires. The daughter resents being told what to feel. It’s her mother after all, and the daughter hears the nurse as dismis- sive, not caring.
How do you make sure you’re not hurting when you’re trying to help? By learning communication skills that will help you more effectively express your car- ing and thereby create a bet- ter experience for patients and families. (See Six ways
to make caring visible.)
3. Paying quality attention
In response to customer serv-
ice strategies, many nurses express frustration that their managers’ expectations are unrealistic—that their managers are urging them to spend more time with patients to provide better service. But unless barriers are removed and staffing and processes are improved, there simply is no more time. The idea that nurses should spend more time with patients— time that nurses don’t have—is maddening. In fact, the key is not to pay more attention to patients, but to pay better attention to them. Focus on quality, not quantity.
If I could advance one skill that would create breakthroughs in patient satisfaction and anxiety re- duction, it would be the skill of presence or mindful- ness. This skill involves controlling your attention, so the person on the receiving end feels like the center of your universe at that moment. Using this skill pro- duces payoffs for both the patient and nurse. When patients feel your focus and caring, you connect with
Six ways to make caring visible
These communication skills are neither simple nor obvious. But by learning and sharpening them, nurses can help patients and families perceive them as the caring people they are.
Communication skill
1. Using active listening
2. Showing caring nonverbally
3. Making explicit your positive intent
4. Using the words “for you”
5. Using the blameless apology
6. Expressing appreciation
Explanation Examples
Acknowledge and reflect the person’s feeling in a nonjudgmental way.
Use facial expression, intonation, posture, eye contact, and the like to mirror the patient’s feelings.
Explain your purpose. Describe how your actions are in the patient’s best interests.
Make it clear that the patient is your focus.
Express genuine regret that the patient is having a negative experience without taking blame or blaming anyone else.
Give the personal gift of positive regard.
• “I can imagine this might feel scary to you.”
• “You seem upset this
morning.”
• Show a sense of urgency nonverbally as you enter the room to respond to a call light.
• Use your facial expression to show concern when the patient appears upset.
• “I want to make you comfortable. Here’s a blanket.”
• “I want to help you with your pain.”
• “I’ll call your daughter for you.”
• “Let me check on the test results for you.”
• “I’m so sorry it’s been a frustrating morning for you.”
• “I’m really sorry about the delay.”
• “I really admire your courage.” • “Thank you so much for
speaking up.”
22 American Nurse Today Volume 3, Issue 1