Nursing is not always easy, especially when you get patients that are a little rough around the edges (ESPECIALLY when the nurse is a little rough around the edges). It’s important to remember that we build relationships with our patients and as we improve this skill we find that we can overcome many obstacles that get in the way of the patient being their awesomest (it’s a word, I swear).
Barriers to awesomeness:
- Loss of independence
- Financial problems
- Lack of knowledge
- Family members
This is not an exhaustive list, but it does highlight some common areas that frequently need to be addressed. I like asking patients open ended questions when I first meet them, like, “What’s shaking?”
Yes, that’s one of my favorite openers. What comes out of their mouth next is the first thing I’m going to address.
“When am I going to get this tube out of my nose!?”
*Insert appropriate education*
It is extremely important when building relationships with a patient that we maintain their trust. One of the best ways to do that is by managing their expectations. Never promise something we can’t deliver.
As soon as we meet a patient at the beginning of the shift, create and explain the agenda for the next eight to 12 hours. Tell the patient we will notify them of any changes or updates to the agenda.
Example: Good morning (patient) Doug. Since you’ve had half of your colon removed (hemicolectomy), today we’re going to focus on managing your pain so we can have you increase the amount of walking needed to return bowel function. That will help wake up your bowels so you can start passing gas. Another goal today will be to remain nausea free. This will help improve your comfort and act as the first step to get your NG (nasogastric) tube removed.
This conversation can happen while we do our physical assessment. It doesn’t need to be a Shakespearian soliloquy. The MD and PA will show up and explain something similar, further building our credibility. This will also improve the patient’s confidence in us and improve their comfort or piece of mind that they are being well taken care of.
We have now demonstrated we have an understanding of the plan of care and can continue updating/educating the patient on the upcoming steps that get them closer to discharge. With repetition and experience these conversations get much easier and the time it takes to build a trusting relationship with our patient decreases.
Let’s make some new friends!