Do We Really Know Who Our Patients Are?
Submitted by Maureen Kroning, RN EdD
Tags: caring connecting with patients fundamendals nursing patient identification pilot study task oriented who is our patient
A Pilot Study
By Maureen Kroning RN EdD
Abstract
The profession of nursing has become so task orientated that we often forget to ask,
"Who is our patient?”What was their life like prior to becoming ill?" With advances in technology and the business atmosphere of healthcare nurses are often not able to provide patients with one of the most fundamental core competencies of nursing, caring.
Both nurse leaders and educators need to teach and model not only day to day nursing skills but the importance of connecting with their patients. In today’s often chaotic healthcare environment nurses are bogged down with so many tasks that we, as nurses, forget to just simply ask who are our patients, and not only what is their diagnosis, what tests are ordered, what medications do I need to give but also to remember to ask ourselves: Who is my patient?; What was my patients life prior to their medical diagnosis and what are their beliefs; dreams and ambitions?
Observation
One day while teaching nursing students at a sub-acute care facility, I observed a group of women appearing bored gathered in their wheelchairs at the end of the hallway. I walked over to start a conversation which provided the opportunity to get to know these four patients while my students were preparing for their post-conference report. I walked over and asked, “If you could go back in time and be any age, what age would you want to be?” I wondered what made me think of that question. I believe it was sparked by watching them sitting silently and appearing bored in wheelchairs, in a facility they would most likely remain until one day they joined God’s kingdom.
Engagement
So, I went down the hall and asked the four women: “If you could go back to any age what age would it be?” Surprisingly the responses were similar which led me to ask yet another question, “Why did you choose that age?” Again there were similar responses. This was a good example to students that nursing practice often presents good opportunity to research a topic further and as nurses we need to follow-up with further questions in order to understand our patients better.
Pilot Study
The two questions that emerged that day from nursing practice served to inspire me to conduct a pilot study. I asked the same two questions to 32 patients ranging from 66 years of age to 100 years of age. A total of 11 males and 21 females answered the two questions. The Mean age patients wanted to be if they could go back in time was 27 and the Medium age chosen was 21. Three out of the 32 patients answered that they were happy at the age they were now and would not want to go back to any particular age in time. Thirteen (11 female and 2 male) out of the 32 patients answered the reason they choose a certain age to go back to had to do with the fact that they were married or had met their spouse. Other response to this question included being young, in school, had fun, good time in life, working, dating, bought a car, traveled and having children. One 92 year old gentleman stated, “I would never think of going back to any age because I am happy where God has put me.
Conclusion
When I asked just these two simple questions, I noticed patients eager to participate and happy to see that I was interested in more than their medical diagnosis. It was as if there was a brief escape from having to focus on the medical side of things and be able to reflect on perhaps a better time in their life. As nursing educators, we need to understand that even though the role of the nurse is changing and healthcare is in a crisis state our patients continue to need nurses that are caring and compassionate, nurses who are willing to ask: “who is the patient I am caring for?”; “what is unique to this person?”; and how can I make a difference in their life. We need to keep in mind our patients are more than the disease, medications and the treatments that we care for. Patients often feel as though who they are is no longer relevant and what is relevant is their diagnosis, treatments and medications. As nurses we need to be sensitive and knowledgeable that this is only a small part of who our patients are and as nursing educators is important we model this philosophy to our students.