10 Ways to Help Nurses Improve Patient Satisfaction

10 Ways to Help Nurses Improve Patient Satisfaction

Rebecca Hendren, for HealthLeaders Media , September 6, 2011

Improving patient satisfaction is a financial imperative. Nurses are on the frontline of patient interaction and can make or break the patient experience. So why do we make it so hard for them to have positive interactions with patients?

Here are 10 changes to nurse procedures and working conditions that would improve patient experience. Some are simple, others more complex, all are effective.

1. Scripting: Many fear that scripting means fast food restaurant–type rote responses. In fact, it’s a useful tool when handled correctly. Scripting empowers nurses with tools to make their communication with patients easier. Regular discussion and training about patient interactions ensures nurses know what is expected. A scripting example: the hospital expects that all nurses will introduce and identify themselves and their professional credentials to new patients, and explain the treatment regimen. Scripting gives nurses tools for handling issues such as delayed procedures and lost test results. It also gives them tools for difficult situations such as deescalating angry patients.

2. Supplies: Keep frequently needed supplies in patient rooms and restock regularly. Maintain a multitude of stockrooms and supply cupboards and don’t make nurses walk miles to track them down. It’s frustrating for patients and staff when nurses have to stop what they are doing to track down supplies.

3. Uniforms: In many hospitals, RNs are indistinguishable to patients from the people delivering their meal trays. Consider choosing a defined scrub color for RNs to ensure that patients know who they can talk to and who is looking out for them.

4. Hourly rounding: Make a commitment to hourly rounding, and you will see patient satisfaction go up and call bell usage go down. Patients feel better when they know someone will be in to check on them within an hour. Alternating visits between RNs and nursing assistants ensures that the time commitment is manageable – and helps both groups plan their workflows since they no longer will spend so much time running after constant call lights.

5. Sitting down: Something as simple as sitting down when talking with patients can make a huge difference in satisfaction scores. Sitting down at the bedside implies that the nurse has time for the patient and is actively interested in the conversation.

6. Patient education: Make time for patient education. Nurses are pulled in a thousand different ways and often feel obligated to complete patient education as quickly as possible. But this time spent one-on-one means so much to patients. We know that patients often are too overwhelmed or intimidated to process information provided by physicians during initial diagnosis or post-procedure, and they look to nurses for easy-to-understand translation of difficult or complicated news. Put a value on this time with patients so that nurses will prioritize it.

7. Bedside report: Instead of conducting report at the nurse’s station or break room, do it at the bedside. Patients should be empowered to take an active part in their care. Increase their autonomy by discussing report in their presence and encouraging their involvement.

8. Nurse-led initiatives: Don’t simply hand down service improvement programs from above and tell nurses what to do. Programs driven by nurses have ready-made support and are often much more effective. Nurses will be more engaged in improving patient satisfaction when they develop ideas themselves and are accountable for success or failure.

9. Nurse empowerment: Nurses with autonomy over their practices provide better patient care. Ensure that the nurse practice council is robust and able to make decisions about clinical practice. Empower a nurse staffing committee to make decisions about safe patient care.

10. Demonstrate caring: According to Gallup polls, nurses are the most trusted professionals in the country. People can relate to nurses, whereas physicians can be intimidating to ordinary patients. The best patient satisfaction scores happen when patients feel genuinely cared for and cared about. Most nurses do this automatically. They bring an extra blanket or sit down and hold a patient’s hand for a few short minutes to provide comfort. Value these small details and recognize them publicly so that nurses know these parts of their role are just as important as the rest.

All for The Patient   ~ Miss Julia

JuliaGrayOnLine.com

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Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She editswww.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.

Listen Up Administrators- Here are 5 Reasons Nurses Want to Leave Your Hospital

5 Reasons Nurses Want to Leave Your Hospital

Your nurses have one eye on the door if you do any of the following.

Although economic woes abound, nurses are planning their exit strategies and will make a move when things improve. A recent survey from healthcare recruiters AMN Healthcare found that one-quarter of the 1,002 registered nurses surveyed say they will look for a new place to work as the economy recovers.

