How Do You Deal With “Difficult” Patients? 

How Do You Deal With “Difficult” Patients? 

Nurses deal with all kinds of patients, and some interactions are more challenging than others. Some patients get labeled as “difficult”. How we think about patients is important and can significantly impact the nurse-patient relationship and quality of care. Changing our habitual thinking can be good for the nurse, the patient, and the care that’s ultimately provided.

What Exactly is a “Good Patient”? 

Dr. Joan Naidorf  is an emergency physician whose book, “Changing How We Think About Difficult Patients: A Guide for Physicians and Healthcare Professionals,” explains how we can improve our work experience by changing our attitudes toward our patients, especially the most challenging ones.

When asked what constitutes a “good patient,” Naidorf states, “When I talk to nurses about interactions with difficult patients and families, it’s useful to contrast those with the interactions that go well.”

She continues, “What characteristics are we looking for? We define ‘good’ as mature, rational thinkers who want to partner with the healthcare team to address their problems. We think good patients treat us respectfully, cooperate, and comply with our present plan. We want questions or disagreements to be presented courteously. We enjoy interacting with good patients and can experience great satisfaction.”

Where Does Our Negative Thinking About Patients Come From?

How do we form negative habits in our thinking about patients? Naidorf has an answer.

Nurses, like all humans, have a strong negativity biasIn medical care, we don’t jump to the conclusion that that leg cramp is something minor — we’re concerned about a life-threatening deep vein thrombosis.

Secondly,” Naidorf continues, “nurses pick up this negative talk during their training. In the classroom, high ideals and ethics are discussed: successful nurses are organized in their thinking and documentation; they’re determined to be empathetic and efficient.”

According to Naidorf, something happens to challenge those ideals. “In the real world, student nurses hear their mentors and colleagues speak in derogatory and mean-spirited terms. A sense of distrust and resentment can permeate the workplace as more cynical nurses harshly judge how patients dress, speak, or behave. It’s easy for inexperienced, impressionable people to think: ‘Well, this is just how it is — these must be the facts.’ But these aren’t facts — this is just a story everyone in the workplace believes.”

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What are Common Thought Distortions About Patients?

Naidorf relates, “There are many unhelpful thought patterns. One common one is all-or-nothing thinking. We often think there’s only one way to get something done or think about a problem. This is a thought distortion because there aren’t just two solutions to a problem — there are dozens. Patients who challenge us can have a very different way of thinking and want to do things their way. A small shift from all-or-nothing thinking can help us find common ground with patients.”

A second is the tendency to place ourselves in the victim role,” Naidorf states. “People with a victim mentality tend to complain a lot. They also tend to blame the doctors, the supervisor, the pharmacy, or the patient. ‘Why does this always happen to me? Why did they put him in my zone? Why do I have to do another septic workup?’ Assigning blame to others and playing the victim places you in a disempowered role. A victim has no power to act or find solutions. We aren’t victims, and we have the power to solve problems and find solutions.”

Thought distortions are important to recognize, and there’s one more Naidorf highlights.

A third distortion is resisting reality, which comes up in many ways. We think to ourselves, ‘This person should’ve been wearing a helmet; that mom should’ve given the child something for fever; that guy should stop getting drunk.’ We can’t change the past, and wishing that things should be different only makes us suffer in the present.”

How Do We Change How We Think About Challenging Patients?

Nurses can do much to change how they think about ‘difficult’ patients,” says Naidorf. “They can remember that many of their thoughts are just thoughts, sentences in the mind that can be changed. Becoming aware of thoughts is the first step to changing them. We can ask ourselves better questions.”

Naidorf has more advice. “When falling into all-or-nothing thoughts, ask: ‘Could I be wrong? Are there other approaches that could work equally well?’

You can also ask, ‘What else is true here? Is that drunk man someone’s father? Does that mother love her child? Is coming to the ED the only way this family can access care?’ Small shifts in thinking can lead to more feelings of curiosity and empathy.”

