First impressions are paramount
“You don’t get a second chance to make a first impression.” The non-verbal message your patient receives in the first few seconds affects how you, other staff, and your entire experience in the department and hospital will be perceived. To better understand how your patients see you, ask another staff member to give you feedback on how you might make a better first impression. We can all improve in this area and an outside observer can be the mirror to see more clearly the clothes that need to be adjusted.
1) Body Language – Before greeting the patient and family, pause and take a deep breath to slow down. You don’t want to appear rushed in this critical first contact, no matter how busy you are. Focus on the here and now, not the latest case or lunch in 30 minutes. This may seem trivial, but it has a great effect on the patient’s perception of how he cares about his work and, consequently, how he will value and care for it.
2) Physical Appearance – Yours – Don’t underestimate the effects of a clean, wrinkle-free gown, name tag, and proper grooming. If you get blood or betadine stains anywhere, go change. A patient will not trust a carer or department that they perceive as sloppy because it will translate that into a sloppy and ambivalent attitude about their job.
The Department: Physical appearance is essential for the department and especially for the procedure room. Be sure to clean contrast and blood splatter from the C-arm, monitors, and other objects patients see when they are sitting and lying on the table. Put your head there and look up and around to see what they see. You’ll be surprised. The room should look like it was the first case of the day for each case. Self-assess the room by looking at it as if you were the patient walking through the door.
3) Eye Contact and Facial Expressions – This is the most important thing you can do. When you approach the patient, smile when you first make eye contact, as if you were a friend you are glad to see. As you introduce yourself, shake his hand firmly and confidently and as you shake his hand hold it for three seconds while looking into his eyes and say “we are going to take good care of you”. They will believe you. Then shake hands with friends and family. These people are your allies in the hospital and after discharge. They will observe the patient better than ward staff and will help with patient compliance throughout the recovery process.
Instill confidence by showing respect
Ask the patient how he is feeling right now and what is bothering him the most. This allows them to express themselves to you and allows you to focus on his personal concerns. Introduce yourself by name and tell them her responsibilities during the procedure. Also mention other staff members and their responsibilities. Add a compliment about a staff member or doctor to build patient confidence in the team.
After introductions, whisper in the patients’ ear and ask if they want you to review their relevant medical history and procedure with their family/friends present or if they want you to do so in private. This will let the patient know that you value him and his privacy. If they want privacy, before bringing family and friends into a waiting room, ask them if they have any questions and take the time to answer them fully.
Briefly review the patient’s main reason for consultation, his hospitalization, and what led him to this point.
Never lie to a patient or their partner. If they have a complaint, listen to them and then tell them what you are going to do about it and ask if that will solve their problem.
All of these FIRST steps will help reduce stress, allowing you to do a better job of improving the quality of information they provide in your medical history, decreasing the number of medications you’ll need for sedation, and improving your understanding and adherence to instructions. intra and post procedure.
Laughter is also very useful. If you have a sense of humor that allows you to make the patient laugh, this is a great advantage. Always be tasteful and considerate in this area.
Sincere care and competence
Your patients know that if you sincerely respect and value them, your subsequent actions will be motivated with their best interest in mind. This is best communicated by showing them with their actions.
Touch them in a way that subtly communicates warmth and concern. For example: 1) When inspecting the IV site simply do not push around the area with a fingertip, instead hold your hand in yours and support your forearm with your other hand, then gently feel around the IV site. the IV. 2) When checking the distal PD and PT pulses, hold the foot with one hand while feeling for the pulses with the other. 3) Especially if they have A. Fib. or an SVT, teach them how to take their pulse by holding their hand, helping them find a radial pulse, and counting for 15 seconds. You get the same thing but you communicate much more with an extra touch.
If you have a blanket warmer, and if you do not need to request one, place it on a warm blanket as soon as you arrive in your pre-procedure area or room. Also, place the electrodes, defibrillation pads, and grounding pad on a warm blanket before putting them on the patient. If you put these items inside the blanket warmer, they will get too hot. The icing on the cake is placing a warm blanket on the table just before transferring the patient. They will extrapolate their attention to these details, so that you pay equal attention to all the essential details of the procedure.
If you really want to stand out, stand at the head of the patients at the beginning of the procedure and talk to them about what they are going to feel right before it happens. This will have a tremendously calming effect and is worth a couple mg. of Versed as they will not feel alone and vulnerable. Anxious patients will love you for this.
Teaching begins when you first meet the patient, family and friends. I like to say to patients, “This is my first case. Can you tell me why you’re here and what we’re supposed to do today?” If you’ve presented yourself with confidence and competence, it will add some comic relief and your response will allow you to gauge your level of knowledge. If you appear exhausted, they will believe you and become even more scared.
Then describe the procedure, specifically mention the sensations that they will experience. A flat, hard bed, medicine to make you sleepy or put you to sleep with anesthesia, oxygen in your nose, a sharp prick and burning sensation in your mouth from the anesthetic medicine, pressure as if someone were pushing a finger as the IV tube is passed through . inside, and racing and heartbeat during the test. Assure them that this is all normal. Tell them if they’re not sure about something, so they’ll let you know right away.
If it is not taught, the patient will not know what is normal vs. what is terribly wrong and they will think the worst. This only needs to take a minute, but it puts the pieces together and helps you understand what has been going on with your body and life.
At the end of the procedure, review with the patient and significant others the results of the procedure, the next steps in their care, and any post-procedure instructions. Hopefully the doctor has already told them, but their high level of stress will create poor retention and repetition will be necessary. Also, enlist significant others to help the patient follow these post-procedure instructions. They will be better problem monitors than floor staff and will also monitor the patient at home.
Patient satisfaction is becoming more important in today’s competitive business environment. Hospitals are spending a lot of time and money pushing employees to improve patient satisfaction scores. This includes telling employees to remind patients to “give me a 10 when you get a follow-up call.” This approach hits me like ipecac. Use the steps outlined above to exceed the expectations of your patient and the hospital.