Utah Nurse - August 2018

August, September, October 2018 Utah Nurse • Page 5
“MUSINGS OF CARING”
SELF-REFLECTIVE MOMENTS BY NURSES
Nurses Enhance Patient Care Interactions in Moments of Connection
Sharon K. Dingman, DNP MS, RN
Nurses provide an innate sense of humanness,
connection, and sense of caring in patients’ lives. There
are powerful moments in the delivery of nursing care that
have an extraordinary impact on the patients’ outcome
and create unforgettable moments and memories
(Dingman, 2012 & Thew, 2018). Nurses inform, connect,
engage and advance the profession through their
interactions in creating profound patient experiences.
Moments of connection include authentic empathy,
respectful caring, collaborative awareness, calming
presence, engaged spirit, informed professionals and
quality outcomes (Dingman, 2012).
Caring Defined
Patients and families define caring as accessibility,
communication, caring moments, non-judgmental
attitudes, and competence (Dingman, 1999). Authentic
caring behaviors influence the patient perceptions and
satisfaction with care are listening, offering comfort,
putting the patient first, talking to the patient, responding
quickly to patient needs, being accessible, monitoring the
patient, and following through (Dingman, et al,1999; Utah
Nurse, May, June, July 2018). Nurses are able to connect
with patients and families through conscious authentic
caring moments based on their professional ability,
knowledge, and experience to impact the lives of patients
and families. When meaningful remarkable moments of
great service that happen in a persons’ life and create a
lasting impression…positive or otherwise.
Within health care organizations, profound human
experiences happen every day. Numerous opportunities
abound daily to create the human connections that
differentiate a caring/healing environment from one that
is not. Who we are and how we work together as nurses
is what our patients and their families receive. Even within
a “state of the art” physical facility, with care centered
on the patient and family, and the empowerment of
caregivers at the point of care/service in decision making;
all would be like an empty shell if those providing the
care/service did not feel cared for themselves.
Moments of Shared Connections
There is a “mindful” presence and sensitivity with
professional satisfaction in the nurse-patient partnership
resulting in mutual satisfaction with the care delivered
and received (Dingman, 2012). Connection with the
caregiver and the patient remain primary to patient/
family satisfaction with care and service. Making
moments of shared connection matter builds positive
patient perceptions of care. Opportunities to recommit
to the “passion and purpose” of why an individual works
in health can be a valuable moment of reflection and
renewal. Creating better experiences and better defining
moments provide insights into shared meaning and
connecting with others (Heath and Heath, 2017, 211).
Where caring and healing are present, where visible
regard for dignity of human being, and where those
who give care do so in teams with mutual respect and
accountability there is a palpable sense of well-being.
The identification of 'critical junctures' or moments
of interruption in care delivery are opportunities to
improve and celebrate the contributions of all caregivers
regardless of their role or job in the organization. Patient
satisfaction is an important measurement of quality
by the consumer from their experience with both the
technical and interpersonal elements of care. Patients
and their families value meaningful affective interactions
with care providers. The two components of nursing
affective and technical care are seen as equal in
providing compassionate care (Dingman, 2012). Evidence
based practice (EBP) models indicate professional
nursing practice impacts the patient’s perceptions and
expectations of caring and their satisfaction with care
received (Dingman, 2012).
Patient Satisfaction: Expectations and Caring
Patients need and want education in managing their
illness from nurse(s) using through personalized care
plans that engage and support care outcomes. Not
every patient has the same diagnosis or reason for
hospitalization, but there is a common need for patient
centered care including their diagnosis, education,
and how to incorporate self-management of their
circumstances. Caring interactions from care providers
gives the control to the patient in their own self-care
(Bardsley, 2018). Creating a relationship in this process
influences patient satisfaction and is an important
indicator of quality of care.
Nurse caring must be displayed to be effective and
patient satisfaction is the expression of the match
between patient expectations and caring received.
Caring is a fundamental value that guides nurses’
ethical decision making and provides a basis for nursecaring
action (Dingman, 2012). Patient satisfaction
is measured and used in healthcare to improve care
delivery. Standards of excellence are commonly
measured and associated with financial incentives to
improve the patient experience with nursing and others
involved in delivering care.
Caring Defined
Humanity is expressed holistically to the patient
through compassion and caring by the nurse, especially
during the one-on-one interactions at the bedside
(Dingman, 2012). Caring is defined as an intentional
presence, affective behaviors, personal ownership,
respect for human dignity, genuine service, a partnership,
and as a matter of integrity that is heartfelt, and given
and received between individuals (Dingman, 1999).
Listening and comforting is a vehicle for caring. Heath
and Heath (2017) state “patient experiences are made
by positive moments of elevation, insight, pride, or
connection that spark positive emotions, and received
within defining moments of care.”
According to Dan Heath (2017), “we need to stop
fixing potholes and start building peaks when it comes to
creating better experiences for the people we care about.