Lastly, Naidorf wants nurses to truly focus on their thinking, which can lead to actual changes in behavior and practice.

One thing you can do is define what the event or circumstance is in as factual a way as possible. No adverbs or adjectives should creep into those definitions. A person with some illness or injury comes to the medical office or urgent care center, and the nurse has a thought about that person. We can choose thoughts with more intention that serve us and them better.”

And when negative thoughts arise, Naidorf has a plan.

Some negative thought will invariably pop up, but we can force ourselves to question if anything else is true. If we think the person should not have come in, we can counter that with, ‘We have all the right people, equipment, and medicines to help this person.’ With positive thoughts, nurses will take actions that further the mission of helping the patient and will get more satisfying results.”

But can we always be positive? Naidorf doesn’t expect perfection.

Sometimes we want to be disappointed or sad about what happens at work, and it’s appropriate and helps us empathize with patients. We work in places where people experience tragedy, so it would be weird to pretend to be always happy,” she reassures us. “It’s ok to feel sadness, disappointment, and frustration — temporary emotions that pass through our bodies. Feeling all the emotions is one amazing part of being a human nurse.”

Own Your Humanity — and Patients’ Humanity, Too

As Dr. Naiforf points out, nurses are human beings, and humans have feelings and flaws. We’re also capable of great empathy and kindness. Our patients are also humans; their lives can be complicated and painful, and we often encounter them at their very worst on some of the most challenging days of their lives.

No matter how stressful our work may be, when we summon our humanity, we can be more curious, thoughtful, and capable of being present without projecting negativity where it doesn’t belong. And sometimes, we’ll fail and fail again. But every day gives us a chance to start anew.

If you can change your thoughts, you can also change your experience and your patients’ experience. And that is a worthy endeavor indeed.

Nursing Certification: Achieving Excellence and Professionalism

Nursing Certification: Achieving Excellence and Professionalism

In the world of nursing, certifications and their corresponding designations carry with them the concepts of excellence, professionalism, and focused dedication to career growth . Not all nurses pursue certification during their years of service in healthcare, but many hear the call and take inspired action to achieve such a goal.

Making an effort to become certified in your nursing specialty is like doubling down on your skills and knowledge. Doing this takes discipline and forward-thinking, demonstrating that you care enough to show the world that nursing excellence and professional mastery matter.

Every year on March 19th, we celebrate National Certified Nurses Day to honor the nurses who take their careers to the next level by becoming certified. This celebration encourages us to take a moment to acknowledge the role that certification plays in strengthening the nursing profession while improving care and patient outcomes. Being certified is meaningful, and we make meaning by pausing for the cause of reflection and recognition of the nurses who choose this path.

Nursing Certification 101

According to the American Association of Critical Care Nurses (AACN), the first nursing certification was issued in 1945 to recognize nurse anesthetists. Certification boards began to be created in the 1960s, and the number of available nursing certifications continues to grow to this day.

Many nurses choose to pursue certification of their own volition, while some employers may encourage or even require nurses in specific specialty areas to become certified. Having your employer pay for and support your certification goals can be a desirable benefit, especially if your certification process has a financial cost you’d rather not bear yourself.

The American Nurse Credentialing Center (ANCC) offers various certification pathways, as do the American Holistic Nurses Credentialing Corporation (AHNCC), the American Academy of Nurse Practitioners Certification Board (AANPCB), and numerous other nursing organizations and associations.

A 2021 Journal of Nursing Administration study states, “Nurse specialty certification is ’a mechanism for validation or formal recognition by documenting individual nurses’ knowledge, skills, and abilities specific to their specialty’. It is a form of individual credentialing above and beyond entry-level education and licensing. By pursuing specialty certification, nurses exhibit a commitment to professional growth and lifelong learning while establishing competency in a specialized area of care such as oncology or medical-surgical nursing. The intended outcome of certification in nursing is to improve safety, quality of care, and health outcomes for those using healthcare services.”

