“It must always be about the patient.”
After joining an amazing nurse leader at a Midwestern hospital, I immediately became aware of the common thread she wove into each answer she provided to the many staff nurses relying on her coaching.
Q: “But what if the patient is sleeping? Should we still conduct our shift report at bedside? I wouldn’t want to be woken up.”
A: “What is your patient’s preference? Have you set the expectation early on in her stay? If not, be sure you discuss rounding, bedside shift report and our goal of actively engaging her in all aspects of her care. Then you will know what she wants and she will understand.”
In other words, as my colleague further put it, “Always keep your eye on your True North … the patient … always keep them in the center of all you do … and your answers will become clear.”
In your organization, how often have you made decisions for your patients and their families based on how you would want to be treated (also known as the Golden Rule)? And how often have these decisions been contrary to how your patients and their families truly wanted to be treated?
This is where relationship-centered care comes in, and with it the Platinum Rule: Treat others the way they want to be treated.
When done well, this will also incorporate two additional must-haves: 1.) individualized patient care and 2.) cultural competence—defined as the ability to effectively deliver healthcare services that meet the social, cultural and linguistic needs of patients.
(Note: Having the ability to deliver this kind of care is all about checking off a box. Actually delivering this care always is the true goal and our obligation to all those we serve and to one another.)
The only way to truly know how our patients and their families want to be treated is to establish relationships and trust with them. We must listen to them and share this information with the clinicians who will be interacting with them, incorporate it into all care delivery processes and update as necessary. We must also honor this additional information as part of the shared decision-making and care plan development and implementation process.
Some years ago, I was leading the Parent Partnership program for a national quality improvement organization as we worked to improve care for children—in this example, children with sickle cell disease. It was not until we established relationships and opened our hearts and minds to these parents did we evolve our care path from one that was set by brilliant physicians strictly relying on their lens, to one that married their wisdom with that of the other experts in the room: our parent partners, who were the experts when it came to their children battling this disease daily.
Only then did we understand the many barriers they were facing to receive optimal care, including access challenges, cultural and socioeconomic barriers and others. And only then did we gather these data, convert it to information and then collaboratively leverage this wisdom to significantly improve care for these brave children.
Each time I partner with nurse leaders throughout the country, I am further reminded of the importance of never losing focus on the patient and family. I strive to never lose touch with why we are here in the first place and always engage patients and families—listening to their stories to understand and partnering with them to improve care, safety and outcomes.
Today, let’s commit to no longer choosing to provide care without the most important information available to us: our patient’s story. Let’s commit to no longer minimize the importance of engaging our patients and their families. Let’s commit to always listen to understand, to always seek out this additional information, to always honor this wisdom through action, and to always keep the patient and family in the center of all we do.