Abstract
The patients’ journey is a complex network involving multiple layers of impactful stakeholders, among these stakeholders are nurses. Nurses’ impact is critical to achieving better health outcomes and an uplifted experience, yet there are gaps in supporting nurses and empowering them to maximize their contribution to patients. Empowering nurses can take place in the form of educational support, recognition, and reducing their workload to limit their burn-out. The impact of such support to nurses would result in improved health outcomes, reduced mortality rates and an increase in patient satisfaction.
Keywords: nursing, organizational culture, patient feedback, quality improvement, relationships in healthcare
Introduction
In this article, I address a crucial void within our healthcare system. Through my perspective as a type 1 diabetic patient who has embarked on a career in health promotion, I intend to raise awareness on the profound impact nurses contribute with in enhancing the patient journey. Despite their pivotal role, it is disconcerting to observe the lack of effective support and empowerment for nurses across various settings. As patients, healthcare colleagues, and members of health administration teams, we hold the power to bridge this gap, with incremental and meaningful contributions. We must recognize and address the challenges faced by nurses, acknowledging them not only as caregivers but as indispensable stakeholders of the patient experience.
Key Factor 1: Nurses Need Continuous Support for Education
Through my various encounters with nurses a patient, the biggest realization I came across was on how passionate the nurses are to help and reduce the physical and emotional pain of patients. I was once admitted to the hospital on my ninth birthday due to ketoacidosis, the nurses did not only wish me a happy birthday, they were kind and thoughtful, took the time to create artworks to decorate my room to celebrate my birthday. Not only from a patient experience perspective, but also professionally, I saw that nurses were always eager to be empowered and supported. As I led and offered multiple training and educational webinars opportunities, I rarely received any refusals from nurses, even if it was at the expense of their own time.
Yet from my observation as well, I witnessed that many nurses’ efforts remain unrecognized. I also received feedback from some nurses, on how much they valued approaches that empower them. This led me to the realization and the urge to create this article in order to emphasize on the importance of offering opportunities to nurses that empower, support, and recognize their true value in the patient experience.
Key Factor 2: Nurses as Life Coaches
Think of your own health experience, how many touch points with nurses do you have in a normal clinic visit, and even more, if you live with a chronic condition? And as a medical practitioner, how would you imagine your day or care for patients would look like without nurses?
Not only the count of encounters, but think about the value. Nurses provide the compassionate support a patient needs, they emphasize on the key information shared by the doctor during the limited time encounter, they provide affirmations and even extend support to help remotely while patients are at home. For example, when a physician shares the negative news of a disease diagnosis, it is the nurse who steps in with a smile and an assuring tone to help the patients and their caregivers calm and understand the impact of the condition and how to treat it. Imagine the added value if those nurses were further empowered through emotional intelligence coaching, support in the work place and gratitude. To do so, nurses can be provided with life coaching training and access to education on neuroplasticity. Providing them with such tools can be empowering to them when dealing with patients who might go through turbulent emotions due to the stressful illness situation. Through this approach, nurses can get equipped with the underlying understanding of why people respond in the way they do and can disseminate the concepts of coping and changing the perception of patients based on science, such as neuroplasticity.
Key Factor 3: Empowering Nurses can Lead to Reduced Mortality Rates and Improve Patient Safety
There are multiple research papers and studies that continue to confirm that nurses play a very important role in improving patient outcomes, and this is highly influenced by the level of empowerment and education that nurses obtain. “What is the impact of professional nursing on patients’ outcomes globally? An overview of research evidence” found that “adequate numbers of well-educated nurses working in acute care areas can reduce the risk of patient mortality”. 1 So not only does educating nurses effectively improve patient experience, but it can also contribute to reduced mortality. Also, in the article “Addressing the Nursing Work Environment to Promote Patient Safety” 2 it was concluded that it is very important to look at the nurses’ work environment as a complex system, break it down to address the difficulties that they may face and then provide solutions and guidance to nurses. As a result, this approach would increase nurses’ level of professionalism, empowerment and therefore improve patient safety. From a patient perspective, to be supported on my condition, I would highly appreciate a credible and empowered companion to support me in my journey. From a professional perspective, I, as well, recognize the importance of having simple yet holistic systems and processes that enable me to perform my job effectively and focus my effort on supporting and improving the patient experience rather than on overwhelming admin tasks.
