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#WeNurses - A 'can do' approach to making every contact count


Did you miss the latest #WeNurses chat discussing making every contact count? Let us sum it up for you…

I recently had the need to go to my local surgery to see the practice nurse. I was due a Hepatitis B booster and I must say I was rather impressed. Whilst I was there the nurse asked me all sorts of questions, from my general health and fitness to checking when I had my last cervical smear. I found myself smiling as I recognised that she was very adeptly making every contact count. But is this something that all of us nurses do? And is it even important that we do make every contact count? This subject was suggested as a #WeNurses discussion by @RobWebster_LCH and @AnitaRolfe:

At the start of this chat @WeNurses asked if making every contact count is this something that chatters thought was realistic.

@AdamRoxby tweeted “Frankly no. It’s something we would like to do of course but maybe I’m a cynic” he went on to add “I don’t think it’s a time thing. I wonder if it’s just an unobtainable aspiration. A utopia we should try and reach”

@cherylwilson2said “I think it really is dependant upon your work place environment”

@cllrfay stated “On the acute ward where I am ‘every contact count’ is unrealistic, though patients often bring other health issues up”

@DGFoord then tweeted “It’s time in some settings. With multiple brief patient contacts, adding health promotion costs more”

@VivJBennett added “My job to get understanding of what nurses can do with our huge contacts to improve public’s health”

@dmarsden49 then asked “Is this not an opportunity to enable all of us to consider how care is delivered slightly differently?” and went on to explain “I was asked whether I thought a pt with learning disabilities should be allowed to go off the ward for a cigarette. I asked the nurse whether we had asked whether he had considered giving up, as many people do in hospital!”

@VivJBennett the asked “How can nurses embrace those ‘teachable moments’?”

@DGFoord answered “We need to move beyond ‘chatting about general health’ & use targetted personalised health improvement interventions”

@JulieVuolo tweeted “Need to be able to think on the spot about the impact they are or can have in any given situation (reflect-in-action)”

@dmarsden49commented “I liked @julievuolo point about reflection in action, is there a novice to expert perspective on this?”

@JulieVuolo then answered “Reflection-in-action a skill that takes time and experience to acquire”

@WeNurses the asked participants “So what are the simple things we can do to make every contact count?”

@skimmingstones1 tweeted “Small steps-strong leadership, peer support, time to reflect and learn provides impetus for change”

@JulieVuolo stated “Know what the positive health messages are e.g. reducing obesity and smoking and role model the messages”

@DGFoord suggested “Release time to care, take opportunities spontaneuosly & plan organised, evidence-based health promotion interventions.”

@VivJBennett added “And believe it is within our responsibility role and skill set?”

@TildaMc said “Think we can only give information ,patient choice to pursue change. Support if changes being made”

RockLobster02tweeted “Nurses won’t be alone delivering this initiative, but all staff at all levels delivering same messages about self care”

One of the tweets that really stood out for me towards the end this chat was when @JulieVuolo stated “Maybe keep the Olympic ‘can do’ mentality going, after all the opening ceremony showcased the NHS to the world”

I think that is exactly what we need to do in relation to initiatives such as making every contact count. Nurses need to start to think that we can - and will - achieve this.

The practice nurse I saw was obviously very skilled at ensuring that her contact with her patients was valuable time well used. I think that we can achieve a lot if we approach change and initiatives with an open mind and a ‘can do’ attitude. Often, it is about being smart - talking about the things that matter and can have an impact. Despite being asked a multitude of questions during my consultation I actually came away as a patient who felt valued and cared for, and as a nurse inspired to think how can I make every contact count in my own practice..

Teresa Chinn is a nurse, a blogger and social media specialist and leads the #WeNurses discussions for WeNurses. Follow@WeNurseson Twitter.


Readers' comments (14)

  • The goverment is very keen on this, and the goverment is also keen on 'nudge theory' - gently pushing people into healthier life-style behaviours.

    If the discussion includes information of all types about conditions and treatments, I think it would be helpful.

    If it only includes 'nudges' - 'you could eat more fruit and veg', 'more exercise might help', etc, etc, then I'm guessing that patients will see this as being lectured to, and will rapidly drift into 'those are my choices - stop telling me what to do !'.

