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'Is your approach to intentional rounding actually meeting patients' needs?'

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One of the frequent tasks I undertake during my day-to-day role as a student nurse is to complete hourly rounding, which usually takes the form of a clipboard or folder situated at a patient’s bedside

The task consists of an hourly column of boxes to tick related to the four Ps - positioning, personal hygiene, pain and placement of nurse call bell and possessions. However, in theory, it serves a greater purpose in helping to reduce patient isolation by increasing the visibility of nursing staff and addressing patients’ needs and anxieties as they arise.

The patients on the wards I work on soon become familiar with this routine, as you would perhaps expect, due to the frequency and repetitive nature of the task. They become accustomed to how staff move around the ward, ask similar questions to each patient and make their way from bed to bed whilst signing off the paperwork.

”I began to wonder if the responses I received truly equated to my patients’ needs”

On one particular shift I was acutely aware of the responses that came from patients. It was almost a pre-emptive nod in recognition of the end of the task and the fact they were OK and I was free to move down to the next bed. I began to wonder if the responses I received were actually true of the needs of my patients. Was I making myself available to them to address any concerns? Was I making full use of my therapeutic self? Or had they become accustomed to my busy routine and not wanted to hold me up?

Whilst being careful to satisfy all of the criteria of the intentional rounding, I decided to change my approach with the patients I was caring for that day. Instead of the usual routine of the task - approach bed, assess patient and complete paperwork - I decided to consciously make myself more available to the patients, to see if the responses I received were different.

”I had purposely made this time for them and would continue to do so throughout the shift. I was amazed at how the responses differed”

I approached the patients in a much more relaxed and informal manner and asked if they were OK, whether they were comfortable and if there was anything at all I could do for them. I tried to make it clear with my body language that I was genuine in my words, I was there if needed and instill confidence that I had purposely made this time for them and would continue to do so throughout the shift. I was amazed at how the responses differed.

This approach seemed to open up a completely different dialogue with the patients and I could see that some of them felt genuinely moved that I was interested in what they had to say. At the end of my shift I received great feedback from the patients I had been caring for. They mentioned how approachable and attentive I had been throughout the shift and how this had improved their sense of wellbeing.

“It initially seemed only a small change to make but led to a big improvement in the care I had provided”

This led me to think about the detail of what it was that I had done differently to improve the relationship between myself and the patients. It initially seemed only a small change to make but led to a big improvement in the care I had provided.

It struck me that it came down to my availability and how the change in approach had affected the way I was perceived by the patients. It may have been that before I was immersed in a task, something the patients had seen as just another part of my busy routine. Even though this task was designed to serve a purpose - and I was following it correctly - I was quite clearly not being as effective as I could be. It’s a valuable lesson learnt.

Saul Lovatt is a current student nurse.

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