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Practice comment

'Patient stories give another view of the world we work in'

Recently, I had the misfortuneof becoming a patient.

Overall, I was satisfied with my care. The environment was clean and I was seen in a reasonably timely manner by the right professionals. However, the doctor left the room three times in as many minutes while she was examining me to answer a bleep. I felt the bleep was more important than me, and the interruptions were disruptive to both of us.

We know interruptions increase errors. So, perhaps the doctor could have answered the bleep between patients. This would have speeded up the examination process and improved the experience for us both.

We need to strengthen efforts to meet patients’ and family members’ needs and expectations (Ledema et al, 2011). Emerging evidence points to a link between patient experience and clinical outcomes, and between quality and financial performance (1000 Lives Plus, 2011; Dr Foster, 2010).

One way of meeting patient needs is through listening to their stories. These stories provide a very different lens through which to view the world we work in, offering a unique, anecdotal and also powerful insight into what has happened from the patient’s or carer’s viewpoint.

Patient stories are a rich source of information and can expose issues and ideas never considered before. They can be used to mitigate against potential complaints, and grant us insight into the disruptiveness of illness that we can only begin to imagine.

Some conversations can be difficult and painful both to the story-teller and to person taking the story. Equally, they can reveal positive experiences to build on.

Taking and analysing patient stories is a skill that requires development and training. A governance structure is needed to ensure the appropriate use and information management of these stories. The Royal College of Nursing has a recognised analysis methodology, which is widely taught.

As nurses, we see “dignity maintained at all times” written in notes. How do we know this has been achieved? Cardiff and Vale University Health Board has a database of more than 400 stories. A ward sister has used patient stories to develop a team approach to ensure dignity and respect is maintained, based not on what nurses think, but on what patients want.

Many of our board meetings start with a story, which enriches decision-making and maintains a focus on patients. On a larger scale, stories have been used to develop the cancer genetics service for Wales.

Imagine if stories were used at all levels from the proverbial board to ward to inform decision-making and effect change. How different would our care and service provision be? NT

Joy Whitlock is quality and safety improvement manager, Cardiff and Vale University Health Board

Readers' comments (7)

  • Being a patient can be a terrifying and disempowering experience whether you are a professional or not. It is the small things that matter, a smile, eye contact and the time staff spend with you. Being made to feel that you are a person not a 'condition' or 'surgical intervention'. We should all imagine ourselves in the patient's position in order to improve practice. Staffing however in some areas appears to be woefully low.

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  • michael stone

    'One way of meeting patient needs is through listening to their stories'

    Yes. And the poster above who commented on imagining that you are in the patient's position, as made a crucial point - it is always useful to try and think like someone else (you can't always get that right, but knowing you should do it a start).

    Perspective plays an enormous role, in many things.

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  • I couldnt believe how vunerable and small I felt as a patient on a post natal ward a couple of years ago. I was easily crushed by an offhand remark by a midwife. i had asked for analgesia only to be told "I'm not looking after this bay". I was too upset to stand up for myself (despite being a qualified nurse for 20 years)!

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  • I am undertaking a simple study in my speciality of neurosurgery - interviewing my patients about their individual journys to find out what is important to them at that given time. The information that I recieve will help to forge an improved service. 'Simple but effective'

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  • recently i was admitted to gynae for a repair and hysterectomy
    the ward was clean one staff nurse excellent helped with my pain relief called a doctor when all else failed
    BUT!!!!
    nurses doing a drug round on ward talked about a patient in the side room who was a nightmare,
    and one other member of staff discussed a sandwich that had alledgeglly been stolen from a fride only to be told by another member of staff i know who it was it was the one with the red stripe ( the only staff with red stripe were student nurses)
    as patients this was fascinating to listen to, i squirmed with embarrassment, being a nurse my self and not at all deaf could not believe what i was hearing, they appeared to be oblivious to the fact there were 5 patients in the ward
    later that night in the early hours my pain returned and i was told incorrectly as it turned out i could have nothing i asked to speak to a doctor and was told hes busy with ill patients as you can imagine that made me feel even worse
    the outcome was i managed to say to the nurse after thinking about the time i had had my last medication please read the notes i am sure you are wrong about the time she was wrong but she tried to say that she had told me another time, this despite the patient in the next bed who had been woken up by the noise of voices saying i was right about the time
    she did apologise in the end but at the time it was very distressing i was in considerable pain and treated like i was making a fuss about nothing
    in no other area would i put up with 2nd rate service why do patients have to in hospital when they are at there most vunerable




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  • My daughter was a patient this year. She is 19years old and was very unwell requiring intravenous antibiotics and suspected pulmonary embolus.
    As a trained nurse I was appalled at the lack of nursing care. No appropriate care plan and not recording observations required for temp 38.9 on iv antibiotics.
    I complained to the ward manager in writing with permission from my daughter. The failure of appropriate care was acknowledged and I recieved letter from Chief Exec of Trust.
    I felt very uncomfortabe about complaining but would not have wanted other patients to have poor care.

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  • It is an eye opener to become a patient. You have expectations and when they are not met you wonder if your values are different .... or have things changed so much ? I recently had an eye operation in the hospital where i had been a theatre sister for twenty years. All the staff where helpful and kind but the best aspect was the volunteer who held my hand throughout the procedure ..... under local anaesthesia , totally surreal. That human contact and the encouragement it gave me was wonderful. Bit funny tho that it was a volunteer and not a nurse .

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