Key Factor 4: Negative Patient-nurse Experience Highly Impacts the Patient Journey
The article: “How Quality Nursing Care Impacts Patient Satisfaction, Experience” 3 provides a great summary and links on how quality nursing plays an integral role in improving patient satisfaction and health outcomes. I highly support this summary; the level of satisfaction and having a positive experience in a clinic a key contributor to my adherence to medication and willingness to improve my condition. Delving into what formulates a positive patient experience, I believe that it would be a sound combination of valuable information provided based on a genuine feel or interest shown by nurses. In the survey study “Patient satisfaction with the quality of nursing care”, 4 the study evaluated patient satisfaction while assessing the quality of nurses’ care. The results were interesting as they showed that patients were at least 5 times more satisfied by nurses’ care that was more compassionate and engaged, rather than the informative approach. This outcome reflects a very sensible perspective of patients, where they need to be supported during their most vulnerable time, and this support is not only based on educational information but rather on actual compassionate care.
Key Factor 5: Patients’ Feedback on Nurses’ Importance
Also, based on my experience, patients’ feedback repeatedly included that they are most comfortable sharing their experiences with nurses. This means that if the nurse is correctly empowered, then they would have the ability to positively and effectively impact the patient experience. As I led digital initiatives that included patients’ insights, it was repeatedly mentioned by patients how they are skeptical to be fully open with physicians; due to time limitations and due to fear of being judged. However, with nurses, patients often reflected on how they become more comfortable to share their vulnerabilities and speak at length with sincerity about their disease management at home. This is a critical factor, as it would indicate that nurses have a wealth of information regarding the different patient experiences, which is critical in mapping the patient journey to understand their disease experience and its impact on health outcomes.
Recommendations
I would recommend applying a multilayered approach to effectively reduce the barriers and improve the nurses’ journey. Firstly, ask the nurses. Provide a platform and a safe environment for nurses to share their perspective, the burdens and how would they wish to be supported. Once this is done, gather the anonymous outcomes and create a working group that includes members from different departments including nurses’ representatives to put an action plan that is thoroughly followed and reviewed. Then, conduct evaluations on how has the journey improved and what can be done to maintain or further develop. The success of such an approach and its outcomes can be shared as a best practice followed by recognition awards to institutions who embrace a nurses’ thoughtful approach. This then becomes a culture of inclusion and appreciation, followed by practical action steps that can be tailored based on different nurses’ needs.
To being with, engage clinic management, patients, healthcare community and companies in recognizing nurses’ efforts as a daily habit through kind words and recognition walls.
Also, I would propose providing more education opportunities to nurses, reducing the admin work and providing the coaching trainings. Nurses soft and communication skills can be empowered and therefore, they would have the tools needed to communicate effectively with patients.
Conclusion
Finally, once revising the practice to a person-centered approach when interacting with nurses, the patient experience would eventually be drastically elevated as nurses care would be empowered. Not only that, but the health ecosystem would be highly uplifted with positive health outcomes, as the nurse's role is extended to be a liaison between the patient, the physician, and in many incidences the payer/insurer too.
Footnotes
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors received no financial support for the research, authorship, and/or publication of this article.
ORCID iD: Maram Dalab https://orcid.org/0009-0008-0938-2443
References
- 1.Coster S, Watkins M, Norman IJ. What is the impact of professional nursing on patients’ outcomes globally? An overview of research evidence. Int J Nurs Stud. 2018;78:76-83. doi: 10.1016/j.ijnurstu.2017.10.009. PMID: 29110907. [DOI] [PubMed] [Google Scholar]
- 2.Lin L, Liang BA. Addressing the nursing work environment to promote patient safety. Nurs Forum. 2007;42(1):20-30. doi: 10.1111/j.1744-6198.2007.00062.x. PMID: 17257392. [DOI] [PubMed] [Google Scholar]
- 3.Heath S. How Quality Nursing Care Impacts Patient Satisfaction, Experience. Patient Engagement Hit. May 9, 2019. Accessed May 4, 2023. https://patientengagementhit.com/news/how-quality-nursing-care-impacts-patient-satisfaction-experience.
- 4.Karaca A, Durna Z. Patient satisfaction with the quality of nursing care. Nurs Open. 2019;6(2):535-45. doi: 10.1002/nop2.237. PMID: 30918704; PMCID: PMC6419107. [DOI] [PMC free article] [PubMed] [Google Scholar]