Popular certifications include:

No matter what certification you choose to pursue, rest assured that being certified is something to be proud of and to clearly and proudly document on your resume as a mark of nursing distinction and professional mastery.

Why Should You Consider Becoming a Certified Nurse

As mentioned above, certification is a demonstration of dedication to your area of specialty nursing practice. Being certified can serve many purposes and brings with it a variety of benefits, including:

  • Marketability: Being certified can make you a stronger candidate in the job market, especially if it sets you apart from non-certified applicants for the same positions.
  • Career mobility: Some employers may value nursing certifications very highly, with certified nurses more likely to advance on the organization’s clinical ladder or into positions of greater responsibility, including nursing leadership.
  • Respect and recognition: Certification can elicit in others a sense of respect for and recognition of your professionalism, expert knowledge, and skill.
  • Personal/professional pride: Certification may elicit pride in your expertise, mastery, and accomplishments as a dedicated nurse.

Certification is a feather in your nurse’s cap. It marks you as a nurse focused on career growth and expert skill and knowledge. By being certified, you benefit not only your career but also inspire others to follow in your footsteps and contribute to the improved quality of patient care, not to mention strengthen your employer’s organizational profile.

Certification Speaks Volumes

Having one or more nursing certifications speaks volumes about your professionalism and desire to develop yourself as a nurse of integrity and mastery. Being certified says a great deal about you, and your certifications can enhance your ability to advance your career in any direction you’d like to go.

Some nurses may sit on their laurels and do the bare minimum, while others may seize the day and take every opportunity to develop themselves professionally. Only you can decide if the path to certification is right for you based on your perception of the benefits of certification and the value of that process to your career.

In recognition of Certified Nurses Day, let’s acknowledge those nurses who’ve stepped up to the plate and taken on certification as a prospect worthy of their attention and hard work. And if you’re already certified, give yourself a pat on the back for going the extra mile and showing the world that you’re a nurse who wants to be the best you can be.

A Longitudinal View of Nursing Leadership

A Longitudinal View of Nursing Leadership

At this time in history, the American nursing profession and its leadership are in a state of flux. The November 2023 American Organization for Nursing Leadership (AONL) Nursing Leadership Insight Longitudinal Study  leverages nursing leaders’ perspectives to shed light on where we are and where we’re headed as a nursing collective.

In coordination with the AONL Foundation and Joslin Insight, five longitudinal studies have been conducted since 2020. The collective data are a fascinating avenue into the hearts and minds of nursing leaders and how they perceive the healthcare industry and nurses’ places in it.

Leadership Identifies Top Challenges

According to the 2,477 nurse leaders surveyed for the current AONL study, the top ten challenges facing the profession are:

  1. Staff recruitment and retention
  2. Emotional health and well-being of staff
  3. Financial resource availability
  4. Workplace violence, bullying, and incivility
  5. Communicating and implementing changing policies
  6. Maintaining standards of care
  7. Health inequity, social determinants of health
  8. Travelers, contingent workforce
  9. Adopting new technologies and innovation
  10. Surge staffing, training, and reallocation

The graphic representations of the more detailed findings from these ten challenges reveal nurse leaders who fall along a continuum of self-perceived success in addressing such real-world issues.

Emotional Health and Workplace Behavior

Focusing on workplace behaviors such as violence, bullying, and incivility, 68% responded that they had witnessed one or more incidents of bullying at work. In terms of having seen one or more incidents of violence, 53% said they had. When it comes to incivility and intimidation, a stunning 77% and 72% had witnessed such aberrant behavior, respectively.

