How to Make Your Patient Happy

 

I’ve been a people pleaser for a long time now. I’m not entirely sure when it all started. I distinctly remember being an annoying, pain in butt kid and teenager.

Whenever it began, it is a large part of the adult me. In my yearbook I was noted at “best known” for my “perkiness”. Without analyzing why I feel the need to make people happy ( I will do that in a later post) I have to admit that I really, really enjoy it.

I currently work in home care. My patients range from basically healthy in need of companionship to end of life hospice. I feel responsible for the happiness of my patients and their families. I accept this responsibility with…

…happiness (of course).

  1. Call ahead- I always give a one hour window for my visit. I always call if I’m running early or late. I also ask if there is anything they need while I’m “out”. The patient often asks me to stop and pick something up for them. I’m happy to help.
  2. Arrive on time-See above.I am very careful about predicting the time of my arrival. Even if they patient is a little old lady who sits in her chair all day, she appreciates knowing what time to expect me.
  3. Listen-For real. I can’t just pretend to listen. When they talk about their hobbies or their kids or whatever, I listen. The next time I speak to them I will reference our previous conversation. They love that. They know I was really listening.
  4. Smile-A genuine smile can be hard if I’m not really happy. That’s ok. I’m practically always happy.
  5. Laugh-When I laugh with my patient, or make them laugh, its like a gold star that I earned.
  6. Ask good questions-It is so important to ask the right questions. I have learned to stop asking “How are you?” because I have received the response “How do you think I am?” one too many times. now I ask, “What’s new?”. To gather accurate information about the patients health and state of mind I have to ask smart questions. “Are you having any pain?” is just not enough. I also ask about discomfort and weakness. Then I ALSO ask about specific types of pain; back, knee, joint, etc. I know that a lot of patients don’t want to “complain” but I beg them to be honest with me.
  7. Give good answers-The answers are as important as the questions. The most important is when I don’t have the answer. If I really don’t have an immediate solution I promise to follow up, and then I do.
  8. Follow up-See above. Follow up is annoying for me, but I know how important it is for my patients. They are so happy when I get results and report back to them. Almost like they’re surprised that I actually did what I said I would do.
  9. Anticipate outcomes-This is where we use our crystal ball that is really our clinical experience, to predict the future. That is what I have to do every day, every minute.
  10. Remember the childrens’ names
  11. Remember the grandchildrens’ names
  12. Remember the pets’ names-I write them down in the patient’s paperwork. Yes, it is that important.
  13. Notice what is hanging on the walls-So much of what I want to know is hanging on my the walls. Are they a veteran? Are they married? Do they have children? Are the paintings on the wall all painted by the same artist? This is something that I actually look for. If so, I ask about the artist, which is usually the patient themself, or a family member.
  14. Do the laundry-How difficult is it to throw in a load of laundry? Even offering is a truly appreciated gesture.
  15. Wash the dishes-See above.
  16. Ask about hobbies and interests-My patients tell me about the most interesting hobbies; breeding horses (see previous post), keeping bees (stay tuned for this post), needlepoint, painting, gardening… 
  17. Take good notes-I take notes about everything. Sometimes the minute details are necessary to reference later. A seemingly unimportant statement or issue can become significant later.
  18. Bring gloves-You can never have too many boxes of gloves. This makes the patient and the caregiver very happy.
  19. Respect them-I am an invited guest in the patients home. I offer to take off my shoes, I ask permission before I sit. My patient is the boss. They deserve respect.
  20. Don’t argue-There is no situation I can think of where this would be appropriate or acceptable. Just don’t do it.

 

Lessons I’ve Learned:

  1. Its the details that count.
  2. Never underestimate your ability to change someone’s day. 
  3. Be present-whatever is going on in your life doesn’t matter when you’re with a patient. 
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6 Reasons Why Home Care?

Home care, visiting nursing, community nurse…we are called many things. But that doesn’t change what we do. Nurses who make home visits, regardless of what we call ourselves, are all the same and have the best nursing job on earth.

I became a nurse for many reasons (see my previous post for details). I knew I needed a job right away so I interviewed A LOT. It quickly became apparent that I had some problems. First of all, I couldn’t work nights, this was non-negotiable. I was a single mother, and I had no one to watch my kids. This made me very unattractive to hospitals. I also didn’t want to work on Shabbos (Saturday), also a problem. I needed reasonable hours and/or something close to home (see single mother excuse). I wasn’t discouraged while I was going to all of my interviews and not getting any offers, I knew something was going to come up.

It did.

I got an offer from a staffing company to work per diem at their flu shot clinics. Back in the old days before CVS and Walgreens started giving flu shots, they used to hire companies to staff flu shot clinics at their stores. I went to pharmacies and large businesses and gave many, many flu shots. One woman complained that I didn’t really give her a shot (I did). She said it didn’t hurt at all and therefore I must be lying about giving her the shot. I told her it didn’t hurt because I’m REALLY good at giving flu shots. She didn’t buy it. After that moment I changed my pre-shot speech. Instead of giving the usual list of possible complications and contraindications I added, “the shot may not hurt, but if you want it to, I can arrange that.”

Eventually I was offered a spot in a training program at a home care agency. It was a dream come true (thanks to Sammy and Aviva). The program offered in class training for several months and then orientation in the field and a gradually increasing workload to productivity. It was a challenging time and I made plenty of mistakes but I made it through. I learned quickly that I had the perfect job. I stayed at that job for three years and my next home care position for three years and am at my current position for one year. I NEVER want to leave.

