Improving Nurse Communication with a 56-Second Strategy

May 24, 2017 - Using nurse communication to deliver compassionate care is a high priority in the healthcare industry, especially considering the unique impact nurses have on the patient experience.

Nurse empathy and communications have a tremendous effect on patient satisfaction because nurses are on the frontlines of most patient encounters. Healthcare organizations across the country are working to instill values of compassionate and connected care with their nurses to improve the patient experience.

However, recognizing the importance of compassionate care in nursing may not be the problem, according to Press Ganey Chief Nursing Officer Christy Dempsey, MSN, CNOR, CENP. Having enough time within the clinician workload is a bigger barrier to meaningful nursing communication.

“When I talk about making a connection with patients and the six themes of compassionate, connected care, nobody ever argues against it,” Dempsey said in an interview with PatientEngagementHIT.com. “Everybody wants to do that. The pushback is always not having the time. Nurses say, ‘you must be joking if you think I can spend 15 to 20 minutes with every patient.’”

Making the elusive patient connection doesn’t have to take that long, Dempsey argued. Amidst the increasing workload nurses face, interpersonal skills are falling by the wayside and connecting with the patient is appearing as a more time-consuming task than it actually is.

READ MORE: Is Sitting the New Patient Communication Strategy for Nurses?

“There is so much to do, so much to accomplish, so many checklists to fulfill that the connected nurse is going away and becoming a lost art,” Dempsey explained. “I wanted to help nurses understand that it doesn’t take more time to connect. Instead, it’s how nurses connect that makes a difference.”

For Dempsey, making that connection can take as little as 56 seconds. As she demonstrates during her numerous speaking engagements with Press Ganey, Dempsey can make a connection with patients when she sits down to introduce herself at the beginning of a shift.

After asking what the patient prefers to be called and reviewing some of the procedures scheduled that day, Dempsey shifts the conversation over to the patient’s real interests.

“When you’re not in the hospital, what do you like to do?” she’d ask.

Patients usually give answers about their families or hobbies, invariably giving Dempsey something she can connect with them.

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“In truth, there aren’t even six degrees of separation between us,” she said. “We can always find something in common that will make a personal interaction. And when I’m ready to wrap up that interaction, I always conclude with that connection.”

When demonstrating this tactic with a nurse at a recent conference, Dempsey remarked how she could potentially connect with a patient about running.

“When I come back we’re going to talk about running because I need your advice,” she said at the time. “In the meantime, I’m going to ask you a lot of questions and I’m going to do an assessment and I want you to ask me any questions that come to mind because we’re in this together.”

In total, these conversations usually don’t take longer than two minutes. To reach that initial connection with the patient, Dempsey typically takes under a minute, she reported.

Nurses also need to be perceptive to what the patient is feeling during those connections.

“Patients are scared to death,” Dempsey asserted. “They don’t know what’s going to happen to them, they don’t know if it’s going to hurt, they don’t know if they can afford it, they don’t know if it’s going to change their lives or the lives of their family.”

Fear can keep patients from retaining important clinical information and following care instructions properly. Thus, it is critical that nurses detect that emotion and allay those fears in their patients.

“When nurses do that 56-second connection, recognizing that their patients are scared and helping them to feel safe is one of the most important things that nurses do in healthcare,” Dempsey said.

“It’s not about keeping them safe, because we are required to do that,” she added. “Regulatory guidelines, Joint Commission, CMS, require that we keep our patients safe. It’s about making them feel safe.”

In addition to concerns about time constraints, nurses are falling short largely because of requirements in their medical education, Dempsey argued.

“We’re graduating people who are fabulous with simulation and electronic documentation and social media,” she pointed out. “But when they sit across the bed from an 80-year-old sick person, new nurses don’t know how to connect.”

Part of the issue is an over-reliance on simulators and mannequins on which nurses and other clinicians practice certain procedures. Because simulators aren’t people, Dempsey said they don’t teach nurses how to be personal.

“The fact of the matter is simulators don’t react and don’t cry and don’t try to hit you, but people do,” Dempsey said. “We aren’t preparing nurses for making those connections.”

Her 56-second connection strategy is one training method for driving more empathy into nursing care, Dempsey said, but it may take more than that. Many new nurses and clinicians haven’t been hospital patients before and therefore cannot connect with their patients on a base level.

Some hospitals are working on building that connection, Dempsey stated. During a visit at a Nevada hospital, Dempsey saw clinical leaders drop new clinicians off in the emergency department with no information, transferring the clinicians to exam rooms in an effort to simulate the patient experience.

The strategy is often jarring and uncomfortable for new nurses, but Dempsey said that’s exactly the point.

“You have taught empathy because now that person can understand what her patients are going through. She’s been there and she can communicate understanding back to patients,” Dempsey explained.

“That is the definition of empathy,” she added. “These are the kinds of things we have to do more of to help people understand what it’s like to be a patient because it completely changes your perspective.”

These kinds of tactics are crucial considering the significant role nurses play in supporting a positive patient experience.

“Nurses do have the biggest impact on the patient experience and we need to ensure we’re setting our nurses up for success,” Dempsey concluded. “It’s important in how we prepare nurses and how we continue to prepare nurses in how to make those connections. It doesn’t take that long to do, but they need to practice that so they can do it.”