AONL concludes:

Nurses frequently encounter verbal abuse, physical assaults, and other forms of violence and intimidation from patients, patient families, the public, and coworkers, including physicians, other nurses, administration, managers, supervisors, faculty, and other staff (Figure 6). This hostile environment not only jeopardizes the safety and well-being of healthcare workers but also impacts patient care. The rising instances of workplace violence can lead to increased stress, burnout, and a sense of insecurity among healthcare professionals.

Addressing workplace violence, intimidation, incivility, and bullying requires comprehensive strategies, including enhanced security measures, de-escalation training, fostering a culture of safety, and providing trauma-informed care to healthcare workers. It also requires advocacy to raise broader public awareness.

Assessing nurse leaders’ emotional health, whereas 44% rated themselves as emotionally healthy in 2021, 52% now see themselves as such, and the number who viewed themselves as emotionally unhealthy dropped from 14% to 11% as we get further from the height of the COVID-19 pandemic.

The researchers state:

Regarding emotional health, there has been a slight improvement from last year. However, the data still shows a mix of emotional health states, ranging from very emotionally healthy to not at all emotionally healthy….. It’s crucial to recognize the need for continued efforts to support nurse leaders, especially nurse managers who fare worse in cultivating and maintaining healthier emotional well-being. Creating a nurturing environment for nurse leaders is vital to ensure their resilience, support, and effectiveness in their roles. 

Intent to Leave

Attrition from the nursing profession and the attempt to retain top talent continues to be a struggle. Reports of nurses’ intent to leave either a current position or the profession as a whole are constantly troubling, especially in light of the ongoing nursing shortage that can be found in many healthcare labor markets around the country.

The AONL longitudinal study reveals the following:

This survey shows a marginal improvement in nurse leaders’ intent to leave with a 5% decrease in those planning to leave from 2022 to 2023. The survey examined intent to leave based on roles. The largest cohort of nurse leaders reporting intent to leave exists in the C-Suite with 15% of CNOs/CNEs planning to leave their positions within the next six months, contrasting with 12% of managers and 10% of directors. Among nurse leaders contemplating leaving, a notable 25% report considering leaving nursing altogether. Previously, 27% of respondents reported considering leaving nursing altogether.

The most often reported reasons for nurse managers and CNOs/CNEs leaving their roles include:

  1. The negative impact of work on health and well-being
  2. Pursuit of new opportunities
  3. Challenges with other leaders or colleagues

Identified strategies for nurse leader retention include facilitating time off for work-life balance, opportunities for professional growth, and the perception that the employing organization understands leaders’ concerns, cares for their well-being, acknowledges and responds to their concerns, notices their contributions, and takes pride in their accomplishments. In fact, employers would do well to enact these strategies universally for all staff consistently in the interest of retention and employee satisfaction.

Conclusions Abound

Many conclusions can be made from the data available from the ongoing series of AONL longitudinal studies. As AONL concludes, there is a “nuanced landscape for nurse leaders, tracking shifts in their challenges and perceptions since July 2020”, with a focus on well-being, retention, financial resources, and workplace violence.

This study demonstrates the need for interdisciplinary collaboration, innovative solutions, and consistently addressing challenges of staffing and retention. And while cookie-cutter solutions can sometimes be helpful, progressive and forward-thinking healthcare organizations would be prudent to create tailor-made solutions based on their challenges on the ground.

The researchers’ conclusions say a great deal regarding what lies ahead:

In conclusion, while certain issues have shown improvement over the course of this survey series beginning during the pandemic in July 2020, nurse leaders continue to face complex challenges. Addressing work-life balance, navigating staffing shortages and innovating models of care remain pivotal. This requires a blend of strategic interventions, policy support and inclusive organizational cultures to strengthen nursing’s future and, ultimately, improve the equitable delivery of quality patient care.

What is Rapid Response Nursing? 

What is Rapid Response Nursing? 

In the setting of acute care, immediate intervention is essential when critically ill patients decompensate. These situations require highly trained experts who can do the job while remaining calm under pressure. Enter the rapid response nurse.

