The First Step to Better Service: Awareness of Others

Recently I was onsite at a hospital, assessing its clinical, operational, cultural and behavioral activities to identify for leaders the barriers to reaching their patient satisfaction goals. It was late in the afternoon, and I was on a medical-surgical inpatient nursing unit. I noticed a nurse seated at her workspace reviewing physician orders, charting notes and reviewing progress notes. The workspace was a nicely sized alcove located in the hallway across from patient rooms – a location that was perfectly situated for her to know what was happening with her patients and respond quickly when needed. The adult son of one of the nurse’s patients stepped off the elevator, walked down the hallway and entered his frail and elderly mother’s room, which was directly across from where the nurse was sitting. The nurse was aware on some level that the son had arrived, but did not acknowledge him. A few minutes later, the son came out of his mother’s room, and tapped the nurse on the shoulder. “Hi Amy, I’m Dave, Mrs. Smith’s son. We met yesterday. Can you tell me what’s happening with my mom, and what the plan is for her?” Amy (the names are changed) proceeded to give Dave an update, and shared with him the plan of care for his mother. Dave then returned to his mother’s room.

So, how would you describe that interaction? Not bad, right? Now think about how Amy might have turned an average interaction into a great interaction. Let’s look at it from Dave’s perspective. He drives to the hospital as soon as he can after work – in fact, he leaves early, because he is concerned about his mother and wants to find out as much as possible about her condition, prognosis and results of diagnostic studies, as well as her plan of care. He steps off the elevator and walks down the hallway to his mother’s room, and notices the nurse sitting outside her room. “Good,” he thinks. He enters his mother’s room, and asks his elderly mother, “How was your day? What was the result of your test?” And, not surprisingly, mom does not have the answers. So he steps back out into the hallway to ask Amy.

How might Dave have felt if instead of seeking out the information from Amy, that instead Amy had acknowledged Dave when he walked down the hallway? “Hi, Mr. Smith, I’m Amy. I met you yesterday, and I’m the nurse taking care of your mom again today. I would like to give you an update, so if you want to go ahead in and say hi to your mom, I’ll be in to talk with you in just a few minutes.” What a great opportunity to make a lasting, positive impression with a patient and her family!

During visits to hospitals and medical office practices, I often witness staff members interacting with one another. Most perform their work with a casualness that speaks to how routine their work has become. This nonchalance is reflected in communication among team members (loud voices, laughing and joking), and the use of acronyms and jargon specific to the work being performed. There is an appropriate time and place for this – “backstage” and out of earshot and visibility of patients and their family members. Unfortunately, many staff members forget where they are – they lose their awareness, forget they are “on-stage” – resulting in patients and family members witnessing unprofessional behavior.

The dictionary defines awareness as “the state or condition of being aware; having knowledge; consciousness.” Synonyms include alert, attentive, cognizant, watchful and vigilant. Amy, on some low level, was aware that Dave had arrived on the unit, but was not fully aware or alert, and therefore missed the perfect opportunity to create a very good impression and provide the level of attention our patients and their family members want, expect and demand.

As you go through your day, try to pay close attention to how you speak: your tone, volume, and verbiage. Also pay attention to how your colleagues speak – with one another, with you, and with patients. Help each other be mindful (aware); encourage the use of “inside voices.” Pay closer attention to your surroundings, of how people react to situations and interactions with others, and be cognizant about how your behaviors, responses and actions affect others. You have complete control over your behaviors, responses, and actions, so how can you modify those to get a different reaction? The first step to making those changes is to develop your personal awareness.