Three Effective Ways to Show Compassion in a Fast-Paced Setting

Giving care in a high turnover setting is a tricky balance of skill, speed, and compassion. Specialties Emergency Article

Three Effective Ways to Show Compassion in a Fast-Paced Setting

I’ve spent most of my career in busy Emergency Departments and Urgent Care. The fast-paced environment and high patient turnover mean I don’t get to spend much time with each patient. From triage to discharge, my job is to give compassionate care in a timely manner. 

But providing compassionate care and moving patients through their visits efficiently are often in conflict. We nurses use our strong clinical and time management skills to help patients; this is how nurses show care. But people often need something more than knowledge and speed to feel cared for. They need compassion that they can understand.  

Compassion is acknowledging others' feelings and expressing that you want to help. It is most meaningful when it is most needed. Compassion makes the biggest impact on the vulnerable, and caring for the vulnerable is where nurses excel.

Here are three ways to show compassion even in a fast-paced setting:

1- Slow Your Roll

Working in a high turnover environment you tend to use the same phrases over and over.  Once you’ve said something 50 times in one day, you’d better believe you can say it really fast. An opening phrase of “Please confirm your name and birthdate, have a seat in the chair, and push up your sleeve so I can check your blood pressure” can easily morph into one long, fast string of demands.  This leaves patients feeling rushed and overwhelmed, and makes us look impatient.  Instead, at each patient interaction try to:

  • Slow down your speech
  • Pause between each question, statement or request
  • Allow patients to process one piece of information at a time

Each time I have a patient interaction, I consciously slow down my words and leave a pause between each sentence. Whether it’s a question, request or information about treatment or testing, pausing gives the patient time to process what I’ve said. Then I let people answer one question or follow one request at a time. 

2- Face the Patient

In many patient care settings, charting is done at the bedside from a computer. This means we often spend an entire patient encounter looking at a screen and not at the patient. This is especially true at triage or during the initial patient encounter when we most need to establish an environment of compassion. Not facing someone you are talking to sends a message of disinterest and leaves people feeling invisible. Ways to counteract this are to:

  • Turn your body towards the patient
  • Look up from the screen often 
  • Make eye contact 

I try to maneuver my computer so I face the patient whenever possible. If I can’t arrange to be facing the patient, I turn towards them as best I can and look up from my screen often.  

Sometimes when computers are mounted to a wall, having your back to a patient simply can’t be helped. In that case, I simply apologize that I can’t face them. Then, I use any time I’m in the room, but not stuck at the computer, to really face the patient and make eye contact. This shows our connection on a human level, not just a nurse-patient level.

3- Offer Reassurance

In high-volume units, we often see similar patient complaints multiple times per shift, making most illnesses and injuries routine for us. But getting medical care is a new and frightening experience for many patients. People feel vulnerable in an unfamiliar environment, especially when experiencing pain or discomfort.  While our experience as nurses allows us to respond to the sick or injured in a controlled way, that control may come across as nonchalance to patients. To reassure patients that we understand their concerns:

  • Repeat back what they say
  • Acknowledge their discomfort 
  • Express desire to help

When I ask patients to list their symptoms or give me a pain scale, I let them know that I hear them by repeating back what they say, often as a clarifying question such as, “so your foot has been hurting for 3 days now?”. Then I also acknowledge how they are feeling with a simple phrase such as, “it sounds like you’re feeling pretty crummy today”.  Finally, it seems obvious to us that we are here to help, but sometimes saying it out loud is comforting for many patients. Without promising to cure them of every ailment in 30 minutes, I say something like, “we’ll take good care of you today” or “this medicine should get you feeling better”. 

Working in a fast-paced unit is a challenging environment for nurses.  Giving patients the care they need while still moving quickly requires a tricky balance of skill, efficiency, and compassion. Putting patients at ease and making them feel comfortable in an uncertain situation often goes just as far towards their healing as the medications and therapies we administer.

 

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Amy Whetstone, MS, BSN, RN, CEN is a nurse specializing in emergency care. With 17 years experience, she has worked as as a paramedic, a critical care nurse, and an ER and Urgent Care nurse. Prior to healthcare, Amy achieved a Master's Degree in Comparative Medicine with a research focus on epidemiogy.

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Thank you for writing this article.  These are all very important points.  

Slow down and give the patient time to process your request/s. Pause and let the patient process one piece of information at a time, and answer one question or follow one request at a time.  Face the patient and make eye contact - this makes all the difference in communication.  It is very unpleasant to try to communicate with someone who is fixedly looking at a computer screen without looking up at you periodically in order to interact with you, gauge your response, or to allow you to express your concerns.

Repeating back what patients have told us, acknowledging how they are feeling, and expressing the desire and intention to help them are very important.  Being a patient in the ER or Urgent Care can be a very frightening experience; providing reassurance and showing kindness to patients/their family is very important.

Thank you for making the point that even working in a fast paced environment such as the ER, one can still put patients at ease and make them comfortable in an often very frightening situation.