Is Sitting the New Patient Communication Strategy for Nurses?

Nurses can add an easy-to-implement patient communication strategy to their tool belts, according to a recent study. Research published in the Patient Experience Journal shows that nurses who sit down when communicating with patients yield higher patient satisfaction scores.

The research team developed the strategy, called the Commit to Sit initiative, by looking at evidence-based communication approaches.

“Qualities that show active listening include being eye level, making eye contact, and undistracted conversation,” the researchers reported. “In the acute care setting, the majority of the patients are lying in a hospital bed, making sitting the most logical and non-threatening way to communicate.”

Sitting, as opposed to standing, while communicating with patients makes patients perceive that nurses are spending more time talking to them. Studies show that patient perceptions of time spent with them is tied to a positive patient experience.

The research team deployed the strategy in a 19-bed unit inside a larger hospital in Texas. The team measured initiative success using the Press Ganey Satisfaction survey, looking specifically at the overall nurse communication composite score, as well as scores for treating patients with courtesy and respect, listening carefully, and explaining concepts understandably.

At the end of the nearly seven-month study, nursing communication and satisfaction scores rose from the 9th percentile to the 43rd percentile. While these results fell short of the research team’s goal of the 60th percentile for nursing communication, it still marked a considerable improvement, the team said.

However, the road to communication improvement was not easy, the researchers reported. In the first months of the study, researchers and nursing participants saw little to no difference in patient satisfaction, despite concerted efforts in Commit to Sit. Nurses reported sitting with all of their patients, but only 40 percent of patients and families perceived these efforts.

Midway through the study, nursing leaders prompted nurses to explicitly ask if they could sit with patients and families before starting health conversations. This gentle approach reinforced nurse efforts, the researchers found.

“Incorporating the word ‘sit’ made an impact as the feedback received during clinical leader rounds was more equivalent to the number of patients the team reported sitting with,” the researchers said. “This may be logically explained as patients make a conscious decision whether a nurse may sit with them at that time or not, increasing their ability to recollect when asked by leaders.”

Nurses also presented some resistance to Commit to Sit, especially with regard to extremely sick patients relegated to contact isolation. The researchers targeted nursing education toward safety protocol in those instances, instructing nurses to use disposable pads for sitting or to wear extra protective garments where necessary.

These findings have positive implications for nursing practice and patient-provider communication improvements, the researchers said. Commit to Sit presents a simple fix that can improve patient experience, a key factor in patient-centered care models.

“Implementing the Commit to Sit initiative provided nurses the opportunity to learn something unique about each patient to share during report to help foster relationships even through shift change,” the researchers said. “Utilizing Commit to Sit to connect with patients, demonstrating caring beyond the patient’s medical diagnosis, positively impacts the patient experience.”

Additionally, these findings are key for nurses, who play an integral role in improving the patient experience through communication. Nurses usually spend the most time communicating with patients and are in charge of alleviating patient concerns and communicating health information clearly to help patients become activated in their care.

Going forward, nurses should continue the Commit to Sit agenda, the researchers concluded. Nurses may also consider using their sitting time to learn more about their patients, building a stronger relationship that can eventually lead to higher patient experience scores.