What healthcare leaders can learn from a home health nurse

(As seen on Hospital Impact AND FierceHealth)

” … a simple touch, a nod, a gesture that lets the patient know that you see them as more than a diagnosis and are engaged and listening to them gives the healthcare provider credibility, forms a trust between patient and provider and starts the relationship off in a positive way to achieve goals.”

I am fortunate to be surrounded by amazing healthcare practitioners who demonstrate healthCARING every day. Be it within my family: bride (registered nurse), mother (x-ray technician / vascular technologist/mammographer), sister (registered ICU nurse), cousin (nurse leader), sister-in-law (social worker); my co-workers: physicians, nurses, therapists; and my friends: physicians, physical therapists, behavioral health practitioners (psychiatrist, psychologist, etc.), and specific to this post, an amazing home health nurse.

This home health nurse recently had her own health challenge and was kind enough to share her experience with me so that I may share with all of you.

“So when I started experiencing discomfort in my chest I ran through the checklist in my mind–indigestion, upper respiratory, strained a muscle working out the day before–but this pain was different. So after experiencing no relief I went to the 24/7 ER Clinic.

There I was quickly escorted into a room, leads were put on, wires were attached, important ‘need-to-know’ clinical questions were asked, and then after this flurry everyone exited the room. I was left alone and I was scared.

Things really didn’t get much better after I was transferred to the hospital.
A nurse came in to introduce himself, asked my name and date of birth and then left. The hospitalist came in to review the information from the ER. She asked about my pain as well as the same diagnostic questions that were already asked and answered. She then turned and left me … alone. I was still scared.

A stress test was scheduled for the next morning.

After struggling through a sleepless night, I forged ahead. And here for the first time in 18 hours there was a real connection between patient (me) and medical professional. The technician asked about me (the whole person), she addressed my concerns regarding the treadmill and my hip (replaced a few years back), and I felt cared for and about. The physician and registered nurse who administered the stress test were like Penn & Teller and had the timing down to a ‘T’ in terms of when I would feel this or that. (They care about me. We were in this together.) Ray (my nurse) even placed his hand lightly on my shoulder for encouragement when he saw I was troubled. A compassionate human touch. How I needed that.

They cared about me, and it was tangible. I felt a safety net. My fears were subsiding.”

By definition, working in home health this nurse has the opportunity to go into people’s homes. She sees photos and interesting knick-knacks. She has her own patient panel, and yet the system she works within provides her with the opportunity to assess the patient’s environment and the time to connect and to listen to and see much of the patient’s whole story. She can reference a photo of her patient at Disney World and learn, “Oh that is me with my grandchild going to see Minnie Mouse. How I hope to be able to walk with no pain again so we can go back this spring.”

The home health system positions home health nurses to connect with patients and families far better than many (most) hospital systems. Tools (e.g., pictures) are readily available, as is time to make important connections and turn a “diagnosis with a patient” into a “patient with a diagnosis.” To ask about fears, to reach out and hold a hand, to show your patient you hear them. That you care.

In other words, as my friend shared …

“I am fortunate to have the opportunity to view my patients as whole people and not simply as ‘the chest pain in bay 8.’ I am positioned to know, to learn, to care and to leverage all of this to co-create with my patients a care plan which positions them to achieve their goal, e.g., walking with their grandchild to see Minnie Mouse in Disney World. And best of all … they know that I care about them as people and that I am there for them.”

As we strive to ensure healthcare becomes healthCARING and as we redesign systems to improve patient experience and instill compassion in healing, we health leaders must continue to learn much from those who work in home health. For example, we must continue to develop tools such as the Patient Passport, which includes a photo the patient loves and home descriptors, and the “This is Me” tool, which also includes photos along with space for life goals, preferred activities, communication style and interaction tips. All information home health nurses have access to on a daily basis with the patients they serve and all essential to provide optimal care of the whole person.

When we do, we will learn much from our patients (their whole stories) and we will all be better positioned to honor their stories, engage with them as whole persons, improve their experience and together, achieve better outcomes.


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