Rapid Response Nursing 

“Contrary to common misconceptions, rapid response nursing isn’t solely about dashing from one Code Blue to another,” says Sarah Lorenzini, MSN-ED, RN, CCRN, CEN , a rapid response nurse, educator, and host of the Rapid Response RN podcast. “Much of our focus revolves around preemptive interventions aimed at averting emergencies before they escalate.”

According to Lorenzini, we don’t want things to get to a crisis point if we can avoid it. “While managing crises is undoubtedly exhilarating, there’s equal satisfaction in identifying at-risk patients and implementing interventions to prevent crises. Rapid response nurses like myself serve as specialized resources available throughout the hospital to support colleagues in handling emergent situations.”

When asked if all hospitals have rapid response teams, Lorenzini responds, “Yes, but each hospital’s team might look different. The roles and responsibilities of rapid response nurses may vary from one institution to another, but their primary objective is always to intervene swiftly and effectively to prevent patient deterioration.”

She continues, “Each hospital has a different structure for who responds to emergencies, but they all have the core goal of providing bedside nurses with access to a team skilled in managing emergencies and critically ill patients.”

How Did the Rapid Response Concept Gain Traction?  

In terms of how rapid response became prevalent, Lorenzini points to the 100,000 Lives Campaign launched by the Institute for Healthcare Improvement (IHI) several decades ago. The campaign highlighted six critical interventions:

  1. Rapid Response Teams
  2. Improved Care for Acute Myocardial Infarction
  3. Medication Reconciliation
  4. Preventing Central Line Infections
  5. Preventing Surgical Site Infections
  6. Preventing Ventilator-Associated Pneumonia

IHI reported in 2016 that the first ten years saw 75% of U.S. hospitals join the campaign, which is encouraging, even though their data shows that far too many patients still needlessly die.

Lorenzini states, “Hospitals were encouraged to implement these teams to convene at the bedside of declining patients, bringing ICU-level care to any unit.”

“Some hospitals have a system where staff are dispatched from different areas in emergencies (e.g., the ICU charge nurse might leave the ICU and meet up with the respiratory therapy supervisor in the patient’s room). Some hospitals have dedicated interdisciplinary teams whose only responsibility is emergency response.”

How do Nurses Become Adept at Rapid Response?

“While every hospital has different standards, having either ED or critical care experience is needed,” Lorenzini states. “Rapid response nurses need to be able to lead a team in a coordinated effort in emergency response. They need experience administering vasopressors and other high-risk medications, assisting with intubation or other resuscitation skills, and managing a critical patient independently (sometimes for hours) while waiting for an ICU bed to become available.”

While not all institutions require it, having CCRN (Critical Care Registered Nurse) or CEN (Certified Emergency Nurse) certification is one way a nurse can be prepared for the role.

“My best advice is to get really good in your specialty (e.g., ED or ICU),” advises Lorenzini. “Become a preceptor or a super user and be seen as a resource on your unit. If you’d like to be a resource for the entire hospital, start by being the person people call on when they have questions.”

When asked if this is a viable career path, Lorenzini responds, “Absolutely! It’s the perfect mix of ER, ICU, and nursing education rolled into one.”

A Rapid Response Story

Rapid response nurses have many stories about their work, and Lorenzini is no exception; that’s the purpose of her podcast, Rapid Response RN. 

She relates this story.

“A nurse once called me for a consult. She was concerned that a patient was breathing faster than normal, and she ‘had a bad feeling’.

“The patient was several days post-op from a bowel resection and had so far recovered well. Their vitals were stable, but the BP had been trending down and was 90/50 with respirations of 28. The nurse had expressed her concern to the doctor and been told that the patient was just ‘the anxious type.’ She called me for a second opinion saying, ‘Should I be concerned, or is this normal?’”

Lorenzini intervened.

