Every once in awhile an article comes along that I love. Heck, I've even been known to rip out an article and put it in the nurses' lounge at the hospital a time or two. In September 2009, they published an article titled "Patients' Perceptions of Nurses' Skill" which I read and loved. The article discusses the factors that our patients use to assess our skill level. How do the factors that they use differ from the factors you use to look at your own nursing skill, or the skill of your coworkers?
Nursing practice has three domains that make up skill: interpersonal, critical thinking, and technical. Which of these can our patients most easily pick up on? Interpersonal, of course. Our patients have very little insight into our critical thinking skills. As they lay in bed trying to breathe post-extubation with stridor, they don't know that you're the one calling the doctor for racemic epi, IV steroids, and heliox because you know the cause of the stridor. The same is true with our technical skills. Sure, they see us removing their central line, but they don't know correct steps to tell if you're performing the procedure in conjunction with best practice standards. All that our patients can see is our attitude about these things. When you call the physician on your patient with respiratory stridor, they see that you are doing this quickly and with confidence. You are in the room reassuring them that things will be okay and educating them on what is happening. When you are pulling the central line, you are explaining each step to the patient to reduce their stress level about the procedure and possibly chatting about another topic to get their mind off of it and show interest in them as a person.
I highly suggest reading the article (I've attached the PDF below), but the big take-aways for me were:
Patients describe the attributes of skilled nurses as: friendly, caring, compassionate, kind, good listener, confident, enjoyed his/her job, well-organized, and followed through with tasks he/she said they would do
Patients describe the attributes of a non-skilled nurse as: Lack of confidence, timidity, rudeness, abrupt answers to questions, indecisiveness, frustration, and a negative attitude
So, I look at these terms that our patients use to decipher our nursing skill and I can see the affect on our unit. There are a certain group of nurses who often get thank you cards or small tokens of appreciation from patients and family members and they display off of the attributes of skilled nurses - seems that this article is telling the truth 🙂
This article helps me remind myself when my day is going horribly, to take a breath. You're getting paid to be at work and these patients/families are going through a hard time right now. Relax and do your job, they don't need to know that you just got chewed out by a jerk physician or that the patient next door is confused, crawling out of bed, and on your last nerve. When you go in the room to do something, do it with a smile and take the extra time to try and make a connection with each one of your patients. You will stand out as they remember their hospital stay and you will personally feel better for having a relaxed attitude.