Are your nurses engaged, committed employees? Or are they biding their time until they can go somewhere better? To predict whether you face an exodus, take a look at the following five reasons why your nurses want out.

1. Mandatory overtime

Nurses work 12-hour shifts that always end up longer than 12 hours due to paperwork and proper handoffs. At the end, they are physically, mentally, and emotionally exhausted. Forcing them to stay longer is as bad for morale as it is for patient safety.  Some overtime is acceptable. People get sick, take vacations, or have unexpected car trouble and holes in the shift must be filled to ensure safe staffing. Nurses are used to picking up the slack, taking overtime, and pitching in. In fact, overtime is an expected and appreciated part of being a nurse. Many use it to help make ends meet. Mandatory overtime, however, is a different matter. Routinely understaffed units that rely on mandatory overtime as the only way to provide safe patient care destroy motivation and morale. Take a look at the last couple of years' news stories about RN picket lines. Most include complaints about mandatory overtime.

2. Floating nurses to other units

One nurse is not the same as another. Plugging a hole in a geriatric med-surg unit by bringing in a nurse from the pediatric floor results in an experienced, competent nurse suddenly becoming an unskilled newbie. A quick orientation won't solve those problems. Forced floating is usually indicative of larger staffing problems, but even so, its routine use is dissatisfying and compromises patient safety.  Instead, create a dedicated float pool staffed by nurses who volunteer and who can be prepared and cross-trained. Institute float pool guidelines that nurses float to like units. For example, critical care nurses find a step-down unit an easier transition than pediatrics.  Float pool shifts open up options for nurses who need more flexibility and offering a higher rate means you'll never be short of volunteers.

3. Non-nursing tasks

Nurses are already understaffed and overworked. Hospitals with too few assistants rub salt on the wounds. RNs shouldn't have to take time from critical patient care activities to clean a room or collect supplies. Gary Sculli, RN, MSN, ATP, patient safety expert and crew resource management author, offers a vivid analogy. Imagine if half way through a flight you saw the pilot come down the aisle handing out drinks because the plane was short staffed. It just wouldn't happen.

Yes, cleaning a room is important, but don't force nurses' attention away from their patients. Distractions are dangerous and compromise patient safety.

4. Bullying and toxic behavior

Bored of hearing about this topic? So am I. So are nurses. Nothing makes nurses want to walk out the door more than toxic colleagues—whether physicians, nurses, or anyone else—who are allowed to behave badly.  It's not enough to have a zero-tolerance policy. Enforce it. Preach it. Talk about the importance of respectful behavior. Explain expectations, not just at orientation but at multiple times through the year. Send information via emails, hold continuing education classes, and have the topic as a standing item on meeting agendas.  Give managers the tools to confront problem employees and back them up when they do. Have a plan in place to educate offenders. If the behavior continues after that, fire them. Support managers through this work. Nurses would rather work a nurse short than keep a disruptive employee who sabotages the morale and cohesiveness of the others.

5. Bad managers

You've heard it before: People don't leave companies, they leave managers. Yet hospitals still don't pay enough attention to leadership skills for nurse managers. Bad nurse managers who don't know how to lead are retention nightmares. Skilled managers are retention magnets.  Some hospitals have good managers who are stretched so thin they become bad ones. How can anyone focus on the professional development of their staff if they're overseeing several units with umpteen nurses across all shifts? Annual performance reviews shouldn't be the only time the manager and nurse engage in conversation. Nurse managers must help staff reflect on growth and plan for the future. 

These five reasons affect every aspect of nursing workload and contribute to fatigue and burnout. Don't forget that nurses always know when their colleagues at the hospital across town are happier.

Take from a Nurse ~ Miss Julia

JuliaGrayOnLine.com

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Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She editswww.StrategiesForNurseManagers.com and manages The Leaders' Lounge blog for nurse managers. Email her at rhendren@hcpro.com.