“I assessed the patient and felt that same bad feeling. Not only was she tachypneic, she was more lethargic than her baseline, and her tachypnea didn’t seem like anxiety. Her color wasn’t right, and her abdomen was tender and firm. I supported the nurse in advocating for the patient, calling the doctor, and pushing for further diagnostics.”

“We got the patient to CT and discovered a perforated bowel leaking into her peritoneum, causing septic shock. Within an hour, she declined rapidly, required vasopressors and intubation, and ultimately returned to the OR. As a rapid response nurse, I supported the bedside nurse in her assessment, taught her how to advocate for the patient with the provider, and facilitated getting the patient stabilized in ICU.”

Response and Proactive Vigilance

“Rapid response nursing isn’t just about reacting swiftly to emergencies,” says Lorenzini. “It’s about proactive vigilance, expert coordination, and unwavering patient advocacy. It’s a dynamic field that demands clinical acumen, leadership, and passion for making a difference in every patient encounter.”

She adds, “At my facility, we’re tasked with responding to a variety of alerts, from cardiac arrests to sepsis, STEMI, stroke alerts, and even unexpected births outside of L&D. But beyond mere response, we prioritize proactive measures. We utilize tools like the Modified Early Warning Score (MEWS) to identify at-risk patients and provide timely interventions. Our ‘nurse consults’ allow healthcare professionals to reach out for assistance even if vital signs don’t raise immediate concerns. This fosters a culture of early intervention and collaboration.”

“In summary,” Lorenzini concludes, “rapid response nurses exist both to respond to and prevent emergencies throughout the hospital.”

Can Hospitality Cure the Woes of Healthcare? 

Can Hospitality Cure the Woes of Healthcare? 

Have you ever wondered about the similarity between “hospital” and “hospitality”? Is this a coincidence, or can we identify how they’re connected? Maybe we can also discover how hospitality concepts could help repair the broken relationship between the healthcare system and its patients.

Healthcare revolves around the delivery of patient care. Thus, customer service and satisfaction must play a role in its success. After all, if our patients are unhappy, don’t feel appreciated, and have a sense that their presence barely matters, they could stop showing up, and we’d all wind up unemployed as our nation’s health suffered. Who wants to see that happen?

Back to the Roots

Sources at Harvard University  identified that the Latin hostis and hospes are related to the concept of the guest. At the same time, other sources also cite Latin terms such as hospitalis and hospitem as related to the modern terms guest and host.

In this case, it’s worthwhile wondering why, if our name for the modern-day hospital stems from such roots, have we strayed so far from customer service and hospitality in how we treat healthcare consumers?

Hospitality Matters

Can you think of any healthcare experience you’ve had that’s gone wrong? According to our research, most adults can. It’s interesting to note the culprit is rarely the clinical outcome. Rather, it’s generally how the care was delivered”, states Peter Yesawich, PhD, a consultant and veteran of both the healthcare and hospitality industries. Yesawich is also co-author of “Hospitable Healthcare: Just What the Patient Ordered!” a remarkably insightful review of how principles of hospitality can improve the patient experience.

Yesawich and his co-author, Stowe Shoemaker, PhD, ask, “How can that experience be improved?” According to the authors, the hospitality industry has increasingly gotten things right while the healthcare system falters at the starting gate.

When considering how to make healthcare more hospitable, Yesawich remarks, “Many people in healthcare default to the notion that it’s just about making staff smile, but that’s not the idea. Smiling and a positive attitude can certainly be beneficial, but it’s more about the way providers anticipate and address patients’ anxieties, needs, and preferences.”

He continues, “One of the things the hospitality industry has done very well is to get to know its customers through strategies that allow them to anticipate the kinds of things their customers appreciate. 

“In healthcare, providers can prepare for the smooth delivery of care by managing things like ease of access to making appointments, providing an estimate of the cost of care in advance, ensuring a positive arrival experience, recognizing patients for their loyalty, and thanking patients for their patronage. After all, patients are also customers who have a choice when selecting the providers from whom they seek care.”