When we create better experiences, we create better
moments for our patients and their families. The peak
moments of these experiences with the delivery of health
care are the most memorable. Great service experiences
are mostly forgettable and occasionally remarkable.
People are willing to forget a lot of mediocrity as long as
there are some moments that are special. Remarkable
moments do not happen themselves.” As nurses focus
on the creation of better experiences we build peaks in
lieu of only fixing problems.
Defining Peak Moments
Chip Heath (2017) states, “the identification of ‘defining
moments’ are powerful for organizations in their thinking,
processes, and structures used to create meaningful and
memorable moments that drive financial performance.”
The value of humor the flight attendants of Southwest
Airlines use during the funny safety instructions on the
selected flights (1.5% of flights) have shown that the
people on these flights are likely to take a half of a flight
more in a subsequent year.” If the airline increased this
to 3% the potential increase in revenue would be $139
million a year for the momentary moment created a peak
experience.
Building peaks and creating positive experiences
may be one way to change from a focus on problems
only and allocate time to creating peaks and improving
experiences of patients and families we serve. The
customer experience is created by peak moments
contains four elements: elevation, insight, pride, and
connection. These four elements come up in stories of
customer service and other defining powerful moments
in our lives. Healthcare can build peak moments in the
lives of patients and families.
I think you will enjoy reading the book “The Power of
Moments – Why Certain Experiences Have Extraordinary
Impact” by Chip Heath and Dan Heath as you discover
the relevance of the perspective of the authors and the
application of “the power of moments of elevation,
insight, pride, and connection” in your practice.
Future articles on “Musings of Caring” by Dr. Dingman
will continue to make references to this book.
Invitation to Share “Musings of Caring”
You are invited to share your “Musings of Caring” with
Utah nurses by contributing your reflective observations
and caring stories from your delivery of care to patients
and families. A few examples from a group of nurses’
reflective observations on “being with and doing for”
patients included how they established a relationship;
confirmed trust by patient through listening and
explaining; without judgment listened to patient fears and
concerns; felt empowered as the patient advocate; sat at
eye level to review a plan of care; and worked as a team
with the patient, nurses and physicians (Dingman, 2012).
We look forward to hearing from you!
Note from Utah Nurse Editor and Author of
“Musings of Caring” Dr. Dingman
The idea for the “Musings of Caring” Column
began with the May, June, July 2018 article and using
the personal experiences and scholarly work of Dr.
Sharon K. Dingman as a hospitalized patient before
she became a nurse, experiences as a nurse caregiver,
administrator and educator, and in tribute to the spirit
of the caring nurses provide to patients and families.
“Musings are forms of self-reflection including meditation,
introspection, contemplative, thoughtful, purposeful,
logical and philosophic (Merriam-Webster Dictionary,
2018). Many nurses often share personal patient caring
moments of connection both given and received among
each other. The nursing literature provides examples
of caring and the impact on patient care outcomes.
Musings are therefore personal “moments of caring
presence” with the patient, family and/or significant
others by being present as a nurse in delivering care.
We are extending an invitation to nurses
to share their “Musings of Caring” stories for
publication consideration in future issues of Utah
Nurse.” beginning with the November, December
2018 and January 2019 edition of Utah Nurse.
Guidelines on the submission process for
a short article to be included in the “Musings
of Caring” column are found in Utah Nurse –
Publications on Page 2. Submissions can be sent
to: editor@utnurse.org or mailed Attn: Editorial
Committee, Utah Nurses Association, 4505 S.
Wasatch Blvd. Suite 330B, Salt Lake City, Utah
84124
Selected References:
Bardsley, J. (2018). Educated, engaged patients, better
diabetes outcomes. Retrieved from http://www.
smartbrief.com/original/2018/05/educated-engagedpatients-better-diabetes-outcomes.
Dingman, S. K., Williams, M., Fosbinder, D., & Warnick,
M. (1999). Implementing a caring model to improve
patient satisfaction. Journal of Nursing Administration,
29(12), 30-37.
Dingman, S. K. (2012). Nurse caring enhancements of
The Caring Model©. Unpublished Doctor of Nursing
Practice Project, Department of Nursing, Texas
Christian University.
Dingman, S. K. (2018). The value of a healthy nurse
workforce. Utah Nurse, 24(4) May, June, July ed. Utah
Nurses Association, SLC, Utah, 6.
Heath, C. (2017). The power of moments at Forrester’s
CXNYC. Retrieved from https://www.youtube.com/
watch?v=-l03bHVF0Ok.
Heath, D. (2017). Build peaks, Don’t fix potholes.
Retrieved from https://www.youtube.com/
watch?v=QxXcL28A89M.
Heath, C. & Heath, Dan (2017). The power of moments:
Why certain experiences have extraordinary impact.
Simon & Schuster: New York, NY.
Merriam-Webster Dictionary (2018). Definition of musings.
Retrieved from https://www.merriam-webster.com/
dictionary/musings.
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