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  • it is also very important how these thought-provoking questions are asked so that they are not perceived by some as intrusive, patronising, accusatory or guilt-provoking which could cause them to clam up instead of open up.

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  • Tiger Girl

    Anonymous | 29-Aug-2012 10:51 am

    That is a challenging balance, especially if you assume that patients are not stupid.

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  • for any effective communication to take place it is up to the communicator to assess the level of knowledge and understanding of the person you are interacting with through verbal and nonverbal and adjust accordingly.

    good communication is not about making assumptions about anybody and passing judgements on those. I have never come across a stupid patient or any other person for that matter - just a few who are challenging and to whom i may have to find different or new ways of communicating. The 'com' bit of the word indicates a sharing of information and has nothing to do with talking at or up to or down to another!

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  • As a 'nurse' and a 'patient' I resent being constantly reminded of what I should and shouldn't do. I hope I am in the minority who feel this way, or am I, or should I be? Health promotion, in theory, will promote longer life, but in reality we are not coping with the increase in the elderly population (I am shortly to be in that category, depending on your/WHO, etc .definition - and being putting in a box). I am probably an older cynical nurse, who has seen it, done it, got the T-Shirt, and history does repeat itself, despite what we like to think. I have medical problems, I know this, take my choices and wish to do so, without being caught up in the 'process', of constant reminders. I want to live my life, without the guilt imposed on me everytime I eat, drink, have a holiday, go to work, relax, read, hear the news, and most of all visit my GP, which I avoid my 'annual review. Why, because I am just a statistic! Who cares if I end up dying suddenly (preferably), have a long term condition, require hospice care, home care or their equivalents, or go without any input because I have smoked, drank or become obese, due to my inability to get out the house, whichever is the latest trend to victimise/blame for the burden on society. We are brainwashed to promote health versus an increase in pensionable age, working longer, increased contributions, pay freezes, and whatever is thrown at us in the future. I want to celebrate my (almost) 40 years in the NHS, but seriously have my doubts. Don't judge me, for many of you, your years lie before you.

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  • Anonymous | 1-Sep-2012 2:15 am

    very well expressed and I agree with you. often the questions will appear intrusive unless as I suggested above they are asked with sensitivity and as described in the summary at the top of the page.

    Anonymous | 29-Aug-2012 10:51

    However, as you imply, these questions may not be asked out of a genuine interest for the well being of the patient but rather to satisfy the latest and moveable government targets.

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  • michael stone

    @JulieVuolo stated “Know what the positive health messages are e.g. reducing obesity and smoking and role model the messages”

    I'm pretty certain that the reason this is being 'pushed', is to try and reduce things like smoking, obesity, etc.

    But surely most people who smoke, already know that smoking will probably be bad for them in health terms ?

    Most people who are very overweight, surely know that eating less would make them lose weight ?

    Anonymous | 1-Sep-2012 2:15 am has surely stated, what many of the people who will be at the patient end of these little interactions will feel - I don't think this can work well, for altering choices. It might work well, if it is being used to explain more (and previously unknown by the patient) options.

    But I could be wrong.

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  • "But surely most people who smoke, already know that smoking will probably be bad for them in health terms ?

    Most people who are very overweight, surely know that eating less would make them lose weight ?"

    probably most do, but the serious and very difficult challenges lie in finding ways of helping them to change their behaviour and prevent triggering or exacerbating serious health problems. to date no simple solutions to this have been found which is why people are still searching by trying to apply different methods of offering them help which is in the interests of the government and the population to reduce escalating healthcare costs now and in the future. Some of these methods may be of little help and others through through the trial and error of research processes lead to the development of more effective methods in the future. If nobody at least tries nothing will ever be achieved!

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  • What involvement do service users have in designing services they need as it appears they are in the best position to determine what might be most helpful to them rather than imposing patriarchal/matriarchal strategies on them, many of which clearly fail and pour money down the drain.

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  • michael stone

    Anonymous | 2-Sep-2012 1:20 pm

    I do agree with you - my point is that many people resist being lectured at.

    Anonymous | 3-Sep-2012 8:40 am

    Good point - lots of scope there.

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