The PAEER Model

According to Yesawich and Shoemaker, their five-part model for more hospitable healthcare is broken down into an acronym from their extensive research: the PAEER model (Prepare, Anticipate, Engage, Evaluate, Reward). The authors offer specific actions practitioners can take to enhance the patient experience.

Prepare: Healthcare facilities can welcome patients by better understanding their needs and preferences. (Hospitality industry providers do this through “Customer Relationship Management” (CRM) programs that record, track, and analyze guest behavior.)

Anticipate: Once patients’ preferences and needs are more clearly understood, we can avoid what decreases patient satisfaction, which, according to the authors’ research, includes the unwelcoming nature of the check-in experience, repeated requests for the same information, ease of access to making appointments and, most importantly, not knowing the estimated cost of care in advance.

When you take your car to the garage for repair, book a hotel room or table at a restaurant, you know the estimated cost of that service in advance,” Yesawich states. “Why don’t healthcare providers also give a pro forma estimate of the cost of the service they are about to deliver in advance, naturally with an appropriate disclaimer, especially given that they know what they are likely to charge based on negotiated reimbursement rates?”

Engage: “Yesawich states, “Hospitality industry professionals refer to the points of actual service delivery as ‘moments of truth’, the specific interactions that ultimately determine the customer experience.”

He continues, “They have developed a number of techniques to ensure these ‘moments’ yield a positive reaction, including the introduction and use of acronyms that reflect their commitment to enhancing guest satisfaction that is easy for staff to remember and recite; the introduction of service standards that reinforce the connection with their mission/vision/values (behaviors repeated over and over define the culture of your organization), and providing invoices/bills for the services they deliver that are easy to understand.”

Yesawich makes one additional point: “Many also offer performance guarantees that underscore the confidence they have in the delivery of services for which the outcome is generally predictable (e.g., clinic wait times, turnaround times for test results, prompt resolution of billing disputes, etc.)”

Evaluate: “I marvel at the fact that many healthcare providers don’t follow up with patients after an appointment to see how things went,” Yesawich shares. While this is becoming more commonplace, there’s often a pervasive feeling that providers don’t care about receiving patient feedback.

Reward: While the authors acknowledge that the law prohibits financial incentives for patients with government insurance, there are no restrictions in using recognition and reward programs to attract patients with commercial insurance.

Yesawich adds, “These could include ‘rewards’ that enhance the future health and well-being of patients. Examples include free health screenings, invitations to attend free lectures by providers or nurses on timely health topics, free admission to cooking and fitness classes, etc.”

What Can You Do? 

For staff nurses without the authority to change how an organization operates, Yesawich maintains that there are still plenty of ways to introduce principles of hospitality. He counsels the first step in the process is understanding the root cause of most patient dissatisfaction: how the care is delivered.

You can get management to recognize that most of the dissatisfaction patients have with healthcare has to do with the manner in which the care is delivered, not the clinical outcome, the author states. “Implementing specific principles of hospitality along the patient journey can positively impact the patient experience, even when the clinical outcome is unsatisfactory.”

Nurses and staff can bring suggestions regarding these concepts to leadership. Nurses can also unilaterally assure that patients feel appreciated, bringing genuine warmth, eagerness to please, and gratitude to the nurse-patient relationship. And when staff interact with patients, they can make eye contact rather than staring at a screen.

The basic tenets of Yesawich and Shoemaker’s research and recommendations are rooted in the values of hospitality. As the largest segment of the healthcare workforce, nurses can leverage their influence in service to the patient experience.

Those of us who work in healthcare want our patients to feel cared about; even the slightest effort can have positive repercussions. In honor of the aforementioned Latin origins of terms close to the heart of care delivery, why don’t we strive to reverse the inhospitable nature of 21st-century healthcare? After all, everyone will benefit — nurses, providers, and patients alike. In making such changes, we have nothing to lose and everything to gain.