An acutely ill patient in a busy medical surgical ward of a tertiary hospital noted over time that everyone who entered her room, doctors and nurses to all janitorial staff and dietary staff, introduced themselves. ”Good morning, I’m Marc and I will be your nurse till this evening.” ”I’m Will and I am going to be cleaning the shower let me know if there is anything you need.” Over the few days that the patient was on the ward she realized this process was obviously a ”policy” or a work rule. She felt more connected to the staff, ”as if they were interested in me as a person not just a case.” She found it helpful that a notice board directly across from her bed showed the name of her nurse and aide and was changed each shift. If she wanted she felt she could call for specific help, not just ”I need a nurse.” These personal introductions felt different to her and ”more reassuring” than other hospital stays where everything ”seemed kind of anonymous.”
Discussion: This close observation of a detail of care is revealing. This could be considered an exemplar of a policy that connects patients and staff in a productive and pro-active way. Needs of patients to know who they are dealing with, and that staff will be available may actually decrease ”needs” of patients. Overburdened staff may avoid interactions by making them superficial and distant. This policy which apparently is ”formal”, that is all staff are expected and instructed to behave in this responsible way, connects staff and patients. The patient felt she had ”a nurse” not a group of relatively inaccessible nurses who would ”not know who I was or what I needed”. One of the more distressing fantasies of patients that unfortunately does sometimes occur, is that they have been ”just forgotten”. This policy constructively addresses the problem of lack of connection even in the presence of limited time for contact.
Knowledge Base: staff-patient relationships, nursing care, work rules, policy, communication, lack of time, exemplar, positive interaction, inpatient care, acute care, moral action, moral agency
Work Points: can I find more examples of designed environment features that support efficacy?, exemplar, good teaching example