When you see a hospital nurse she is really busy, focused and usually very serious. Home care nurses are always smiling, why is that?

My patients often ask me about my family and how many children I have. Then they all ask exactly the same question, “When do you relax?” “I’m relaxing right now”, I tell them. That is not a joke.

  1. Independence. 

No one was looking over my shoulder. That may sound like a bad thing when you’re a new nurse, but it wasn’t. I may not have done things perfectly right on the first try, but I figured things out. Coming to the solution on my own was very satisfying and exciting as a new nurse. I had a supervisor and case managers in the office who could sometimes answer my questions when I could get them on the phone, but I learned not to bother.

2. Flexibility

I don’t just see patients in their homes. I have done new employee orientation, HHA classes, chart audits, quality control, community lectures, staff education and competencies. Sometimes its nice to spend some times in the office.

I decide when to see each patient. If the patient isn’t available when I want to see them (most were, they were usually homebound) we would chose another option that worked for both of us on a different day/time. This meant that I could go home and eat lunch…or go out for lunch (which nurses get to actually eat?). It also meant that I could schedule doctor appointments for myself or my kids and plan my patients around that appointment…or my kids school play, or a teacher conference, or a trip to the mechanic to get an oil change, or the post office. How do working mothers get things done?

3. The patients

I can sit with my patient for an hour talking about; the photographs on their walls, the numbers on their arm, what they’re cooking on the stove, the work they did “before”, the origin of their last name, their garden, their dog, their paintings, their piano…Of course I discuss their medical history but only after we have made friends. Why would I do it any other way? If I do a good job and I ask the right questions, most of my home and health assessment has been completed before I ask any of the questions on my nursing assessment. My patients are happy to share personal details with me because they trust me. When I teach new nurses I remind them that we are a guest in the patient’s home. We must ask permission before we sit down or place our bag on a chair.

4. The stories

My patients share the stories of their lives with me. Stories of immigration, illness, happiness and sadness. They trust me with the stories that make them who they are. I have met some truly amazing people who have experienced truly wondrous things. I am always humbled by the gifts they give me in the form of memories.

5. The money

The money is comparable to hospital nursing and the opportunity for overtime is usually available depending on the type of agency you work for. Even if your agency does not have overtime availability you can work for other home care agencies per diem while you are working full time for another. I have done this and it has created quite a financial opportunity for me.

6. The nursing

I have treated a wide variety of health issues. No matter what you may hear, home care IS real nursing. Wounds, staples, trachs, PEGs, foleys, sutures, vents, amputations and many more.

I may see a patient two or three times, or I may see them daily for years. Either way I am invited into their life. In this environment I have the ability to help my patients make real changes and I have the honor of watching it happen.

11 Reasons Why I became a Nurse

1. The money.

One of the main reasons I chose nursing was because of the earning capability. I was in the middle of a divorce, had two small children and no career to fall back on. I figured that I would always have a job if I worked in healthcare. I hoped for job security. I know that the market has changed significantly since I graduated but I still believe this is true. I’m not embarrassed to admit this, it happens to be the truth.

2. The respect.

I have ALWAYS been proud to be a nurse. Even when the work is hard and the time is short I have always known that I am serving humankind when they are the most needy. My patients are always happy to see me. How could any other profession be more important or satisfying?

3. The thrill. 

The amazing feeling I get when I help someone, whether it was something big or small, is almost unmatched in my personal or professional life. I am often so excited that I want to shout from the rooftops.

4. The fun. 

Um. This is hard to explain if you aren’t a nurse, but take my word for it. Getting the foley in on the first try, getting the IV in on the first try, healing a wound, teaching someone a new skill, seeing a patient get better or bringing comfort to a patient or family member.

5. The friends. 

The people I have worked with since I became a nurse all hold a special place in my heart. The friendships and camaraderie is almost instantaneous. This is a special feeling I share with nurses even those I have only just met. Being a nurse is like being part of a huge extended family.

6. The experiences. 

The experiences I have had with my patients, their families and the other people I work with have shaped my life in a way I could not have imagined.

7. The options.

Being a nurse can mean many things. I can work with blood and guts or I can sit at a desk. I can work with children and then decide I want to work with the elderly. I can work full time, part time, summers only, shift work, occasional visits, or even from home. This is hugely attractive to me and to most people I’m sure.

8. The knowledge. 

Having the ability to save someone’s life is quite the useful talent. Knowing all the other stuff comes in handy also.

9. The people. 

I have met so many different people living completely different lives than my own. It is easy to live life in your small circle of friends and family and not realize that there are so many different types of people on this Earth that you may never get to meet or experience. I am so grateful for what I have, seeing how terrible some peoples’ lives are, its impossible not to gain perspective.

10. The stories. 

My patients share the most interesting stories with me. They often don’t want to talk about being sick so we talk about everything else instead. I have learned so much from these conversations-stories about the holocaust, about family, about all different types of professions. I have learned incredible things about strength and honor and even bravery. Of course I can’t tell any one else these stories, but take my word for it, they are amazing.

11. The stories. 

I have the best stories. I have a story for every disease you have ever heard of and several you have never heard of. Want to scare your kid into wearing a helmet? Not using drugs? Wearing a seat belt? Using sunscreen? Yup, got a terrible story for every scenario. Need a feel good story, got that too. Miraculous recoveries? Sure thing. Just let me know what you’re in the mood for and I will provide the entertainment or the inspiration, whatever you’re looking for.

Bottom line, I highly recommend nursing as quite the incredible profession. It has been for me.

Lessons I Have Learned

1. See 1-10